End of Life Issues

MedlinePlus

... difficult. But by deciding what end-of-life care best suits your needs when you are healthy, ... making choices about the following: The goals of care (for example, whether to use certain medicines during ...

E-Counselling Implementation: Students' Life Stories and Counselling Technologies in Perspective

ERIC Educational Resources Information Center

Kolog, Emmanuel Awuni; Sutinen, Erkki; Vanhalakka-Ruoho, Marjatta

2014-01-01

Given the current global trend of mimicking real life situations into digital counselling games and its related digital counselling platforms, we decided to contextually understand from the Ghanaian senior high school students, their life challenges arising from their life stories. The study also explores the extent to which ICT is currently being…

Imagining the Alternatives to Life Prolonging Treatments: Elders' Beliefs about the Dying Experience

ERIC Educational Resources Information Center

Winter, Laraine; Parker, Barbara; Schneider, Melissa

2007-01-01

Deciding for or against a life-prolonging treatment represents a choice between prolonged life and death. When the death alternative is not described, individuals must supply their own assumptions. How do people imagine the experience of dying? The authors asked 40 elderly people open-ended questions about dying without 4 common life-prolonging…

Switched-On Physics: "If You Can Dream It, You Can Do It"

ERIC Educational Resources Information Center

Graham, Scotty

2011-01-01

As classroom science teachers, we are all often reminded of the inevitable and sometimes not small challenges that face us in captivating and keeping the interest of our students. To give additional relevance and life to my teaching of physics, I decided to integrate global, hands-on projects into my approach. I decided from the onset that the…

Mosquito Life Cycle

EPA Pesticide Factsheets

Knowing the stages of the mosquito's life will help you prevent mosquitoes around your home and help you choose the right pesticides for your needs, if you decide to use them. All mosquito species go through four distinct stages during their live cycle.

Life Cycle Costs in Education: Operations & Maintenance Considered.

ERIC Educational Resources Information Center

Moussatche, Helena; Languell-Urquhart, Jennifer; Woodson, Carol

2000-01-01

Discusses life cycle cost analysis when deciding on flooring finishes and examines operations and maintenance cost effectiveness relative to hard, resilient, and soft flooring. A chart of evaluated flooring materials' characteristics, appropriate maintenance procedures, and recommended frequency is included. (GR)

Deciding in Democracies: A Role for Thinking Skills?

ERIC Educational Resources Information Center

Gardner, Peter

2014-01-01

In societies that respect our right to decide many things for ourselves, exercising that right can be a source of anxiety. We want to make the right decisions, which is difficult when we are confronted with complex issues that are usually the preserve of specialists. But is help at hand? Are thinking skills the very things that non-specialists…

Dr. Inside and Dr. Outside: Physicists Involved With National Security and Foreign Policy

NASA Astrophysics Data System (ADS)

Zimmerman, Peter D.

2009-05-01

Physicists have had a special interest in American national security and arms control since at least the Manhattan Project. They have served our country in uniform and in the career civil service. Some have left academic careers for brief periods to work as political appointees, consultants, or resident scholars and then returned to an academic life, but often with changed goals. Some have tried government life and left nearly immediately, while others dipped a toe in and decided to stay. I will look at real-life examples, mostly using real names, drawn from my career and circle of colleagues to try to explain why some physicists have been extremely successful, why others have not, and what happens to a physicist who moved to Washington and decides to stay. I will also discuss routes into public service for those interesting in giving it a try.

Art and Its Tantalizing Effects

ERIC Educational Resources Information Center

Huynh, Kelly

2013-01-01

The author first decided to take art classes out of curiosity, but art gradually changed her perspective on life and became a medium through which she saw herself. This hobby became a process by which she began to create an artwork of her own life. This article describes what the author has learned about her own life through art and how it has…

E-DECIDER Decision Support Gateway For Earthquake Disaster Response

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Stough, T. M.; Parker, J. W.; Burl, M. C.; Donnellan, A.; Blom, R. G.; Pierce, M. E.; Wang, J.; Ma, Y.; Rundle, J. B.; Yoder, M. R.

2013-12-01

Earthquake Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response (E-DECIDER) is a NASA-funded project developing capabilities for decision-making utilizing remote sensing data and modeling software in order to provide decision support for earthquake disaster management and response. E-DECIDER incorporates earthquake forecasting methodology and geophysical modeling tools developed through NASA's QuakeSim project in order to produce standards-compliant map data products to aid in decision-making following an earthquake. Remote sensing and geodetic data, in conjunction with modeling and forecasting tools, help provide both long-term planning information for disaster management decision makers as well as short-term information following earthquake events (i.e. identifying areas where the greatest deformation and damage has occurred and emergency services may need to be focused). E-DECIDER utilizes a service-based GIS model for its cyber-infrastructure in order to produce standards-compliant products for different user types with multiple service protocols (such as KML, WMS, WFS, and WCS). The goal is to make complex GIS processing and domain-specific analysis tools more accessible to general users through software services as well as provide system sustainability through infrastructure services. The system comprises several components, which include: a GeoServer for thematic mapping and data distribution, a geospatial database for storage and spatial analysis, web service APIs, including simple-to-use REST APIs for complex GIS functionalities, and geoprocessing tools including python scripts to produce standards-compliant data products. These are then served to the E-DECIDER decision support gateway (http://e-decider.org), the E-DECIDER mobile interface, and to the Department of Homeland Security decision support middleware UICDS (Unified Incident Command and Decision Support). The E-DECIDER decision support gateway features a web interface that delivers map data products including deformation modeling results (slope change and strain magnitude) and aftershock forecasts, with remote sensing change detection results under development. These products are event triggered (from the USGS earthquake feed) and will be posted to event feeds on the E-DECIDER webpage and accessible via the mobile interface and UICDS. E-DECIDER also features a KML service that provides infrastructure information from the FEMA HAZUS database through UICDS and the mobile interface. The back-end GIS service architecture and front-end gateway components form a decision support system that is designed for ease-of-use and extensibility for end-users.

Undecidability and Irreducibility Conditions for Open-Ended Evolution and Emergence.

PubMed

Hernández-Orozco, Santiago; Hernández-Quiroz, Francisco; Zenil, Hector

2018-01-01

Is undecidability a requirement for open-ended evolution (OEE)? Using methods derived from algorithmic complexity theory, we propose robust computational definitions of open-ended evolution and the adaptability of computable dynamical systems. Within this framework, we show that decidability imposes absolute limits on the stable growth of complexity in computable dynamical systems. Conversely, systems that exhibit (strong) open-ended evolution must be undecidable, establishing undecidability as a requirement for such systems. Complexity is assessed in terms of three measures: sophistication, coarse sophistication, and busy beaver logical depth. These three complexity measures assign low complexity values to random (incompressible) objects. As time grows, the stated complexity measures allow for the existence of complex states during the evolution of a computable dynamical system. We show, however, that finding these states involves undecidable computations. We conjecture that for similar complexity measures that assign low complexity values, decidability imposes comparable limits on the stable growth of complexity, and that such behavior is necessary for nontrivial evolutionary systems. We show that the undecidability of adapted states imposes novel and unpredictable behavior on the individuals or populations being modeled. Such behavior is irreducible. Finally, we offer an example of a system, first proposed by Chaitin, that exhibits strong OEE.

When Groups Decide to Use Asynchronous Online Discussions: Collaborative Learning and Social Presence under a Voluntary Participation Structure

ERIC Educational Resources Information Center

So, H.-J.

2009-01-01

The purpose of this study is to explore how groups decide to use asynchronous online discussion forums in a non-mandatory setting, and, after the group decision is made, how group members use online discussion forums to complete a collaborative learning project requiring complex data gathering and research processes. While a large body of research…

The Computational Complexity of RaceTrack

NASA Astrophysics Data System (ADS)

Holzer, Markus; McKenzie, Pierre

Martin Gardner in the early 1970's described the game of RaceTrack [M. Gardner, Mathematical games - Sim, Chomp and Race Track: new games for the intellect (and not for Lady Luck), Scientific American, 228(1):108-115, Jan. 1973]. Here we study the complexity of deciding whether a RaceTrack player has a winning strategy. We first prove that the complexity of RaceTrack reachability, i.e., whether the finish line can be reached or not, crucially depends on whether the car can touch the edge of the carriageway (racetrack): the non-touching variant is NL-complete while the touching variant is equivalent to the undirected grid graph reachability problem, a problem in L but not known to be L-hard. Then we show that single-player RaceTrack is NL-complete, regardless of whether driving on the track boundary is allowed or not, and that deciding the existence of a winning strategy in Gardner's original two-player game is P-complete. Hence RaceTrack is an example of a game that is interesting to play despite the fact that deciding the existence of a winning strategy is most likely not NP-hard.

Who Should Decide How Machines Make Morally Laden Decisions?

PubMed

Martin, Dominic

2017-08-01

Who should decide how a machine will decide what to do when it is driving a car, performing a medical procedure, or, more generally, when it is facing any kind of morally laden decision? More and more, machines are making complex decisions with a considerable level of autonomy. We should be much more preoccupied by this problem than we currently are. After a series of preliminary remarks, this paper will go over four possible answers to the question raised above. First, we may claim that it is the maker of a machine that gets to decide how it will behave in morally laden scenarios. Second, we may claim that the users of a machine should decide. Third, that decision may have to be made collectively or, fourth, by other machines built for this special purpose. The paper argues that each of these approaches suffers from its own shortcomings, and it concludes by showing, among other things, which approaches should be emphasized for different types of machines, situations, and/or morally laden decisions.

30 CFR 285.1006 - How will MMS decide whether to issue an Alternate Use RUE?

Code of Federal Regulations, 2010 CFR

2010-07-01

... minimizes adverse effects to the coastal and marine environments, including their physical, atmospheric, and... (including OCS mineral deposits and oil, gas, and sulphur resources in areas leased or not leased), any life (including fish and other aquatic life), or property (including sites, structures, or objects of historical...

“It is not the fading candle that one expects”: general practitioners’ perspectives on life-preserving versus “letting go” decision-making in end-of-life home care

PubMed Central

Renterghem, Veerle Van; Pype, Peter; Aelbrecht, Karolien; Derese, Anselme; Deveugele, Myriam

2015-01-01

Background Many general practitioners (GPs) are willing to provide end-of-life (EoL) home care for their patients. International research on GPs’ approach to care in patients’ final weeks of life showed a combination of palliative measures with life-preserving actions. Aim To explore the GP’s perspective on life-preserving versus “letting go” decision-making in EoL home care. Design Qualitative analysis of semi-structured interviews with 52 Belgian GPs involved in EoL home care. Results Nearly all GPs adopted a palliative approach and an accepting attitude towards death. The erratic course of terminal illness can challenge this approach. Disruptive medical events threaten the prospect of a peaceful end-phase and death at home and force the GP either to maintain the patient’s (quality of) life for the time being or to recognize the event as a step to life closure and “letting the patient go”. Making the “right” decision was very difficult. Influencing factors included: the nature and time of the crisis, a patient’s clinical condition at the event itself, a GP’s level of determination in deciding and negotiating “letting go” and the patient’s/family’s wishes and preparedness regarding this death. Hospitalization was often a way out. Conclusions GPs regard alternation between palliation and life-preservation as part of palliative care. They feel uncertain about their mandate in deciding and negotiating the final step to life closure. A shortage of knowledge of (acute) palliative medicine as one cause of difficulties in letting-go decisions may be underestimated. Sharing all these professional responsibilities with the specialist palliative home care teams would lighten a GP’s burden considerably.Key PointsA late transition from a life-preserving mindset to one of “letting go” has been reported as a reason why physicians resort to life-preserving actions in an end-of-life (EoL) context. We investigated GPs’ perspectives on this matter.Not all GPs involved in EoL home care adopt a “letting go” mindset. For those who do, this mindset is challenged by the erratic course of terminal illness.GPs prioritize the quality of the remaining life and the serenity of the dying process, which is threatened by disruptive medical events.Making the “right” decision is difficult. GPs feel uncertain about their own role and responsibility in deciding and negotiating the final step to life closure. PMID:26654583

"It is not the fading candle that one expects": general practitioners' perspectives on life-preserving versus "letting go" decision-making in end-of-life home care.

PubMed

Sercu, Maria; Renterghem, Veerle Van; Pype, Peter; Aelbrecht, Karolien; Derese, Anselme; Deveugele, Myriam

2015-01-01

Many general practitioners (GPs) are willing to provide end-of-life (EoL) home care for their patients. International research on GPs' approach to care in patients' final weeks of life showed a combination of palliative measures with life-preserving actions. To explore the GP's perspective on life-preserving versus "letting go" decision-making in EoL home care. Qualitative analysis of semi-structured interviews with 52 Belgian GPs involved in EoL home care. Nearly all GPs adopted a palliative approach and an accepting attitude towards death. The erratic course of terminal illness can challenge this approach. Disruptive medical events threaten the prospect of a peaceful end-phase and death at home and force the GP either to maintain the patient's (quality of) life for the time being or to recognize the event as a step to life closure and "letting the patient go". Making the "right" decision was very difficult. Influencing factors included: the nature and time of the crisis, a patient's clinical condition at the event itself, a GP's level of determination in deciding and negotiating "letting go" and the patient's/family's wishes and preparedness regarding this death. Hospitalization was often a way out. GPs regard alternation between palliation and life-preservation as part of palliative care. They feel uncertain about their mandate in deciding and negotiating the final step to life closure. A shortage of knowledge of (acute) palliative medicine as one cause of difficulties in letting-go decisions may be underestimated. Sharing all these professional responsibilities with the specialist palliative home care teams would lighten a GP's burden considerably. Key Points A late transition from a life-preserving mindset to one of "letting go" has been reported as a reason why physicians resort to life-preserving actions in an end-of-life (EoL) context. We investigated GPs' perspectives on this matter. Not all GPs involved in EoL home care adopt a "letting go" mindset. For those who do, this mindset is challenged by the erratic course of terminal illness. GPs prioritize the quality of the remaining life and the serenity of the dying process, which is threatened by disruptive medical events. Making the "right" decision is difficult. GPs feel uncertain about their own role and responsibility in deciding and negotiating the final step to life closure.

Update on lifetime tests results and analysis carried out on Thales Cryogenics integral coolers (RM family)

NASA Astrophysics Data System (ADS)

Cauquil, Jean-Marc; Martin, Jean-Yves; Bruins, Peter; Benschop, A. A. J.

2003-01-01

The life time tests realised on the serial production of Rotary Mmonoblock RM2 coolers show a measured MTTF of 4900 hours. The conventional test profile applied to these coolers is representative of operation in typical application. The duration of such life time tests is very long. The results of a design change and its impact on MTTF are available only several months after the assembly of the prototypes. We decided to develop a test method in order to reduce the duration of these life time tests. The principle is to define a test protocol easy to implement, more severe than typical application profile in order to accelerate life time tests. The accelerated test profile was defined and tested successfully. This new technique allows us to reduce life time tests costs and duration and thus the costs involved. As a consequence, we decided to have a screening of our production with this accelerated test. This allows us to master continuously the quality of our serial products and to collect additional data. This paper presents the results of life time tests performed on RM2 coolers according to the conventional and accelerated test profiles as well as the first results on the new RM2 design which show a calculated MTTF of 10000 hours.

Multi-Level Modeling of Complex Socio-Technical Systems - Phase 1

DTIC Science & Technology

2013-06-06

is to detect anomalous organizational outcomes, diagnose the causes of these anomalies , and decide upon appropriate compensation schemes. All of...monitor process outcomes. The purpose of this monitoring is to detect anomalous process outcomes, diagnose the causes of these anomalies , and decide upon...monitor work outcomes in terms of performance. The purpose of this monitoring is to detect anomalous work outcomes, diagnose the causes of these anomalies

Advance Care Planning Beyond Advance Directives: Perspectives from Patients and Surrogates

PubMed Central

McMahan, Ryan; Knight, Sara J.; Fried, Terri R.; Sudore, Rebecca L.

2014-01-01

Context Advance care planning (ACP) has focused on documenting life-sustaining treatment preferences in advance directives (ADs). ADs alone may be insufficient to prepare diverse patients and surrogates for complex medical decisions. Objectives To understand what steps best prepare patients and surrogates for decision making. Methods We conducted 13 English/Spanish focus groups with participants from a Veterans Affairs and county hospital and the community. Seven groups included patients (n=38) aged ≥65 years, who reported making serious medical decisions. Six separate groups included surrogates (n=31), aged ≥18 years, who made decisions for others. Semi-structured focus groups asked what activities best prepared participants for decision making. Two investigators independently coded data and performed thematic content analysis. Disputes were resolved by consensus. Results Mean±SD patient age was 78±8 years and 61% were non-white. Mean±SD surrogate age was 57±10 years and 91% were non-white. Qualitative analysis identified four overarching themes about how to best prepare for decision making: 1) identify values based on past experiences and quality of life, 2) choose surrogates wisely and verify they understand their role, 3) decide whether to grant leeway in surrogate decision making, and 4) inform other family and friends of one's wishes to prevent conflict. Conclusion Beyond ADs, patients and surrogates recommend several additional steps to prepare for medical decision making including using past experiences to identify values, verifying the surrogate understands their role, deciding whether to grant surrogates leeway, and informing other family and friends of one's wishes. Future ACP interventions should consider incorporating these additional ACP activities. PMID:23200188

The Stability of Learners' Choices for Real-Life Situations to Be Used in Mathematics

ERIC Educational Resources Information Center

Julie, Cyril

2013-01-01

One of the efforts to improve and enhance the performance and achievement in mathematics of learners is the incorporation of life-related contexts in mathematics teaching and assessments. These contexts are normally, with good reasons, decided upon by curriculum makers, textbook authors, teachers and constructors of examinations and tests.…

Fatigue properties of JIS H3300 C1220 copper for strain life prediction

NASA Astrophysics Data System (ADS)

Harun, Muhammad Faiz; Mohammad, Roslina

2018-05-01

The existing methods for estimating strain life parameters are dependent on the material's monotonic tensile properties. However, a few of these methods yield quite complicated expressions for calculating fatigue parameters, and are specific to certain groups of materials only. The Universal Slopes method, Modified Universal Slopes method, Uniform Material Law, the Hardness method, and Medians method are a few existing methods for predicting strain-life fatigue based on monotonic tensile material properties and hardness of material. In the present study, nine methods for estimating fatigue life and properties are applied on JIS H3300 C1220 copper to determine the best methods for strain life estimation of this ductile material. Experimental strain-life curves are compared to estimations obtained using each method. Muralidharan-Manson's Modified Universal Slopes method and Bäumel-Seeger's method for unalloyed and low-alloy steels are found to yield batter accuracy in estimating fatigue life with a deviation of less than 25%. However, the prediction of both methods only yield much better accuracy for a cycle of less than 1000 or for strain amplitudes of more than 1% and less than 6%. Manson's Original Universal Slopes method and Ong's Modified Four-Point Correlation method are found to predict the strain-life fatigue of copper with better accuracy for a high number of cycles of strain amplitudes of less than 1%. The differences between mechanical behavior during monotonic and cyclic loading and the complexity in deciding the coefficient in an equation are probably the reason for the lack of a reliable method for estimating fatigue behavior using the monotonic properties of a group of materials. It is therefore suggested that a differential approach and new expressions be developed to estimate the strain-life fatigue parameters for ductile materials such as copper.

Challenges of regulatory rights of half-capacitated persons: A sociological perspective on the French Civil Code reform.

PubMed

Eyraud, Benoît

2016-01-01

Democratic societies are based on the principle of equal legal capacity of all citizens to decide and act for themselves in all areas of social life. This "socio-civil capacity", which may involve both material property of an individual, as well as private life in matters ranging from health to personal relationships, is recognized by the law (both codified law and common law). These rights guarantee the autonomy and freedom of individuals in the name of respect for human dignity. Civil capacity of a person is legally diminished because his or her "natural" abilities, capacity, or competence are reduced. Recent social changes have lead to increased uses of legal measures of protection. The reasons for these changes are complex and they are accompanied by legislative reforms that modify the rights of half-capacitated persons. In this article, we examine certain issues of civil capacity rights based on the French example. We start present a perspective of the historical definition and practice of these rights as well as their democratization. Copyright © 2016. Published by Elsevier Ltd.

Making Healthy Decisions About Sex

MedlinePlus

... For Teens: How to Make Healthy Decisions About Sex Page Content Article Body Before you decide to ... alcohol or use drugs. Are You Ready for Sex? Sex can change your life and relationships. Having ...

Deciding about treatments that prolong life

MedlinePlus

... you are receiving or may need in the future. Learn about the treatments and how they would ... patients and their families. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...

'Do not resuscitate order' in neonatology: authority rules.

PubMed

Niebrój, L T; Jadamus-Niebrój, D

2007-11-01

Ethical dilemmas in medicine should be resolved in light of four essential principles. To specify and guide concrete actions, it is necessary to 'supplement' these principles by certain other (substantive, authority and procedural) rules. The purpose of this paper is to establish and justify the authority rules regarding the order not to resuscitate newborns. The authority rules are intended to indicate who should decide, but they do not determine what should be chosen. Decision regarding newborn's treatment/letting die depends on medical and quality-of-life judgments. Parents, doctors, and society are considered to possess decisional authority in the matter. However, who in a given case should decide ought to be inferred from the reasoning which assumes, as its premises, the medical and quality-of-life judgments. The 'logical' syntax of this reasoning is presented in this paper.

Quality of Life Issues for Families Who Make the Decision to Use a Feeding Tube for Their Child with Disabilities.

ERIC Educational Resources Information Center

Brotherson, Mary Jane; And Others

1995-01-01

Eight families deciding to use a feeding tube to meet the nutrition needs of their children with disabilities were interviewed over a two-year period. Family decision making in the context of quality of life was examined using a theoretical family systems model. Implications for future interventions are addressed. (Author/SW)

Sentencing Juveniles to Life in Prison: The Reproduction of Juvenile Justice for Young Adolescents Charged with Murder

ERIC Educational Resources Information Center

Singer, Simon I.

2011-01-01

In "Roper v. Simmons," the U.S. Supreme Court determined that the sentencing of juveniles to death violated the constitutional amendment against cruel and unusual punishment. Similarly, the Court most recently decided that life without parole for non-homicide offenses is also unconstitutional ("Graham v. Florida," 2010). Part of the reason for the…

16 CFR 4.11 - Disclosure requests.

Code of Federal Regulations, 2010 CFR

2010-01-01

... threat to the life or physical safety of an individual, or, with respect to a request made by a person... diligence in responding to the request. (D) If the deciding official (as designated by the General Counsel...

Identification and Addressing Reduction-Related Misconceptions

ERIC Educational Resources Information Center

Gal-Ezer, Judith; Trakhtenbrot, Mark

2016-01-01

Reduction is one of the key techniques used for problem-solving in computer science. In particular, in the theory of computation and complexity (TCC), mapping and polynomial reductions are used for analysis of decidability and computational complexity of problems, including the core concept of NP-completeness. Reduction is a highly abstract…

Withholding Food and Water from Vegetative Patients in Military Hospitals: Constitutional and Practical Concerns

DTIC Science & Technology

1990-04-01

privacy included the right to be free from such life-sustaining technology , since she was "irreversibly 0 doomed" anyway. 25 The unanimous court said...that opinions about a patient’s "quality of life" should be considered when deciding whether to use life-sustaining technology , and 70% believed that... technologically supplied respiration, nutrition or hydration.",8 7 The AAN agreed, calling artificial nutrition and hydration "analogous to other forms of

[Interculturality in the medical practice of Dr. Albert Schweitzer].

PubMed

Campos-Navarro, Roberto; Ruiz-Llanos, Adriana

2004-01-01

Albert Schweitzer (1875-1965) was a young and promising German who at age 29 decided to undertake the profession of Medical Doctor at the University of Strassburg after finishing a career in musical studies in Paris (1899) and obtaining in Berlin a doctoral degree in Philosophy and Theology. Surprisingly, Albert Schweitzer, despite his comfortable life in Europe, decided in 1913 to practice his medical career in a remote and small Equatorial African country. He devoted nearly 50 years of his life caring for the Black population at Lamaberene, where he built a hospital. In this paper, we attempt to develop some theoretical aspects related with interculturality in the medical practice of Dr. Albert Schweitzer. We begin by considering certain sociocultural variables in hospitals that give care to patients with cultural characteristics that are substantially different from those of the health care personnel who organize, administer, and execute medical functions.

Creative Writing as Public Pedagogy: A Short History of My Life in the Movies

ERIC Educational Resources Information Center

Ryan, Michael

2005-01-01

In the early 1970's the author of this article decided to dedicate his life to two tasks. The first was to write politically and creatively in popular literary genres such as the detective novel for a larger public than one was likely to find through academic writing. The second was to write politically and inventively within the genres of…

What Is the Value of Life? … and Other Socratic Questions

ERIC Educational Resources Information Center

Cuny, Casey

2014-01-01

Casey Cuny was frustrated with the lack of depth in his high school English students' writing. He'd heard about Socratic seminars but was reluctant to try them until he saw them in action. He decided to conduct Socratic seminars with his students centered on the question, What is the value of life? In past years, student papers on this…

Model Organisms Fact Sheet: Using Model Organisms to Study Health and Disease

MedlinePlus

... NIGMS use research organisms to explore the basic biology and chemistry of life. Scientists decide which organism ... controls allow for more precise understanding of the biological factors being studied and provide greater certainty about ...

Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?

PubMed

Clarke, Gemma; Galbraith, Sarah; Woodward, Jeremy; Holland, Anthony; Barclay, Stephen

2015-06-11

Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team. A three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process? Decision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: (1) Risks, burdens and benefits; (2) Treatment goals; (3) Normative ethical values; (4) Interested parties. Decision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of 'who decides' cannot be fully answered. There is a potential for anonymity of multiple decision-makers to arise. Decisions in real world clinical practice may not fit precisely into a model of decision-making. The findings from this service evaluation illustrate that within multi-professional team decision-making; decisions may contain elements of both substituted and supported decision-making, and may be better represented as existing upon a continuum.

Life Stories of Graduate Students in Chile and the United States: Becoming a Scientist from Childhood to Adulthood

NASA Astrophysics Data System (ADS)

Silva Fernandez, Marta A.

The purpose of this cross-national study was to gain a more comprehensive understanding about doctoral students in the United States and Chile and how their decisions to pursue a career in the life sciences field occurred throughout their lives. . I interviewed 15 doctoral students from the Seven Lakes University (Chile) and 15 students from the West Coast University (US), using a life history approach. Analyses revealed that the degree of flexibility in the schooling system and the degree of individualism and collectivism of the social groups in which the students were learning science seemed to influence the informants' vocational decisions in three interrelated processes: (1) Deciding the informants' degree of interest and ability in science by the opportunity of choosing science classes and activities. The highly tracked Chilean system socializes students to science at an early age. The more flexible school system in the US enabled the interviewees to gradually decide about pursuing their interest in science; (2) Experiencing science as a collective learning process for the Chilean informants and an individualistic learning process for the US students; (3) Perceiving science differently at each life stage for both groups of interviewees including: Playing science, Studying science, Doing science, Working in science, Practicing Science in their doctoral programs.

Gender-dependence of substituted judgment on quality of life in patients with dementia

PubMed Central

2011-01-01

Background Substituted judgment asks the proxy to decide what the patient would have decided, had he or she been competent. It is unclear whether substituted judgment of the patient's quality of life can serve as a surrogate measure in patients with dementia. Methods 212 patients with dementia and their proxies were interviewed in their homes. Dementia syndrome was characterized with cognitive, non-cognitive and functional scales. Quality of life (QoL) was assessed with the QoL-AD. Results Substituted judgment of the patient's QoL was unrelated to dementia severity but also correlated with the proxie's own QoL (r = 0.356; p < 0.001). Gender-specific analysis reveals that for male proxies the most important variable is severity of patient's depression (r = -0.895; p = 0.001) while for female proxies it is the proxie's own QoL (r = 0.371; p < 0.001). Subjective burden correlates with the proxie's QoL in females (r = -0.282; p = 0.001) but not in males (r = -0.163, p = 0.161). Conclusion Substituted judgment of the patient's QoL does not correlate with dementia severity. Substituted judgment is subject to proxy-related variables in a gender-dependent fashion and therefore not suited to serve as an appropriate surrogate of the patients' quality of life. PMID:21961477

End-of-life decisions for people with intellectual disabilities, an interview study with patient representatives.

PubMed

Wagemans, Annemieke M A; Van Schrojenstein Lantman-de Valk, Henny M J; Proot, Ireen M; Metsemakers, Job; Tuffrey-Wijne, Irene; Curfs, Leopold M G

2013-09-01

Not much is known about the process of end-of-life decision-making for people with intellectual disabilities. To clarify the process of end-of-life decision-making for people with intellectual disabilities from the perspective of patient representatives. A qualitative study based on semi-structured interviews, recorded digitally and transcribed verbatim. Data were analysed using Grounded Theory procedures. We interviewed 16 patient representatives after the deaths of 10 people with intellectual disabilities in the Netherlands. The core category 'Deciding for someone else' describes the context in which patient representatives took end-of-life decisions. The patient representatives felt highly responsible for the outcomes. They had not involved the patients in the end-of-life decision-making process, nor any professionals other than the doctor. The categories of 'Motives' and 'Support' were connected to the core category of 'Deciding for someone else'. 'Motives' refers to the patient representatives' ideas about quality of life, prevention from suffering, patients who cannot understand the burden of interventions and emotional reasons reported by patient representatives. 'Support' refers to the support that patient representatives wanted the doctors to give to them in the decision-making process. From the perspective of the patient representatives, the process of end-of-life decision-making can be improved by ensuring clear roles and an explicit description of the tasks and responsibilities of all participants. Regular discussion between everyone involved including people with intellectual disabilities themselves can improve knowledge about each other's motives for end-of-decisions and can clarify expectations towards each other.

Roe v. Wade and the lesson of the pre-Roe case law.

PubMed

Morgan, R G

1979-08-01

The attempt is made in this discussion to demonstrate that the Supreme Court in deciding the Roe v. Wade case should not have decided an abortion case when it did and that the opinion was almost destined to be bad in that the Court could find no persuasive rationale in the pre-Roe cases for each of the points in its decision. In 1973 political forces were actively debating abortion. Abortions had been prohibited by most states, except to save a woman's life, since the 19th century. In the 5 years immediately preceding Roe, 13 states had revised their statutes to resemble the Model Penal Code's provisions, which permitted abortions if the pregnancy threatened the woman's life, if it would gravely impair her physical or mental health, if it resulted from rape or incest, or if the child would be born with grave physical or mental defects. 4 states had removed all restrictions on the permissible reasons for seeking an abortion before a pregnancy passed specified lengths. In short, in many states the political process had yet to decide on abortion, but Roe's rejection of Texas's statute voided almost every other state's statutes as well. Between 1970 and 1972, a flurry of constitutional challenges hit the courts. 3 years was hardly sufficient time for the judicial system to evolve sound analysis for such an emotionally charged issue as abortion. The Court could justifiably have allowed the dispute to simmer longer in the lower courts. There is some indication that a sounder case law might evolved if given time, but that was prevented by Roe. The Court could not find a rationale in 1973, but it decided anyway, suggesting a legislative rather than a judicial process.

Redefining self: patients' decision making about treatment for multiple sclerosis.

PubMed

Lowden, Diane; Lee, Virginia; Ritchie, Judith A

2014-08-01

The treatment of multiple sclerosis (MS) has become possible with the advent of disease-modifying therapies, but little is known about patients' experiences when faced with a complex array of treatment options. The purpose of this phenomenological study was to explore the lived experience of making a first decision about treatment with disease-modifying therapies for relapsing-remitting MS. Nine participants shared their perspectives on negotiating the decision to accept, refuse, or delay treatment. All individuals described a core theme in which decision making about treatment was part of a process of coming to a "redefined self." This core theme included reflections about self-image, quality of life, goals, and being a person with MS. Six common themes supporting this core theme were (a) weighing and deciding what's important, (b) acknowledging the illness as part of oneself, (c) playing the mental game, (d) seeking credible resources, (e) evaluating symptoms and fit with quality of life, and (f) managing the roles and involvement of family. The findings of this study provide a greater understanding about the experience of making a therapeutic choice for those with MS and offer insights for nurses when supporting patients faced with options about treatment.

Who Am I to Decide Whether This Person Is to Die Today? Physicians' Life-or-Death Decisions for Elderly Critically Ill Patients at the Emergency Department-ICU Interface: A Qualitative Study.

PubMed

Fassier, Thomas; Valour, Elizabeth; Colin, Cyrille; Danet, François

2016-07-01

We explored physicians' perceptions of and attitudes toward triage and end-of-life decisions for elderly critically ill patients at the emergency department (ED)-ICU interface. This was a qualitative study with thematic analysis of data collected through semistructured interviews (15 emergency physicians and 9 ICU physicians) and nonparticipant observations (324 hours, 8 units, in 2 hospitals in France). Six themes emerged: (1) Physicians revealed a representation of elderly patients that comprised both negative and positive stereotypes, and expressed the concept of physiologic age. (2) These age-related factors influenced physicians' decisionmaking in resuscitate/not resuscitate situations. (3) Three main communication patterns framed the decisions: interdisciplinary decisions, decisions by 2 physicians on their own, and unilateral decisions by 1 physician; however, some physicians avoided decisions, facing uncertainty and conflicts. (4) Conflicts and communication gaps occurred at the ED-ICU interface and upstream of the ED-ICU interface. (5) End-of-life decisions were perceived as more complex in the ED, in the absence of family or of information about elderly patients' end-of-life preferences, and when there was conflict with relatives, time pressure, and a lack of training in end-of-life decisionmaking. (6) During decisionmaking, patients' safety and quality of care were potentially compromised by delayed or denied intensive care and lack of palliative care. These qualitative findings highlight the cognitive heuristics and biases, interphysician conflicts, and communication gaps influencing physicians' triage and end-of-life decisions for elderly critically ill patients at the ED-ICU interface and suggest strategies to improve these decisions. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

REPRODUCTIVE AND DEVELOPMENTAL PHARMACOKINETIC AND MECHANISTIC RESEARCH

EPA Science Inventory

In 1993, an expert panel convened by the EPA and the International Life Sciences Institute (ILSI) decided that: 1) screening studies should be implemented to fill critical data gaps; 2) fertility assessments should be enhanced; and 3) biomarkers of effect should be developed. Mor...

Global issues put a new perspective on working life.

PubMed

Subirana, Josep

2016-03-19

Having worked in general practice, Josep Subirana decided to broaden his experience in animal welfare and get involved in international development. Since then, he has worked across the world helping charities, universities and organisations with animal welfare issues. British Veterinary Association.

Stalking the IQ Quark.

ERIC Educational Resources Information Center

Sternberg, Robert J.

1979-01-01

An information-processing framework is presented for understanding intelligence. Two levels of processing are discussed: the steps involved in solving a complex intellectual task, and higher-order processes used to decide how to solve the problem. (MH)

Education: A second career

NASA Technical Reports Server (NTRS)

Authement, Kong Cha

1993-01-01

Education provides women with the freedom to choose their destiny and forge a life for themselves if desired or necessary. Many women are denied the opportunity of education while growing up and must attempt to achieve such schooling later in life. For most women the decision to pursue this education can represent a very traumatic moment in their lives. Having faced the dilemma and decided to proceed, results in a very satisfying feeling when success has been achieved.

Difficulties in everyday life: young persons with attention-deficit/hyperactivity disorder and autism spectrum disorders perspectives. A chat-log analysis.

PubMed

Ahlström, Britt H; Wentz, Elisabet

2014-01-01

This study focuses on the everyday life of young persons with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). There are follow-up studies describing ADHD, and ASD in adults, and residual impairments that affect life. Few qualitative studies have been conducted on the subject of their experiences of everyday life, and even fewer are from young persons' perspectives. This study's aim was to describe how young persons with ADHD and ASD function and how they manage their everyday life based on analyses of Internet-based chat logs. Twelve young persons (7 males and 5 females aged 15-26) diagnosed with ADHD and ASD were included consecutively and offered 8 weeks of Internet-based Support and Coaching (IBSC). Data were collected from 12 chat logs (445 pages of text) produced interactively by the participants and the coaches. Qualitative content analysis was applied. The text was coded and sorted into subthemes and further interpreted into themes. The findings revealed two themes: "fighting against an everyday life lived in vulnerability" with the following subthemes: "difficult things," "stress and rest," and "when feelings and thoughts are a concern"; and the theme "struggling to find a life of one's own" with the following subthemes: "decide and carry out," "making life choices," and "taking care of oneself." Dealing with the problematic situations that everyday encompasses requires personal strength and a desire to find adequate solutions, as well as to discover a role in society. This study, into the provision of support and coaching over the Internet, led to more in-depth knowledge about these young persons' everyday lives and revealed their ability to use IBSC to express the complexity of everyday life for young persons with ADHD and ASD. The implications of the findings are that using online coaching makes available new opportunities for healthcare professionals to acknowledge these young persons' problems.

Imagining the alternatives to life prolonging treatments: elders' beliefs about the dying experience.

PubMed

Winter, Laraine; Parker, Barbara; Schneider, Melissa

2007-08-01

Deciding for or against a life-prolonging treatment represents a choice between prolonged life and death. When the death alternative is not described, individuals must supply their own assumptions. How do people imagine the experience of dying? We asked 40 elderly people open-ended questions about dying without 4 common life-prolonging treatments, eliciting beliefs about pain, length of time, loneliness, and palliative care. Beliefs were diverse, loneliness was commonly assumed, and palliation was rarely mentioned spontaneously. Results underscore needs for improved understanding of the dying process and palliative care and for fuller communication between patients and healthcare providers.

A Demonstration of Ideal Gas Principles Using a Football.

ERIC Educational Resources Information Center

Bare, William D.; Andrews, Lester

1999-01-01

Uses a true-to-life story of accusations made against a college football team to illustrate ideal gas laws. Students are asked to decide whether helium-filled footballs would increase punt distances and how to determine whether a football contained air or helium. (WRM)

Conjoined Twins: Philosophical Problems and Ethical Challenges

PubMed Central

Savulescu, Julian; Persson, Ingmar

2016-01-01

We examine the philosophical and ethical issues associated with conjoined twins and their surgical separation. In cases in which there is an extensive sharing of organs, but nevertheless two distinguishable functioning brains, there are a number of philosophical and ethical challenges. This is because such conjoined twins: 1. give rise to puzzles concerning our identity, about whether we are identical to something psychological or biological;2. force us to decide whether what matters from an ethical point of view is the biological life of our organisms or the existence of our consciousness or mind;3. raise questions concerning when, if ever, it is morally acceptable to sacrifice one of us to save another;4. force us to reflect on the conditions for ownership of organs and the justification of removal of organs for transplantation which causes the death of the donor;5. raise questions about who should take decisions about life-risking treatments when this cannot be decided by patients themselves. We examine and suggest answers to these questions. PMID:26671962

An Application of Generalizability Theory and Many-Facet Rasch Measurement Using a Complex Problem-Solving Skills Assessment

ERIC Educational Resources Information Center

Smith, Jr., Everett V.; Kulikowich, Jonna M.

2004-01-01

This study describes the use of generalizability theory (GT) and many-facet Rasch measurement (MFRM) to evaluate psychometric properties of responses obtained from an assessment designed to measure complex problem-solving skills. The assessment revolved around the school activity of kickball. The task required of each student was to decide on a…

[End-of-life decisions: results of the expert-validated questionnaire].

PubMed

Ortiz-Gonçalves, Belén; Albarrán Juan, Elena; Labajo González, Elena; Santiago-Sáez, Andrés; Perea-Pérez, Bernardo

2018-02-02

To assess the attitudes and knowledge in the life's end about palliative care, advance directives, psychological-physical care, medically assisted suicide and spiritual accompaniment. A cross-sectional study performed in the population at primary health care center of the Autonomous Region of Madrid (Spain). It participated 425 selected people that a simple random was applied in the consultation sheets of health professionals. They analyzed 42 variables of self-administered questionnaire. The surveyed population of Madrid displayed the following characteristics: university studies 58%, 51-70 years 47%, married 60%, and women 61%. 91% would like to decide about their care at life's end. 58% of respondents are aware of palliative care and 53% would request spiritual accompaniment. They know advance directives (50%) but have not made the document. 54% are in favor of legalizing the euthanasia and 42% the assisted suicide. Madrid's people state they would like to decide what care they will receive at life's end and request spiritual accompaniment. Outstanding advocates of euthanasia against assisted suicide. They would like to receive palliative care and complete advance directives documents. To draw comparisons within the population, thereby increasing awareness about social health care resources in Autonomous Region of Madrid, surveys should be conducted in different primary health care centers areas of Madrid. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Punto de Vista--The Significance of a Well.

ERIC Educational Resources Information Center

D'Andrea, Patricia

1979-01-01

The article discusses community action in the Mora Valley, as the Mora Land and Water Protective Association decides whether--and how--to fight an intrusion into traditional life in the valley by the Mora Research Center (a tree farm operated by New Mexico State University). (Editor/NQ)

Hey Teach! Do You Drink?

ERIC Educational Resources Information Center

Finn, Peter

1981-01-01

Three strategies can be used by health educators to respond to students' questions about the instructor's personal life: (1) answer honestly; (2) refuse to answer; and (3) equivocate or lie. In deciding how to respond, instructors should try to ensure educational value and be as truthful as possible. (JN)

Experience with duplex bearings in narrow angle oscillating applications

NASA Technical Reports Server (NTRS)

Phinney, D. D.; Pollard, C. L.; Hinricks, J. T.

1988-01-01

Duplex ball bearings are matched pairs on which the abutting faces of the rings have been accurately ground so that when the rings are clamped together, a controlled amount of interference (preload) exists across the balls. These bearings are vulnerable to radial temperature gradients, blocking in oscillation and increased sensitivity to contamination. These conditions decrease the service life of these bearings. It was decided that an accelerated thermal vacuum life test should be conducted. The test apparatus and results are described and the rationale is presented for reducing a multiyear life test on oil lubricated bearings to less than a year.

An Efficient Scheduling Scheme on Charging Stations for Smart Transportation

NASA Astrophysics Data System (ADS)

Kim, Hye-Jin; Lee, Junghoon; Park, Gyung-Leen; Kang, Min-Jae; Kang, Mikyung

This paper proposes a reservation-based scheduling scheme for the charging station to decide the service order of multiple requests, aiming at improving the satisfiability of electric vehicles. The proposed scheme makes it possible for a customer to reduce the charge cost and waiting time, while a station can extend the number of clients it can serve. A linear rank function is defined based on estimated arrival time, waiting time bound, and the amount of needed power, reducing the scheduling complexity. Receiving the requests from the clients, the power station decides the charge order by the rank function and then replies to the requesters with the waiting time and cost it can guarantee. Each requester can decide whether to charge at that station or try another station. This scheduler can evolve to integrate a new pricing policy and services, enriching the electric vehicle transport system.

Structural study of surfactant-dependent interaction with protein

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mehan, Sumit; Aswal, Vinod K., E-mail: vkaswal@barc.gov.in; Kohlbrecher, Joachim

2015-06-24

Small-angle neutron scattering (SANS) has been used to study the complex structure of anionic BSA protein with three different (cationic DTAB, anionic SDS and non-ionic C12E10) surfactants. These systems form very different surfactant-dependent complexes. We show that the structure of protein-surfactant complex is initiated by the site-specific electrostatic interaction between the components, followed by the hydrophobic interaction at high surfactant concentrations. It is also found that hydrophobic interaction is preferred over the electrostatic interaction in deciding the resultant structure of protein-surfactant complexes.

Structural study of surfactant-dependent interaction with protein

NASA Astrophysics Data System (ADS)

Mehan, Sumit; Aswal, Vinod K.; Kohlbrecher, Joachim

2015-06-01

Small-angle neutron scattering (SANS) has been used to study the complex structure of anionic BSA protein with three different (cationic DTAB, anionic SDS and non-ionic C12E10) surfactants. These systems form very different surfactant-dependent complexes. We show that the structure of protein-surfactant complex is initiated by the site-specific electrostatic interaction between the components, followed by the hydrophobic interaction at high surfactant concentrations. It is also found that hydrophobic interaction is preferred over the electrostatic interaction in deciding the resultant structure of protein-surfactant complexes.

Relative Utility of Selected Software Requirement Metrics

DTIC Science & Technology

1991-12-01

testing . They can also help in deciding if and how to use complexity reduction techniques. In summary, requirement metrics can be useful because they...answer items in a test instrument. In order to differentiate between misinterpretation and comprehension, the measurement technique must be able to...effectively test a requirement, it is verifiable. Ramamoorthy and others have proposed requirements complexity metrics that can be used to infer the

The First Amendment.

ERIC Educational Resources Information Center

O'Shea, Kevin F.

2002-01-01

Surveys the most significant court cases in 2000 involving First Amendment rights in higher education, especially those that may have received scant attention when decided but which promise to affect campus life for years to come. Provides insight into legal trends and shifting thinking as it applies to the First Amendment in the college and…

15 CFR 4.6 - Time limits and expedited processing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... could reasonably be expected to pose an imminent threat to the life or physical safety of an individual... interest involving questions about the Government's integrity which affect public confidence; or (iv) An... decide whether to grant it and shall notify the requester of the decision. Solely for purposes of...

Role of Service Learning in Water Quality Studies

ERIC Educational Resources Information Center

Richards, Wilfred Sugumar

2009-01-01

Background: Chemistry students often complain that they are unmotivated because they see no applications of chemical principles in "real life." It was thus decided to put into use the knowledge gained during the course on water quality and analysis. Learning the principles of quantitative chemical analysis requires innovative, hands-on…

Deciding Factors: Do Factors beyond Achievement Influence Teachers' Student Placement Decisions?

ERIC Educational Resources Information Center

Riley, Tasha

2014-01-01

Since teachers' decisions potentially have consequences for learners' future educational and life opportunities, it is imperative to determine the basis of teachers' decision-making in order to determine whether it is discriminatory. This study combines qualitative and quantitative methods towards a multi-school, multi-region study of Australian…

Design Thinking for Life

ERIC Educational Resources Information Center

Watson, Andrew D.

2015-01-01

According to Vande Zande (2007), understanding the Design Process can help students become stronger critical thinkers. With this in mind, Andrew Watson decided to undertake an observational case study in which he focused directly on Design Thinking and addressed it more intentionally in his teaching. The hope was to understand how students saw…

National Assessment's Consumer Skills Assessments.

ERIC Educational Resources Information Center

Education Commission of the States, Denver, CO. National Assessment of Educational Progress.

The National Assessment of Educational Progress (NAEP) encountered problems when developing a comprehensive assessment of consumer skills of 17-year-olds in 1978. When NAEP conducted a nationwide assessment of basic life skills of 17-year-olds in 1977, there was considerable interest in the consumer skills portion. Therefore, it was decided to…

I'm like ... Professional

ERIC Educational Resources Information Center

Kyburz, Bonnie

2010-01-01

"Given that my film is exploring a punk ethos that attends DIY filmmaking, I decided that the rough nature of the video created appropriate content... these are the sorts of details that reveal the complex, cinema verite nature of the DIY experience."

Survey of United States Army Physician Opinion: The Issue of Written ’Do Not Resuscitate’ Orders

DTIC Science & Technology

1984-08-01

Westminister Press, 1975), p. 176-7. 71Cushing, p. 29. 72Alexander, p. 26. 73Kevin M. McIntyre, "Mediolegal Aspects of Decision Making in Resuscitation and Life...34Physicians Opinions Toward Legislation Defining Death and Withholding Life Support," Southern Medical Journal 74 (February 1981): 215-18. 82Norman K...Louis S. Let the Patient Decide. Philadelphia: The Westminister Press, 1978. Browning, Mary H. and Lewis, Edith P. comps. The Dying Patient: A Nursing

Quality versus quantity: The complexities of quality of life determinations for neonatal nurses.

PubMed

Green, Janet; Darbyshire, Philip; Adams, Anne; Jackson, Debra

2017-11-01

The ability to save the life of an extremely premature baby has increased substantially over the last decade. This survival, however, can be associated with unfavourable outcomes for both baby and family. Questions are now being asked about quality of life for survivors of extreme prematurity. Quality of life is rightly deemed to be an important consideration in high technology neonatal care; yet, it is notoriously difficult to determine or predict. How does one define and operationalise what is considered to be in the best interest of a surviving extremely premature baby, especially when the full extent of the outcomes might not be known for several years? The research investigates the caregiving dilemmas often faced by neonatal nurses when caring for extremely premature babies. This article explores the issues arising for neonatal nurses when they considered the philosophical and ethical questions about quality of life in babies ≤24 weeks gestation. Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical considerations: Ethical processes and procedures have been adhered to by the researchers. A qualitative approach was used to analyse the data. The theme 'difficult choices' was generated which comprised three sub-themes: 'damaged through survival', 'the importance of the brain' and 'families are important'. The results show that neonatal nurses believed that quality of life was an important consideration; yet they experienced significant inner conflict and uncertainty when asked to define or suggest specific elements of quality of life, or to suggest how it might be determined. It was even more difficult for the nurses to say when an extremely premature baby's life possessed quality. Their previous clinical and personal experiences led the nurses to believe that the quality of the family's life was important, and possibly more so than the quality of life of the surviving baby. This finding contrasts markedly with much of the existing literature in this field. Quality of life for extremely premature babies was an important consideration for neonatal nurses; however, they experienced difficulty deciding how to operationalise such considerations in their everyday clinical practice.

Respiratory support withdrawal in intensive care units: families, physicians and nurses views on two hypothetical clinical scenarios

PubMed Central

2010-01-01

Introduction Evidence suggests that dying patients' physical and emotional suffering is inadequately treated in intensive care units. Although there are recommendations regarding decisions to forgo life-sustaining therapy, deciding on withdrawal of life support is difficult, and it is also difficult to decide who should participate in this decision. Methods We distributed a self-administered questionnaire in 13 adult intensive care units (ICUs) assessing the attitudes of physicians and nurses regarding end-of-life decisions. Family members from a medical-surgical ICU in a tertiary cancer hospital were also invited to participate. Questions were related to two hypothetical clinical scenarios, one with a competent patient and the other with an incompetent patient, asking whether the ventilator treatment should be withdrawn and about who should make this decision. Results Physicians (155) and nurses (204) of 12 ICUs agreed to take part in this study, along with 300 family members. The vast majority of families (78.6%), physicians (74.8%) and nurses (75%) want to discuss end-of-life decisions with competent patients. Most of the physicians and nurses desire family involvement in end-of-life decisions. Physicians are more likely to propose withdrawal of the ventilator with competent patients than with incompetent patients (74.8% × 60.7%, P = 0.028). When the patient was incompetent, physicians (34.8%) were significantly less prone than nurses (23.0%) and families (14.7%) to propose decisions regarding withdrawal of the ventilator support (P < 0.001). Conclusions Physicians, nurses and families recommended limiting life-support therapy with terminally ill patients and favored family participation. In decisions concerning an incompetent patient, physicians were more likely to maintain the therapy. PMID:21190560

Respiratory support withdrawal in intensive care units: families, physicians and nurses views on two hypothetical clinical scenarios.

PubMed

Fumis, Renata R L; Deheinzelin, Daniel

2010-01-01

Evidence suggests that dying patients' physical and emotional suffering is inadequately treated in intensive care units. Although there are recommendations regarding decisions to forgo life-sustaining therapy, deciding on withdrawal of life support is difficult, and it is also difficult to decide who should participate in this decision. We distributed a self-administered questionnaire in 13 adult intensive care units (ICUs) assessing the attitudes of physicians and nurses regarding end-of-life decisions. Family members from a medical-surgical ICU in a tertiary cancer hospital were also invited to participate. Questions were related to two hypothetical clinical scenarios, one with a competent patient and the other with an incompetent patient, asking whether the ventilator treatment should be withdrawn and about who should make this decision. Physicians (155) and nurses (204) of 12 ICUs agreed to take part in this study, along with 300 family members. The vast majority of families (78.6%), physicians (74.8%) and nurses (75%) want to discuss end-of-life decisions with competent patients. Most of the physicians and nurses desire family involvement in end-of-life decisions. Physicians are more likely to propose withdrawal of the ventilator with competent patients than with incompetent patients (74.8% × 60.7%, P = 0.028). When the patient was incompetent, physicians (34.8%) were significantly less prone than nurses (23.0%) and families (14.7%) to propose decisions regarding withdrawal of the ventilator support (P < 0.001). Physicians, nurses and families recommended limiting life-support therapy with terminally ill patients and favored family participation. In decisions concerning an incompetent patient, physicians were more likely to maintain the therapy.

On Elementary Affective Decisions: To Like Or Not to Like, That Is the Question

PubMed Central

Jacobs, Arthur; Hofmann, Markus J.; Kinder, Annette

2016-01-01

Perhaps the most ubiquitous and basic affective decision of daily life is deciding whether we like or dislike something/somebody, or, in terms of psychological emotion theories, whether the object/subject has positive or negative valence. Indeed, people constantly make such liking decisions within a glimpse and, importantly, often without expecting any obvious benefit or knowing the exact reasons for their judgment. In this paper, we review research on such elementary affective decisions (EADs) that entail no direct overt reward with a special focus on Neurocognitive Poetics and discuss methods and models for investigating the neuronal and cognitive-affective bases of EADs to verbal materials with differing degrees of complexity. In line with evolutionary and appraisal theories of (aesthetic) emotions and data from recent neurocognitive studies, the results of a decision tree modeling approach simulating EADs to single words suggest that a main driving force behind EADs is the extent to which such high-dimensional stimuli are associated with the “basic” emotions joy/happiness and disgust. PMID:27933013

Persistent bacteraemia caused by Staphylococcus aureus in the gall bladder.

PubMed

Yu, Alexander Tin Han; Cun, Tony; Benamu, Esther; Renault, Cybele

2017-11-08

Staphylococcus aureus bacteraemia (SAB) remains a complex disease with a high associated morbidity and mortality, especially when it is able to establish an occult nidus safe from antimicrobial eradication. Without rapid identification and intervention, the nidus can cause persistent relapse of disease, morbidity and mortality. Having a high clinical suspicion for the foci of occult S. aureus is important, and awareness of potential sites of infection is critical and can be life-saving.We present a unique case of a 65-year-old man with end-stage renal disease receiving haemodialysis who developed septic shock from SAB. Despite 18 days of appropriate antibiotics, the patient had persistent high-grade bacteraemia until his gall bladder was ultimately percutaneously drained. The day after drainage, he cleared his blood cultures, although he ultimately passed away as he decided to transition his care to focus on comfort measures. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

New treatments for psoriasis: which biologic is best?

PubMed

Nelson, Andrew A; Pearce, Daniel J; Fleischer, Alan B; Balkrishnan, Rajesh; Feldman, Steven R

2006-01-01

Psoriasis is a chronic, debilitating disease affecting not only the skin, but also having a significant impact on a patient's quality of life. The treatment of severe psoriasis is quite challenging due to the chronic, relapsing nature of the disease and the difficulties inherent in treatment planning. Though the biologics are perhaps the most promising of available psoriasis treatments, the decision to institute a given therapy may be fraught with complexity for the clinician. Patients now hear of these promising new treatments for psoriasis via print, television and radio advertising; they frequently come to their physician asking if they are eligible for any of these agents and, if so, 'which biologic is best?'. This paper attempts to determine the ideal biologic agent based upon several parameters: FDA- and EU-approved indications, therapeutic efficacy, impact on quality of life, cost-effectiveness, and safety profile. Certainly the physician is central to medical decision-making, though ultimately patient preference may play the largest role in determining the 'best' biologic agent. There is no single ideal biologic for all patients and a physician's job is to educate patients on the relative advantages and disadvantages of each agent. Through informed discussion, the clinician can help each individual patient decide which biologic agent is ideal for them.

The molecular mechanisms of larval cestode development: first steps into an unknown world.

PubMed

Brehm, Klaus; Spiliotis, Markus; Zavala-Góngora, Ricardo; Konrad, Christian; Frosch, Matthias

2006-01-01

Several hundred million years ago, the free-living ancestors of all extant helminth parasites decided to colonize entirely new habitats, the bodies of other metazoan animals. As a consequence of the resulting adaptation processes, they evolved highly complex life-cycles in which many developmental transitions were initiated and controlled by host-derived signals. Understanding the molecular basis of the original developmental mechanisms, and the modifications that occurred during co-evolution with the host, is not only fundamental to our understanding of parasitism but also highly relevant for the design of anti-parasitic drugs and vaccines. In the past several years, molecular investigations on parasitic nematode and trematode development have made considerable progress and, supported by respective genome sequencing projects and emerging methods of genetic manipulation, will be a flourishing field in the years to come. We consider it time that corresponding studies are also pushed for the third large group of parasitic helminths, the cestodes. Here, we review the first experimental steps into that area, which have been undertaken recently. We report on cestode genomics, the identification of signaling factors associated with larval development, and the establishment as well as improvement of in vitro cultivation systems by which cestode life-cycles can be studied in the laboratory.

Women Choose Their Careers: A Study of Natural Decision Making.

ERIC Educational Resources Information Center

Eisenhart, Margaret A.

1985-01-01

Ethnographic interviews with 23 college-aged women revealed most considered few career alternatives, relied on easily accessible information sources, made choices early in life, stayed with the choice, and decided to either "earn money" or "stay at home." The others considered several alternatives, pursued them, and linked them to relationships…

22 CFR 303.8 - Requests for records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... treatment could reasonably be expected to pose an imminent threat to the life or physical safety of an... affect public confidence. (2) A request for expedited processing may be made at the time of the initial... Officer shall decide whether to grant the request and shall notify the requester of the decision. If a...

28 CFR 16.5 - Timing of responses to requests.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the lack of expedited treatment could reasonably be expected to pose an imminent threat to the life or... exist possible questions about the government's integrity which affect public confidence. (2) A request... component shall decide whether to grant it and shall notify the requester of the decision. If a request for...

Promoting Moral Growth through Pluralism and Social Justice Education

ERIC Educational Resources Information Center

Stewart, Dafina Lazarus

2012-01-01

Issues of morality, including deciding among competing values and negotiating obligations to self and community, are pervasive and saturate many aspects of life. This article explores the role of educating for pluralism and social justice in promoting moral growth among college students. James Rest's four-component model of moral maturity frames…

Treatment or Involuntary Euthanasia for Severely Handicapped Newborns: Issues of Philosophy and Public Policy.

ERIC Educational Resources Information Center

Powell, T. Hennessy; And Others

1982-01-01

Recent reports have indicated that parents and/or physicians occasionally decide not to provide life-sustaining treatment (referred to as involuntary euthanasia), thus ensuring that the severely handicapped newborn will die. The issues involved relative to treatment or involuntary euthanasia are reviewed from two opposing perspectives…

76 FR 53816 - Advisory Committee; Change of Name and Function; Technical Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... amending the standing advisory committees' regulations to change the name and function of the Anesthetic...: FDA is announcing that the name of the Anesthetic and Life Support Drugs Advisory Committee, which was established on May 1, 1978, has been changed. The Agency decided that the name ``Anesthetic and Analgesic Drug...

Antecedents and Consequences of Career Decisional States in Adolescence

ERIC Educational Resources Information Center

Creed, Peter; Prideaux, Lee-Ann; Patton, Wendy

2005-01-01

This longitudinal study tested students in Grade 8 and again in Grade 10 on career (maturity, barriers, indecision, decision-making and self-efficacy), well-being (self-esteem, life satisfaction, and coping), and social (school achievement, paid work experience) variables. Students were allocated to decided or undecided conditions at T1, T2 and…

Older Adults Have Difficulty in Decoding Sarcasm

ERIC Educational Resources Information Center

Phillips, Louise H.; Allen, Roy; Bull, Rebecca; Hering, Alexandra; Kliegel, Matthias; Channon, Shelley

2015-01-01

Younger and older adults differ in performance on a range of social-cognitive skills, with older adults having difficulties in decoding nonverbal cues to emotion and intentions. Such skills are likely to be important when deciding whether someone is being sarcastic. In the current study we investigated in a life span sample whether there are…

Integrating scientific data for drug discovery and development using the Life Sciences Grid.

PubMed

Dow, Ernst R; Hughes, James B; Stephens, Susie M; Narayan, Vaibhav A; Bishop, Richard W

2009-06-01

There are many daunting challenges for companies who wish to bring novel drugs to market. The information complexity around potential drug targets has increased greatly with the introduction of microarrays, high-throughput screening and other technological advances over the past decade, but has not yet fundamentally increased our understanding of how to modify a disease with pharmaceuticals. Further, the bar has been raised in getting a successful drug to market as just being new is no longer enough: the drug must demonstrate improved performance compared with the ever increasing generic pharmacopeia to gain support from payers and government authorities. In addition, partly as a consequence of a climate of concern regarding the safety of drugs, regulatory authorities have approved fewer new molecular entities compared to historical norms over the past few years. To overcome these challenges, the pharmaceutical industry must fully embrace information technology to bring better understood compounds to market. An important first step in addressing an unmet medical need is in understanding the disease and identifying the physiological target(s) to be modulated by the drug. Deciding which targets to pursue for a given disease requires a multidisciplinary effort that integrates heterogeneous data from many sources, including genetic variations of populations, changes in gene expression and biochemical assays. The Life Science Grid was developed to provide a flexible framework to integrate such diverse biological, chemical and disease information to help scientists make better-informed decisions. The Life Science Grid has been used to rapidly and effectively integrate scientific information in the pharmaceutical industry and has been placed in the open source community to foster collaboration in the life sciences community.

Protein Modelling: What Happened to the “Protein Structure Gap”?

PubMed Central

Schwede, Torsten

2013-01-01

Computational modeling and prediction of three-dimensional macromolecular structures and complexes from their sequence has been a long standing vision in structural biology as it holds the promise to bypass part of the laborious process of experimental structure solution. Over the last two decades, a paradigm shift has occurred: starting from a situation where the “structure knowledge gap” between the huge number of protein sequences and small number of known structures has hampered the widespread use of structure-based approaches in life science research, today some form of structural information – either experimental or computational – is available for the majority of amino acids encoded by common model organism genomes. Template based homology modeling techniques have matured to a point where they are now routinely used to complement experimental techniques. With the scientific focus of interest moving towards larger macromolecular complexes and dynamic networks of interactions, the integration of computational modeling methods with low-resolution experimental techniques allows studying large and complex molecular machines. Computational modeling and prediction techniques are still facing a number of challenges which hamper the more widespread use by the non-expert scientist. For example, it is often difficult to convey the underlying assumptions of a computational technique, as well as the expected accuracy and structural variability of a specific model. However, these aspects are crucial to understand the limitations of a model, and to decide which interpretations and conclusions can be supported. PMID:24010712

On Organizational Theory and Practice: Some Lessons Learned from the Severely Mentally "Disabled."

ERIC Educational Resources Information Center

Sprowl, John Parrish

Realizing that communications theory and research have little to do with organizational life, a communications scholar decided to become an organizational participant while still analyzing events and episodes in a scholarly way. In the spring of 1986, he joined the board of directors of Interface Precision Benchworks (IPB), a not-for-profit…

Capturing Movement

ERIC Educational Resources Information Center

Lord, Lynda

2007-01-01

The idea for the art lesson presented in this article grew out of watching the lively actions of fourth grade students. Since drawing is the author's first love, she is always looking for new ways to teach it. This time, instead of setting up a still life, she decided to teach students how to capture their actions on paper. (Contains 5 online…

Medical Pluralism in the Life of a Mexican Immigrant Woman

ERIC Educational Resources Information Center

Belliard, Juan Carlos; Ramirez-Johnson, Johnny

2005-01-01

This case study reflects on the variety of approaches to health care in a pluralistic immigrant urban enclave in Southern California. In-depth interviews were conducted with a Mexican immigrant woman to explore and understand her health worldview and the strategies she uses in deciding among the diverse health care options available to protect and…

Lying in the Name of the Collective Good: A Developmental Study

ERIC Educational Resources Information Center

Fu, Genyue; Evans, Angela D.; Wang, Lingfeng; Lee, Kang

2008-01-01

The present study examined the developmental origin of "blue lies", a pervasive form of lying in the adult world that is told purportedly to benefit a collective. Seven, 9-, and 11-year-old Chinese children were surreptitiously placed in a real-life situation where they decided whether to lie to conceal their group's cheating behavior. Children…

How Will the U.S. Supreme Court Decide?

ERIC Educational Resources Information Center

O'Brien, Joseph E.

2002-01-01

The U.S. Supreme Court is less visible to students than either Congress or the president. The Court's rulings on cases, however, are as influential on everyday life and on the political system as any bill passed by Congress or signed into law by the president. "Brown v. Board of Education," "Roe v. Wade," and "Bush v.…

Making Connections through the Lens of Blue Man Group

ERIC Educational Resources Information Center

Stephens, Pam

2005-01-01

The Blue Man Group began in 1988 when friends Matt Goldman, Phil Stanton, and Chris Wink all living in New York--voiced their increasing disgruntlement and boredom with urban life. With a gut feeling that creativity and a tribal-like community could prosper in their metropolitan environment, the friends decided to confront the issues rather than…

Bringing Culture to Life through Children's Literature: The Mississippi Delta in the 1930's

ERIC Educational Resources Information Center

Hopper, Peggy F.

2011-01-01

After hearing reminisces from her parents about childhood adventures that took place in the 1930's Mississippi Delta, the author, Peggy F. Hopper, decided to document these stores in two children's books, "Peggy Sue and the Pepper Patch" and "The Adventures of Theodore Roosevelt Hollumway Jones and John Hart: Chasing Bandits."…

Knowing Who Knows: Laypersons' Capabilities to Judge Experts' Pertinence for Science Topics

ERIC Educational Resources Information Center

Bromme, Rainer; Thomm, Eva

2016-01-01

Because modern societies are built on elaborate divisions of cognitive labor, individuals remain laypersons in most knowledge domains. Hence, they have to rely on others' expertise when deciding on many science-related issues in private and public life. Even children already locate and discern expertise in the minds of others (e.g., Danovitch…

George Washington and the Temple of Democracy. Teaching with Historic Places.

ERIC Educational Resources Information Center

Hunter, Kathleen A.

This document, from the lesson plan series, "Teaching with Historic Places," provides a description of George Washington's life and the building of the U.S. Capitol. George Washington became the first U.S. President after leading the colonies through the revolutionary war. The U.S. Congress and the President decided to create a federal…

Satellite Maps Deliver More Realistic Gaming

NASA Technical Reports Server (NTRS)

2013-01-01

When Redwood City, California-based Electronic Arts (EA) decided to make SSX, its latest snowboarding video game, it faced challenges in creating realistic-looking mountains. The solution was NASA's ASTER Global Digital Elevation Map, made available by the Jet Propulsion Laboratory, which EA used to create 28 real-life mountains from 9 different ranges for its award-winning game.

Bean Plants: A Growth Experience

ERIC Educational Resources Information Center

West, Donna

2004-01-01

Teaching plant growth to seventh-grade life science students has been interesting for the author because she grew up in a rural area and always had to help in the garden. She made many assumptions about what her rural and suburban students knew. One year she decided to have them grow plants to observe the roots, stems, leaves, flowers, and fruit…

Both Parents and Adolescents Project Their Own Values When Perceiving Each Other's Values

ERIC Educational Resources Information Center

Stattin, Håkan; Kim, Yunhwan

2018-01-01

How parents and adolescents perceive each other's life values is a key to understanding successful value transmission. In the value socializations literature, it has been proposed that parents' values become internalized when children correctly perceive their parents' values and decide to adopt them as their own. In the current study, we propose…

Scripted Reading Programs: Fishing for Success

ERIC Educational Resources Information Center

Duncan-Owens, Deborah

2009-01-01

"Give a man a fish and he will eat for a day. Teach a man to fish and he will eat for the rest of his life." This popular Chinese proverb is an apt metaphor for the dilemma faced by principals and curriculum coordinators when deciding whether to purchase a scripted commercial reading program. Although a scripted reading program may solve…

Adolescents' Moral Engagement in Urban Settings

ERIC Educational Resources Information Center

Thorkildsen, Theresa A.

2007-01-01

Adolescents who live in urban settings regularly encounter a complex array of people and circumstances that require sophisticated decision-making skills. Using their personal standards, adolescents coordinate moral thoughts and emotions when deciding how to act. After defining what the author refers to as moral engagement, several empirical…

How Should We Value a Planet?

NASA Astrophysics Data System (ADS)

Haqq-Misra, J.

2014-04-01

The idea that a planet or its biota may be intrinsically valuable, apart from its usefulness to humans, is contentious among ethicists, while difficulties abound in attempting to decide what is objectively better or worse for a planet or life. As a way of dissecting the issue of value and life, I present a two-axis comparative tool for ethical frameworks that considers the intrinsic or instrumental value placed upon organisms, environments, planetary systems, and space. I discuss ethical considerations relevant to contemporary space exploration, near-future human exploration of Solar System bodies, and long-term possibilities of interplanetary colonization. This allows for more transparent discussions of value with regard to future space exploration or the discovery of extraterrestrial life.

Switched-On Physics: If you can dream it, you can do it

NASA Astrophysics Data System (ADS)

Graham, Scotty

2011-05-01

As classroom science teachers, we are all often reminded of the inevitable and sometimes not small challenges that face us in captivating and keeping the interest of our students. To give additional relevance and life to my teaching of physics, I decided to integrate global, hands-on projects into my approach. I decided from the onset that the projects had to be innovative, spectacular, and creative, and they must include input from students and colleagues from their inception. This chosen course of action resulted in the development of a dynamic three-year physics odyssey culminating with the Switched-On Physics Project. In this paper, I describe the program and encourage other teachers to consider engaging in projects that capture their interest and that of their students.

Meeting on flows of granular materials in complex geometries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Passman, S.L.; Fukushima, E.; Evans, R.E.

1994-11-01

The International Energy Agency Fossil Fuel Multiphase Flow Sciences Agreement has been in effect since 1986. The traditional mechanism for the effort has been information exchange, effected by the inclusion of scientists in annual Executive committee meetings, by exchange of reports and papers, and by visits of scientists to one another`s institutions. In a sequence of informal meetings and at the 1993 Executive committee meeting, held in Pittsburgh, US in March 1994, it was decided that more intensive interactions could be productive. A candidate for such interactions would be specific projects. Each of these would be initiated through a meetingmore » of scientists in which feasibility of the particular project was decided, followed by relatively intense international co-operation in which the work would be done. This is a report of the first of these meetings. Official or unofficial representatives from Canada, italy, japan, mexico, the United Kingdom, and the US met in Albuquerque, New Mexico, US, to consider the subject Flows of Granular Materials in Complex Geometries. Representatives of several other countries expressed interest but were unable to attend this meeting. Sixteen lectures were given on aspects of this topic. It was decided that a co-operative effort was desirable and possible. The most likely candidate for the area of study would be flows in bins and hoppers. Each of the countries wishing to co-operate will pursue funding for its effort. This report contains extended abstracts of the sixteen presentations and a transcription of the final discussion.« less

Debate on the Draft--Helping Students Decide Where They Stand.

ERIC Educational Resources Information Center

Victory, James

1981-01-01

Presents four exercises to help secondary school social studies students understand the complex issues of the draft. Students participate in a mock draft lottery, analyze Phil Och's Draft Dodger Rag, examine how individual experiences affect attitudes, and compare writings by Bill Mauldin and Ron Kovic. (KC)

Rooms with a View

ERIC Educational Resources Information Center

Kearney, Kerri S.; Mathers, Judith K.

2007-01-01

This case, based on actual events, was developed for a course in educational leadership or media management. Students will test their own processes for ethical leadership through this complex crisis in which a superintendent must decide whether to take public responsibility for questionable decisions made by his staff. This case highlights the…

The Role of Censorship in School

ERIC Educational Resources Information Center

Petress, Ken

2005-01-01

School authorities face great complexities and inevitable challenges when deciding to make or not to make censorship decisions in schools. Matters of educational content, age level, acceptability by parents and communities, and appropriateness in the school setting are among the decisions having to be made. When school official decisions result in…

Responding to an RFP: A Vendor's Viewpoint.

ERIC Educational Resources Information Center

Kington, Robert A.

1987-01-01

Outlines factors used by online vendors to decide whether to bid on RFPs (requests for proposals) for library automation systems, including specifications for software, hardware or performance requirements not met by the vendor; specifications based on competitors' systems; the size and complexity of the request itself; and vendors' time…

Navigating the Peaks and Valleys of Teaching

ERIC Educational Resources Information Center

Seeley, Cathy

2010-01-01

After 30 years in education, the author decided to follow a lifelong dream to join the Peace Corps. She was assigned to teach mathematics (in French) in a small country in West Africa for two years. Reflecting on her life as a new Peace Corps volunteer, the author offers in this article some parallels between that experience and the early days,…

Great Expectations in the Joint Advanced Manufacturing Region

DTIC Science & Technology

2016-12-01

would be continuous experimentation and risk reduction prototyping. The entire manufacturing life cycle— design , testing, product development...on the back of a napkin, they decided to call their effort the Joint Advanced Manufacturing Region (JAMR) and manage it as an Integrated Product ... designed to support the continuous experimentation of advanced manufacturing tactics, tech- niques and procedures under actual operational or combat

Analysis of the Effectiveness of the Retire Tool When Deciding Between High 36 Retirement and Blended TSP Retirement

DTIC Science & Technology

2016-12-01

based on life expectancy and the TSP account selected. The TSP Growth and Annuity Element also estimates how taxes will increase at the time the service...the BRS. 14. SUBJECT TERMS military retirement, blended retirement, HIGH-36, thrift savings plan, investment risk, retirement taxes , net present...20 2. Tax Impacts

The US/Global Achilles heel : economic terrorism.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Backus, George A.

2005-04-01

While loss of life is the operating concern of Department of Homeland Security (DHS), the security of the economy ultimately decides the success of the war on terrorism. This project focuses on mitigation, containment, response, and impact of terrorist events on the economy. Conventional economic methods are inadequate, but agent-based methods (Discrete Simulation) appears to uniquely capture the dynamics and emergent (human) behaviors.

Blogging and the Learning of Linear Algebra Concepts through Contextual Mathematics

ERIC Educational Resources Information Center

Nehme, Zeina

2011-01-01

Contextual mathematics is an area of mathematics teaching and learning through which researchers and educators believe that mathematics is better taught, and learned, if connected to real-life situations and problems. It is also very helpful if it makes sense in the students' world. Thus, the author decided to start a project by creating a blog,…

Diversity to the Next Level

ERIC Educational Resources Information Center

Stuart, Reginald

2010-01-01

When Colgate University decided a few years ago to recast its diversity efforts, it joined a small, but growing, number of schools across the U.S. in taking a new approach to a decades-old challenge of how best to make their school more appealing to people from all walks of life and more compelling to employers as a good place to recruit. Colgate,…

Death and Dying--A Living Study. Profiles of Promise 35.

ERIC Educational Resources Information Center

Hawke, Sharryl

Realizing that all students have to deal with death at some time, yet receive no formal education in the subject, Alex Kramer, a high school teacher at Moon High School, Corapolis, Pennsylvania, decided to create a program which would give students an opportunity to study death and the process of dying as integral parts of life. Kramer's goals,…

Mobile Fatwa (M-Fatwa): The Integration of Islamic Fatwa through Mobile Technology

ERIC Educational Resources Information Center

Nawi, Mohd Aliff Mohd; Hamzah, Mohd Isa

2014-01-01

Fatwa institutions play an important role to disseminate information about the fatwa decision that has been discussed. Fatwa is decided will be a guide and reference to the Muslims for dismantling all the problems related to religious law in everyday life. The purpose of this paper to discuss the integration method fatwa information using a mobile…

A New Perspective on Design Education: A "Creative Production-Manufacturing Model" in "The Maker Movement" Context

ERIC Educational Resources Information Center

Zhong, Xiang-Ming; Fan, Kuo-Kuang

2016-01-01

When "The Maker Movement" started, it made a great impact and influence on many aspects of society. "The Maker Movement" has transformed industries as well as people's way of life and thinking. For this reason, many people decided to create something by turning their ideas to tangible products. Media has become a bridge that…

How You Can Help Save a Life | Poster

Cancer.gov

By Carolynne Keenan, Contributing Writer Kevin Zecher, a maintenance mechanic in Facilities Maintenance and Engineering, Leidos Biomedical Research, Inc., hasn’t missed a double-red cell donation at a blood drive at NCI at Frederick in four years. He marks the time by his first granddaughter’s birth—that’s when he first decided to donate more than whole blood.

America is in Trouble, National Wildlife Federation's 1970 National EQ Index.

ERIC Educational Resources Information Center

National Wildlife Federation, Washington, DC.

This is the second annual edition of the EQ (Environmental Quality) Index and is reprinted from the October-November, 1970 National Wildlife Magazine. The index is an attempt "to assign some values and form some judgements on those vital factors that make up the quality of our life--and to decide whether we were winning or losing the pollution…

Flipped!: Want to Get Teens Excited about Summer Reading? Just Add Video

ERIC Educational Resources Information Center

Wooten, Jennifer

2009-01-01

Fully 57 percent of youth online watch videos, according to a Pew Internet & American Life study. And more and more are creating and sharing clips of their own making. With online engagement such an integral part of their world, Washington state's King County Library System (KCLS) decided to meet kids on their own turf by launching…

Life Designing: A Paradigm for Career Construction in the 21st Century

ERIC Educational Resources Information Center

Savickas, Mark L.; Nota, Laura; Rossier, Jerome; Dauwalder, Jean-Pierre; Duarte, Maria Eduarda; Guichard, Jean; Soresi, Salvatore; Van Esbroeck, Raoul; van Vianen, Annelies E. M.

2009-01-01

At the beginning of the 21st century, a new social arrangement of work poses a series of questions and challenges to scholars who aim to help people develop their working lives. Given the globalization of career counseling, we decided to address these issues and then to formulate potentially innovative responses in an international forum. We used…

Assisted suicide and the savings clause.

PubMed

Helminski, F

1995-06-01

In December 1994, the Michigan Supreme Court decided a group of cases comprising constitutional challenges to a Michigan statute against assisted suicide and prosecutions of Dr. Jack Kevorkian for his role in two incidents of suicide. The court rejected arguments that the statute infringed a right of "personal autonomy" under the Fourteenth Amendment to the US Constitution; it noted that, although US Supreme Court opinions indicate that decisions to withdraw or reject life-sustaining treatment are constitutionally protected, a legal difference exists between permitting death to occur by natural means and taking affirmative steps to end life. The Michigan court also decided that Kevorkian could not be charged with murder for supplying only the means by which suicide occurred, but he could be charged with a common law crime of assisting in suicide although the statute outlawing such actions became effective only after the suicides occurred. Because suicide was a crime under the prerevolutionary English Common Law, which forms the foundation of Michigan law, assisting in suicide is also a residual crime under the "savings clause" of the Michigan statutes, which incorporates common law crimes into the law of that state when no superseding statute exists.

[Diagnosis of musculoskeletal ambulation disability symptom complex (MADS)].

PubMed

Ito, Hiromoto

2008-11-01

It was described to diagnosis of Musculoskeletal Ambulation Disability Symptom Complex (MADS). The definition of MADS is an person of advanced years with lower leveled balance and walking ability, high risk for fall, and who is keeping to the house. The diagnosis of MADS was decided to a history of 11 musculoskeletal disorders and evaluation of balanced and walking function. The determination method of time of one leg standing and 3 m timed timed up and go test were described.

Node 3 Relocation Environmental Control and Life Support System Modification Kit Verification and Updated Status

NASA Technical Reports Server (NTRS)

Williams, David E.; Spector, Lawrence N.

2009-01-01

Node 1 (Unity) flew to International Space Station (ISS) on Flight 2A. Node 1 was the first module of the United States On-Orbit Segment (USOS) launched to ISS. The Node 1 ISS Environmental Control and Life Support (ECLS) design featured limited ECLS capability. The main purpose of Node 1 was to provide internal storage by providing four stowage rack locations within the module and to allow docking of multiple modules and a truss segment to it. The ECLS subsystems inside Node 1 were routed through the element prior to launch to allow for easy integration of the attached future elements, particularly the Habitation Module which was planned to be located at the nadir docking port of Node 1. After Node 1 was on-orbit, the Program decided not to launch the Habitation Module and instead, to replace it with Node 3 (Tranquility). In 2007, the Program became concerned with a potential Russian docking port approach issue for the Russian FGB nadir docking port after Node 3 is attached to Node 1. To solve this concern the Program decided to relocate Node 3 from Node 1 nadir to Node 1 port. To support the movement of Node 3 the Program decided to build a modification kit for Node 1, an on-orbit feedthrough leak test device, and new vestibule jumpers to support the ECLS part of the relocation. This paper provides a design overview of the modification kit, a summary of the Node 1 ECLS re-verification to support the Node 3 relocation from Node 1 nadir to Node 1 port, and a status of the ECLS modification kit installation into Node 1.

Node 3 Relocation Environmental Control and Life Support System Modification Kit Verification and Updated Status

NASA Technical Reports Server (NTRS)

Williams, David E.; Spector Lawrence N.

2010-01-01

Node 1 (Unity) flew to International Space Station (ISS) on Flight 2A. Node 1 was the first module of the United States On-Orbit Segment (USOS) launched to ISS. The Node 1 ISS Environmental Control and Life Support (ECLS) design featured limited ECLS capability. The main purpose of Node 1 was to provide internal storage by providing four stowage rack locations within the module and to allow docking of multiple modules and a truss segment to it. The ECLS subsystems inside Node 1 were routed through the element prior to launch to allow for easy integration of the attached future elements, particularly the Habitation Module which was planned to be located at the nadir docking port of Node 1. After Node I was on-orbit, the Program decided not to launch the Habitation Module and instead, to replace it with Node 3 (Tranquility). In 2007, the Program became concerned with a potential Russian docking port approach issue for the Russian FGB nadir docking port after Node 3 is attached to Node 1. To solve this concern the Program decided to relocate Node 3 from Node I nadir to Node 1 port. To support the movement of Node 3 the Program decided to build a modification kit for Node 1, an on-orbit feedthrough leak test device, and new vestibule jumpers to support the ECLS part of the relocation. This paper provides a design overview of the modification kit for Node 1, a summary of the Node 1 ECLS re-verification to support the Node 3 relocation from Node 1 nadir to Node 1 port, and a status of the ECLS modification kit installation into Node 1.

Physician Communication in Pediatric End-of-Life Care: A Simulation Study.

PubMed

Bateman, Lori Brand; Tofil, Nancy M; White, Marjorie Lee; Dure, Leon S; Clair, Jeffrey Michael; Needham, Belinda L

2016-12-01

The objective of this exploratory study is to describe communication between physicians and the actor parent of a standardized 8-year-old patient in respiratory distress who was nearing the end of life. Thirteen pediatric emergency medicine and pediatric critical care fellows and attendings participated in a high-fidelity simulation to assess physician communication with an actor-parent. Fifteen percent of the participants decided not to initiate life-sustaining technology (intubation), and 23% of participants offered alternatives to life-sustaining care, such as comfort measures. Although 92% of the participants initiated an end-of-life conversation, the quality of that discussion varied widely. Findings indicate that effective physician-parent communication may not consistently occur in cases involving the treatment of pediatric patients at the end of life in emergency and critical care units. The findings in this study, particularly that physician-parent end-of-life communication is often unclear and that alternatives to life-sustaining technology are often not offered, suggest that physicians need more training in both communication and end-of-life care. © The Author(s) 2015.

Dignity at the end of our days: personal, familial, and cultural location.

PubMed

McDonald, Michael

2004-01-01

The desire to be treated with dignity, particularly at the end of one's life, is a fairly universal preference found in most cultures. Such treatment requires positive actions of respect in the behaviour of others toward the dying and the dead. It also involves negative actions, particularly refraining from doing "dignatory harms" to the dead and the dying. Yet it is not always easy for clinicians and researchers who deal with the dying and dead to decide on appropriate action or inaction. I suggest that such decision making can be helped by locating the dying person along three dimensions: the personal, the familial, and the cultural. These elements are interrelated in complex ways that need to be unpacked in context. Thus, one person may locate herself within a familial context while a sibling may locate himself against that context. While locating individuals along the three dimensions suggested does not "solve" ethical problems, it should help clinicians in understanding and dealing more compassionately with the dead, the dying, their families, and their communities.

Chronicle of a death foretold: Plasmodium liver stage parasites decide on the fate of the host cell.

PubMed

Graewe, Stefanie; Stanway, Rebecca R; Rennenberg, Annika; Heussler, Volker T

2012-01-01

Protozoan parasites of the genus Plasmodium are the causative agents of malaria. Despite more than 100 years of research, the complex life cycle of the parasite still bears many surprises and it is safe to say that understanding the biology of the pathogen will keep scientists busy for many years to come. Malaria research has mainly concentrated on the pathological blood stage of Plasmodium parasites, leaving us with many questions concerning parasite development within the mosquito and during the exo-erythrocytic stage in the vertebrate host. After the discovery of the Plasmodium liver stage in the middle of the last century, it remained understudied for many years but the realization that it represents a promising target for vaccination approaches has brought it back into focus. The last decade saw many new and exciting discoveries concerning the exo-erythrocytic stage and in this review we will discuss the highlights of the latest developments in the field. © 2011 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

Strategic Planning for Prevention Professionals on Campus. A Prevention 101 Series Publication

ERIC Educational Resources Information Center

Langford, Linda; DeJong, William

2008-01-01

The nation's institutions of higher education continue to face serious problems with respect to student alcohol and other drug abuse and violence (AODV). For campus administrators, deciding how to respond effectively means understanding and taking into account both the complexity of these social problems and the individuality of each campus…

Self-Organising Navigational Support in Lifelong Learning: How Predecessors Can Lead the Way

ERIC Educational Resources Information Center

Janssen, Jose; Tattersall, Colin; Waterink, Wim; van den Berg, Bert; van Es, Rene; Bolman, Catherine; Koper, Rob

2007-01-01

Increased flexibility and modularisation in higher education complicates the process of learners finding their way through the offerings of higher education institutions. In lifelong learning, where learning opportunities are diverse and reach beyond institutional boundaries, it becomes even more complex to decide on a learning path. However,…

Multiple "Curriculum" Meanings Heighten Debate over Standards

ERIC Educational Resources Information Center

Gewertz, Catherine

2011-01-01

Calls for shared curricula for the common standards have triggered renewed debates about who decides what students learn, and even about varied meanings of the word "curriculum," adding layers of complexity to the job of translating the broad learning goals into classroom teaching. The most recent calls for common curricula came from the American…

Agency and Reflexivity in Boomtown Transitions: Young People Deciding on a School and Work Direction

ERIC Educational Resources Information Center

O'Connor, Christopher D.

2014-01-01

In recent decades, young people's transitions from school to work have undergone substantial changes. As young people make their way from compulsory schooling to employment, they find themselves having to navigate an increasingly complex, technologically innovative and globalised world. These social changes have prompted youth researchers to…

Order Matters: Sequencing Scale-Realistic versus Simplified Models to Improve Science Learning

ERIC Educational Resources Information Center

Chen, Chen; Schneps, Matthew H.; Sonnert, Gerhard

2016-01-01

Teachers choosing between different models to facilitate students' understanding of an abstract system must decide whether to adopt a model that is simplified and striking or one that is realistic and complex. Only recently have instructional technologies enabled teachers and learners to change presentations swiftly and to provide for learning…

Teaching Is Our Calling: Do Something Worthwhile!

ERIC Educational Resources Information Center

Shedd, Peter J.

2012-01-01

In this article, the author shares his thoughts about teaching. He says in every class teachers enter, during every conversation they have, through everything they do, they should strive to create the environment that allows learning to occur. How they decide what is "worthwhile" is too complex for a simple prescription. Teachers must exercise…

Agroforestry adoption in the Calakmul biosphere reserve, Campeche, Mexico

Treesearch

D. Evan Mercer; Jeremy Haggar; Ann Snook; Mauricio Sosa

2005-01-01

Since farmers engage in a complex, dynamic process of learning-by-doing, evaluating economic incentives, and assessing risks in deciding whether to adopt agroforestry systems, a multi-pronged research approach is required for a complete analysis of adoption potential and to develop effective technological and institutional interventions. A case study is presented for...

Net Neutrality and Its Implications to Online Learning

ERIC Educational Resources Information Center

Yamagata-Lynch, Lisa C.; Despande, Deepa R.; Do, Jaewoo; Garty, Erin; Mastrogiovanni, Jason M.; Teagu, Stephanie J.

2017-01-01

In this article, we studied net neutrality as a complex sociocultural phenomenon that can affect the works of distance education scholars and online learners. We decided to take part in this research because many distance education scholars and learners take net neutrality for granted. We engaged in a qualitative investigation of US public…

"What Exactly Is Parliament?": Finding the Place of Substantive Knowledge in History

ERIC Educational Resources Information Center

Palek, Dominik

2015-01-01

The relationship between knowledge and literacy is a central concern for all teachers. In his teaching, Palek noted that his students were struggling to understand complex substantive concepts such as "parliament" and decided to explore the relationship between students' understanding of a concept and their wider substantive knowledge…

Assisted suicide in the care of mentally ill patients: the Lucio Magri's case.

PubMed

Frati, Paola; Gulino, Matteo; Mancarella, Paola; Cecchi, Rossana; Ferracuti, Stefano

2014-01-01

A year after Mario Monicelli's suicide, the death of another famous person in Italy, Lucio Magri, reawakened the Italian debate on social, ethical and juridical issues in end-of-life decisions. Unlike Monicelli, Lucio Magri decided to end his own life in Switzerland with the help of a physician because his mental illness rendered his life unbearable. Both Monicelli and Magri suffered from a severe depression. The authors analyze the ethical issues regarding the right to die for mentally ill patients and neurological disabled patients, discussing the decision-making autonomy in persons suffering from severe depression. The role of the psychiatry in the management of end-of-life decision requests is considered along with pros and cons of suicide prevention and rationale suicide. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

How the powerful decide: access to research participation by those at the margins.

PubMed

McDonald, Katherine E; Keys, Christopher B

2008-09-01

How do those in power decide to include and exclude those at the margins from community life? We used simulated review of research vignettes to examine how researchers and members of Institutional Review Boards make decisions concerning the research participation of adults with and without intellectual disabilities. Results indicate that decision-makers are influenced by the disability status of the sample, characteristics of the research in which they are engaged, and their attitudes toward the research participation of adults with intellectual disabilities as well as their own relationship to the research process. For example, decision-makers may create situations that limit the self-determination of adults with intellectual disabilities and adults without disabilities within the research context, particularly when the research poses some risk of harm to participants. Implications for theory, action and research are explored.

Leveraging Campus Network Capabilities at the Desktop: Helping Users Get Real Work Done or How Windows Sockets & MacTCP Changed My Life.

ERIC Educational Resources Information Center

Ezekiel, Aaron B.

At the University of New Mexico, stakeholders from the Computer and Information Resources and Technology (CIRT) department, Financial Systems, the Health Sciences Center, and the General Libraries, were involved in deciding on the goals of a project to replace Telnet with a suite of network middleware and productivity software on campus computer…

JPRS Report, Soviet Union, International Affairs

DTIC Science & Technology

1988-10-04

ignate-elect in perpetuity. Democratic procedure in elec- tions and everyday life, openness and glasnost—those are the essence of public movements...a high enough level of civic awareness to elect for themselves worthy chairmen without directives from the outside. That is the essence of popular...neighbor cooperation within the framework of the continent: Deciding questions about the essence and form of choosing the social path is the sovereign

La Gocciolina (The Little Drop of Water).

ERIC Educational Resources Information Center

Palandra, Maria

This primary level reader in Italian intended for use in a bilingual education setting, is about the life cycle of a drop of water. The drop of water is personified and the story tells of its adventures as it travels from the top of the lake to the bottom, its meeting with the inhabitants of the lake, and its trip to the clouds. After deciding not…

Building "Bob": A Project Exploring the Human Body at Western Illinois University Preschool Center

ERIC Educational Resources Information Center

Brouette, Scott

2008-01-01

When the children at Western Illinois University Preschool Center embarked on a study of human bodies, they decided to build a life-size model of a body, organ by organ from the inside out, to represent some of the things they were learning. This article describes the building of "Bob," the human body model, highlighting the children's…

The Case of the Ivory-Billed Woodpecker: The Scientific Process and How It Relates to Everyday Life

ERIC Educational Resources Information Center

Stanger-Hall, Kathrin; Merriam, Jennifer; Greuling, Ruth Ann

2007-01-01

In this case study, based on the reported rediscovery of the Ivory-billed Woodpecker in April 2005, students examine a real-world example of the scientific process and explore the practical implications of their conclusions. The case tells the story of Brad Murky, a student and research assistant who must decide whether the available evidence is…

Career Cruiser: A Career and Education Planning Guide

ERIC Educational Resources Information Center

Florida Department of Education, 2015

2015-01-01

Life is a journey filled with many twists and turns. While the journey can be exciting, it is a good idea to know where you are going so you can decide how to get there. Career development is all about getting the knowledge and skills you need to make more informed career decisions. Right now is an excellent time to develop skills that will help…

The Importance of Quantification: Philip M. Davis--Albert R. Mann Library, Cornell University

ERIC Educational Resources Information Center

Library Journal, 2004

2004-01-01

As a college student, Phil Davis intended to become a scientist. But as he studied population genetics of a family of mosses, monitoring his experiments daily, he wondered, "Is this really how I want to spend my life?" After taking time off to read philosophy and bike his way around France, his answer was, "No." Instead, he decided to advance the…

JPRS Report, East Europe.

DTIC Science & Technology

1990-02-23

can’t tell you that. Albania indeed [Lekka I] Everything depends on the Albanian nation, remains isolated for foreigners, but Albanians can get in My...utive committee elects the organizational secretariat to accorded these rights remain members of the basic manage routine work and the party apparatus...norms of party life . It decides on the removal of party plenipotentiary meeting or conference of delegates. It members in matters of membership

The evolution of life cycle complexity in aphids: Ecological optimization or historical constraint?

PubMed

Hardy, Nate B; Peterson, Daniel A; von Dohlen, Carol D

2015-06-01

For decades, biologists have debated why many parasites have obligate multihost life cycles. Here, we use comparative phylogenetic analyses of aphids to evaluate the roles of ecological optimization and historical constraint in the evolution of life cycle complexity. If life cycle complexity is adaptive, it should be evolutionarily labile, that is, change in response to selection. We provide evidence that this is true in some aphids (aphidines), but not others (nonaphidines)-groups that differ in the intensity of their relationships with primary hosts. Next, we test specific mechanisms by which life cycle complexity could be adaptive or a constraint. We find that among aphidines there is a strong association between complex life cycles and polyphagy but only a weak correlation between life cycle complexity and reproductive mode. In contrast, among nonaphidines the relationship between life cycle complexity and host breadth is weak but the association between complex life cycles and sexual reproduction is strong. Thus, although the adaptiveness of life cycle complexity appears to be lineage specific, across aphids, life cycle evolution appears to be tightly linked with the evolution of other important natural history traits. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

From genes to landscapes: conserving biodiversity at multiple scales.

Treesearch

Sally Duncan

2000-01-01

Biodiversity has at last become a familiar term outside of scientific circles. Ways of measuring it and mapping it are advancing and becoming more complex, but ways of deciding how to conserve it remain mixed at best, and the resources available to manage dimishing biodiversity are themselves scarce. One significant problem is that policy decisions are frequently at...

The BCR signalosome: where cell fate is decided.

PubMed

Ulivieri, C; Baldari, C T

2005-01-01

B cell antigen receptor (BCR) engagement results in the assembly of a multimolecular complex at the cytosolic side of the plasma membrane, known as signalosome. Here we briefly review the current knowledge on the molecules which participate in the BCR signalosome and on the response modulators which control the final signal output by enhancing or dampening BCR signaling.

Attitudes towards Saving in Polish Society during Transformation

ERIC Educational Resources Information Center

Roszkiewicz, Malgorzata

2006-01-01

Since 1999 the complex reform of the old-age pension system was introduced in Poland and the process of changes is still ongoing. The multi-pillar system replaced the pay-as-you-go system. Voluntary third pillar will guarantee higher pensions for those that decide to save more. However, the systemic changes were placed in the new market economy…

Points of View: A Survey of Survey Courses--Are They Effective? Argument Favoring a Survey as the First Course for Majors

ERIC Educational Resources Information Center

Ledbetter, Mary Lee; Campbell, A. Malcolm

2005-01-01

Reasonable people disagree about how to introduce undergraduate students to the marvels and complexities of the biological sciences. With intrinsically varied subdisciplines within biology, exponentially growing bases of information, and new unifying theories rising regularly, introduction to the curriculum is a challenge. Some decide to focus…

Eye-Tracking Study on Facial Emotion Recognition Tasks in Individuals with High-Functioning Autism Spectrum Disorders

ERIC Educational Resources Information Center

Tsang, Vicky

2018-01-01

The eye-tracking experiment was carried out to assess fixation duration and scan paths that individuals with and without high-functioning autism spectrum disorders employed when identifying simple and complex emotions. Participants viewed human photos of facial expressions and decided on the identification of emotion, the negative-positive emotion…

Rational suicide among patients who are terminally ill.

PubMed

Valente, S M; Trainor, D

1998-08-01

Patients' end-of-life decisions challenge nurses. Often, aggressive, life prolonging strategies create ethical dilemmas for nurses when patients decide to stop treatment. In Oregon, assisted suicide is legal and will have a profound effect on nursing practice. When a patient considers suicide, nurses need to examine the patient's mental health, symptom management, and rational decision-making ability. Evaluation of suicide risk is a priority. Nurses need to recognize that medical land psychological symptoms often trigger thoughts of suicide, but prompt treatment of pain and symptoms also reduces suicide risk. Ethical issues and guidelines for management of patients considering suicide and evaluation of rationality are presented.

An Extravagant Gift From a Grateful Patient.

PubMed

Sharma, Akshay; Johnson, Liza-Marie; Caruso Brown, Amy; Unguru, Yoram; Lantos, John D

2018-06-01

media-1vid110.1542/5787668327001PEDS-VA_2017-2837 Video Abstract Gift giving is psychologically and culturally complex. In any context, a gift can have multiple meanings. In the context of the doctor-patient relationship, the giving of gifts and decisions about whether to accept gifts raise complex ethical issues. In this essay, a number of pediatric oncologists discuss the ethical considerations that should guide physicians as they decide how to respond to an extravagant gift from a family. Copyright © 2018 by the American Academy of Pediatrics.

Change in Cardiopulmonary Arrest Response in an Anesthesiology Residency: A practice-based learning initiative.

PubMed

Takla, Amgad; Dorotta, Ihab; Staszak, John; Tetzlaff, John E

2007-01-01

Because of increases in the acuity in our patient population, increasing complexity of the care provided and the structure of our residency, we decided to systematically alter our participation in the hospital-wide cardiac arrest system. The need to provide optimum service in an increasingly complex clinical care system was the motivation for change. With substantive input from trainees and practitioners, we created a multi-tier-system of response along with predefined criteria for the anesthesiology response. We report the result of our practice based learning initiative.

Study protocol for 'we DECide': implementation of advance care planning for nursing home residents with dementia.

PubMed

Ampe, Sophie; Sevenants, Aline; Coppens, Evelien; Spruytte, Nele; Smets, Tinne; Declercq, Anja; van Audenhove, Chantal

2015-05-01

To evaluate the effects of 'we DECide', an educational intervention for nursing home staff on shared decision-making in the context of advance care planning for residents with dementia. Advance care planning (preparing care choices for when persons no longer have decision-making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision-making (the involvement of persons and their families in care and treatment decisions). This quasi-experimental pre-test-post-test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff. 'We DECide' focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The 'ACP-audit' assesses participants' views on the organization of advance care planning (organizational level), the 'OPTION scale' evaluates the degree of shared decision-making in individual conversations (clinical level) and the 'IFC-SDM Questionnaire' assesses participants' views on Importance, Frequency and Competence of realizing shared decision-making (clinical level). (Project funded: July 2010). The study hypothesis is that 'we DECide' results in a higher realization of shared decision-making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end-of-life care and more person-centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy-makers. © 2014 John Wiley & Sons Ltd.

Celebrity Appeal: Reaching Women to Promote Colorectal Cancer Screening

PubMed Central

Cooper, Crystale Purvis; Gelb, Cynthia A.; Lobb, Kathleen

2015-01-01

The Centers for Disease Control and Prevention’s Screen for Life: National Colorectal Cancer Action Campaign works with the Entertainment Industry Foundation’s National Colorectal Cancer Research Alliance to develop public service announcements (PSAs) featuring celebrities. Selection of Screen for Life celebrity spokespersons is based on a variety of factors, including their general appeal and personal connection to colorectal cancer. Screen for Life PSAs featuring celebrities have been disseminated exclusively through donated media placements and have been formatted for television, radio, print, and out-of-home displays such as dioramas in airports, other transit stations, and shopping malls. A 2012 national survey with women aged 50–75 years (n = 772) investigated reported exposure to Screen for Life PSAs featuring actor Terrence Howard. In total, 8.3% of women recalled exposure to the PSAs. Celebrity spokespersons can attract the attention of both target audiences and media gatekeepers who decide which PSAs will receive donated placements. PMID:25521047

Effect of the Contents in Advance Directives on Individuals' Decision-Making.

PubMed

Park, Jae Yoon; Lim, Chi-Yeon; Puurveen, Gloria; Kim, Do Yeun; Lee, Jae Hang; Do, Han Ho; Kim, Kyung Soo; Yoo, Kyung Don; Kim, Hyo Jin; Kim, Yunmi; Shin, Sung Joon

2018-01-01

Completing an advance directive offers individuals the opportunity to make informed choices about end-of-life care. However, these decisions could be influenced in different ways depending on how the information is presented. We randomly presented 185 participants with four distinct types of advance directive: neutrally framed (as reference), negatively framed, religiously framed, and a combination. Participants were asked which interventions they would like to receive at the end of life. Between 60% and 70% of participants responded "accept the special interventions" on the reference form. However, the majority (70%-90%) chose "refuse the interventions" on the negative form. With respect to the religious form, 70% to 80% chose "not decided yet." Participants who refused special life-sustaining treatments were older, female, and with better prior knowledge about advance directives. Our findings imply that the specific content of advance directives could affect decision-making with regard to various interventions for end-of-life care.

Celebrity appeal: reaching women to promote colorectal cancer screening.

PubMed

Cooper, Crystale Purvis; Gelb, Cynthia A; Lobb, Kathleen

2015-03-01

The Centers for Disease Control and Prevention's Screen for Life: National Colorectal Cancer Action Campaign works with the Entertainment Industry Foundation's National Colorectal Cancer Research Alliance to develop public service announcements (PSAs) featuring celebrities. Selection of Screen for Life celebrity spokespersons is based on a variety of factors, including their general appeal and personal connection to colorectal cancer. Screen for Life PSAs featuring celebrities have been disseminated exclusively through donated media placements and have been formatted for television, radio, print, and out-of-home displays such as dioramas in airports, other transit stations, and shopping malls. A 2012 national survey with women aged 50-75 years (n=772) investigated reported exposure to Screen for Life PSAs featuring actor Terrence Howard. In total, 8.3% of women recalled exposure to the PSAs. Celebrity spokespersons can attract the attention of both target audiences and media gatekeepers who decide which PSAs will receive donated placements.

[Bioethics of protection and the laic compassion: the moral debate on euthanasia].

PubMed

Siqueira-Batista, Rodrigo; Schramm, Fermin Roland

2009-01-01

The bioethical debate on euthanasia (good death) has been classically polarized between the principles of sacredness of life--the argumentation against--and the quality of life, represented by the vicarious principle of respect for autonomy--the argumentation in favor. In both cases the question is built around the pertinence and moral legitimacy--or not--of the individual possibility to decide about the termination of ones own existence, demanding for oneself a good death. Undoubtedly, euthanasia always implies besides the self, the other, who will either carry out the action--or hold to non-action--culminating in the abbreviation of life. To propose a discussion about this last referred issue, based on the bioethics of protection theoretical references and the concept of laic compassion is the scope of the present essay.

Availability analysis of mechanical systems with condition-based maintenance using semi-Markov and evaluation of optimal condition monitoring interval

NASA Astrophysics Data System (ADS)

Kumar, Girish; Jain, Vipul; Gandhi, O. P.

2018-03-01

Maintenance helps to extend equipment life by improving its condition and avoiding catastrophic failures. Appropriate model or mechanism is, thus, needed to quantify system availability vis-a-vis a given maintenance strategy, which will assist in decision-making for optimal utilization of maintenance resources. This paper deals with semi-Markov process (SMP) modeling for steady state availability analysis of mechanical systems that follow condition-based maintenance (CBM) and evaluation of optimal condition monitoring interval. The developed SMP model is solved using two-stage analytical approach for steady-state availability analysis of the system. Also, CBM interval is decided for maximizing system availability using Genetic Algorithm approach. The main contribution of the paper is in the form of a predictive tool for system availability that will help in deciding the optimum CBM policy. The proposed methodology is demonstrated for a centrifugal pump.

Life begins at 40

DOE Office of Scientific and Technical Information (OSTI.GOV)

Neal, L.

1995-12-31

A new rule makes nuclear power plant license renewal a viable option. A small group of corporate executives will soon face one of the toughest decisions of their careers-a decision that will affect 17 million American homes. Forty-five commercial nuclear power plants will reach the end of their operating licenses early in the next century. They represent billions of dollars in capital investment, and the companies that own them must decide whether to keep them on the grid or scrap them. But before a company decides whether to pull the plug on a big generating plant, it will have tomore » do some homework. Company executives will have to roll up their sleeves and dig deep into projections of electricity demand, assessments of generating options and cold, hard economics. At the same time, they must keep wary eyes on the political landscape, scanning ahead for roadblocks and quicksand.« less

Using a new analysis of the best interests standard to address cultural disputes: whose data, which values?

PubMed

Kopelman, Loretta M; Kopelman, Arthur E

2007-01-01

Clinicians sometimes disagree about how much to honor surrogates' deeply held cultural values or traditions when they differ from those of the host country. Such a controversy arose when parents requested a cultural accommodation to let their infant die by withdrawing life saving care. While both the parents and clinicians claimed to be using the Best Interests Standard to decide what to do, they were at an impasse. This standard is analyzed into three necessary and jointly sufficient conditions and used to resolve the question of how much to accommodate cultural preferences and how to treat this infant. The extreme versions of absolutism and relativism are rejected. Properly understood, the Best Interests Standard can serve as a powerful tool in settling disputes about how to make good decisions for those who cannot decide for themselves.

Russian Energy Policy vis-a-vis Europe: Natural Resources as a Means of Foreign Policy

DTIC Science & Technology

2012-06-01

that lag. For instance, after the March 2011 Fukushima disaster , German political leadership decided...memories for the rest of my life. xii THIS PAGE INTENTIONALLY LEFT BLANK 1 I. INTRODUCTION A. BACKGROUND After the resignation of Boris Yeltsin...the first president of the Russian Federation after the dissolution of the USSR, on December 31, 1999, and de facto appointment of his successor

Getting and Keeping Students' Brains Energized and Eager

ERIC Educational Resources Information Center

Stormon-Flynn, Mary

2011-01-01

A brain has the capacity to absorb a great deal of information and can make decisions about what role or roles, major or minor, that data will play in its life. While it is most likely true that we learn one new thing every day, our brain, the controller of our thoughts, can decide what number of new things we can learn and remember each day. As I…

Expectations About Civilian Labor Markets and Army Officer Retention

DTIC Science & Technology

2011-01-01

when-50-year-olds-decide Kotler , Philip , Ned Roberto, and Nancy Lee, Social Marketing: Improving the Quality of Life, Thousand Oaks, Calif.: Sage...three relevant channels, or methods, to disseminate information to officers (Weinreich, 1999; Kotler , Roberto, and Lee, 2002): 3 Social marketing...is “the use of marketing principles and techniques to influence a target audience to voluntarily . . . modify . . . behavior” ( Kotler , Roberto, and

School-based nutrition education: lessons learned and new perspectives.

PubMed

Pérez-Rodrigo , C; Aranceta , J

2001-02-01

Nutrition is a major environmental influence on physical and mental growth and development in early life. Food habits during infancy can influence preferences and practices in later life and some evidence suggests fair to moderate tracking of food habits from childhood to adolescence. Studies support that good nutrition contributes to improving the wellbeing of children and their potential learning ability, thus contributing to better school performance. Children and young people who learn healthy eating habits, are encouraged to be physically active, to avoid smoking and to learn to manage stress, have the potential for reduced impact of chronic diseases in adulthood. Nutrition education is a key element to promoting lifelong healthy eating and exercise behaviours and should start from the early stages of life; it should also address the specific nutritional needs associated with pregnancy, including reinforcing breastfeeding. Food habits are complex in nature and multiple conditioning factors interact in their development. Young children do not choose what they eat, but their parents decide and prepare the food for them. During infancy and early childhood the family is a key environment for children to learn and develop food preferences and eating habits. As they grow and start school, teachers, peers and other people at school, together with the media and social leaders, become more important. Progressively children become more independent and start making their own food choices. The peer group is very important for adolescents and has a major influence in developing both food habits and lifestyles. Community trials suggest that nutrition education is an accessible effective tool in health promotion programmes with a focus on the development of healthy eating practices.

Smallpox still haunts scientists: results of a questionnaire-based inquiry on the views of health care and life science experts and students on preserving the remaining variola virus stocks.

PubMed

Srinivasan, Thangavelu; Dedeepiya, Vidyasagar Devaprasad; John, Sudhakar; Senthilkumar, Rajappa; Reena, Helen C; Rajendran, Paramasivam; Balamurugan, Madasamy; Kurosawa, Gene; Iwasaki, Masaru; Preethy, Senthilkumar; Abraham, Samuel J K

2013-01-01

The World Health Organization (WHO) declared eradication of the dreadful disease "smallpox" in 1980. Though the disease has died down, the causative virus "variola" has not, as it has been well preserved in two high security laboratories-one in USA and another in Russia. The debate on whether the remaining stocks of the smallpox virus should be destroyed or not is ongoing, and the World Health Assembly (WHA) in 2011 has decided to postpone the review on this debate to the 67th WHA in 2014. A short questionnaire-based inquiry was organized during a one-day stem cell meeting to explore the views of various health care and life science specialists especially students on this aspect. Among the 200 participants of the meeting, only 66 had answered the questionnaire. 60.6% of participants who responded to the questionnaire were for preserving the virus for future reference, while 36.4% of the participants were for destroying the virus considering the magnitude with which it killed millions. However, 3% of the respondents were not able to decide on any verdict. Therefore, this inquiry expresses the view that "what we cannot create, we do not have the right to destroy."

From Molecules to Life: Quantifying the Complexity of Chemical and Biological Systems in the Universe.

PubMed

Böttcher, Thomas

2018-01-01

Life is a complex phenomenon and much research has been devoted to both understanding its origins from prebiotic chemistry and discovering life beyond Earth. Yet, it has remained elusive how to quantify this complexity and how to compare chemical and biological units on one common scale. Here, a mathematical description of molecular complexity was applied allowing to quantitatively assess complexity of chemical structures. This in combination with the orthogonal measure of information complexity resulted in a two-dimensional complexity space ranging over the entire spectrum from molecules to organisms. Entities with a certain level of information complexity directly require a functionally complex mechanism for their production or replication and are hence indicative for life-like systems. In order to describe entities combining molecular and information complexity, the term biogenic unit was introduced. Exemplified biogenic unit complexities were calculated for ribozymes, protein enzymes, multimeric protein complexes, and even an entire virus particle. Complexities of prokaryotic and eukaryotic cells, as well as multicellular organisms, were estimated. Thereby distinct evolutionary stages in complexity space were identified. The here developed approach to compare the complexity of biogenic units allows for the first time to address the gradual characteristics of prebiotic and life-like systems without the need for a definition of life. This operational concept may guide our search for life in the Universe, and it may direct the investigations of prebiotic trajectories that lead towards the evolution of complexity at the origins of life.

A Life Worth Giving? The Threshold for Permissible Withdrawal of Life Support From Disabled Newborn Infants

PubMed Central

Wilkinson, Dominic James

2011-01-01

When is it permissible to allow a newborn infant to die on the basis of their future quality of life? The prevailing official view is that treatment may be withdrawn only if the burdens in an infant's future life outweigh the benefits. In this paper I outline and defend an alternative view. On the Threshold View, treatment may be withdrawn from infants if their future well-being is below a threshold that is close to, but above the zero-point of well-being. I present four arguments in favor of the Threshold View, and identify and respond to several counterarguments. I conclude that it is justifiable in some circumstances for parents and doctors to decide to allow an infant to die even though the infant's life would be worth living. The Threshold View provides a justification for treatment decisions that is more consistent, more robust, and potentially more practical than the standard view. PMID:21337273

Johannes Heinrich Schultz and National Socialism.

PubMed

Brunner, Jürgen; Schrempf, Matthias; Steger, Florian

2008-01-01

Johannes Heinrich Schultz (1884-1970) established the set of techniques known as "autogenic training." From 1936 until 1945 he worked as assistant director of the Göring Institute. His role during National Socialism has been underestimated in our opinion. We considered Schultz's academic publications and his "autobiography" from 1964. Schultz publicly advocated compulsory sterilization as well as the "annihilation of life unworthy of life" and developed a diagnostic scheme which distinguished between the neurotic/curable and the hereditary/ incurable. In fact, this classification was then employed to decide between life and death. In order to justify the "New German Psychotherapy" alongside eugenic psychiatry, Schultz carried out degrading and inhuman "treatments" of homosexual prisoners of concentration camps who were in mortal danger. This study was based on written documents. We were not able to interview contemporary witnesses. By advocating compulsory sterilization and the "annihilation of life unworthy of life" and by the abuse of homosexuals as research objects Schultz violated fundamental ethical principles of psychiatry.

Withholding and withdrawing of life support from patients with severe head injury.

PubMed

O'Callahan, J G; Fink, C; Pitts, L H; Luce, J M

1995-09-01

To characterize the withholding or withdrawing of life support from patients with severe head injury. San Francisco General Hospital, a city and county hospital with a Level I trauma center. A standardized questionnaire was used to collect data on demographics and functional outcome of severely head-injured (Glasgow Coma Score of < or = 7) patients admitted to the medical-surgical intensive care unit, and to interview the patients' physician and family members. Forty-seven patients who were admitted to a medical-surgical intensive care unit over a 1-yr period. Twenty-four patients had life support withheld or withdrawn, and 23 patients did not. Physician and family separately assessed patient's probable functional outcome, degree of communication between them, reasons important in recommending or deciding on discontinuation of life support, and the result of action taken. Six months later, the families reviewed the process of their decision, how well physician(s) had communicated, and what might have improved communication. Of 24 patients with life support discontinued, 22 died; two were discharged from the hospital. Twenty-three of the 24 patients had a poor prognosis on admission. Of the 23 patients who were continued on life support for the duration of their hospitalization, ten had a poor (p < .001) prognosis on admission. Prognosis improved for two patients from the first group and five from the latter. Family's assessment of prognosis agreed with physician's assessment in 22 of the 24 patients from whom life support was discontinued (p < .001). Physicians' ability to convey the prognosis appeared to influence families' assessments. Physicians' considerations in recommending limitation of care and families' considerations in making decisions were the same, primarily an inevitably poor prognosis. Neither physician nor families cited cost or availability of care as a deciding factor. Two families disagreed with the recommendation to limit care after initial agreement because the patients' prognosis improved from "likely death" to "vegetative." Care was therefore continued, and both patients remained vegetative 6 months after admission to the hospital and discharge to chronic care facilities. Life support is commonly withheld or withdrawn from patients with severe head injury at San Francisco General Hospital, and usually it is accompanied by death. A reciprocal consideration exists in most cases between the physician and family making the difficult decision to limit care. Care is provided for patients whose families request it despite physician recommendations.

Knowing When Help Is Needed: A Developing Sense of Causal Complexity

ERIC Educational Resources Information Center

Kominsky, Jonathan F.; Zamm, Anna P.; Keil, Frank C.

2018-01-01

Research on the division of cognitive labor has found that adults and children as young as age 5 are able to find appropriate experts for different causal systems. However, little work has explored how children and adults decide when to seek out expert knowledge in the first place. We propose that children and adults rely (in part) on…

Deciding to Have a Cochlear Implant and Subsequent After-Care: Parental Perspectives

ERIC Educational Resources Information Center

Archbold, Sue; Sach, Tracey; O/Neill, Ciaran; Lutman, Mark; Gregory, Susan

2006-01-01

Cochlear implantation provides a means of hearing to profoundly deaf children. As it is an elective procedure, parents must make the decision to proceed with this option if their child is suitable. The processes involved are complex and stressful, involving hope and expectation on the one hand, and doubts and caution on the other. This study…

The Evolving Role of the Courts in Educational Policy: The Tension between Judicial, Scientific, and Democratic Decision Making in "Kitzmiller v. Dover"

ERIC Educational Resources Information Center

Superfine, Benjamin Michael

2009-01-01

In "Kitzmiller v. Dover" (2005), a court defined science to decide the legitimacy of teaching intelligent design to high school biology students. This study analyzes "Kitzmiller" in light of the complex and interrelated tensions between judicial, scientific, and democratic decision making that lie at the heart of modern…

A Case of Inconsistent Equatings: How the Man with Four Watches Decides What Time It Is

ERIC Educational Resources Information Center

Livingston, Samuel A.; Antal, Judit

2010-01-01

A simultaneous equating of four new test forms to each other and to one previous form was accomplished through a complex design incorporating seven separate equating links. Each new form was linked to the reference form by four different paths, and each path produced a different score conversion. The procedure used to resolve these inconsistencies…

The Social Progress Index in International Business Site Selection: Three Case Studies

ERIC Educational Resources Information Center

Pate, Sandra K.

2016-01-01

International businesses face a difficult task when trying to decide where to place or expand a business that could be located anywhere in the world. Each country is a complex system of human capabilities, technical systems, [infrastructure bases, laws, cultures and economic systems. How can a company know which country is best for it today, and…

Measurement of Quality of Life VI. Quality-Adjusted Life Years (QALY) is an Unfortunate Use of the Quality-of-Life Concept

PubMed Central

Ventegodt, Soren; Merrick, Joav; Andersen, Niels Jorgen

2003-01-01

The QALY (quality-adjusted life years) attempts to incorporate the dimension of quality of life into the evaluation by adjusting life years by a quality factor. In practice, this is based on discussing with people the progression of a number of hypothetical illnesses and their ensuing side effects. From this information, the person assesses how each state of health described compares with a theoretical maximum state of health. For example, 1 day with a certain condition might the equivalent of living only 0.5 days in good health.We believe that QALY value only represents a superficial impression of a person's quality of life. In short, the QALY does not express what it means for a person to live a life at reduced quality. We believe that if the patients were optimally informed and allowed to decide for themselves, they would more often reject high-tech expensive biomedical treatments that only serve to prolong life and do not increase its quality. The problem of priorities may then turn out to be far more simple and also more ethical: the focus will be on the quality of life, not on QALY, and the question of the meaning of life and death will achieve greater openness and respect. PMID:14570991

STT Doubles with Large δM - Part VI: Cygnus Multiples

NASA Astrophysics Data System (ADS)

Knapp, Wilfried; Nanson, John

2016-10-01

The results of visual double star observing sessions suggested a pattern for STT doubles with large delta_M of being harder to resolve than would be expected based on the WDS catalog data. It was felt this might be a problem with expectations on one hand, and on the other might be an indication of a need for new precise measurements, so we decided to take a closer look at a selected sample of STT doubles and do some research. Of these objects we found three rather complex multiples in Cygnus of special interest so we decided to write a separate report to have more room to include the non STT components as well. Again like for the other objects covered so far several of the components show parameters quite different from the current WDS data.

Quantum Clique Gossiping.

PubMed

Li, Bo; Li, Shuang; Wu, Junfeng; Qi, Hongsheng

2018-02-09

This paper establishes a framework of quantum clique gossiping by introducing local clique operations to networks of interconnected qubits. Cliques are local structures in complex networks being complete subgraphs, which can be used to accelerate classical gossip algorithms. Based on cyclic permutations, clique gossiping leads to collective multi-party qubit interactions. We show that at reduced states, these cliques have the same acceleration effects as their roles in accelerating classical gossip algorithms. For randomized selection of cliques, such improved rate of convergence is precisely characterized. On the other hand, the rate of convergence at the coherent states of the overall quantum network is proven to be decided by the spectrum of a mean-square error evolution matrix. Remarkably, the use of larger quantum cliques does not necessarily increase the speed of the network density aggregation, suggesting quantum network dynamics is not entirely decided by its classical topology.

A Strong Fighting Force Is a Diverse Fighting Force

DTIC Science & Technology

2015-01-01

and store managers were all white. It would not be until much later in life that I understood the impact those images had on my self - esteem . As I...longer permissible . Following that decision, the Prince Edward County School District decided to withhold funding from all county public schools...used car lot to buy a car, the doctors, sales- men, lawyers, pilots, military officers (my father was enlisted in the Army), police, firefighters

Interacting Brain Modules for Memory: An Adaptive Representations Architecture

DTIC Science & Technology

2008-06-01

term intention goal is to satisfy hunger . This decision will be passed back to the prefrontal cortex and forwarded to more motor planning areas...continues until the first action of the sequence is decided upon, perhaps rising from a chair. The medium term goal of hunger satiation remains. The... Neuropsychology , 20, 451-486. Smith, L., & Gasser, M. (2005). The development of embodied cognition: Six lessons from babies. Artificial Life, 11, 13

When to resume sports after infectious mononucleosis. How soon is safe?

PubMed

Haines, J D

1987-01-01

Numerous factors must be taken into account in deciding when to allow an athlete to return to sports activities after having infectious mononucleosis. Factors such as length of illness, splenic size, and proper use of diagnostic testing have considerable bearing on this important decision. Splenic rupture is a potentially life-threatening complication of infectious mononucleosis, so extreme exercise and alcohol consumption should be avoided for a month after this infection.

Fitness and Individuality in Complex Life Cycles.

PubMed

Herron, Matthew D

2016-12-01

Complex life cycles are common in the eukaryotic world, and they complicate the question of how to define individuality. Using a bottom-up, gene-centric approach, I consider the concept of fitness in the context of complex life cycles. I analyze the fitness effects of an allele (or a trait) on different biological units within a complex life history and how these effects drive evolutionary change within populations. Based on these effects, I attempt to construct a concept of fitness that accurately predicts evolutionary change in the context of complex life cycles.

The evolution of complex life.

PubMed

Billingham, J

1989-01-01

In considering the probabilities that intelligent life might exist elsewhere in the Universe, it is important to ask questions about the factors governing the emergence of complex living organisms in the context of evolutionary biology, planetary environments and events in space. Two important problems arise. First, what can be learned about the general laws governing the evolution of complex life anywhere in space by studying its history on the Earth? Second, how is the evolution of complex life affected by events in space? To address these problems, a series of Science Workshops on the Evolution of Complex Life was held at the Ames Research Center. Included in this paper are highlights of those workshops, with particular emphasis on the first question, namely the evolution of complex extraterrestrial life.

Proper care for the dying: a critical public issue.

PubMed Central

Crispell, K R; Gomez, C F

1987-01-01

The ability of the medical profession to sustain life, or more appropriately, to prolong dying, in patients with terminal illness, creates a most complex and controversial situation for all involved: the patient, if mentally alert; the patient's family; and the medical care team including physicians, nurses and attendants. This situation is especially complex in large acute care hospitals where medical and nursing students, residents and house officers receive advanced medical training. A major problem, prolonging the dying of the terminally ill, with its medical, legal, ethical and economic complexities now confronts American society. The problem is particularly acute in teaching hospitals, in which one finds a disproportionate number of terminally ill patients. The ability to work at these questions as a community rather than as adversaries will determine much about the ability of the health care system to respect the dignity and autonomy of those who seek aid and comfort when faced with serious illness and impending death. Better communication between the physicians, health care providers, the lawyers and ethicists must be developed in order to solve these problems. Over the next ten years society and our elected representatives will be making very demanding decisions about the use of the health dollar. One possible way to prevent increasing costs is to reach significant agreement on the proper care of the dying. Proper care for the dying is being considered, discussed, and evaluated by very thoughtful people. It is not governments which should decide who is to live or who is to die. There is the serious problem of the 'slippery slope' to euthanasia by omission if cost containment becomes the major force in formulating policy on the proper care of the dying. PMID:3612698

The formation, elements of success, and challenges in managing a critical care program: part II.

PubMed

St Andre, Arthur

2015-05-01

Leaders of critical care services require knowledge and skills not typically acquired during their medical education and training. Leaders possess personality characteristics and evolve and adopt behaviors and knowledge in addition to those useful in the care of patients and rounding with an ICU team. Successful leaders have impeccable integrity, possess a service mentality, are decisive, and speak the truth consistently and accurately. Effective leaders are thoughtful listeners, introspective, develop a range of relationships, and nurture others. They understand group psychology, observe, analyze assumptions, decide, and improve the system of care and the performance of their team members. A leader learns to facilely adapt to circumstance, generate new ideas, and be a catalyst of change. Those most successful further their education as a leader and learn when and where to seek mentorship. Leaders understand their organization and its operational complexities. Leaders learn to participate and knowledgeably contribute to the fiscal aspects of income, expense, budget, and contracts from an institutional and department perspective. Clinician compensation must be commensurate with expectations and be written to motivate and make clear duties that are clinical and nonclinical. A leader understands and plans to address the evolving challenges facing healthcare, especially resource constraints, the emotions and requirements of managing the end of life, the complexities of competing demands and motivations, the bureaucracy of healthcare practice, and reimbursement. Responsibilities to manage and evolve must be met with intelligence, sensitivity, and equanimity.

A patient with autism and severe depression: medical and ethical challenges for an adolescent medicine unit.

PubMed

Skinner, S Rachel; Ng, Cindy; McDonald, Ann; Walters, Tamara

2005-10-17

An adolescent with autism and intellectual disability presented with severe depression related to menstruation. Because of the complex medical, psychiatric and ethical issues involved, her care was coordinated by a hospital-based adolescent medicine unit. After trials of other therapies over an extended period and interdisciplinary and intersectoral case conferencing, it was decided that hysterectomy was the most appropriate management. This case highlights the complexity of adolescent health care in a tertiary hospital, the importance of intersectoral cooperation between hospital and community, and the integral role of interdisciplinary care of adolescent patients with chronic conditions.

Intelligibility in microbial complex systems: Wittgenstein and the score of life.

PubMed

Baquero, Fernando; Moya, Andrés

2012-01-01

Knowledge in microbiology is reaching an extreme level of diversification and complexity, which paradoxically results in a strong reduction in the intelligibility of microbial life. In our days, the "score of life" metaphor is more accurate to express the complexity of living systems than the classic "book of life." Music and life can be represented at lower hierarchical levels by music scores and genomic sequences, and such representations have a generational influence in the reproduction of music and life. If music can be considered as a representation of life, such representation remains as unthinkable as life itself. The analysis of scores and genomic sequences might provide mechanistic, phylogenetic, and evolutionary insights into music and life, but not about their real dynamics and nature, which is still maintained unthinkable, as was proposed by Wittgenstein. As complex systems, life or music is composed by thinkable and only showable parts, and a strategy of half-thinking, half-seeing is needed to expand knowledge. Complex models for complex systems, based on experiences on trans-hierarchical integrations, should be developed in order to provide a mixture of legibility and imageability of biological processes, which should lead to higher levels of intelligibility of microbial life.

The President's Physician: An African Play : Emmanuel Babatunde Omobowale, 2004, All Saints' Publishers (Ibadan, 978-978-37727-3-1, 77 pp.).

PubMed

Mayaki, Joseph Ajagunmolu

2017-12-01

This review examines issues relating to biomedical ethics and literature in the African drama The President's Physician by Emmanuel Babatunde Omobowale. The play investigates the psychological dilemma of Doctor Bituki Warunga, a personal physician to General Kalunga Ntibantunganyah who brutally and inhumanely rules Wavaria, a fictional African country. The doctor is faced with deciding to uphold the ethics of his profession versus terminating the tyrant's life to set the nation free. The play aims to help budding medical doctors rightly inculcate the principles of medical ethics-autonomy, beneficence, competence, and power-by providing a fictional platform to investigate difficult issues that can arise in clinical practice. The play highlights Warunga's complex dilemma as he struggles to uphold the Hippocratic Oath and at the same time satisfy his conscience towards his contribution to his country's freedom. This review explores the difficulties in decision-making when professional duties not only clash with personal preferences but also with the well-being of an entire nation. This discussion is done alongside the ethical concept of utilitarianism and also highlights significant literary concepts such as satire, symbolism, intertextuality, utopian aesthetics, and authorial vision as conveyed in the text.

A synthesis of the literature on breaking bad news or truth telling: potential for research in India.

PubMed

Martis, Lawrence; Westhues, Anne

2013-01-01

The high incidence of fatal diseases, inequitable access to health care, and socioeconomic disparities in India generate plentiful clinical bad news including diagnosis of a life-limiting disease, poor prognosis, treatment failure, and impending death. These contexts compel health care professionals to become the messengers of bad news to patients and their families. In global literature on breaking bad news, there is very little about such complex clinical interactions occurring in India or guiding health care providers to do it well. The purpose of this article is to identify the issues for future research that would contribute to the volume, comprehensiveness, and quality of empirical literature on breaking bad news in clinical settings across India. Towards this end, we have synthesized the studies done across the globe on breaking bad news, under four themes: (a) deciding the amount of bad news to deliver; (b) attending to cultural and ethical issues; (c) managing psychological distress; and (d) producing competent messengers of bad news. We believe that robust research is inevitable to build an indigenous knowledge base, enhance communicative competence among health care professionals, and thereby to improve the quality of clinical interactions in India.

A practical approach to risk-benefit estimation in pediatric drug research.

PubMed

Koren, Gideon

2015-02-01

One of the most difficult challenges in pediatric drug research is in exposing children to risk, often without a balanced chance of benefits. While the concept of risk is similar in adult research, the adult patient can decide for himself/herself on an acceptable level of risk, whereas children have to accept the decisions of their guardians. This paper attempts to put the complexities of estimating risk in pediatric drug research into their practical perspective, and to familiarize the reader with the way such processes are conducted in different parts of the world. Although there are regional differences, all authorities typically quantify risks of pediatric research in general, and drug research in particular, in three levels: those experienced in day-to-day life; risks slightly above this 'baseline' risk; and risks substantially above 'baseline risk'. Proportionally, the diligence of the ethics process depends on these levels, as well as on the potential benefits (or lack of) to the child involved in the research. Importantly, risk is context dependent, and a particular intervention may be effective or safe in one setting but not in another, based on local experience, staffing levels, and similar variabilities.

A Synthesis of the Literature on Breaking Bad News or Truth Telling: Potential for Research in India

PubMed Central

Martis, Lawrence; Westhues, Anne

2013-01-01

The high incidence of fatal diseases, inequitable access to health care, and socioeconomic disparities in India generate plentiful clinical bad news including diagnosis of a life-limiting disease, poor prognosis, treatment failure, and impending death. These contexts compel health care professionals to become the messengers of bad news to patients and their families. In global literature on breaking bad news, there is very little about such complex clinical interactions occurring in India or guiding health care providers to do it well. The purpose of this article is to identify the issues for future research that would contribute to the volume, comprehensiveness, and quality of empirical literature on breaking bad news in clinical settings across India. Towards this end, we have synthesized the studies done across the globe on breaking bad news, under four themes: (a) deciding the amount of bad news to deliver; (b) attending to cultural and ethical issues; (c) managing psychological distress; and (d) producing competent messengers of bad news. We believe that robust research is inevitable to build an indigenous knowledge base, enhance communicative competence among health care professionals, and thereby to improve the quality of clinical interactions in India. PMID:23766589

Knowledge Development Generic Framework Concept

DTIC Science & Technology

2008-12-18

requirements. The conceptual model serves as a communication interface among analysts, military staff, and other actors involved [22015] Systems Analysis will...It designates all long- lived basic mechanisms of material and institutional kind, which guarantee the functioning of a complex community . 2.2.3.2...cooperation with users) • Analyze and decide whether it is better to communicate an information object automatically (“document-to-people”) or via human

Tumors Induce Complex DNA Damage in Distant Proliferative Tissues in Vivo | Center for Cancer Research

Cancer.gov

In radiation biology, a bystander effect occurs when cells not directly exposed to ionizing radiation show increased genomic instability and impaired viability due to the release of signaling molecules by the irradiated cells in their vicinity. Christophe Redon, Ph.D., and colleagues in CCR’s Laboratory of Molecular Pharmacology, decided to ask whether a tumor itself could

JPRS Report Soviet Union USA: Economics, Politics, Ideology No 12, December 1987.

DTIC Science & Technology

1988-06-05

legitimate interests; the right of people to decide their own destiny; strict respect for the sover- eignty and territorial integrity of states and the...along with different approaches to human rights , are essentially regarded as the ideological conflicts our the- ory did not extend to bilateral Soviet...88-006 5 July 1988 specific standard of living or way of life, the degree of economic and political human rights or the nature of securing them

Ontology for the Gridded Met Database

DTIC Science & Technology

2007-07-01

several concerned one or other of the following two possibilities: A “crib sheet” interpreted as a cloth sheet used in a baby’s crib or, alternately...brain decided that the math professor was the guy, but as it turned out, they both were—the math professor had made a mid-life career change to artist... bulletproof . If you tell your teenager to take out the garbage and she doesn’t, should you attribute the failure to lack of understanding? With

Smallpox Still Haunts Scientists: Results of a Questionnaire-Based Inquiry on the Views of Health Care and Life Science Experts and Students on Preserving the Remaining Variola Virus Stocks

PubMed Central

Srinivasan, Thangavelu; Dedeepiya, Vidyasagar Devaprasad; John, Sudhakar; Senthilkumar, Rajappa; Reena, Helen C.; Rajendran, Paramasivam; Balamurugan, Madasamy; Kurosawa, Gene; Iwasaki, Masaru; Abraham, Samuel J. K.

2013-01-01

The World Health Organization (WHO) declared eradication of the dreadful disease “smallpox” in 1980. Though the disease has died down, the causative virus “variola” has not, as it has been well preserved in two high security laboratories—one in USA and another in Russia. The debate on whether the remaining stocks of the smallpox virus should be destroyed or not is ongoing, and the World Health Assembly (WHA) in 2011 has decided to postpone the review on this debate to the 67th WHA in 2014. A short questionnaire-based inquiry was organized during a one-day stem cell meeting to explore the views of various health care and life science specialists especially students on this aspect. Among the 200 participants of the meeting, only 66 had answered the questionnaire. 60.6% of participants who responded to the questionnaire were for preserving the virus for future reference, while 36.4% of the participants were for destroying the virus considering the magnitude with which it killed millions. However, 3% of the respondents were not able to decide on any verdict. Therefore, this inquiry expresses the view that “what we cannot create, we do not have the right to destroy.” PMID:23970838

Intelligibility in microbial complex systems: Wittgenstein and the score of life

PubMed Central

Baquero, Fernando; Moya, Andrés

2012-01-01

Knowledge in microbiology is reaching an extreme level of diversification and complexity, which paradoxically results in a strong reduction in the intelligibility of microbial life. In our days, the “score of life” metaphor is more accurate to express the complexity of living systems than the classic “book of life.” Music and life can be represented at lower hierarchical levels by music scores and genomic sequences, and such representations have a generational influence in the reproduction of music and life. If music can be considered as a representation of life, such representation remains as unthinkable as life itself. The analysis of scores and genomic sequences might provide mechanistic, phylogenetic, and evolutionary insights into music and life, but not about their real dynamics and nature, which is still maintained unthinkable, as was proposed by Wittgenstein. As complex systems, life or music is composed by thinkable and only showable parts, and a strategy of half-thinking, half-seeing is needed to expand knowledge. Complex models for complex systems, based on experiences on trans-hierarchical integrations, should be developed in order to provide a mixture of legibility and imageability of biological processes, which should lead to higher levels of intelligibility of microbial life. PMID:22919679

Challenges in implementing an advance care planning programme in long-term care.

PubMed

McGlade, Ciara; Daly, Edel; McCarthy, Joan; Cornally, Nicola; Weathers, Elizabeth; O'Caoimh, Rónán; Molloy, D William

2017-02-01

A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. Research aim: To identify challenges in implementing the 'Let Me Decide' advance care planning programme in long-term-care. This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families. Participants and research context: long-term-care residents in two nursing homes and one community hospital. Ethical considerations: The local research ethics committee granted ethical approval. Following implementation, over 50% of all residents had completed some form of end-of-life care plan. Of the 70 residents who died in the post-implementation period, 14% had no care plan, 10% (with capacity) completed an advance care directive and lacking such capacity, 76% had an end-of-life care plan completed for them by the medical team, following discussions with the resident (if able) and family. The considerable logistical challenge of releasing staff for training triggered development of an e-learning programme to facilitate training. The challenges encountered were largely concerned with preserving resident's autonomy, avoiding harm and suboptimal or crisis decision-making, and ensuring residents were treated fairly through optimisation of finite resources. Although it may be too late for many long-term-care residents to complete their own advance care directive, the ' Let Me Decide' programme includes a feasible and acceptable option for structured end-of-life care planning for residents with variable capacity to complete an advance care directive, involving discussion with the resident (to the extent they were able) and their family. While end-of-life care planning was time-consuming to deliver, nursing staff were willing to overcome this and take ownership of the programme, once the benefits in improved communication and enhanced peace of mind among all parties involved became apparent in practice.

[Edward Blyth (1810-1873). Father of the Indian ornitology].

PubMed

Malec, Grzegorz

2014-01-01

Edward Blyth was born on 23 December 1810. When he was ayoung man he took an interest with the zoology which became his life's passion. As a young naturalist he was a conscientious observer of the nature and a man gifted with a superb memory. Unfortunately his career was not successful in London because of the conflict with the younger of the Gray brothers. Facing the prospect of no employment in The British Museum, Blyth decided to leave England for Calcutta where he was offered a post of a museum curator. The English naturalist spent in India the years from 1841 to 1862. During that time he greatly enriched the zoological collection of the museum and consequently the place had much more visitors. Regarding his private life he got married in 1854 to Elisabeth Mary Turner Hodges. Undoubtedly the next four year were the happiest in Blyth's life. After his wife's death Blyth's health condition deteriorated. The ongoing conflicts he kept having while the first stay in India and constant struggle to improve his financial status made him decide to return to England. Blyth left India in 1862. After coming back to his homeland he continued the naturalistic passions. Nevertheless Blyth was constantly troubled by the financial problems. Also, his health, both mental and physical, systematically deteriorated. Finally the death came on 27 December 1873, in London. Blyth tried in vain to gain the recognition and join the scientific establishment of the 19th century England. Constant lack of satisfactory income and often problems with health prevented the ornithologist to be fully devote to his passion. The aim of this article is to highlight some of the most important and interesting events of Blyth's life. Moreover, another objective is to popularise Blyth and his work since he was one of the greatest naturalists of that time.

How do clinicians practise the principles of beneficence when deciding to allow or deny family presence during resuscitation?

PubMed

Giles, Tracey; de Lacey, Sheryl; Muir-Cochrane, Eimear

2018-03-01

To examine how clinicians practise the principles of beneficence when deciding to allow or deny family presence during resuscitation. Family presence during resuscitation has important benefits for family and is supported by professional bodies and the public. Yet, many clinicians restrict family access to patients during resuscitation, and rationales for decision-making are unclear. Secondary analysis of an existing qualitative data set using deductive category application of content analysis. We analysed 20 interview transcripts from 15 registered nurses, two doctors and three paramedics who had experienced family presence during resuscitation in an Australian hospital. The transcripts were analysed for incidents of beneficent decision-making when allowing or denying family presence during resuscitation. Decision-making around family presence during resuscitation occurred in time poor environments and in the absence of local institutional guidelines. Clinicians appeared to be motivated by doing "what's best" for patients and families when allowing or denying family presence during resuscitation. However, their individual interpretations of "what's best" was subjective and did not always coincide with family preferences or with current evidence that promotes family presence during resuscitation as beneficial. The decision to allow or deny family presence during resuscitation is complex, and often impacted by personal preferences and beliefs, setting norms and tensions between clinicians and consumers. As a result, many families are missing the chance to be with their loved ones at the end of life. The introduction of institutional guidelines and policies would help to establish what safe and effective practice consists of, reduce value-laden decision-making and guide beneficent decision-making. These findings highlight current deficits in decision-making around FPDR and could prompt the introduction of clinical guidelines and policies and in turn promote the equitable provision of safe, effective family-centred care during resuscitation events. © 2017 John Wiley & Sons Ltd.

Use of Erythropoietin-Stimulating Agents (ESA) in Patients With End-Stage Renal Failure Decided to Forego Dialysis: Palliative Perspective.

PubMed

Cheng, Hon Wai Benjamin; Chan, Kwok Ying; Lau, Hoi To; Man, Ching Wah; Cheng, Suk Ching; Lam, Carman

2017-05-01

Normochromic normocytic anemia is a common complication in chronic kidney disease (CKD) and is associated with many adverse clinical consequences. Erythropoiesis-stimulating agents (ESAs) act to replace endogenous erythropoietin for patients with end-stage renal disease having anemia. Today, ESAs remain the main tool for treating anemia associated with CKD. In current practice, the use of ESA is not limited to the patients on renal replacement therapy but has extended to nondialysis patients under palliative care (PC). Current evidence on ESA usage in patients with CKD decided to forego dialysis often have to take reference from studies conducted in other groups of patients with CKD, including pre-dialysis patients and those on renal replacement therapy. There is paucity of studies targeting use of ESAs in renal PC patients. Small-scale retrospective study in renal PC patients had suggested clinical advantage of ESAs in terms of hemoglobin improvement, reduction in fatigue, and hospitalization rate. With the expected growth in elderly patients with CKD decided to forego dialysis and manage conservatively, there remains an urgent need to call for large-scale prospective trial in exploring efficacy of ESAs in this population, targeting on quality of life and symptoms improvement outcome. This article also reviews the mechanism of action, pharmacology, adverse effects, and clinical trial evidence for ESA in patients with CKD under renal PC.

A Comparative Study of Randomized Constraint Solvers for Random-Symbolic Testing

NASA Technical Reports Server (NTRS)

Takaki, Mitsuo; Cavalcanti, Diego; Gheyi, Rohit; Iyoda, Juliano; dAmorim, Marcelo; Prudencio, Ricardo

2009-01-01

The complexity of constraints is a major obstacle for constraint-based software verification. Automatic constraint solvers are fundamentally incomplete: input constraints often build on some undecidable theory or some theory the solver does not support. This paper proposes and evaluates several randomized solvers to address this issue. We compare the effectiveness of a symbolic solver (CVC3), a random solver, three hybrid solvers (i.e., mix of random and symbolic), and two heuristic search solvers. We evaluate the solvers on two benchmarks: one consisting of manually generated constraints and another generated with a concolic execution of 8 subjects. In addition to fully decidable constraints, the benchmarks include constraints with non-linear integer arithmetic, integer modulo and division, bitwise arithmetic, and floating-point arithmetic. As expected symbolic solving (in particular, CVC3) subsumes the other solvers for the concolic execution of subjects that only generate decidable constraints. For the remaining subjects the solvers are complementary.

Considerations for Bioassay Monitoring of Mixtures of Radionuclides

DOE PAGES

Klumpp, John; Waters, Tom; Bertelli, Luiz

2017-10-01

Complying with regulations for bioassay monitoring of radionuclide intakes is significantly more complex for mixtures than it is for pure radionuclides. Different constituents will naturally have different dose coefficients, be detectable at significantly different levels, and may require very different amounts of effort to bioassay. The ability to use certain constituents as surrogates for others will depend on how well characterized the mixture is, as well as whether the employee is also working with other radionuclides. This is further compounded by the fact that the composition of a mixture (or even of a pure radionuclide) is likely to change overmore » time. Internal dosimetrists must decide how best to monitor employees who work with radionuclide mixtures. In particular, they must decide which constituents should be monitored routinely, which constituents only need to be monitored in the case of an intake, and how to estimate doses based on intakes of monitored and unmonitored constituents.« less

Unexpected benefits of deciding by mind wandering

PubMed Central

Giblin, Colleen E.; Morewedge, Carey K.; Norton, Michael I.

2013-01-01

The mind wanders, even when people are attempting to make complex decisions. We suggest that mind wandering—allowing one's thoughts to wander until the “correct” choice comes to mind—can positively impact people's feelings about their decisions. We compare post-choice satisfaction from choices made by mind wandering to reason-based choices and randomly assigned outcomes. Participants chose a poster by mind wandering or deliberating, or were randomly assigned a poster. Whereas forecasters predicted that participants who chose by mind wandering would evaluate their outcome as inferior to participants who deliberated (Experiment 1), participants who used mind wandering as a decision strategy evaluated their choice just as positively as did participants who used deliberation (Experiment 2). In some cases, it appears that people can spare themselves the effort of deliberation and instead “decide by wind wandering,” yet experience no decrease in satisfaction. PMID:24046760

Measuring unintended effects in peacebuilding: What the field of international cooperation can learn from innovative approaches shaped by complex contexts.

PubMed

Lemon, Adrienne; Pinet, Mélanie

2018-06-01

Capturing unintended impacts has been a persistent struggle in all fields of international development, and the field of peacebuilding is no exception. However, because peacebuilding focuses on relationships in complex contexts, the field of peacebuilding has, by necessity, made efforts towards finding practical ways to reflect upon both the intended and unintended effects of this work. To explore what lessons can be learned from the peacebuilding field, this study examines the evaluations of Search for Common Ground, a peacebuilding organisation working in over 35 countries across the world. Analysis focuses on 96 evaluations completed between 2013 and 2016 in 24 countries across Africa, Asia, and the MENA regions that found unintended effects. Programmes focusing on women, youth, and radio were most effective at identifying and explaining unintended effects, likely because the project design guided broader lines of questioning from the beginning. The paper argues that OECD-DAC guidelines are not enough on their own to guide evaluators into exploration of unintended effects, and teams instead need to work together to decide where, when and how they will look for them. Different approaches were also used to capture positive and negative outcomes, suggesting that evaluators need to decide at what level they are evaluating and how to tie effects back to the project's contribution. This study explores evaluation techniques and approaches used to understand impact in complex contexts in the peacebuilding field, and draws on lessons learned for the benefit of other fields dealing with similar complexities in international development and cooperation among actors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evidence for sequential decision making in the medicinal leech.

PubMed

Esch, Teresa; Mesce, Karen A; Kristan, William B

2002-12-15

Decision making can be a complex task involving a sequence of subdecisions. For example, we decide to pursue a goal (e.g., get something to eat), then decide how to accomplish that goal (e.g., go to a restaurant), and then make a sequence of more specific plans (e.g., which restaurant to go to, how to get there, what to order, etc.). In characterizing the effects of stimulating individual brain neurons in the isolated nervous system of the leech Hirudo medicinalis, we have found evidence that leeches also make decisions sequentially. In this study, we describe a pair of interneurons that elicited locomotory motor programs, either swimming or crawling, in isolated nerve cords. In semi-intact animals, stimulating the same neurons also produced either swimming or crawling, and which behavior was produced could be controlled experimentally by manipulating the depth of saline around the intact part of the leech. These same neurons were excited and fired strongly when swimming or crawling occurred spontaneously or in response to mechanosensory stimulation. We conclude that these brain interneurons help to decide on locomotion (i.e., they are "locomotory command-like neurons") and that the ultimate behavior is determined downstream, in a part of the decision-making hierarchy that monitors stimuli related to the depth of fluid surrounding the leech.

How rare is complex life in the Milky Way?

PubMed

Bounama, Christine; von Bloh, Werner; Franck, Siegfried

2007-10-01

An integrated Earth system model was applied to calculate the number of habitable Earth-analog planets that are likely to have developed primitive (unicellular) and complex (multicellular) life in extrasolar planetary systems. The model is based on the global carbon cycle mediated by life and driven by increasing stellar luminosity and plate tectonics. We assumed that the hypothetical primitive and complex life forms differed in their temperature limits and CO(2) tolerances. Though complex life would be more vulnerable to environmental stress, its presence would amplify weathering processes on a terrestrial planet. The model allowed us to calculate the average number of Earth-analog planets that may harbor such life by using the formation rate of Earth-like planets in the Milky Way as well as the size of a habitable zone that could support primitive and complex life forms. The number of planets predicted to bear complex life was found to be approximately 2 orders of magnitude lower than the number predicted for primitive life forms. Our model predicted a maximum abundance of such planets around 1.8 Ga ago and allowed us to calculate the average distance between potentially habitable planets in the Milky Way. If the model predictions are accurate, the future missions DARWIN (up to a probability of 65%) and TPF (up to 20%) are likely to detect at least one planet with a biosphere composed of complex life.

The effect of Ramadan fasting on quiescent systemic lupus erythematosus (SLE) patients' disease activity, health quality of life and lipid profile: a pilot study.

PubMed

Goharifar, Hamid; Faezi, Seyedeh Tahereh; Paragomi, Pedram; Montazeri, Ali; Banihashemi, Arash Tehrani; Akhlaghkhah, Maryam; Abdollahi, Bahar Sadeghi; Kamazani, Zahra; Akbarian, Mahmood

2015-08-01

SLE is a common autoimmune disease with considerable morbidity. Ramadan fasting is a religious custom Muslims regularly practice. We aimed to evaluate the effect of Ramadan fasting on SLE patients' disease activity, health quality of life and lipid profile. We conducted this case control study as a pilot study in 40 quiescent SLE patients, 21 cases who decided to fast and 19 controls who decided not to have Ramadan fasting between August and November 2009 in lupus unit of Rheumatology Research Center in Tehran University of Medical Sciences, Iran. They were assessed for SLE Disease Activity Index, lipid profile and quality of life with Short-Form 36 (SF-36) Health Survey, 1 day before Ramadan, the day after and 3 months after Ramadan fasting. After 24.1 ± 5.4 (mean ± SD) days of fasting, anti-ds DNA increased for 0.34 ± 0.41 mmol/dL in cases versus 0.07 ± 0.31 in controls (P = 0.026). Likewise C3 increased more dramatically in cases (16.8 ± 17.5 vs. 2.3 ± 13.2 mg/dL, P = 0.006). Three months after fasting, anti-ds DNA was still increased 0.28 ± 0.46 mmol/dL in cases while a 0.02 ± 0.43 mmol/dL drop in controls was detected (P = 0.04). On the contrary, C3 returned to baseline. These changes were not accompanied with significant changes in disease activity and health quality of life. Ramadan fasting had no effect on lipid profile except for delayed total cholesterol decrease in cases in comparison with controls (16.4 ± 29.4 decrease vs. 4.6 ± 23.9 mg/dL decrease, P = 0.018). Ramadan fasting probably has no detrimental effect on SLE patients' disease activity and their quality of life in the quiescent phase of disease.

The Effect of Drive Signal Limiting on High Cycle Fatigue Life Analysis

NASA Technical Reports Server (NTRS)

Kihm, Frederic; Rizzi, Stephen A.

2014-01-01

It is common practice to assume a Gaussian distribution of both the input acceleration and the response when modeling random vibration tests. In the laboratory, however, shaker controllers often limit the drive signal to prevent high amplitude peaks. The high amplitudes may either be truncated at a given level (socalled brick wall limiting or abrupt clipping), or compressed (soft limiting), resulting in drive signals which are no longer Gaussian. The paper first introduces several methods for limiting a drive signal, including brick wall limiting and compression. The limited signal is then passed through a linear time-invariant system representing a device under test. High cycle fatigue life predictions are subsequently made using spectral fatigue and rainflow cycle counting schemes. The life predictions are compared with those obtained from unclipped input signals. Some guidelines are provided to help the test engineer decide how clipping should be applied under different test scenarios.

Fatigue-environment interactions in a SiC/Ti-15-3 composite

NASA Technical Reports Server (NTRS)

Gayda, J.; Gabb, T. P.; Lerch, B. A.

1993-01-01

Load-controlled isothermal and nonisothermal fatigue lives of a (0-deg)s SiC/Ti-15-3 were evaluated at temperatures between 150 and 550 C and a target strain range of about 0.45 percent. In nonisothermal fatigue tests, load was first cycled at minimum temperature and then temperature was cycled at zero load. For fatigue tests with peak temperatures at or above 300 C, fatigue life was dramatically reduced compared to that at 150 C. The shortest life was produced by the nonisothermal test with the greatest temperature range (Delta T = 400 C) and highest peak temperature (T(max) = 550 C). Vacuum testing showed that much of the life reduction under isothermal and nonisothermal conditions was related to environmental effects, although the nature of the fatigue-environment interaction was decidedly different for the isothermal and nonisothermal test cycles which were studied.

USSR Report Machine Tools and Metalworking Equipment.

DTIC Science & Technology

1986-04-22

directors decided to teach the Bulat a new trade. This generator is now used to strengthen high-speed cutting mills by hardening them in a medium of...modules (GPM) and flexible production complexes ( GPK ). The flexible automated line is usually used for mass production of components. Here the...of programmable coordinates (x^ithout grip) 5 4 Method of programming teaching Memory capacity of robot system, points 300 Positioning error, mm

More Effective VET and Lifelong Learning Policies: Awareness Raising, Analysis and Advice--Cedefop's Achievements in 2012 and Plans for 2013. Briefing Note

ERIC Educational Resources Information Center

Cedefop - European Centre for the Development of Vocational Training, 2013

2013-01-01

Reform of vocational education and training (VET) in Europe is complex, especially at a time of economic crisis. Cedefop raises awareness and provides analysis and advice to policy-makers at European level and in Member States to help them decide on policies and actions. Cedefop's work supports the European policy agenda for VET and lifelong…

From "Wiggly Structures" to "Unshaky Towers": Problem Framing, Solution Finding, and Negotiation of Courses of Actions During a Civil Engineering Unit for Elementary Students.

ERIC Educational Resources Information Center

Roth, Wolff-Michael

1995-01-01

Investigated problem- and solution-related activity of (n=28) fourth and fifth graders in ill-defined and open-ended settings. In the course of their negotiations, students demonstrated an uncanny competence to frame and reframe problems and solutions and to decide courses of actions of different complexities in spite of the ambiguous nature of…

Relationship of breastfeeding self-efficacy with quality of life in Iranian breastfeeding mothers.

PubMed

Mirghafourvand, Mojgan; Kamalifard, Mahin; Ranjbar, Fatemeh; Gordani, Nasrin

2017-07-20

Due to the importance of breastfeeding, we decided to conduct a study to examine the relationship between breastfeeding self-efficacy and quality of life. This study was a cross-sectional study, which was carried out on 547 breastfeeding mothers that had 2-6 months old infants. The participants were selected randomly, and the sociodemographic characteristics questionnaire, Dennis' breastfeeding self-efficacy scale, and WHO's Quality of Life (WHOQOL) questionnaire were completed through interview. The multivariate linear regression model was used for data analysis. The means (standard deviations) of breastfeeding self-efficacy score and quality of life score were 134.5 (13.3) and 67.7 (13.7), respectively. Quality of life and all of its dimensions were directly and significantly related to breastfeeding self-efficacy. According to the results of multivariate linear regression analysis, there was a relationship between breastfeeding self-efficacy and the following variables: environmental dimension of quality of life, education, spouse's age, spouse's job, average duration of previous breastfeeding period and receiving breastfeeding training. Findings showed that there is direct and significant relationship between breastfeeding self-efficacy and quality of life. Moreover, it seems that the development of appropriate training programs is necessary for improving the quality of life of pregnant women, as it consequently enhances breastfeeding self-efficacy.

Morals and markets.

PubMed

Falk, Armin; Szech, Nora

2013-05-10

The possibility that market interaction may erode moral values is a long-standing, but controversial, hypothesis in the social sciences, ethics, and philosophy. To date, empirical evidence on decay of moral values through market interaction has been scarce. We present controlled experimental evidence on how market interaction changes how human subjects value harm and damage done to third parties. In the experiment, subjects decide between either saving the life of a mouse or receiving money. We compare individual decisions to those made in a bilateral and a multilateral market. In both markets, the willingness to kill the mouse is substantially higher than in individual decisions. Furthermore, in the multilateral market, prices for life deteriorate tremendously. In contrast, for morally neutral consumption choices, differences between institutions are small.

Divergent Views on Abortion and the Period of Ensoulment

PubMed Central

Khitamy, Badawy A. B.

2013-01-01

A Muslim woman in her sixteenth week of pregnancy was informed that her ultrasound scan showed spina bifida, and laboratory results confirmed the diagnosis. The child would have various complications and, most probably, would need medical care for life. With the consent of her husband she decided to terminate the pregnancy. Her decision sparked controversy among Muslim clerics in her community, sparking debate between those who would allow abortion for medical reasons and those who oppose abortion for any reason. This paper will review the philosophical and theological arguments of the pro-life and pro-choice groups as well as the Islamic perspective concerning a woman’s autonomy over her reproductive system, the sanctity of the fetus and the embryo, therapeutic abortion, and ensoulment. PMID:23573379

In thunder, lightning or in rain: what three doctors can do.

PubMed

Annas, G J

1987-01-01

Annas discusses three 1987 New Jersey Supreme Court cases in which the court decided that life-sustaining treatment could be terminated either because this was what the patient clearly wanted (In re Farrell and In re Peter) or because it was the family's best judgment of what the patient wanted (In re Jobes). He is critical of the court's opinions because they appear to place limits on the right to refuse treatment through the use of procedural "rules." By categorizing patients in terms of, for example, being in a persistent vegetative state, and by requiring medical consultations in cases involving refusal of life-sustaining treatment, the court followed the Quinlan precedent of focusing on decision making by physicians.

British Logistics Challenges in the American Revolution: How Logistics was a Critical Vulnerability in the British Effort to Ensure Victor

DTIC Science & Technology

2012-05-01

as the French entered the war, the British had to divide resources and supplies elsewhere. The British General Cornwallis decided to chase the...military equipment, such as ammunition, cannons, and life support, such as food and water, then how could they expect to sustain operations...problems of supplying the army from Great Britain were great, and the most serious challenge was that of providing food over such a tremendous

Ethical dilemmas in veterinary medicine.

PubMed

Morgan, Carol A; McDonald, Michael

2007-01-01

Veterinarians frequently encounter situations that are morally charged and potentially difficult to manage. Situation involving euthanasia, end-of-life care, economics, and inadequate provision of care create practical and moral dilemmas. Ethical tension may be attributable to differences in beliefs regarding the moral value of animals, client and veterinary responsibilities, and deciding what is best for an animal. Veterinarians can employ communication skills used in medical situations to explore the reasons underpinning ethical dilemmas and to search for solutions with clients, staff, and colleagues.

Continuous deep sedation and homicide: an unsolved problem in law and professional morality.

PubMed

den Hartogh, Govert

2016-06-01

When a severely suffering dying patient is deeply sedated, and this sedated condition is meant to continue until his death, the doctor involved often decides to abstain from artificially administering fluids. For this dual procedure almost all guidelines require that the patient should not have a life expectancy beyond a stipulated maximum of days (4-14). The reason obviously is that in case of a longer life-expectancy the patient may die from dehydration rather than from his lethal illness. But no guideline tells us how we should describe the dual procedure in case of a longer life-expectancy. Many arguments have been advanced why we should not consider it to be a form of homicide, that is, ending the life of the patient (with or without his request). I argue that none of these arguments, taken separately or jointly, is persuasive. When a commission, even one that is not itself life-shortening, foreseeably renders a person unable to undo the life-shortening effects of another, simultaneous omission, the commission and the omission together should be acknowledged to kill her. I discuss the legal and ethical implications of this conclusion.

Maggot therapy in treatment of a complex hand injury complicated by mycotic infection.

PubMed

Bohac, M; Cambal, M; Zamborsky, R; Takac, P; Fedeles, J

2015-01-01

Complex injuries of the hand remain a therapeutic challenge for surgeons. We present the case of a male who suffered a devastating injury of the hand caused by a conveyor belt. The patient developed a progressive Absidia corymbifera infection of the affected soft tissues. Initial treatments with serial surgical debridement and topical and intravenous itraconazole were unsuccessful in eliminating the infection. We decided to use maggot debridement therapy in a new special design to debride all necrotic, devitalized tissue and preserve only healthy tissue and functioning structures. This maneuverer followed by negative pressure therapy allowed progressive healing. In such complex hand injuries, maggot debridement combined with negative pressure therapy could be considered to achieve effective and considerable results, although future functional morbidity may occur (Fig. 4, Ref. 18).

Surface plasmon holographic microscopy for near-field refractive index detection and thin film mapping

NASA Astrophysics Data System (ADS)

Zhao, Jianlin; Zhang, Jiwei; Dai, Siqing; Di, Jianglei; Xi, Teli

2018-02-01

Surface plasmon microscopy (SPM) is widely applied for label-free detection of changes of refractive index and concentration, as well as mapping thin films in near field. Traditionally, the SPM systems are based on the detection of light intensity or phase changes. Here, we present two kinds of surface plasmon holographic microscopy (SPHM) systems for amplitude- and phase-contrast imaging simultaneously. Through recording off-axis holograms and numerical reconstruction, the complex amplitude distributions of surface plasmon resonance (SPR) images can be obtained. According to the Fresnel's formula, in a prism/ gold/ dielectric structure, the reflection phase shift is uniquely decided by refractive index of the dielectric. By measuring the phase shift difference of the reflected light exploiting prism-coupling SPHM system based on common-path interference configuration, monitoring tiny refractive index variation and imaging biological tissue are performed. Furthermore, to characterize the thin film thickness in near field, we employ a four-layer SPR model in which the third film layer is within the evanescent field. The complex reflection coefficient, including the reflectivity and reflection phase shift, is uniquely decided by the film thickness. By measuring the complex amplitude distributions of the SPR images exploiting objective-coupling SPHM system based on common-path interference configuration, the thickness distributions of thin films are mapped with sub-nanometer resolution theoretically. Owing to its high temporal stability, the recommended SPHMs show great potentials for monitoring tiny refractive index variations, imaging biological tissues and mapping thin films in near field with dynamic, nondestructive and full-field measurement capabilities in chemistry, biomedicine field, etc.

The effect of group psycho-educational program on quality of life in families of patients with mood disorders.

PubMed

Ghazavi, Zahra; Dehkhoda, Fateme; Yazdani, Mohsen

2014-01-01

Mood disorders related behaviors are imposed on family members and influence the family's mental atmosphere and level of quality of life. Therefore, the researchers decided to study the effect of group psycho-educational program on the quality of life in families of patients with mood disorders. This is a two-group interventional study conducted on 32 members of families of the patients with mood disorders selected through random sampling. A group psycho-educational program was conducted in ten 90-min sessions (twice a week) for the study group. (World Health Organization's Quality of Life-BREF WHOQOL-BREF) questionnaire was adopted in the study and was filled before, immediately after, and 1 month after the intervention. Independent t-test showed a significant difference in the scores of quality of life in the domains of mental health, social communications, and environmental health, immediately after and 1 month after intervention in the study group compared to the control group. Repeated measure analysis of variance showed a significant increase in the mean scores of quality of life in the study group. The results showed that the impact of group psycho-educational program is observed in the prevention of reduction in quality of life and its promotion in the families of patients with mood disorders.

Scoping review of pediatric tonsillectomy quality of life assessment instruments.

PubMed

Kao, Stephen Shih-Teng; Peters, Micah D J; Dharmawardana, Nuwan; Stew, Benjamin; Ooi, Eng Hooi

2017-10-01

Sleep-disordered breathing or recurrent tonsillitis have detrimental effects on the child's physical health and quality of life. Tonsillectomy is commonly performed to treat these common conditions and improve the child's quality of life. This scoping review aims to present a comprehensive and descriptive analysis of quality of life questionnaires as a resource for clinicians and researchers when deciding which tool to use when assessing the quality of life effects after tonsillectomy. A comprehensive search strategy was undertaken across MEDLINE (PubMed), CINAHL, Embase, and Cochrane CENTRAL. Quality of life questionnaires utilized in studies investigating pediatric patients undergoing tonsillectomy for chronic tonsillitis or sleep-disordered breathing were included. Methodological quality and data extraction were conducted as per Joanna Briggs Institute methodology. Ten questionnaires were identified, consisting of six generic and four disease-specific instruments. The Pediatric Quality of Life Inventory was the most commonly utilized generic questionnaire. The Obstructive Sleep Apnea-18 was the most commonly utilized disease-specific questionnaire. This review identified a range of generic and disease-specific quality of life questionnaires utilized in pediatric patients who have undergone tonsillectomy with or without adenoidectomy for sleep-disordered breathing or chronic tonsillitis. Important aspects of each questionnaire have been summarized to aid researchers and clinicians in choosing the appropriate questionnaire when evaluating the quality of life effects of tonsillectomy. NA Laryngoscope, 127:2399-2406, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Family Physicians Managing Medical Requests From Family and Friends.

PubMed

Giroldi, Esther; Freeth, Robin; Hanssen, Maurice; Muris, Jean W M; Kay, Margareth; Cals, Jochen W L

2018-01-01

Although guidelines generally state that physicians should not treat their family members or friends (nonpatients), physicians regularly receive medical requests from nonpatients. We aimed to explore junior and senior family physicians' experiences with and attitudes toward managing medical requests from nonpatients. We conducted a qualitative study with 7 focus groups with junior and senior physicians. We performed a thematic analysis during an iterative cycle of data collection and analysis. When confronted with a medical request from a nonpatient, physicians first oriented themselves to the situation: who is this person, what is he or she asking of me, and where are we? Physicians next considered the following interrelated factors: (1) nature/strength of the relationship with the nonpatient, (2) amount of trust in his/her own knowledge and skills, (3) expected consequences of making mistakes, (4) importance of work-life balance, and (5) risk of disturbing the physician-patient process. Senior physicians applied more nuanced considerations when deciding whether to respond, whereas junior physicians experienced more difficulties dealing with these requests, were less inclined to respond, and were more concerned about disturbing the existing relationship that a person had with his/her own physician. This study provides insight into the complexity that physicians face when managing medical questions and requests from nonpatients. Facilitated group discussions during which experiences are shared can help junior physicians become more confident in dealing with these complex issues as they formulate their own personal strategy regarding provision of medical advice or treatment to family and friends. © 2018 Annals of Family Medicine, Inc.

Treatment at scale in Brazil: a physician's perspective.

PubMed

Schechter, Mauro

2007-07-01

In 1996, Brazil became the first developing country to provide universal access to antiretroviral therapy (ART), based on a strategy that utilizes an individualized approach to treatment and an open formulary. At the time, the number of patients in need of treatment was less than 15% of what it is today, there were six approved drugs for the treatment of HIV infection (compared with 25 today), and the life expectancy of patients was measured in months and years, not in decades. In recent years, preventable and treatable conditions such as cardiovascular diseases increased significantly faster as causes of death among HIV-infected individuals than in the general population. In the near future there will be a substantial increase in the number of patients in need of therapy and in the number of patients using more complex regimens who also have co-morbidities that impact prognosis. Brazil will thus need to expand its network of treatment facilities, increase its capacity to manage more complex clinical conditions, and decide on the proper balance of sophistication that will be required. As the Brazilian scientific output is not commensurate with its successes in the treatment and prevention of HIV infection, there is little empirical basis to inform decisions on how best to allocate finite resources. The Brazilian response to the HIV/AIDS epidemic, universal access to ART in particular, is an example to other developing countries. The Brazilian experience also shows that operational research should be an integral part of programmes of access to treatment, if their long-term sustainability is to be ensured.

Room for improvement: tackling high-cost patients for high potential return.

PubMed

2004-06-01

Assuming that most DM programs do a decent job of managing the typical chronically ill patient, a California company decided to take on the atypical patient with a program that seeks out highly complex, at high-cost patients, and uses some non-traditional interventions to get these patients stabilized. In fact, pilot study results suggest developers may be on the right track with their "SWAT team" approach to care.

Thematic or Sequential Analysis in Causal Explanations?: Investigating the Kinds of Historical Understanding that Year 8 and Year 10 Demonstrate in Their Efforts to Construct Narratives

ERIC Educational Resources Information Center

Kemp, Robin

2011-01-01

Struck by what he saw as the complexity, artistry and cognitive achievement of historians' narrative accounts, Robin Kemp decided to explore ways of teaching his pupils to write narrative and to analyse the role of such writing in developing various kinds of historical thinking. Working with Year 8 and Year 10 he designed a research project that…

Simulation Technologies for C2IS Development & Training

DTIC Science & Technology

2008-02-01

break down complex goals or meta -reasoning events that the agent uses to decide which plans to implement. They are integral to the ongoing...controlled through various programming means, which may include the posting of a PlanChoice event. JACK agents are fully capable of meta -level...China [6] Jaillet, Christophe; Krajecki, Michael; and Fugere, Dr. Benoit Jean (2002). ParaZJeZisation en memoire partagee d’un moteur de simulation du

A Distributed Value of Information (VoI)-Based Approach for Mission-Adaptive Context-Aware Information Management and Presentation

DTIC Science & Technology

2016-05-16

metrics involve regulating automation of complex systems , such as aircraft .12 Additionally, adaptive management of content in user interfaces has also...both the user and environmental context would aid in deciding how to present the information to the Warfighter. The prototype system currently...positioning system , and rate sensors can provide user - specific context to disambiguate physiologic data. The consumer “quantified self” market has driven

Living donor transplantation--the real gift of life. Procurement and the ethical assessment.

PubMed

Banasik, Mirosław

2006-01-01

It has been observed during the past 10-15 years a greater disparity between the supply of kidneys for transplantation and the demand of patients on waiting lists. The number of cadaveric kidneys available for transplantation have not increased in many countries. Countries and their societies are faced with a choice, let patients with the end- stage renal disease stay on, dialysis giving a faster death and a lower quality of life, or decide to introduce the more active living donation program. There are countries, historically Scandinavian countries, the U.S.A. and U.K., which decided to change medical, social and ethical attitudes to help their citizens and patients on dialysis. For many other countries approval of the new approach of their donation seems to cause difficulties. The main problem for medical staff is the principle Primum non nocere (First do no harm), removal of a living kidney conflicts with this principle. From the other point of view is the human right of an individual to autonomy for donation of a kidney. The donor is completely informed for the risks involved in donation of a kidney to an awaiting recipient. The donors reasons for donation of the kidney must be understood and family pressure excluded. Where is the borderline between the paternalistic approach of the medical personnel preventing the altruistic attitude of the donor? How far is the role of the medical staff to extend in the assessment of the altruistic nature and goodwill of the donors?

Involving people with dementia in developing an interactive web tool for shared decision-making: experiences with a participatory design approach.

PubMed

Span, Marijke; Hettinga, Marike; Groen-van de Ven, Leontine; Jukema, Jan; Janssen, Ruud; Vernooij-Dassen, Myrra; Eefsting, Jan; Smits, Carolien

2018-06-01

The aim of this study was at gaining insight into the participatory design approach of involving people with dementia in the development of the DecideGuide, an interactive web tool facilitating shared decision-making in their care networks. An explanatory case study design was used when developing the DecideGuide. A secondary analysis focused on the data gathered from the participating people with dementia during the development stages: semi-structured interviews (n = 23), four focus group interviews (n = 18), usability tests (n = 3), and a field study (n = 4). Content analysis was applied to the data. Four themes showed to be important regarding the participation experiences of involving people with dementia in research: valuable feedback on content and design of the DecideGuide, motivation to participate, perspectives of people with dementia and others about distress related to involvement, and time investment. People with dementia can give essential feedback and, therefore, their contribution is useful and valuable. Meaningful participation of people with dementia takes time that should be taken into account. It is important for people with dementia to be able to reciprocate the efforts others make and to feel of significance to others. Implications for Rehabilitation People with dementia can contribute meaningfully to the content and design and their perspective is essential for developing useful and user-friendly tools. Participating in research activities may contribute to social inclusion, empowerment, and quality of life of people with dementia.

Decisions Regarding Pregnancy Termination Due to β-Thalassemia Major: a Mixed-Methods Study in Sistan and Baluchestan, Iran.

PubMed

Moudi, Zahra; Miri-Moghaddam, Ebrahim

2017-06-01

In the present study, an embedded design was applied in order to conduct a one-year cross-sectional audit of chorionic villus sampling (CVS) and foetal outcomes affected by β-thalassemia major (β-TM) in a prenatal diagnosis (PND) setting. In addition, we explored the decisions regarding pregnancy termination among women whose pregnancy (or child) was affected by β-TM. In the quantitative phase, the available data in the clients' medical records were analysed, while the qualitative phase was performed using a grounded theory method. Interviews were performed with nine pregnant women who had decided against pregnancy termination despite positive CVS results, 11 mothers who had admitted their child to the thalassemia ward for blood transfusion, and 19 mothers who had received positive CVS results and had decided against pregnancy termination in the preceding year. Over one year, 18.6 % of women decided against pregnancy termination despite positive CVS results. Two main themes related to decisions against pregnancy termination emerged from the qualitative data: 1) Cognitive factors (questioning the reliability of the tests or doubts about the accuracy of the results, understanding disease recurrence, curability, perceived severity of the disease, and lack of "real-life experiences"); and 2) Sociocultural responsiveness (family opposition, responsibility before God, and self-responsiveness). All of the mentioned factors could intensify fear of abortion in couples due to possible regret, and encourage a decision against pregnancy termination.

Long-term outcome of autistic spectrum disorder: a retrospective case study in a southern italian region.

PubMed

Operto, Francesca Felicia; Martino, Federica; Rinaldi, Annalisa; Cerracchio, Angelo; Salvati, Giovanni; Orza, Mariano; Lembo, Claudia; Panzarino, Gianvito; Di Paolantonio, Claudia; Verrotti, Alberto; Farello, Giovanni; Coppola, Giangennaro

2017-09-20

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder, characterized by impaired social communication and restricted and repetitive behaviours, as well as associated features including intellectual disability and impaired sensorimotor function. Despite a growing interest in this devastating disorder for families and young parents, there are no certainties as regards its aetiology, although a significant genetic background is considered to be important. Since there is little information about the social adaptation and quality of life of patients with Autism Spectrum Disorder, we decided to study and evaluate the long-term outcome and quality of life in a sample of children, adolescent and young adults. This is a case study of subjects diagnosed with ASD and followed by clinics and rehabilitation centers in Campania region, in the south of Italy. The study sample was composed by 110 patients (83 males, 27 females), aged between 8.1 and 28.0 years (mean 20.6; median 21.2; SD ± 4.85), recruited in 8 rehabilitation centers of Campania region. A follow-up interview was performed by means of a questionnaire administered to the parents/caregivers of patients at a mean age of their son/daughter of 20.6 years (median 21.2 years; range 8.1-28.0). Reports from parents or caregivers show an overall improvement with regard to social and adaptive abilities in a group of teen-agers and young adults with ASD. Major concerns on significant quality of life parameters such as independent living, work experiences, friendships and relationships, accommodation type, recreational activities and personal autonomy were persisting. The present study shows an overall improvement with regard to social and adaptive abilities in a large number of subjects. Considerable problems are related to autonomy, employment opportunities and social relationships of these patients. Parents need more recreational activities and continuous support with facilities for families.

Decision-making process of prenatal screening described by pregnant women and their partners.

PubMed

Wätterbjörk, Inger; Blomberg, Karin; Nilsson, Kerstin; Sahlberg-Blom, Eva

2015-10-01

Pregnant women are often faced with having to decide about prenatal screening for Down's syndrome. However, the decision to participate in or refrain from prenatal screening can be seen as an important decision not only for the pregnant woman but also for both the partners. The aim of this study was to explore the couples' processes of decision making about prenatal screening. A total of 37 semi-structured interviews conducted at two time points were analysed using the interpretive description. The study was carried out in Maternal health-care centres, Örebro County Council, Sweden. Fifteen couples of different ages and with different experiences of pregnancy and childbirth were interviewed. Three different patterns of decision making were identified. For the couples in 'The open and communicative decision-making process', the process was straightforward and rational, and the couples discussed the decision with each other. 'The closed and personal decision-making process' showed an immediate and non-communicative decision making where the couples decided each for themselves. The couples showing 'The searching and communicative decision-making process' followed an arduous road in deciding whether to participate or not in prenatal screening and how to cope with the result. The decision-making process was for some couples a fairly straightforward decision, while for others it was a more complex process that required a great deal of consideration. © 2013 John Wiley & Sons Ltd.

Benefits of physical exercise in postmenopausal women.

PubMed

Mendoza, Nicolás; De Teresa, Carlos; Cano, Antonio; Godoy, Débora; Hita-Contreras, Fidel; Lapotka, Maryna; Llaneza, Placido; Manonelles, Pedro; Martínez-Amat, Antonio; Ocón, Olga; Rodríguez-Alcalá, Laura; Vélez, Mercedes; Sánchez-Borrego, Rafael

2016-11-01

Physical inactivity not only places women's health at risk during menopause, but also increases menopausal problems. Abundant evidence links habitual physical exercise (PE) to a better status on numerous health indicators and better quality of life and to the prevention and treatment of the ailments that typically occur from mid-life onwards. We can infer that PE is something more than a lifestyle: it constitutes a form of therapy in itself. A panel of experts from various Spanish scientific societies related to PE and menopause (Spanish Menopause Society, Spanish Cardiology Society, Spanish Federation of Sports Medicine) met to reach a consensus on these issues and to decide the optimal timing of and methods of exercise, based on the best evidence available. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Vignettes and Viewpoints From a Professional Autobiography.

PubMed

Lyness, Jeffrey M

2018-03-01

In this professional autobiography, the author describes factors contributing to important decisions in his academic geriatric psychiatry career. Major inflection points included embarking on clinical research and later deciding to focus more on leadership roles in education and in faculty affairs. The discussion then examines themes that have emerged in reviewing this career arc, including the value of: the variety and social connectedness inherent in the academic life; cultivation of interpersonal relationships and best efforts as much as possible; an open mind ready to (collegially) seize new opportunities; and family, friends, and avocational pursuits as complements to one's profession. The author hopes that this public life review is of help to others planning or reflecting on their own career paths. . Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

A Social Potential Fields Approach for Self-Deployment and Self-Healing in Hierarchical Mobile Wireless Sensor Networks

PubMed Central

González-Parada, Eva; Cano-García, Jose; Aguilera, Francisco; Sandoval, Francisco; Urdiales, Cristina

2017-01-01

Autonomous mobile nodes in mobile wireless sensor networks (MWSN) allow self-deployment and self-healing. In both cases, the goals are: (i) to achieve adequate coverage; and (ii) to extend network life. In dynamic environments, nodes may use reactive algorithms so that each node locally decides when and where to move. This paper presents a behavior-based deployment and self-healing algorithm based on the social potential fields algorithm. In the proposed algorithm, nodes are attached to low cost robots to autonomously navigate in the coverage area. The proposed algorithm has been tested in environments with and without obstacles. Our study also analyzes the differences between non-hierarchical and hierarchical routing configurations in terms of network life and coverage. PMID:28075364

A remarkable legacy

NASA Astrophysics Data System (ADS)

Parkinson, Stuart

2008-02-01

Joseph Rotblat, who died in 2005 at the age of 96, was a rare combination of distinguished scientist and leading peace advocate. During the Second World War he was involved with the Manhattan Project - which created the world's first atomic bombs - but then decided to resign on ethical grounds. This life-changing decision set the scene for the dual role that he would play for the rest of his life. On the one hand, Rotblat was a key figure in setting up and leading the Pugwash Conferences on Science and World Affairs, which bring together scientists and public figures concerned with reducing the danger of armed conflict and seeking co-operative solutions for global problems. On the other, he was an accomplished nuclear and medical physicist, eventually becoming president of the British Institute of Radiology.

A Social Potential Fields Approach for Self-Deployment and Self-Healing in Hierarchical Mobile Wireless Sensor Networks.

PubMed

González-Parada, Eva; Cano-García, Jose; Aguilera, Francisco; Sandoval, Francisco; Urdiales, Cristina

2017-01-09

Autonomous mobile nodes in mobile wireless sensor networks (MWSN) allow self-deployment and self-healing. In both cases, the goals are: (i) to achieve adequate coverage; and (ii) to extend network life. In dynamic environments, nodes may use reactive algorithms so that each node locally decides when and where to move. This paper presents a behavior-based deployment and self-healing algorithm based on the social potential fields algorithm. In the proposed algorithm, nodes are attached to low cost robots to autonomously navigate in the coverage area. The proposed algorithm has been tested in environments with and without obstacles. Our study also analyzes the differences between non-hierarchical and hierarchical routing configurations in terms of network life and coverage.

Exploiting Complexity Information for Brain Activation Detection

PubMed Central

Zhang, Yan; Liang, Jiali; Lin, Qiang; Hu, Zhenghui

2016-01-01

We present a complexity-based approach for the analysis of fMRI time series, in which sample entropy (SampEn) is introduced as a quantification of the voxel complexity. Under this hypothesis the voxel complexity could be modulated in pertinent cognitive tasks, and it changes through experimental paradigms. We calculate the complexity of sequential fMRI data for each voxel in two distinct experimental paradigms and use a nonparametric statistical strategy, the Wilcoxon signed rank test, to evaluate the difference in complexity between them. The results are compared with the well known general linear model based Statistical Parametric Mapping package (SPM12), where a decided difference has been observed. This is because SampEn method detects brain complexity changes in two experiments of different conditions and the data-driven method SampEn evaluates just the complexity of specific sequential fMRI data. Also, the larger and smaller SampEn values correspond to different meanings, and the neutral-blank design produces higher predictability than threat-neutral. Complexity information can be considered as a complementary method to the existing fMRI analysis strategies, and it may help improving the understanding of human brain functions from a different perspective. PMID:27045838

The life span-prolonging effect of sirtuin-1 is mediated by autophagy.

PubMed

Morselli, Eugenia; Maiuri, Maria Chiara; Markaki, Maria; Megalou, Evgenia; Pasparaki, Angela; Palikaras, Konstantinos; Criollo, Alfredo; Galluzzi, Lorenzo; Malik, Shoaib Ahmad; Vitale, Ilio; Michaud, Mickael; Madeo, Frank; Tavernarakis, Nektarios; Kroemer, Guido

2010-01-01

The life span of various model organisms can be extended by caloric restriction as well as by autophagy-inducing pharmacological agents. Life span-prolonging effects have also been observed in yeast cells, nematodes and flies upon the overexpression of the deacetylase Sirtuin-1. Intrigued by these observations and by the established link between caloric restriction and Sirtuin-1 activation, we decided to investigate the putative implication of Sirtuin-1 in the response of human cancer cells and Caenorhabditis elegans to multiple triggers of autophagy. Our data indicate that the activation of Sirtuin-1 (by the pharmacological agent resveratrol and/or genetic means) per se ignites autophagy, and that Sirtuin-1 is required for the autophagic response to nutrient deprivation, in both human and nematode cells, but not for autophagy triggered by downstream signals such as the inhibition of mTOR or p53. Since the life spanextending effects of Sirtuin-1 activators are lost in autophagy-deficient C. elegans, our results suggest that caloric restriction and resveratrol extend longevity, at least in experimental settings, by activating autophagy.

Applicability of the principle of respect for autonomy: the perspective of Turkey.

PubMed

Kara, Mahmut Alpertunga

2007-11-01

Turkey has a complex character, which has differences from the Western world or Eastern Asia as well as common points. Even after more than a century of efforts to modernise and integrate with the West, Turkish society has values that are different from those of the West, as well as having Western values. It is worth questioning whether ordinary Turkish people show an individualistic character. The principle of respect for individual autonomy arises from a perception of oneself as an individual, and the person's situation may affect the applicability of the principle. Patients who perceive themselves to be members of a community rather than free persons and who prefer to participate in the common decisions of the community and to consider the common interest and the common value system of the community concerning problems of their life (except healthcare or biomedical research) rather than to decide as independent, rational individuals may not be competent to make an autonomous choice. Expectations that such patients will behave as autonomous individuals may be unjustified. The family, rather than the patient, may take a primary role in decisions. A flexible system considering cultural differences in the concept of autonomy may be more feasible than a system following strict universal norms.

Update on US EPA's Revision to the 1985 Guidelines for ...

EPA Pesticide Factsheets

National Water Quality Criteria for the Protection of Aquatic Organisms and Their Uses (Stephan et al. 1985), to reflect the current state-of-the-science for aquatic effects assessments. Following a 2015 public meeting soliciting early input from the scientific community, EPA decided to undertake two overarching parallel tracks for this revision: 1) updating and refining methods for deriving state-of-the-science criteria through comprehensive analyses, and 2) developing criteria more rapidly for the broader protection of aquatic life from the potential adverse effects of the large number of chemicals released into the aquatic environment. The first track reflects that for a smaller group of chemicals, criteria development may be scientifically complex, and deriving robust criteria for these chemicals may require detailed investigation. The second track reflects the recognition that extensive testing of all chemicals is infeasible and there is a need to efficiently derive criteria using approaches that estimate safe environmental concentrations with limited empirical data. Based on these objectives, EPA will develop two criteria documents for this revision: 1) a Comprehensive Guidelines Document, intended to directly update and expand upon approaches presented in the 1985 Guidelines, and that will describe methods that provide criteria for chemicals requiring a more detailed level of evaluation, and 2) an Expedited Guidelines Document, which will focus on criteri

Applicability of the principle of respect for autonomy: the perspective of Turkey

PubMed Central

Kara, Mahmut Alpertunga

2007-01-01

Turkey has a complex character, which has differences from the Western world or Eastern Asia as well as common points. Even after more than a century of efforts to modernise and integrate with the West, Turkish society has values that are different from those of the West, as well as having Western values. It is worth questioning whether ordinary Turkish people show an individualistic character. The principle of respect for individual autonomy arises from a perception of oneself as an individual, and the person's situation may affect the applicability of the principle. Patients who perceive themselves to be members of a community rather than free persons and who prefer to participate in the common decisions of the community and to consider the common interest and the common value system of the community concerning problems of their life (except healthcare or biomedical research) rather than to decide as independent, rational individuals may not be competent to make an autonomous choice. Expectations that such patients will behave as autonomous individuals may be unjustified. The family, rather than the patient, may take a primary role in decisions. A flexible system considering cultural differences in the concept of autonomy may be more feasible than a system following strict universal norms. PMID:17971462

A Cultural Diffusion Model for the Rise and Fall of Programming Languages.

PubMed

Valverde, Sergi; Solé, Ricard V

2015-07-01

Our interaction with complex computing machines is mediated by programming languages (PLs), which constitute one of the major innovations in the evolution of technology. PLs allow flexible, scalable, and fast use of hardware and are largely responsible for shaping the history of information technology since the rise of computers in the 1950s. The rapid growth and impact of computers were followed closely by the development of PLs. As occurs with natural, human languages, PLs have emerged and gone extinct. There has been always a diversity of coexisting PLs that compete somewhat while occupying special niches. Here we show that the statistical patterns of language adoption, rise, and fall can be accounted for by a simple model in which a set of programmers can use several PLs, decide to use existing PLs used by other programmers, or decide not to use them. Our results highlight the influence of strong communities of practice in the diffusion of PL innovations.

Evaluating New Technology.

PubMed

Carniol, Paul J; Heffelfinger, Ryan N; Grunebaum, Lisa D

2018-05-01

There are multiple complex issues to consider when evaluating any new technology. First evaluate the efficacy of the device. Then considering your patient population decide whether this technology brings an added benefit to your patients. If it meets these 2 criteria, then proceed to the financial analysis of acquiring this technology. The complete financial analysis has several important components that include but are not limited to cost, value, alternatives, return on investment, and associated marketing expense. Copyright © 2018 Elsevier Inc. All rights reserved.

Defending the Driniumor. Covering Force Operations in New Guinea, 1944 (Leavenworth Papers, Number 9)

DTIC Science & Technology

1984-02-01

remains Robert Ross Smith’s The Approach to the Philippines . This Leavenworth Paper adds tactical detail to a single phase of the complex operations...divisions, supported by the U.S. Pacific Fleet, attack Hollandia on 15 April as a step toward MacArt the Philippines . One week later, the JCS...controlling the southern approach to the Philippines and the Caroline Islands. The Japanese primary defense line, decided at an imperial conference on

A Survey of Current Russion RTG Capabilities

NASA Technical Reports Server (NTRS)

Chmielewski, A.; Borshchevsky, A.; Lange, R.; Cook, B.

1994-01-01

Supplying radioisotope thermoelectric generators (RTG) to American space missions became very complex. The process is marred by many obstacles: high cost, lack of new developments, difficult launch approval and NEPA compliance. At the same time there are many ambitious space missions for which an RTG would indisputably be the lightest, smallest and most robust power source. An American delegation investigated status of RTG production in Russia to decide if our product line could be supplemented by the Russian designs.

Reinforcing Success: Using Lesson’s Learned from Foreign Aid Delivery to Plan Theater Security Cooperation in Africa

DTIC Science & Technology

2009-04-01

Africa is a questionable undertaking because of the expansive size and complexity of the cultural and political landscape. “You can drop the United...powers decided, bears no relationship to cultural or tribal ties within national boundaries. Hundreds of different languages and dialects are spoken in...Africa. Language is one of the main mechanisms for defining culture , for binding people together. In Nigeria alone, over 500 distinct dialects are

Some comments on the substituted judgement standard.

PubMed

Egonsson, Dan

2010-02-01

On a traditional interpretation of the substituted judgement standard (SJS) a person who makes treatment decisions on behalf of a non-competent patient (e.g. concerning euthanasia) ought to decide as the patient would have decided had she been competent. I propose an alternative interpretation of SJS in which the surrogate is required to infer what the patient actually thought about these end-of-life decisions. In clarifying SJS it is also important to differentiate the patient's consent and preference. If SJS is part of an autonomy ideal of the sort found in Kantian ethics, consent seems more important than preference. From a utilitarian perspective a preference-based reading of SJS seems natural. I argue that the justification of SJS within a utilitarian framework will boil down to the question whether a non-competent patient can be said to have any surviving preferences. If we give a virtue-ethical justification of SJS the relative importance of consent and preferences depends on which virtue one stresses--respect or care. I argue that SJS might be an independent normative method for extending the patient's autonomy, both from a Kantian and a virtue ethical perspective.

Spontaneous giving and calculated greed.

PubMed

Rand, David G; Greene, Joshua D; Nowak, Martin A

2012-09-20

Cooperation is central to human social behaviour. However, choosing to cooperate requires individuals to incur a personal cost to benefit others. Here we explore the cognitive basis of cooperative decision-making in humans using a dual-process framework. We ask whether people are predisposed towards selfishness, behaving cooperatively only through active self-control; or whether they are intuitively cooperative, with reflection and prospective reasoning favouring 'rational' self-interest. To investigate this issue, we perform ten studies using economic games. We find that across a range of experimental designs, subjects who reach their decisions more quickly are more cooperative. Furthermore, forcing subjects to decide quickly increases contributions, whereas instructing them to reflect and forcing them to decide slowly decreases contributions. Finally, an induction that primes subjects to trust their intuitions increases contributions compared with an induction that promotes greater reflection. To explain these results, we propose that cooperation is intuitive because cooperative heuristics are developed in daily life where cooperation is typically advantageous. We then validate predictions generated by this proposed mechanism. Our results provide convergent evidence that intuition supports cooperation in social dilemmas, and that reflection can undermine these cooperative impulses.

The light of a new age

NASA Technical Reports Server (NTRS)

Goldin, Daniel S.

1992-01-01

Given here is the address of NASA Administrator Daniel S. Goldin to the Association of Space Explorers. Mr. Goldin's remarks are on the topic of why we should go to Mars, a subject he approaches by first answering the question, What would it mean if we decided today not to go to Mars? After a discussion of the meaning of Columbus' voyage to America, he answers the question by saying that if we decide not to go to Mars, our generation will truly achieve a first in human history - we will be the first to stop at a frontier. After noting that the need to explore is intrinsic to life itself, Mr. Goldin presents several reasons why we should go to the Moon and go to Mars. One reason is economic, another is to increase our scientific knowledge, and yet another is to further the political evolution of humankind through the international cooperation required for building settlements on the Moon and Mars. He concludes by expanding upon the idea that this nation has never been one to shrink from a challenge.

Management of the Floating Knee in Polytrauma Patients

PubMed Central

Bertrand, M.L.; Andrés-Cano, P.

2015-01-01

Ipsilateral fracture of the femur and tibia, or floating knee, is a rare injury that is found almost exclusively in polytrauma or high-energy trauma patients. It presents a combination of diaphyseal, metaphyseal and intra-articular fractures of the femur and tibia, with a high incidence of neurovascular, ligamentous and soft-tissue injuries. The functional outcome and, in some cases, the life, of such polytrauma patients depends largely on a correct therapeutic approach being taken. In general, the treatment decided upon will depend on the individual characteristics present, regarding aspects such as the patient’s general condition, the fracture line and the state of the soft tissues. The treatment provided may be the same as when single fractures are presented, but it is often necessary to consider whether certain techniques or surgical approaches may interfere with other lines of treatment. It is essential at all times to take into consideration the associated injuries and complications before deciding upon a treatment strategy. Ligamentous injuries play an important role in these injuries, much more so than when fractures occur singly. Therefore, these injuries require management by an experienced multidisciplinary team. PMID:26312119

Growing up in the Ocean: Complex Life Cycles of Common Marine Invertebrates

ERIC Educational Resources Information Center

Bennett, Katie; Hiebert, Laurel

2010-01-01

Most people are familiar with the concept that animals come in all shapes and sizes and that the body plan of some animals can completely transform during their lifetime. Well-known examples of such complex life cycles of terrestrial animals include butterflies and frogs. Many people are unaware, however, that complex life cycles are exceedingly…

[To start eating again could be dangerous].

PubMed

Weibel, M; Ossola, N

2012-01-04

A 36-year-old woman with anorexia nervosa and resulting malnutrition decided to change her life and eat properly. One day after the refeeding start, instead of feeling better she felt much worse: fatigue, nausea and leg swelling occurred. She consulted our emergency department. A «refeeding syndrome» has been diagnosed. In this case report we discuss causes, clinical presentation and treatment of this illness. The aim is to make practitians aware about the existing of this disease even with oral refeeding. Warning signs have to be interpreted correctly in order to avoid dramatic consequences.

Second-hand market as an alternative in reverse logistics

NASA Astrophysics Data System (ADS)

Pochampally, Kishore K.; Gupta, Surendra M.

2004-02-01

Collectors of discarded products seldom know when those products were bought and why they are discarded. Also, the products do not indicate their remaining life periods. So, it is difficult to decide if it is "sensible" to repair (if necessary) a particular product for subsequent sale on the second-hand market or to disassemble it partially or completely for subsequent remanufacture and/or recycle. To this end, we build an expert system using Bayesian updating process and fuzzy set theory, to aid such decision-making. A numerical example demonstrates the building approach.

Perspective.

PubMed

Wolpert, Lewis

2015-01-01

I am a developmental biologist, but I started off as a civil engineer. I did some research on soil mechanics but decided to change to biology. A friend changed my life when he told me about the mechanics of cell division, on which I did my PhD at Kings College. I then worked on the morphogenesis of the sea urchin embryo and became interested in how embryos are patterned, and I proposed positional information as a basic mechanism. I was a professor at the Middlesex Hospital Medical School, where we concentrated on how the chick limb developed.

A Study of Depression and Quality of Life in Patients of Lichen Planus

PubMed Central

Sawant, Neena S.; Vanjari, Nakul A.; Khopkar, Uday; Adulkar, Satish

2015-01-01

The precise cause of lichen planus is unknown, but the disease seems to be immunologically mediated. It is a psychocutaneous disorder. Due to scarcity of Indian studies in this field, we decided to study in patients of lichen planus the prevalence of depression and quality of life with comparison of the same in both the genders. Patients diagnosed as having lichen planus by consultant dermatologist were enrolled after informed consent and ethics approval. 45 patients were screened, of which 35 who satisfied the criteria were taken up for the study. A semistructured proforma was designed to collect the necessary information with administration of dermatology life quality index and Beck's depression inventory. While 25% were depressed with females being more affected than males, quality of life was impaired in more than 90% patients. Impairment was maximum due to symptoms and illness feelings, disturbed daily activities, or work and time consumption in treatment. There was a strong association between depression and impairment in quality of life in both the genders. This study helps in early identification of psychological problems in lichen planus patients and in planning their future course of management, hence reducing the lack of productivity and improving the prognosis and quality of life. PMID:25802892

Quality of life in old age - a concept analysis.

PubMed

Boggatz, Thomas

2016-03-01

To identify existing definitions of quality of life in old age and to determine the most suitable for evaluating outcomes of nursing care for older adults. Promoting quality of life is a central concern of nursing care for older persons. There is, however, a lack of clarity about the meaning of this concept. Attributes of quality of life are often confused with those factors influencing them. Concept analysis according to Walker and Avant. A search was carried out in the databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO(®) and Gerolit for the years 1992-2013. Excerpts dealing with definitions, antecedents, consequences and empirical referents of the concept were compiled. Three basic concepts for quality of life were identified: satisfying life conditions, subjective general well-being and subjective fulfilment of dimensions of human life. Satisfying life conditions are antecedent to the other concepts. It is not suitable to view such conditions as an outcome of nursing care for older adults because an outcome has to be a consequence. General well-being is likely to remain stable over time and changing conditions due to adaptation taking place. Fulfilment of dimensions of human life as a multidimensional inner state may be more sensitive to changing conditions. Fulfilment of dimensions of human life is the most suitable definition of quality of life in old age as an outcome of nursing care. Studies are needed to decide whether it is responsive to changing circumstances. Fulfilment of dimensions of human life should be assessed to provide care that meets the needs of clients. © 2015 John Wiley & Sons Ltd.

From climate models to planetary habitability: temperature constraints for complex life

NASA Astrophysics Data System (ADS)

Silva, Laura; Vladilo, Giovanni; Schulte, Patricia M.; Murante, Giuseppe; Provenzale, Antonello

2017-07-01

In an effort to derive temperature-based criteria of habitability for multicellular life, we investigated the thermal limits of terrestrial poikilotherms, i.e. organisms whose body temperature and the functioning of all vital processes is directly affected by the ambient temperature. Multicellular poikilotherms are the most common and evolutionarily ancient form of complex life on earth. The thermal limits for the active metabolism and reproduction of multicellular poikilotherms on earth are approximately bracketed by the temperature interval 0°C <= T <= 50°C. The same interval applies to the photosynthetic production of oxygen, an essential ingredient of complex life, and for the generation of atmospheric biosignatures observable in exoplanets. Analysis of the main mechanisms responsible for the thermal thresholds of terrestrial life suggests that the same mechanisms would apply to other forms of chemical life. We therefore propose a habitability index for complex life, h 050, representing the mean orbital fraction of planetary surface that satisfies the temperature limits 0°C <= T <= 50°C. With the aid of a climate model tailored for the calculation of the surface temperature of Earth-like planets, we calculated h 050 as a function of planet insolation, S, and atmospheric columnar mass, N atm, for a few earth-like atmospheric compositions with trace levels of CO2. By displaying h 050 as a function of S and N atm, we built up an atmospheric mass habitable zone (AMHZ) for complex life. At variance with the classic habitable zone, the inner edge of the complex life habitable zone is not affected by the uncertainties inherent to the calculation of the runaway greenhouse limit. The complex life habitable zone is significantly narrower than the habitable zone of dry planets. Our calculations illustrate how changes in ambient conditions dependent on S and N atm, such as temperature excursions and surface dose of secondary particles of cosmic rays, may influence the type of life potentially present at different epochs of planetary evolution inside the AMHZ.

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The worldwide semisubmersible drilling rig fleet is approaching retirement. But replacement is not an attractive option even though dayrates are reaching record highs. In 1991, Schlumberger Sedco Forex managers decided that an alternative might exist if regulators and insurers could be convinced to extend rig life expectancy through restoration. Sedco Forex chose their No. 704 semisubmersible, an 18-year North Sea veteran, to test their process. The first step was to determine what required restoration, meaning fatigue life analysis of each weld on the huge vessel. If inspected, the task would be unacceptably time-consuming and of questionable accuracy. Instead a suitemore » of computer programs modeled the stress seen by each weld, statistically estimated the sea states seen by the rig throughout its North Sea service and calibrated a beam-element model on which to run their computer simulations. The elastic stiffness of the structure and detailed stress analysis of each weld was performed with ANSYS, a commercially available finite-element analysis program. The use of computer codes to evaluate service life extension is described.« less

The Interaction between Vector Life History and Short Vector Life in Vector-Borne Disease Transmission and Control.

PubMed

Brand, Samuel P C; Rock, Kat S; Keeling, Matt J

2016-04-01

Epidemiological modelling has a vital role to play in policy planning and prediction for the control of vectors, and hence the subsequent control of vector-borne diseases. To decide between competing policies requires models that can generate accurate predictions, which in turn requires accurate knowledge of vector natural histories. Here we highlight the importance of the distribution of times between life-history events, using short-lived midge species as an example. In particular we focus on the distribution of the extrinsic incubation period (EIP) which determines the time between infection and becoming infectious, and the distribution of the length of the gonotrophic cycle which determines the time between successful bites. We show how different assumptions for these periods can radically change the basic reproductive ratio (R0) of an infection and additionally the impact of vector control on the infection. These findings highlight the need for detailed entomological data, based on laboratory experiments and field data, to correctly construct the next-generation of policy-informing models.

A Life Fulfilled: Should There Be Assisted Suicide for Those Who Are Done with Living?

PubMed

Buijsen, Martin

2018-07-01

The issue of assisted suicide for those with a "fulfilled life" is being hotly debated in the Netherlands. A large number of Dutch people feel that elderly people (i.e., people who have reached the age of 70) with a "fulfilled life" should have access to assisted suicide. Citizens have therefore requested Parliament to expand the existing legislation that governs euthanasia and physician-assisted suicide. The Dutch constitution does not permit national legislation to be incompatible with higher international (human rights) law. An analysis of the case law of the European Court of Human Rights shows that a person's right to decide on the time and manner of his or her death should be regarded as an aspect of the right to privacy. Although no positive obligation has been imposed on parties to the European Convention for the Protection of Human Rights and Fundamental Freedoms to facilitate suicide, they may do so, provided that certain conditions are met.

What I've Learned and Unlearned as a Physical Scientist in the Life Science Industry

NASA Astrophysics Data System (ADS)

Morgenstern, David

2008-04-01

I joined Monsanto in 1996 with a Ph.D. in Physical Chemistry and a background in photochemistry and supercritical fluids, just as the company was exiting the chemical business. Since then, I experienced a merger into a pharmaceutical company (Pharmacia) and a spinoff into a purely agricultural company, focused on Biotech and Crop Protection. Change of this kind is typical in industrial research. I have found it to be a continuing challenge to decide when to adapt and when to focus on marketing the expertise that I brought into the company. Viewed as a problem in career tactics in a constantly changing technical, business, and organizational landscape, it might seem overwhelmingly difficult. But, as I will discuss, life in industrial research is constantly offering opportunities to provide new answers to the question, ``what should I do with my life?'' Thus, particularly for those who believe that research should serve society, the satisfactions of an industrial research career are deep and varied.

Early Life Manipulations Alter Learning and Memory in Rats

PubMed Central

Kosten, Therese A; Kim, Jeansok J; Lee, Hongjoo J.

2012-01-01

Much research shows early life manipulations have enduring behavioral, neural, and hormonal effects. However, findings of learning and memory performance vary widely across studies. We reviewed studies in which pre-weaning rat pups were exposed to stressors and tested on learning and memory tasks in adulthood. Tasks were classified as aversive conditioning, inhibitory learning, or spatial/relational memory. Variables of duration, type, and timing of neonatal manipulation and sex and strain of animals were examined to determine if any predict enhanced or impaired performance. Brief separations enhanced and prolonged separations impaired performance on spatial/relational tasks. Performance was impaired in aversive conditioning and enhanced in inhibitory learning tasks regardless of manipulation duration. Opposing effects on performance for spatial/relational memory also depended upon timing of manipulation. Enhanced performance was likely if the manipulation occurred during postnatal week 3 but performance was impaired if it was confined to the first two postnatal weeks. Thus, the relationship between early life experiences and adulthood learning and memory performance is multifaceted and decidedly task-dependent. PMID:22819985

A closed life-support system for space colonies

NASA Technical Reports Server (NTRS)

Johnson, R. D.; Jebens, H. J.; Sweet, H. C.

1977-01-01

In 1975, a system design study was performed to examine a completely self-contained system for a permanent colony of 10,000 inhabitants in space. Fundamental to this design was the life support system. Since resupply from earth is prohibitive in transportation costs, it was decided to use a closed system with the initial supply of oxygen coming from processing of lunar ores, and the supply of carbon, nitrogen and hydrogen from earth. The problem of life support was treated starting with the nutritional and metabolic requirements for the human population, creating a food and water chain sufficient to supply these demands, adding the additional requirements for the animal and plant sources in the food chain, feeding back useful waste products, supplying water as required from different sources, and closing the loop by processing organic wastes into CO2. This concept places the burden of the system upon plants for O2 generation and waste processing the CO2 generation.

The Simud-Tiu Valles hydrologic system: A multidisciplinary study of a possible site for future Mars on-site exploration

NASA Astrophysics Data System (ADS)

Pajola, Maurizio; Rossato, Sandro; Baratti, Emanuele; Mangili, Clara; Mancarella, Francesca; McBride, Karen; Coradini, Marcello

2016-04-01

When looking for traces of past life on Mars, we have to look primarily for places where water was present, possibly for long time intervals. The Simud and Tiu Valles are two large outflow channels connected to the north with the Chryse Basin, Oxia Palus quadrangle. The area, carved by water during the Noachian/Early Hesperian is characterized by a complex geological evolution. The geomorphological analysis shows the presence of fluvial and alluvial structures, interpreted as fluvial channels and terraces, debris flow fronts and short-lasting small water flows coexisting with maar-diatremes and mud volcanoes. Several morphological features indicate a change in water flux direction after the main erosive phase. During this period water originated from the Masursky crater and flown southwards into the Hydraotes Chaos. This phenomenon caused the studied area to become a depocenter where fine-grained material deposition took place, possibly in association with ponding water. This setting is potentially quite valuable as traces of life may have been preserved. The presence of water at various times over a period of about 1 Ga in the area is corroborated by mineralogical analyses of different areas that indicate the possible presence of hydrated minerals mixtures, such as sulfate-bearing deposits. Given the uniqueness of the evolution of this region, the long term interactions between fluvial, volcanic, and tectonic processes and its extremely favorable landing parameters (elevation, slope, roughness, rock distribution, thermal inertia, albedo, etc.), we decided to propose this location as a possible landing site for the ESA ExoMars 2018, the NASA Mars 2020 and future on-site missions.

Improved Management of Water and Natural Resources Requires Open, Cognizant, Adaptive Science and Policy

NASA Astrophysics Data System (ADS)

Glynn, P. D.; Voinov, A. A.; Shapiro, C. D.; Jenni, K. E.

2017-12-01

Water issues impact the availability and use of other natural resources as well as environmental conditions. In an increasingly populated hyper-connected world, water issues are increasingly "wicked problems": complex problems with high uncertainties and no independent observers. Water is essential to life, and life affects water quality and availability. Scientists, managers, decision-makers, and the greater public all have a stake in improving the management of water resources. In turn, they are part of the systems that they are studying, deciding on, affecting, or trying to improve. Governance of water issues requires greater accessibility, traceability, and accountability (ATA) in science and policy. Water-related studies and decision-making need transdisciplinary science, inclusive participatory processes, and consideration and acceptance of multiple perspectives. Biases, Beliefs, Heuristics, and Values (BBHV) shape much of our perceptions and knowledge, and inevitably, affect both science and policy. Understanding the role of BBHV is critical to (1) understanding individual and group judgments and choices, (2) recognizing potential differences between societal "wants" and societal "needs", and (3) identifying "winners" and "losers" of policy decisions. Societal acceptance of proposed policies and actions can be fostered by enhancing participatory processes and by providing greater ATA in science, in policy, and in development of the laws, rules, and traditions that constrain decision-making. An adaptive science-infused governance framework is proposed that seeks greater cognizance of the role of BBHV in shaping science and policy choices and decisions, and that also seeks "Open Traceable Accountable Policy" to complement "Open Science". We discuss the limitations of the governance that we suggest, as well as tools and approaches to help implementation.

Autonomy and integration in complex parasite life cycles.

PubMed

Benesh, Daniel P

2016-12-01

Complex life cycles are common in free-living and parasitic organisms alike. The adaptive decoupling hypothesis postulates that separate life cycle stages have a degree of developmental and genetic autonomy, allowing them to be independently optimized for dissimilar, competing tasks. That is, complex life cycles evolved to facilitate functional specialization. Here, I review the connections between the different stages in parasite life cycles. I first examine evolutionary connections between life stages, such as the genetic coupling of parasite performance in consecutive hosts, the interspecific correlations between traits expressed in different hosts, and the developmental and functional obstacles to stage loss. Then, I evaluate how environmental factors link life stages through carryover effects, where stressful larval conditions impact parasites even after transmission to a new host. There is evidence for both autonomy and integration across stages, so the relevant question becomes how integrated are parasite life cycles and through what mechanisms? By highlighting how genetics, development, selection and the environment can lead to interdependencies among successive life stages, I wish to promote a holistic approach to studying complex life cycle parasites and emphasize that what happens in one stage is potentially highly relevant for later stages.

When fast logic meets slow belief: Evidence for a parallel-processing model of belief bias.

PubMed

Trippas, Dries; Thompson, Valerie A; Handley, Simon J

2017-05-01

Two experiments pitted the default-interventionist account of belief bias against a parallel-processing model. According to the former, belief bias occurs because a fast, belief-based evaluation of the conclusion pre-empts a working-memory demanding logical analysis. In contrast, according to the latter both belief-based and logic-based responding occur in parallel. Participants were given deductive reasoning problems of variable complexity and instructed to decide whether the conclusion was valid on half the trials or to decide whether the conclusion was believable on the other half. When belief and logic conflict, the default-interventionist view predicts that it should take less time to respond on the basis of belief than logic, and that the believability of a conclusion should interfere with judgments of validity, but not the reverse. The parallel-processing view predicts that beliefs should interfere with logic judgments only if the processing required to evaluate the logical structure exceeds that required to evaluate the knowledge necessary to make a belief-based judgment, and vice versa otherwise. Consistent with this latter view, for the simplest reasoning problems (modus ponens), judgments of belief resulted in lower accuracy than judgments of validity, and believability interfered more with judgments of validity than the converse. For problems of moderate complexity (modus tollens and single-model syllogisms), the interference was symmetrical, in that validity interfered with belief judgments to the same degree that believability interfered with validity judgments. For the most complex (three-term multiple-model syllogisms), conclusion believability interfered more with judgments of validity than vice versa, in spite of the significant interference from conclusion validity on judgments of belief.

Drake Equation for the Multiverse:. from the String Landscape to Complex Life

NASA Astrophysics Data System (ADS)

Gleiser, M.

It is argued that the selection criteria usually referred to as "anthropic conditions" for the existence of intelligent (typical) observers widely adopted in cosmology amount only to preconditions for primitive life. The existence of life does not imply in the existence of intelligent life. On the contrary, the transition from single-celled to complex, multicellular organisms is far from trivial, requiring stringent additional conditions on planetary platforms. An attempt is made to disentangle the necessary steps leading from a selection of universes out of a hypothetical multiverse to the existence of life and of complex life. It is suggested that what is currently called the "anthropic principle" should instead be named the "prebiotic principle."

Using Plants to Explore the Nature & Structural Complexity of Life

ERIC Educational Resources Information Center

Howard, Ava R.

2014-01-01

Use of real specimens brings the study of biology to life. This activity brings easily acquired plant specimens into the classroom to tackle common alternative conceptions regarding life, size, complexity, the nature of science, and plants as multicellular organisms. The activity occurs after a discussion of the characteristics of life and engages…

Pros and Cons of Antigen-Presenting Cell Targeted Tumor Vaccines.

PubMed

Goyvaerts, Cleo; Breckpot, Karine

2015-01-01

In therapeutic antitumor vaccination, dendritic cells play the leading role since they decide if, how, when, and where a potent antitumor immune response will take place. Since the disentanglement of the complexity and merit of different antigen-presenting cell subtypes, antitumor immunotherapeutic research started to investigate the potential benefit of targeting these subtypes in situ. This review will discuss which antigen-presenting cell subtypes are at play and how they have been targeted and finally question the true meaning of targeting antitumor-based vaccines.

Practice considerations in providing cancer risk assessment and genetic testing in women's health.

PubMed

Mahon, Suzanne M; Crecelius, Mary E

2013-01-01

Providers of women's health services are often confronted with questions about cancer genetic testing. The provision of these services is complex. The process begins with accurate risk assessment and identification of individuals who might benefit from genetic testing services. There are practice, administrative, legal, and ethical considerations that should be considered when developing policies for the referral of at-risk individuals or before deciding to provide genetic services. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Tumors Induce Complex DNA Damage in Distant Proliferative Tissues in Vivo | Center for Cancer Research

Cancer.gov

In radiation biology, a bystander effect occurs when cells not directly exposed to ionizing radiation show increased genomic instability and impaired viability due to the release of signaling molecules by the irradiated cells in their vicinity. Christophe Redon, Ph.D., and colleagues in CCR’s Laboratory of Molecular Pharmacology, decided to ask whether a tumor itself could exhibit a similar effect. Their results were recently published in the Proceedings of the National Academy of Sciences.

Presynaptic Inhibition in the Striatum of the Basal Ganglia Improves Pattern Classification and Thus Promotes Superior Goal Selection

PubMed Central

Schwab, David J.; Houk, James C.

2015-01-01

This review article takes a multidisciplinary approach to understand how presynaptic inhibition in the striatum of the basal ganglia (BG) contributes to pattern classification and the selection of goals that control behavior. It is a difficult problem both because it is multidimensional and because it is has complex system dynamics. We focus on the striatum because, as the main site for input to the BG, it gets to decide what goals are important to consider. PMID:26696840

[Implementation of ethics services. Opportunities and obstacles].

PubMed

Salomon, F

2015-04-01

Medical success in the last century has caused situations, in which the question arises whether therapy is right. In the same time autonomy has become more and more important. Furthermore, human beings want to decide on health, life and dying. Experience of limitations of life and desire of autonomy in healthcare lead to ethical questions. Different ethical services were established to deal with and to solve problems. Ethics committees with multiprofessional members and different qualifications will give guidance in critical decision making. Ethics services do not receive responsibility for the decision, but helps those who are responsible by structured reflection, estimation of values and including all concerned. Implementing ethics services also encounters obstructions and scepticism. Time, responsibility for therapy and criticism of customs and structures must be considered to perpetuate success. Instructions for implementing ethics services are presented.

[Neonatal hyperthyroidism and maternal Graves disease].

PubMed

Ben Ameur, K; Chioukh, F Z; Marmouch, H; Ben Hamida, H; Bizid, M; Monastiri, K

2015-04-01

The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

The promise and peril of the pharmacological enhancer Modafinil.

PubMed

Tannenbaum, Julie

2014-10-01

The neuro-enhancement Modafinil promises to dramatically increase users' waking hours without much sacrifice to clarity of thought and without serious side effects (inducing addiction). For Modafinil to be advantageous, its usage must enable access to goods that themselves improve the quality of one's life. I draw attention to a variety of conditions that must be met for an experience, activity or object to improve the quality of one's life, such as positional, relational, and saturation conditions, as well as it's being good for its own sake. I discuss and describe the contexts in which widespread usage (legal or not) of Modafinil would undermine these conditions being met, and thus users would fail to significantly improve the quality of their lives and would in fact potentially make both themselves and nonusers worse off in important respects thus far overlooked by critics. In the right contexts, where free time is protected and prolonged, Modafinil does have a variety of potential benefits including, most interestingly, a distinctive form of agency possible only in free time. The potential disadvantages and advantages highlighted in this article are relevant not only to public institutions deciding whether to legalize Modafinil's use as an enhancement but also to individuals deciding whether to use it illegally, as well as to the questions of how and whether to alter key features of one's context (e.g. regulating work hours or extending social services) rather than, or in addition, to regulating the use of enhancement drugs such as Modafinil. © 2012 John Wiley & Sons Ltd.

Computational complexity in entanglement transformations

NASA Astrophysics Data System (ADS)

Chitambar, Eric A.

In physics, systems having three parts are typically much more difficult to analyze than those having just two. Even in classical mechanics, predicting the motion of three interacting celestial bodies remains an insurmountable challenge while the analogous two-body problem has an elementary solution. It is as if just by adding a third party, a fundamental change occurs in the structure of the problem that renders it unsolvable. In this thesis, we demonstrate how such an effect is likewise present in the theory of quantum entanglement. In fact, the complexity differences between two-party and three-party entanglement become quite conspicuous when comparing the difficulty in deciding what state changes are possible for these systems when no additional entanglement is consumed in the transformation process. We examine this entanglement transformation question and its variants in the language of computational complexity theory, a powerful subject that formalizes the concept of problem difficulty. Since deciding feasibility of a specified bipartite transformation is relatively easy, this task belongs to the complexity class P. On the other hand, for tripartite systems, we find the problem to be NP-Hard, meaning that its solution is at least as hard as the solution to some of the most difficult problems humans have encountered. One can then rigorously defend the assertion that a fundamental complexity difference exists between bipartite and tripartite entanglement since unlike the former, the full range of forms realizable by the latter is incalculable (assuming P≠NP). However, similar to the three-body celestial problem, when one examines a special subclass of the problem---invertible transformations on systems having at least one qubit subsystem---we prove that the problem can be solved efficiently. As a hybrid of the two questions, we find that the question of tripartite to bipartite transformations can be solved by an efficient randomized algorithm. Our results are obtained by encoding well-studied computational problems such as polynomial identity testing and tensor rank into questions of entanglement transformation. In this way, entanglement theory provides a physical manifestation of some of the most puzzling and abstract classical computation questions.

Time to consider search strategies for complex life on exoplanets

NASA Astrophysics Data System (ADS)

Schulze-Makuch, Dirk; Bains, William

2018-06-01

Upcoming telescopes might be able to detect signatures of complex life on other worlds, but we need to involve physical, chemical and life scientists at the planning stage in order to interpret the findings when the time comes.

Time to consider search strategies for complex life on exoplanets

NASA Astrophysics Data System (ADS)

Schulze-Makuch, Dirk; Bains, William

2018-05-01

Upcoming telescopes might be able to detect signatures of complex life on other worlds, but we need to involve physical, chemical and life scientists at the planning stage in order to interpret the findings when the time comes.

Complex life cycles in a pond food web: effects of life stage structure and parasites on network properties, trophic positions and the fit of a probabilistic niche model.

PubMed

Preston, Daniel L; Jacobs, Abigail Z; Orlofske, Sarah A; Johnson, Pieter T J

2014-03-01

Most food webs use taxonomic or trophic species as building blocks, thereby collapsing variability in feeding linkages that occurs during the growth and development of individuals. This issue is particularly relevant to integrating parasites into food webs because parasites often undergo extreme ontogenetic niche shifts. Here, we used three versions of a freshwater pond food web with varying levels of node resolution (from taxonomic species to life stages) to examine how complex life cycles and parasites alter web properties, the perceived trophic position of organisms, and the fit of a probabilistic niche model. Consistent with prior studies, parasites increased most measures of web complexity in the taxonomic species web; however, when nodes were disaggregated into life stages, the effects of parasites on several network properties (e.g., connectance and nestedness) were reversed, due in part to the lower trophic generality of parasite life stages relative to free-living life stages. Disaggregation also reduced the trophic level of organisms with either complex or direct life cycles and was particularly useful when including predation on parasites, which can inflate trophic positions when life stages are collapsed. Contrary to predictions, disaggregation decreased network intervality and did not enhance the fit of a probabilistic niche model to the food webs with parasites. Although the most useful level of biological organization in food webs will vary with the questions of interest, our results suggest that disaggregating species-level nodes may refine our perception of how parasites and other complex life cycle organisms influence ecological networks.

25 CFR 39.133 - Who decides how Language Development funds can be used?

Code of Federal Regulations, 2012 CFR

2012-04-01

... SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Language Development Programs § 39.133 Who decides how Language Development funds can be used? Tribal governing bodies or local school boards decide... 25 Indians 1 2012-04-01 2011-04-01 true Who decides how Language Development funds can be used? 39...

A management system for end-of-life tyres: a Portuguese case study.

PubMed

Ferrão, Paulo; Ribeiro, Paulo; Silva, Paulo

2008-01-01

The European Union introduced several policy instruments based in the extended producer responsibility (EPR) in order to improve the environmental performance of products and services through their life cycles. In this context, the Portuguese government decided to apply the EPR concept to tyres, and producers were obliged to constitute an end-of-life management system to promote the collection, recycling and reuse of end-of-life (EOL) tyres. This required producers, distributors, recyclers and retreaders to be identified and characterized, and local processing infrastructures to be analyzed. The information was used to design an economically optimised EOL tyre management system while promoting the activity of all EOL operators in order for the imposed collecting and recovery targets to be fulfilled. This paper discusses the interaction between the different governmental, private and academic institutions for the creation of the integrated management system for EOL tyres, the approach taken, the technical, political and legal aspects underneath them, as well as the environmental consequences induced by the creation of the management system. The results obtained during the first years of operation are reported and show an increase in the collection and recycling of EOL tyres and the consolidation of the collection and processing infrastructures.

Background qualitative analysis of the European reference life cycle database (ELCD) energy datasets - part II: electricity datasets.

PubMed

Garraín, Daniel; Fazio, Simone; de la Rúa, Cristina; Recchioni, Marco; Lechón, Yolanda; Mathieux, Fabrice

2015-01-01

The aim of this paper is to identify areas of potential improvement of the European Reference Life Cycle Database (ELCD) electricity datasets. The revision is based on the data quality indicators described by the International Life Cycle Data system (ILCD) Handbook, applied on sectorial basis. These indicators evaluate the technological, geographical and time-related representativeness of the dataset and the appropriateness in terms of completeness, precision and methodology. Results show that ELCD electricity datasets have a very good quality in general terms, nevertheless some findings and recommendations in order to improve the quality of Life-Cycle Inventories have been derived. Moreover, these results ensure the quality of the electricity-related datasets to any LCA practitioner, and provide insights related to the limitations and assumptions underlying in the datasets modelling. Giving this information, the LCA practitioner will be able to decide whether the use of the ELCD electricity datasets is appropriate based on the goal and scope of the analysis to be conducted. The methodological approach would be also useful for dataset developers and reviewers, in order to improve the overall Data Quality Requirements of databases.

Influence of the impact assessment method on the conclusions of a LCA study. Application to the case of a part made with virgin and recycled HDPE.

PubMed

Simões, Carla L; Xará, Susana M; Bernardo, C A

2011-10-01

Recent legislation has stressed the need to decide the best end-of-life (EoL) option for post-consumer products considering their full life-cycle and the corresponding overall environmental impacts. The life cycle assessment (LCA) technique has become a common tool to evaluate those impacts. The present study aimed to contribute to the better understanding of the application of this technique, by evaluating the influence of the selection of the life cycle impact assessment (LCIA) method in its results and conclusions. A specific case study was chosen, using previous information related to an anti-glare lamellae (AGL) for highway use, made with virgin and recycled high-density polyethylene (HDPE). Five distinct LCIA methods were used: Eco-indicator 99, CML 2 (2000), EPS 2000, Eco-indicator 95 and EDIP 97. Consistent results between these methods were obtained for the Climate change, Ozone layer depletion, Acidification and Eutrophication environmental indicators. Conversely, the Summer smog indicator showed large discrepancies between impact assessment methods. The work sheds light on the advantages inherent in using various LCIA methods when doing the LCA study of a specific product, thus evidencing complementary analysis perspectives.

Searching for life in the Universe: unconventional methods for an unconventional problem.

PubMed

Nealson, K H; Tsapin, A; Storrie-Lombardi, M

2002-12-01

The search for life, on and off our planet, can be done by conventional methods with which we are all familiar. These methods are sensitive and specific, and are often capable of detecting even single cells. However, if the search broadens to include life that may be different (even subtly different) in composition, the methods and even the approach must be altered. Here we discuss the development of what we call non-earthcentric life detection--detecting life with methods that could detect life no matter what its form or composition. To develop these methods, we simply ask, can we define life in terms of its general properties and particularly those that can be measured and quantified? Taking such an approach we can search for life using physics and chemistry to ask questions about structure, chemical composition, thermodynamics, and kinetics. Structural complexity can be searched for using computer algorithms that recognize complex structures. Once identified, these structures can be examined for a variety of chemical traits, including elemental composition, chirality, and complex chemistry. A second approach involves defining our environment in terms of energy sources (i.e., reductants), and oxidants (e.g. what is available to eat and breathe), and then looking for areas in which such phenomena are inexplicably out of chemical equilibrium. These disequilibria, when found, can then be examined in detail for the presence of the structural and chemical complexity that presumably characterizes any living systems. By this approach, we move the search for life to one that should facilitate the detection of any earthly life it encountered, as well as any non-conventional life forms that have structure, complex chemistry, and live via some form of redox chemistry.

Scope of Gradient and Genetic Algorithms in Multivariable Function Optimization

NASA Technical Reports Server (NTRS)

Shaykhian, Gholam Ali; Sen, S. K.

2007-01-01

Global optimization of a multivariable function - constrained by bounds specified on each variable and also unconstrained - is an important problem with several real world applications. Deterministic methods such as the gradient algorithms as well as the randomized methods such as the genetic algorithms may be employed to solve these problems. In fact, there are optimization problems where a genetic algorithm/an evolutionary approach is preferable at least from the quality (accuracy) of the results point of view. From cost (complexity) point of view, both gradient and genetic approaches are usually polynomial-time; there are no serious differences in this regard, i.e., the computational complexity point of view. However, for certain types of problems, such as those with unacceptably erroneous numerical partial derivatives and those with physically amplified analytical partial derivatives whose numerical evaluation involves undesirable errors and/or is messy, a genetic (stochastic) approach should be a better choice. We have presented here the pros and cons of both the approaches so that the concerned reader/user can decide which approach is most suited for the problem at hand. Also for the function which is known in a tabular form, instead of an analytical form, as is often the case in an experimental environment, we attempt to provide an insight into the approaches focusing our attention toward accuracy. Such an insight will help one to decide which method, out of several available methods, should be employed to obtain the best (least error) output. *

Deliberating Tarceva: A case study of how British NHS managers decide whether to purchase a high-cost drug in the shadow of NICE guidance.

PubMed

Hughes, David; Doheny, Shane

2011-11-01

This paper examines audio-recorded data from meetings in which NHS managers decide whether to fund high-cost drugs for individual patients. It investigates the work of a Welsh individual patient commissioning (IPC) panel responsible for sanctioning the purchase of 'un-commissioned' treatments for exceptional cases. The case study presented highlights the changing rationales used for approving or denying a cancer drug, Tarceva, during a period when NICE first suggested it was not cost effective, but then changed its position in a final technology appraisal recommending use when the cost did not exceed that of an alternative product. Our data show how decisions taken in the shadow of NICE guidance remain complex and subject to local discretion. Guidance that takes time to prepare, is released in stages, and relates to particular disease stages, must be interpreted in the context of particular cases. The case-based IPC panel discourse stands in tension with the standardised population-based recommendations in guidance. Panel members, who based their decisions on the central notions of 'efficacy' and 'exceptionality', often struggled to apply NICE information on cost-effectiveness to their deliberations on efficacy (clinical effectiveness). The case study suggests that the complex nature of decision making makes standardization of outcomes very difficult to achieve, so that local professional judgement is likely to remain central to health care rationing at this level. Copyright © 2011 Elsevier Ltd. All rights reserved.

Emergence of life: Physical chemistry changes the paradigm.

PubMed

Spitzer, Jan; Pielak, Gary J; Poolman, Bert

2015-06-10

Origin of life research has been slow to advance not only because of its complex evolutionary nature (Franklin Harold: In Search of Cell History, 2014) but also because of the lack of agreement on fundamental concepts, including the question of 'what is life?'. To re-energize the research and define a new experimental paradigm, we advance four premises to better understand the physicochemical complexities of life's emergence: (1) Chemical and Darwinian (biological) evolutions are distinct, but become continuous with the appearance of heredity. (2) Earth's chemical evolution is driven by energies of cycling (diurnal) disequilibria and by energies of hydrothermal vents. (3) Earth's overall chemical complexity must be high at the origin of life for a subset of (complex) chemicals to phase separate and evolve into living states. (4) Macromolecular crowding in aqueous electrolytes under confined conditions enables evolution of molecular recognition and cellular self-organization. We discuss these premises in relation to current 'constructive' (non-evolutionary) paradigm of origins research - the process of complexification of chemical matter 'from the simple to the complex'. This paradigm artificially avoids planetary chemical complexity and the natural tendency of molecular compositions toward maximum disorder embodied in the second law of thermodynamics. Our four premises suggest an empirical program of experiments involving complex chemical compositions under cycling gradients of temperature, water activity and electromagnetic radiation.

Astronomy stories

NASA Astrophysics Data System (ADS)

Berenson, Rhoda

2015-03-01

For many years I have taught physics and astronomy courses to liberal arts students. I have found most of my students to be intelligent and diligent, but not anxious to study science. They typically take the class only because their degree requires a science course. Many arrive having already decided they will not be able to do the math or understand the scientific concepts, and have essentially built a wall between themselves and science. In the 1990s, in an effort to help break down that wall, as part of an NSF-supported course, "The Evolution of the Universe, Earth and Life," I began using creative writing assignments.

Teacher in Space Participants testing space food in orientation session

NASA Image and Video Library

1985-09-25

S85-39978 (10 Sept. 1985) --- Sharon Christa McAuliffe, left, appears to be deciding what she thinks of a piece of space food she tastes during a session of interfacing with space shuttle life sciences. Barbara R. Morgan samples an apricot. The two are in early training at the Johnson Space Center (JSC) in preparation for the STS-51L spaceflight early next year. McAuliffe is prime payload specialist representing the Teacher in Space Project, and Morgan is her backup. Dr. C.T. Bourland, a dietitian specialist, assists the two. Photo credit: NASA

Geographic variation and evolution in the life cycle of the witch-hazel leaf gall aphid, Hormaphis hamamelidis.

PubMed

von Dohlen, C D; Gill, D E

1989-02-01

Two divergent life cycles associated with different elevations and latitudes have been documented for the witch-hazel leaf gall aphid, Hormaphis hamamelidis. At low elevation in northern Virginia, the aphid had seven distinct generations alternating between the primary host, witchhazel (Hamamelis virginiana), and a secondary host, river birch (Betula nigra). These findings confirm the original published life cycle description for the same locality. A second, abbreviated life cycle consisting of only three generations restricted to witch-hazel was discovered at high elevation (1000 m) in north central and northwestern Virginia. Aphids of both life cycles were sympatric at a middle elevation site. The life cycles and morphology suggest that the two forms are separate species. Although monoecious life cycles on primary hosts in aphids generally are thought to be ancestral to complex host-alternating ones, it is certainly possible that monoecious cycles are sometimes secondarily derived from complex cycles. By constructing a preliminary phylogeny of the described species in the tribe Hormaphidini, we propose that the abbreviated life cycle is derived from the complex one in the case of these witchhazel gall aphids. Our findings are discussed in the context of current theory regarding the evolutionary stability of complex life cycles.

RADIOACTIVE ELEMENTS IN THE STANDARD ATOMIC WEIGHTS TABLE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holden, N.E.; Holden, N.; Holden,N.E.

2011-07-27

In the 1949 Report of the Atomic Weights Commission, a series of new elements were added to the Atomic Weights Table. Since these elements had been produced in the laboratory and were not discovered in nature, the atomic weight value of these artificial products would depend upon the production method. Since atomic weight is a property of an element as it occurs in nature, it would be incorrect to assign an atomic weight value to that element. As a result of that discussion, the Commission decided to provide only the mass number of the most stable (or longest-lived) known isotopemore » as the number to be associated with these entries in the Atomic Weights Table. As a function of time, the mass number associated with various elements has changed as longer-lived isotopes of a particular element has been found in nature, or as improved half-life values of an element's isotopes might cause a shift in the longest-lived isotope from one mass to another. In the 1957 Report of the Atomic Weights Commission, it was decided to discontinue the listing of the mass number in the Atomic Weights Table on the grounds that the kind of information supplied by the mass number is inconsistent with the primary purpose of the Table, i.e., to provide accurate values of 'these constants' for use in various chemical calculations. In addition to the Table of Atomic Weights, the Commission included an auxiliary Table of Radioactive Elements for the first time, where the entry would be the isotope of that element which was the most stable, i.e., the one with the longest known half-life. In their 1973 Report, the Commission noted that the users of the main Table of Atomic Weights were dissatisfied with the omission of values for some elements in that Table and it was decided to reintroduce the mass number for the radioactive elements into the main Table. In their 1983 Report, the Commission decided that radioactive elements were considered to lack a characteristic terrestrial isotopic composition, from which an atomic weight value could be calculated to five or more figure accuracy, without prior knowledge of the sample involved. These elements were again listed in the Atomic Weights Table with no further information, i.e., with no mass number or atomic weight value. For the elements, which have no stable characteristic terrestrial isotopic composition, the data on the half-lives and the relative atomic masses for the nuclides of interest for those elements have been evaluated. The values of the half-lives with their uncertainties are listed in the table. The uncertainties are given for the last digit quoted of the half-life and are given in parentheses. A half-life entry for the Table having a value and an uncertainty of 7 {+-} 3 is listed in the half-life column as 7 (3). The criteria to include data in this Table, is to be the same as it has been for over sixty years. It is the same criteria, which are used for all data that are evaluated for inclusion in the Standard Table of Atomic Weights. If a report of data is published in a peer-reviewed journal, that data is evaluated and considered for inclusion in the appropriate table of the biennial report of the Atomic Weights Commission. As better data becomes available in the future, the information that is contained in either of the Tables of Standard Atomic Weights or in the Table of Radioactive Elements may be modified. It should be noted that the appearance of any datum in the Table of the Radioactive Elements is merely for the purposes of calculating an atomic mass value for any sample of a radioactive material, which might have a variety of isotopic compositions and it has no implication as to the priority for claiming discovery of a given element and is not intended to. The atomic mass values have been taken primarily from the 2003 Atomic Mass Table. Mass values for those radioisotopes that do not appear in the 2003 Atomic mass Table have been taken from preliminary data of the Atomic Mass Data Center. Most of the quoted half-lives.« less

Choice and Decision Processes and Careers. Information Series No. 7.

ERIC Educational Resources Information Center

Tiedeman, David V.; Miller-Tiedeman, Anna

The state of the art review depicts comprehension of choice and decision making as knowable and demonstrates that something is already known about both processes and how to facilitate their comprehension. The assumption is made that deciding to choose, choosing to decide, deciding in order to choose, and choosing in order to decide must be…

The Cosmic Zoo: The (Near) Inevitability of the Evolution of Complex, Macroscopic Life

PubMed Central

Bains, William; Schulze-Makuch, Dirk

2016-01-01

Life on Earth provides a unique biological record from single-cell microbes to technologically intelligent life forms. Our evolution is marked by several major steps or innovations along a path of increasing complexity from microbes to space-faring humans. Here we identify various major key innovations, and use an analytical toolset consisting of a set of models to analyse how likely each key innovation is to occur. Our conclusion is that once the origin of life is accomplished, most of the key innovations can occur rather readily. The conclusion for other worlds is that if the origin of life can occur rather easily, we should live in a cosmic zoo, as the innovations necessary to lead to complex life will occur with high probability given sufficient time and habitat. On the other hand, if the origin of life is rare, then we might live in a rather empty universe. PMID:27376334

On the feasibility of benefit-cost analysis applied to remote sensing projects. [California water resources

NASA Technical Reports Server (NTRS)

Merewitz, L.

1973-01-01

The following step-wise procedure for making a benefit-cost analysis of using remote sensing techniques could be used either in the limited context of California water resources, or a context as broad as the making of integrated resource surveys of the entire earth resource complex on a statewide, regional, national, or global basis. (1) Survey all data collection efforts which can be accomplished by remote sensing techniques. (2) Carefully inspect the State of California budget and the Budget of the United States Government to find annual cost of data collection efforts. (3) Decide the extent to which remote sensing can obviate each of the collection efforts. (4) Sum the annual costs of all data collection which can be equivalently accomplished through remote sensing. (5) Decide what additional data could and would be collected through remote sensing. (6) Estimate the value of this information. It is not harmful to do a benefit-cost analysis so long as its severe limitations are recalled and it is supplemented with socio-economic impact studies.

Abstract principles and concrete cases in intuitive lawmaking.

PubMed

Ellman, Ira Mark; Braver, Sanford L; MacCoun, Robert J

2012-04-01

Citizens awaiting jury service were asked a series of items, in Likert format, to determine their endorsement of various statements about principles to use in setting child support amounts. These twenty items were derived from extant child support systems, from past literature and from Ellman and Ellman's (2008) Theory of Child Support. The twenty items were found to coalesce into four factors (principles). There were pervasive gender differences in respondent's endorsement of the principles. More importantly, three of these four principles were systematically reflected, in very rational (if complex) ways, in the respondents' resolution of the individual child support cases they were asked to decide. Differences among respondents in their endorsement of these three principles accounted for differences in their patterns of child support judgments. It is suggested that the pattern of coherent arbitrariness (Ariely et al., Q J Econ 118(1):73-105, 2003) in those support judgments, noted in an earlier study (Ellman, Braver, & MacCoun, 2009) is thus partially explained, in that the seeming arbitrariness of respondents' initial support judgments reflect in part their differing views about the basic principles that should decide the cases.

Development of New Cooling System Using Gm/jt Cryocoolers for the SKS Magnet

NASA Astrophysics Data System (ADS)

Aoki, K.; Haruyama, T.; Makida, Y.; Araoka, O.; Kasami, K.; Takahashi, T.; Nagae, T.; Kakiguchi, Y.; Sekimoto, M.; Tosaka, T.; Miyazaki, H.; Kuriyama, T.; Ono, M.; Orikasa, T.; Tsuchihashi, T.; Hirata, Y.

2008-03-01

We plan to develop a new improved cooling system for the Superconducting Kaon Spectrometer (SKS) magnet and transfer the magnet to the K1.8 beamline of the Hadron Hall of the Japan Proton Accelerator Research Complex (J-PARC) for further use in nuclear physics experiments. To replace the present 300 W cryogenic system, we will adopt a new cooling method that uses 4 K Gifford-McMahon/Joule-Thomson (GM/JT) cryocoolers. In order to decide a practical design for the new liquid helium reservoir of the magnet, which will be equipped with GM/JT cryocoolers, cooling tests on a GM/JT cryocooler were performed from February to March 2007. We constructed a new cooling test stand with a GM/JT cryocooler and measured the cooling capacities under several thermal shield temperatures with or without a baffle, which helped prevent convection. Based on the test results, we have finally decided to adopt three GM/JT cryocoolers for the new SKS along with a baffle and an additional dedicated GM cooler to cool the thermal shield of the GM/JT ports.

[Human cloning in Muslim and Arab law].

PubMed

Aldeeb Abu-Sahlieh, Sami A

2009-01-01

Cloning is a modern medical procedure that Muslim religious authorities treat en resorting to the general principles established by classical Muslim law based on the Koran and the Sunnah of Muhhamad as the messenger of God. In this regard, human beings are not capable of deciding what is or what is not lawful without resorting to divine norms. Cloning clashes with several principles. Firstly, the principle of the respect for life in relation to surpernumeraries, but Muslim authors are not in unanimous agreement on the determination of the moment at which life begins. Secondly, is the respect of progeny: cloning could only take place between a married couple. But even if these two principles are respected, cloning poses two major problems: the diversity of species expounded by the Koran and the Sunnah and a lack of interest. Which explains the quasi-unanimous opposition of Muslim writings regarding cloning.

Is it Useful to Have a Clear-cut Definition of Life? On the Use of Fuzzy Logic in Prebiotic Chemistry

NASA Astrophysics Data System (ADS)

Bruylants, Gilles; Bartik, Kristin; Reisse, Jacques

2010-04-01

Many scientists, including one of the authors of the present paper, have devoted time to try to find a definition for life (Bersini and Reisse 2007). It is clear that a consensus will never be reached but, more importantly, it seems that the issue itself could be without major interest. It is indeed impossible to define a “natural” frontier between non-living and living systems and therefore also impossible to define dichotomic criteria which could be used in order to classify systems in one of these two classes (living or non-living). Fuzzy logic provides a natural way to deal with problems where class membership lacks sharply defined criteria. It also offers the possibility to avoid losing time with unnecessary controversies such as deciding whether a virus is, or is not, a living system.

Is it useful to have a clear-cut definition of life? On the use of fuzzy logic in prebiotic chemistry.

PubMed

Bruylants, Gilles; Bartik, Kristin; Reisse, Jacques

2010-04-01

Many scientists, including one of the authors of the present paper, have devoted time to try to find a definition for life (Bersini and Reisse 2007). It is clear that a consensus will never be reached but, more importantly, it seems that the issue itself could be without major interest. It is indeed impossible to define a "natural" frontier between non-living and living systems and therefore also impossible to define dichotomic criteria which could be used in order to classify systems in one of these two classes (living or non-living). Fuzzy logic provides a natural way to deal with problems where class membership lacks sharply defined criteria. It also offers the possibility to avoid losing time with unnecessary controversies such as deciding whether a virus is, or is not, a living system.

A New Innovative Spherical Cermet Nuclear Fuel Element to Achieve an Ultra-Long Core Life for use in Grid-Appropriate LWRs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Senor, David J.; Painter, Chad L.; Geelhood, Ken J.

2007-12-01

Spherical cermet fuel elements are proposed for use in the Atoms For Peace Reactor (AFPR-100) concept. AFPR-100 is a small-scale, inherently safe, proliferation-resistant reactor that would be ideal for deployment to nations with emerging economies that decide to select nuclear power for the generation of carbon-free electricity. The basic concept of the AFPR core is a water-cooled fixed particle bed, randomly packed with spherical fuel elements. The flow of coolant within the particle bed is at such a low rate that the bed does not fluidize. This report summarizes an approach to fuel fabrication, results associated with fuel performance modeling,more » core neutronics and thermal hydraulics analyses demonstrating a ~20 year core life, and a conclusion that the proliferation resistance of the AFPR reactor concept is high.« less

Adjuvant Whole Brain Radiotherapy: Strong Emotions Decide But Rational Studies Are Needed

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, Paul D.; Asher, Anthony L.; Farace, Elana

2008-04-01

Brain metastases are common in cancer patients and cause considerable morbidity and mortality. For patients with limited disease and good performance status, treatment typically involves a combination of focal measures (e.g., surgical resection or radiosurgery) for the radiographically apparent disease, followed by adjuvant whole brain radiotherapy (WBRT) to treat subclinical disease. Because of concerns regarding the toxicity of WBRT, especially neurocognitive deterioration, many have advocated withholding adjuvant WBRT. Recently published studies have shed more light on the efficacy of adjuvant WBRT and the neurocognitive effects of WBRT. However, the inclusion of neurocognitive and quality-of-life data in clinical trials are stillmore » required to better define the role of adjuvant WBRT. Currently, two Phase III trials are underway, one in Europe and one in North America, that will determine the effect of adjuvant WBRT on patients' quality of life, neurocognitive function, and survival.« less

Development of life skills through physics content

NASA Astrophysics Data System (ADS)

Pivarči, Tomáš; Raganová, Janka

2017-01-01

The paper deals with students' life skills which the physics teacher should intentionally develop through physics content. An attention is given not only to the physics content and activities connected with it, but also to the development of responsibility, freedom, ability to make decisions, group cooperation, self-evaluation and experience of success. Three activities implemented in the seventh class of the elementary school are described in the paper. Authors describe reasons for class selection, the physics content and the used methods as well as the skills which they decided to purposely develop. They emphasize the importance of activities requiring students' inquiry-based learning and the need to change organization and philosophy of physics teaching at secondary schools. At the end of the paper authors analyze the achievement of objectives, positives as well as negatives of the implemented approaches and propose changes for a future realization.

Real-life decision making in college students. I: Consistency across specific decisions.

PubMed

Galotti, Kathleen M; Wiener, Hillary J D; Tandler, Jane M

2014-01-01

First-year undergraduates participated in a short-term longitudinal study of real-life decision making over their first 14 months of college. They were surveyed about 7 different decisions: choosing courses for an upcoming term (3 different terms), choosing an academic major (twice), planning for the upcoming summer, and planning for sophomore-year housing. Participants showed moderate levels of consistency in the options they considered and in the criteria they used to decide between options, with about half of the options or criteria being used at 2 different points on the decision repeatedly studied. Participants varied somewhat in structural consistency, the tendency to consider the same number of options or criteria across decisions. They also varied in the way they integrated information across decision-making tasks. We suggest that people attempt to keep the information demands of the task within workable limits, sometimes sacrificing consistency as a result.

Online fault adaptive control for efficient resource management in Advanced Life Support Systems

NASA Technical Reports Server (NTRS)

Abdelwahed, Sherif; Wu, Jian; Biswas, Gautam; Ramirez, John; Manders, Eric-J

2005-01-01

This article presents the design and implementation of a controller scheme for efficient resource management in Advanced Life Support Systems. In the proposed approach, a switching hybrid system model is used to represent the dynamics of the system components and their interactions. The operational specifications for the controller are represented by utility functions, and the corresponding resource management problem is formulated as a safety control problem. The controller is designed as a limited-horizon online supervisory controller that performs a limited forward search on the state-space of the system at each time step, and uses the utility functions to decide on the best action. The feasibility and accuracy of the online algorithm can be assessed at design time. We demonstrate the effectiveness of the scheme by running a set of experiments on the Reverse Osmosis (RO) subsystem of the Water Recovery System (WRS).

Multilayer Network Analysis of Nuclear Reactions

NASA Astrophysics Data System (ADS)

Zhu, Liang; Ma, Yu-Gang; Chen, Qu; Han, Ding-Ding

2016-08-01

The nuclear reaction network is usually studied via precise calculation of differential equation sets, and much research interest has been focused on the characteristics of nuclides, such as half-life and size limit. In this paper, however, we adopt the methods from both multilayer and reaction networks, and obtain a distinctive view by mapping all the nuclear reactions in JINA REACLIB database into a directed network with 4 layers: neutron, proton, 4He and the remainder. The layer names correspond to reaction types decided by the currency particles consumed. This combined approach reveals that, in the remainder layer, the β-stability has high correlation with node degree difference and overlapping coefficient. Moreover, when reaction rates are considered as node strength, we find that, at lower temperatures, nuclide half-life scales reciprocally with its out-strength. The connection between physical properties and topological characteristics may help to explore the boundary of the nuclide chart.

Adjuvant whole brain radiotherapy: strong emotions decide but rational studies are needed.

PubMed

Brown, Paul D; Asher, Anthony L; Farace, Elana

2008-04-01

Brain metastases are common in cancer patients and cause considerable morbidity and mortality. For patients with limited disease and good performance status, treatment typically involves a combination of focal measures (e.g., surgical resection or radiosurgery) for the radiographically apparent disease, followed by adjuvant whole brain radiotherapy (WBRT) to treat subclinical disease. Because of concerns regarding the toxicity of WBRT, especially neurocognitive deterioration, many have advocated withholding adjuvant WBRT. Recently published studies have shed more light on the efficacy of adjuvant WBRT and the neurocognitive effects of WBRT. However, the inclusion of neurocognitive and quality-of-life data in clinical trials are still required to better define the role of adjuvant WBRT. Currently, two Phase III trials are underway, one in Europe and one in North America, that will determine the effect of adjuvant WBRT on patients' quality of life, neurocognitive function, and survival.

Resuscitation decisions in the elderly: a discussion of current thinking.

PubMed

Bruce-Jones, P N

1996-10-01

Decisions about cardiopulmonary resuscitation may be based on medical prognosis, quality of life and patients' choices. Low survival rates indicate its overuse. Although the concept of medical futility has limitations, several strong predictors of non-survival have been identified and prognostic indices developed. Early results indicate that consideration of resuscitation in the elderly should be very selective, and support "opt-in" policies. In this minority of patients, quality of life is the principal issue. This is subjective and best assessed by the individual in question. Patients' attitudes cannot be predicted reliably and surrogate decision-making is inadequate. Lay knowledge is poor. However, patients can use prognostic information to make rational choices. The majority welcome discussion of resuscitation and prefer this to be initiated by their doctors; many wish to decide for themselves. There is little evidence that this causes distress. The views of such patients, if competent, should be sought actively.

Online fault adaptive control for efficient resource management in Advanced Life Support Systems.

PubMed

Abdelwahed, Sherif; Wu, Jian; Biswas, Gautam; Ramirez, John; Manders, Eric-J

2005-01-01

This article presents the design and implementation of a controller scheme for efficient resource management in Advanced Life Support Systems. In the proposed approach, a switching hybrid system model is used to represent the dynamics of the system components and their interactions. The operational specifications for the controller are represented by utility functions, and the corresponding resource management problem is formulated as a safety control problem. The controller is designed as a limited-horizon online supervisory controller that performs a limited forward search on the state-space of the system at each time step, and uses the utility functions to decide on the best action. The feasibility and accuracy of the online algorithm can be assessed at design time. We demonstrate the effectiveness of the scheme by running a set of experiments on the Reverse Osmosis (RO) subsystem of the Water Recovery System (WRS).

To abort or not? A Greek dilemma--case study.

PubMed

Theofanidis, Dimitrios; Fountouki, Antigoni; Pediaditaki, Ourania

2013-06-01

Abortion is a major issue in contemporary Greece as it is often practiced but not debated openly and accordingly. To present and discuss critically a real case scenario with strong ethical implications concerning abortion under two polar ethical doctrines, i.e. Utilitarianism and Deontologism. From a Deontological point of view the baby's life should be spared regardless of reason. In contrast, Utilitarians reason that the effect on the mother and family life should be drawn into the decision equation. The mother, who was heavily influence by her religious beliefs, decided to keep the baby, and the pregnancy continued as planned. The importance of weighing up the views of the patient and respecting her autonomy is crucial when dealing with such issues. Health care professionals need to be adequately prepared in order to facilitate and support patients and families in similar circumstances. Copyright © 2012 Elsevier Ltd. All rights reserved.

Signal coverage approach to the detection probability of hypothetical extraterrestrial emitters in the Milky Way.

PubMed

Grimaldi, Claudio

2017-04-12

The lack of evidence for the existence of extraterrestrial life, even the simplest forms of animal life, makes it is difficult to decide whether the search for extraterrestrial intelligence (SETI) is more a high-risk, high-payoff endeavor than a futile attempt. Here we insist that even if extraterrestrial civilizations do exist and communicate, the likelihood of detecting their signals crucially depends on whether the Earth lies within a region of the galaxy covered by such signals. By considering possible populations of independent emitters in the galaxy, we build a statistical model of the domain covered by hypothetical extraterrestrial signals to derive the detection probability that the Earth is within such a domain. We show that for general distributions of the signal longevity and directionality, the mean number of detectable emitters is less than one even for detection probabilities as large as 50%, regardless of the number of emitters in the galaxy.

Signal coverage approach to the detection probability of hypothetical extraterrestrial emitters in the Milky Way

NASA Astrophysics Data System (ADS)

Grimaldi, Claudio

2017-04-01

The lack of evidence for the existence of extraterrestrial life, even the simplest forms of animal life, makes it is difficult to decide whether the search for extraterrestrial intelligence (SETI) is more a high-risk, high-payoff endeavor than a futile attempt. Here we insist that even if extraterrestrial civilizations do exist and communicate, the likelihood of detecting their signals crucially depends on whether the Earth lies within a region of the galaxy covered by such signals. By considering possible populations of independent emitters in the galaxy, we build a statistical model of the domain covered by hypothetical extraterrestrial signals to derive the detection probability that the Earth is within such a domain. We show that for general distributions of the signal longevity and directionality, the mean number of detectable emitters is less than one even for detection probabilities as large as 50%, regardless of the number of emitters in the galaxy.

Identifying of meat species using polymerase chain reaction (PCR)

NASA Astrophysics Data System (ADS)

Foong, Chow Ming; Sani, Norrakiah Abdullah

2013-11-01

Meat has been widely consumed as an important protein source in daily life of human. Furthermore, with busy and intense urban lifestyle, processed food is now one of the main protein sources of one's diet. Consumers rely on the food labeling to decide if the meat product purchased is safe and reliable. Therefore, it is important to ensure the food labeling is done in a correct manner to avoid consumer fraud. More consumers are now concern about the food quality and safety as compared to before. This study described the meat species identification and detection method using Polymerase Chain Reaction (PCR) in 8 types of meats (cattle, buffalo, goat, sheep, chicken, duck, pork and horse). The objective of this study is to decide on the specificity of oligonucleotide sequences obtained from previous study. There were 5 proposed oligonucleotide primer in this study. The main important finding in this work is the specificity of oligonucleotide primers to raw meats. It if found that the oligonucleotide primers proposed were not specific to the local raw meat species. Therefore, further study is needed to obtain a species-specific oligonucletide primers for PCR, in order to be applied in food product testing.

The effect of road characteristics on motorcycle accident in Batu east Java Indonesia

NASA Astrophysics Data System (ADS)

Abusini, Sobri

2013-09-01

Safe of transportation on road is global problem with not only transportation problem, but also social teritory problem in sosial life. WHO pay attention to safe transportation on road to decide healthy day in the world 2004 with caption: Road Safety is no Accident. WHO is clariafy that road accident level in the world have to reach 1.2 mellion victim death and over 30 mellion injuries every year. As much 85% sacrifice death are accident in develop state, where vehicle number only 32% from vehicle number in the world. That becouse as the objective is to decide influence road charakteristics geometrics for motorcycle accident in Batu East Java Indonesia. Using some statistical analysis it is found that the best-fit motorcycle accident model is: Acc = 0,009F0,703exp(-0,334SW-0,361G+0.077S) Where: Acc = number of accident, F = Flow, pcu/hr, SW = shoulder width (m), S = speed, km/hr, G = Gradient (0,1) The model shows that the affecting factors are flow, shoulder width and speed, therefore local government should improve some related factor (flow, shoulder width, Gradient and speed) that can reduce the number of motorcycle accident at crossing road in Batu.

The history of ethical decision making in neonatal intensive care.

PubMed

Placencia, Frank X; McCullough, Laurence B

2011-01-01

Neonatal ethics has focused on 2 questions: is withholding potentially live-saving treatment from neonates ethically justified? and if so, who has the authority to decide? This article details how these questions developed and provides a description of the possible answers. In the first section, we review a selection of seminal articles by noted authors in the fields of ethics, medicine, and law. The second section provides a detailed account of the development of the Baby Doe Regulations and the impact they had on neonatal ethics, with particular attention to the emergence of the Best Interest Standard as a guideline for decision making. In the last section, we review the landmark position statements by the American Academy of Pediatric (AAP), and the focus on evidence-based decision making. We conclude that forgoing life-saving treatment is ethically justified. However, this requires a rigorous evidence-based process and is limited by the Best Interest Standard. The second question is more difficult to answer, but we feel that in light of legal limitations, physicians acting as both the infant advocate and a proxy for the state, decide what falls in the range of acceptable treatment options, with the parents free to choose within that range.

Identifying of meat species using polymerase chain reaction (PCR)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Foong, Chow Ming; Sani, Norrakiah Abdullah

Meat has been widely consumed as an important protein source in daily life of human. Furthermore, with busy and intense urban lifestyle, processed food is now one of the main protein sources of one’s diet. Consumers rely on the food labeling to decide if the meat product purchased is safe and reliable. Therefore, it is important to ensure the food labeling is done in a correct manner to avoid consumer fraud. More consumers are now concern about the food quality and safety as compared to before. This study described the meat species identification and detection method using Polymerase Chain Reactionmore » (PCR) in 8 types of meats (cattle, buffalo, goat, sheep, chicken, duck, pork and horse). The objective of this study is to decide on the specificity of oligonucleotide sequences obtained from previous study. There were 5 proposed oligonucleotide primer in this study. The main important finding in this work is the specificity of oligonucleotide primers to raw meats. It if found that the oligonucleotide primers proposed were not specific to the local raw meat species. Therefore, further study is needed to obtain a species-specific oligonucletide primers for PCR, in order to be applied in food product testing.« less

Development and evaluation of the DECIDE to move! Physical activity educational video.

PubMed

Majid, Haseeb M; Schumann, Kristina P; Doswell, Angela; Sutherland, June; Hill Golden, Sherita; Stewart, Kerry J; Hill-Briggs, Felicia

2012-01-01

To develop a video that provides accessible and usable information about the importance of physical activity to type 2 diabetes self-management and ways of incorporating physical activity into everyday life. A 15-minute physical activity educational video narrated by US Surgeon General Dr Regina Benjamin was developed and evaluated. The video addresses the following topics: the effects of exercise on diabetes, preparations for beginning physical activity, types of physical activity, safety considerations (eg, awareness of symptoms of hypoglycemia during activity), and goal setting. Two patient screening groups were held for evaluation and revision of the video. Patient satisfaction ratings ranged 4.6 to 4.9 out of a possible 5.0 on dimensions of overall satisfaction, how informative they found the video to be, how well the video held their interest and attention, how easy the video was to understand, and how easy the video was to see and hear. Patients reported the educational video effective in empowering them to take strides toward increasing and maintaining physical activity in their lives. The tool is currently used in a clinical research trial, Project DECIDE, as one component of a diabetes and cardiovascular disease self-management program.

Adolescents with a diagnosis of anorexia nervosa: parents' experience of recognition and deciding to seek help.

PubMed

Thomson, Samuel; Marriott, Michael; Telford, Katherine; Law, Hou; McLaughlin, Jo; Sayal, Kapil

2014-01-01

Adolescents with anorexia nervosa rarely present themselves as having a problem and are usually reliant on parents to recognise the problem and facilitate help-seeking. This study aimed to investigate parents' experiences of recognising that their child had an eating problem and deciding to seek help. A qualitative study with interpretative phenomenological analysis applied to semi-structured interviews with eight parents of adolescents with a diagnosis of anorexia nervosa. Parents commonly attributed early signs of anorexia nervosa to normal adolescent development and they expected weight loss to be short-lived. As parents' suspicions grew, close monitoring exposing their child's secretive attempts to lose weight and the use of internet searches aided parental recognition of the problem. They avoided using the term anorexia as it made the problem seem 'real'. Following serial unsuccessful attempts to effect change, parental fear for their child's life triggered a desire for professional help. Parents require early advice and support to confirm their suspicions that their child might have anorexia nervosa. Since parents commonly approach the internet for guidance, improving awareness of useful and accurate websites could reduce delays in help-seeking.

49 CFR 40.377 - Who decides whether to issue a PIE?

Code of Federal Regulations, 2010 CFR

2010-10-01

... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Public Interest Exclusions § 40.377 Who decides whether to issue a PIE? (a) The ODAPC Director, or his or her designee, decides whether to issue a PIE. If a designee... 49 Transportation 1 2010-10-01 2010-10-01 false Who decides whether to issue a PIE? 40.377 Section...

Individual nurse and organizational context considerations for better Knowledge Use in Pain Care.

PubMed

Latimer, Margot A; Ritchie, Judith A; Johnston, Celeste C

2010-08-01

Nurses are involved in many of the painful procedures performed on hospitalized children. In collaboration with physicians, nurses have an exceptional responsibility to have knowledge to manage the pain; however, the evidence indicates this is not being done. Issues may be twofold: (a) opportunities to improve knowledge of better pain care practices and/or (b) ability to use knowledge. Empirical evidence is available that if used by health care providers can reduce pain in hospitalized children. Theory-guided interventions are necessary to focus resources designated for learning and knowledge translation initiatives in the area of pain care. This article presents the Knowledge Use in Pain Care (KUPC) conceptual model that blends concepts from the fields of knowledge utilization and work life context, which are believed to influence the translation of knowledge to practice. The four main components in the KUPC model include those related to the organization, the individual nurse, the individual patient, and the sociopolitical context. The KUPC model was conceptualized to account for the complex circumstances surrounding nurse's knowledge uptake and use in the context of pain care. The model provides a framework for health care administrators, clinical leaders, and researchers to consider as they decide how to intervene to increase knowledge use to reduce painful experiences of children in the hospital. Copyright 2010 Elsevier Inc. All rights reserved.

Identifying the processes underpinning anticipation and decision-making in a dynamic time-constrained task.

PubMed

Roca, André; Ford, Paul R; McRobert, Allistair P; Mark Williams, A

2011-08-01

A novel, representative task was used to examine skill-based differences in the perceptual and cognitive processes underlying performance on a dynamic, externally paced task. Skilled and less skilled soccer players were required to move and interact with life-size, action sequences involving 11 versus 11 soccer situations filmed from the perspective of a central defender in soccer. The ability of participants to anticipate the intentions of their opponents and to make decisions about how they should respond was measured across two separate experiments. In Experiment 1, visual search behaviors were examined using an eye-movement registration system. In Experiment 2, retrospective verbal reports of thinking were gathered from a new sample of skilled and less skilled participants. Skilled participants were more accurate than less skilled participants at anticipating the intentions of opponents and in deciding on an appropriate course of action. The skilled players employed a search strategy involving more fixations of shorter duration in a different sequential order and toward more disparate and informative locations in the display when compared with the less skilled counterparts. The skilled players generated a greater number of verbal report statements with a higher proportion of evaluation, prediction, and planning statements than the less skilled players, suggesting they employed more complex domain-specific memory representations to solve the task. Theoretical, methodological, and practical implications are discussed.

Self-management of type 2 diabetes mellitus: a qualitative investigation from the perspective of participants in a nurse-led, shared-care programme in the Netherlands.

PubMed

Moser, Albine; van der Bruggen, Harry; Widdershoven, Guy; Spreeuwenberg, Cor

2008-03-18

Diabetes mellitus is a major public health problem. Little is known about how people with type 2 diabetes experience self-management in a nurse-led, shared-care programme. The purpose of this article is to report an empirically grounded conceptualization of self-management in the context of autonomy of people with type 2 diabetes. This study has a qualitative descriptive, and exploratory design with an inductive approach. Data were collected by means of in-depth interviews. The sample consisted of older adults with type 2 diabetes in a nurse-led, shared-care setting. The data analysis was completed by applying the constant comparative analysis as recommended in grounded theory. People with type 2 diabetes use three kinds of self-management processes: daily, off-course, and preventive. The steps for daily self-management are adhering, adapting, and acting routinely. The steps for off-course self-management are becoming aware, reasoning, deciding, acting, and evaluating. The steps for preventive self-management are experiencing, learning, being cautious, and putting into practice. These processes are interwoven and recurring. Self-management consists of a complex and dynamic set of processes and it is deeply embedded in one's unique life situation. Support from diabetes specialist nurses and family caregivers is a necessity of self-managing diabetes.

Location and vocation: why some government doctors stay on in rural Chhattisgarh, India.

PubMed

Sheikh, Kabir; Rajkumari, Babita; Jain, Kamlesh; Rao, Krishna; Patanwar, Pratibha; Gupta, Garima; Antony, K R; Sundararaman, T

2012-09-01

We conducted a qualitative research study in Chhattisgarh State, India, to explore why some qualified medical practitioners decide to stay on in government rural service. The fieldwork consisted of in-depth interviews with 37 practitioners who had an established record of rural service, and data were analyzed using the 'framework' approach for applied policy research. Study participants cited complexes of reasons for staying on, including geographical and ethnic (tribal) affinities, rural upbringing, availability of schools, personal values of service, professional interests, co-location with spouses, and relations with co-workers. Extrinsic (environmental) and intrinsic (personal) factors both play a part in determining the decisions of doctors to stay on, and are interdependent. Some doctors were influenced to remain by the close relationships they had developed with local communities and their acclimatisation over time to rural life. The policy imperative of rural workforce adequacy may be served less by choosing one retention strategy over another than by developing multi-dimensional solutions focused simultaneously on identifying and incentivising rural practitioners with appropriate characteristics, and on creating external conditions for their improved performance and welfare. Further, in a low-income setting such as India, questions of rural workforce adequacy cannot be addressed in isolation, but need to be tackled as part of broad agenda of social development that include strengthening public service systems and empowering communities.

[The problem of economic and population development (author's transl)].

PubMed

Maier, W

1977-04-01

The question is raised whether the apparent complexity and differentiation excludes chance. Generally a chance occurrence is without prior determination. The laws established by economics and demography with mathematical methods are therefore not capable to determine all facts because of their hypothetical arrangement. Reality can only be expressed in a categorical judgment. It is possible to arrive from hypothetical judgments--when there is A so there is B to an existence of a categorical B. Any theory of economic balance and any calculation in a demographic model to arrive at a balanced population development are methods which correlate facts with facts and allow conclusions when the correlation is actually existent. However, no conclusion as to the idea of determination of the generative behavior by economic production can be arrived at. Revorsely the conclusion that sociologie developments and generative behavior are completely independant of economic production is not possible. Hypothetical type of thinking in a model does not exclude chance and each fact has an element of chance in it. This appears to be a heuristic circle. Noncircular conclusions for the practice of life in order to advise, decide and act, do not exist without assumptions and without value judgments. In order to influence the development of the population continued scientific reflection, observation and argumentation is necessary. Correct technical functioning is translated into social realms. New reflections and interpretations are constantly required.

Our Children: Parental Decisions - How Much to Invest in Your Offspring

NASA Astrophysics Data System (ADS)

Shenk, Mary K.

Reproduction is the most fundamental of evolutionary behaviors, yet human parents face especially complex tradeoffs when deciding how many children to have and how much to invest in each of them. This chapter reviews parental investment theory, including both the key concepts and some important questions to which they have been applied in humans. Written primarily from the perspective of human behavioral ecology, this chapter also discusses how evolutionary social scientists have approached cross-cultural variation in parenting behavior. The chapter begins with an overview of life history theory and the concept of reproductive tradeoffs, focusing especially on the tradeoffs between current vs. future reproduction and quantity vs. quality of offspring. Discussing the critical question of who invests in offspring, I next compare motivations for investment between mothers and fathers, and explore the roles of many types of kin in investment, while considering whether humans can be viewed as cooperative breeders. I then explore the role of parent-offspring conflict and sibling conflict in parental investment and inheritance systems, followed by an exploration of sex biases in investment, including the Trivers-Willard effect local resource competition, and local resource enhancement. In conclusion, I argue that parental investment has been one of the most active areas of enquiry among evolutionary researchers over the last twenty years, and is likely to remain one of the mainstays of the field during the coming decades.

Rational therapeutic choice for older patients with lymphoma.

PubMed

Bron, Dominique; Soubeyran, Pierre

2017-09-01

The choice for an optimal treatment in older lymphoma patients is a real challenge for hemato-oncologists. They have to treat a potentially curative lymphoma, and concomitantly protect their patients from unacceptable toxicities. Some recommendations are provided for the major subtypes of lymphomas including the antitumoral treatment and primarily the optimal supportive care. All the recent literature data converge to say that the approach of an older patient with a malignant hemopathy is a multistep procedure. This process comprises the appraisal of life expectancy of the patient with or without the disease, the prognostic factors of the tumor, the functional, physiological and cognitive functions evaluation, the socio-economical environment and the patient's expectancy in terms of quality of life. Major progresses have been achieved in the management of diffuse large B cell lymphoma and mantle cell lymphoma in patients up to 80 and above 80 years old. With all these information in hands, the hematologist will decide if the treatment's objective is the standard treatment with optimal supportive care (fit patients), tailor-made adapted chemotherapy (unfit patients) or preservation of quality of life (frail patients).

Killing by organ procurement: brain-based death and legal fictions.

PubMed

Veatch, Robert M

2015-06-01

The dead donor rule (DDR) governs procuring life-prolonging organs. They should be taken only from deceased donors. Miller and Truog have proposed abandoning the rule when patients have decided to forgo life-sustaining treatment and have consented to procurement. Organs could then be procured from living patients, thus killing them by organ procurement. This proposal warrants careful examination. They convincingly argue that current brain or circulatory death pronouncement misidentifies the biologically dead. After arguing convincingly that physicians already cause death by withdrawing treatment, they claim no bright-line differences preclude organ removal from the living. The argument fails for those who accept the double effect doctrine or other grounds for distinguishing forgoing life support from active, intentional killing. If the goal is determining irreversible loss of somatic function, they correctly label current death pronouncement a "legal fiction." Recognizing a second, public policy meaning of the term death provides grounds for maintaining the DDR without jeopardizing procurement. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sexual functioning of adult patients born with meningomyelocele. A pilot study.

PubMed

Vroege, J A; Zeijlemaker, B Y; Scheers, M M

1998-01-01

This pilot study was started to get an impression of the sexual activity and sexual difficulties of adult patients born with meningomyelocele in control at Utrecht University Hospital, and to find out whether these problems deserve more attention from the Spina Bifida Team. Seventeen patients (9 men, 8 women; aged 19-44) were asked to participate; 11 (8 men, 3 women) decided to take part in this study. All these patients were interviewed by their physician about their present sexual life; 6 of them also completed the 'Questionnaire for screening Sexual Dysfunctions' (QSD). With 1 exception, all patients expressed a desire for sexual contact. Five of them masturbated and 6 patients sometimes had sexual contact. Eight patients had problems in the field of sexuality, but only 3 were dissatisfied with their present sexual life. It is advantageous to invite adult patients born with meningomyelocele for an interview about their sexual life. When raising this subject, however, one has to act with caution: for quite a few patients (in this study mostly women) sexuality still is a delicate subject.

Background qualitative analysis of the European Reference Life Cycle Database (ELCD) energy datasets - part I: fuel datasets.

PubMed

Garraín, Daniel; Fazio, Simone; de la Rúa, Cristina; Recchioni, Marco; Lechón, Yolanda; Mathieux, Fabrice

2015-01-01

The aim of this study is to identify areas of potential improvement of the European Reference Life Cycle Database (ELCD) fuel datasets. The revision is based on the data quality indicators described by the ILCD Handbook, applied on sectorial basis. These indicators evaluate the technological, geographical and time-related representativeness of the dataset and the appropriateness in terms of completeness, precision and methodology. Results show that ELCD fuel datasets have a very good quality in general terms, nevertheless some findings and recommendations in order to improve the quality of Life-Cycle Inventories have been derived. Moreover, these results ensure the quality of the fuel-related datasets to any LCA practitioner, and provide insights related to the limitations and assumptions underlying in the datasets modelling. Giving this information, the LCA practitioner will be able to decide whether the use of the ELCD fuel datasets is appropriate based on the goal and scope of the analysis to be conducted. The methodological approach would be also useful for dataset developers and reviewers, in order to improve the overall DQR of databases.

Health workers' attitudes toward euthanasia in Japan.

PubMed

Takeo, K; Satoh, K; Minamisawa, H; Mitoh, T

1991-01-01

Despite impressive life-saving medical advancements, diseases for which there are no cure still exist. In the past doctors and health workers in Japan often preferred not to disclose the diagnosis of an incurable disease--particularly cancer--to patients. A 1980 study revealed that only 17% of the Japanese doctors questioned actually had the experience of informing their patients they had cancer, while reportedly in the US 98% of doctors inform patients they have cancer. This attitude in Japan, however, is changing. And with this change such issues as care of the terminally ill after being informed about their diagnosis, human rights problems and other issues have arisen. In fact, euthanasia, although highly criticized when first introduced, is now being increasingly preferred to medical treatment that prolongs life in the presence of severe pain associated with an incurable disease. After reading a 1982 survey that revealed that 84% of the Japanese people interviewed would prefer to die with dignity rather than prolong life with a machine, four researchers decided to examine terminal care more fully, this time from the viewpoint of the medical staff. Below, their study results.

Dual use research: investigation across multiple science disciplines.

PubMed

Oltmann, Shannon

2015-04-01

Most recent studies of dual use research have focused on the life sciences, although some researchers have suggested that dual use research occurs across many disciplines. This research is an initial investigation into the prevalence of dual use research in other scientific disciplines by surveying senior editors of scientific journals, drawn from Journal Citation Reports. The survey was emailed to 7,500 journal editors with a response rate of 10.1 %. Approximately 4.8 % of life science editors reported they had to consider whether to publish dual use research and 38.9 % said they decided to not publish the research in question. In disciplines other than the life sciences, 7.2 % of editors from other science disciplines reported that they had to consider whether to publish dual use research, and 48.4 % declined to publish it. The survey investigated relationships between dual use and the journal's source of funding and place of publication, but no relationships were found. Further research is needed to better understand the occurrence of dual use research in other science disciplines.

Predictive factors for work capacity in patients with musculoskeletal disorders.

PubMed

Lydell, Marie; Baigi, Amir; Marklund, Bertil; Månsson, Jörgen

2005-09-01

To identify predictive factors for work capacity in patients with musculoskeletal disorders. A descriptive, evaluative, quantitative study. The study was based on 385 patients who participated in a rehabilitation programme. Patients were divided into 2 groups depending on their ability to work. The groups were compared with each other with regard to sociodemographic factors, diagnoses, disability pension and number of sick days. The patient's level of exercise habits, ability to undertake activities, physical capacity, pain and quality of life were compared further using logistic regression analysis. Predictive factors for work capacity, such as ability to undertake activities, quality of life and fitness on exercise, were identified as important independent factors. Other well-known factors, i.e. gender, age, education, pain and earlier sickness certification periods, were also identified. Factors that were not significantly different between the groups were employment status, profession, diagnosis and levels of exercise habits. Identifying predictors for ability to return to work is an essential task for deciding on suitable individual rehabilitation. This study identified new predictive factors, such as ability to undertake activities, quality of life and fitness on exercise.

[Physician's professional retirement. Family dynamics].

PubMed

Aguirre Gas, Héctor G

2011-01-01

Human beings have a natural resistance to think about their old age, both personally and professionally. Governments have targeted efforts to successfully prolong the life of the population, situation which already is a social and economic problem. “Old is a person with physical, intellectual and emotional limitations, who has a reduced autonomy and welfare, as a result of the years lived”. Not everyone ages at the same age; it will depend on health, habits, physical and intellectual activity, nutritional status, vices and attitude towards life. A physician may decide not to continue exercising medicine due to: health problems, because they do not want to, because they do not feel competent, because of the risk of having to deal with a complaint or a lawsuit, to have a new life project, or because they have no patients. The options available for a doctor at the time of retirement will depend on his/her age, health status, stage of the aging process: autonomy, dependency or old age; his/her physical and mental condition, professional development, economic situation and family environment. A doctor may remain independent, join another family or seek shelter in a retirement home.

Cells distribution in the modeling of fibrosis. Comment on "Towards a unified approach in the modeling of fibrosis: A review with research perspectives" by Martine Ben Amar and Carlo Bianca

NASA Astrophysics Data System (ADS)

Abdel-Aty, Mahmoud

2016-07-01

The modeling of a complex system requires the analysis of all microscopic constituents and in particular of their interactions [1]. The interest in this research field has increased considering also recent developments in the information sciences. However interaction among scholars working in various fields of the applied sciences can be considered the true motor for the definition of a general framework for the analysis of complex systems. In particular biological systems constitute the platform where many scientists have decided to collaborate in order to gain a global description of the system. Among others, cancer-immune system competition (see [2] and the review papers [3,4]) has attracted much attention.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bales, Benjamin B; Barrett, Richard F

In almost all modern scientific applications, developers achieve the greatest performance gains by tuning algorithms, communication systems, and memory access patterns, while leaving low level instruction optimizations to the compiler. Given the increasingly varied and complicated x86 architectures, the value of these optimizations is unclear, and, due to time and complexity constraints, it is difficult for many programmers to experiment with them. In this report we explore the potential gains of these 'last mile' optimization efforts on an AMD Barcelona processor, providing readers with relevant information so that they can decide whether investment in the presented optimizations is worthwhile.

Cancer screening is not only about numbers.

PubMed

Knottnerus, B J

2017-05-01

In the cancer screening debate, arguments for and against screening are often based on statistics, whereas for individuals personal, non-statistical factors are at least as important when deciding whether to participate in screening. Health care professionals have a responsibility in helping individuals navigate in this complex field by identifying and clarifying the individuals' beliefs, fears and preferences while being aware of their own. Moreover, researchers should explore beliefs and motives that matter for individuals and not only report numbers that can be interpreted in different ways. © 2017 John Wiley & Sons Ltd.

Multiple paths in complex tasks

NASA Technical Reports Server (NTRS)

Galanter, Eugene; Wiegand, Thomas; Mark, Gloria

1987-01-01

The relationship between utility judgments of subtask paths and the utility of the task as a whole was examined. The convergent validation procedure is based on the assumption that measurements of the same quantity done with different methods should covary. The utility measures of the subtasks were obtained during the performance of an aircraft flight controller navigation task. Analyses helped decide among various models of subtask utility combination, whether the utility ratings of subtask paths predict the whole tasks utility rating, and indirectly, whether judgmental models need to include the equivalent of cognitive noise.

Decision making.

PubMed

Chambers, David W

2011-01-01

A decision is a commitment of resources under conditions of risk in expectation of the best future outcome. The smart decision is always the strategy with the best overall expected value-the best combination of facts and values. Some of the special circumstances involved in decision making are discussed, including decisions where there are multiple goals, those where more than one person is involved in making the decision, using trigger points, framing decisions correctly, commitments to lost causes, and expert decision makers. A complex example of deciding about removal of asymptomatic third molars, with and without an EBD search, is discussed.

Risk Management Technique for design and operation of facilities and equipment

NASA Technical Reports Server (NTRS)

Fedor, O. H.; Parsons, W. N.; Coutinho, J. De S.

1975-01-01

The Risk Management System collects information from engineering, operating, and management personnel to identify potentially hazardous conditions. This information is used in risk analysis, problem resolution, and contingency planning. The resulting hazard accountability system enables management to monitor all identified hazards. Data from this system are examined in project reviews so that management can decide to eliminate or accept these risks. This technique is particularly effective in improving the management of risks in large, complex, high-energy facilities. These improvements are needed for increased cooperation among industry, regulatory agencies, and the public.

[Nose surgical anatomy in six aesthetic subunits].

PubMed

Chaput, B; Lauwers, F; Lopez, R; Saboye, J; André, A; Grolleau, J-L; Chavoin, J-P

2013-04-01

The nose is a complex entity, combining aesthetic and functional roles. Descriptive anatomy is a fundamental science that it can be difficult to relate directly to our daily surgical activity. Reasoning in terms of aesthetic subunits to decide on his actions appeared to us so obvious. The aim of this paper is to resume the anatomical bases relevant to our daily practice in order to fully apprehend the restorative or cosmetic procedures. We discuss the limits of the systematization of these principles in nasal oncology. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

The Use of Information Transmission as Nonparametric Correlation in the Analysis of Complex Behavior: A Preliminary Report.

DTIC Science & Technology

1980-05-01

different cells of the histogram are recognisably those of a IGaussian distribution. On the other hand, at Q = 2 there is no way to decide whether the...levels. INote further that the first row (Q=8) contains the same data as in Table 6, but the cells are arranged in a different order. Consequent- Ily the...values of the more coarsely merged cells will be different at lower levels of Q. Now since we are dealing with nominal data the order of the bins is

Evaluating geographic information systems technology

USGS Publications Warehouse

Guptill, Stephen C.

1989-01-01

Computerized geographic information systems (GISs) are emerging as the spatial data handling tools of choice for solving complex geographical problems. However, few guidelines exist for assisting potential users in identifying suitable hardware and software. A process to be followed in evaluating the merits of GIS technology is presented. Related standards and guidelines, software functions, hardware components, and benchmarking are discussed. By making users aware of all aspects of adopting GIS technology, they can decide if GIS is an appropriate tool for their application and, if so, which GIS should be used.

Making Decisions About Participating in Elections

ERIC Educational Resources Information Center

Patrick, John J.

1976-01-01

Suggestions are offered for teaching about three kinds of decisions in electoral politics which all citizens face: deciding whether to participate, deciding how to participate, and deciding for whom to vote. (AV)

What quality-of-life issues do women with ductal carcinoma in situ (DCIS) consider important when making treatment decisions?

PubMed

Mercieca-Bebber, Rebecca; King, Madeleine T; Boxer, Miriam M; Spillane, Andrew; Winters, Zoë E; Butow, Phyllis N; McPherson, Joan; Rutherford, Claudia

2017-09-01

To explore quality-of-life (QOL) issues considered important when deciding on treatment for ductal carcinoma in situ (DCIS). Breast Cancer Network of Australia members diagnosed with DCIS in the past 5 years (self-identified) participated in an online survey (Sep-Nov 2015). From a list of 74 QOL issues, participants selected all issues they experienced during DCIS diagnosis, treatment or recovery, then the issues they felt important to making a DCIS treatment decision, and completed the Health Literacy Questionnaire (HLQ). Associations between QOL issues and self-reported treatment received were assessed with χ 2 tests. The primary analysis included 38 participants treated with breast-conserving surgery (n = 15), mastectomy (n = 23), and/or radiotherapy (n = 14). Fatigue-related symptoms (82%) and "fear of progression" (50%) were the most frequently-experienced issues. When deciding on DCIS treatment, the most important consideration was "fear of progression" (50%). A higher proportion of mastectomy (compared to non-mastectomy) patients considered "difficultly looking at yourself naked" (p = 0.03). Radiotherapy (compared to non-radiotherapy) patients were more likely to consider "feeling unwell" important (p = 0.006). Results were similar in a sensitivity analysis involving all 101 respondents (i.e., including 63 respondents who reported receiving chemotherapy, endocrine therapy, and/or Herceptin, suggesting that they may have been treated for invasive breast cancer). Health literacy was high across all nine HLQ scales. Fear of progression is a key consideration in DCIS treatment decision making for women with high health literacy. QOL treatment considerations differed by treatments received. Women diagnosed with DCIS may benefit from evidence about QOL to inform treatment decision making.

Why do employees follow their superiors' instructions? Identification of the reasons to comply with superiors' will in a group of Polish employees.

PubMed

Wójcik, Aleksandra; Merecz-Kot, Dorota; Andysz, Aleksandra

2015-01-01

Managers influence the way organization works as well as the functioning of subordinates - in the context of their work life but non-professional functioning as well e.g., attitude towards work-life balance or taking care of health. We focused on the superior-subordinate relation, referring to social power bases theory by Raven. We identified the reasons why subordinates decide to follow their superiors' orders and determined specific styles of compliance with superiors' will. Understanding why employees listen to their superiors may be valuable in the context of supporting healthy organizational climate and atmosphere of co-operation or communicating values - for example, as regards taking care of own health. We discussed the results referring to the issue of influencing employees in the context of their health behavior. The research involved 100 Polish employees, aged 28 years old on average, who filled in the Interpersonal Power Inventory by Raven et al. for subordinates in a Polish adaptation by Zaleski. The questionnaire includes 11 subscales referring to power bases. Based on the cluster analysis results, we recognized people who complied because of: all kinds of power bases (typical for 46% of the respondents); the respect for superiors' professionalism (34%); and formal/objective reasons (20%). Employees differ in terms of their styles of compliance. Their motives to comply with superiors' instructions constitute compilations of power bases. The superiors' awareness of the reasons why their employees decide to follow orders is necessary for successful management. It may motivate employees to work but also to take care of their own health. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Family life events in the first year of acute lymphoblastic leukemia therapy: a children's oncology group report.

PubMed

Lau, Samantha; Lu, Xiaomin; Balsamo, Lyn; Devidas, Meenakshi; Winick, Naomi; Hunger, Stephen P; Carroll, William; Stork, Linda; Maloney, Kelly; Kadan-Lottick, Nina

2014-12-01

Despite higher cure rates, childhood acute lymphoblastic leukemia (ALL) may continue to result in considerable family strain. We sought to (i) measure incidence of divorce, reduced career opportunities, changes to work hours, home relocation, and changes to family planning at one year after ALL diagnosis; and (ii) Identify family and patient factors associated with these events. We conducted a prospective cohort study of 159 children with average risk-ALL enrolled and treated on COG protocol AALL0331 at 31 selected sites. Eligibility criteria included age ≥2 years and English or Spanish comprehension. Parents completed surveys at three time points during the first 12 months of therapy. Parents were at significantly increased risk of loss of employment (46% vs. 9.1%, P ≤ 0.001) than peers nationally. 13% divorced/separated, 27% relocated homes, 22% decided not to have more children, 51% declined occupational opportunities, and 68% decreased work hours. In adjusted analyses, relocation correlated with less maternal education (OR: 4.27 [95% CI: 1.43-12.82]). Declining parental opportunities associated with family income <$50,000 (OR: 4.25 [95% CI: 1.50-12.02]) and child <5 years old (OR: 4.21 [95% CI: 1.73-10.25]). Deciding not to have more children correlated with smaller family size 2-3 versus 4-5 (OR: 3.62 [95% CI: 1.10-11.96]). Families experience a high incidence of major life changes in the first year of ALL treatment. Understanding these burdens helps health care providers to provide appropriate anticipatory guidance and support. No unifying factor was associated with the different family events. Ongoing follow-up is planned to measure long-term outcomes. © 2014 Wiley Periodicals, Inc.

An attempt to estimate the economic value of the loss of human life due to landslide and flood events in Italy

NASA Astrophysics Data System (ADS)

Salvati, Paola; Bianchi, Cinzia; Hussin, Haydar; Guzzetti, Fausto

2013-04-01

Landslide and flood events in Italy cause wide and severe damage to buildings and infrastructure, and are frequently involved in the loss of human life. The cost estimates of past natural disasters generally refer to the amount of public money used for the restoration of the direct damage, and most commonly do not account for all disaster impacts. Other cost components, including indirect losses, are difficult to quantify and, among these, the cost of human lives. The value of specific human life can be identified with the value of a statistical life (VLS), defined as the value that an individual places on a marginal change in their likelihood of death This is different from the value of an actual life. Based on information of fatal car accidents in Italy, we evaluate the cost that society suffers for the loss of life due to landslide and flood events. Using a catalogue of fatal landslide and flood events, for which information about gender and age of the fatalities is known, we determine the cost that society suffers for the loss of their life. For the purpose, we calculate the economic value in terms of the total income that the working-age population involved in the fatal events would have earned over the course of their life. For the computation, we use the pro-capita income calculated as the ratio between the GDP and the population value in Italy for each year, since 1980. Problems occur for children and retired people that we decided not to include in our estimates.

A comparison of "life threatening injury" concept in the Turkish Penal Code and trauma scoring systems.

PubMed

Fedakar, Recep; Aydiner, Ahmet Hüsamettin; Ercan, Ilker

2007-07-01

To compare accuracy and to check the suitability of the Glasgow Coma Scale (GCS), the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the New Injury Severity Score (NISS) and the Trauma and Injury Severity Score (TRISS), the scoring systems widely used in international trauma studies, in the evaluation of the "life threatening injury" concept established by the Turkish Penal Code. The age, sex, type of trauma, type and localizations of wounds, GCS, RTS, ISS, NISS and TRISS values, the decision of life threatening injury of 627 trauma patients admitted to Emergency Department of the Uludag University Medical School Hospital in year 2003 were examined. A life-threatening injury was present in 35.2% of the cases examined. GCS, RTS, ISS, NISS and TRISS confirmed the decision of life threatening injury with percentages of 74.8%, 76.9%, 88.7%, 86.6% and 68.6%, respectively. The best cut-off point 14 was determined in the ISS system with 79.6% sensitivity and 93.6% specificity. All of the cases with sole linear skull fracture officially decided as life threatening injury had an ISS of 5, a NISS of 6 and the best scores of GCS (15), RTS (7.8408) and TRISS (100%). ISS and NISS appeared to be the best trauma scoring systems that can be used for the decision of life threatening injury, compared with GCS, RTS and TRISS. Thus, ISS and NISS can be acceptable for using the evaluation of the life threatening injury concept established by the Turkish Penal Code.

30 CFR 204.208 - May a State decide that it will or will not allow one or both of the relief options under this...

Code of Federal Regulations, 2010 CFR

2010-07-01

... MARGINAL PROPERTIES Accounting and Auditing Relief § 204.208 May a State decide that it will or will not... not grant that type of marginal property relief. (b) To help States decide whether to allow one or... Report of Marginal Properties by October 1 preceding the calendar year. (c) If a State decides under...

Economic (gross cost) analysis of systematically implementing a programme of advance care planning in three Irish nursing homes.

PubMed

O'Sullivan, Ronan; Murphy, Aileen; O'Caoimh, Rónán; Cornally, Nicola; Svendrovski, Anton; Daly, Brian; Fizgerald, Carol; Twomey, Cillian; McGlade, Ciara; Molloy, D William

2016-04-26

Although advance care planning (ACP) and the use of advanced care directives (ACD) and end-of-life care plans are associated with a reduction in inappropriate hospitalisation, there is little evidence supporting the economic benefits of such programmes. We assessed the economic impact (gross savings) of the Let Me Decide (LMD) ACP programme in Ireland, specifically the impact on hospitalisations, bed days and location of resident deaths, before and after systematic implementation of the LMD-ACP combined with a palliative care education programme. The LMD-ACP was introduced into three long-term care (LTC) facilities in Southern Ireland and outcomes were compared pre and post implementation. In addition, 90 staff were trained in a palliative care educational programme. Economic analysis including probabilistic sensitivity analysis was performed. The uptake of an ACD or end-of-life care post-implementation rose from 25 to 76%. Post implementation, there were statistically significant decreases in hospitalisation rates from baseline (hospitalisation incidents declined from 27.8 to 14.6%, z = 3.96, p < 0.001; inpatient hospital days reduced from 0.54 to 0.36%, z = 8.85, p < 0.001). The percentage of hospital deaths also decreased from 22.9 to 8.4%, z = 3.22, p = 0.001. However, length of stay (LOS) increased marginally (7-9 days). Economic analysis suggested a cost-reduction related to reduced hospitalisations ranging between €10 and €17.8 million/annum and reduction in ambulance transfers, estimated at €0.4 million/annum if these results were extrapolated nationally. When unit costs and LOS estimates were varied in scenario analyses, the expected cost reduction owing to reduced hospitalisations, ranged from €17.7 to €42.4 million nationally. Implementation of the LMD-ACP (ACD/end-of-life care plans combined with palliative care education) programme resulted in reduced rates of hospitalisation. Despite an increase in LOS, likely reflecting more complex care needs of admitted residents, gross costs were reduced and scenario analysis projected large annual savings if these results were extrapolated to the wider LTC population in Ireland.

Development towards sustainability: how to judge past and proposed policies?

PubMed

Dittmar, Michael

2014-02-15

Most countries have, at least since the 1992 United Nations summit in RIO, adopted some vague "sustainable development" policies. The goals of such policies are to combine economic growth with social development, while protecting our fragile planetary life support system. The scientific data about the state of our planet, presented at the 2012 (Rio+20) summit, documented that today's human family lives even less sustainably than it did in 1992. The data indicate furthermore that the environmental impacts from our current economic activities are so large, that we are approaching situations where potentially controllable regional problems can easily lead to uncontrollable global disasters. Despite these obvious failures, our political global leaders and their institutions are continuing the same "sustainable development" policies, which are now supplemented by equally vague ideas about future "green economies". Assuming that (1) the majority of the human family, once adequately informed, wants to achieve a "sustainable way of life" and (2) that the "development towards sustainability" roadmap will be based on scientific principles, one must begin with unambiguous and quantifiable definitions of these goals. As will be demonstrated, the well known scientific method to define abstract and complex issues by their negation, satisfies these requirements. Following this new approach, it also becomes possible to decide if proposed and actual policy changes will make our way of life less unsustainable, and thus move us potentially into the direction of sustainability. Furthermore, if potentially dangerous tipping points are to be avoided, the transition roadmap must include some minimal speed requirements. Combining the negation method and the time evolution of that remaining natural capital in different domains, the transition speed for a "development towards sustainability" can be quantified at local, regional and global scales. The presented ideas allow us to measure the rate of natural capital depletion and the rate of restoration that will be required if humanity is to avoid reaching a sustainable future by a collapse transition. Unfortunately, the existence of quantifiable methods and tools in no way guarantees that they will be used in changing the direction of our journey. Copyright © 2013 Elsevier B.V. All rights reserved.

Minorities with lupus nephritis and medications: a study of facilitators to medication decision-making.

PubMed

Singh, Jasvinder A; Qu, Haiyan; Yazdany, Jinoos; Chatham, Winn; Shewchuk, Richard

2015-12-17

Medication decision-making poses a challenge for a significant proportion of patients. This is an even more challenging for patients who have complex, rare, immune conditions that affect them at a young age and are associated with the use of life-long treatment, perceived by some as having significant risk of side effects and toxicity. The aim of our study was to examine the perspectives of women with lupus nephritis on facilitators to medication decision-making. We used the nominal group technique (NGT), a structured formative process to elicit patient perspectives. An NGT expert moderated eight patient group meetings. Participants (n = 52) responded to the question "What sorts of things make it easier for people to decide to take the medicines that doctors prescribe for treating their lupus kidney disease?" Patients nominated, discussed, and prioritized facilitators to medication decisional processes. Fifty-two women with lupus nephritis participated in eight NGT meetings (27 African-American, 13 Hispanic, and 12 Caucasian). Average age was 40.6 years (standard deviation (SD) = 13.3), and disease duration was 11.8 years (SD = 8.3); 36.5 % obtained at least a college education, and 55.8 % had difficulty in reading health materials. Patients generated 280 decision-making facilitators (range of 26 to 42 per panel). Of these, 102 (36 %) facilitators were perceived by patients as having relatively more influence in decision-making processes than others. Prioritized facilitators included effective patient-physician communication regarding benefits/harms, patient desire to live a normal life and improve quality of life, concern for their dependents, experiencing benefits and few/infrequent/no harms with lupus medications, and their affordability. Relative to African-Americans, Caucasian and Hispanic patients endorsed a smaller percentage of facilitators as influential. Level of agreement with which patients within panels independently agreed in their selections of the three most influential facilitators ranged from 33 % to 60 %. We identified facilitators to lupus medication decision-making. This information will be used to populate a decision aid for lupus nephritis.

Predoctoral dental students' perceptions and experiences with prosthodontics.

PubMed

Dhima, Matilda; Petropoulos, Vicki C; Salinas, Thomas J; Wright, Robert F

2013-02-01

The aims of this study were to: (1) investigate the perceptions and experiences of predoctoral dental students and advanced standing students on mentorship, exposure to prosthodontics, and future need for the specialty, and (2) establish a baseline of students' perceptions of the impact of prosthodontics on salary, personal and patient quality of life, and the profession of dentistry. A survey was distributed to 494 predoctoral and advanced standing students at the University of Pennsylvania School of Dental Medicine. Questions focused on the perceptions and experiences with the specialty of prosthodontics. A total of 410 surveys were analyzed using Chi Square tests and univariate and multivariate analysis with statistical software. Response rate was 83%. A positive initial introduction to prosthodontics was reported by 57% of students. Most students had positive experiences with prosthodontic faculty and enjoyed laboratory work and challenging/complex dentistry. A greater need for prosthodontists in the future was perceived by 82% of respondents, with 63% reporting that the future of prosthodontics had been emphasized. Students reported (1) a preclinical course directed by prosthodontists and (2) working in the clinic with prosthodontic faculty (p < 0.006) as having the biggest impact on their introduction to prosthodontics. A desire to pursue training or a career in prosthodontics was reported by 3.4% of the respondents, with 1.7% of them pursuing prosthodontics. Enjoyment of providing care in prosthodontics was the most important factor for those who decided to pursue prosthodontic postgraduate training. When compared to other specialties, prosthodontics ranked low with regards to its impact on salary (7(th) ), personal quality of life (5(th) ), patient quality of life (4(th) ), and strengthening of the dental field (7(th) ). Reasons few students are interested in prosthodontics as a career, despite a positive first introduction and high perceived future need for prosthodontists may be attributed to a number of factors. These include insufficient prosthodontically, trained faculty, lack of a mentorship program, lack of an advanced graduate program, a perception of feeling unprepared upon graduation, and misconception of potential income in prosthodontics. © 2012 by the American College of Prosthodontists.

[Occupational complexity and late-life memory and reasoning abilities].

PubMed

Ishioka, Yoshiko; Gondo, Yasuyuki; Masui, Yukie; Nakagawa, Takeshi; Tabuchi, Megumi; Ogawa, Madoka; Kamide, Kei; Ikebe, Kazunori; Arai, Yasumichi; Ishizaki, Tatsuro; Takahashi, Ryutaro

2015-08-01

This study examined the associations between the complexity of an individual's primary lifetime occupation and his or her late-life memory and reasoning performance, using data from 824 community-dwelling participants aged 69-72 years. The complexity of work with data, people, and things was evaluated based on the Japanese job complexity score. The associations between occupational complexity and participant's memory and reasoning abilities were examined in multiple regression analyses. An association was found between more comple work with people and higher memory performance, as well as between more complex work with data and higher reasoning performance, after having controlled for gender, school records, and education. Further, an interaction effect was observed between gender and complexity of work with data in relation to reasoning performance: work involving a high degree of complexity with data was associated with high reasoning performance in men. These findings suggest the need to consider late-life cognitive functioning within the context of adulthood experiences, specifically those related to occupation and gender.

Two-year comprehensive medical management of degenerative lumbar spine disease (lumbar spondylolisthesis, stenosis, or disc herniation): a value analysis of cost, pain, disability, and quality of life: clinical article.

PubMed

Parker, Scott L; Godil, Saniya S; Mendenhall, Stephen K; Zuckerman, Scott L; Shau, David N; McGirt, Matthew J

2014-08-01

Current health care reform calls for a reduction of procedures and treatments that are less effective, more costly, and of little value (high cost/low quality). The authors assessed the 2-year cost and effectiveness of comprehensive medical management for lumbar spondylolisthesis, stenosis, and herniation by utilizing a prospective single-center multidisciplinary spine center registry in a real-world practice setting. Analysis was performed on a prospective longitudinal quality of life spine registry. Patients with lumbar spondylolisthesis (n = 50), stenosis (n = 50), and disc herniation (n = 50) who had symptoms persisting after 6 weeks of medical management and who were eligible for surgical treatment were entered into a prospective registry after deciding on nonsurgical treatment. In all cases, comprehensive medical management included spinal steroid injections, physical therapy, muscle relaxants, antiinflammatory medication, and narcotic oral agents. Two-year patient-reported outcomes, back-related medical resource utilization, and occupational work-day losses were prospectively collected and used to calculate Medicare fee-based direct and indirect costs from the payer and societal perspectives. The maximum health gain associated with medical management was defined as the improvement in pain, disability, and quality of life experienced after 2 years of medical treatment or at the time a patient decided to cross over to surgery. The maximum health gain in back pain, leg pain, disability, quality of life, depression, and general health state did not achieve statistical significance by 2 years of medical management, except for pain and disability in patients with disc herniation and back pain in patients with lumbar stenosis. Eighteen patients (36%) with spondylolisthesis, 11 (22%) with stenosis, and 17 (34%) with disc herniation eventually required surgical management due to lack of improvement. The 2-year improvement did not achieve a minimum clinically important difference in any outcome measure. The mean 2-year total cost (direct plus indirect) of medical management was $6606 for spondylolisthesis, $7747 for stenosis, and $7097 for herniation. In an institution-wide, prospective, longitudinal quality of life registry that measures cost and effectiveness of all spine care provided, comprehensive medical management did not result in sustained improvement in pain, disability, or quality of life for patients with surgically eligible degenerative lumbar spondylolisthesis, stenosis, or disc herniation. From both the societal and payer perspective, continued medical management of patients with these lumbar pathologies in whom 6 weeks of conservative therapy failed was of minimal value given its lack of health utility and effectiveness and its health care costs. The findings from this real-world practice setting may more accurately reflect the true value and effectiveness of nonoperative care in surgically eligible patient populations.

Hierarchical complexity and the size limits of life.

PubMed

Heim, Noel A; Payne, Jonathan L; Finnegan, Seth; Knope, Matthew L; Kowalewski, Michał; Lyons, S Kathleen; McShea, Daniel W; Novack-Gottshall, Philip M; Smith, Felisa A; Wang, Steve C

2017-06-28

Over the past 3.8 billion years, the maximum size of life has increased by approximately 18 orders of magnitude. Much of this increase is associated with two major evolutionary innovations: the evolution of eukaryotes from prokaryotic cells approximately 1.9 billion years ago (Ga), and multicellular life diversifying from unicellular ancestors approximately 0.6 Ga. However, the quantitative relationship between organismal size and structural complexity remains poorly documented. We assessed this relationship using a comprehensive dataset that includes organismal size and level of biological complexity for 11 172 extant genera. We find that the distributions of sizes within complexity levels are unimodal, whereas the aggregate distribution is multimodal. Moreover, both the mean size and the range of size occupied increases with each additional level of complexity. Increases in size range are non-symmetric: the maximum organismal size increases more than the minimum. The majority of the observed increase in organismal size over the history of life on the Earth is accounted for by two discrete jumps in complexity rather than evolutionary trends within levels of complexity. Our results provide quantitative support for an evolutionary expansion away from a minimal size constraint and suggest a fundamental rescaling of the constraints on minimal and maximal size as biological complexity increases. © 2017 The Author(s).

Problem based learning - A brief review

NASA Astrophysics Data System (ADS)

Nunes, Sandra; Oliveira, Teresa A.; Oliveira, Amílcar

2017-07-01

Teaching is a complex mission that requires not only the theoretical knowledge transmission, but furthermore requires to provide the students the necessary skills for solving real problems in their respective professional activities where complex issues and problems must be frequently faced. Over more than twenty years we have been experiencing an increase in scholar failure in the scientific area of mathematics, which means that Teaching Mathematics and related areas can be even a more complex and hard task. Scholar failure is a complex phenomenon that depends on various factors as social factors, scholar factors or biophysical factors. After numerous attempts made in order to reduce scholar failure our goal in this paper is to understand the role of "Problem Based Learning" and how this methodology can contribute to the solution of both: increasing mathematical courses success and increasing skills in the near future professionals in Portugal. Before designing a proposal for applying this technique in our institutions, we decided to conduct a survey to provide us with the necessary information about and the respective advantages and disadvantages of this methodology, so this is the brief review aim.

Health related quality of life and emotional health in children with chronic granulomatous disease: a comparison of those managed conservatively with those that have undergone haematopoietic stem cell transplant.

PubMed

Cole, Theresa; McKendrick, Fiona; Titman, Penny; Cant, Andrew J; Pearce, Mark S; Cale, Catherine M; Goldblatt, David; Gennery, Andrew R

2013-01-01

Chronic Granulomatous Disease (CGD) is a rare primary immunodeficiency that predisposes to life-threatening infections and inflammation. Haematopoietic stem cell transplant (HSCT) can cure CGD. Chronic illness reduces quality of life. Children with haematological malignancies report improved quality of life post-HSCT. There are no data for children with CGD. This study evaluated quality of life and emotional well-being in CGD children treated conventionally or transplanted. Parents and children completed the Pediatric Quality of Life Inventory v4.0 (PedsQL) and Strengths and Difficulties Questionnaires (SDQ). Mean scores were compared with published UK norms. Comparisons were made for those that had or had not undergone HSCT. Forty-seven parents completed PedsQL (children aged 3-15). Twenty-one were post-HSCT. Forty-two completed SDQ (children aged 3-15). Nineteen post-HSCT. Median age for non-HSCT group 9 years. Median age for post-HSCT group 10 years. The HSCT group were median 3 years post-HSCT (range 1-9 years). HSCT survival was 90 %-two died without completing questionnaires Parent and self-reported quality of life for non-transplanted children was significantly lower than healthy children. Parents reported increased emotional difficulties compared to published norms. PedsQL and SDQ scores for transplanted children were not significantly different from healthy norms. This study demonstrates the quality of life is reduced in CGD. Transplanted patients have quality of life comparable to levels reported in healthy children. This data will help inform families and clinicians when deciding about treatment and may have relevance for other immunodeficiencies treated with transplant.

Differences in attitudes to end-of-life care among patients, relatives and healthcare professionals

PubMed Central

Ang, Guat Cheng; Zhang, Di; Lim, Kim Hwa Jim

2016-01-01

INTRODUCTION This study explored and compared the differences in attitudes toward end-of-life care among patients, relatives and healthcare professionals, including doctors and nurses. METHODS We performed a descriptive study on a cross-section of the population of a tertiary hospital in Singapore. Data was collected using a questionnaire survey involving 50 participants from each of the four groups of patients, relatives, doctors and nurses. RESULTS Family members were the most commonly nominated surrogate decision-makers by the patient group (76%) and the majority of the relative group (74%) felt comfortable deciding on end-of-life care for their loved ones. However, the patient and relative groups differed significantly in their preferences on end-of-life care options, including cardiopulmonary resuscitation (CPR) (p = 0.001), intubation (p = 0.003), nasogastric tube feeding (p < 0.001) and the use of antibiotics (p = 0.023). Doctors, nurses and relatives demonstrated differences in preference between end-of-life care for themselves and for their loved ones, especially with regard to the use of nasogastric tube feeding. There was also a difference between patients and doctors in their decisions on CPR (p < 0.001) and intubation (p = 0.008). CONCLUSION This study demonstrated the importance of early planning for end-of-life care. This must be initiated proactively by healthcare professionals to engage patients in a culturally sensitive manner to discuss their preferences, in order to facilitate open communication between the patient and family. PMID:26831313

Integrating palliative care with usual care of diabetic foot wounds.

PubMed

Dunning, Trisha

2016-01-01

Palliative care is a philosophy and a system for deciding care and can be used alone or integrated with usual chronic disease care. Palliative care encompasses end-of-life care. Palliative care aims to enhance quality of life, optimize function and manage symptoms including early in the course of chronic diseases. The purposes of this article are to outline palliative care and discuss how it can be integrated with usual care of diabetic foot wounds. Many people with diabetes who have foot wounds also have other comorbidities and diabetes complications such as cardiovascular and renal disease and depression, which affect medicine and other treatment choices, functional status, surgical risk and quality of life. Two broad of diabetic foot disease exist: those likely to heal but who could still benefit from integrated palliative care such as managing pain and those where healing is unlikely where palliation can be the primary focus. People with diabetes can die suddenly, although the life course is usually long with periods of stable and unstable disease. Many health professionals are reluctant to discuss palliative care or suggest people to document their end-of-life care preferences. If such preferences are not documented, the person might not achieve their desired death or place of death and health professionals and families can be confronted with difficult decisions. Palliative care can be integrated with usual foot care and is associated with improved function, better quality of life and greater patient and family satisfaction. Copyright © 2016 John Wiley & Sons, Ltd.

A case of a brain stem abscess with a favorable outcome

PubMed Central

Bulthuis, Vincent J.; Gubler, Felix S.; Teernstra, Onno P. M.; Temel, Yasin

2015-01-01

Background: A brain stem abscess is a rare and severe medical condition. Here, we present a rare case of a brain stem abscess in a young pregnant woman, requiring acute stereotactic intervention. Case Description: A 36-year-old woman presented with a headache, nausea, and vomiting, and computed tomography showed a space-occupying lesion in the brain stem. She became shortly after comatose, and we decided to perform an acute stereotactic aspiration of the abscess. Soon after surgery, her neurological condition improved dramatically. Conclusion: A brainstem abscess is a life-threatening condition with a potentially good outcome if treated adequately. PMID:26543670

Intelligence Control System for Landfills Based on Wireless Sensor Network

NASA Astrophysics Data System (ADS)

Zhang, Qian; Huang, Chuan; Gong, Jian

2018-06-01

This paper put forward an intelligence system for controlling the landfill gas in landfills to make the landfill gas (LFG) exhaust controllably and actively. The system, which is assigned by the wireless sensor network, were developed and supervised by remote applications in workshop instead of manual work. An automatic valve control depending on the sensor units embedded is installed in tube, the air pressure and concentration of LFG are detected to decide the level of the valve switch. The paper also proposed a modified algorithm to solve transmission problem, so that the system can keep a high efficiency and long service life.

Endogenous longevity, biological deterioration and economic growth.

PubMed

Sanso, Marcos; Aísa, Rosa M

2006-05-01

The identification of the types of bidirectional interactions that take place between longevity and economic growth in the long-run is carried out by means of the integration of human capital accumulation, innovation in medical technology, a health goods sector, and individual decisions on health and longevity in a dynamic general equilibrium set-up. In this context, in which individual agents decide not only on their "quality" of life but also on its "quantity", the mere process of biological deterioration, that is to say, the continuous loss of health goods effectiveness in maintaining a given level of health as individuals age, provides the reason for an additional, and new, engine of growth.

When and why do doctors decide to become general practitioners? Implications for recruitment into UK general practice specialty training.

PubMed

Irish, Bill; Lake, Jonathan

2011-01-01

All applicants to round 1 of national recruitment into the general practice specialty recruitment process were surveyed as to the reasons for, and the timing of their career choices. Most applicants reported decision making after completing undergraduate training citing variety, continuity of care and work-life balance as their main drivers for a career in general practice. Applicants were statistically more likely to have undertaken a Foundation placement in general practice than their peers on a Foundation programme. Reasons for choice of deanery were largely related to location and social ties, rather than to the educational 'reputation' of its programmes.

Acknowledged Dependence and the Virtues of Perinatal Hospice

PubMed Central

Cobb, Aaron D.

2016-01-01

Prenatal screening can lead to the detection and diagnosis of significantly life-limiting conditions affecting the unborn child. Recognizing the difficulties facing parents who decide to continue the pregnancy, some have proposed perinatal hospice as a new modality of care. Although the medical literature has begun to devote significant attention to these practices, systematic philosophical reflection on perinatal hospice has been relatively limited. Drawing on Alasdair MacIntyre’s account of the virtues of acknowledged dependence, I contend that perinatal hospice manifests and facilitates virtues essential to living well with human dependency and vulnerability. For this reason, perinatal hospice deserves broad support within society. PMID:26661051

A decade after Guatemala's agreement on identity and rights of indigenous peoples: Mayan-Tz'utujil women's views on health, healing, and disease.

PubMed

Giralt, Alicia

2012-01-01

Mayan women have been called "guardians of life and ancestral culture." As such, one of their main responsibilities is the health of those in their care. Mothers are the ones who, as soon as a child, husband, or older relative falls sick, assess the symptoms and decide how to proceed. Although Mayan-Tz'utujil healing practices have been the subject of study on numerous occasions, the literature lacks women's views on health, healing, and disease. In this study I present those views within the framework of postcolonial studies, reflecting on the changes in Guatemala's national health policy.

The TOM Complex of Amoebozoans: the Cases of the Amoeba Acanthamoeba castellanii and the Slime Mold Dictyostelium discoideum.

PubMed

Wojtkowska, Małgorzata; Buczek, Dorota; Stobienia, Olgierd; Karachitos, Andonis; Antoniewicz, Monika; Slocinska, Małgorzata; Makałowski, Wojciech; Kmita, Hanna

2015-07-01

Protein import into mitochondria requires a wide variety of proteins, forming complexes in both mitochondrial membranes. The TOM complex (translocase of the outer membrane) is responsible for decoding of targeting signals, translocation of imported proteins across or into the outer membrane, and their subsequent sorting. Thus the TOM complex is regarded as the main gate into mitochondria for imported proteins. Available data indicate that mitochondria of representative organisms from across the major phylogenetic lineages of eukaryotes differ in subunit organization of the TOM complex. The subunit organization of the TOM complex in the Amoebozoa is still elusive, so we decided to investigate its organization in the soil amoeba Acanthamoeba castellanii and the slime mold Dictyostelium discoideum. They represent two major subclades of the Amoebozoa: the Lobosa and Conosa, respectively. Our results confirm the presence of Tom70, Tom40 and Tom7 in the A. castellanii and D. discoideum TOM complex, while the presence of Tom22 and Tom20 is less supported. Interestingly, the Tom proteins display the highest similarity to Opisthokonta cognate proteins, with the exception of Tom40. Thus representatives of two major subclades of the Amoebozoa appear to be similar in organization of the TOM complex, despite differences in their lifestyle. Copyright © 2015 The Authors. Published by Elsevier GmbH.. All rights reserved.

Mapping infectious disease hospital surge threats to lessons learnt in Singapore: a systems analysis and development of a framework to inform how to DECIDE on planning and response strategies.

PubMed

Singh, Shweta R; Coker, Richard; Vrijhoef, Hubertus J-M; Leo, Yee Sin; Chow, Angela; Lim, Poh Lian; Tan, Qinghui; Chen, Mark I-Cheng; Hildon, Zoe Jane-Lara

2017-09-04

Hospital usage and service demand during an Infectious Disease (ID) outbreak can tax the health system in different ways. Herein we conceptualize hospital surge elements, and lessons learnt from such events, to help build appropriately matched responses to future ID surge threats. We used the Interpretive Descriptive qualitative approach. Interviews (n = 35) were conducted with governance and public health specialists; hospital based staff; and General Practitioners. Key policy literature in tandem with the interview data were used to iteratively generate a Hospital ID Surge framework. We anchored our narrative account within this framework, which is used to structure our analysis. A spectrum of surge threats from combinations of capacity (for crowding) and capability (for treatment complexity) demands were identified. Starting with the Pyramid scenario, or an influx of high screening rates flooding Emergency Departments, alongside fewer and manageable admissions; the Reverse-Pyramid occurs when few cases are screened and admitted but those that are, are complex; during a 'Black' scenario, the system is overburdened by both crowding and complexity. The Singapore hospital system is highly adapted to crowding, functioning remarkably well at constant near-full capacity in Peacetime and resilient to Endemic surges. We catalogue 26 strategies from lessons learnt relating to staffing, space, supplies and systems, crystalizing institutional memory. The DECIDE model advocates linking these strategies to types of surge threats and offers a step-by-step guide for coordinating outbreak planning and response. Lack of a shared definition and decision making of surge threats had rendered the procedures somewhat duplicative. This burden was paradoxically exacerbated by a health system that highly prizes planning and forward thinking, but worked largely in silo until an ID crisis hit. Many such lessons can be put into play to further strengthen our current hospital governance and adapted to more diverse settings.

Perceptions of terminally ill patients and family members regarding home and hospice as places of care at the end of life.

PubMed

Luijkx, K G; Schols, J M G A

2011-09-01

To enable demand-based palliative care, it is important to know the perceptions of terminally ill patients and their family members regarding home and hospice as places of care at the end of life. Eight women and five men suffering from cancer and with a life expectancy of 3 months or less were interviewed. In each case one of the family members was also interviewed. Four patients spent their last phase of life at home, nine in a hospice. This paper provides further insight in the patient perspective in palliative care. The results reveal that a cohabiting partner seems an important prerequisite for terminally ill patients to stay at home. For spouses it is an obvious choice to facilitate the patients' stay at home, even when it becomes too demanding, something not discussed between spouse and patient. When sufficient care at home seems impossible and the negotiation between patients and family members results in the opinion that living at home is no longer an option, it is decided that the patient moves to a hospice. The choice for the specific setting of the patients' new residence seems to be random; one possibility is pointed out to them and seems appropriate. © 2010 Blackwell Publishing Ltd.

Deciding life and death in the courtroom. From Quinlan to Cruzan, Glucksberg, and Vacco--a brief history and analysis of constitutional protection of the 'right to die'.

PubMed

Gostin, L O

1997-11-12

This article analyzes judicial determinations on the "right to die" from Quinlan to Cruzan, Glucksberg, and Vacco. The body of law known as right-to-die cases extends ordinary treatment refusal doctrine to end-of-life decisions. The courts, having affirmed a right to refuse life-sustaining treatment, held that certain categorical distinctions that had been drawn lacked a rational basis. No rational distinction could be made between competent vs incompetent patients, withholding vs withdrawing treatment, and ordinary vs extraordinary treatment. The courts, however, had persistently affirmed one categorical distinction: between withdrawing life-sustaining treament on the one hand and active euthanasia or physician-assisted dying on the other. In Washington v Glucksberg and Vacco v Quill, the Supreme Court unanimously held that physician-assisted suicide is not a fundamental liberty interest protected by the Constitution. Notably, five members of the Court wrote or joined in concurring opinions that took a more liberal view. The Court powerfully approved aggressive palliation of pain. The Supreme Court, hinting that it would find state legalization of physician-assisted suicide constitutional, invited the nation to pursue an earnest debate on physician assistance in the dying process.

'Aid-in-dying' and the taking of human life.

PubMed Central

Campbell, C S

1992-01-01

In several US states, the legalisation of euthanasia has become a question for voters to decide in public referenda. This democratic approach in politics is consistent with notions of personal autonomy in medicine, but the right of choice does not mean all choices are morally equal. A presumption against the taking of human life is embedded in the formative moral traditions of society; human life does not have absolute value, but we do and should impose a strict burden of justification for exceptions to the presumption, as exemplified by the moral criteria invoked to justify self-defence, capital punishment, or just war. These criteria can illuminate whether another exception should be carved out for doctor-assisted suicide or active euthanasia. It does not seem, in the United States at any rate, that all possible alternatives to affirm the control and dignity of the dying patient and to relieve pain and suffering, short of taking life, have been exhausted. Moreover, the procedural safeguards built into many proposals for legalised euthanasia would likely be undone by the sorry state of the US health care system, with its lack of universal access to care, chronic cost-containment ills, a litigious climate, and socioeconomic barriers to care. There remains, however, common ground in the quest for humane care of the dying. PMID:1404279

[Moyse Charas, a typical master apothecary and physician for his time (1619-1698)].

PubMed

Bonnemain, Bruno

2016-09-01

The life of Moyse Charas has been very stormy, especially after 1680. One can consider three main periods in his carrier : a first one from his birth in Uzès (France), in 1619, to 1680 ; his exile from 1680 to 1689 in various European countries ; and finally, his return to Paris in 1690 until his death in 1698. He decided his return to Paris and confirmed his conversion to Catholicism the 1st of July 1691, being received by Louis XIV and elected as a member of the French Academy of Sciences in 1692. Charas dictated his one’s will the 12th of January 1698, a few days before his death. All along his very active life, Charas was noteworthy by two major achievements : his interest and works on viper and, as a consequence, on theriac ; and his book that became a reference for all apothecaries and physicians at the time, the Pharmacopée Royale galénique et chimique (the Galenic and Chemical Royal Pharmacopoeia). The present study examines specifically the influence of Charas’ pharmacopoeia to the Universal Pharmacopeia of Lémery, and the conceptual visible differences between the two authors. He decided his return to Paris and confirmed his conversion to Catholicism the 1st of July 1691, being received by Louis XIV and elected as a member of the French Academy of Sciences in 1692. Charas dictated his one’s will the 12th of January 1698, a few days before his death. All along his very active life, Charas was noteworthy by two major achievements : his interest and works on viper and, as a consequence, on theriac ; and his book that became a reference for all apothecaries and physicians at the time, the Pharmacopée Royale galénique et chimique (the Galenic and Chemical Royal Pharmacopoeia). The present study examines specifically the influence of Charas’ pharmacopoeia to the Universal Pharmacopeia of Lémery, and the conceptual visible differences between the two authors.

Effects of supportive-educative program on quality of life of adolescents living with a parent with cancer.

PubMed

Azarbarzin, Mehrdad; Malekian, Azadeh; Taleghani, Fariba

2015-01-01

Cancer has significant traumatic effects on the family members of the patients, particularly in Asia's tightly knitted families. Research evidence suggests a debilitating impact of cancer on the quality of life of the afflicted individuals, their spouses, and their families. Since a few studies have been carried out on the quality of life of adolescents living with parents diagnosed with cancer, especially in Iran, the research team decided to evaluate the quality of life of them and also investigate the effects of supportive-educative program on it. The present quasi-experimental, one-group study had a pre-test-post-test design and was performed in Esfahan in 2014. The sample of this study consisted of 30 adolescents. The data gathering tool was the short form of quality of life questionnaire (SF-36). Data were analyzed by descriptive statistics and paired sample t-test. P-value of 0.05 was considered significant. The paired sample t-test showed that before and after presenting the program, there were significant statistical differences in some aspects of quality of life, such as physical functioning (P = 0.01), energy/fatigue (P < 0.0001), emotional well-being (P < 0.0001), social functioning (P = 0.001), pain (P < 0.0001), and general health (P = 0.01). This research showed that supportive-educative program can enhance some aspects of quality of life. Therefore, nurses and other health professionals can use this scheme or similar programs for helping adolescents living with a parent with cancer.

Effects of supportive-educative program on quality of life of adolescents living with a parent with cancer

PubMed Central

Azarbarzin, Mehrdad; Malekian, Azadeh; Taleghani, Fariba

2015-01-01

Background: Cancer has significant traumatic effects on the family members of the patients, particularly in Asia's tightly knitted families. Research evidence suggests a debilitating impact of cancer on the quality of life of the afflicted individuals, their spouses, and their families. Since a few studies have been carried out on the quality of life of adolescents living with parents diagnosed with cancer, especially in Iran, the research team decided to evaluate the quality of life of them and also investigate the effects of supportive-educative program on it. Materials and Methods: The present quasi-experimental, one-group study had a pre-test–post-test design and was performed in Esfahan in 2014. The sample of this study consisted of 30 adolescents. The data gathering tool was the short form of quality of life questionnaire (SF-36). Data were analyzed by descriptive statistics and paired sample t-test. P-value of 0.05 was considered significant. Results: The paired sample t-test showed that before and after presenting the program, there were significant statistical differences in some aspects of quality of life, such as physical functioning (P = 0.01), energy/fatigue (P < 0.0001), emotional well-being (P < 0.0001), social functioning (P = 0.001), pain (P < 0.0001), and general health (P = 0.01). Conclusions: This research showed that supportive-educative program can enhance some aspects of quality of life. Therefore, nurses and other health professionals can use this scheme or similar programs for helping adolescents living with a parent with cancer. PMID:26457095

When weight management lasts. Lower perceived rule complexity increases adherence.

PubMed

Mata, Jutta; Todd, Peter M; Lippke, Sonia

2010-02-01

Maintaining behavior change is one of the major challenges in weight management and long-term weight loss. We investigated the impact of the cognitive complexity of eating rules on adherence to weight management programs. We studied whether popular weight management programs can fail if participants find the rules too complicated from a cognitive perspective, meaning that individuals are not able to recall or process all required information for deciding what to eat. The impact on program adherence of participants' perceptions of eating rule complexity and other behavioral factors known to influence adherence (including previous weight management, self-efficacy, and planning) was assessed via a longitudinal online questionnaire given to 390 participants on two different popular weight management regimens. As we show, the regimens, Weight Watchers and a popular German recipe diet (Brigitte), strongly differ in objective rule complexity and thus their cognitive demands on the dieter. Perceived rule complexity was the strongest factor associated with increased risk of quitting the cognitively demanding weight management program (Weight Watchers); it was not related to adherence length for the low cognitive demand program (Brigitte). Higher self-efficacy generally helped in maintaining a program. The results emphasize the importance of considering rule complexity to promote long-term weight management. 2009 Elsevier Ltd. All rights reserved.

The evolution of complex life cycles when parasite mortality is size- or time-dependent.

PubMed

Ball, M A; Parker, G A; Chubb, J C

2008-07-07

In complex cycles, helminth larvae in their intermediate hosts typically grow to a fixed size. We define this cessation of growth before transmission to the next host as growth arrest at larval maturity (GALM). Where the larval parasite controls its own growth in the intermediate host, in order that growth eventually arrests, some form of size- or time-dependent increase in its death rate must apply. In contrast, the switch from growth to sexual reproduction in the definitive host can be regulated by constant (time-independent) mortality as in standard life history theory. We here develop a step-wise model for the evolution of complex helminth life cycles through trophic transmission, based on the approach of Parker et al. [2003a. Evolution of complex life cycles in helminth parasites. Nature London 425, 480-484], but which includes size- or time-dependent increase in mortality rate. We assume that the growing larval parasite has two components to its death rate: (i) a constant, size- or time-independent component, and (ii) a component that increases with size or time in the intermediate host. When growth stops at larval maturity, there is a discontinuous change in mortality to a constant (time-independent) rate. This model generates the same optimal size for the parasite larva at GALM in the intermediate host whether the evolutionary approach to the complex life cycle is by adding a new host above the original definitive host (upward incorporation), or below the original definitive host (downward incorporation). We discuss some unexplored problems for cases where complex life cycles evolve through trophic transmission.

Childhood school performance, education and occupational complexity: a life-course study of dementia in the Kungsholmen Project

PubMed Central

Dekhtyar, Serhiy; Wang, Hui-Xin; Fratiglioni, Laura; Herlitz, Agneta

2016-01-01

Abstract Background: Cognitive reserve hypothesis predicts that intellectually demanding activities over the life course protect against dementia. We investigate if childhood school performance remains associated with dementia once education and occupational complexity are taken into account. Methods: A cohort of 440 individuals aged 75+ from the Kungsholmen Project was followed up for 9 years to detect dementia. To measure early-life contributors to reserve, we used grades at age 9–10 extracted from the school archives. Data on formal education and occupational complexity were collected at baseline and first follow-up. Dementia was ascertained through comprehensive clinical examination. Cox models estimated the relationship between life-course cognitive reserve measures and dementia. Results: Dementia risk was elevated [hazard ratio (HR): 1.54, 95% confidence interval (CI): 1.03 to 2.29] in individuals with low early-life school grades after adjustment for formal educational attainment and occupational complexity. Secondary education was associated with a lower risk of dementia (HR: 0.72, 95% CI: 0.50 to 1.03), although the effects of post-secondary and university degrees were indistinguishable from baseline. Occupational complexity with data and things was not related to dementia. However, an association was found between high occupational complexity with people and dementia, albeit only in women (HR: 0.39, 95% CI: 0.14 to 0.99). The pattern of results remained unchanged after adjustment for genetic susceptibility, comorbidities and depressive symptoms. Conclusion: Low early-life school performance is associated with an elevated risk of dementia, independent of subsequent educational and occupational attainment. PMID:26968481

Cochlear Implant: the complexity involved in the decision making process by the family.

PubMed

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention.

Designing Effective Interactions for Concordance around End-of-Life Care Decisions: Lessons from Hospice Admission Nurses

PubMed Central

Candrian, Carey; Tate, Channing; Broadfoot, Kirsten; Tsantes, Alexandra; Matlock, Daniel; Kutner, Jean

2017-01-01

Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual’s acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable. One goal of these interactions is ensuring patients and families have accurate and clear information about hospice care to facilitate informed decisions. So inconsistent are practices across hospices in consenting patients that a 2016 report from the Office of Inspector General (OIG) entitled “Hospices should improve their election statements and certifications of terminal illness” called for complete and accurate election statements to ensure that hospice patients and their caregivers can make informed decisions and understand the costs and benefits of choosing hospice care. Whether complete and accurate information at initial admission visits improves interactions and outcomes is unknown. Our recent qualitative work investigating interactions between patients, caregivers, and hospice nurses has uncovered diverse and often diverging stakeholder-specific expectations and perceptions which if not addressed can create discordance and inhibit decision-making. This paper focuses on better understanding the communication dynamics and practices involved in hospice admission interactions in order to design more effective interactions and support the mandate from the OIG to provide hospice patients and their caregivers with accurate and complete information. This clarity is particularly important when discussing the non-curative nature of hospice care, and the choice patients make to forego aggressive treatment measures when they enroll in hospice. In a literal sense, to enroll in hospice means to bring in support for end-of-life care. It means to identify the need for expertise around symptom management at end-of-life, and agree to having a care team come and manage someone’s physical, psychosocial, and/or spiritual needs. As with all care, hospice can be stopped if it is no longer considered appropriate. To uncover the communication tensions undergirding a hospice admission interaction, we use Street’s ecological theory of patient-centered communication to analyze a case exemplar of a hospice admission interaction. This analysis reveals diverse points of struggle within hospice decision-making processes around hospice care and the need for communication techniques that promote trust and acceptance of end-of-life care. Lessons learned from talking about hospice care can inform other quality initiatives around communication and informed decision-making in the context of advance care planning, palliative care, and end-of-life care. PMID:28420191

Behavior of the gypsy moth life system model and development of synoptic model formulations

Treesearch

J. J. Colbert; Xu Rumei

1991-01-01

Aims of the research: The gypsy moth life system model (GMLSM) is a complex model which incorporates numerous components (both biotic and abiotic) and ecological processes. It is a detailed simulation model which has much biological reality. However, it has not yet been tested with life system data. For such complex models, evaluation and testing cannot be adequately...

[Is abortion murder?].

PubMed

Werning, C

1995-09-01

Discussions about Paragraph 218 of the German federal abortion law have spawned antithetical opinions: on the one hand, the full right of the mother or parents to decide about the incipient human life; and on the other hand, under the dogma of abortion is murder, providing abortion is rejected even when the pregnancy is the result of rape and it is unwanted. Two questions are closely related to this issue: 1) what makes human beings human and 2) when does human life begin. From a medical point of view the function of the brain is fundamentally linked to being human. The brain controls almost all functions of the body and determines its psychological makeup, such as intellect and, in a theological sense, the soul. Without the brain such functioning is not possible, since brain death means the death of human life. Children born with anencephaly and microencephaly can never live a human life. At the end of life various diseases (stroke, Alzheimer disease) can severely damage the brain. In these cases normal living is also no longer possible. Yet ethically it is untenable to actively kill these human beings. But when one considers that life-threatening diseases can require life-support intervention, then often the pragmatic intervention is not far removed from active euthanasia. The other question related to the beginning of human life is even more difficult to answer. It is the fertilization of the egg cells; but a conglomeration of cells in the early phase of pregnancy can hardly be characterized as a human person. The human identity, personality, and worth is associated with the functioning of the brain, so only when the brain is fully developed can there be any talk about an unborn human being.

5 CFR 890.1023 - Information considered in deciding a contest.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Imposed Against Health Care Providers Permissive Debarments § 890.1023 Information considered in deciding... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Information considered in deciding a contest. 890.1023 Section 890.1023 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED...

Applying Movement Ecology to Marine Animals with Complex Life Cycles.

PubMed

Allen, Richard M; Metaxas, Anna; Snelgrove, Paul V R

2018-01-03

Marine animals with complex life cycles may move passively or actively for fertilization, dispersal, predator avoidance, resource acquisition, and migration, and over scales from micrometers to thousands of kilometers. This diversity has catalyzed idiosyncratic and unfocused research, creating unsound paradigms regarding the role of movement in ecology and evolution. The emerging movement ecology paradigm offers a framework to consolidate movement research independent of taxon, life-history stage, scale, or discipline. This review applies the framework to movement among life-history stages in marine animals with complex life cycles to consolidate marine movement research and offer insights for scientists working in aquatic and terrestrial realms. Irrespective of data collection or simulation strategy, breaking each life-history stage down into the fundamental units of movement allows each unit to be studied independently or interactively with other units. Understanding these underlying mechanisms of movement within each life-history stage can then be used to construct lifetime movement paths. These paths can allow further investigation of the relative contributions and interdependencies of steps and phases across a lifetime and how these paths influence larger research topics, such as population-level movements.

Applying Movement Ecology to Marine Animals with Complex Life Cycles

NASA Astrophysics Data System (ADS)

Allen, Richard M.; Metaxas, Anna; Snelgrove, Paul V. R.

2018-01-01

Marine animals with complex life cycles may move passively or actively for fertilization, dispersal, predator avoidance, resource acquisition, and migration, and over scales from micrometers to thousands of kilometers. This diversity has catalyzed idiosyncratic and unfocused research, creating unsound paradigms regarding the role of movement in ecology and evolution. The emerging movement ecology paradigm offers a framework to consolidate movement research independent of taxon, life-history stage, scale, or discipline. This review applies the framework to movement among life-history stages in marine animals with complex life cycles to consolidate marine movement research and offer insights for scientists working in aquatic and terrestrial realms. Irrespective of data collection or simulation strategy, breaking each life-history stage down into the fundamental units of movement allows each unit to be studied independently or interactively with other units. Understanding these underlying mechanisms of movement within each life-history stage can then be used to construct lifetime movement paths. These paths can allow further investigation of the relative contributions and interdependencies of steps and phases across a lifetime and how these paths influence larger research topics, such as population-level movements.

Value for money in changing clinical practice: should decisions about guidelines and implementation strategies be made sequentially or simultaneously?

PubMed

Hoomans, Ties; Severens, Johan L; Evers, Silvia M A A; Ament, Andre J H A

2009-01-01

Decisions about clinical practice change, that is, which guidelines to adopt and how to implement them, can be made sequentially or simultaneously. Decision makers adopting a sequential approach first compare the costs and effects of alternative guidelines to select the best set of guideline recommendations for patient management and subsequently examine the implementation costs and effects to choose the best strategy to implement the selected guideline. In an integral approach, decision makers simultaneously decide about the guideline and the implementation strategy on the basis of the overall value for money in changing clinical practice. This article demonstrates that the decision to use a sequential v. an integral approach affects the need for detailed information and the complexity of the decision analytic process. More importantly, it may lead to different choices of guidelines and implementation strategies for clinical practice change. The differences in decision making and decision analysis between the alternative approaches are comprehensively illustrated using 2 hypothetical examples. We argue that, in most cases, an integral approach to deciding about change in clinical practice is preferred, as this provides more efficient use of scarce health-care resources.

Guidelines to support nurse-researchers reflect on role conflict in qualitative interviewing.

PubMed

Jack, Susan

2008-01-01

The conduct of a qualitative research interview is a complex social interaction that has the potential to influence, or be influenced by, both the researcher and the study participant. When a researcher is identified as a professional nurse, the identification of this role has the potential to influence the researcher-participant interaction. To understand the effect of a nurse-researcher's involvement in an in-depth interview and on the data collected, issues to address include: clearly identifying the paradigmatic approach in which the research design is situated, examining the study participants' past experiences with research and the researcher's profession, establishing appropriate boundaries with participants, deciding how to introduce the role of nurse-researcher to the participant and deciding if, or when, it would be appropriate to intervene within the research context. As nurse-researchers, professional knowledge and experiences have the potential to affect relationship development with study participants and obfuscate the purpose of the research interview. It is the researcher's responsibility to participate in the activity of reflexivity to understand the effect of the nurse-researcher's involvement on the data and make decisions that protect the participant's integrity.

Guidelines to Support Nurse-Researchers Reflect on Role Conflict in Qualitative Interviewing

PubMed Central

Jack, Susan

2008-01-01

The conduct of a qualitative research interview is a complex social interaction that has the potential to influence, or be influenced by, both the researcher and the study participant. When a researcher is identified as a professional nurse, the identification of this role has the potential to influence the researcher-participant interaction. To understand the effect of a nurse-researcher’s involvement in an in-depth interview and on the data collected, issues to address include: clearly identifying the paradigmatic approach in which the research design is situated, examining the study participants' past experiences with research and the researcher’s profession, establishing appropriate boundaries with participants, deciding how to introduce the role of nurse-researcher to the participant and deciding if, or when, it would be appropriate to intervene within the research context. As nurse-researchers, professional knowledge and experiences have the potential to affect relationship development with study participants and obfuscate the purpose of the research interview. It is the researcher’s responsibility to participate in the activity of reflexivity to understand the effect of the nurse-researcher’s involvement on the data and make decisions that protect the participant’s integrity. PMID:19319221

Why do children decide not to participate in clinical research: a quantitative and qualitative study.

PubMed

Hein, Irma M; Troost, Pieter W; de Vries, Martine C; Knibbe, Catherijne A J; van Goudoever, Johannes B; Lindauer, Ramón J L

2015-07-01

More pediatric drug trials are needed, but although specific pediatric regulations warrant safety, recruitment of children for these trials remains one of the main difficulties. Therefore, we investigated potential determining factors of nonparticipation in clinical research, in order to optimize research participation of children by recommending improved recruitment strategies. Between 1 January 2012 and 1 January 2014, we performed a prospective study among161 pediatric patients, aged 6 to 18 y, who were eligible for clinical research. We quantitatively analyzed the association of potential explanatory variables (e.g., age, cognitive development, experience, ethnicity) with nonparticipation and qualitatively analyzed interviews on reasons for nonparticipation. Sixty percent of the children did not participate in the research project on offer (39% decided not to participate, 21% were indecisive). Lower age, less disease experience, and less complex research with lower risk were predictive for not participating. Time constraint and extra burden were expressed as decisive reasons for not participating. Strategies to optimize research participation should be aimed at younger children and their families, who are logistically challenged and unfamiliar with health care and research. Recommendations include informing pediatric patients and their families of the value of research; minimizing logistic burdens; and improving accessibility.

Quality of service policy control in virtual private networks

NASA Astrophysics Data System (ADS)

Yu, Yiqing; Wang, Hongbin; Zhou, Zhi; Zhou, Dongru

2004-04-01

This paper studies the QoS of VPN in an environment where the public network prices connection-oriented services based on source, destination and grade of service, and advertises these prices to its VPN customers (users). As different QoS technologies can produce different QoS, there are according different traffic classification rules and priority rules. The internet service provider (ISP) may need to build complex mechanisms separately for each node. In order to reduce the burden of network configuration, we need to design policy control technologies. We considers mainly directory server, policy server, policy manager and policy enforcers. Policy decision point (PDP) decide its control according to policy rules. In network, policy enforce point (PEP) decide its network controlled unit. For InterServ and DiffServ, we will adopt different policy control methods as following: (1) In InterServ, traffic uses resource reservation protocol (RSVP) to guarantee the network resource. (2) In DiffServ, policy server controls the DiffServ code points and per hop behavior (PHB), its PDP distributes information to each network node. Policy server will function as following: information searching; decision mechanism; decision delivering; auto-configuration. In order to prove the effectiveness of QoS policy control, we make the corrective simulation.

Dormancy and germination: How does the crop seed decide?

PubMed

Shu, K; Meng, Y J; Shuai, H W; Liu, W G; Du, J B; Liu, J; Yang, W Y

2015-11-01

Whether seeds germinate or maintain dormancy is decided upon through very intricate physiological processes. Correct timing of these processes is most important for the plants life cycle. If moist conditions are encountered, a low dormancy level causes pre-harvest sprouting in various crop species, such as wheat, corn and rice, this decreases crop yield and negatively impacts downstream industrial processing. In contrast, a deep level of seed dormancy prevents normal germination even under favourable conditions, resulting in a low emergence rate during agricultural production. Therefore, an optimal seed dormancy level is valuable for modern mechanised agricultural systems. Over the past several years, numerous studies have demonstrated that diverse endogenous and environmental factors regulate the balance between dormancy and germination, such as light, temperature, water status and bacteria in soil, and phytohormones such as ABA (abscisic acid) and GA (gibberellic acid). In this updated review, we highlight recent advances regarding the molecular mechanisms underlying regulation of seed dormancy and germination processes, including the external environmental and internal hormonal cues, and primarily focusing on the staple crop species. Furthermore, future challenges and research directions for developing a full understanding of crop seed dormancy and germination are also discussed. © 2015 German Botanical Society and The Royal Botanical Society of the Netherlands.

Deciding on gender in children with intersex conditions: considerations and controversies.

PubMed

Thyen, Ute; Richter-Appelt, Hertha; Wiesemann, Claudia; Holterhus, Paul-Martin; Hiort, Olaf

2005-01-01

Biologic factors such as genetic and hormonal influences contribute to gender identity, gender role behavior, and sexual orientation in humans, but this relationship is considerably modified by psychologic, social, and cultural factors. The recognition of biologically determined conditions leading to incongruity of genetically determined sex, somatic phenotype, and gender identity has led to growing interest in gender role development and gender identity in individuals with intersex conditions. Sex assignment of children with ambiguous genitalia remains a difficult decision for the families involved and subject to controversial discussion among professionals and self-help groups. Although systematic empirical data on outcomes of functioning and health-related quality of life are sparse, anecdotal evidence from case series and individual patients about their experiences in healthcare suggests traumatic experiences in some. This article reviews the earlier 'optimal gender policy' as well as the more recent 'full consent policy' and reviews published data on both surgical and psychosocial outcomes. The professional debate on deciding on sex assignment in children with intersex conditions is embedded in a much wider public discourse on gender as a social construction. Given that the empirical basis of our knowledge of the causes, treatment options, long-term outcomes, and patient preferences is insufficient, we suggest preliminary recommendations based on clinical experience, study of the literature, and interviews with affected individuals.

Reproductive medicine: the ethical issues in the twenty-first century.

PubMed

Campbell, Alastair V

2002-02-01

Reproductive medicine has developed to such an extent that numerous moral questions arise about the boundaries of applications of new reproductive technology. It is possible to imagine a future in which 'designer babies' are created and in which cloning, sex selection and male pregnancy become the instruments of individual desire or social policy. In this article, the concept of 'natural' is explored but rejected as an insufficient moral criterion for deciding these complex questions. A case is made for the criterion of welfare of the child and for the concept of the child as gift rather than product.

[Quorum sensing in bacteria and yeast].

PubMed

March Rosselló, Gabriel Alberto; Eiros Bouza, José María

2013-10-19

Bacterial sets are complex dynamic systems, which interact with each other and through the interaction, bacteria coexist, collaborate, compete and share information in a coordinated manner. A way of bacterial communication is quorum sensing. Through this mechanism the bacteria can recognize its concentration in a given environment and they can decide the time at which the expression of a particular set of genes should be started for developing a specific and simultaneous response. The result of these interconnections raises properties that cannot be explained from a single isolated bacterial cell. Copyright © 2012 Elsevier España, S.L. All rights reserved.

A simplified modification of a reconstruction plate into a mandibular transport distraction device: A technical note.

PubMed

Mohanty, Sujata; Dabas, Jitender; Gupta, Rekha

2015-01-01

Transport distraction is nowadays gaining enormous popularity and is becoming a promising option for reconstruction of mandibular defects. However, the vast number of distraction device designs create huge confusion in the clinician's mind to choose the right one. Considering these complex and costly designs, the authors decided to find a simplified way of combining a modified conventional reconstruction plate and monofocal distraction device that can act as a transport distraction device for bridging of bony defects. A case performed by this technique and device has been presented along with the description of device design.

Mutually unbiased bases and semi-definite programming

NASA Astrophysics Data System (ADS)

Brierley, Stephen; Weigert, Stefan

2010-11-01

A complex Hilbert space of dimension six supports at least three but not more than seven mutually unbiased bases. Two computer-aided analytical methods to tighten these bounds are reviewed, based on a discretization of parameter space and on Gröbner bases. A third algorithmic approach is presented: the non-existence of more than three mutually unbiased bases in composite dimensions can be decided by a global optimization method known as semidefinite programming. The method is used to confirm that the spectral matrix cannot be part of a complete set of seven mutually unbiased bases in dimension six.

A New Nightly Build System for LHCb

NASA Astrophysics Data System (ADS)

Clemencic, M.; Couturier, B.

2014-06-01

The nightly build system used so far by LHCb has been implemented as an extension of the system developed by CERN PH/SFT group (as presented at CHEP2010). Although this version has been working for many years, it has several limitations in terms of extensibility, management and ease of use, so that it was decided to develop a new version based on a continuous integration system. In this paper we describe a new implementation of the LHCb Nightly Build System based on the open source continuous integration system Jenkins and report on the experience of configuring a complex build workflow in Jenkins.

5 CFR 890.1036 - Information considered in deciding a contest.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Imposed Against Health Care Providers Suspension § 890.1036 Information considered in deciding a contest... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Information considered in deciding a contest. 890.1036 Section 890.1036 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED...

5 CFR 890.1036 - Information considered in deciding a contest.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Imposed Against Health Care Providers Suspension § 890.1036 Information considered in deciding a contest... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Information considered in deciding a contest. 890.1036 Section 890.1036 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED...

5 CFR 890.1036 - Information considered in deciding a contest.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Imposed Against Health Care Providers Suspension § 890.1036 Information considered in deciding a contest... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Information considered in deciding a contest. 890.1036 Section 890.1036 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED...

Comparative muscle development of scyphozoan jellyfish with simple and complex life cycles.

PubMed

Helm, Rebecca R; Tiozzo, Stefano; Lilley, Martin K S; Lombard, Fabien; Dunn, Casey W

2015-01-01

Simple life cycles arise from complex life cycles when one or more developmental stages are lost. This raises a fundamental question - how can an intermediate stage, such as a larva, be removed, and development still produce a normal adult? To address this question, we examined the development in several species of pelagiid jellyfish. Most members of Pelagiidae have a complex life cycle with a sessile polyp that gives rise to ephyrae (juvenile medusae); but one species within Pelagiidae, Pelagia noctiluca, spends its whole life in the water column, developing from a larva directly into an ephyra. In many complex life cycles, adult features develop from cell populations that remain quiescent in larvae, and this is known as life cycle compartmentalization and may facilitate the evolution of direct life cycles. A second type of metamorphic processes, known as remodeling, occurs when adult features are formed through modification of already differentiated larval structures. We examined muscle morphology to determine which of these alternatives may be present in Pelagiidae. We first examined the structure and development of polyp and ephyra musculature in Chrysaora quinquecirrha, a close relative of P. noctiluca with a complex life cycle. Using phallotoxin staining and confocal microscopy, we verified that polyps have four to six cord muscles that persist in strobilae and discovered that cord muscles is physically separated from ephyra muscle. When cord muscle is removed from ephyra segments, normal ephyra muscle still develops. This suggests that polyp cord muscle is not necessary for ephyra muscle formation. We also found no evidence of polyp-like muscle in P. noctiluca. In both species, we discovered that ephyra muscle arises de novo in a similar manner, regardless of the life cycle. The separate origins of polyp and ephyra muscle in C. quinquecirrha and the absence of polyp-like muscle in P. noctiluca suggest that polyp muscle is not remodeled to form ephyra muscle in Pelagiidae. Life cycle stages in Scyphozoa may instead be compartmentalized. Because polyp muscle is not directly remodeled, this may have facilitated the loss of the polyp stage in the evolution of P. noctiluca.

Linguistic ability in early life and cognitive function and Alzheimer's disease in late life. Findings from the Nun Study.

PubMed

Snowdon, D A; Kemper, S J; Mortimer, J A; Greiner, L H; Wekstein, D R; Markesbery, W R

1996-02-21

To determine if linguistic ability in early life is associated with cognitive function and Alzheimer's disease in late life. Two measures of linguistic ability in early life, idea density and grammatical complexity, were derived from autobiographies written at a mean age of 22 years. Approximately 58 years later, the women who wrote these autobiographies participated in an assessment of cognitive function, and those who subsequently died were evaluated neuropathologically. Convents in the United States participating in the Nun Study; primarily convents in the Milwaukee, Wis, area. Cognitive function was investigated in 93 participants who were aged 75 to 95 years at the time of their assessments, and Alzheimer's disease was investigated in the 14 participants who died at 79 to 96 years of age. Seven neuropsychological tests and neuropathologically confirmed Alzheimer's disease. Low idea density and low grammatical complexity in autobiographies written in early life were associated with low cognitive test scores in late life. Low idea density in early life had stronger and more consistent associations with poor cognitive function than did low grammatical complexity. Among the 14 sisters who died, neuropathologically confirmed Alzheimer's disease was present in all of those with low idea density in early life and in none of those with high idea density. Low linguistic ability in early life was a strong predictor of poor cognitive function and Alzheimer's disease in late life.

Inteins, introns, and homing endonucleases: recent revelations about the life cycle of parasitic genetic elements

PubMed Central

Gogarten, J Peter; Hilario, Elena

2006-01-01

Self splicing introns and inteins that rely on a homing endonuclease for propagation are parasitic genetic elements. Their life-cycle and evolutionary fate has been described through the homing cycle. According to this model the homing endonuclease is selected for function only during the spreading phase of the parasite. This phase ends when the parasitic element is fixed in the population. Upon fixation the homing endonuclease is no longer under selection, and its activity is lost through random processes. Recent analyses of these parasitic elements with functional homing endonucleases suggest that this model in its most simple form is not always applicable. Apparently, functioning homing endonuclease can persist over long evolutionary times in populations and species that are thought to be asexual or nearly asexual. Here we review these recent findings and discuss their implications. Reasons for the long-term persistence of a functional homing endonuclease include: More recombination (sexual and as a result of gene transfer) than previously assumed for these organisms; complex population structures that prevent the element from being fixed; a balance between active spreading of the homing endonuclease and a decrease in fitness caused by the parasite in the host organism; or a function of the homing endonuclease that increases the fitness of the host organism and results in purifying selection for the homing endonuclease activity, even after fixation in a local population. In the future, more detailed studies of the population dynamics of the activity and regulation of homing endonucleases are needed to decide between these possibilities, and to determine their relative contributions to the long term survival of parasitic genes within a population. Two outstanding publications on the amoeba Naegleria group I intron (Wikmark et al. BMC Evol Biol 2006, 6:39) and the PRP8 inteins in ascomycetes (Butler et al.BMC Evol Biol 2006, 6:42) provide important stepping stones towards integrated studies on how these parasitic elements evolve through time together with, or despite, their hosts. PMID:17101053

Governance and Factions--Who Decides Who Decides?

ERIC Educational Resources Information Center

Hodgkinson, Harold L.

In several projects, the Center is studying the question: who will decide which factions will be represented in the decision-making process. In the Campus Governance Project investigating the nature of governance, over 3,000 questionnaires were administered and 900 intensive interviews conducted at 19 institutions. The questionnaire was designed…

Childhood school performance, education and occupational complexity: a life-course study of dementia in the Kungsholmen Project.

PubMed

Dekhtyar, Serhiy; Wang, Hui-Xin; Fratiglioni, Laura; Herlitz, Agneta

2016-08-01

Cognitive reserve hypothesis predicts that intellectually demanding activities over the life course protect against dementia. We investigate if childhood school performance remains associated with dementia once education and occupational complexity are taken into account. A cohort of 440 individuals aged 75+ from the Kungsholmen Project was followed up for 9 years to detect dementia. To measure early-life contributors to reserve, we used grades at age 9-10 extracted from the school archives. Data on formal education and occupational complexity were collected at baseline and first follow-up. Dementia was ascertained through comprehensive clinical examination. Cox models estimated the relationship between life-course cognitive reserve measures and dementia. Dementia risk was elevated [hazard ratio (HR): 1.54, 95% confidence interval (CI): 1.03 to 2.29] in individuals with low early-life school grades after adjustment for formal educational attainment and occupational complexity. Secondary education was associated with a lower risk of dementia (HR: 0.72, 95% CI: 0.50 to 1.03), although the effects of post-secondary and university degrees were indistinguishable from baseline. Occupational complexity with data and things was not related to dementia. However, an association was found between high occupational complexity with people and dementia, albeit only in women (HR: 0.39, 95% CI: 0.14 to 0.99). The pattern of results remained unchanged after adjustment for genetic susceptibility, comorbidities and depressive symptoms. Low early-life school performance is associated with an elevated risk of dementia, independent of subsequent educational and occupational attainment. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Optimizing decision making at the end of life of a product

NASA Astrophysics Data System (ADS)

Gonzalez-Torre, Beatriz; Adenso-Diaz, Belarmino

2004-02-01

European environmental legislation has significantly evolved over the last few years, forcing manufacturers to be more environmentally aware and to introduce ecological criteria in their traditional practices. One of the most important goals of this set of regulations is to reduce the amount of solid waste generated per unit of time by promoting recycling, repair, reuse and other recovery strategies at the product end of life (EOL). However, one of the most difficult steps for manufacturers is that of deciding which of these options or which combination of them should be implemented to get the maximum recovery value taking into account the specific characteristics of each product. In this paper, a recurrent algorithm is proposed to determine the optimal end-of-life strategy. On the basis of the product bill of materials and its graphical CAD/CAM representation, the model will determine to what extent the product should be disassembled and what the final end of each disassembled part should be (reuse, recycling or disposal). The paper starts by presenting an overview of the model, to then focus on the CAD-integrated algorithm for determining the optimum disassembly sequence, a necessary step in EOL decision-making.

[Neurotrophin therapy. Some bioethical considerations].

PubMed

Serrano-Sánchez, T; Díaz-Armesto, I

Bioethics , which provides a new ethical outlook on human life, is a term used in public health and biomedical research issues. It is for this reason that, in this paper, we decided to analyse certain aspects associated with the ethical considerations we must bear in mind when conducting research in humans, although the purpose of doing so is to cure or to improve the quality of life of people who suffer from certain diseases, many of which are fatal. Reasons are put forward to make it necessary to doubt which is the strategy with the most favourable benefit/risk relation for those who will undergo such interventions. We describe Alzheimer s disease and discuss the possible use of neurotrophic drugs in the treatment of this disorder (NGF therapy). We also emphasise the care that will have to be taken in each of the stages of development of the research. That is why we are witnessing the emergence of a new culture that is needed to regulate the multiple interventions that can be performed on life, and to guarantee the primacy of what is good, both for the human being of today and those of generations to come.

"I don't need my patients' opinion to withdraw treatment": patient preferences at the end-of-life and physician attitudes towards advance directives in England and France.

PubMed

Horn, Ruth

2014-08-01

This paper presents the results of a qualitative interview study exploring English and French physicians' moral perspectives and attitudes towards end-of-life decisions when patients lack capacity to make decisions for themselves. The paper aims to examine the importance physicians from different contexts accord to patient preferences and to explore the (potential) role of advance directives (ADs) in each context. The interviews focus on (1) problems that emerge when deciding to withdraw/-hold life-sustaining treatment from both conscious and unconscious patients; (2) decision-making procedures and the participation of proxies/relatives; (3) previous experience with ADs and views on their usefulness; and (4) perspectives on ways in which the decision-making processes in question might be improved. The analysis reveals differences in the way patient preferences are taken into consideration and shows how these differences influence the reasons physicians in each country invoke to justify their reluctance to adhering to ADs. Identifying cultural differences that complicate efforts to develop the practical implementation of ADs can help to inform national policies governing ADs and to better adapt them to practice.

Excellently guarded materials against UV and oxygen in the surfactant molecular complex crystal matrix

NASA Astrophysics Data System (ADS)

Ichikawa, Haruyo; Iimura, Nahoko; Hirata, Hirotaka

2000-07-01

Crystalline surfactant molecular complexes (SCMs) generated between quaternary ammonium cationic surfactants such as CTAB and various additives disclose their excellent protective properties from UV light and oxygen to complex additive materials, which are occluded in the complex crystal matrix. The effects of UV and oxygen were followed by the absorption decay of additive chromophores in comparing that of naked additive specimens with that of those in the complexed state. From the decay profiles, the rate constants and the half-life times were estimated under the assumptions in which the photo and oxidation processes were dominated in accordance with the first-ordered reaction. The results afford us promising prospects in extending the shelf-life of every material, above all medicinal drug, with the consequence that these obtained values evidently demonstrate the remarkably suppressed rate and extremely elongated half-life times.

Diagnosis and management of people with venous thromboembolism and advanced cancer: how do doctors decide? A qualitative study.

PubMed

Johnson, Miriam J; Sheard, Laura; Maraveyas, Anthony; Noble, Simon; Prout, Hayley; Watt, Ian; Dowding, Dawn

2012-07-20

The treatment of cancer associated thrombosis (CAT) is well established, with level 1A evidence to support the recommendation of a low molecular weight heparin (LMWH) by daily injection for 3-6 months. However, registry data suggest compliance to clinical guidelines is poor. Clinicians face particular challenges in treating CAT in advanced cancer patients due to shorter life expectancy, increased bleeding risk and concerns that self injection may be too burdensome. For these reasons decision making around the diagnosis and management of CAT in people with advanced cancer, can be complex, and should focus on its likely net benefit for the patient. We explored factors that influence doctors' decision making in this situation and sought to gain an understanding of the barriers and facilitators to the application of best practice. Think aloud exercises using standardised case scenarios, and individual in depth interviews were conducted. All were transcribed. The think aloud exercises were analysed using Protocol Analysis and the interviews using Framework Analysis. 46 participants took part in the think aloud exercises and 45 participants were interviewed in depth. Each group included oncologists, palliative physicians and general practitioners and included both senior doctors and those in training. Two Strategic Health Authority regions, one in the north of England and one in Wales. The following key issues arose from the data synthesis: the importance of patient prognosis; the concept of "appropriateness"; "benefits and burdens" of diagnosis and treatment; LMWH or warfarin for treatment and sources of information which changed practice. Although interlinked, they do describe distinct aspects of the factors that influence doctors in their decisions in this area. The above factors are issues doctors take into account when deciding whether to send a patient to hospital for investigation or to anticoagulate a patient with confirmed or suspected VTE. Many factors interweave and are themselves influenced by and dependent on each other. It is only after all are taken into account that the doctor arrives at the point of referring the patient for investigation. Some factors including logistic and organisational issues appeared to influence whether a patient would be investigated or treated with LMWH for a confirmed VTE. It is important that services are optimised to ensure that these do not hinder the appropriate investigation and management of individual patients.

Integral multidisciplinary approach in a patient with chronic complete spinal cord injury and hip disarticulation.

PubMed

Quinzaños-Fresnedo, J; Rodríguez-Reyes, G; Mendoza-Cosío, C; Pérez-Zavala, R; Márquez-Guitérrez, E A; Hernández-Sandoval, S

2015-01-01

Case report. To highlight the importance of the integral multidisciplinary management of a patient with complete chronic spinal cord injury and hip disarticulation secondary to pressure ulcers (PU). Mexico City. The case of a 40-year-old male violinist with a spinal cord injury, American Spinal Injury Association Impairment Scale A and neurological level T4, is reported. The patient initiated with bilateral ischiatic, left trochanteric and sacral PU. The ulcers were complicated with infection with sluggish evolution. Thus, it was decided a multidisciplinary management by means of left hip disarticulation and elaboration of a cosmetic prosthesis and the manufacture of a viscous elastic foam cushion for the prevention of new PU. The patient was quickly included in his professional and social activities. This study proves that multidisciplinary management of patients with spinal cord injury with complications such as the presence of PU that are resistant to noninvasive treatment can be the solution for the patient's reintegration into their normal life with adequate quality of life.

Microorganisms isolated from cultures and infection focus and antibiotic treatments in febrile neutropenic children from Şanlıurfa, Turkey.

PubMed

Özdemir, Z Canan; Koç, Ahmet; Ayçiçek, Ali

2016-01-01

Chemotherapy induced febrile neutropenia predisposes patients to life threatening infections. We aimed to determine the causative microorganisms, infection focus and antibiotic treatment success in febrile neutropenic children with leukemia. A total of 136 febrile neutropenic episodes in 48 leukemic children were reviewed retrospectively from records. Among 136 febrile neutropenic episodes, 68 (50%) episodes were microbiologically documented. Methicillin sensitive coagulase (-) Staphylococcus aureus were the most common isolates from hemoculture (20.5%). The most frequently documented infection focus was mucositis (31.9%). Ceftazidime plus amikacin was the most commonly used antimicrobial treatment for the empirical therapy (52.9%). The overall response rates were 70.5%, 86.9%, and 66.6% of first line, second line and third line therapies, respectively. The spectrum of isolates among febrile neutropenic children in our hematology clinic appears to be gram positive pathogens which are the most common agents. Therefore the, documentation of the flora in each unit could help to decide appropriate empirical therapy which is life saving.

Sexual counseling and cardiovascular disease: practical approaches

PubMed Central

Steinke, Elaine E; Jaarsma, Tiny

2015-01-01

Patients with cardiovascular disease and their partners expect health care providers to provide sexual counseling to assist them in maintaining sexual quality of life. Evidence suggests however, that there is a gap in integrating evidence into practice and that relatively few cardiac patients receive sexual counseling. This can result in negative psychological, physical, and quality of life outcomes for couples who may needlessly decide sexual activity is too risky and cease all sexual activity. Two scientific statements now exist that provide ample guidance to health care providers in discussing this important topic. Using a team approach that includes physicians, nurses, physical therapists, rehabilitation staff, and others is important to ensure that sexual counseling occurs throughout recovery. In addition, several trials using interventional approaches for sexual counseling provide insight into successful approaches for sexual counseling in practice. This article provides practical strategies and evidence-based approaches for assessment and sexual counseling for all cardiac patients and their partners, and specific counseling for those with ischemic conditions, heart failure, and implanted devices. PMID:25219908

Sexual counseling and cardiovascular disease: practical approaches.

PubMed

Steinke, Elaine E; Jaarsma, Tiny

2015-01-01

Patients with cardiovascular disease and their partners expect health care providers to provide sexual counseling to assist them in maintaining sexual quality of life. Evidence suggests however, that there is a gap in integrating evidence into practice and that relatively few cardiac patients receive sexual counseling. This can result in negative psychological, physical, and quality of life outcomes for couples who may needlessly decide sexual activity is too risky and cease all sexual activity. Two scientific statements now exist that provide ample guidance to health care providers in discussing this important topic. Using a team approach that includes physicians, nurses, physical therapists, rehabilitation staff, and others is important to ensure that sexual counseling occurs throughout recovery. In addition, several trials using interventional approaches for sexual counseling provide insight into successful approaches for sexual counseling in practice. This article provides practical strategies and evidence-based approaches for assessment and sexual counseling for all cardiac patients and their partners, and specific counseling for those with ischemic conditions, heart failure, and implanted devices.

Mathematics and Physics in Cuba Before 1959: A Personal Recollection

NASA Astrophysics Data System (ADS)

Altshuler, José

On the occasion of the 50th anniversary of the formal inauguration of the Republic of Cuba (May 20, 1902), the then Historian of the City of Havana, Emilio Roig de Leuchsenring, decided to publish a memorial volume which would include various special studies on the progress made in the country during the preceding half century with regard to specific aspects of national collective life. The volume, entitled Facetas de la vida de Cuba republicana, 1902-1952 (Facets of Life in Republican Cuba, 1902-1952) appeared in print in 1954. Its publication was delayed—as Roig explained in his prologue, somewhat cryptically—"due to causes beyond our control or of that of the Cuban writers to whom we entrusted the preparation of the said studies." Needless to say, the causes referred to were none other than those derived from the atmosphere of political unrest in the country after the military coup staged in March 1952 by former strongman, General Batista.

Unusual headache syndromes.

PubMed

Queiroz, Luiz P

2013-01-01

Some headache syndromes have few cases reported in the literature. Their clinical characteristics, pathogenesis, and treatment may have not been completely defined. They may not actually be uncommon but rather under-recognized and/or underreported. A literature review of unusual headache syndromes, searching PubMed and ISI Web of Knowledge, was performed. After deciding which disorders to study, relevant publications in scientific journals, including original articles, reviews, meeting abstracts, and letters or correspondences to the editors were searched. This paper reviewed the clinical characteristics, the pathogenesis, the diagnosis, and the treatment of five interesting and unusual headache syndromes: exploding head syndrome, red ear syndrome, neck-tongue syndrome, nummular headache, and cardiac cephalgia. Recognizing some unusual headaches, either primary or secondary, may be a challenge for many non-headache specialist physicians. It is important to study them because the correct diagnosis may result in specific treatments that may improve the quality of life of these patients, and this can even be life saving. © 2013 American Headache Society.

Overview of ESA life support activities in preparation of future exploration

NASA Astrophysics Data System (ADS)

Lasseur, Christophe; Paille, Christel

2016-07-01

Since 1987, the European Space Agency has been active in the field of Life Support development. When compare to its international colleagues, it is clear that ESA started activities in the field with a "delay of around 25 years. Due to this situation and to avoid duplication, ESA decided to focus more on long term manned missions and to consider more intensively regenerative technologies as well as the associated risks management ( e.g. physical, chemical and contaminants). Fortunately or not, during the same period, no clear plan of exploration and consequently not specific requirements materialized. This force ESA to keep a broader and generic approach of all technologies. Today with this important catalogue of technologies and know-how, ESA is contemplating the different scenario of manned exploration beyond LEO. In this presentation we review the key scenario of future exploration, and identify the key technologies who loo the more relevant. An more detailed status is presented on the key technologies and their development plan for the future.

Signal coverage approach to the detection probability of hypothetical extraterrestrial emitters in the Milky Way

PubMed Central

Grimaldi, Claudio

2017-01-01

The lack of evidence for the existence of extraterrestrial life, even the simplest forms of animal life, makes it is difficult to decide whether the search for extraterrestrial intelligence (SETI) is more a high-risk, high-payoff endeavor than a futile attempt. Here we insist that even if extraterrestrial civilizations do exist and communicate, the likelihood of detecting their signals crucially depends on whether the Earth lies within a region of the galaxy covered by such signals. By considering possible populations of independent emitters in the galaxy, we build a statistical model of the domain covered by hypothetical extraterrestrial signals to derive the detection probability that the Earth is within such a domain. We show that for general distributions of the signal longevity and directionality, the mean number of detectable emitters is less than one even for detection probabilities as large as 50%, regardless of the number of emitters in the galaxy. PMID:28401943

Life-cycle cost as basis to optimize waste collection in space and time: A methodology for obtaining a detailed cost breakdown structure.

PubMed

Sousa, Vitor; Dias-Ferreira, Celia; Vaz, João M; Meireles, Inês

2018-05-01

Extensive research has been carried out on waste collection costs mainly to differentiate costs of distinct waste streams and spatial optimization of waste collection services (e.g. routes, number, and location of waste facilities). However, waste collection managers also face the challenge of optimizing assets in time, for instance deciding when to replace and how to maintain, or which technological solution to adopt. These issues require a more detailed knowledge about the waste collection services' cost breakdown structure. The present research adjusts the methodology for buildings' life-cycle cost (LCC) analysis, detailed in the ISO 15686-5:2008, to the waste collection assets. The proposed methodology is then applied to the waste collection assets owned and operated by a real municipality in Portugal (Cascais Ambiente - EMAC). The goal is to highlight the potential of the LCC tool in providing a baseline for time optimization of the waste collection service and assets, namely assisting on decisions regarding equipment operation and replacement.

From Astrochemistry to prebiotic chemistry? An hypothetical approach toward Astrobiology

NASA Astrophysics Data System (ADS)

Le Sergeant d'Hendecourt, L.; Danger, G.

2012-12-01

We present in this paper a general perspective about the evolution of molecular complexity, as observed from an astrophysicist point of view and its possible relation to the problem of the origin of life on Earth. Based on the cosmic abundances of the elements and the molecular composition of our life, we propose that life cannot really be based on other elements. We discuss where the necessary molecular complexity is built-up in astrophysical environments, actually within inter/circumstellar solid state materials known as ``grains''. Considerations based on non-directed laboratory experiments, that must be further extended in the prebiotic domain, lead to the hypothesis that if the chemistry at the origin of life may indeed be a rather universal and deterministic phenomenon, once molecular complexity is installed, the chemical evolution that generated the first prebiotic reactions that involve autoreplication must be treated in a systemic approach because of the strong contingency imposed by the complex local environment(s) and associated processes in which these chemical systems have evolved.

Virtual reality cerebral aneurysm clipping simulation with real-time haptic feedback.

PubMed

Alaraj, Ali; Luciano, Cristian J; Bailey, Daniel P; Elsenousi, Abdussalam; Roitberg, Ben Z; Bernardo, Antonio; Banerjee, P Pat; Charbel, Fady T

2015-03-01

With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping. To develop and evaluate the usefulness of a new haptic-based virtual reality simulator in the training of neurosurgical residents. A real-time sensory haptic feedback virtual reality aneurysm clipping simulator was developed using the ImmersiveTouch platform. A prototype middle cerebral artery aneurysm simulation was created from a computed tomographic angiogram. Aneurysm and vessel volume deformation and haptic feedback are provided in a 3-dimensional immersive virtual reality environment. Intraoperative aneurysm rupture was also simulated. Seventeen neurosurgery residents from 3 residency programs tested the simulator and provided feedback on its usefulness and resemblance to real aneurysm clipping surgery. Residents thought that the simulation would be useful in preparing for real-life surgery. About two-thirds of the residents thought that the 3-dimensional immersive anatomic details provided a close resemblance to real operative anatomy and accurate guidance for deciding surgical approaches. They thought the simulation was useful for preoperative surgical rehearsal and neurosurgical training. A third of the residents thought that the technology in its current form provided realistic haptic feedback for aneurysm surgery. Neurosurgical residents thought that the novel immersive VR simulator is helpful in their training, especially because they do not get a chance to perform aneurysm clippings until late in their residency programs.

To tell or not to tell: disclosure to children and family amongst Thai women living with HIV/AIDS.

PubMed

Liamputtong, Pranee; Haritavorn, Niphattra

2016-03-01

HIV disclosure is a complex phenomenon. The choice of disclosure or non-disclosure is a reflection of how each HIV-positive person experiences and deals with HIV/AIDS in their everyday life. In this study, we qualitatively explore the experiences of disclosing HIV status to family members and children among HIV-positive women living in Thailand. Due to fear of stigma and discrimination, the women decided to tell only a few people, usually their significant others including parents and children. Although most women received good support from their family members, some were rejected and discriminated against by their family members. This stems from lack of knowledge about HIV/AIDS among family members. Women found disclosure to their children a difficult decision to make. Only some women told their children about their HIV status. They wished to protect their children from emotional burden. This protection also appeared in their attempts to prepare their children for dealing with HIV/AIDS. Support from family members played a major role in the lives of HIV-positive women. Although disclosure has been promoted as a means of ending stigma and discrimination, our data suggested that disclosure may not be positive for some women. This has implications for health promotion in HIV health care. Healthcare providers need to appreciate the ramifications of promoting disclosure to HIV-positive women who are mothers. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Refuting phylogenetic relationships

PubMed Central

Bucknam, James; Boucher, Yan; Bapteste, Eric

2006-01-01

Background Phylogenetic methods are philosophically grounded, and so can be philosophically biased in ways that limit explanatory power. This constitutes an important methodologic dimension not often taken into account. Here we address this dimension in the context of concatenation approaches to phylogeny. Results We discuss some of the limits of a methodology restricted to verificationism, the philosophy on which gene concatenation practices generally rely. As an alternative, we describe a software which identifies and focuses on impossible or refuted relationships, through a simple analysis of bootstrap bipartitions, followed by multivariate statistical analyses. We show how refuting phylogenetic relationships could in principle facilitate systematics. We also apply our method to the study of two complex phylogenies: the phylogeny of the archaea and the phylogeny of the core of genes shared by all life forms. While many groups are rejected, our results left open a possible proximity of N. equitans and the Methanopyrales, of the Archaea and the Cyanobacteria, and as well the possible grouping of the Methanobacteriales/Methanoccocales and Thermosplasmatales, of the Spirochaetes and the Actinobacteria and of the Proteobacteria and firmicutes. Conclusion It is sometimes easier (and preferable) to decide which species do not group together than which ones do. When possible topologies are limited, identifying local relationships that are rejected may be a useful alternative to classical concatenation approaches aiming to find a globally resolved tree on the basis of weak phylogenetic markers. Reviewers This article was reviewed by Mark Ragan, Eugene V Koonin and J Peter Gogarten. PMID:16956399

Predictable dental rehabilitation in maxillomandibular reconstruction with free flaps. The role of implant guided surgery

PubMed Central

Cebrian-Carretero, José L.; Sobrino, José A.; Yu, Tomás; Burgueño-García, Miguel

2014-01-01

The reconstruction of maxillomandibular defects secondary to oral cancer surgery, represent a great challenge for Maxillofacial surgeons. During the last decades the reconstructive surgery has experimented a big advance due to the development of the microsurgical techniques. At present, we are able to reconstruct complex defects using free flaps that provide both soft and bone tissue. Fibula, iliac crest and scapula free flaps have been the three classic options for the maxillomandibular reconstruction owing to the amount of bone that this flaps provide, allowing the posterior dental rehabilitation with implants. Today, our objective it is not only the aesthetic reconstruction, but also the functional reconstruction of the patients enhancing their life quality. Guided implant surgery in free flap reconstructed patients has become an essential tool, helping to define the exact position of the dental implant in the flap. In this way it is possible to look for the areas with better bone conditions, avoiding the osteosynthesis material used to fixate the flap with the native bone and deciding the best biomechanical option, in terms of number and situation of the implants, for the future dental prostheses. In summary, using the guided implant surgery, it is possible to design an exact and predictable dental implant rehabilitation in patients with oral cancer who are reconstructed with free microvascular flap, resulting in an optimal aesthetic and functional result. Key words:Oral cancer, mandibulectomy, maxillectomy, microvascular reconstruction, fibula flap, dental implant, guided surgery. PMID:25129241

Prothrombin Complex Concentrate for Intracerebral Hemorrhage Secondary to Vitamin K Deficiency Bleeding in a 6-Week-Old Child.

PubMed

Rech, Megan A; Wittekindt, Lindsay; Friedman, Samantha D; Kling, Kendall; Ubogy, David

2015-12-01

Four-factor prothrombin complex concentrate is approved for use of life-threatening bleeding secondary to vitamin K antagonism in adults. We describe the use of four-factor prothrombin complex concentrate for hemostasis in a 6-week-old child with life-threatening vitamin K dependent-bleeding who never received vitamin K prophylaxis at birth. Copyright © 2015 Elsevier Inc. All rights reserved.

25 CFR 39.133 - Who decides how Language Development funds can be used?

Code of Federal Regulations, 2010 CFR

2010-04-01

... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Language Development Programs § 39.133 Who decides how Language Development funds can be used? Tribal governing bodies or local school... 25 Indians 1 2010-04-01 2010-04-01 false Who decides how Language Development funds can be used...

25 CFR 39.133 - Who decides how Language Development funds can be used?

Code of Federal Regulations, 2014 CFR

2014-04-01

... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Language Development Programs § 39.133 Who decides how Language Development funds can be used? Tribal governing bodies or local school... 25 Indians 1 2014-04-01 2014-04-01 false Who decides how Language Development funds can be used...

25 CFR 39.133 - Who decides how Language Development funds can be used?

Code of Federal Regulations, 2013 CFR

2013-04-01

... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Language Development Programs § 39.133 Who decides how Language Development funds can be used? Tribal governing bodies or local school... 25 Indians 1 2013-04-01 2013-04-01 false Who decides how Language Development funds can be used...

25 CFR 39.133 - Who decides how Language Development funds can be used?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Who decides how Language Development funds can be used... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Language Development Programs § 39.133 Who decides how Language Development funds can be used? Tribal governing bodies or local school...

75 FR 62482 - List of Nonconforming Vehicles Decided To Be Eligible for Importation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-12

... [Docket No. NHTSA-2010-0125; Notice 2] List of Nonconforming Vehicles Decided To Be Eligible for... Register on Tuesday, September 21, 2010, (75 FR 57396) that revised the list of vehicles not originally manufactured to conform to the Federal Motor Vehicle Safety Standards (FMVSS) that NHTSA has decided to be...

Decided and Undecided Students: Career Self-Efficacy, Negative Thinking, and Decision-Making Difficulties

ERIC Educational Resources Information Center

Bullock-Yowell, Emily; McConnell, Amy E.; Schedin, Emily A.

2014-01-01

The career concern differences between undecided and decided college students (N = 223) are examined. Undecided college students (n = 83) reported lower career decision-making self-efficacy, higher incidences of negative career thoughts, and more career decision-making difficulties than their decided peers (n = 143). Results reveal that undecided…

13 CFR 125.17 - Who decides if a contract opportunity for SDVO competition exists?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Who decides if a contract opportunity for SDVO competition exists? 125.17 Section 125.17 Business Credit and Assistance SMALL BUSINESS... opportunity for SDVO competition exists? The contracting officer for the contracting activity decides if a...

Cross-Cultural Adaptation of the Physician Orders for Life-Sustaining Treatment Form to Brazil.

PubMed

Mayoral, Vania F S; Fukushima, Fernanda B; Rodrigues, Aniela M; Carvalho, Raissa P; Carvalho, Larissa P; Pinheiro, Leandro A F V; Polegato, Bertha F; Minicucci, Marcos F; Bassett, Rick; Moss, Alvin H; Steinberg, Karl E; Vidal, Edison I O

2018-06-01

The Physician Orders for Life-Sustaining Treatment (POLST) paradigm is considered one of the most important strategies to respect patients' values at the end of life in the United States. The cross-cultural adaptation of POLST entailed several methodological considerations, which may be informative for international researchers who may also consider bringing POLST to their countries as a means to promote care at the end of life that is consistent with patients' preferences. To report the methods and outcome of the cross-cultural adaptation of the POLST form to Brazil. Cross-cultural adaptation study. Twenty physicians and 10 patients at a university hospital participated in the pilot tests. The cross-cultural adaptation process included choosing which existing POLST form(s) to use as a source, deciding the intended reading level, which healthcare professionals should be allowed to sign the form, and consultation with attorneys, bioethicists, and members of the National POLST Paradigm Task Force. Pilot tests occurred in two stages using different approaches. First, 20 physicians were trained about POLST and asked for any unclear aspects related to the form. Second, trained investigators completed POLST forms after engaging in advance care planning conversations with 10 hospitalized patients or patients' surrogates. This report provides a basis for future cross-cultural adaptations of POLST to other countries. The authors hope such new adaptations will broaden the possibilities of research using POLST and also may promote wider provision of care at the end of life that is consistent with patients' preferences.

The importance of early life in childhood obesity and related diseases: a report from the 2014 Gravida Strategic Summit.

PubMed

Macaulay, E C; Donovan, E L; Leask, M P; Bloomfield, F H; Vickers, M H; Dearden, P K; Baker, P N

2014-12-01

Obesity and its related non-communicable diseases (NCDs), such as type 2 diabetes, heart disease and cancer, impose huge burdens on society, particularly the healthcare system. Until recently, public health and policy were primarily focused on secondary prevention and treatment of NCDs. However, epidemiological and experimental evidence indicates that early-life exposures influence the risk of childhood obesity and related diseases later in life, and has now focused attention on the health of both mother and child. During pregnancy and the early neonatal period, individuals respond to their environment by establishing anatomical, physiological and biochemical trajectories that shape their future health. This period of developmental plasticity provides an early window of opportunity to mitigate the environmental insults that may increase an individual's sensitivity to, or risk of, developing obesity or related diseases later in life. Although much investigation has already occurred in the area of Developmental Origins of Health and Disease research, the science itself is still in its infancy. It remains for researchers to tackle the important outstanding questions and translate their knowledge into workable solutions for the public good. The challenge, however, is to decide which areas to focus on. With these opportunities and challenges in mind, the 2014 Gravida Summit convened to examine how its early-life research program can determine which areas of research into mechanisms, biomarkers and interventions could contribute to the international research strategy to fight childhood obesity and its related diseases.

Why O2 Is Required by Complex Life on Habitable Planets and the Concept of Planetary "Oxygenation Time"

NASA Astrophysics Data System (ADS)

Catling, David C.; Glein, Christopher R.; Zahnle, Kevin J.; McKay, Christopher P.

2005-06-01

Life is constructed from a limited toolkit: the Periodic Table. The reduction of oxygen provides the largest free energy release per electron transfer, except for the reduction of fluorine and chlorine. However, the bonding of O2 ensures that it is sufficiently stable to accumulate in a planetary atmosphere, whereas the more weakly bonded halogen gases are far too reactive ever to achieve significant abundance. Consequently, an atmosphere rich in O2 provides the largest feasible energy source. This universal uniqueness suggests that abundant O2 is necessary for the high-energy demands of complex life anywhere, i.e., for actively mobile organisms of ~10-1-100 m size scale with specialized, differentiated anatomy comparable to advanced metazoans. On Earth, aerobic metabolism provides about an order of magnitude more energy for a given intake of food than anaerobic metabolism. As a result, anaerobes do not grow beyond the complexity of uniseriate filaments of cells because of prohibitively low growth efficiencies in a food chain. The biomass cumulative number density, n, at a particular mass, m, scales as n (>m)~m-1 for aquatic aerobes, and we show that for anaerobes the predicted scaling is n~m -1.5, close to a growth-limited threshold. Even with aerobic metabolism, the partial pressure of atmospheric O2 (PO2) must exceed ~103 Pa to allow organisms that rely on O2 diffusion to evolve to a size ~10-3 m. PO2 in the range ~103-104 Pa is needed to exceed the threshold of ~10-2 m size for complex life with circulatory physiology. In terrestrial life, O2 also facilitates hundreds of metabolic pathways, including those that make specialized structural molecules found only in animals. The time scale to reach PO2 ~104 Pa, or "oxygenation time," was long on the Earth (~3.9 billion years), within almost a factor of 2 of the Sun's main sequence lifetime. Consequently, we argue that the oxygenation time is likely to be a key rate-limiting step in the evolution of complex life on other habitable planets. The oxygenation time could preclude complex life on Earth-like planets orbiting short-lived stars that end their main sequence lives before planetary oxygenation takes place. Conversely, Earth-like planets orbiting long-lived stars are potentially favorable habitats for complex life.

Social life cycle assessment and participatory approaches: A methodological proposal applied to citrus farming in Southern Italy.

PubMed

De Luca, Anna Irene; Iofrida, Nathalie; Strano, Alfio; Falcone, Giacomo; Gulisano, Giovanni

2015-07-01

Recently, Social Life Cycle Assessment (S-LCA) has been developed under the methodological framework of Life Cycle Thinking (LCT) to evaluate the social impacts that emerge during the overall life cycle of a product or service. There is not yet a standardized methodology for S-LCA as there is for environmental LCA (eLCA), due to the nature of social impacts that do not depend only on the processes themselves, but also on the behavior and context of actors (manufactures, consumers, local community members, etc.). One of the most critical steps in the application of S-LCA concerns the choice of criteria for selecting affected actors, impact categories, subcategories, and the taxonomic relation among them. Moreover, the importance (in terms of weight) of these impacts may be felt differently by affected actors, confirming the importance of the context within which impacts arise. In this sense, the integration of participatory tools can be useful in making the S-LCA more locally relevant. The aim of the present study is twofold. First, we will outline a methodology that combines S-LCA with two research tools. The first is the focus group, adopted from qualitative research. The second is the Analytic Hierarchy Process (AHP), adopted from operational research, which belongs to the framework of Multicriteria Decision Analysis (MCDA). These have been used to make the S-LCA more locally relevant and to legitimate the criteria used. Second, we will test this methodology by applying it to a specific field, i.e., 3 production areas and 3 different crop systems of citrus growing in the Calabria region in Southern Italy. Citrus growing is one of the most important agricultural sectors at regional level, and it is also well known for issues of social concern, particularly in relation to immigrant workers. The results show a number of differences between cases and could offer useful insights to both local decision makers, such as agricultural entrepreneurs, and to those public decision makers that design and implement territorial planning strategies. Results have allowed the authors to rank the social performance of each case and to reflect on the most critical steps in conducting an S-LCA. The integration of qualitative techniques and a multicriteria in sLCA allows catching local specificities by involving local experts and stakeholders Results highlighted that impact categories mostly contributed to performance differences Public deciders can be supported in deciding which farming practices should be encouraged, which social domains must be paid more attention, and where social problems mostly occur The methodological application allowed the authors also to foresee the feasibility of the integration of LCA and LCC results as inputs in sLCA to conduct a Life Cycle Sustainability Assessment (LCSA). © 2015 SETAC.

Accelerated testing of space mechanisms

NASA Technical Reports Server (NTRS)

Murray, S. Frank; Heshmat, Hooshang

1995-01-01

This report contains a review of various existing life prediction techniques used for a wide range of space mechanisms. Life prediction techniques utilized in other non-space fields such as turbine engine design are also reviewed for applicability to many space mechanism issues. The development of new concepts on how various tribological processes are involved in the life of the complex mechanisms used for space applications are examined. A 'roadmap' for the complete implementation of a tribological prediction approach for complex mechanical systems including standard procedures for test planning, analytical models for life prediction and experimental verification of the life prediction and accelerated testing techniques are discussed. A plan is presented to demonstrate a method for predicting the life and/or performance of a selected space mechanism mechanical component.

Empirical support for the definition of a complex trauma event in children and adolescents.

PubMed

Wamser-Nanney, Rachel; Vandenberg, Brian R

2013-12-01

Complex trauma events have been defined as chronic, interpersonal traumas that begin early in life (Cook, Blaustein, Spinazzola, & van der Kolk, 2003). The complex trauma definition has been examined in adults, as indicated by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) field trial; however, this research was lacking in child populations. The symptom presentations of complexly traumatized children were contrasted with those exposed to other, less severe trauma ecologies that met 1 or 2 features of the complex trauma definition. Included in this study were 346 treatment-seeking children and adolescents (ages 3–18 years) who had experienced atraumatic event. Results indicated that child survivors of complex trauma presented with higher levels of generalized behavior problems and trauma-related symptoms than those who experienced (a) acute noninterpersonal trauma, (b) chronic interpersonal trauma that begins later in life, and (c) acute interpersonal trauma. Greater levels of behavioral problems were observed in children exposed to complex trauma as compared to those who experienced a traumatic event that begins early in life. These results provide support for the complex trauma event definition and suggest the need for a complex trauma diagnostic construct for children and adolescents.

Analyzing SystemC Designs: SystemC Analysis Approaches for Varying Applications

PubMed Central

Stoppe, Jannis; Drechsler, Rolf

2015-01-01

The complexity of hardware designs is still increasing according to Moore's law. With embedded systems being more and more intertwined and working together not only with each other, but also with their environments as cyber physical systems (CPSs), more streamlined development workflows are employed to handle the increasing complexity during a system's design phase. SystemC is a C++ library for the design of hardware/software systems, enabling the designer to quickly prototype, e.g., a distributed CPS without having to decide about particular implementation details (such as whether to implement a feature in hardware or in software) early in the design process. Thereby, this approach reduces the initial implementation's complexity by offering an abstract layer with which to build a working prototype. However, as SystemC is based on C++, analyzing designs becomes a difficult task due to the complex language features that are available to the designer. Several fundamentally different approaches for analyzing SystemC designs have been suggested. This work illustrates several different SystemC analysis approaches, including their specific advantages and shortcomings, allowing designers to pick the right tools to assist them with a specific problem during the design of a system using SystemC. PMID:25946632

Analyzing SystemC Designs: SystemC Analysis Approaches for Varying Applications.

PubMed

Stoppe, Jannis; Drechsler, Rolf

2015-05-04

The complexity of hardware designs is still increasing according to Moore's law. With embedded systems being more and more intertwined and working together not only with each other, but also with their environments as cyber physical systems (CPSs), more streamlined development workflows are employed to handle the increasing complexity during a system's design phase. SystemC is a C++ library for the design of hardware/software systems, enabling the designer to quickly prototype, e.g., a distributed CPS without having to decide about particular implementation details (such as whether to implement a feature in hardware or in software) early in the design process. Thereby, this approach reduces the initial implementation's complexity by offering an abstract layer with which to build a working prototype. However, as SystemC is based on C++, analyzing designs becomes a difficult task due to the complex language features that are available to the designer. Several fundamentally different approaches for analyzing SystemC designs have been suggested. This work illustrates several different SystemC analysis approaches, including their specific advantages and shortcomings, allowing designers to pick the right tools to assist them with a specific problem during the design of a system using SystemC.

A study on substance abuse among school going male adolescents of Doiwala Block, District Dehradun.

PubMed

Saxena, Vartika; Saxena, Yogesh; Kishore, Gaurav; Kumar, Pratap

2010-01-01

Adolescent boys are recognized as a vulnerable group to substance abuse. The present study has the objective to study the biosocial profile and habit pattern of substance abusers. The study was conducted on 511 male adolescents, students of 10 th to 12 th class from the four intermediate schools of the Doiwala block of Dehradun district. 46.9% students accepted substance abuse. In 75.5% cases, friends were providing the substances. 80.2% substance abusers expressed their desire to quit the habit. The study is indicative of need for developing a supportive environment involving both parents and teachers so that adolescent can decide and sustain with the right choices for healthy life.

The mandatory sentence and Section 2.

PubMed Central

Dell, S

1986-01-01

Sentencing in homicide depends on how psychiatrists view the issues of Section 2. In most killings that do not involve clear-cut mental disorder, strong emotions and stress play a part. Both can be cited in aid of diminished responsibility. If doctors cite them, however tentatively, it becomes feasible for the court to review any mitigating factors and to choose an appropriate penalty. Otherwise, the mandatory penalty is imposed. Thus doctors, by opining not on the medical but on the legal and moral aspects of Section 2, decide who shall automatically get a life sentence and who shall not. Anomaly and injustice are the results. They would be remedied by the abolition of the mandatory sentence for murder. PMID:3959037

Commentary: Pursuing justice in death penalty trials.

PubMed

Watson, Clarence; Eth, Spencer; Leong, Gregory B

2012-01-01

The capital trial, by its nature, is fraught with emotionally disturbing elements that jurors must face when deciding the ultimate fate of a guilty defendant. A confluence of mitigating and aggravating factors influences a capital jury's decision to impose a sentence of death. The presence or absence of defendant remorse in these cases may make all the difference in whether a capital defendant's life is spared. This commentary examines the onerous emotional toll encountered by capital jurors in light of the findings of Corwin and colleagues regarding defendant remorse and juror's need for affect. The commentary also presents practical and ethics-related considerations that should be kept in mind when reflecting on their study.

Structural changes of homodimers in the PDB.

PubMed

Koike, Ryotaro; Amemiya, Takayuki; Horii, Tatsuya; Ota, Motonori

2018-04-01

Protein complexes are involved in various biological phenomena. These complexes are intrinsically flexible, and structural changes are essential to their functions. To perform a large-scale automated analysis of the structural changes of complexes, we combined two original methods. An application, SCPC, compares two structures of protein complexes and decides the match of binding mode. Another application, Motion Tree, identifies rigid-body motions in various sizes and magnitude from the two structural complexes with the same binding mode. This approach was applied to all available homodimers in the Protein Data Bank (PDB). We defined two complex-specific motions: interface motion and subunit-spanning motion. In the former, each subunit of a complex constitutes a rigid body, and the relative movement between subunits occurs at the interface. In the latter, structural parts from distinct subunits constitute a rigid body, providing the relative movement spanning subunits. All structural changes were classified and examined. It was revealed that the complex-specific motions were common in the homodimers, detected in around 40% of families. The dimeric interfaces were likely to be small and flat for interface motion, while large and rugged for subunit-spanning motion. Interface motion was accompanied by a drastic change in contacts at the interface, while the change in the subunit-spanning motion was moderate. These results indicate that the interface properties of homodimers correlated with the type of complex-specific motion. The study demonstrates that the pipeline of SCPC and Motion Tree is useful for the massive analysis of structural change of protein complexes. Copyright © 2017 Elsevier Inc. All rights reserved.

Longitudinal Prediction of Quality-of-Life Scores and Locomotion in Individuals With Traumatic Spinal Cord Injury.

PubMed

Hiremath, Shivayogi V; Hogaboom, Nathan S; Roscher, Melissa R; Worobey, Lynn A; Oyster, Michelle L; Boninger, Michael L

2017-12-01

To examine (1) differences in quality-of-life scores for groups based on transitions in locomotion status at 1, 5, and 10 years postdischarge in a sample of people with spinal cord injury (SCI); and (2) whether demographic factors and transitions in locomotion status can predict quality-of-life measures at these time points. Retrospective case study of the National SCI Database. Model SCI Systems Centers. Individuals with SCI (N=10,190) from 21 SCI Model Systems Centers, identified through the National SCI Model Systems Centers database between the years 1985 and 2012. Subjects had FIM (locomotion mode) data at discharge and at least 1 of the following: 1, 5, or 10 years postdischarge. Not applicable. FIM-locomotion mode; Severity of Depression Scale; Satisfaction With Life Scale; and Craig Handicap Assessment and Reporting Technique. Participants who transitioned from ambulation to wheelchair use reported lower participation and life satisfaction, and higher depression levels (P<.05) than those who maintained their ambulatory status. Participants who transitioned from ambulation to wheelchair use reported higher depression levels (P<.05) and no difference for participation (P>.05) or life satisfaction (P>.05) compared with those who transitioned from wheelchair to ambulation. Demographic factors and locomotion transitions predicted quality-of-life scores at all time points (P<.05). The results of this study indicate that transitioning from ambulation to wheelchair use can negatively impact psychosocial health 10 years after SCI. Clinicians should be aware of this when deciding on ambulation training. Further work to characterize who may be at risk for these transitions is needed. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The under reporting of recruitment strategies in research with children with life-threatening illnesses: A systematic review

PubMed Central

Hudson, Briony F; Oostendorp, Linda JM; Candy, Bridget; Vickerstaff, Victoria; Jones, Louise; Lakhanpaul, Monica; Bluebond-Langner, Myra; Stone, Paddy

2016-01-01

Background: Researchers report difficulties in conducting research with children and young people with life-limiting conditions or life-threatening illnesses and their families. Recruitment is challenged by barriers including ethical, logistical and clinical considerations. Aim: To explore how children and young people (aged 0–25 years) with life-limiting conditions or life-threatening illnesses and their families were identified, invited and consented to research published in the last 5 years. Design: Systematic review. Data sources: MEDLINE, PsycINFO, Web of Science, Sciences Citation Index and SCOPUS were searched for original English language research published between 2009 and 2014, recruiting children and young people with life-limiting conditions or life-threatening illness and their families. Results: A total of 215 studies – 152 qualitative, 54 quantitative and 9 mixed methods – were included. Limited recruitment information but a range of strategies and difficulties were provided. The proportion of eligible participants from those screened could not be calculated in 80% of studies. Recruitment rates could not be calculated in 77%. A total of 31% of studies recruited less than 50% of eligible participants. Reasons given for non-invitation included missing clinical or contact data, or clinician judgements of participant unsuitability. Reasons for non-participation included lack of interest and participants’ perceptions of potential burdens. Conclusion: All stages of recruitment were under reported. Transparency in reporting of participant identification, invitation and consent is needed to enable researchers to understand research implications, bias risk and to whom results apply. Research is needed to explore why consenting participants decide to take part or not and their experiences of research recruitment. PMID:27609607

Planetary Atmospheres and Evolution of Complex Life

NASA Astrophysics Data System (ADS)

Catling, D.

2014-04-01

Let us define "complex life" as actively mobile organisms exceeding tens of centimeter size scale with specialized, differentiated anatomy comparable to advanced metazoans. Such organisms on any planet will need considerable energy for growth and metabolism, and an atmosphere is likely to play a key role. The history of life on Earth suggests that there were at least two major hurdles to overcome before complex life developed. The first was biological. Large, three-dimensional multicellular animals and plants are made only of eukaryotic cells, which are the only type that can develop into a large, diverse range of cell types unlike the cells of microbes. Exactly how eukaryotes allow 3D multicellularity and how they originated are matters of debate. But the internal structure and bigger and more modular genomes of eukaryotes are important factors. The second obstacle for complex life was having sufficient free, diatomic oxygen (O2). Aerobic metabolism provides about an order of magnitude more energy for a given intake of food than anaerobic metabolism, so anaerobes don't grow multicellular beyond filaments because of prohibitive growth efficiencies. A precursor to a 2.4 Ga rise of oxygen was the evolution of water-splitting, oxygen-producing photosynthesis. But although the atmosphere became oxidizing at 2.4 Ga, sufficient atmospheric O2 did not occur until about 0.6 Ga. Earth-system factors were involved including planetary outgassing (as affected by size and composition), hydrogen escape, and processing of organic carbon. An atmosphere rich in O2 provides the largest feasible energy source per electron transfer in the Periodic Table, which suggests that O2 would be important for complex life on exoplanets. But plentiful O2 is unusual in a planetary atmosphere because O2 is easily consumed in chemical reactions with reducing gases or surface materials. Even with aerobic metabolism, the partial pressure of O2 (pO2) must exceed 10^3 Pa to allow organisms that rely on O2 diffusion to evolve to mm size. pO2 in the range 10^3-10^4 Pa is needed to exceed the threshold of cm size for complex life with circulatory physiology. The timescale to reach pO2 10^4 Pa, or "oxygenation time", was long on the Earth ( 3.9 billion years), within almost a factor of two of the Sun's main sequence lifetime. The oxygenation time could preclude complex life on rocky planets with prodigious reducing volatiles orbiting stars that end their main sequence lives before planetary oxygenation takes place. Conversely, Earth-like planets orbiting long-lived stars are potentially favorable places for complex life.

Agent-Based Models in Social Physics

NASA Astrophysics Data System (ADS)

Quang, Le Anh; Jung, Nam; Cho, Eun Sung; Choi, Jae Han; Lee, Jae Woo

2018-06-01

We review the agent-based models (ABM) on social physics including econophysics. The ABM consists of agent, system space, and external environment. The agent is autonomous and decides his/her behavior by interacting with the neighbors or the external environment with the rules of behavior. Agents are irrational because they have only limited information when they make decisions. They adapt using learning from past memories. Agents have various attributes and are heterogeneous. ABM is a non-equilibrium complex system that exhibits various emergence phenomena. The social complexity ABM describes human behavioral characteristics. In ABMs of econophysics, we introduce the Sugarscape model and the artificial market models. We review minority games and majority games in ABMs of game theory. Social flow ABM introduces crowding, evacuation, traffic congestion, and pedestrian dynamics. We also review ABM for opinion dynamics and voter model. We discuss features and advantages and disadvantages of Netlogo, Repast, Swarm, and Mason, which are representative platforms for implementing ABM.

Multidisciplinary Approach in the Management of a Complex Case: Implant-Prosthetic Rehabilitation of a Periodontal Smoking Patient with Partial Edentulism, Malocclusion, and Aesthetic Diseases

PubMed Central

Di Francesco, Fabrizio; De Marco, Gennaro; Scognamiglio, Fabio; Aruta, Valeria; Itro, Angelo

2017-01-01

Complex periprosthetic cases are considered as challenges by clinicians. Clinical and radiographic parameters should be considered separately to make the right choice between an endodontically or periodontally compromised treated tooth and implant. Therefore, in order to decide whether the tooth is safe or not, data that have to be collected are specific parameters of both the patient and the clinician. In addition, the presence of periodontal, prosthetic, and orthodontic diseases requires patients to be set in multidisciplinary approach. The aim of this case report is to describe how the multidisciplinary approach could be the best way to manage difficult cases of implant-prosthetic rehabilitation. How to rehabilitate with fixed prosthesis on natural teeth and dental implants a smoker patient who presents with active periodontitis, multiple edentulous areas, dental malocclusion, and severe aesthetic problems was also described. PMID:28421148

The journey from proton to gamma knife.

PubMed

Ganz, Jeremy C

2014-01-01

It was generally accepted by the early 1960s that proton beam radiosurgery was too complex and impractical. The need was seen for a new machine. The beam design had to be as good as a proton beam. It was also decided that a static design was preferable even if the evolution of that notion is no longer clear. Complex collimators were designed that using sources of cobalt-60 could produce beams with characteristics adequately close to those of proton beams. The geometry of the machine was determined including the distance of the sources from the patient the optimal distance between the sources. The first gamma unit was built with private money with no contribution from the Swedish state, which nonetheless required detailed design information in order to ensure radiation safety. This original machine was built with rectangular collimators to produce lesions for thalamotomy for functional work. However, with the introduction of dopamine analogs, this indication virtually disappeared overnight.

Neural Classifiers for Learning Higher-Order Correlations

NASA Astrophysics Data System (ADS)

Güler, Marifi

1999-01-01

Studies by various authors suggest that higher-order networks can be more powerful and are biologically more plausible with respect to the more traditional multilayer networks. These architectures make explicit use of nonlinear interactions between input variables in the form of higher-order units or product units. If it is known a priori that the problem to be implemented possesses a given set of invariances like in the translation, rotation, and scale invariant pattern recognition problems, those invariances can be encoded, thus eliminating all higher-order terms which are incompatible with the invariances. In general, however, it is a serious set-back that the complexity of learning increases exponentially with the size of inputs. This paper reviews higher-order networks and introduces an implicit representation in which learning complexity is mainly decided by the number of higher-order terms to be learned and increases only linearly with the input size.

Cochlear Implant: the complexity involved in the decision making process by the family1

PubMed Central

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

Objective to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. Method qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). Results knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. Conclusion deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention. PMID:25029052

DOE Office of Scientific and Technical Information (OSTI.GOV)

Russell, J.S.

Several factors in the development of the East Wilmington oil field by THUMS Long Beach Co. are described. These include: critical path scheduling, complex stratigraphy, reservoir engineering, drilling program, production methods, pressure maintenance, crude oil processing, automation, transportation facilities, service lines, and electrical facilities. The complexity and closely scheduled operational events interwoven in the THUMS project demands a method for the carefully planned sequence of jobs to be done, beginning with island construction up through routine production and to the LACT system. These demanding requirements necessitated the use of a critical path scheduling program. It was decided to use themore » program evaluation technique. This technique is used to assign responsibilities for individual assignments to time assignments, and to keep the overall program on schedule. The stratigraphy of East Wilmington complicates all engineering functions associated with recovery methods and reservoir evaluation. At least 5 major faults are anticipated.« less

Accelerated Gaussian mixture model and its application on image segmentation

NASA Astrophysics Data System (ADS)

Zhao, Jianhui; Zhang, Yuanyuan; Ding, Yihua; Long, Chengjiang; Yuan, Zhiyong; Zhang, Dengyi

2013-03-01

Gaussian mixture model (GMM) has been widely used for image segmentation in recent years due to its superior adaptability and simplicity of implementation. However, traditional GMM has the disadvantage of high computational complexity. In this paper an accelerated GMM is designed, for which the following approaches are adopted: establish the lookup table for Gaussian probability matrix to avoid the repetitive probability calculations on all pixels, employ the blocking detection method on each block of pixels to further decrease the complexity, change the structure of lookup table from 3D to 1D with more simple data type to reduce the space requirement. The accelerated GMM is applied on image segmentation with the help of OTSU method to decide the threshold value automatically. Our algorithm has been tested through image segmenting of flames and faces from a set of real pictures, and the experimental results prove its efficiency in segmentation precision and computational cost.

Identification and addressing reduction-related misconceptions

NASA Astrophysics Data System (ADS)

Gal-Ezer, Judith; Trakhtenbrot, Mark

2016-07-01

Reduction is one of the key techniques used for problem-solving in computer science. In particular, in the theory of computation and complexity (TCC), mapping and polynomial reductions are used for analysis of decidability and computational complexity of problems, including the core concept of NP-completeness. Reduction is a highly abstract technique that involves revealing close non-trivial connections between problems that often seem to have nothing in common. As a result, proper understanding and application of reduction is a serious challenge for students and a source of numerous misconceptions. The main contribution of this paper is detection of such misconceptions, analysis of their roots, and proposing a way to address them in an undergraduate TCC course. Our observations suggest that the main source of the misconceptions is the false intuitive rule "the bigger is a set/problem, the harder it is to solve". Accordingly, we developed a series of exercises for proactive prevention of these misconceptions.

Methods Used to Support a Life Cycle of Complex Engineering Products

NASA Astrophysics Data System (ADS)

Zakharova, Alexandra A.; Kolegova, Olga A.; Nekrasova, Maria E.; Eremenko, Andrey O.

2016-08-01

Management of companies involved in the design, development and operation of complex engineering products recognize the relevance of creating systems for product lifecycle management. A system of methods is proposed to support life cycles of complex engineering products, based on fuzzy set theory and hierarchical analysis. The system of methods serves to demonstrate the grounds for making strategic decisions in an environment of uncertainty, allows the use of expert knowledge, and provides interconnection of decisions at all phases of strategic management and all stages of a complex engineering product lifecycle.

Goldilocks and the three inorganic equilibria: how Earth's chemistry and life coevolve to be nearly in tune.

PubMed

Rickaby, R E M

2015-03-13

Life and the chemical environment are united in an inescapable feedback cycle. The periodic table of the elements essential for life has transformed over Earth's history, but, as today, evolved in tune with the elements available in abundance in the environment. The most revolutionary time in life's history was the advent and proliferation of oxygenic photosynthesis which forced the environment towards a greater degree of oxidation. Consideration of three inorganic chemical equilibria throughout this gradual oxygenation prescribes a phased release of trace metals to the environment, which appear to have coevolved with employment of these new chemicals by life. Evolution towards complexity was chemically constrained, and changes in availability of notably Fe, Zn and Cu paced the systematic development of complex organisms. Evolving life repeatedly catalysed its own chemical challenges via the unwitting release of new and initially toxic chemicals. Ultimately, the harnessing of these allowed life to advance to greater complexity, though the mechanism responsible for translating novel chemistry to heritable use remains elusive. Whether a chemical acts as a poison or a nutrient lies both in the dose and in its environmental history. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

P15.04DEVELOPMENT OF A NEW QUESTIONNAIRE TO MEASURE INSTRUMENTAL ACTIVITIES OF DAILY LIVING (I-ADL) IN PATIENTS WITH PRIMARY BRAIN TUMOURS: RESULTS OF PHASE 1

PubMed Central

Dirven, L.; Meijer, W.; Sikkes, S.A.M.; Reijneveld, J.C.; Aaronson, N.K.; Uitdehaag, B.M.J.; Taphoorn, M. J. B.

2014-01-01

BACKGROUND: Next to health-related quality of life, information on daily life functioning in brain tumour patients is essential. Instrumental Activities of Daily Living (I-ADL) are complex daily activities, such as food preparation and shopping. I-ADL may be negatively influenced by a cognitive decline, characteristic of brain tumor patients. OBJECTIVE: In the first phase of this project, we generated a provisional list of items measuring I-ADL that are relevant for primary brain tumour patients. METHODS: Questions from the Amsterdam IADL Questionnaire®, a 70-item questionnaire developed and validated to measure I-ADL in patients with dementia, were evaluated for relevance to brain tumour patients. In addition, new activities were generated. In the first step, 6 professional experts in neuro-oncology and 10 primary brain tumour patient-proxy dyads were asked to evaluate items in the Amsterdam IADL Questionnaire®. Experts had to indicate if these activities (1) could be considered as I-ADL, (2) were affected in brain tumour patients and (3) were clearly formulated. Patients and their proxies only needed to answer the latter two questions. In the second step, the same 6 experts, and in addition 6 other patient-proxy dyads were asked to generate new activities. To do so, in-depth interviews were conducted. Decision rules were determined to aid in deciding which items to retain (step 1) or to add (step 2). Activities that were indicated as IADL, affected and clearly formulated were retained. Activities that were considered as IADL and affected, but not clearly formulated, were rephrased. New activities that were frequently generated were added to the existing list of items. RESULTS: In step 1, experts indicated that 37% of the activities described in the Amsterdam IADL questionnaire® fulfilled all three criteria: conform the definition of IADL, clearly formulated and affected in brain tumour patients. Twenty-three per cent of the activities were affected and conform the provided definition, but not clearly formulated. According to patients and their proxies, 19% and 17% of the activities were clearly formulated and affected in brain tumour patients, respectively. Moreover, 1-3% of the activities were indicated to be affected, but not clearly formulated. Several new activities (concerning social interaction and work) were generated in step 2. With the decision rules as guide, it was decided in consensus that a total of 30 questions of the Amsterdam IADL questionnaire® could also be used to measure I-ADL in primary brain tumour patients. In addition, 16 new questions covering other relevant activities for brain tumour patients were added. CONCLUSION: This first phase resulted in a provisional questionnaire of 46 items intending to measure I-ADL in primary brain tumour patients. The next step is to validate this provisional questionnaire in a larger sample of patients.

Family caregiver distress with children having rare genetic disorders: a qualitative study involving Russell-Silver Syndrome in Taiwan.

PubMed

Weng, Hsin-Ju; Niu, Dau-Ming; Turale, Sue; Tsao, Lee-Ing; Shih, Fu-Jong; Yamamoto-Mitani, Noriko; Chang, Chun-Chi; Shih, Fu-Jin

2012-01-01

To extend nursing knowledge of distress experienced by family caregivers of children with rare genetic disorders, by exploring the perspectives of caregivers of children with Russell-Silver Syndrome in Taiwan. Caring for a child with a rare genetic disorder often has profound effects on families, especially when diagnosis and treatment is complex or not yet well developed, such as that in Russell-Silver Syndrome (or Silver-Russell syndrome). This disorder causes dwarfism and developmental difficulties, requiring long-term care planning. Previous research has focused mostly on medical care, but little is known about families' perspectives of caring difficulties, the help they need and nursing care required. An exploratory qualitative approach was used to inform this study. Family caregivers, whose children were undergoing medical care in a leading Taiwan medical centre, were invited to participate in face-to-face, in-depth interviews. Data were analysed by content analysis. Fifteen caregivers including 11 mothers, two fathers and two grandmothers participated. Five major themes and 13 sub-themes of care-giving distress were identified: endless psychological worries; the lengthy process to confirm a medical diagnosis; adjustment efforts in modifying family roles; dilemmas in deciding between Western or Chinese traditional medicine; and negative responses to society's concerns. Their primary sources of support were spouses, parents and health professionals, accordingly. Complex physio-psycho-social and decision-making distress in caring for children with a rare genetic disorder were systematically revealed from the perspectives of ethnic-Chinese family caregivers. Long-term care plans for children with a rare genetic disorder such as Russell-Silver Syndrome need to focus on positive dynamic family interactions, life-stage development and family caregiver support. Research on care-giving in rare genetic disorders is also warranted across cultures and countries to develop a substantial knowledge basis for nursing practice. © 2011 Blackwell Publishing Ltd.

36 CFR 215.8 - Appeal Deciding Officer.

Code of Federal Regulations, 2010 CFR

2010-07-01

... names, the Appeal Deciding Officer shall identify all qualified appellants (§ 215.13). (ii) The Appeal Deciding Officer may appoint the first name listed as the lead appellant (§ 215.2) to act on behalf of all parties to that appeal when the appeal does not specify a lead appellant (§ 215.14(b)(3)). (3) Appeal...

36 CFR 215.8 - Appeal Deciding Officer.

Code of Federal Regulations, 2011 CFR

2011-07-01

... names, the Appeal Deciding Officer shall identify all qualified appellants (§ 215.13). (ii) The Appeal Deciding Officer may appoint the first name listed as the lead appellant (§ 215.2) to act on behalf of all parties to that appeal when the appeal does not specify a lead appellant (§ 215.14(b)(3)). (3) Appeal...

20 CFR 670.200 - Who decides where Job Corps centers will be located?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Who decides where Job Corps centers will be... LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Site Selection and Protection and Maintenance of Facilities § 670.200 Who decides where Job Corps centers will be located? (a...

13 CFR 124.1008 - When will SBA not decide an SDB protest?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false When will SBA not decide an SDB... SDB protest? (a) SBA will not decide a protest as to disadvantaged status of any concern other than... protested concern's circumstances have materially changed since SBA certified it as an SDB, or that the...

13 CFR 124.1008 - When will SBA not decide an SDB protest?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false When will SBA not decide an SDB... SDB protest? (a) SBA will not decide a protest as to disadvantaged status of any concern other than... protested concern's circumstances have materially changed since SBA certified it as an SDB, or that the...

13 CFR 124.1008 - When will SBA not decide an SDB protest?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false When will SBA not decide an SDB... SDB protest? (a) SBA will not decide a protest as to disadvantaged status of any concern other than... protested concern's circumstances have materially changed since SBA certified it as an SDB, or that the...

13 CFR 124.1008 - When will SBA not decide an SDB protest?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false When will SBA not decide an SDB... SDB protest? (a) SBA will not decide a protest as to disadvantaged status of any concern other than... protested concern's circumstances have materially changed since SBA certified it as an SDB, or that the...

13 CFR 124.1008 - When will SBA not decide an SDB protest?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false When will SBA not decide an SDB... SDB protest? (a) SBA will not decide a protest as to disadvantaged status of any concern other than... protested concern's circumstances have materially changed since SBA certified it as an SDB, or that the...

78 FR 38811 - Small Business Size and Status Integrity

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... made by a judge, jury, or other decider of fact. Given the fact-specific nature of such a finding, SBA... certification is a factual determination best made by a judge, jury, or other decider of fact. One commenter..., jury or other decider of fact. SBA has made minor wording changes in the limitation of liability...

Career Cruising Impact on the Self Efficacy of Deciding Majors

ERIC Educational Resources Information Center

Smother, Anthony William

2012-01-01

The purpose of this study was to analyze the impact of "Career Cruising"© on self-efficacy of deciding majors in a university setting. The use of the self-assessment instrument, "Career Cruising"©, was used with measuring the career-decision making self-efficacy in a pre and post-test with deciding majors. The independent…

20 CFR 416.1881 - Deciding whether someone is your parent or stepparent.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Deciding whether someone is your parent or... SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Relationship Who Is Considered Your Parent § 416.1881 Deciding whether someone is your parent or stepparent. (a) We consider your parent to be— (1) Your natural...

Deciding How To Decide: Decision Making in Schools. A Presenter's Guide. Research Based Training for School Administrators. Revised.

ERIC Educational Resources Information Center

Oregon Univ., Eugene. Center for Educational Policy and Management.

This workshop presenter's guide is intended for use by administrators in training one another in the Project Leadership program developed by the Association of California School Administrators (ACSA). The purposes of the guide are: to provide administrators with a framework for deciding when others (particularly subordinates) should participate in…

13 CFR 126.604 - Who decides if a contract opportunity for HUBZone set-aside competition exists?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Who decides if a contract opportunity for HUBZone set-aside competition exists? 126.604 Section 126.604 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION HUBZONE PROGRAM Contractual Assistance § 126.604 Who decides if a contract...

Novel Repair Technique for Life-Extension of Hydraulic Turbine Components in Hydroelectric Power Stations

NASA Astrophysics Data System (ADS)

Hiramatsu, Yoichi; Ishii, Jun; Funato, Kazuhiro

A significant number of hydraulic turbines operated in Japan were installed in the first half of the 20th century. Today, aging degradation and flaws are observed in these turbine equipments. So far, Japanese engineers have applied NDI technology of Ultrasonic Testing (UT) to detect the flaws, and after empirical evaluation of the remaining life they decided an adequate moment to replace the equipments. Since the replacement requires a large-scale field site works and high-cost, one of the solutions for life-extension of the equipments is introduction of repair services. We have been working in order to enhance the accuracy of results during the detection of flaws and flaws dimensioning, in particular focusing on the techniques of Tip-echo, TOFD and Phased-Array UT, accompanied by the conventional UT. These NDI methods made possible to recognize the entire image of surface and embedded flaws with complicated geometry. Then, we have developed an evaluation system of these flaws based on the theory of crack propagation, of the logic of crack growth driven by the stress-intensity factor of the crack tip front. The sophisticated evaluation system is constituted by a hand-made software and database of stress-intensity factor. Based on these elemental technologies, we propose a technique of repair welding to provide a life-extension of hydraulic turbine components.

Medicare and Advance Planning: The Importance of Context.

PubMed

Dresser, Rebecca

2016-05-01

In January 2016, a long-delayed Medicare change took effect. The Medicare program will now reimburse doctors for time they spend talking with patients about end-of-life care. This is the move that Sarah Palin and other Affordable Care Act critics said would authorize government "death panels" to decide whether older Americans should live or die. Today virtually no one buys into Palin's death panel rhetoric. But many people do think the Medicare change is a big deal. Representative Earl Blumenauer, a Democrat from Oregon who sponsored the original ACA reimbursement proposal, lauded the Medicare provision as "a turning point in end-of-life care." Others are not so sure about that. After all, laws promoting advance care planning have existed for decades. The federal Patient Self-Determination Act of 1990 and the many court decisions and state laws supporting advance care planning have had relatively little impact. Similarly, legal recognition of physician orders for life-sustaining treatment as advance planning instruments have not produced the improvements that were predicted. And from a broad perspective, advance care planning is a small piece of the puzzle. The effort to improve end-of-life care must take into account the limitations of advance decision-making, as well as the overriding importance of the general standard of care for terminally ill patients. © 2016 The Hastings Center.

Quantum Game of Life

NASA Astrophysics Data System (ADS)

Glick, Aaron; Carr, Lincoln; Calarco, Tommaso; Montangero, Simone

2014-03-01

In order to investigate the emergence of complexity in quantum systems, we present a quantum game of life, inspired by Conway's classic game of life. Through Matrix Product State (MPS) calculations, we simulate the evolution of quantum systems, dictated by a Hamiltonian that defines the rules of our quantum game. We analyze the system through a number of measures which elicit the emergence of complexity in terms of spatial organization, system dynamics, and non-local mutual information within the network. Funded by NSF

A critical review of Dr. Charles S. Greene's article titled "Managing the Care of Patients with Temporomandibular Disorders: a new Guideline for Care" and a revision of the American Association for Dental Research's 1996 policy statement on temporomandibular disorders, approved by the AADR Council in March 2010, published in the Journal of the American Dental Association September 2010.

PubMed

Simmons, H Clifton

2012-01-01

Dr. Charles Greene's article, "Managing the Care of Patients with TMDs A New Guideline for Care," and the American Association for Dental Research's (AADR) 2010 Policy Statement on Temporomandibular Disorders, published in the Journal of the American Dental Association (JADA) September 2010, are reviewed in detail. The concept that all temporomandibular disorders (TMDs) should be lumped into one policy statement for care is inappropriate. TMDs are a collection of disorders that are treated differently, and the concept that TMDs must only be managed within a biopsychosocial model of care is inappropriate. TMDs are usually a musculoskeletal orthopedic disorder, as defined by the AADR. TMD orthopedic care that is peer-reviewed and evidence-based is available and appropriate for some TMDs. Organized dentistry, including the American Dental Association, and mainstream texts on TMDs, support the use of orthopedics in the treatment of some TMDs. TMDs are not psychological or social disorders. Informed consent requires that alternative care is discussed with patients. Standard of care is a legal concept that is usually decided by a court of law and not decided by a policy statement, position paper, guidelines or parameters of care handed down by professional organizations. The 2010 AADR Policy Statement on TMD is not the standard of care in the United States. Whether a patient needs care for a TMD is not decided by a diagnostic test, but by whether the patient has significant pain, dysfunction and/or a negative change in quality of life from a TMD and they want care. Some TMDs need timely invasive and irreversible care.

Comparative effectiveness studies to improve clinical outcomes in end stage renal disease: the DEcIDE patient outcomes in end stage renal disease study

PubMed Central

2012-01-01

Background Evidence is lacking to inform providers’ and patients’ decisions about many common treatment strategies for patients with end stage renal disease (ESRD). Methods/design The DEcIDE Patient Outcomes in ESRD Study is funded by the United States (US) Agency for Health Care Research and Quality to study the comparative effectiveness of: 1) antihypertensive therapies, 2) early versus later initiation of dialysis, and 3) intravenous iron therapies on clinical outcomes in patients with ESRD. Ongoing studies utilize four existing, nationally representative cohorts of patients with ESRD, including (1) the Choices for Healthy Outcomes in Caring for ESRD study (1041 incident dialysis patients recruited from October 1995 to June 1999 with complete outcome ascertainment through 2009), (2) the Dialysis Clinic Inc (45,124 incident dialysis patients initiating and receiving their care from 2003–2010 with complete outcome ascertainment through 2010), (3) the United States Renal Data System (333,308 incident dialysis patients from 2006–2009 with complete outcome ascertainment through 2010), and (4) the Cleveland Clinic Foundation Chronic Kidney Disease Registry (53,399 patients with chronic kidney disease with outcome ascertainment from 2005 through 2009). We ascertain patient reported outcomes (i.e., health-related quality of life), morbidity, and mortality using clinical and administrative data, and data obtained from national death indices. We use advanced statistical methods (e.g., propensity scoring and marginal structural modeling) to account for potential biases of our study designs. All data are de-identified for analyses. The conduct of studies and dissemination of findings are guided by input from Stakeholders in the ESRD community. Discussion The DEcIDE Patient Outcomes in ESRD Study will provide needed evidence regarding the effectiveness of common treatments employed for dialysis patients. Carefully planned dissemination strategies to the ESRD community will enhance studies’ impact on clinical care and patients’ outcomes. PMID:23217181