The Role of Compensation Criteria to Minimize Face-Time Bias and Support Faculty Career Flexibility

PubMed Central

Elsbach, Kimberly D.; Villablanca, Amparo C.

2016-01-01

Work-life balance is important to recruitment and retention of the younger generation of medical faculty, but medical school flexibility policies have not been fully effective. We have reported that our school’s policies are underutilized due to faculty concerns about looking uncommitted to career or team. Since policies include leaves and accommodations that reduce physical presence, faculty may fear “face-time bias,” which negatively affects evaluation of those not “seen” at work. Face-time bias is reported to negatively affect salary and career progress. We explored face-time bias on a leadership level and described development of compensation criteria intended to mitigate face-time bias, raise visibility, and reward commitment and contribution to team/group goals. Leaders from 6 partner departments participated in standardized interviews and group meetings. Ten compensation plans were analyzed, and published literature was reviewed. Leaders did not perceive face-time issues but saw team pressure and perception of availability as performance motivators. Compensation plans were multifactor productivity based with many quantifiable criteria; few addressed team contributions. Using these findings, novel compensation criteria were developed based on a published model to mitigate face-time bias associated with team perceptions. Criteria for organizational citizenship to raise visibility and reward group outcomes were included. We conclude that team pressure and perception of availability have the potential to lead to bias and may contribute to underuse of flexibility policies. Recognizing organizational citizenship and cooperative effort via specific criteria in a compensation plan may enhance a culture of flexibility. These novel criteria have been effective in one pilot department. PMID:28725757

Challenges Facing a Deaf Family Member Concerning a Loved One’s Dying

PubMed Central

Kehl, Karen A.; Gartner, Constance M.

2010-01-01

Individuals who are Deaf face challenges both similar and unique from those faced by hearing individuals when a family member is dying. This study was guided by the question “What are the challenges faced by a Deaf family member when a loved one is dying?” Methods - This qualitative study is guided by critical theory and an interpretive perspective. Robert, a college-educated older adult who has been Deaf from birth was interviewed in American Sign Language using a death history format. Results – There are challenges for Deaf family members that affect communication with both the dying person and health care professionals. Patient-family communication issues included physical challenges and financial challenges. Lack of cultural competence concerning the Deaf community created challenges communicating with professionals. Decision-making was also a challenge. Conclusions These findings provide a framework for future research concerning the needs of Deaf individuals facing the end of life and provide guidance for clinicians. PMID:19910395

L-connect routing of die surface pads to the die edge for stacking in a 3D array

DOEpatents

Petersen, Robert W.

2000-01-01

Integrated circuit chips and method of routing the interface pads from the face of the chip or die to one or more sidewall surfaces of the die. The interconnection is routed from the face of the die to one or more edges of the die, then routed over the edge of the die and onto the side surface. A new pad is then formed on the sidewall surface, which allows multiple die or chips to be stacked in a three-dimensional array, while enabling follow-on signal routing from the sidewall pads. The routing of the interconnects and formation of the sidewall pads can be carried out in an L-connect or L-shaped routing configuration, using a metalization process such as laser pantography.

The Role of Compensation Criteria to Minimize Face-Time Bias and Support Faculty Career Flexibility: An Approach to Enhance Career Satisfaction in Academic Pathology.

PubMed

Howell, Lydia Pleotis; Elsbach, Kimberly D; Villablanca, Amparo C

2016-01-01

Work-life balance is important to recruitment and retention of the younger generation of medical faculty, but medical school flexibility policies have not been fully effective. We have reported that our school's policies are underutilized due to faculty concerns about looking uncommitted to career or team. Since policies include leaves and accommodations that reduce physical presence, faculty may fear "face-time bias," which negatively affects evaluation of those not "seen" at work. Face-time bias is reported to negatively affect salary and career progress. We explored face-time bias on a leadership level and described development of compensation criteria intended to mitigate face-time bias, raise visibility, and reward commitment and contribution to team/group goals. Leaders from 6 partner departments participated in standardized interviews and group meetings. Ten compensation plans were analyzed, and published literature was reviewed. Leaders did not perceive face-time issues but saw team pressure and perception of availability as performance motivators. Compensation plans were multifactor productivity based with many quantifiable criteria; few addressed team contributions. Using these findings, novel compensation criteria were developed based on a published model to mitigate face-time bias associated with team perceptions. Criteria for organizational citizenship to raise visibility and reward group outcomes were included. We conclude that team pressure and perception of availability have the potential to lead to bias and may contribute to underuse of flexibility policies. Recognizing organizational citizenship and cooperative effort via specific criteria in a compensation plan may enhance a culture of flexibility. These novel criteria have been effective in one pilot department.

Facing Up to Death

ERIC Educational Resources Information Center

Ross, Elizabeth Kubler

1972-01-01

Doctor urges that Americans accept death as a part of life and suggests ways of helping dying patients and their families face reality calmly, with peace. Dying children and their siblings, as well as children's feelings about relatives' deaths, are also discussed. (PD)

A 94GHz Temperature Compensated Low Noise Amplifier in 45nm Silicon-on-Insulator Complementary Metal-Oxide Semiconductor (SOI CMOS)

DTIC Science & Technology

2014-01-01

ring oscillator based temperature sensor will be designed to compensate for gain variations over temperature. For comparison to a competing solution...Simulated (Green) Capacitance of the GSG Pads ........................ 9 Figure 6: Die Picture and Schematic of the L-2L Coplanar Waveguides...complementary metal-oxide-semiconductor (CMOS) technology. A ring oscillator based temperature sensor was designed to compensate for gain variations

38 CFR 11.128 - Veteran dies without having filed application for final settlement.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Application for Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Veteran dies without having filed application for final settlement. 11.128 Section 11.128 Pensions, Bonuses, and Veterans...

38 CFR 11.128 - Veteran dies without having filed application for final settlement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Application for Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Veteran dies without having filed application for final settlement. 11.128 Section 11.128 Pensions, Bonuses, and Veterans...

38 CFR 11.128 - Veteran dies without having filed application for final settlement.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Application for Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Veteran dies without having filed application for final settlement. 11.128 Section 11.128 Pensions, Bonuses, and Veterans...

38 CFR 11.128 - Veteran dies without having filed application for final settlement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Application for Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Veteran dies without having filed application for final settlement. 11.128 Section 11.128 Pensions, Bonuses, and Veterans...

38 CFR 11.128 - Veteran dies without having filed application for final settlement.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Application for Payment of Adjusted Service Certificate Under the World War Adjusted Compensation Act, As... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Veteran dies without having filed application for final settlement. 11.128 Section 11.128 Pensions, Bonuses, and Veterans...

Evolution of the Die-Wall Pressure during the Compression of Biconvex Tablets: Experimental Results and Comparison with FEM Simulation.

PubMed

Mazel, Vincent; Diarra, Harona; Busignies, Virginie; Tchoreloff, Pierre

2015-12-01

Capping is a classical manufacturing problem for tablets, which is known to affect more biconvex tablets than flat-faced ones. One reason could be the development of a higher residual die-wall pressure during unloading. Unfortunately, contradictory results were published on the subject. In this work, the evolution of the die-wall pressure during the compaction of biconvex tablets was studied experimentally and using finite element method (FEM) modeling. It was compared with the case of flat-faced tablets. Experimental and numerical results showed that during the compression of biconvex tablet, a lower maximum die-wall pressure and a higher residual die-wall pressure were obtained compared with the case of flat-faced tablet. Moreover, both approaches showed, for biconvex tablets, a temporary increase of the die-wall pressure at the end of the unloading phase. FEM demonstrated that this phenomenon was due to a gradual loss of contact between the punch and the tablet from the side to the center. This complex unloading behavior causes the temporary increase of the die-wall pressure and the development of a shear stress between the convex part and the land of the tablet. This could explain the capping tendency of biconvex tablets. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

Developing a blended course on dying, loss, and grief.

PubMed

Kavanaugh, Karen; Andreoni, V Ann; Wilkie, Diana J; Burgener, Sandra; Buschmann, Mary Beth Tank; Henderson, Gloria; Hsiung, Yi-Fang Yvonne; Zhao, Zhongsheng

2009-01-01

An important component of end-of-life education is to provide health professionals with content related to dying, loss, and grief. The authors describe the strategies used to develop and offer a blended course (integration of classroom face-to-face learning with online learning) that addressed the sensitive and often emotional content associated with grieving and bereavement. Using Kolb's Experiential Learning Theory, a set of 4 online learning modules, with engaging, interactive elements, was created. Course evaluations demonstrated the success of the blended course in comparison to the traditional, exclusive face-to-face approach.

Asymmetric Die Grows Purer Silicon Ribbon

NASA Technical Reports Server (NTRS)

Kalejs, J. P.; Chalmers, B.; Surek, T.

1983-01-01

Concentration of carbide impurities in silicon ribbon is reduced by growing crystalline ribbon with die one wall higher than other. Height difference controls shape of meniscus at liquid/crystal interface and concentrates silicon carbide impurity near one of broad faces. Opposite face is left with above-average purity. Significantly improves efficiency of solar cells made from ribbon.

Developing a Blended Course on Dying, Loss, and Grief

PubMed Central

Kavanaugh, Karen; Andreoni, V. Ann; Wilkie, Diana J.; Burgener, Sandra; Buschmann, MaryBeth Tank; Henderson, Gloria; Hsiung, Yi-Fang Yvonne; Zhao, Zhongsheng

2010-01-01

An important component of end-of-life education is to provide health professionals with content related to dying, loss, and grief. The authors describe the strategies used to develop and offer a blended course (integration of classroom face-to-face learning with online learning) that addressed the sensitive and often emotional content associated with grieving and bereavement. Using Kolb’s experiential learning theory, a set of 4 online learning modules, with engaging, interactive elements, was created. Course evaluations demonstrated the success of the blended course in comparison to the traditional, exclusive face-to-face approach. PMID:19412055

Accident insurance, sickness, and science: New Zealand's no-fault system.

PubMed

Dew, Kevin

2002-01-01

This article explores the process of seeking compensation for occupational illness under a no-fault accident insurance scheme. The author uses two case studies--firefighters who attended a fire at a chemical storage depot and timbermill workers who worked with pentachlorophenol--to illustrate how science can be used to deny compensation to sick and dying workers. The results of the studies suggest that a no-fault accident compensation scheme, considered to be a victory for workers, offers no guarantee of just outcomes for working people. And science can be co-opted and used to support business and state interests against workers; this ideological support is increasingly hidden behind the development of "objective" systems of assessing compensation claims.

ELID grinding characteristics of large stamping die for Wolter mirror.

PubMed

Yin, Shaohui; Ohmori, Hitoshi; Liu, Qing; Morita, Shinnya; Chen, Fengjun; Asami, Muneaki; Fan, Yufeng

2009-01-01

An ultra-precision ELID grinding of large stamping dies of Wolter mirror for X-ray telescope was presented in this paper. The large stamping dies (S55C) with confocal paraboloid and hyperboloid was ground by ELID arc-enveloped grinding. In this ELID grinding system, cast iron fiber bonded (CIFB) diamond wheels were controlled by 3-dimentional ways to scan the work-piece and generate required surfaces. Its grinding characteristics such as attainable form accuracy, surface roughness were investigated. Furthermore, some measures to improve form accuracy were discussed and verified such as truing, compensating, and on-machine measuring.

Ethics and the compensation of immigrant workers for work-related injuries and illnesses.

PubMed

Gravel, Sylvie; Vissandjée, Bilkis; Lippel, Katherine; Brodeur, Jean-Marc; Patry, Louis; Champagne, François

2010-10-01

This paper examines the compensation process for work-related injuries and illnesses by assessing the trajectories of a sample of immigrant and non-immigrant workers (n = 104) in Montreal. Workers were interviewed to analyze the complexity associated with the compensation process. Experts specialized in compensation issues assessed the difficulty of the interviewees' compensation process. Immigrant workers faced greater difficulties with medical, legal, and administrative issues than non-immigrants did. While immigrant workers' claim forms tended to be written more often by employers or friends (58% vs. 8%), the claims were still more often contested by employers (64% vs. 24%). Immigrant workers were less likely to obtain a precise diagnosis (64% vs. 42%) and upon returning to work were more likely to face sub-optimal conditions. Such results throw into relief issues of ethics and equity in host societies that are building their economy with migrant workers.

Computer-mediated and face-to-face communication in metastatic cancer support groups.

PubMed

Vilhauer, Ruvanee P

2014-08-01

To compare the experiences of women with metastatic breast cancer (MBC) in computer-mediated and face-to-face support groups. Interviews from 18 women with MBC, who were currently in computer-mediated support groups (CMSGs), were examined using interpretative phenomenological analysis. The CMSGs were in an asynchronous mailing list format; women communicated exclusively via email. All the women were also, or had previously been, in a face-to-face support group (FTFG). CMSGs had both advantages and drawbacks, relative to face-to-face groups (FTFGs), for this population. Themes examined included convenience, level of support, intimacy, ease of expression, range of information, and dealing with debilitation and dying. CMSGs may provide a sense of control and a greater level of support. Intimacy may take longer to develop in a CMSG, but women may have more opportunities to get to know each other. CMSGs may be helpful while adjusting to a diagnosis of MBC, because women can receive support without being overwhelmed by physical evidence of disability in others or exposure to discussions about dying before they are ready. However, the absence of nonverbal cues in CMSGs also led to avoidance of topics related to death and dying when women were ready to face them. Agendas for discussion, the presence of a facilitator or more time in CMSGs may attenuate this problem. The findings were discussed in light of prevailing research and theories about computer-mediated communication. They have implications for designing CMSGs for this population.

Contoured inner after-heater shield for reducing stress in growing crystalline bodies

DOEpatents

Kalejs, Juris P.

1996-09-24

An apparatus for growing hollow crystalline bodies by the EFG process, comprising an EFG die having a top surface shaped for growing a hollow crystalline body having a cross-sectional configuration in the shape of a polygon having n faces, and a radiation shield adjacent to and surrounded by the top end surface of the die, characterized in that the shield has an inner edge defining a similar polygon with n sides, and the inner edge of the shield is notched so that the spacing between the n faces and the n sides is greatest between the central portions of the n faces and the n sides, whereby the greater spacing at the central portions helps to reduce lateral temperature gradients in the crystalline body that is grown by use of the die.

20 CFR 10.910 - What if a person entitled to a portion of the death gratuity payment dies after the death of the...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What if a person entitled to a portion of the death gratuity payment dies after the death of the covered employee but before receiving his or her portion of the death gratuity? 10.910 Section 10.910 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL...

Improved survival of patients with hepatocellular carcinoma and compensated hepatitis C virus-related cirrhosis who attained sustained virological response.

PubMed

Bruno, Savino; Di Marco, Vito; Iavarone, Massimo; Roffi, Luigi; Boccaccio, Vincenzo; Crosignani, Andrea; Cabibbo, Giuseppe; Rossi, Sonia; Calvaruso, Vincenza; Aghemo, Alessio; Giacomelli, Luca; Craxì, Antonio; Colombo, Massimo; Maisonneuve, Patrick

2017-10-01

Few studies examined the outcome of patients with hepatitis C virus (HCV)-related cirrhosis who developed hepatocellular carcinoma (HCC). The relative weight as determinant of death for cancer vs end-stage liver disease (ESLD) and the benefit of HCV eradication remain undefined. This multicentre, retrospective analysis evaluates overall survival (OS), rate of decompensation and tumour recurrence in compensated HCC patients treated with interferon (IFN) according to HCV status since HCC diagnosis. Two groups of patients with HCV-related cirrhosis and HCC were followed since HCC diagnosis: (i) compensated cirrhotics with prior sustained virological response (SVR) on IFN-based regimens (N=19); (ii) compensated cirrhotics without SVR (viraemic) (N=156). Over a median follow-up of 3.0 years since the onset of HCC, OS was longer for HCC patients with SVR than for viraemic patients (log-rank P=.004). The 5-year OS rate was 65.9% in patients with SVR vs 31.9% in viraemic patients. Similar trends were reported for hepatic decompensation (log-rank P=.01) and tumour recurrence (log-rank P=.01). These findings were confirmed at multivariable and propensity score analysis. At propensity analysis, 0/19 compensated patients with SVR died for ESLD vs 7/19 (37%) viraemic patients (P=.004). HCC mortality was similar in the two groups. Hepatocellular carcinoma patients with prior SVR and compensated cirrhosis at the time of tumour diagnosis have prolonged OS than viraemic patients. Given the lack of cirrhosis progression, no SVR patient ultimately died for ESLD while this condition appears the main cause of death among viraemic patients. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Springback Compensation Process for High Strength Steel Automotive Parts

NASA Astrophysics Data System (ADS)

Onhon, M. Fatih

2016-08-01

This paper is about an advanced stamping simulation methodology used in automotive industry to shorten total die manufacturing times in a new vehicle project by means of benefiting leading edge virtual try-out technology.

How Can Women Escape the Compensation Negotiation Dilemma? Relational Accounts Are One Answer

ERIC Educational Resources Information Center

Bowles, Hannah Riley; Babcock, Linda

2013-01-01

Policy makers, academics, and media reports suggest that women could shrink the gender pay gap by negotiating more effectively for higher compensation. Yet women entering compensation negotiations face a dilemma: They have to weigh the benefits of negotiating against the social consequences of having negotiated. Research shows that women are…

Student Nurses' Perception of Death and Dying

ERIC Educational Resources Information Center

Niederriter, Joan E.

2009-01-01

Student nurses are involved in caring for patients who are actively dying or who have been told they have a terminal illness and are faced with the process of dying. Students encounter these patients in hospitals, nursing homes, at home or in hospice care settings. According to Robinson (2004), "nurses are the healthcare providers that are most…

Sacrificing something important: the lived experience of compensated kidney donors in the Philippines.

PubMed

Paguirigan, Medel Salvador

2012-01-01

The sale of solid organs is illegal in many countries, but the reality is that it happens. This study investigated and identified the structure of sacrificing something important among compensated kidney donors in the Philippines by conducting in-depth, face-to-face dialogues from 13 participants in the town of Baseco, Manila, Philippines. The structure of sacrificing something important among compensated kidney donors emerges from the extrinsic intent of adversity and the intrinsic intent of altruism, which is instrumental to the struggle of making a difficult decision, emerging in the act with reciprocation, and although resulting in the consequences of health deterioration and loss, resilience makes bouncing back possible.

Power module packaging with double sided planar interconnection and heat exchangers

DOEpatents

Liang, Zhenxian; Marlino, Laura D.; Ning, Puqi; Wang, Fei

2015-05-26

A double sided cooled power module package having a single phase leg topology includes two IGBT and two diode semiconductor dies. Each IGBT die is spaced apart from a diode semiconductor die, forming a switch unit. Two switch units are placed in a planar face-up and face-down configuration. A pair of DBC or other insulated metallic substrates is affixed to each side of the planar phase leg semiconductor dies to form a sandwich structure. Attachment layers are disposed on outer surfaces of the substrates and two heat exchangers are affixed to the substrates by rigid bond layers. The heat exchangers, made of copper or aluminum, have passages for carrying coolant. The power package is manufactured in a two-step assembly and heating process where direct bonds are formed for all bond layers by soldering, sintering, solid diffusion bonding or transient liquid diffusion bonding, with a specially designed jig and fixture.

Tablet compression tooling - Impact of punch face edge modification.

PubMed

Anbalagan, Parthiban; Heng, Paul Wan Sia; Liew, Celine Valeria

2017-05-30

The influence of punch face edge geometry modification on tablet compression and the properties of the resultant tablets produced on a rotary press were investigated. The results revealed that tablets produced from the punches with radius edge face geometry consistently displayed better physical quality; higher tensile strength and lower capping tendency. Modification of the angled edge of the bevel face to the curved edge of the radius face, enabled deeper punch penetration in the die cavity during the compression cycle, bringing about greater compact densification. Improved die fill packing increased interparticulate bond formation and helped to dissipate destructive elasticity within the compact, consequently reduced tablet expansion during the decompression phase. The positive impact of punch face edge modification was also more noticeable at a higher turret speed. The application of the precompression force along with dwell time extension amplified the tableting performance of radius edge punch face design to a greater extent when compared to bevel edge punch face design. This could be attributed to the enhanced packing efficiency at both precompression and main compression stages. Copyright © 2017 Elsevier B.V. All rights reserved.

Thermal expansion compensator having an elastic conductive element bonded to two facing surfaces

NASA Technical Reports Server (NTRS)

Determan, William (Inventor); Matejczyk, Daniel Edward (Inventor)

2012-01-01

A thermal expansion compensator is provided and includes a first electrode structure having a first surface, a second electrode structure having a second surface facing the first surface and an elastic element bonded to the first and second surfaces and including a conductive element by which the first and second electrode structures electrically and/or thermally communicate, the conductive element having a length that is not substantially longer than a distance between the first and second surfaces.

Confined Tube Crimp Using Portable Hand Tools

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

Reynolds, Joseph James; Pereyra, R. A.; Archuleta, Jeffrey Christopher

2016-04-04

The Lawrence Radiation Laboratory developed handheld tools that crimp a 1/16 inch OD tube, forming a leak tight seal1 (see Figure 1). The leak tight seal forms by confining the 1/16 inch OD tubing inside a die while applying crimp pressure. Under confined pressure, the tube walls weld at the crimp. The purpose of this study was to determine conditions for fabricating a leak tight tube weld. The equipment was used on a trial-and-error basis, changing the conditions after each attempt until successful welds were fabricated. To better confine the tube, the die faces were polished. Polishing removed a fewmore » thousandths of an inch from the die face, resulting in a tighter grip on the tubing wall. Using detergent in an ultrasonic bath, the tubing was cleaned. Also, the time under crimp pressure was increased to 30 seconds. With these modifications, acceptable cold welds were fabricated. After setting the conditions for an acceptable cold weld, the tube was TIG welded across the crimped face.« less

Assisted suicide by oxygen deprivation with helium at a Swiss right-to-die organisation.

PubMed

Ogden, Russel D; Hamilton, William K; Whitcher, Charles

2010-03-01

In Switzerland, right-to-die organisations assist their members with suicide by lethal drugs, usually barbiturates. One organisation, Dignitas, has experimented with oxygen deprivation as an alternative to sodium pentobarbital. To analyse the process of assisted suicide by oxygen deprivation with helium and a common face mask and reservoir bag. This study examined four cases of assisted suicide by oxygen deprivation using helium delivered via a face mask. Videos of the deaths were provided by the Zurich police. Dignitas provided protocol and consent information. One man and three women were assisted to death by oxygen deprivation. There was wide variation in the time to unconsciousness and the time to death, probably due to the poor mask fit. Swiss law prevented attendants from effectively managing the face mask apparatus. Purposeless movements of the extremities were disconcerting for Dignitas attendants, who are accustomed to assisting suicide with barbiturates. None of the dying individuals attempted self-rescue. The dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted suicide. Oxygen deprivation with a face mask is not acceptable because leaks are difficult to control and it may not eliminate rebreathing. These factors will extend time to unconsciousness and time to death. A hood method could reduce the problem of mask fit. With a hood, a flow rate of helium sufficient to provide continuous washout of expired gases would remedy problems observed with the mask.

Is clinician refusal to treat an emerging problem in injury compensation systems?

PubMed Central

Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

2016-01-01

Objective The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Design Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Setting Compensable injury management in general practice in Melbourne, Australia. Participants 25 GPs who were treating, or had treated a patient with compensable injury. Results The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. Conclusions In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. PMID:26792215

An idea whose time has come: Compensation for vaccine-related injuries and death in India.

PubMed

Nadimpally, Sarojini; Banerjee, Sneha; Venkatachalam, Deepa; Bhagianadh, Divya

2017-01-01

This paper emphasises the urgent need for a compensation policy for those affected by adverse events following immunisation in India. In the absence of such a mechanism in the country, people claim compensation by taking recourse to tort law and have to face the ensuing uncertainty and challenges with regard to the award of compensation. The paper argues that people should be provided compensation in the event of death and serious adverse events following compulsory immunisation, irrespective of whether there is a causal association between the adverse event and the vaccine, on the basis of no fault compensation.

Meditations on the unitary rhythm of dying-grieving.

PubMed

Malinski, Violet M

2012-07-01

When someone faces loss of a loved one, that person simultaneously grieves and dies a little, just as the one dying also grieves. The author's personal conceptualization of dying and grieving as a unitary rhythm is explored based primarily on her interpretation of Rogers' science of unitary human beings, along with selected examples from related nursing literature and from the emerging focus on continuing bonds in other disciplines. Examples from contemporary songwriters that depict such a unitary conceptualization are given along with personal examples. The author concludes with her description of the unitary rhythm of dying-grieving.

Fear processing and social networking in the absence of a functional amygdala.

PubMed

Becker, Benjamin; Mihov, Yoan; Scheele, Dirk; Kendrick, Keith M; Feinstein, Justin S; Matusch, Andreas; Aydin, Merve; Reich, Harald; Urbach, Horst; Oros-Peusquens, Ana-Maria; Shah, Nadim J; Kunz, Wolfram S; Schlaepfer, Thomas E; Zilles, Karl; Maier, Wolfgang; Hurlemann, René

2012-07-01

The human amygdala plays a crucial role in processing social signals, such as face expressions, particularly fearful ones, and facilitates responses to them in face-sensitive cortical regions. This contributes to social competence and individual amygdala size correlates with that of social networks. While rare patients with focal bilateral amygdala lesion typically show impaired recognition of fearful faces, this deficit is variable, and an intriguing possibility is that other brain regions can compensate to support fear and social signal processing. To investigate the brain's functional compensation of selective bilateral amygdala damage, we performed a series of behavioral, psychophysiological, and functional magnetic resonance imaging experiments in two adult female monozygotic twins (patient 1 and patient 2) with equivalent, extensive bilateral amygdala pathology as a sequela of lipoid proteinosis due to Urbach-Wiethe disease. Patient 1, but not patient 2, showed preserved recognition of fearful faces, intact modulation of acoustic startle responses by fear-eliciting scenes, and a normal-sized social network. Functional magnetic resonance imaging revealed that patient 1 showed potentiated responses to fearful faces in her left premotor cortex face area and bilaterally in the inferior parietal lobule. The premotor cortex face area and inferior parietal lobule are both implicated in the cortical mirror-neuron system, which mediates learning of observed actions and may thereby promote both imitation and empathy. Taken together, our findings suggest that despite the pre-eminent role of the amygdala in processing social information, the cortical mirror-neuron system may sometimes adaptively compensate for its pathology. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Caring for dying cancer patients in the Chinese cultural context: A qualitative study from the perspectives of physicians and nurses.

PubMed

Dong, Fengqi; Zheng, Ruishuang; Chen, Xuelei; Wang, Yanhui; Zhou, Hongyuan; Sun, Rong

2016-04-01

To explore the experiences of Chinese physicians and nurses who care for dying cancer patients in their practical work. This was a qualitative study using semi-structured face-to-face interviews. Fifteen physicians and 22 nurses were recruited from a cancer center in mainland China. The data were analyzed by qualitative thematic analysis. Disclosure of information on death and cancer to dying cancer patients is taboo in traditional Chinese culture, which greatly decreases the physicians' and nurses' effective communication with dying patients in end-of-life (EOL) care. Both physicians and nurses described strong ambitions to give dying cancer patients high-quality care, and they emphasized the importance of maintaining dying patients' hopes in the death-denying cultural context. However, the nurses were more concerned with dying patients' physical comfort and wish fulfillment, while the physicians placed greatest emphasis on patients' rights and symptom management. Both physicians and nurses suffered whilst also benefitting from taking care of dying patients which helped with their personal growth and allowed greater insight into themselves and their clinical practice. Our results also indicated that Chinese physicians and nurses require improved methods of communication on EOL care, as well as needing more support to provide quality EOL care. Chinese physicians and nurses experience a challenge when caring for dying cancer patients in the Chinese cultural context. Flexible and specific education and training in EOL cancer care are required to meet the needs of Chinese physicians and nurses at the cancer center studied. Copyright © 2015 Elsevier Ltd. All rights reserved.

Is clinician refusal to treat an emerging problem in injury compensation systems?

PubMed

Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

2016-01-20

The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Compensable injury management in general practice in Melbourne, Australia. 25 GPs who were treating, or had treated a patient with compensable injury. The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Historical review of die drool phenomenon during plastics extrusion

NASA Astrophysics Data System (ADS)

Musil, Jan; Zatloukal, Martin

2013-04-01

Die drool phenomenon is defined as unwanted spontaneous accumulation of extruded polymer melt on open faces of extrusion die during extrusion process. Such accumulated material builds up on the die exit and frequently or continually sticks onto the extruded product and thus damages it. Since die drool appears, extrusion process must be shut down and die exit must be manually cleaned which is time and money consuming. Although die drool is complex phenomenon and its formation mechanism is not fully understood yet, variety of proposed explanations of its formation mechanism and also many ways to its elimination can be found in open literature. Our review presents in historical order breakthrough works in the field of die drool research, shows many ways to suppress it, introduces methods for its quantitative evaluation and composition analysis and summarizes theories of die drool formation mechanism which can be helpful for extrusion experts.

Dying in the age of choice.

PubMed

Black, Kathy; Csikai, Ellen L

2015-01-01

Due to the unprecedented increase in the United States aging demographics, many more people are living longer and reaching older ages than ever before. However, a longer life is not necessarily a better life, as the vast majority will face a period of prolonged deteriorating health prior to death. Although notable efforts have been underway that are designed to improve the end-of-life experience, increasing numbers of individuals express a desire and/or act upon an intent to end their lives precipitously. Though still limited, the options to actively participate in their own deaths are growing. Requests for a hastened death can occur among people of all ages and includes those with advanced illness as well as others wanting to die due to unbearable suffering. This article provides an overview of the ongoing discourse about the experience of dying faced by many older adults, including aspects frequently associated with "a good death." The limitations of established practices which seek to provide a "better" dying experience are identified followed by discussion of the growing availability of alternative options. Reflective considerations are presented to guide practice vis-à-vis the changing landscape surrounding options in dying.

The Compensation Question

ERIC Educational Resources Information Center

Richwine, Jason; Biggs, Andrew; Mishel, Lawrence; Roy, Joydeep

2012-01-01

Over the past few years, as cash-strapped states and school districts have faced tough budget decisions, spending on teacher compensation has come under the microscope. The underlying question is whether, when you take everything into account, today's teachers are fairly paid, underpaid, or overpaid. In this forum, two pairs of respected…

Counseling Older Persons: Careers, Retirement, Dying.

ERIC Educational Resources Information Center

Sinick, Daniel

The focus of this monograph is on three areas of counseling with older clients: career counseling, retirement counseling, and counseling regarding death and dying. The portion on career counseling includes reasons older persons change careers, obstacles they are likely to face when seeking employment, myths surrounding the employability of older…

Making sense of dying: a review of narratives written since 1950 by people facing death from cancer and other diseases.

PubMed

Bingley, A F; McDermott, E; Thomas, C; Payne, S; Seymour, J E; Clark, D

2006-04-01

This article reviews a sample of narratives written since 1950 by people knowingly facing death as a result of cancer and other diseases, in order to compare experiences and show how these relate to wider changes in practice in end of life care. A bibliographic search of libraries, archives, journals and internet sources located English spoken literature, including books, poems, newspapers, journal articles, diaries, and internet postings of writings by people facing terminal disease. Bibliometric and qualitative content analysis explored changing authorship, experiences, purpose in writing, and reported the impact on readers. The initial search located a wide range of published and unpublished narratives, to which inclusion/exclusion criteria were applied, yielding 148 narratives by different authors since 1950. A purposive sub-sample of 63 of these narratives was reviewed. Over the last half century there have been changes in both the volume of available literature and patterns of writing about end of life experience. Therapeutic benefits of writing are reported as a way of making sense of dying combined with a strong sense of purpose in sharing the story. There is a clear awareness of social needs when dying, along with issues of communication with medical staff, symptom control, realities of suffering, and spiritual aspects of dying. Differences are found in the nature and style of writing about cancer in comparison to other illnesses.

Paying the Professoriate: A Global Comparison of Compensation and Contracts

ERIC Educational Resources Information Center

Altbach, Philip, Ed.; Reisberg, Liz, Ed.; Yudkevich, Maria, Ed.; Androushchak, Gregory, Ed.; Pacheco, Ivan, Ed.

2012-01-01

How are professors paid? Can the "best and brightest" be attracted to the academic profession? With universities facing international competition, which countries compensate their academics best, and which ones lag behind? "Paying the Professoriate" examines these questions and provides key insights and recommendations into the current state of…

The Competitive Disadvantage: Teacher Compensation in Rural America. Policy Brief.

ERIC Educational Resources Information Center

Jimerson, Lorna

Three components of the teacher shortage are the recruitment challenge, the retention problem, and the demand for teacher quality. Although the teacher shortage problem involves many factors, any solution must address salaries. Rural districts face a threefold disadvantage: teachers are not compensated as well as other rural professionals; rural…

Methods and Algorithms for Computer-aided Engineering of Die Tooling of Compressor Blades from Titanium Alloy

NASA Astrophysics Data System (ADS)

Khaimovich, A. I.; Khaimovich, I. N.

2018-01-01

The articles provides the calculation algorithms for blank design and die forming fitting to produce the compressor blades for aircraft engines. The design system proposed in the article allows generating drafts of trimming and reducing dies automatically, leading to significant reduction of work preparation time. The detailed analysis of the blade structural elements features was carried out, the taken limitations and technological solutions allowed to form generalized algorithms of forming parting stamp face over the entire circuit of the engraving for different configurations of die forgings. The author worked out the algorithms and programs to calculate three dimensional point locations describing the configuration of die cavity.

Method for hot press forming articles

DOEpatents

Baker, Robert R.; Hartsock, Dale L.

1982-01-01

This disclosure relates to an improved method for achieving the best bond strength and for minimizing distortion and cracking of hot pressed articles. In particular, in a method for hot press forming both an outer facing circumferential surface of and an inner portion of a hub, and of bonding that so-formed outer facing circumferential surface to an inner facing circumferential surface of a pre-formed ring thereby to form an article, the following improvement is made. Normally, in this method, the outside ring is restrained by a restraining sleeve of ring-shaped cross-section having an inside diameter. A die member, used to hot press form the hub, is so-formed as to have an outside diameter sized to engage the inside diameter of the restraining sleeve in a manner permitting relative movement therebetween. The improved method is one in which several pairs of matched restraining sleeve and die member are formed with each matched pair having a predetermined diameter. The predetermined diameter of each matched pair is different from another matched pair by stepped increments. The largest inside diameter of a restraining sleeve is equal to the diameter of the outer facing circumferential surface of the hub. Each pair of the matched restraining sleeve and die member is used to form an article in which an inside hub is bonded to an outside ring. The several samples so-formed are evaluated to determine which sample has the best bond formed between the hub and the ring with the least or no cracking or distortion in the ring portion of the article. Thereafter, the matched restraining sleeve and die member which form the article having the best bonding characteristics and least distortion cracking is then used for repeated formations of articles.

Accuracy of a new ring-opening metathesis elastomeric dental impression material with spray and immersion disinfection.

PubMed

Kronström, Mats H; Johnson, Glen H; Hompesch, Richard W

2010-01-01

A new elastomeric impression material has been formulated with a ring-opening metathesis chemistry. In addition to other properties of clinical significance, the impression accuracy must be confirmed. The purpose of this study was to compare the accuracy of the new elastomeric impression material with vinyl polysiloxane and polyether following both spray and immersion disinfection. Impressions of a modified dentoform with a stainless steel crown preparation in the lower right quadrant were made, and type IV gypsum working casts and dies were formed. Anteroposterior (AP), cross-arch (CA), buccolingual (BL), mesiodistal (MD), occlusogingivobuccal (OGB), and occlusogingivolingual (OGL) dimensions were measured using a microscope. Working cast and die dimensions were compared to those of the master model. The impression materials were a newly formulated, ring-opening metathesis-polymerization impression material (ROMP Cartridge Tray and ROMP Volume Wash), vinyl polysiloxane (VPS, Aquasil Ultra Monophase/LV), and a polyether (PE, Impregum Penta Soft/Permadyne Garant L). Fifteen impressions with each material were made, of which 5 were disinfected by spray for 10 minutes (CaviCide), 5 were disinfected by immersion for 90 minutes (ProCide D), and 5 were not disinfected. There were significant cross-product interactions with a 2-way ANOVA, so a 1-way ANOVA and Dunnett's T3 multiple comparison test were used to compare the dimensional changes of the 3 impression materials, by disinfection status and for each location (alpha=.05). For ROMP, there were no significant differences from the master, for any dimension, when comparing the control and 2 disinfectant conditions. No significant differences were detected among the 3 impression materials for CA, BL, and MD. The working die dimensions of OGB and OGL for VPS with immersion disinfection were significantly shorter than with PE and ROMP (P<.05). Overall, the AP dimension was more accurate than CA, and the BL of working dies was 0.040 mm greater in diameter than MD. The accuracy of gypsum working casts and working dies from the new and 2 existing types of impression material were similar, for both spray and immersion disinfection. Judicious application of a die spacer can compensate for the small differences observed. VPS may require additional laboratory accommodation to compensate for a shorter working die. Copyright 2010 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

20 CFR 61.307 - Transportation of recovered bodies of missing persons.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Transportation of recovered bodies of missing persons. 61.307 Section 61.307 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF... Benefits § 61.307 Transportation of recovered bodies of missing persons. If an employee dies while in...

20 CFR 61.307 - Transportation of recovered bodies of missing persons.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Transportation of recovered bodies of missing persons. 61.307 Section 61.307 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF... Benefits § 61.307 Transportation of recovered bodies of missing persons. If an employee dies while in...

20 CFR 61.307 - Transportation of recovered bodies of missing persons.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Transportation of recovered bodies of missing persons. 61.307 Section 61.307 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF... Benefits § 61.307 Transportation of recovered bodies of missing persons. If an employee dies while in...

20 CFR 61.307 - Transportation of recovered bodies of missing persons.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Transportation of recovered bodies of missing persons. 61.307 Section 61.307 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF... Benefits § 61.307 Transportation of recovered bodies of missing persons. If an employee dies while in...

Education, the Brain and Dementia: Neuroprotection or Compensation?

ERIC Educational Resources Information Center

Brayne, Carol; Ince, Paul G.; Keage, Hannah A. D.; McKeith, Ian G.; Matthews, Fiona E.; Polvikoski, Tuomo; Sulkava, Raimo

2010-01-01

The potential protective role of education for dementia is an area of major interest. Almost all older people have some pathology in their brain at death but have not necessarily died with dementia. We have explored these two observations in large population-based cohort studies (Epidemiological Clinicopathological Studies in Europe; EClipSE) in…

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

20 CFR 10.903 - Is the death gratuity payment applicable retroactively?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Is the death gratuity payment applicable...' COMPENSATION ACT, AS AMENDED Death Gratuity § 10.903 Is the death gratuity payment applicable retroactively? An employee's death qualifies for the death gratuity if the employee died on or after October 7, 2001, and...

A Novel for High School Seniors: Hal Borland's "When the Legends Die."

ERIC Educational Resources Information Center

Adkins, Carl A.

1968-01-01

Hal Borland's "When the Legends Die" is especially appropriate for high school seniors because its central problem--a Ute Indian boy's search for his identity and expected role in society--is exactly that faced by these students. The novel is divided into four sections, each concerned with a specific stage in the development of the…

The Compensation Question: Are Public School Teachers Underpaid? Analysis and Opinion

ERIC Educational Resources Information Center

Mishel, Lawrence

2012-01-01

Over the past few years, as cash-strapped states and school districts have faced tough budget decisions, spending on teacher compensation has come under the microscope. The underlying question is whether teachers are fairly paid, underpaid, or overpaid. In this forum, two pairs of respected economists offer very different answers. Andrew Biggs of…

Regenerator seal design

DOEpatents

Eckart, Francis H.

1982-01-01

A rotary regenerator disc matrix has a face seal with a cross arm and arcuate rim segments joined by prestress clamps to prestrain the arcuate rim seals so as to compensate seal rim twisting or coning and resultant disc face seal leakage as produced by operating thermal gradients across the seal.

Reframing the Role of Educational Media Technologies

ERIC Educational Resources Information Center

Westera, Wim

2015-01-01

Distance universities excel in using digital media technologies for content delivery and collaborative interaction to compensate for limited face-to-face opportunities. Now that an ever-growing variety of media technologies, devices, and services are flooding the market, possession of expertise about the educational opportunities of these…

Opening Life's Gifts: Facing Death for a Second Time.

PubMed

Hold, Judith L; Blake, Barbara J; Byrne, Michelle; Varga, Michael

Prior to the development of effective antiretroviral therapy, persons diagnosed with HIV thought they were going to die. Now, long-term survivors are contemplating death again as they age and develop other chronic diseases. The purpose of our study was to understand the experiences of adults living with HIV for 20 or more years as they faced death for a second time. Hermeneutic phenomenology guided the research as participants shared their lived experience through storytelling. Each person's story was audiotaped and transcribed verbatim. Transcript analysis occurred as data were collected. Three common themes from the narratives were identified: Making Choices, Transformation of Fear, and Meaning of Death. Positive and negative pathways influenced each participants' decision-making. Over time, fear of dying was transformed and energy was directed toward living. Even though the participants in this study were facing death again, they recognized it as a natural part of life. Published by Elsevier Inc.

Death and Dying Course Offerings in Psychology: A Survey of Nine Midwestern States

ERIC Educational Resources Information Center

Eckerd, Lizabeth M.

2009-01-01

The certainty of facing death and bereavement and the complex personal and societal issues involved argue for the importance of death education. The current study addresses a gap in knowledge by beginning to assess the extent of dying, death, and bereavement (DD&B) course offerings by U.S. psychology departments. This article reports on data…

Breaking Down Barriers: Hospice Palliative Care as a Human Right in Canada

ERIC Educational Resources Information Center

Freeman, Shannon; Heckman, George; Naus, Peter J.; Marston, Hannah R.

2013-01-01

The need to attend to terminally ill persons and provide improved quality of living and dying should be a national priority in Canada. Hospice palliative care (HPC), a person-centered approach that addresses the needs of the whole person, improves the quality of living and dying of persons facing a life-threatening illness. To ensure Canadians are…

38 CFR 3.703 - Two parents in same parental line.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 3.703 Two parents in same parental line. (a) General. Death compensation or dependency and indemnity... to the surviving spouse on account of the child by reason of the death of another parent in the same parental line where both parents died before June 9, 1960. Where the death of one such parent occurred on...

38 CFR 3.703 - Two parents in same parental line.

Code of Federal Regulations, 2013 CFR

2013-07-01

... § 3.703 Two parents in same parental line. (a) General. Death compensation or dependency and indemnity... to the surviving spouse on account of the child by reason of the death of another parent in the same parental line where both parents died before June 9, 1960. Where the death of one such parent occurred on...

38 CFR 3.703 - Two parents in same parental line.

Code of Federal Regulations, 2011 CFR

2011-07-01

... § 3.703 Two parents in same parental line. (a) General. Death compensation or dependency and indemnity... to the surviving spouse on account of the child by reason of the death of another parent in the same parental line where both parents died before June 9, 1960. Where the death of one such parent occurred on...

38 CFR 3.703 - Two parents in same parental line.

Code of Federal Regulations, 2012 CFR

2012-07-01

... § 3.703 Two parents in same parental line. (a) General. Death compensation or dependency and indemnity... to the surviving spouse on account of the child by reason of the death of another parent in the same parental line where both parents died before June 9, 1960. Where the death of one such parent occurred on...

38 CFR 3.703 - Two parents in same parental line.

Code of Federal Regulations, 2014 CFR

2014-07-01

... § 3.703 Two parents in same parental line. (a) General. Death compensation or dependency and indemnity... to the surviving spouse on account of the child by reason of the death of another parent in the same parental line where both parents died before June 9, 1960. Where the death of one such parent occurred on...

20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

Code of Federal Regulations, 2014 CFR

2014-04-01

... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

Code of Federal Regulations, 2011 CFR

2011-04-01

... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

Code of Federal Regulations, 2010 CFR

2010-04-01

... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

Code of Federal Regulations, 2013 CFR

2013-04-01

... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?

Code of Federal Regulations, 2012 CFR

2012-04-01

... benefits filed? (a) If an employee dies from a work-related traumatic injury or an occupational disease...' COMPENSATION ACT, AS AMENDED Filing Notices and Claims; Submitting Evidence Notices and Claims for Injury.... 8122(b)). (d) The filing of a notice of injury or occupational disease will satisfy the time...

CAD system of design and engineering provision of die forming of compressor blades for aircraft engines

NASA Astrophysics Data System (ADS)

Khaimovich, I. N.

2017-10-01

The articles provides the calculation algorithms for blank design and die forming fitting to produce the compressor blades for aircraft engines. The design system proposed in the article allows generating drafts of trimming and reducing dies automatically, leading to significant reduction of work preparation time. The detailed analysis of the blade structural elements features was carried out, the taken limitations and technological solutions allowed forming generalized algorithms of forming parting stamp face over the entire circuit of the engraving for different configurations of die forgings. The author worked out the algorithms and programs to calculate three dimensional point locations describing the configuration of die cavity. As a result the author obtained the generic mathematical model of final die block in the form of three-dimensional array of base points. This model is the base for creation of engineering documentation of technological equipment and means of its control.

Insights into the Experiences of Older Workers and Change: Through the Lens of Selection, Optimization, and Compensation

ERIC Educational Resources Information Center

Unson, Christine; Richardson, Margaret

2013-01-01

Purpose: The study examined the barriers faced, the goals selected, and the optimization and compensation strategies of older workers in relation to career change. Method: Thirty open-ended interviews, 12 in the United States and 18 in New Zealand, were conducted, recorded, transcribed verbatim, and analyzed for themes. Results: Barriers to…

NMR imaging of density distributions in tablets.

PubMed

Djemai, A; Sinka, I C

2006-08-17

This paper describes the use of (1)H nuclear magnetic resonance (NMR) for 3D mapping of the relative density distribution in pharmaceutical tablets manufactured under controlled conditions. The tablets are impregnated with a compatible liquid. The technique involves imaging of the presence of liquid which occupies the open pore space. The method does not require special calibration as the signal is directly proportional to the porosity for the imaging conditions used. The NMR imaging method is validated using uniform density flat faced tablets and also by direct comparison with X-ray computed tomography. The results illustrate (1) the effect of die wall friction on density distribution by compressing round, curved faced tablets using clean and pre-lubricated tooling, (2) the evolution of density distribution during compaction for both clean and pre-lubricated die wall conditions, by imaging tablets compressed to different compaction forces, and (3) the effect of tablet image on density distribution by compressing two complex shape tablets in identical dies to the same average density using punches with different geometries.

Dynamical compensation and structural identifiability of biological models: Analysis, implications, and reconciliation.

PubMed

Villaverde, Alejandro F; Banga, Julio R

2017-11-01

The concept of dynamical compensation has been recently introduced to describe the ability of a biological system to keep its output dynamics unchanged in the face of varying parameters. However, the original definition of dynamical compensation amounts to lack of structural identifiability. This is relevant if model parameters need to be estimated, as is often the case in biological modelling. Care should we taken when using an unidentifiable model to extract biological insight: the estimated values of structurally unidentifiable parameters are meaningless, and model predictions about unmeasured state variables can be wrong. Taking this into account, we explore alternative definitions of dynamical compensation that do not necessarily imply structural unidentifiability. Accordingly, we show different ways in which a model can be made identifiable while exhibiting dynamical compensation. Our analyses enable the use of the new concept of dynamical compensation in the context of parameter identification, and reconcile it with the desirable property of structural identifiability.

The Life Review in Five Short Stories about Characters Facing Death.

ERIC Educational Resources Information Center

Nicholl, Grier

1985-01-01

Uses five modern short stories about people facing death to illustrate and connect various observations of and theories about the dying process developed by Elisabeth Kubler-Ross and Robert N. Butler. In response to the imminence of their deaths, the characters survey their past, attempting to reintegrate their life's experiences. (JAC)

Lower incisor dentoalveolar compensation and symphysis dimensions among Class I and III malocclusion patients with different facial vertical skeletal patterns.

PubMed

Molina-Berlanga, Núria; Llopis-Perez, Jaume; Flores-Mir, Carlos; Puigdollers, Andreu

2013-11-01

To compare lower incisor dentoalveolar compensation and mandible symphysis morphology among Class I and Class III malocclusion patients with different facial vertical skeletal patterns. Lower incisor extrusion and inclination, as well as buccal (LA) and lingual (LP) cortex depth, and mandibular symphysis height (LH) were measured in 107 lateral cephalometric x-rays of adult patients without prior orthodontic treatment. In addition, malocclusion type (Class I or III) and facial vertical skeletal pattern were considered. Through a principal component analysis (PCA) related variables were reduced. Simple regression equation and multivariate analyses of variance were also used. Incisor mandibular plane angle (P < .001) and extrusion (P  =  .03) values showed significant differences between the sagittal malocclusion groups. Variations in the mandibular plane have a negative correlation with LA (Class I P  =  .03 and Class III P  =  .01) and a positive correlation with LH (Class I P  =  .01 and Class III P  =  .02) in both groups. Within the Class III group, there was a negative correlation between the mandibular plane and LP (P  =  .02). PCA showed that the tendency toward a long face causes the symphysis to elongate and narrow. In Class III, alveolar narrowing is also found in normal faces. Vertical facial pattern is a significant factor in mandibular symphysis alveolar morphology and lower incisor positioning, both for Class I and Class III patients. Short-faced Class III patients have a widened alveolar bone. However, for long-faced and normal-faced Class III, natural compensation elongates the symphysis and influences lower incisor position.

Taking the Sting out of Death: A Christian Educational Perspective

ERIC Educational Resources Information Center

Riley, Clarence E., Jr.; Green, Gregory

2012-01-01

Every day someone is faced with the news that they are dying or that they have a loved one who is dying. Often times this is very unsettling and fear creeps into their hearts for one reason or another. This paper is an attempt to identify the most common reasons for that fear, and offer suggestions for handling that fear in a Christian manner.

Can Individuals Who Are Specialists in Death, Dying, and Bereavement Contribute to the Prevention and/or Mitigation of Armed Conflicts and Cycles of Violence?

ERIC Educational Resources Information Center

Death Studies, 2011

2011-01-01

Specialists in death, dying, and bereavement and their consequences for individuals, families, and communities have experience and research findings that are relevant to an understanding of the reactions of individuals faced by deadly violence. At such times, powerful emotions and ingrained patterns of thought and behavior can given rise to…

Women's reasons for participation in a clinical trial for menstrual pain: a qualitative study

PubMed Central

Blödt, Susanne; Witt, Claudia M; Holmberg, Christine

2016-01-01

Objectives The aim of the study was to explore women's motivations for participating in a clinical trial and to evaluate how financial compensation impacts women's explanations for participation. Design, setting and participants Semistructured interviews were conducted face to face or by telephone with 25 of 220 women who participated in a pragmatic randomised trial for app-administered self-care acupressure for dysmenorrhoea (AKUD). Of these 25 women, 10 had entered AKUD knowing they would receive a financial compensation of €30. A purposive sampling strategy was used. Results Women had a long history of seeking help and were unsatisfied with the options available, namely painkillers and oral contraceptives. While interviewees were open to painkillers, they were uneasy about taking them on a monthly basis. The AKUD trial offered the possibility to find an alternative solution. A second reason for participation was the desire to add a new treatment to routine medical care, for which the interviewees considered randomised trials a prerequisite. The financial incentive was a subsidiary motivation in the interviewees' narratives. Conclusions Our results contribute to the ongoing discussion of the impact of financial compensation on research participants' assessment of risk. The interviewed women considered all research participants able to make their own choices regarding trial participation, even in the face of financial compensation or payment of study participants. Furthermore, the importance of clinical trials providing new treatments that could change medical practice might be an overlooked reason for trial participation and could be used in future recruitment strategies. PMID:27965251

Life of the onion not knowing up from down

NASA Technical Reports Server (NTRS)

Gordeyev, A.

1980-01-01

The absence of the force of gravity has a negative effect on plant life. Plants grown on spacecraft have died prematurely. Tests are being made to discover whether or not electricity will compensate for the absence of gravitation. It was found that an onion under current is not subject to the force of gravity. Tremendous possibilities are opened up by these experiments.

Alcoholism and dampened temporal limbic activation to emotional faces.

PubMed

Marinkovic, Ksenija; Oscar-Berman, Marlene; Urban, Trinity; O'Reilly, Cara E; Howard, Julie A; Sawyer, Kayle; Harris, Gordon J

2009-11-01

Excessive chronic drinking is accompanied by a broad spectrum of emotional changes ranging from apathy and emotional flatness to deficits in comprehending emotional information, but their neural bases are poorly understood. Emotional abnormalities associated with alcoholism were examined with functional magnetic resonance imaging in abstinent long-term alcoholic men in comparison to healthy demographically matched controls. Participants were presented with emotionally valenced words and photographs of faces during deep (semantic) and shallow (perceptual) encoding tasks followed by recognition. Overall, faces evoked stronger activation than words, with the expected material-specific laterality (left hemisphere for words, and right for faces) and depth of processing effects. However, whereas control participants showed stronger activation in the amygdala and hippocampus when viewing faces with emotional (relative to neutral) expressions, the alcoholics responded in an undifferentiated manner to all facial expressions. In the alcoholic participants, amygdala activity was inversely correlated with an increase in lateral prefrontal activity as a function of their behavioral deficits. Prefrontal modulation of emotional function as a compensation for the blunted amygdala activity during a socially relevant face appraisal task is in agreement with a distributed network engagement during emotional face processing. Deficient activation of amygdala and hippocampus may underlie impaired processing of emotional faces associated with long-term alcoholism and may be a part of the wide array of behavioral problems including disinhibition, concurring with previously documented interpersonal difficulties in this population. Furthermore, the results suggest that alcoholics may rely on prefrontal rather than temporal limbic areas in order to compensate for reduced limbic responsivity and to maintain behavioral adequacy when faced with emotionally or socially challenging situations.

Setup of a Parameterized FE Model for the Die Roll Prediction in Fine Blanking using Artificial Neural Networks

NASA Astrophysics Data System (ADS)

Stanke, J.; Trauth, D.; Feuerhack, A.; Klocke, F.

2017-09-01

Die roll is a morphological feature of fine blanked sheared edges. The die roll reduces the functional part of the sheared edge. To compensate for the die roll thicker sheet metal strips and secondary machining must be used. However, in order to avoid this, the influence of various fine blanking process parameters on the die roll has been experimentally and numerically studied, but there is still a lack of knowledge on the effects of some factors and especially factor interactions on the die roll. Recent changes in the field of artificial intelligence motivate the hybrid use of the finite element method and artificial neural networks to account for these non-considered parameters. Therefore, a set of simulations using a validated finite element model of fine blanking is firstly used to train an artificial neural network. Then the artificial neural network is trained with thousands of experimental trials. Thus, the objective of this contribution is to develop an artificial neural network that reliably predicts the die roll. Therefore, in this contribution, the setup of a fully parameterized 2D FE model is presented that will be used for batch training of an artificial neural network. The FE model enables an automatic variation of the edge radii of blank punch and die plate, the counter and blank holder force, the sheet metal thickness and part diameter, V-ring height and position, cutting velocity as well as material parameters covered by the Hensel-Spittel model for 16MnCr5 (1.7131, AISI/SAE 5115). The FE model is validated using experimental trails. The results of this contribution is a FE model suitable to perform 9.623 simulations and to pass the simulated die roll width and height automatically to an artificial neural network.

A review: Application of adhesive bonding on semiconductor interconnection joints

NASA Astrophysics Data System (ADS)

Suppiah, Sarveshvaran; Ong, Nestor Rubio; Sauli, Zaliman; Sarukunaselan, Karunavani; Alcain, Jesselyn Barro; Shahimin, Mukhzeer Mohamad; Retnasamy, Vithyacharan

2017-09-01

A comprehensive review on adhesive die bonding is presented in this paper. Adhesive bonding technique involved electrically conductive adhesives that bond by evaporation of a solvent or by curing a bonding agent with three main parameters; heat, pressure, and time. Isotropic conductive adhesive (ICA) and anisotropic conductive adhesive (ACA) are the commonly used adhesive in this technique. In order to achieve and promote a better adhesion of die on the substrate, surface cleaning steps and methods were very crucial. The major challenge faced by this technique is entrapment of the conductive particles between the die and substrate. An adequate amount of conductive particle is needed between the die and substrate in order to avoid increase in contact resistance.

Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

PubMed

Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

2018-05-15

MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

Otorhinolaryngological patient injuries in Finland.

PubMed

Lehtivuori, Tuuli; Palonen, Reima; Mussalo-Rauhamaa, Helena; Holi, Tarja; Henriksson, Markus; Aaltonen, Leena-Maija

2013-10-01

Otorhinolaryngology (ORL) is considered a specialty associated with few serious patient injuries. Research data that support this belief are, however, scarce. We analyzed claims associated with ORL to determine the number of Finnish cases and the possible common denominators. Register study of ORL cases in the Patient Insurance Centre (PIC), the Regional State Administrative Agencies (RSAA), and the National Supervisory Authority for Welfare and Care (Valvira) during the years 2004 to 2008. These three agencies are the main actors in the field of patient injury in Finland. We analyzed compensated ORL patient injury cases from the PIC and cases associated with the ORL specialty for Valvira and RSAA from 2004 to 2008 and surveyed patient treatment files, statements from specialists, and compensation decisions. Injuries were usually associated with operations; three patients who experienced injuries during these procedures died. Common ORL operations such as tonsillectomy, septoplasty, and paranasal sinus surgery were most often associated with compensated injuries. Serious injuries were few, with a total of 110 out of 422 (26.1%) claims compensated by the PIC. Of the 110 compensated cases, 30 (27.3%) were related to tumor surgery. The most usual compensated case had iatrogenic nerve injury affecting the facial or trigeminal nerves. Of the compensated cases, 79 (71.8%) were treated by specialists, 15 (13.6%) by residents, and the rest by other medical professionals. Patient injuries in ORL are seldom severe and are strongly associated with surgery. A typical compensated injury was one that occurred in a central hospital during working hours. N/A. Copyright © 2013 The American Laryngological, Rhinological, and Otological Society, Inc.

Claims for compensation after alleged birth asphyxia: a nationwide study covering 15 years.

PubMed

Andreasen, Stine; Backe, Bjørn; Øian, Pål

2014-02-01

To analyze compensation claims with neurological sequela or death following alleged birth asphyxia. A cohort study. A nationwide study in Norway. All claims made to The Norwegian System of Compensation to Patients (NPE) concerning sequela related to alleged birth asphyxia, between 1994 and 2008. A total of 315 claims of which 161 were awarded compensation. Examination of hospital records, experts' assessments and the decisions made by the NPE, the appeal body and courts of law. Characteristics of deliveries resulting in intrapartum asphyxia and causes of substandard care categorized in eight groups. In the 161 compensated cases, 107 children survived (96 with neurological sequela), and 54 children died. Human error was a frequent reason of substandard care, seen as inadequate fetal monitoring (50%), lack of clinical knowledge and skills (14%), noncompliance with clinical guidelines (11%), failure in referral for senior medical help (10%) and error in drug administration (4%). System errors were registered in only 3%, seen as poor organization of the department, lack of guidelines and time conflicts. The health personnel held responsible for substandard care was an obstetrician in 49% and a midwife in 46%. Substandard care is common in birth asphyxia, and human error is the cause in most cases. Inadequate fetal monitoring and lack of clinical knowledge and skills are the most frequent reasons for compensation after birth asphyxia. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

OVMS-plus at the LBT: disturbance compensation simplified

NASA Astrophysics Data System (ADS)

Böhm, Michael; Pott, Jörg-Uwe; Borelli, José; Hinz, Phil; Defrère, Denis; Downey, Elwood; Hill, John; Summers, Kellee; Conrad, Al; Kürster, Martin; Herbst, Tom; Sawodny, Oliver

2016-07-01

In this paper we will briefly revisit the optical vibration measurement system (OVMS) at the Large Binocular Telescope (LBT) and how these values are used for disturbance compensation and particularly for the LBT Interferometer (LBTI) and the LBT Interferometric Camera for Near-Infrared and Visible Adaptive Interferometry for Astronomy (LINC-NIRVANA). We present the now centralized software architecture, called OVMS+, on which our approach is based and illustrate several challenges faced during the implementation phase. Finally, we will present measurement results from LBTI proving the effectiveness of the approach and the ability to compensate for a large fraction of the telescope induced vibrations.

Science versus policy in establishing equitable Agent Orange disability compensation policy.

PubMed

Brown, Mark A

2011-07-01

This article makes the case that current Agent Orange compensation policy for Vietnam War veterans is based neither wholly upon scientific findings about Agent Orange health effects nor on pure public health policy considerations. Rather, it is the logical culmination of decades of experience among policy makers and public health scientists trying to establish clear-cut, equitable, and scientifically defensible compensation policy in the face of limited relevant science and poor or nonexistent exposure data-all within the broader context of Veterans Affairs disability compensation policies, and a deep-seated commitment to support the men and women who served their country during the Vietnam War. Finally, attempts to update current policy will benefit from an understanding of this background.

Numerical simulation on chain-die forming of an AHSS top-hat section

NASA Astrophysics Data System (ADS)

Majji, Raju; Xiang, Yang; Ding, Scott; Yang, Chunhui

2018-05-01

The applications of Advanced High-Strength Steels (AHSS) in the automotive industry are rapidly increasing due to a demand for a lightweight material that significantly reduces fuel consumption without compromising passenger safety. Automotive industries and material suppliers are expected by consumers to deliver reliable and affordable products, thus stimulating these manufacturers to research solutions to meet these customer requirements. The primary advantage of AHSS is its extremely high strength to weight ratio, an ideal material for the automotive industry. However, its low ductility is a major disadvantage, in particular, when using traditional cold forming processes such as roll forming and deep drawing process to form profiles. Consequently, AHSS parts frequently fail to form. Thereby, in order to improve quality and reliability on manufacturing AHSS products, a recently-developed incremental cold sheet metal forming technology called Chain-die Forming (CDF) is recognised as a potential solution to the forming process of AHSS. The typical CDF process is a combination of bending and roll forming processes which is equivalent to a roll with a large deforming radius, and incrementally forms the desired shape with split die and segments. This study focuses on manufacturing an AHSS top-hat section with minimum passes without geometrical or surface defects by using finite element modelling and simulations. The developed numerical simulation is employed to investigate the influences on the main control parameter of the CDF process while forming AHSS products and further develop new die-punch sets of compensation design via a numerical optimal process. In addition, the study focuses on the tool design to compensate spring-back and reduce friction between tooling and sheet-metal. This reduces the number of passes, thereby improving productivity and reducing energy consumption and material waste. This numerical study reveals that CDF forms AHSS products of complex profiles with much less residual stress, low spring back, low strain and of higher geometrical accuracy compared to other traditional manufacturing processes.

Understanding Pennsylvania living wills: the 5 Ws.

PubMed

Pina, Linda L

2009-12-01

The working world of nurses is often filled with deep-running emotions and physical exhaustion as we care for our dying patients. We feel the need to step back and gain perspective when faced with a dying patient, or more appropriately, a dying person. We must also keep in mind the family of the dying who may have similar feelings. It is nearly impossible to be a nurse and not have to care for a dying patient; thus, we often find ourselves dealing with living wills. The living will is the more common of the two forms of an advance directive; the other is the durable power of attorney for healthcare. Since living wills are so common, and laws about them vary from state-to-state, it is important for the professional nurse in Pennsylvania to understand how living wills work in our state. This may best be approached by considering the 5 Ws related to living wills.

Women's reasons for participation in a clinical trial for menstrual pain: a qualitative study.

PubMed

Blödt, Susanne; Witt, Claudia M; Holmberg, Christine

2016-12-13

The aim of the study was to explore women's motivations for participating in a clinical trial and to evaluate how financial compensation impacts women's explanations for participation. Semistructured interviews were conducted face to face or by telephone with 25 of 220 women who participated in a pragmatic randomised trial for app-administered self-care acupressure for dysmenorrhoea (AKUD). Of these 25 women, 10 had entered AKUD knowing they would receive a financial compensation of €30. A purposive sampling strategy was used. Women had a long history of seeking help and were unsatisfied with the options available, namely painkillers and oral contraceptives. While interviewees were open to painkillers, they were uneasy about taking them on a monthly basis. The AKUD trial offered the possibility to find an alternative solution. A second reason for participation was the desire to add a new treatment to routine medical care, for which the interviewees considered randomised trials a prerequisite. The financial incentive was a subsidiary motivation in the interviewees' narratives. Our results contribute to the ongoing discussion of the impact of financial compensation on research participants' assessment of risk. The interviewed women considered all research participants able to make their own choices regarding trial participation, even in the face of financial compensation or payment of study participants. Furthermore, the importance of clinical trials providing new treatments that could change medical practice might be an overlooked reason for trial participation and could be used in future recruitment strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Dynamical compensation and structural identifiability of biological models: Analysis, implications, and reconciliation

PubMed Central

2017-01-01

The concept of dynamical compensation has been recently introduced to describe the ability of a biological system to keep its output dynamics unchanged in the face of varying parameters. However, the original definition of dynamical compensation amounts to lack of structural identifiability. This is relevant if model parameters need to be estimated, as is often the case in biological modelling. Care should we taken when using an unidentifiable model to extract biological insight: the estimated values of structurally unidentifiable parameters are meaningless, and model predictions about unmeasured state variables can be wrong. Taking this into account, we explore alternative definitions of dynamical compensation that do not necessarily imply structural unidentifiability. Accordingly, we show different ways in which a model can be made identifiable while exhibiting dynamical compensation. Our analyses enable the use of the new concept of dynamical compensation in the context of parameter identification, and reconcile it with the desirable property of structural identifiability. PMID:29186132

Mammalian X Chromosome Dosage Compensation: Perspectives From the Germ Line.

PubMed

Sangrithi, Mahesh N; Turner, James M A

2018-06-01

Sex chromosomes are advantageous to mammals, allowing them to adopt a genetic rather than environmental sex determination system. However, sex chromosome evolution also carries a burden, because it results in an imbalance in gene dosage between females (XX) and males (XY). This imbalance is resolved by X dosage compensation, which comprises both X chromosome inactivation and X chromosome upregulation. X dosage compensation has been well characterized in the soma, but not in the germ line. Germ cells face a special challenge, because genome wide reprogramming erases epigenetic marks responsible for maintaining the X dosage compensated state. Here we explain how evolution has influenced the gene content and germ line specialization of the mammalian sex chromosomes. We discuss new research uncovering unusual X dosage compensation states in germ cells, which we postulate influence sexual dimorphisms in germ line development and cause infertility in individuals with sex chromosome aneuploidy. © 2018 The Authors. BioEssays Published by Periodicals, Inc.

Working on reform. How workers' compensation medical care is affected by health care reform.

PubMed

Himmelstein, J; Rest, K

1996-01-01

The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies?

Alcoholism and Dampened Temporal Limbic Activation to Emotional Faces

PubMed Central

Marinkovic, Ksenija; Oscar-Berman, Marlene; Urban, Trinity; O’Reilly, Cara E.; Howard, Julie A.; Sawyer, Kayle; Harris, Gordon J.

2013-01-01

Background Excessive chronic drinking is accompanied by a broad spectrum of emotional changes ranging from apathy and emotional flatness to deficits in comprehending emotional information, but their neural bases are poorly understood. Methods Emotional abnormalities associated with alcoholism were examined with functional magnetic resonance imaging in abstinent long-term alcoholic men in comparison to healthy demographically matched controls. Participants were presented with emotionally valenced words and photographs of faces during deep (semantic) and shallow (perceptual) encoding tasks followed by recognition. Results Overall, faces evoked stronger activation than words, with the expected material-specific laterality (left hemisphere for words, and right for faces) and depth of processing effects. However, whereas control participants showed stronger activation in the amygdala and hippocampus when viewing faces with emotional (relative to neutral) expressions, the alcoholics responded in an undifferentiated manner to all facial expressions. In the alcoholic participants, amygdala activity was inversely correlated with an increase in lateral prefrontal activity as a function of their behavioral deficits. Prefrontal modulation of emotional function as a compensation for the blunted amygdala activity during a socially relevant face appraisal task is in agreement with a distributed network engagement during emotional face processing. Conclusions Deficient activation of amygdala and hippocampus may underlie impaired processing of emotional faces associated with long-term alcoholism and may be a part of the wide array of behavioral problems including disinhibition, concurring with previously documented interpersonal difficulties in this population. Furthermore, the results suggest that alcoholics may rely on prefrontal rather than temporal limbic areas in order to compensate for reduced limbic responsivity and to maintain behavioral adequacy when faced with emotionally or socially challenging situations. PMID:19673745

Photomedicine and Stem Cells; The Janus face of photodynamic therapy (PDT) to kill cancer stem cells, and photobiomodulation (PBM) to stimulate normal stem cells

NASA Astrophysics Data System (ADS)

Abrahamse, Heidi; Hamblin, Michael R.

2017-12-01

Janus, the ancient Roman god depicted with two faces is an appropriate metaphor for light therapy. In the right photodynamic therapy conditions, light is able to kill nearly anything that is living such as cancers, microorganisms, parasites, and more. On the opposite face, light of the correct wavelength and proper dose (photobiomodulation) can heal, regenerate, protect, revitalize and restore any kind of dead, damaged, stressed, dying, degenerating cells, tissue, or organ system. This book discusses both sides of Janus' face in regards to light therapy.

From 9/11 to Katrina: Helping Students Grieve

ERIC Educational Resources Information Center

Black, Susan

2005-01-01

Many kids in school will come face-to-face with the death of a close relative or friend. As such, schools need to reach out to grieving students. While it is certainly true that schools cannot compensate for children's severe losses, and it is also true that teachers and counselors cannot assuage children's grief alone, it is also the case that…

Obsessive-Compulsive Disorder

MedlinePlus

... hurt, or die things might be germy or dirty something isn't straight, even, or exactly right ... not doing rituals weakens OCD. They learn and practice ways to face fears. They gain confidence. Kids ...

Obsessive-Compulsive Disorder

MedlinePlus

... hurt, or die things might be germy or dirty something isn't straight, even, or exactly right ... doing rituals weakens OCD. You will learn and practice ways to face fears and ignore worry messages ...

Numerical solutions of pulsating flow and heat transfer characteristics in a channel with a backward-facing step

NASA Astrophysics Data System (ADS)

Valencia, A.; Hinojosa, L.

The incompressible laminar flow of air and heat transfer in a channel with a backward-facing step is studied for steady cases and for pulsatile inlet conditions. For steady flows the influence of the inlet velocity profile, the height of the step and the Reynolds number on the reattachment length is investigated. A parabolic entrance profile was used for pulsatile flow. It was found with amplitude of oscillation of one by Re=100 that the primary vortex breakdown through one pulsatile cycle. The wall shear rate in the separation zone varied markedly with pulsatile flows and the wall heat transfer remained relatively constant. The time-average pulsatile heat transfer at the walls was greater as with steady flow with the same mean Reynolds number. Zusammenfassung Es wird eine zweidimensionale numerische Untersuchung des instationären Wärmeübergangs und Druckverlustes im laminar durchströmten Spaltkanal mit einer plötzlichen Kanalerweiterung dargelegt und zwar für stationäre und periodische Geschwindigkeitsprofile am Eintritt des Kanals. Für stationäre Strömungen wurden die Form des Eintrittsprofils, die Reynoldszahl und die Kanalerweiterung variiert. Als Lösung der Navier/Stokes-und der Energiegleichungen mit periodischen Randbedingungen resultiert eine oszillierende Strömung, die das Aufplatzen des Primärwirbels in einer Schwingungsperiode zur Folge hat. Der Einfluß dieser Oszillation auf den Wärmeübergang und den Strömungsverlust wurde für die maximale Amplitude und für Re=100 eingehend untersucht.

The ethics of hastening death during terminal weaning.

PubMed

Walton, Laura; Bell, Dominic

2013-12-01

Withdrawal of life-sustaining medical treatment (LSMT) is under scrutiny as next-of-kin challenge medical decision-making in the courts and established end-of-life pathways are withdrawn in the face of public criticism. With persistent lobbying for medically assisted dying as the other side of the coin, and professional advice that doctors distance themselves from this activity, the fine line between defensible palliative care and hastening a death needs to be unambiguously defined, particularly with additional confounders such as transplantation initiatives. The medical literature in this domain is dominated by ethical debate on euthanasia and medically assisted dying rather than defensibility within intensive care at the point of withdrawal of LSMT. The process and, therefore, the timing of dying is open to manipulation by intensivists, families, other hospital physicians, courts of law and extraneous influences such as organ donation. Intensivists faced with these challenging processes need to consider some key principles to help them navigate the management of dying. They need to demonstrate transparency in order to engender trust, be responsive to the dynamically evolving needs of patient and family, avoid ambiguity, show consistency and predictability and, finally, they need to conform with society's expectations and professional standards to achieve defensibility for their actions. Adherence to these principles is likely to minimize conflict, maximize patient benefit, maintain public confidence and avoid professional jeopardy.

Application of Face-Gear Drives in Helicopter Transmissions

NASA Technical Reports Server (NTRS)

Litvin, F. L.; Wang, J.-C.; Bossler, R. B., Jr.; Chen, Y.-J. D.; Heath, G.; Lewicki, D. G.

1992-01-01

The use of face gears in helicopter transmissions was explored. A light-weight, split torque transmission design utilizing face gears was described. Face-gear design and geometry were investigated. Topics included tooth generation, limiting inner and outer radii, tooth contact analysis, contact ratio, gear eccentricity, and structural stiffness. Design charts were developed to determine minimum and maximum face-gear inner and outer radii. Analytical study of transmission error showed face-gear drives were relatively insensitive to gear misalignment, but tooth contact was affected by misalignment. A method of localizing bearing contact to compensate for misalignment was explored. The proper choice of shaft support stiffness enabled good load sharing in the split torque transmission design. Face-gear experimental studies were also included and the feasibility of face gears in high-speed, high-load applications such as helicopter transmissions was demonstrated.

Method of assembling a thermal expansion compensator

NASA Technical Reports Server (NTRS)

Matejczyk, Daniel Edward (Inventor); Determan, William (Inventor)

2012-01-01

A thermal expansion compensator is provided and includes a first electrode structure having a first surface, a second electrode structure having a second surface facing the first surface and an elastic element bonded to the first and second surfaces and including a conductive element by which the first and second electrode structures electrically and/or thermally communicate, the conductive element having a length that is not substantially longer than a distance between the first and second surfaces.

A long-term evaluation of the stage of change approach and compensable injury outcomes - a cluster-randomised trial.

PubMed

Rothmore, Paul; Aylward, Paul; Gray, Jodi; Karnon, Jonathan

2017-05-01

This study investigated the long-term injury outcomes for workers in companies from a range of industries which had been randomly allocated to receive ergonomics interventions tailored according to the stage of change (SOC) approach or standard ergonomics advice. Differences in compensable injury outcomes between the groups were analysed using logistic regression models. Questionnaire results from face-to-face interviews to assess musculoskeletal pain and discomfort (MSPD), job satisfaction and other factors were also analysed. Although not significant at the 0.05 level, after adjusting for workgroup clustering, workers in receipt of tailored advice were 55% (OR = 0.45, 95% CI = 0.19-1.08) less likely to report a compensable injury than those in receipt of standard ergonomics advice. Workload, job satisfaction and MSPD were significantly correlated with injury outcomes. The observed outcomes support the potential value of the SOC approach, as well as highlighting the need to consider workload, job satisfaction and MSPD when planning injury prevention programmes. Practitioner Summary: This study investigated compensable injury outcomes for workers who had received ergonomics advice tailored according to the stage of change (SOC) approach compared with standard ergonomics advice. The results support the potential value of the SOC approach and highlight the need to consider workload, job satisfaction and musculoskeletal pain and discomfort when planning injury prevention interventions.

Enhance End-of-Life Care

MedlinePlus

... care provided to a dying patient. It includes palliative care (easing symptoms, such as pain) for those faced ... live. Ideally, all health care planning should include palliative care at the time of diagnosis of any life- ...

Defense Small Business Innovation Research Program (SBIR). Volume 2. Navy Abstracts of Phase 1 Awards 1991

DTIC Science & Technology

1991-01-01

NAVY ABSTRACTS OF SBIR PHASE I AWARDS mmhancemegs to be added. Advanced processor architeturs which u- new technology hardware and software for...Adaptive Compensation System for Performance Improvenent of piezoelectric Hydropbones Abstract: Hydopbone output level is, in gena, insly proportional to die...growth rate is proportional to the mode frequency and under optimal conditions, the cavity mode TMI 10 exponcntiates in only 10 oscillation periods. In

United States Army Rangers in Somalia: an analysis of combat casualties on an urban battlefield.

PubMed

Mabry, R L; Holcomb, J B; Baker, A M; Cloonan, C C; Uhorchak, J M; Perkins, D E; Canfield, A J; Hagmann, J H

2000-09-01

This study was undertaken to determined the differences in injury patterns between soldiers equipped with modern body armor in an urban environment compared with the soldiers of the Vietnam War. From July 1998 to March 1999, data were collected for a retrospective analysis on all combat casualties sustained by United States military forces in Mogadishu, Somalia, on October 3 and 4, 1993. This was the largest and most recent urban battle involving United States ground forces since the Vietnam War. There were 125 combat casualties. Casualty distribution was similar to that of Vietnam; 11% died on the battlefield, 3% died after reaching a medical facility, 47% were evacuated, and 39% returned to duty. The incidence of bullet wounds in Somalia was higher than in Vietnam (55% vs. 30%), whereas there were fewer fragment injuries (31% vs. 48%). Blunt injury (12%) and burns (2%) caused the remaining injuries in Somalia. Fatal penetrating injuries in Somalia compared with Vietnam included wounds to the head and face (36% vs. 35%), neck (7% vs. 8%), thorax (14% vs. 39%), abdomen (14% vs. 7%), thoracoabdominal (7% vs. 2%), pelvis (14% vs. 2%), and extremities (7% vs. 7%). No missiles penetrated the solid armor plate protecting the combatants' anterior chests and upper abdomens. Most fatal penetrating injuries were caused by missiles entering through areas not protected by body armor, such as the face, neck, pelvis, and groin. Three patients with penetrating abdominal wounds died from exsanguination, and two of these three died after damage-control procedures. The incidence of fatal head wounds was similar to that in Vietnam in spite of modern Kevlar helmets. Body armor reduced the number of fatal penetrating chest injuries. Penetrating wounds to the unprotected face, groin, and pelvis caused significant mortality. These data may be used to design improved body armor.

Daughters caring for dying parents: a process of relinquishing.

PubMed

Read, Trudy; Wuest, Judith

2007-09-01

Caring for elderly, dying parents is challenging for daughters as they try to balance other obligations and responsibilities. The purpose of this grounded theory study was to explain the domain of daughters' caregiving experiences in Newfoundland and Labrador, Canada. The primary author interviewed 12 women whose parents had died. Three types of turmoil (emotional, relational, and societal) emerged as the central issue for these women. The authors discovered a substantive theory of Relinquishing with interdependent processes of Keeping Vigil, Navigating Systems, Facing Loss, and an end process of Coming to Terms. In moving through the process of Relinquishing, social conditions of personal ideals, family expectations, and societal demands determine strategies employed by any one daughter to manage her turmoil. The findings fill a gap in knowledge related to daughters' caregiving for dying parents by contributing a theoretical framework that will inform women, health care providers, researchers, and health policy makers.

Perspectives of Canadian oocyte donors and recipients on donor compensation and the establishment of a personal health information registry.

PubMed

Blyth, Eric; Yee, Samantha; Ka Tat Tsang, A

2012-01-01

We report the views of 33 women who were involved in an altruistic oocyte donation program about provisions under Canada's Assisted Human Reproduction Act 2004 to prohibit donor compensation and to establish a Personal Health Information Registry. The participants had been either donors of oocytes to a recipient known to them (15) or recipients of such donation (18) through services provided by a clinic in a large Canadian city, and they each participated in a semi-structured face-to-face or telephone interview. Among the 15 donor participants, seven were friends of the recipient, six were sisters, one was a niece of the recipient, and one donor donated twice, once to her sister and once to a friend. In eight cases the donor and recipient participated in interviews independently. At the time of interview, 11 of the 25 separate cases had resulted in a live birth and one in an ongoing pregnancy, so that "successful" and "unsuccessful" donations were equally represented among participants. While divergent views were reported among and between donors and recipients on an altruistic model versus a compensated model of donation, most participants largely endorsed the establishment of a personal health information registry.

Dying at home in rural residential aged care: A mixed-methods study in the Snowy Monaro region, Australia.

PubMed

Rainsford, Suzanne; Phillips, Christine B; Glasgow, Nicholas J; MacLeod, Roderick D; Wiles, Robert B

2018-05-16

Residential aged care (RAC) is a significant provider of end-of-life care for people aged 65 years and older. Rural residents perceive themselves as different to their urban counterparts. Most studies describing place of death (PoD) in RAC are quantitative and reflect an urban voice. Using a mixed-methods design, this paper examines the PoD of 80 RAC residents (15 short-stay residents who died in RAC during respite or during an attempted step-down transition from hospital to home, and 65 permanent residents), within the rural Snowy Monaro region, Australia, who died between 1 February 2015 and 31 May 2016. Death data were collected from local funeral directors, RAC facilities, one multi-purpose heath service and obituary notices in the local media. The outcome variable was PoD: RAC, local hospital or out-of-region tertiary hospital. For the permanent RAC residents, the outcome of interest was dying in RAC or dying in hospital. Cross tabulations by PoD and key demographic data were performed. Pearson Chi squared tests and exact p-values were used to determine if any of the independent variables were associated with PoD. Using an ethnographic approach, data were collected from 12 face-to-face, open-ended interviews with four RAC residents, with a life expectancy of ≤6 months, and six family caregivers. Interviews were audio-recorded, transcribed and analysed thematically. Fifty-one (78.5%) of the permanent residents died in RAC; 21.5% died in hospital. Home was the initial preferred POD for most interviewed participants; most eventually accepted the transfer to RAC. Long-term residents considered RAC to be their "home"-a familiar place, and an important part of their rural community. The participants did not consider a transfer to hospital to be necessary for end-of-life care. Further work is required to explore further the perspectives of rural RAC residents and their families, and if transfers to hospital are avoidable. © 2018 John Wiley & Sons Ltd.

Application of discrete choice experiment to assess farmers' willingness to report swine diseases in the Red River Delta region, Vietnam.

PubMed

Pham, Hoa T T; Peyre, Marisa; Trinh, Tuyen Quang; Nguyen, Oanh Cong; Vu, Ton Dinh; Rukkwamsuk, Theera; Antoine-Moussiaux, Nicolas

2017-03-01

A discrete choice experiment (DCE) is carried out to value socio-economic factors influencing the farmer's decision to report swine diseases and to assess the willingness of farmers to report swine diseases. Data were collected between March and July 2015 in two provinces in the Red River Delta, Northern Vietnam, from 196 pig producers by face-to face interview. A conditional logit model is used to measure the relative importance of the socio-economic factors and calculate the expected probability of disease reporting under changes of levels of these factors. Results of the study indicated that the likelihood of compensation and the type of culling implemented (all or only unrecovered pigs) are the two most important factors influencing farmer reporting. Compensation level, movement restriction and delay in compensation payment also have significant impacts on farmer's decision to report animal disease but they are not as important as the above factors. Three different scenarios including changes in six different factors (attributes) are tested to predict probability of animal disease reporting. Under the current situation (uncertainty of being compensated), only 4% of the farmers would report swine disease outbreak to the official surveillance system if the culling policy involves all pigs in affected farms. This number is increased to 26% if culling in affected farms is restricted to unrecovered pigs only. Ensuring certainty of compensation increases reporting probability by up to 50% and 90% if all or only unrecovered pigs are destroyed, respectively. The results of this study are important for improving the performance and sustainability of swine disease surveillance system in Vietnam. Copyright © 2017 Elsevier B.V. All rights reserved.

Forest Ecosystem Services and Eco-Compensation Mechanisms in China

NASA Astrophysics Data System (ADS)

Deng, Hongbing; Zheng, Peng; Liu, Tianxing; Liu, Xin

2011-12-01

Forests are a major terrestrial ecosystem providing multiple ecosystem services. However, the importance of forests is frequently underestimated from an economic perspective because of the externalities and public good properties of these services. Forest eco-compensation is a transfer mechanism that serves to internalize the externalities of forest ecosystem services by compensating individuals or companies for the losses or costs resulting from the provision of these services. China's current forest eco-compensation system is centered mainly on noncommercial forest. The primary measures associated with ecosystem services are (1) a charge on destructive activities, such as indiscriminate logging, and (2) compensation for individual or local activities and investments in forest conservation. The Compensation Fund System for Forest Ecological Benefits was first listed in the Forest Law of the People's Republic of China in 1998. In 2004, the Central Government Financial Compensation Fund, an important source for the Compensation Fund for Forest Ecological Benefits, was formally established. To improve the forest eco-compensation system, it is crucial to design and establish compensation criteria for noncommercial forests. These criteria should take both theoretical and practical concerns into account, and they should be based on the quantitative valuation of ecosystem services. Although some initial headway has been made on this task, the implementation of an effective forest eco-compensation system in China still has deficiencies and still faces problems. Implementing classification-based and dynamic management for key noncommercial forests and establishing an eco-compensation mechanism with multiple funding sources in the market economy are the key measures needed to conquer these problems and improve the forest eco-compensation system and China's forestry development in sequence.

NASA Ultra-Sensitive Miniature Accelerometer

NASA Technical Reports Server (NTRS)

Zavracky, Paul M.; Hartley, Frank T.

1994-01-01

Using micro-machined silicon technology, an ultra-sensitive miniature acce.,rometer can be constructed which meets the requirements for microgravity experiments in the space environment.Such an accelerometer will have a full scale sensitivity of 1C2 g a resolution of lC8 g, low cross axis sensitivity, and low temperature sensitivity. Mass of the device is approximately five grams and its footprint is 2 cm x 2 cm. Innovative features of the accelerometer, which are patented, are: electrostatic caging to withstand handling shock up to 150 g, in-situ calibration, in situ performance characterization, and both static and dynamic compensation. The transducer operates on a force balance principle wherein the displacement of the proof mass is monitored by measuring tunneling electron current flow between a conductive tip, and a fixed platen. The four major parts of the accelerometer are tip die, incorporating the tunneling tip and four field plates for controlling pitch and roll of the proof mass; two proof mass dies, attached to the surrounding frame by sets of four leg" springs; and a force plate die. The four parts are fuse-bonded into a complete assembly. External electrical connections are made at bond pads on the front surface of the force plate die. Materials and processes used in the construction of the transducer are compatible with volume production.

Shifting hospital-hospice boundaries: historical perspectives on the institutional care of the dying.

PubMed

Risse, Guenter B; Balboni, Michael J

2013-06-01

Social forces have continually framed how hospitals perceive their role in care of the dying. Hospitals were originally conceived as places of hospitality and spiritual care, but by the 18th century illness was an opponent, conquered through science. Medicalization transformed hospitals to places of physical cure and scientific prowess. Death was an institutional liability. Equipped with new technologies, increased public demand, and the establishment of Medicare in 1965, modern hospitals became the most likely place for Americans to die--increasing after the 1940s and spiking in the 1990s. Medicare's 1983 hospice benefit began to reverse this trend. Palliative care has more recently proliferated, suggesting an institutional shift of alignment with traditional functions of care toward those facing death.

77 FR 55271 - Truth in Lending Act (Regulation Z); Loan Originator Compensation

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... otherwise face radical restructuring of its existing pricing structures and practices to comply with the new... what terms they can expect.\\23\\ Moreover, prior to 2010, mortgage brokers were free to charge consumers...

Achieving Gender Equity in Physician Compensation and Career Advancement: A Position Paper of the American College of Physicians.

PubMed

Butkus, Renee; Serchen, Joshua; Moyer, Darilyn V; Bornstein, Sue S; Hingle, Susan Thompson

2018-05-15

Women comprise more than one third of the active physician workforce, an estimated 46% of all physicians-in-training, and more than half of all medical students in the United States. Although progress has been made toward gender diversity in the physician workforce, disparities in compensation exist and inequities have contributed to a disproportionately low number of female physicians achieving academic advancement and serving in leadership positions. Women in medicine face other challenges, including a lack of mentors, discrimination, gender bias, cultural environment of the workplace, imposter syndrome, and the need for better work-life integration. In this position paper, the American College of Physicians summarizes the unique challenges female physicians face over the course of their careers and provides recommendations to improve gender equity and ensure that the full potential of female physicians is realized.

Attitudes and experiences of nurses toward death and caring for dying patients in Turkey.

PubMed

Cevik, Banu; Kav, Sultan

2013-01-01

Caring of the dying patients and facing the death can be a stressful and difficult experience for nurses. Besides personal and professional experiences, nurses' own attitudes toward death may affect the care given to dying individuals. The aim of this study was to examine Turkish nurses' attitudes toward and experiences with death and caring for dying patients. A descriptive, cross-sectional study was conducted at 2 university hospitals and 1 state hospital located in Ankara, Turkey. Data were collected via sociodemographics form, the Death Attitude Profile-Revised, and Frommelt's Attitude Toward Caring for Dying Patients. The attitudes of Turkish nurses toward death and caring for dying patients are less positive than the reported attitudes of nurses in other studies. Significant relationships were found among level of education, willingness to care for dying patients, and scores on Frommelt's Attitude Toward Caring for Dying Patients and on Death Attitude Profile-Revised subscales (P < .05). Although the majority of nurses (85%) stated that they had received education on end of life, most of them (82%) were not comfortable talking about death. A lack of education and experience may contribute to the negative attitudes. Providing a reflective narrative environment in which nurses can express their personal feelings about death and dying could be a potentially effective approach. This study highlights the need for further educational research and development of better educational programs to help nurses to explore and understand their attitudes toward death, overcome fears, increase communication skills, and enhance coping strategies.

Spinal cord injuries in South African Rugby Union (1980 - 2007).

PubMed

Hermanus, Fiona J; Draper, Catherine E; Noakes, Timothy D

2010-03-30

To address an apparent increase in the number of rugby-related spinal cord injuries (SCIs) in South Africa, a retrospective case-series study was conducted on injuries that occurred between 1980 and 2007. We aimed to identify preventable causes to reduce the overall rate of SCIs in South African rugby. We identified 264 rugby-related SCIs. A structured questionnaire was used, and it was possible to obtain information on a total of 183 players, including 30 who had died. SCIs increased in number in the 1980s and in 2006. Forwards sustained 76% of all SCIs, and club players 60%. Players aged 17 had the highest number of SCIs. In only 50% of cases were medical personnel present at the time of injury, and 49% of injured players waited longer than 6 hours for acute management. Of players with an SCI, 61% had a catastrophic outcome after 12 months, including 8% who died during that time; 65% received no financial compensation; and only 29% of players had medical aid or health insurance. A register of all rugby-related SCIs in South Africa is essential to monitor the magnitude of the problem, identify potential risk factors, and formulate appropriate preventive interventions. The lack of reliable denominator data limits calculation of incident rates. Players from previously disadvantaged communities in particular suffered the consequences of limited public health care resources and no financial compensation.

Solar cooking

USDA-ARS?s Scientific Manuscript database

Over two billion people face fuel wood shortages, causing tremendous personal and environmental stress. Over 4 million people die prematurely from indoor air pollution. Solar cooking can reduce fuel wood consumption and indoor air pollution. Solar cooking has been practiced and published since th...

The impact of no-fault compensation on health care expenditures: an empirical study of OECD countries.

PubMed

Vandersteegen, Tom; Marneffe, Wim; Cleemput, Irina; Vereeck, Lode

2015-03-01

Around the world, governments are faced with spiralling health care expenditures. This raises the need for further insight in the determinants of these expenditures. Existing literature focuses primarily on income, ageing, health care financing and supply variables. This paper includes medical malpractice system characteristics as determinants of health spending in OECD countries. Estimates from our regression models suggest that no-fault schemes for medical injuries with decoupling of deterrence and compensation reduce health expenditures per capita by 0.11%. Furthermore, countries that introduced a no-fault system without decoupling of deterrence and compensation are found to have higher (+0.06%) health care spending. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Adaptive non-local smoothing-based weberface for illumination-insensitive face recognition

NASA Astrophysics Data System (ADS)

Yao, Min; Zhu, Changming

2017-07-01

Compensating the illumination of a face image is an important process to achieve effective face recognition under severe illumination conditions. This paper present a novel illumination normalization method which specifically considers removing the illumination boundaries as well as reducing the regional illumination. We begin with the analysis of the commonly used reflectance model and then expatiate the hybrid usage of adaptive non-local smoothing and the local information coding based on Weber's law. The effectiveness and advantages of this combination are evidenced visually and experimentally. Results on Extended YaleB database show its better performance than several other famous methods.

Working on reform. How workers' compensation medical care is affected by health care reform.

PubMed Central

Himmelstein, J; Rest, K

1996-01-01

The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies? Images p13-a p14-a p15-a p16-a p18-a p19-a p20-a p22-a p24-a PMID:8610187

Applications of multi-walled carbon nanotube in electronic packaging

PubMed Central

2012-01-01

Thermal management of integrated circuit chip is an increasing important challenge faced today. Heat dissipation of the chip is generally achieved through the die attach material and solders. With the temperature gradients in these materials, high thermo-mechanical stress will be developed in them, and thus they must also be mechanically strong so as to provide a good mechanical support to the chip. The use of multi-walled carbon nanotube to enhance the thermal conductivity, and the mechanical strength of die attach epoxy and Pb-free solder is demonstrated in this work. PMID:22405035

Possibility of dying as a unified explanation of why we discount the future, get weaker with age, and display risk-aversion.

PubMed

Chowdhry, Bhagwan

2011-01-01

I formulate a simple and parsimonious evolutionary model that shows that because most species face a possibility of dying because of external factors, called extrinsic mortality in the biology literature, it can simultaneously explain (a) why we discount the future, (b) get weaker with age, and (c) display risk-aversion. The paper suggests that testable restrictions—across species, across time, or across genders—among time preference, aging, and risk-aversion could be analyzed in a simple framework .

The human resource crisis in neuro-ophthalmology.

PubMed

Frohman, Larry P

2008-09-01

Neuro-ophthalmology is facing a serious human resource issue. Few are entering the subspecialty, which is perceived as being poorly compensated compared with other subspecialties of ophthalmology. The low compensation comes from the fact that 1) non-procedural encounters remain undervalued, 2) efforts that benefit other medical specialists are not counted, and 3) the relatively low expenses of neuro-ophthalmologists are not factored into compensation formulas. Mission-based budgeting, which forces academic departments to be financially accountable without the expectation of fiscal relief from medical schools or practice plans, has exacerbated the compensation issue. Solutions must come from within neuro-ophthalmology, academic departments, medical schools, and medical practice plans. They include 1) providing educational resources so that neuro-ophthalmologists need not spend so much time teaching the basics, 2) factoring into compensation the impact of neuro-ophthalmologists in teaching and on revenue generation by procedure-based specialists, 3) improving the efficiency of neuro-ophthalmologists in their consultative practices by providing ample clerical support and other measures, 4) providing contractual salary compensation by departments such as neurosurgery to recognize the contributions made by neuro-ophthalmologists, and 5) reorganizing the academic clinical effort as multidisciplinary rather than departmental.

The construction FACE database - Codifying the NIOSH FACE reports.

PubMed

Dong, Xiuwen Sue; Largay, Julie A; Wang, Xuanwen; Cain, Chris Trahan; Romano, Nancy

2017-09-01

The National Institute for Occupational Safety and Health (NIOSH) has published reports detailing the results of investigations on selected work-related fatalities through the Fatality Assessment and Control Evaluation (FACE) program since 1982. Information from construction-related FACE reports was coded into the Construction FACE Database (CFD). Use of the CFD was illustrated by analyzing major CFD variables. A total of 768 construction fatalities were included in the CFD. Information on decedents, safety training, use of PPE, and FACE recommendations were coded. Analysis shows that one in five decedents in the CFD died within the first two months on the job; 75% and 43% of reports recommended having safety training or installing protection equipment, respectively. Comprehensive research using FACE reports may improve understanding of work-related fatalities and provide much-needed information on injury prevention. The CFD allows researchers to analyze the FACE reports quantitatively and efficiently. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

Dying Is Unexpectedly Positive.

PubMed

Goranson, Amelia; Ritter, Ryan S; Waytz, Adam; Norton, Michael I; Gray, Kurt

2017-07-01

In people's imagination, dying seems dreadful; however, these perceptions may not reflect reality. In two studies, we compared the affective experience of people facing imminent death with that of people imagining imminent death. Study 1 revealed that blog posts of near-death patients with cancer and amyotrophic lateral sclerosis were more positive and less negative than the simulated blog posts of nonpatients-and also that the patients' blog posts became more positive as death neared. Study 2 revealed that the last words of death-row inmates were more positive and less negative than the simulated last words of noninmates-and also that these last words were less negative than poetry written by death-row inmates. Together, these results suggest that the experience of dying-even because of terminal illness or execution-may be more pleasant than one imagines.

Existential concerns about death: a qualitative study of dying patients in a Danish hospice.

PubMed

Moestrup, Lene; Hansen, Helle Ploug

2015-06-01

Research suggests that addressing dying patients' existential concerns can improve their quality of life. We aimed to illuminate dying patients' existential concerns about the impending death through a descriptive analysis of semistructured interviews with 17 patients in Danish hospices. The main findings demonstrated how the patients faced the imminent death without being anxious of death but sorrowful about leaving life. Some patients expressed that they avoided thinking about death. They wished to focus on positive aspects in their daily life. We argue that the patients' existential concerns could not be fully captured by Yalom's existential psychology or by Kübler-Ross's theory about death stages. Patients' complex concerns could be more fully explained taking an outset in Heidegger's phenomenological thinking. © The Author(s) 2014.

Living with Dying in the Pediatric Intensive Care Unit: A Nursing Perspective.

PubMed

Stayer, Debbie; Lockhart, Joan Such

2016-07-01

Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units. To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children's families. A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences. Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child's death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support. Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children's families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying. ©2016 American Association of Critical-Care Nurses.

Thoughts about Dying in America: Enhancing the impact of one's life journey and legacy by also planning for the end of life.

PubMed

Pizzo, Philip A

2016-11-15

This Perspective offers a summary of the recommendations in the Institute of Medicine report Dying in America How we die is a deeply personal issue that each of us will face. However, the approach to end-of-life (EOL) care in the United States needs improvement. Too frequently, healthcare delivery is uncoordinated and has many providers who are not adequately prepared to have meaningful conversations about EOL planning. This is amplified by payment systems and policies that create impediments, misunderstanding, and sometimes misinformation. Dying in America made five recommendations to improve quality and honor individual preferences near the EOL beginning with making conversations with providers and families something that occurs during various phases of the life cycle and not just when one is facing serious illness or possible EOL. It was recommended (i) that public and private payers and care delivery organizations cover the provision of comprehensive care that is accessible and available to individuals on a 24/7 schedule; (ii) that professional societies and other entities establish standards for clinician patient communication and advance care planning and that payers and care delivery organizations adopt them; (iii) that educational institutions, credentialing bodies, accrediting boards, state regulatory agencies, and care delivery organizations establish palliative care training, certification, and/or licensure requirements; (iv) that public and private payers and care delivery organizations integrate the financing of health and social services; and (v) that public and private organizations should engage their constituents and provide fact-based information to encourage advance care planning and informed choice.

Efficient dense blur map estimation for automatic 2D-to-3D conversion

NASA Astrophysics Data System (ADS)

Vosters, L. P. J.; de Haan, G.

2012-03-01

Focus is an important depth cue for 2D-to-3D conversion of low depth-of-field images and video. However, focus can be only reliably estimated on edges. Therefore, Bea et al. [1] first proposed an optimization based approach to propagate focus to non-edge image portions, for single image focus editing. While their approach produces accurate dense blur maps, the computational complexity and memory requirements for solving the resulting sparse linear system with standard multigrid or (multilevel) preconditioning techniques, are infeasible within the stringent requirements of the consumer electronics and broadcast industry. In this paper we propose fast, efficient, low latency, line scanning based focus propagation, which mitigates the need for complex multigrid or (multilevel) preconditioning techniques. In addition we propose facial blur compensation to compensate for false shading edges that cause incorrect blur estimates in people's faces. In general shading leads to incorrect focus estimates, which may lead to unnatural 3D and visual discomfort. Since visual attention mostly tends to faces, our solution solves the most distracting errors. A subjective assessment by paired comparison on a set of challenging low-depth-of-field images shows that the proposed approach achieves equal 3D image quality as optimization based approaches, and that facial blur compensation results in a significant improvement.

Compensatory internet use among individuals higher in social anxiety and its implications for well-being

PubMed Central

Weidman, Aaron C.; Fernandez, Katya C.; Levinson, Cheri A.; Augustine, Adam A; Larsen, Randy J.; Rodebaugh, Thomas L.

2012-01-01

The social compensation hypothesis states that the internet primarily benefits individuals who feel uncomfortable communicating face-to-face. In the current research, we tested whether individuals higher in social anxiety use the internet as a compensatory social medium, and whether such use is associated with greater well-being. In Study 1, individuals higher in social anxiety reported greater feelings of comfort and self-disclosure when socializing online than less socially anxious individuals, but reported less self-disclosure when communicating face-to-face. However, in Study 2, social anxiety was associated with lower quality of life and higher depression most strongly for individuals who communicated frequently online. Our results suggest that, whereas social anxiety may be associated with using the internet as an alternative to face-to-face communication, such a strategy may result in poorer well-being. PMID:22791928

Compensatory internet use among individuals higher in social anxiety and its implications for well-being.

PubMed

Weidman, Aaron C; Fernandez, Katya C; Levinson, Cheri A; Augustine, Adam A; Larsen, Randy J; Rodebaugh, Thomas L

2012-08-01

The social compensation hypothesis states that the internet primarily benefits individuals who feel uncomfortable communicating face-to-face. In the current research, we tested whether individuals higher in social anxiety use the internet as a compensatory social medium, and whether such use is associated with greater well-being. In Study 1, individuals higher in social anxiety reported greater feelings of comfort and self-disclosure when socializing online than less socially anxious individuals, but reported less self-disclosure when communicating face-to-face. However, in Study 2, social anxiety was associated with lower quality of life and higher depression most strongly for individuals who communicated frequently online. Our results suggest that, whereas social anxiety may be associated with using the internet as an alternative to face-to-face communication, such a strategy may result in poorer well-being.

Death and caring for dying patients: exploring first-year nursing students' descriptive experiences.

PubMed

Ek, Kristina; Westin, Lars; Prahl, Charlotte; Osterlind, Jane; Strang, Susann; Bergh, Ingrid; Hammarlund, Kina

2014-10-01

To describe first-year nursing students' experiences of witnessing death and providing end-of-life care. This study is part of a larger longitudinal project. Interviews (n=17) were conducted with nursing students at the end of their first year of education. To analyse the interviews (lived-experience descriptions), a thematic analysis, 'a search for meaning' ( Van Manen, 1997 ) was applied. The results are presented within the framework of four separate themes: (1) The thought of death is more frightening than the actual experience, (2) Daring to approach the dying patient and offering something of oneself, (3) The experience of not sufficing in the face of death and (4) Being confronted with one's own feelings. Nursing students require continuous support and opportunity to reflect and discuss their experiences about caring for dying patients and confronting death throughout the entirety of their education. In addition, teachers and clinical supervisors need to give support using reflective practice to help students to develop confidence in their capacity for caring for dying patients.

Conditions of life and death of psychiatric patients in France during World War II: euthanasia or collateral casualties?

PubMed

Lemoine, Patrick; Stahl, Stephen M

2018-04-01

Between 1940 and 1944, an estimated 48,588 patients resident in French psychiatric hospitals died of starvation. Standard prisons, while facing similar problems, did not experience the same number of deaths by starvation, partly due to their ability to develop a black market for food and rations. Patients in psychiatric hospitals, on the other hand, were completely at the mercy of their doctors and the personnel in charge. At Hôpital du Vinatier, a psychiatric facility in Lyon, the mortality rate increased sharply from 1940 to 1944. In 1942, the worst year, 42% of patients died of hunger and exposure. In the end, more than 2,000 patients died at Vinatier. Was this due to a supposed lack of rations, or was it something more sinister? In Germany at the same time, tens of thousands of psychiatric patients died of purposeful starvation in psychiatric hospitals as part of the Nazi program of psychiatric euthanasia. Was the same thing occurring in Lyon?

Creating beauty: creativity compensates for low physical attractiveness when individuals assess the attractiveness of social and romantic partners.

PubMed

Watkins, Christopher D

2017-04-01

Although creativity is attractive in a potential mate, it is unclear (i) whether the effects of creativity on attractiveness generalize to other social contexts and (ii) whether creativity has equivalent effects on men's and women's attractiveness. As social knowledge of creativity may either enhance or 'offset' the appeal of social partners who differ in physical attractiveness, three repeated measures experiments were conducted to directly address these issues. Here, participants rated a series of face-text pairs for attractiveness on trials that differed in one of four combinations of facial attractiveness (attractive and less attractive) and creativity (creative and less creative), rating story-tellers in two experiments (short interpretations of an identical painting) and creative ideas in a further experiment (alternative uses for an everyday object). Regardless of the sex of the judge, creativity and facial attractiveness had independent effects on men's overall attractiveness (initial experiment) and, in further experiments, more substantial effects on the attractiveness of men with less attractive faces than men with attractive faces (when using a different measure of creativity) and specific effects on the attractiveness of individuals with less attractive faces (when using different face stimuli). Collectively, across three experiments, these findings suggest that creativity may compensate for putative cues to lower biological 'quality' and that the benefits of creativity to social groups more generally enhance attraction to creative men (in two experiments) and creative men and women (one experiment). More broadly, the data suggest that species can integrate knowledge of cognitive intelligence with visual cues to biological 'quality' to facilitate mate and/or ally choice.

Dying means suffocating: perceptions of people living with severe COPD facing the end of life.

PubMed

Hall, Sylvie; Legault, Alan; Côté, José

2010-09-01

The purpose of this research was to describe the perceptions of people living with severe chronic obstructive pulmonary disease (COPD) with respect to the end of life. For this descriptive exploratory qualitative study, semi-structured interviews were conducted with six participants suffering from severe COPD hospitalized in the past year following an exacerbation episode. The data were analyzed using the method developed by Miles and Huberman (2003), which comprises three main steps: data reduction, data display, and conclusion drawing/verification. The analysis yielded four themes that reflect the perceptions of participants with respect to the end of life, namely: living and seeing oneself decline, living and preparing to die, dying of COPD means suffocating, and dying in hospital surrounded by family and friends. What emerges from the study is that persons living with severe COPD wish to die without suffocating, in hospital, surrounded by family and friends, all the while hoping to go on living. This study contributes to a more comprehensive understanding of the end-of-life experience. It shows the importance of accompanying these persons properly towards the end of life and at the moment of dying. The study proposes a series of avenues for future research and makes recommendations for practice.

Progress in Medicine: Compensation and medical negligence in India: Does the system need a quick fix or an overhaul?

PubMed Central

Chandra, Meghana S.; Math, Suresh Bada

2016-01-01

In a recent judgment on medical negligence, the Supreme Court awarded compensation amounting to Rs. 11 crore to a victim, which was to be paid by the doctors and the private hospital deemed responsible for the wrongful death of a patient. This landmark decision was by far the largest compensation award in the history of Indian medical negligence litigation. Hence, the process of calculating compensation for medical negligence has received great attention and debate, largely due to the impact that it is going to have on the practice of medicine within the country, in the near future. However, the method of calculation of compensation is unpredictable as it varies hugely across different cases, courts and tribunals resulting, in a loss of faith in the system, protracted litigation, and frequent appeals. With over 80% of India's healthcare being provided by the private sector, predictability and uniformity in the regulation of compensation in medical negligence would benefit the victims and the doctors concerned. A basic knowledge of how medical negligence compensation is calculated and adjudicated in the judicial courts of India will aid a doctor in planning his/her professional indemnity insurance, as well as in practicing his/her profession without undue worry about facing litigation for alleged medical negligence. This article addresses the merits and demerits of large compensation awards, and also discusses whether the system is broken, needs a quick fix, or a massive overhaul. PMID:27891021

Progress in Medicine: Compensation and medical negligence in India: Does the system need a quick fix or an overhaul?

PubMed

Chandra, Meghana S; Math, Suresh Bada

2016-10-01

In a recent judgment on medical negligence, the Supreme Court awarded compensation amounting to Rs. 11 crore to a victim, which was to be paid by the doctors and the private hospital deemed responsible for the wrongful death of a patient. This landmark decision was by far the largest compensation award in the history of Indian medical negligence litigation. Hence, the process of calculating compensation for medical negligence has received great attention and debate, largely due to the impact that it is going to have on the practice of medicine within the country, in the near future. However, the method of calculation of compensation is unpredictable as it varies hugely across different cases, courts and tribunals resulting, in a loss of faith in the system, protracted litigation, and frequent appeals. With over 80% of India's healthcare being provided by the private sector, predictability and uniformity in the regulation of compensation in medical negligence would benefit the victims and the doctors concerned. A basic knowledge of how medical negligence compensation is calculated and adjudicated in the judicial courts of India will aid a doctor in planning his/her professional indemnity insurance, as well as in practicing his/her profession without undue worry about facing litigation for alleged medical negligence. This article addresses the merits and demerits of large compensation awards, and also discusses whether the system is broken, needs a quick fix, or a massive overhaul.

Sensor fusion to enable next generation low cost Night Vision systems

NASA Astrophysics Data System (ADS)

Schweiger, R.; Franz, S.; Löhlein, O.; Ritter, W.; Källhammer, J.-E.; Franks, J.; Krekels, T.

2010-04-01

The next generation of automotive Night Vision Enhancement systems offers automatic pedestrian recognition with a performance beyond current Night Vision systems at a lower cost. This will allow high market penetration, covering the luxury as well as compact car segments. Improved performance can be achieved by fusing a Far Infrared (FIR) sensor with a Near Infrared (NIR) sensor. However, fusing with today's FIR systems will be too costly to get a high market penetration. The main cost drivers of the FIR system are its resolution and its sensitivity. Sensor cost is largely determined by sensor die size. Fewer and smaller pixels will reduce die size but also resolution and sensitivity. Sensitivity limits are mainly determined by inclement weather performance. Sensitivity requirements should be matched to the possibilities of low cost FIR optics, especially implications of molding of highly complex optical surfaces. As a FIR sensor specified for fusion can have lower resolution as well as lower sensitivity, fusing FIR and NIR can solve performance and cost problems. To allow compensation of FIR-sensor degradation on the pedestrian detection capabilities, a fusion approach called MultiSensorBoosting is presented that produces a classifier holding highly discriminative sub-pixel features from both sensors at once. The algorithm is applied on data with different resolution and on data obtained from cameras with varying optics to incorporate various sensor sensitivities. As it is not feasible to record representative data with all different sensor configurations, transformation routines on existing high resolution data recorded with high sensitivity cameras are investigated in order to determine the effects of lower resolution and lower sensitivity to the overall detection performance. This paper also gives an overview of the first results showing that a reduction of FIR sensor resolution can be compensated using fusion techniques and a reduction of sensitivity can be compensated.

Responding to home maintenance challenge scenarios: the role of selection, optimization, and compensation in aging-in-place.

PubMed

Kelly, Andrew John; Fausset, Cara Bailey; Rogers, Wendy; Fisk, Arthur D

2014-12-01

This study examined potential issues faced by older adults in managing their homes and their proposed solutions for overcoming hypothetical difficulties. Forty-four diverse, independently living older adults (66-85) participated in structured group interviews in which they discussed potential solutions to manage difficulties presented in four scenarios: perceptual, mobility, physical, and cognitive difficulties. The proposed solutions were classified using the Selection, Optimization, and Compensation (SOC) model. Participants indicated they would continue performing most tasks and reported a range of strategies to manage home maintenance challenges. Most participants reported that they would manage home maintenance challenges using compensation; the most frequently mentioned compensation strategy was using tools and technologies. There were also differences across the scenarios: Optimization was discussed most frequently with perceptual and cognitive difficulty scenarios. These results provide insights into supporting older adults' potential needs for aging-in-place and provide evidence of the value of the SOC model in applied research. © The Author(s) 2012.

Management of heatstroke in Malaysian pilgrims in Saudi Arabia.

PubMed

Merican, M I

1989-09-01

Heat stroke is hardly seen in Malaysia. However, it occurs commonly in Saudi Arabia during the Haj season. Many Malaysian pilgrims are affected every year and some die. Having faced this environmental hazard for eight years, the Malaysian Medical Mission, sent each year to look after our pilgrims, modified its treatment strategy in 1988 and successfully decreased the overall morbidity and mortality of affected patients without the use of sophisticated equipment. A brief account of the management of 17 cases seen in 1988 is given. Only one died following treatment. The rest recovered fully without any residual neurological deficit or other complications.

Thirst for living of alcoholic patients: medical care's experience.

PubMed

Augeraud, Emmanuel; Puertolas, Christian; Rouchon, Dominique

2004-01-01

The medical care lavished on terminal and on alcoholic patients leads us to observe an analogy between these two life paths. This raises a question: do links exist between these two conditions? We will present Mr. B's record with alcohol. Analysing alcohol withdrawal allows us to show that during withdrawal, after having experienced similar stages to those described by Kübler-Ross, the alcoholic patient is in a grieving process. When abstinent, Mr. B faces two possibilities: either the grief is incomplete and the drive towards alcohol leads him to die to life; or he remains abstinent, with the help sometimes of what we call 'support dyads'. All this presupposes that the initial stages of dying to alcohol, followed by a psychic work of dis-fusion, have been brought to a successful conclusion. Links do exist between these two life paths, in the sense that these stages enable them to face the major trauma of their lives, e.g. alcoholism and serious illness.

Something to smile about: the interrelationship between attractiveness and emotional expression.

PubMed

Golle, Jessika; Mast, Fred W; Lobmaier, Janek S

2014-01-01

Previous studies have suggested a link between the processing of the emotional expression of a face and how attractive it appears. In two experiments we investigated the interrelationship between attractiveness and happiness. In Experiment 1 we presented morphed faces varying in attractiveness and happiness and asked participants to choose the more attractive of two simultaneously presented faces. In the second experiment we used the same stimuli as in Experiment 1 and asked participants to choose the happier face. The results of Experiment 1 revealed that the evaluation of attractiveness is strongly influenced by the intensity of a smile expressed on a face: A happy facial expression could even compensate for relative unattractiveness. Conversely, the findings of Experiment 2 showed that facial attractiveness also influences the evaluation of happiness: It was easier to choose the happier of two faces if the happier face was also more attractive. We discuss the interrelationship of happiness and attractiveness with regard to evolutionary relevance of positive affective status and rewarding effects.

A Cost‐Benefit Analysis of Government Compensation of Kidney Donors

PubMed Central

McCormick, F.; Ojo, A.; Roberts, J. P.

2016-01-01

Abstract From 5000 to 10 000 kidney patients die prematurely in the United States each year, and about 100 000 more suffer the debilitating effects of dialysis, because of a shortage of transplant kidneys. To reduce this shortage, many advocate having the government compensate kidney donors. This paper presents a comprehensive cost‐benefit analysis of such a change. It considers not only the substantial savings to society because kidney recipients would no longer need expensive dialysis treatments—$1.45 million per kidney recipient—but also estimates the monetary value of the longer and healthier lives that kidney recipients enjoy—about $1.3 million per recipient. These numbers dwarf the proposed $45 000‐per‐kidney compensation that might be needed to end the kidney shortage and eliminate the kidney transplant waiting list. From the viewpoint of society, the net benefit from saving thousands of lives each year and reducing the suffering of 100 000 more receiving dialysis would be about $46 billion per year, with the benefits exceeding the costs by a factor of 3. In addition, it would save taxpayers about $12 billion each year. PMID:26474298

A Right to Die?: Ethical Dilemmas of Euthanasia.

ERIC Educational Resources Information Center

Albright, Dianne E.; Hazler, Richard J.

1992-01-01

Euthanasia is considered an important social issue of the 1990s. Mental health professionals should understand the differences between voluntary, involuntary, passive, and active euthanasia; mercy killing, and assisted suicide. Encourages counselors to ethically formulate client-supportive positions to help clients face life-and-death decisions.…

Communication About Dying, Death, and Bereavement: A Systematic Review of Children's Literature

PubMed Central

Arruda-Colli, Marina N. F.; Weaver, Meaghann S.

2017-01-01

Abstract Background: Children's books have the potential to facilitate communication about death for children living with a serious illness and for children coping with the death of a loved one. Objectives: This study examines the content of children's literature relevant to the topic of dying and death and identifies books providers can share with children and their families. Design: A search of children's literature was conducted using four electronic databases and one additional search engine using the word “Death” or “Dying.” Storybooks about dying, death, and bereavement published in English, French, or Spanish between 1995 and 2015 were included. Measurements: Each book underwent content analysis by at least two independent reviewers. Strict PRISMA standard was followed. Full protocol is available as PROSPERO #CRD42016042129. Results: Two hundred ten books met inclusion criteria. The dying subject was primarily a grandparent (n = 78) or pet (n = 44). Books on the experience of a child dying were scarce (n = 5). The word death or dying was used in 75% of the books (n = 158), while others utilized euphemisms. The majority of books featured animals (n = 40) or Caucasian subjects (n = 122) and included spiritual elements such as heaven (n = 122). Less than one-quarter of the books included tools for readers to address the topic of death. Conclusions: Storybooks can be a helpful tool to introduce communication about dying and death with children. Gaps exist in current children's literature to effectively enable children to reflect on their own dying process. A general summary of available books is provided to assist those caring for children and families facing end-of-life issues. PMID:28346862

Mental files theory of mind: When do children consider agents acquainted with different object identities?

PubMed

Huemer, Michael; Perner, Josef; Leahy, Brian

2018-02-01

Mental files theory explains why children pass many perspective taking tasks like the false belief test around age 4 (Perner & Leahy, 2016). It also explains why older children struggle to understand that beliefs about an object depend on how one is acquainted with it (intensionality or aspectuality). If Heinz looks at an object that is both a die and an eraser, but cannot tell by looking that it is an eraser, he will not reach for it if he needs an eraser. Four- to 6-year olds find this difficult (Apperly & Robinson, 1998). We tested 129 35- to 86-month olds with a modified version of Apperly and Robinson's task. Each child faced four tasks resulting from two experimental factors, timing and mode of information. Timing: Children saw Heinz learn the die's location either before or after they learn that the die is an eraser. Mode of information: Heinz learns where the die is either perceptually or verbally. When Heinz' learning is verbal, he never perceives the die at all. We found that Apperly and Robinson's problem occurs only in the seen-after condition, where Heinz sees the die afterchildren had learnt that it was also an eraser. It vanishes when Heinz learns where the die is before children learn that it is also an eraser. The problem also vanishes when Heinz learns where the die is purely verbally (e.g., "The die is in the red box") and never sees it. This evidence lets us refine existing mental files theory, and eliminate several alternatives from the literature. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Being One with the Universe: Finding a Silver Lining in Dying.

PubMed

Caratao-Mojica, Rhea

2015-07-01

Woody Allen once quoted, "I don't mind dying so much, I just don't want to be there when it happens" (as cited in Ingram, 2002, p. 1). Oftentimes, death is not a happy subject, a reality that most of us fear, yet something we all must face. In this paper, three articles were reviewed that explored the living-dying (Phillips, 1992) process of the terminally ill and the material was conceptualized in light of Rogers (1994) science of unitary human beings. To further understand and explore the living-dying process, creative examples (movie screenplay, novel, song and others) were cited. During the living-dying process exploration, three common themes were expressed by the subjects (dying persons), namely: valuing own perspective of quality of life; choosing personal meanings with ways of moving beyond with the possibles (Lee & Pilkington, 1999), while focusing on life's meaning rather than life's details (Dobratz, 2002); and connecting to the world-as-unknown while self-separating to the world-as-known in actively seeking the union with death (Kubler-Ross, 1981; Callanan & Kelly, 1992; Dobratz, 2002). It is important for healthcare providers to recognize and acknowledge all three themes to be able to understand dying persons, to focus on their wholeness rather than their disease, and to help families discern symbolic messages conveyed by them. Moreover, knowing these themes also enables healthcare providers to help all parties to transition and be able to accept and embrace the most difficult process—the living-dying (Phillips, 1992) process. © The Author(s) 2015.

Superior voice recognition in a patient with acquired prosopagnosia and object agnosia.

PubMed

Hoover, Adria E N; Démonet, Jean-François; Steeves, Jennifer K E

2010-11-01

Anecdotally, it has been reported that individuals with acquired prosopagnosia compensate for their inability to recognize faces by using other person identity cues such as hair, gait or the voice. Are they therefore superior at the use of non-face cues, specifically voices, to person identity? Here, we empirically measure person and object identity recognition in a patient with acquired prosopagnosia and object agnosia. We quantify person identity (face and voice) and object identity (car and horn) recognition for visual, auditory, and bimodal (visual and auditory) stimuli. The patient is unable to recognize faces or cars, consistent with his prosopagnosia and object agnosia, respectively. He is perfectly able to recognize people's voices and car horns and bimodal stimuli. These data show a reverse shift in the typical weighting of visual over auditory information for audiovisual stimuli in a compromised visual recognition system. Moreover, the patient shows selectively superior voice recognition compared to the controls revealing that two different stimulus domains, persons and objects, may not be equally affected by sensory adaptation effects. This also implies that person and object identity recognition are processed in separate pathways. These data demonstrate that an individual with acquired prosopagnosia and object agnosia can compensate for the visual impairment and become quite skilled at using spared aspects of sensory processing. In the case of acquired prosopagnosia it is advantageous to develop a superior use of voices for person identity recognition in everyday life. Copyright © 2010 Elsevier Ltd. All rights reserved.

Differential Tuition: A Community College Budgetary Strategy

ERIC Educational Resources Information Center

Friedel, Janice Nahra; Thomas, Gregory

2013-01-01

Community colleges are currently facing the perfect fiscal storm: historical reductions in state appropriations while at the same time experiencing significant enrollment growth. Community college leaders are pondering how to effectively compensate for unprecedented budget cuts while meeting the demands of student access and increasing levels of…

The Role Consumerism Plays in Student Learning

ERIC Educational Resources Information Center

Harrison, Laura M.; Risler, Laura

2015-01-01

In nations facing austerity measures, students risk diminished quality in their higher education experiences. Universities function increasingly like corporations as they struggle to compensate for budget shortfalls caused by declining public support. As a result, students become positioned as consumers of a private commodity that exists to…

Learning to recognize face shapes through serial exploration.

PubMed

Wallraven, Christian; Whittingstall, Lisa; Bülthoff, Heinrich H

2013-05-01

Human observers are experts at visual face recognition due to specialized visual mechanisms for face processing that evolve with perceptual expertize. Such expertize has long been attributed to the use of configural processing, enabled by fast, parallel information encoding of the visual information in the face. Here we tested whether participants can learn to efficiently recognize faces that are serially encoded-that is, when only partial visual information about the face is available at any given time. For this, ten participants were trained in gaze-restricted face recognition in which face masks were viewed through a small aperture controlled by the participant. Tests comparing trained with untrained performance revealed (1) a marked improvement in terms of speed and accuracy, (2) a gradual development of configural processing strategies, and (3) participants' ability to rapidly learn and accurately recognize novel exemplars. This performance pattern demonstrates that participants were able to learn new strategies to compensate for the serial nature of information encoding. The results are discussed in terms of expertize acquisition and relevance for other sensory modalities relying on serial encoding.

Reflectance from images: a model-based approach for human faces.

PubMed

Fuchs, Martin; Blanz, Volker; Lensch, Hendrik; Seidel, Hans-Peter

2005-01-01

In this paper, we present an image-based framework that acquires the reflectance properties of a human face. A range scan of the face is not required. Based on a morphable face model, the system estimates the 3D shape and establishes point-to-point correspondence across images taken from different viewpoints and across different individuals' faces. This provides a common parameterization of all reconstructed surfaces that can be used to compare and transfer BRDF data between different faces. Shape estimation from images compensates deformations of the face during the measurement process, such as facial expressions. In the common parameterization, regions of homogeneous materials on the face surface can be defined a priori. We apply analytical BRDF models to express the reflectance properties of each region and we estimate their parameters in a least-squares fit from the image data. For each of the surface points, the diffuse component of the BRDF is locally refined, which provides high detail. We present results for multiple analytical BRDF models, rendered at novel orientations and lighting conditions.

Salaries and compensation practices in public health, environmental, and agricultural laboratories: findings from a 2010 national survey.

PubMed

DeBoy, John M; Boulton, Matthew L; Carpenter, David F

2013-01-01

The public health, environmental, and agricultural laboratory (PHEAL) workforce is a key component of the public health infrastructure. The national laboratory workforce faces an ongoing challenge of recruitment and retention of workers often related to pay and other compensation issues. To collect information on laboratory salaries and laboratory compensation practices using a national compensation survey targeting the PHEAL workforce. Seventy-three of 109 (67%) PHEAL directors in the 50 states and District of Columbia collectively employ 3723/4830 (77%) PHEAL employees in the United States. A standardized survey was developed and administered in 2010. Compensation data were compiled by job classification, geographic region, laboratory gross operating budget size, laboratory staff size, and laboratory type. Laboratory staff size ranged from 3 to 327 individuals (mean = 74 and median = 51). Median base salaries were lowest in the Southwest and South and highest in the Mountain and Pacific regions. Mean and median laboratory gross operating budgets for all participating PHEALs were $8 609 238 and $5 671 500, respectively. Extra cash compensation, used by 8 of 60 (13.3%) PHEALs, was more likely to go to a scientist-manager or scientist-supervisor. In 2010, a standardized national compensation survey of technical and scientific public health employees working in 73 PHEALs was effective in collecting previously unavailable data about laboratory salaries, laboratory budgets, and payroll practices. Laboratory salaries varied by geographic region and there was an uneven distribution of extra cash compensation among job classifications. The compensation data collected may be useful in characterizing and improving laboratory salary structures and practices to better support workforce recruitment and retention.

What Happens When America Flunks Geography.

ERIC Educational Resources Information Center

Grosvenor, Gilbert M.

Knowledge of geography is fundamental to understanding many other disciplines and many of the important issues which face the world, yet it has practically disappeared from our curricula, having been swallowed and dissolved by social studies. We know about malnutrition, but we know little about where millions are dying of famine. Ignorance of…

Terminal Illness: Counseling with a Family Perspective

ERIC Educational Resources Information Center

Krieger, G. W.; Bascue, L. O.

1975-01-01

When facing terminal illness, the dying individual needs to accept death and his feelings about it, deal with potential isolation from friends and relatives, and find meaning in his remaining time. Family members need also to accept death. Family counseling offers a treatment method for responding to these needs. (Author)

Development of a web-based tool for projecting costs of managing emerald ash borer in municipal forests

Treesearch

Clifford S. Sadof

2009-01-01

City managers faced with the invasion of emerald ash borer into their urban forests need to plan for the invasion in order to obtain the resources they need to protect the public from harm caused by dying ash trees. Currently, city...

Drought survival and perennial grass success in the face of cheatgrass invasion: germination, emergence, seedling die-off and reproduction

USDA-ARS?s Scientific Manuscript database

Cheatgrass (Bromus tectorum) dominance and competitiveness is often attributed to early (fall) germination. We hypothesize that cheatgrass germinates earlier compared to three commonly used restoration/rehabilitation perennial grass species [‘Hycrest’ crested wheatgrass( Agropyron desertorum ssp. c...

Pensions under Pressure: Charter Innovation in Teacher Retirement Benefits

ERIC Educational Resources Information Center

Podgursky, Michael; Aud Pendergrass, Susan; Hesla, Kevin

2018-01-01

Public school districts are facing twin challenges: maintaining a labor supply of qualified teachers while shoring up the deteriorating system that compensates them. Keeping public-school teachers' pensions plans flush is expensive, and it accounts for a growing share of education spending. In some states, public charter schools provide an…

From the Floor: Raising Child Care Salaries.

ERIC Educational Resources Information Center

Whitebook, Marcy; And Others

The comprehensive National Child Care Staffing Study confirmed that American children are in jeopardy because their teachers are poorly compensated and minimally trained. An increasing number of local and state efforts have begun to face this crisis head-on. This booklet reviews these efforts, focusing primarily on strategies for raising salaries.…

38 CFR 10.22 - Payment to estate of decedent.

Code of Federal Regulations, 2011 CFR

2011-07-01

... face value of an adjusted service certificate, issued pursuant to the World War Adjusted Compensation... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Payment to estate of decedent. 10.22 Section 10.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

38 CFR 10.22 - Payment to estate of decedent.

Code of Federal Regulations, 2014 CFR

2014-07-01

... face value of an adjusted service certificate, issued pursuant to the World War Adjusted Compensation... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Payment to estate of decedent. 10.22 Section 10.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

38 CFR 10.22 - Payment to estate of decedent.

Code of Federal Regulations, 2012 CFR

2012-07-01

... face value of an adjusted service certificate, issued pursuant to the World War Adjusted Compensation... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Payment to estate of decedent. 10.22 Section 10.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

38 CFR 10.22 - Payment to estate of decedent.

Code of Federal Regulations, 2010 CFR

2010-07-01

... face value of an adjusted service certificate, issued pursuant to the World War Adjusted Compensation... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Payment to estate of decedent. 10.22 Section 10.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

38 CFR 10.22 - Payment to estate of decedent.

Code of Federal Regulations, 2013 CFR

2013-07-01

... face value of an adjusted service certificate, issued pursuant to the World War Adjusted Compensation... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Payment to estate of decedent. 10.22 Section 10.22 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

The Personal Assistance Dilemma for People with Disabilities Living in Rural Areas.

ERIC Educational Resources Information Center

Nosek, Margaret A.

1992-01-01

Disabled persons may receive needed personal assistance from spouse, parents, other family, or a hired assistant (possibly shared) who is compensated by cash or barter. Disabled persons in rural areas rely heavily on family members and face overwhelming locational, financial, and attitudinal barriers to independent living. (SV)

Nurses attitudes towards death, dying patients and euthanasia: A descriptive study.

PubMed

Ay, Melike Ayça; Öz, Fatma

2018-01-01

Attitudes of nurses towards death and related concepts influence end-of-life care. Determining nurses' views and attitudes towards these concepts and the factors that affect them are necessary to ensure quality end-of-life care. The purpose of this study was to determine nurses' views and attitudes about death, dying patient, euthanasia and the relationships between nurses' characteristics. Participants consist of the nurses who volunteered to take part in this descriptive study from 25 hospitals (n = 340) which has a paediatric or adult intensive care unit and located within the boundaries of Ankara, Turkey. 'Nurse Information Form' and 'Attitude Scale about Euthanasia, Death and Dying Patients (DAS)' were used as data collection tool. Ethical consideration: Written permissions were received from the 'Noninterventional Clinical Researches Ethics Board' of authors' university and education councils of each hospital. Informed consent was obtained from participants. It is found that there are statistically significant difference among the factors of marital status, having a child, years of experience, bereavement experience, affected by working with dying patient, definition of euthanasia, views about patients who are appropriate for euthanasia, views about patients who desire to die and feeling need for counselling on these concepts according to the mean total score of nurses' attitudes about euthanasia, death and dying patient (p < 0.05). The results indicate that nurses are negatively affected to face the concepts of death, euthanasia and work with dying patient. This is reflected in their attitude. In order to gain positive attitude towards death, dying patient and euthanasia, the implementation of training and consulting services to nurses at appropriate intervals during both education and professional life are required.

Impact of beacon wavelength on phase-compensation performance

NASA Astrophysics Data System (ADS)

Enterline, Allison A.; Spencer, Mark F.; Burrell, Derek J.; Brennan, Terry J.

2017-09-01

This study evaluates the effects of beacon-wavelength mismatch on phase-compensation performance. In general, beacon-wavelength mismatch occurs at the system level because the beacon-illuminator laser (BIL) and high-energy laser (HEL) are often at different wavelengths. Such is the case, for example, when using an aperture sharing element to isolate the beam-control sensor suite from the blinding nature of the HEL. With that said, this study uses the WavePlex Toolbox in MATLAB® to model ideal spherical wave propagation through various atmospheric-turbulence conditions. To quantify phase-compensation performance, we also model a nominal adaptive-optics (AO) system. We achieve correction from a Shack-Hartmann wavefront sensor and continuous-face-sheet deformable mirror using a least-squares phase reconstruction algorithm in the Fried geometry and a leaky integrator control law. To this end, we plot the power in the bucket metric as a function of BIL-HEL wavelength difference. Our initial results show that positive BIL-HEL wavelength differences achieve better phase compensation performance compared to negative BIL-HEL wavelength differences (i.e., red BILs outperform blue BILs). This outcome is consistent with past results.

The battle over workers' compensation.

PubMed

Ellenberger, J N

2000-01-01

Faced with lower profits and rapidly increasing premium costs in the 1980s, insurers and employer organizations cleverly parlayed the public perception of worker fraud and abuse in the workers' compensation system (that they helped to create) into massive legislative changes. Over the last decade, state legislators and governors, Republican and Democrat alike, have jumped on this bandwagon, one that workers and their allies have dubbed the workers' compensation "deform" movement. Alleging a "game plan" and a calculated campaign on the part of insurers and employers, the author looks at the major components of changes that were made, examines the elements of workers' compensation over which employers and insurers have gained control, and discusses Newt Gingrich's efforts to capitalize on employer and insurer fervor over the system. This campaign whistled through the country until it goaded the labor movement, injured workers, the trial bar, and others in Ohio in 1997 to organize themselves to stand up to employers by defeating the deform law through a ballot initiative. The article details that battle and suggests that similar voices can be achieved through a return to grassroots organizing and mobilization.

Self-determination, the right to die, and culture: a literature review.

PubMed

McCormick, Andrew J

2011-04-01

Self-determination is a primary ethical principle underlying social work practice in health care settings. Since the 1970s, a right-to-die movement that shares the social work commitment to self-determination has grown and influences end-of-life care decisions. However, the role of culture is notably absent in discussions of the right to die. A literature review was conducted to explore self-determination and the role of culture in the context of the history of the right-to-die movement. A total of 54 articles met the criteria for inclusion in the review. Of the total, 21 related to self-determination, and 12 related to ethnicity and culture at the end of life. A history based on the review of the right-to-die movement is presented. The review found that social workers support passively hastening death and that views of self-determination are affected by both law and culture. In response, social workers will face three tasks: (1) becoming more public in their support for client self-determination as an important standard in end-of-life care, (2) being more explicit in support of diverse cultural traditions in end-of-life decision making, and (3) expanding their traditional educational and bridging roles between families and medical personnel.

Music therapy with imminently dying hospice patients and their families: facilitating release near the time of death.

PubMed

Krout, Robert E

2003-01-01

Hospice care seeks to address the diverse needs of terminally ill patients in a number of physical, psychosocial, and spiritual areas. Family members of the patient often are included in the care and services provided by the hospice team, and hospice clinicians face a special challenge when working with families of patients who are imminently dying. When loved ones are anticipating the patient's impending death, they may find it difficult to express feelings, thoughts, and last wishes. Music therapy is a service modality that can help to facilitate such communication between the family and the patient who is actively dying, while also providing a comforting presence. Music therapy as a way to ease communication and sharing between dying patients and their loved ones is discussed in this article. The ways in which music therapy can facilitate a means of release for both patients and family members in an acute care unit of a large US hospice organization are specifically described. Case descriptions illustrate how music therapy functioned to allow five patients and their families to both come together and let go near the time of death. Elements to consider when providing such services to imminently dying patients and their families are discussed.

Self-care for the caregiver.

PubMed

Radziewicz, R M

2001-12-01

Palliative care nurses can face unique stressors and compassion fatigue working in their field. Working with the dying and their families, communicating with other health care professionals, and handling ethical issues are often sources of stress in palliative care. The biochemistry and theory of stress are discussed. Various strategies to cope with caregiver stress are explained.

Burned saguaro: Will they live or die?

Treesearch

Marcia G. Narog; Bonni M. Corcoran; Ruth C. Wilson

2013-01-01

Thousands of acres of giant saguaro (Carnegiea gigantea) habitat in the Sonoran Desert have been scorched by fire in recent decades. Resource managers struggle to maintain scenic landscapes featuring majestic saguaro faced with the challenges of fire, non-native species invasion, and recreational needs of millions of annual visitors. Successfully managing this iconic...

Two different ways for waveguides and optoelectronics components on top of C-MOS

NASA Astrophysics Data System (ADS)

Fedeli, J. M.; Jeannot, S.; Kostrzewa, M.; Di Cioccio, L.; Jousseaume, V.; Orobtchouk, R.; Maury, P.; Zussy, M.

2006-02-01

While fabrication of photonic components at the wafer level is a long standing goal of integrated optics, new applications such as optical interconnects are introducing new challenges for waveguides and optoelectronic component fabrication. Indeed, global interconnects are expected to face severe limitations in the near future. To face this problem, optical links on top of a CMOS circuits could be an alternative. The critical points to perform an optical link on a chip are firstly the realization of compact passive optical distribution and secondly the report of optoelectronic components for the sources and detectors. This paper presents two different approaches for the integration of both waveguides and optoelectronic components. In a first "total bonding" approach, waveguides have been elaborated using classical "Silicon On Insulators" technology and then reported using molecular bonding on top off Si wafers. The S0I substrate was then chemically etched, after what InP dies were moleculary bonded on top of the waveguides. With this approach, optical components with low loses and a good equilibrium are demonsrated. Using molecular bonding, InP dies were reported with no degradation of the optoelectronic properties of the films. In a second approach, using PECVD silicon nitride or amorphous silicon coupled to PECVD silicon oxide, basic optical components are demonstrated. This low temperature technology is compatible with a microelectronic Back End process, allowing an integration of the waveguides directly on top of CMOS circuits. InP dies can then be bonded on top of the waveguides.

Differentiation and Glucocorticoid Regulated Apopto-Phagocytic Gene Expression Patterns in Human Macrophages. Role of Mertk in Enhanced Phagocytosis

PubMed Central

Zahuczky, Gábor; Kristóf, Endre; Majai, Gyöngyike; Fésüs, László

2011-01-01

The daily clearance of physiologically dying cells is performed safely mainly by cells in the mononuclear phagocyte system. They can recognize and engulf dying cells utilizing several cooperative mechanisms. In our study we show that the expression of a broad range of apopto-phagocytic genes is strongly up-regulated during differentiation of human monocytes to macrophages with different donor variability. The glucocorticoid dexamethasone has a profound effect on this process by selectively up-regulating six genes and down-regulating several others. The key role of the up-regulated mer tyrosine kinase (Mertk) in dexamethasone induced enhancement of phagocytosis could be demonstrated in human monocyte derived macrophages by gene silencing as well as blocking antibodies, and also in a monocyte-macrophage like cell line. However, the additional role of other glucocorticoid induced elements must be also considered since the presence of autologous serum during phagocytosis could almost completely compensate for the blocked function of Mertk. PMID:21731712

["Grounded theory" develops medicine. Popular research method for exploring human behavior can discover new connections].

PubMed

Thulesius, Hans; Barfod, Toke; Ekström, Helene; Håkansson, Anders

2004-09-30

Grounded theory (GT) is a popular research method for exploring human behavior. GT was developed by the medical sociologists Glaser and Strauss while they studied dying in hospitals in the 1960s resulting in the book "Awareness of dying". The goal of a GT is to generate conceptual theories by using all types of data but without applying existing theories and hypotheses. GT procedures are mostly inductive as opposed to deductive research where hypotheses are tested. A good GT has a core variable that is a central concept connected to many other concepts explaining the main action in the studied area. A core variable answers the question "What's going on?". Examples of core variables are: "Cutting back after a heart attack"--how people adapt to life after a serious illness; and "Balancing in palliative cancer care"--a process of weighing, shifting, compensating and compromising when treating people with a progressive and incurable illness trajectory.

Titanium dental copings prepared by a powder metallurgy method: a preliminary report.

PubMed

Eriksson, Mikael; Andersson, Matts; Carlström, Elis

2004-01-01

The purpose of this study was to determine if the Procera pressed-powder method can be used to fabricate titanium copings. Commercially pure titanium powder was used to prepare the copings. The powder was pressed onto an enlarged tooth preparation die of aluminum using cold isostatic pressing. The outer shape of the coping was formed using a Procera milling machine, and the copings were vacuum sintered. Titanium copings could be prepared using this method. The density of the sintered copings reached 97% to 99%+ of theoretic density, and the copings showed ductile behavior after sintering. Enlarging the tooth preparation die to compensate for the sintering shrinkage could optimize the final size of the copings. Ductile and dense titanium dental copings can be produced with powder-metal processing using cold isostatic pressing, followed by milling and sintering to final shape. The forming technique has, if properly optimized, a potential of becoming a more cost-efficient production method than spark erosion.

A Cost-Benefit Analysis of Government Compensation of Kidney Donors.

PubMed

Held, P J; McCormick, F; Ojo, A; Roberts, J P

2016-03-01

From 5000 to 10 000 kidney patients die prematurely in the United States each year, and about 100 000 more suffer the debilitating effects of dialysis, because of a shortage of transplant kidneys. To reduce this shortage, many advocate having the government compensate kidney donors. This paper presents a comprehensive cost-benefit analysis of such a change. It considers not only the substantial savings to society because kidney recipients would no longer need expensive dialysis treatments--$1.45 million per kidney recipient--but also estimates the monetary value of the longer and healthier lives that kidney recipients enjoy--about $1.3 million per recipient. These numbers dwarf the proposed $45 000-per-kidney compensation that might be needed to end the kidney shortage and eliminate the kidney transplant waiting list. From the viewpoint of society, the net benefit from saving thousands of lives each year and reducing the suffering of 100 000 more receiving dialysis would be about $46 billion per year, with the benefits exceeding the costs by a factor of 3. In addition, it would save taxpayers about $12 billion each year. © 2015 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

Equitable Education for All: Using a Comprehensive Instructional Model to Improve Preschool Teacher Practices

ERIC Educational Resources Information Center

Carlson, Abby G.; Curby, Timothy W.; Brown, Chavaughn A.; Trygstad, Kelly M.; Truong, Felicia R.

2017-01-01

The current study evaluates the effectiveness of a comprehensive instructional model, ("Every Child Ready"), as a vehicle to provide equitable education experiences for all children by compensating for gaps in teacher knowledge. The ECR instructional model addresses several challenges facing the early childhood landscape. Specifically,…

Running on Empty

ERIC Educational Resources Information Center

Hall, Julie

2006-01-01

With the national average cost of diesel fuel hovering around $3 per gallon, school and university administrators face the challenge of compensating their budgets for money lost to the gas tank. Some are playing with numbers, looking at their budgets for ways to move money around and make things work. Others are scouring for places where cost…

Organizing Schools to Improve Student Achievement: Start Times, Grade Configurations, and Teacher Assignments

ERIC Educational Resources Information Center

Jacob, Brian A.; Rockoff, Jonah E.

2012-01-01

Proposals for school reform often focus on large and sometimes controversial systemic changes, such as charter schools, accountability standards, and changes to the way teachers are hired, fired, and compensated. Although these reforms may offer great opportunity to improve student outcomes, they may also be costly, face substantial implementation…

A Case Study: Introducing a New Benefit Plan on Campus

ERIC Educational Resources Information Center

Gustin, Karen; Bursic, Paul

2004-01-01

Many higher education institutions are strapped by benefit compensation costs for medical and pharmaceutical insurance, and there are few budget dollars left over for other health benefits, such as dental and eye care. Cornell University faced this dilemma and found voluntary dental and eye care plans to be an excellent solution. This article…

Neither Honor nor Compensation: Faculty and Public Service

ERIC Educational Resources Information Center

Jaeger, Audrey J.; Thornton, Courtney H.

2006-01-01

Land-grant institutions that are also research extensive may face the unique position of asking faculty to fulfill a historical mission with low consideration of public service in the reward structure. This paradox between mission and reward results in the socialization of many faculty away from participation in public service. This article…

Cross-sectional research into counselling for non-physician assisted suicide: who asks for it and what happens?

PubMed

Hagens, Martijn; Pasman, H Roeline W; Onwuteaka-Philipsen, Bregje D

2014-10-02

In the Netherlands, people with a wish to die can request physician assistance in dying. However, almost two thirds of the explicit requests do not result in physician assistance in dying. Some people with a wish to end life seek counselling outside the medical context to end their own life. The aim of this cross-sectional research was to obtain information about clients receiving counselling for non-physician assisted suicide, and the characteristics and outcome of the counselling itself. All counsellors working with foundation De Einder (an organisation that offers professional counselling for people with a wish to end life) (N=12) filled in registration forms about all clients they counselled in 2011 and/or 2012. Only client registration data forms with at least one face-to-face contact with the counsellor were selected for analysis (n=595). More than half of the clients were over 65 years old. More than one third of the clients had no wish to end life and 16% had an urgent wish to end life. Almost two thirds of the clients had not requested physician assistance in dying. Half of the clients had others involved in the counselling. More than half of the clients received explicit practical information concerning non-physician assisted suicide, while 13% of all clients actually ended their own life through non-physician assisted suicide. Clients without a (severe) disease were older than clients with a severe disease. They also had more problems of old age and existential suffering and more often wanted to be prepared for self-determination. The clients without a (severe) disease more often had no wish to end life and requested physician assistance in dying less often than clients with a severe disease. While some of the clients receiving counselling for non-physician assisted suicide seem to be looking for a peaceful death to escape from current suffering, others have no wish to end life and seem to be looking for reassurance in anticipation of prospective suffering. If non-physician assisted suicide is be distinguished from 'mutilating' suicide, this asks for a different approach than suicide crisis intervention, for example suicide-attempt prevention.

Age-related differences in brain activity during implicit and explicit processing of fearful facial expressions.

PubMed

Zsoldos, Isabella; Cousin, Emilie; Klein-Koerkamp, Yanica; Pichat, Cédric; Hot, Pascal

2016-11-01

Age-related differences in neural correlates underlying implicit and explicit emotion processing are unclear. Within the framework of the Frontoamygdalar Age-related Differences in Emotion model (St Jacques et al., 2009), our objectives were to examine the behavioral and neural modifications that occur with age for both processes. During explicit and implicit processing of fearful faces, we expected to observe less amygdala activity in older adults (OA) than in younger adults (YA), associated with poorer recognition performance in the explicit task, and more frontal activity during implicit processing, suggesting compensation. At a behavioral level, explicit recognition of fearful faces was impaired in OA compared with YA. We did not observe any cerebral differences between OA and YA during the implicit task, whereas in the explicit task, OA recruited more frontal, parietal, temporal, occipital, and cingulate areas. Our findings suggest that automatic processing of emotion may be preserved during aging, whereas deliberate processing is impaired. Additional neural recruitment in OA did not appear to compensate for their behavioral deficits. Copyright © 2016 Elsevier B.V. All rights reserved.

Beyond Incentives for Involvement to Compensation for Consultants

PubMed Central

Black, Kristin Z.; Hardy, Christina Yongue; De Marco, Molly; Ammerman, Alice S.; Corbie-Smith, Giselle; Council, Barbara; Ellis, Danny; Eng, Eugenia; Harris, Barbara; Jackson, Melvin; Jean-Baptiste, Jimmy; Kearney, William; Legerton, Mac; Parker, Donald; Wynn, Mysha; Lightfoot, Alexandra

2013-01-01

Background: Community-based participatory research (CBPR) strives for equitable collaboration among community and academic partners throughout the research process. To build the capacity of academia to function as effective research partners with communities, the North Carolina Translational and Clinical Sciences Institute (NC TraCS), home of the University of North Carolina at Chapel Hill (UNC-CH)’s Clinical and Translational Sciences Award (CTSA), developed a community engagement consulting model. This new model harnesses the expertise of community partners with CBPR experience and compensates them equitably to provide technical assistance to community–academic research partnerships. Objectives: This paper describes approaches to valuing community expertise, the importance of equitable compensation for community partners, the impact on the community partners, opportunities for institutional change, and the constraints faced in model implementation. Methods: Community Experts (CEs) are independent contractor consultants. CEs were interviewed to evaluate their satisfaction with their engagement and compensation for their work. Lessons Learned: (1) CEs have knowledge, power, and credibility to push for systems change. (2) Changes were needed within the university to facilitate successful consultation to community–academic partnerships. (3) Sustaining the CE role requires staff support, continued compensation, increased opportunities for engagement, and careful consideration of position demands. (4) The role provides benefits beyond financial compensation. (5) Opportunities to gather deepened relationships within the partnership and built collective knowledge that strengthened the project. Conclusions: Leveraging CE expertise and compensating them for their role benefits both university and community. Creating a place for community expertise within academia is an important step toward equitably including the community in research. PMID:24056508

Beyond incentives for involvement to compensation for consultants: increasing equity in CBPR approaches.

PubMed

Black, Kristin Z; Hardy, Christina Yongue; De Marco, Molly; Ammerman, Alice S; Corbie-Smith, Giselle; Council, Barbara; Ellis, Danny; Eng, Eugenia; Harris, Barbara; Jackson, Melvin; Jean-Baptiste, Jimmy; Kearney, William; Legerton, Mac; Parker, Donald; Wynn, Mysha; Lightfoot, Alexandra

2013-01-01

Community-based participatory research (CBPR) strives for equitable collaboration among community and academic partners throughout the research process. To build the capacity of academia to function as effective research partners with communities, the North Carolina Translational and Clinical Sciences Institute (NC TraCS), home of the University of North Carolina at Chapel Hill (UNC-CH)'s Clinical and Translational Sciences Award (CTSA), developed a community engagement consulting model. This new model harnesses the expertise of community partners with CBPR experience and compensates them equitably to provide technical assistance to community-academic research partnerships. This paper describes approaches to valuing community expertise, the importance of equitable compensation for community partners, the impact on the community partners, opportunities for institutional change, and the constraints faced in model implementation. Community Experts (CEs) are independent contractor consultants. CEs were interviewed to evaluate their satisfaction with their engagement and compensation for their work. (1) CEs have knowledge, power, and credibility to push for systems change. (2) Changes were needed within the university to facilitate successful consultation to community-academic partnerships. (3) Sustaining the CE role requires staff support, continued compensation, increased opportunities for engagement, and careful consideration of position demands. (4) The role provides benefits beyond financial compensation. (5) Opportunities to gather deepened relationships within the partnership and built collective knowledge that strengthened the project. Leveraging CE expertise and compensating them for their role benefits both university and community. Creating a place for community expertise within academia is an important step toward equitably including the community in research.

On the emotional connection of medical specialists dealing with death and dying: a qualitative study of oncologists, surgeons, intensive care specialists and palliative medicine specialists.

PubMed

Zambrano, Sofia Carolina; Chur-Hansen, Anna; Crawford, Gregory B

2012-09-01

This paper reports on qualitative data exploring the experiences and coping mechanisms of medical specialists from the specialties of intensive care, surgery, oncology and palliative care, when dealing with death and dying and their emotional connection with dying patients in the context of a life-threatening illness. Thirty-three semi-structured individual interviews were analysed using thematic analysis. One of the key themes of medical specialists' experiences with death and dying was their ambivalence about developing emotional connections with patients and families. Advantages of not engaging emotionally with patients were related to preserving objectivity in the decision making process, while a perceived disadvantage was the loss of the opportunity to engage in meaningful relationships that could positively influence patients, families and the medical specialist. Finding a balance in the face of ambivalence was a preferred approach and participants employed a variety of coping strategies. Participants took different positions about the emotional connection that should develop with their dying patients and their families. Although there was agreement about finding a balance between objectivity and connection, their strategies for achieving this seem to be subjective and prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying, which may enhance personal and professional relationships and may ultimately influence future generations of medical practitioners.

The Alignment and Blending of Payment Incentives within Physician Organizations

PubMed Central

Robinson, James C; Shortell, Stephen M; Li, Rui; Casalino, Lawrence P; Rundall, Thomas

2004-01-01

Objective To analyze the blend of retrospective (fee-for-service, productivity-based salary) and prospective (capitation, nonproductivity-based salary) methods for compensating individual physicians within medical groups and independent practice associations (IPAs) and the influence of managed care on the compensation blend used by these physician organizations. Data Sources Of the 1,587 medical groups and IPAs with 20 or more physicians in the United States, 1,104 responded to a one-hour telephone survey, with 627 providing detailed information on physician payment methods. Study Design We calculated the distribution of compensation methods for primary care and specialty physicians, separately, in both medical groups and IPAs. Multivariate regression methods were used to analyze the influence of market and organizational factors on the payment method developed by physician organizations for individual physicians. Principal Findings Within physician organizations, approximately one-quarter of physicians are paid on a purely retrospective (fee-for-service) basis, approximately one-quarter are paid on a purely prospective (capitation, nonproductivity-based salary) basis, and approximately one-half on blends of retrospective and prospective methods. Medical groups and IPAs in heavily penetrated managed care markets are significantly less likely to pay their individual physicians based on fee-for-service than are organizations in less heavily penetrated markets. Conclusions Physician organizations rely on a wide range of prospective, retrospective, and blended payment methods and seek to align the incentives faced by individual physicians with the market incentives faced by the physician organization. PMID:15333124

Communicating without the Face: Holistic Perception of Emotions of People with Facial Paralysis

PubMed Central

Bogart, Kathleen; Tickle-Degnen, Linda; Ambady, Nalini

2015-01-01

People with facial paralysis (FP) report social difficulties, but some attempt to compensate by increasing expressivity in their bodies and voices. We examined perceivers’ emotion judgments of videos of people with FP to understand how they interpret the combination of an inexpressive face with an expressive body and voice. Results suggest perceivers form less favorable impressions of people with severe FP, but compensatory expression is effective in improving impressions. Perceivers seemed to form holistic impressions when rating happiness and possibly sadness. Findings have implications for basic emotion research and social functioning interventions for people with FP. PMID:26412919

Examination of Veterans Affairs disability compensation as a disincentive for employment in a population-based sample of Veterans under age 65.

PubMed

Tsai, Jack; Rosenheck, Robert A

2013-12-01

Concerns that disability benefits may create disincentives for employment may be especially relevant for young American military veterans, particularly veterans of the recent wars in Iraq and Afghanistan who are facing a current economic recession and turning in large numbers to the Department of Veterans Affairs (VA) for disability compensation. This study describes the rate of employment and VA disability compensation among a nationally representative sample of veterans under the age of 65 and examines the association between levels of VA disability compensation and employment, adjusting for sociodemographics and health status. Data on a total of 4,787 veterans from the 2010 National Survey of Veterans were analyzed using multinomial logistic regressions to compare employed veterans with two groups that were not employed. Two-thirds of veterans under the age of 65 were employed, although only 36 % of veterans with a VA service-connected disability rating of 50 % or higher were employed. Veterans who received no VA disability compensation or who were service-connected 50 % or more were more likely to be unemployed and not looking for employment than veterans who were not service-connected or were service-connected less than 50 %, suggesting high but not all levels of VA disability compensation create disincentives for employment. Results were similar when analyses were limited to veterans who served in Iraq and Afghanistan. Education and vocational rehabilitation interventions, as well as economic work incentives, may be needed to maximize employment among veterans with disabilities.

Multiple statistical tests: Lessons from a d20.

PubMed

Madan, Christopher R

2016-01-01

Statistical analyses are often conducted with α= .05. When multiple statistical tests are conducted, this procedure needs to be adjusted to compensate for the otherwise inflated Type I error. In some instances in tabletop gaming, sometimes it is desired to roll a 20-sided die (or 'd20') twice and take the greater outcome. Here I draw from probability theory and the case of a d20, where the probability of obtaining any specific outcome is (1)/ 20, to determine the probability of obtaining a specific outcome (Type-I error) at least once across repeated, independent statistical tests.

Menstrual cycle, pregnancy and oral contraceptive use alter attraction to apparent health in faces.

PubMed

Jones, B C; Perrett, D I; Little, A C; Boothroyd, L; Cornwell, R E; Feinberg, D R; Tiddeman, B P; Whiten, S; Pitman, R M; Hillier, S G; Burt, D M; Stirrat, M R; Law Smith, M J; Moore, F R

2005-02-22

Previous studies demonstrating changes in women's face preferences have emphasized increased attraction to cues to possible indirect benefits (e.g. heritable immunity to infection) that coincides with periods of high fertility (e.g. the late follicular phase of the menstrual cycle). By contrast, here we show that when choosing between composite faces with raised or lowered apparent health, women's preferences for faces that are perceived as healthy are (i) stronger during the luteal phase of the menstrual cycle than during the late follicular, fertile phase, (ii) stronger in pregnant women than in non-pregnant women and (iii) stronger in women using oral contraceptives than in women with natural menstrual cycles. Change in preference for male faces was greater for short- than long-term relationships. These findings indicate raised progesterone level is associated with increased attraction to facial cues associated with possible direct benefits (e.g. low risk of infection) and suggest that women's face preferences are influenced by adaptations that compensate for weakened immune system responses during pregnancy and reduce the risk of infection disrupting foetal development.

Severe and fatal complications after diagnostic and therapeutic ERCP: a prospective series of claims to insurance covering public hospitals.

PubMed

Trap, R; Adamsen, S; Hart-Hansen, O; Henriksen, M

1999-02-01

Increasing numbers of patients are undergoing endoscopic retrograde cholangiopancreatography (ERCP) prior to laparoscopic cholecystectomy, and more departments and doctors are performing ERCP, while new data from large prospective series have documented the risks of both diagnostic and therapeutic ERCP. The establishment in Denmark of a Patient Insurance Association, which has covered injury caused during investigation and treatment in public hospitals since July 1992, has made it possible to collect and analyze a large prospective series of ERCP complications for which compensation has been claimed. Thirty-nine consecutive claims for compensation due to complications after ERCP occurring between 1 July 1992 and 31 December 1996 were investigated. Case notes were reviewed, along with laboratory reports and radiographs. The complications were classified according to the international consensus. Claims for compensation were made in 39 cases from 25 hospitals. The indication for ERCP was appropriate in 31. Precut papillotomy for access had been performed in seven. The severity of the complications was mild in one patient, moderate in three patients, severe in 24, and fatal in nine; in two cases, the severity was not classifiable. The complications were: pancreatitis in 23 patients (seven cases fatal, one of which had involved a precut procedure), bleeding in two, perforation in nine (six had a precut procedure, one died), and other reasons in five (including one fatal case). Among the nine fatal cases, cannulation had not been achieved in two and the endoscopic retrograde cholangiogram was normal in four, one of whom underwent a sphincterotomy. One patient with a previous adenoma had an endoprosthesis removed, developed gangrenous cholecystitis afterward, and died. Thirty patients were eligible for compensation. The rejected cases included mild and moderate pancreatitis, a case of fatal hemorrhagic pancreatitis in which the patient had refused blood transfusion, and one patient who had pancreatitis prior to ERCP. ERCP, even for diagnostic purposes, may be associated with very serious and even fatal complications. The use of the precut procedure for access should still be considered dangerous. Other means of investigating the bile ducts should be developed. If endoscopic ultrasonography and magnetic resonance cholangiography prove to have the same diagnostic value as ERCP, which must be considered the gold standard for visualizing the ducts today, they might replace ERCP as the primary investigation in patients with an intermediate or low risk of bile duct stones; this would reduce the numbers of patients exposed to the risks of ERCP.

Facing Finality: Cognitive and Cultural Studies on Death and Dying "Arabic Culture"

ERIC Educational Resources Information Center

Al-Meshhedany, Amna A. Hasan; Al-Sammerai, Nabiha S. Mehdi

2010-01-01

Semantics is a study of human beings cultural background, has from its beginning as a field of study been concerned with the study of humans understanding of culture. Understanding the meaning of "death" has been of great importance to many of the central theoretical developments in this field, especially as it imposes on studies of…

Clinical and Pastoral Issues and Challenges in Working with the Dying and Their Families

ERIC Educational Resources Information Center

Rayburn, Carole A.

2008-01-01

How might counseling professionals interact with clients facing their own or a loved one's serious illness or death and help prepare them for this severe stress and loss? Counseling professionals are encouraged to do no harm, be sensitive to beliefs and traditions, use life stories, and help resolve unfinished business.

The Management of Death in the Middle Class American Family.

ERIC Educational Resources Information Center

Clay, Vidal S.

Starting with the observation that attitudes towards death cannot be divorced from attitudes towards life, the author proceeds with a critical and reflective look at American society's poor management of death, both in terms of the dying person and the bereaved. Denial is the mechanism used to protect ourselves from facing the fact of death, and…

Tree Owner's Manual for the Northeastern Midwestern United States

Treesearch

Jill Johnson; Gary Johnson; Maureen McDonough; Lisa Burban; Janette Monear

2008-01-01

One common issue facing our urban forests is the fact that trees are dying prematurely. Many are planted improperly, setting them up for failure. Many do not receive regular maintenance. And few are adequately protected during construction projects. To help remedy this issue, the Forest Service has created this Tree Owner's Manual. Just like the owner...

[Significances of the life experience for the long-lived elderly person in the process of death/dying and mourning].

PubMed

Menezes, Tânia Maria de Oliva; Lopes, Regina Lúcia Mendonça

2014-08-01

This is a study using the Heideggerian theoretical-phenomenological approach, which sought to understand the significances of the life experience for the long-lived elderly person in the process of death/dying and mourning. It was conducted in 2009 with 16 long-lived senior citizens of both genders who were aged between 80 and 90, members of a community center for the elderly located in a suburban neighborhood of the city of Salvador in the state of Bahia, Brazil. The results showed that the long-lived elderly person experiences the mourning status process when relatives and friends become ill and die. Furthermore, they gave ambiguous reports with respect to the fear of death. With the attributed significances, it was possible to arrive at the unit of significance, namely the authenticity and lack of authenticity of the individual regarding imminent death. The conclusion reached is that long-lived elderly individuals faced with the process of death/dying and mourning is apparent or concealed in accordance with the moment they are experiencing and the opportunities that present themselves, in other words, it is greatly influenced by their past.

Representations in learning new faces: evidence from prosopagnosia.

PubMed

Polster, M R; Rapcsak, S Z

1996-05-01

We report the performance of a prosopagnosic patient on face learning tasks under different encoding instructions (i.e., levels of processing manipulations). R.J. performs at chance when given no encoding instructions or when given "shallow" encoding instruction to focus on facial features. By contrast, he performs relatively well with "deep" encoding instructions to rate faces in terms of personality traits or when provided with semantic and name information during the study phase. We propose that the improvement associated with deep encoding instructions may be related to the establishment of distinct visually derived and identity-specific semantic codes. The benefit associated with deep encoding in R.J., however, was found to be restricted to the specific view of the face presented at study and did not generalize to other views of the same face. These observations suggest that deep encoding instructions may enhance memory for concrete or pictorial representations of faces in patients with prosopagnosia, but that these patients cannot compensate for the inability to construct abstract structural codes that normally allow faces to be recognized from different orientations. We postulate further that R.J.'s poor performance on face learning tasks may be attributable to excessive reliance on a feature-based left hemisphere face processing system that operates primarily on view-specific representations.

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

Quality of dying and death with cancer in Israel.

PubMed

Braun, Michal; Hasson-Ohayon, Ilanit; Hales, Sarah; Zimmermann, Camilla; Rydall, Anne; Peretz, Tamar; Rodin, Gary

2014-07-01

The quality of dying and death refers to the evaluation of the final days of life and the moment of death with respect to how it is prepared for, faced and experienced by those with a terminal illness. It includes experience in multiple domains: physical, psychological, social, spiritual or existential, the nature of health care, life closure and death preparation, and the circumstances of death. To explore the quality of dying and death in cancer patients in Israel and its relationship to place of death and socio-demographic characteristics of the primary caregivers and the deceased. Retrospective assessment of the quality of dying and death, based on caregiver responses to the Quality of Dying and Death (QODD) questionnaire (overall score ranges from 0 to 100; higher scores reflect better dying and death experiences) 8 to 10 months after the death. Ninety-five caregivers of Jewish cancer patients, most of whom were female spouses or children of the deceased. Mean QODD score was 57.2 (standard deviation [SD]=15), which is in the low-moderate range. Place of death, gender and age of the caregiver, and age of the deceased, were associated with QODD score. This retrospective study in Israel demonstrated that the overall quality of dying and death was regarded as poor by almost half of the caregivers. These findings may reflect the relative lack of specialized palliative care and advance care planning in Israel at the time of this study, which took place between 2006 and 2009. Further research and enhancement of palliative care resources may be needed in Israel and several encouraging recent developments (e.g. staff training and legislation) suggest that such changes are now underway.

Skeletal dysplasia with craniofacial deformity and disproportionate dwarfism in hair sheep of northeastern Brazil.

PubMed

Dantas, F P M; Medeiros, G X; Figueiredo, A P M; Thompson, K; Riet-Correa, F

2014-01-01

This paper reports a newly described form of skeletal dysplasia affecting Brazilian hair sheep of the Cabugi breed. This breed is characterized by having a short head and in some cases the animals are smaller and more compact than sheep of similar breeds. Lambs born with craniofacial abnormalities and dwarfism that die at 2-6 months of age are frequent in this breed. In a flock of 68 ewes and three rams of the Cabugi breed, 134 lambs were born over a 4-year period. Of these, 14 (10.4%) had marked cranial abnormalities and dwarfism and died or were humanely destroyed, 43 (32%) had a normal face and 77 (57.5%) had the short face characteristic of the breed. Dwarf lambs were much smaller than normal, with short legs, a domed head with retruded muzzle and protruded mandible, sternal deformities and exophthalmic eyes situated more laterally in the face than normal. Microscopical examination of long bones of the limbs, bones of the base of the skull and vertebrae showed no lesions. Bones from four affected lambs and one control lamb were macerated for morphometric examination. Although the length of the spinal cord was similar, there was disproportionate shortening of the appendicular bones, particularly the distal segments. Thus the disease was defined as a skeletal dysplasia characterized by craniofacial deformity and disproportionate dwarfism. It is suggested that the disease is inherited as an incomplete dominant trait. The shortened face, which is a feature of the Cabugi breed, may represent the heterozygous state and the more severe, often lethal, dwarfism may occur in homozygotes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Experiences with and attitudes toward death and dying among homeless persons.

PubMed

Song, John; Ratner, Edward R; Bartels, Dianne M; Alderton, Lucy; Hudson, Brenda; Ahluwalia, Jasjit S

2007-04-01

Homeless persons face many barriers to health care, have few resources, and experience high death rates. They live lives of disenfranchisement and neglect. Few studies have explored their experiences and attitudes toward death and dying. Unfortunately, studies done in other populations may not apply to homeless persons. Exploring these experiences and attitudes may provide insight into life, health care, and end-of-life (EOL) concerns of this population. To explore the experiences and attitudes toward death and dying among homeless persons. Qualitative study utilizing focus groups. Fifty-three homeless persons recruited from homeless service agencies. In-depth interviews, which were audiotaped and transcribed. We present seven themes, some of which are previously unreported. Homeless persons described many significant experiences with death and dying, and many participants suffered losses while very young. These encounters influenced participants' attitudes toward risks and risky behavior: e.g., for some, these experiences provided justification for high-risk behaviors and influenced their behaviors while living on the streets. For others, they may be associated with their homelessness. Finally, these experiences informed their attitudes toward death and dying as well as EOL care; homeless persons believe that care will be poor at the EOL. Findings from this study have implications for addressing social services, health promotion, prevention, and EOL care for homeless persons, as well as for others who are poor and disenfranchised.

Experiences With and Attitudes Toward Death and Dying Among Homeless Persons

PubMed Central

Ratner, Edward R; Bartels, Dianne M.; Alderton, Lucy; Hudson, Brenda; Ahluwalia, Jasjit S.

2007-01-01

Background Homeless persons face many barriers to health care, have few resources, and experience high death rates. They live lives of disenfranchisement and neglect. Few studies have explored their experiences and attitudes toward death and dying. Unfortunately, studies done in other populations may not apply to homeless persons. Exploring these experiences and attitudes may provide insight into life, health care, and end-of-life (EOL) concerns of this population. Objective To explore the experiences and attitudes toward death and dying among homeless persons. Design Qualitative study utilizing focus groups. Participants Fifty-three homeless persons recruited from homeless service agencies. Measurements In-depth interviews, which were audiotaped and transcribed. Results We present seven themes, some of which are previously unreported. Homeless persons described many significant experiences with death and dying, and many participants suffered losses while very young. These encounters influenced participants’ attitudes toward risks and risky behavior: e.g., for some, these experiences provided justification for high-risk behaviors and influenced their behaviors while living on the streets. For others, they may be associated with their homelessness. Finally, these experiences informed their attitudes toward death and dying as well as EOL care; homeless persons believe that care will be poor at the EOL. Conclusions Findings from this study have implications for addressing social services, health promotion, prevention, and EOL care for homeless persons, as well as for others who are poor and disenfranchised. PMID:17372788

[Assisted suicide and euthanasia: an old and tragic debate, with a guarded prognosis].

PubMed

Júdez, J

2007-01-01

The basic effort in "regulation of help in dying" is a cultural one. The social and professional energies must above all be directed towards a renovated "organisation of care in dying" that, far from breaking off our relationships, strengthens them. That, besides providing dignity to dying, facilitates "living" it humanely inasmuch as possible, attending to the bio-psycho-socio-emotional (and spiritual) dimension. At the individual level the desire to die rather than to continue living is a drama that requires mobilising the moral effort of everyone, according to the corresponding responsibility for exploring and evaluating the situation in the search for alternative plans. And, at the social level, the fact of not providing an open outcome to those highly exceptional situations (between 01-2%) can be a tragedy. But the basic social effort does not lie at the end, in providing or not proving a way out, for a few patients (although the accumulated data for Oregon indicate that there is no slippery slope and in Holland there has been a change of attitude towards a fall in euthanasia facing the rise of the alternative of terminal sedation). The cultural, social, organisational, professional and individual effort from which we will all benefit comes much earlier, and involves changing our paradigm of care in particular at the end of life. Although death is inevitable, dying badly should not be so unavoidable.

Going Beyond Standard English: An Instructional Module for Improving International Business Communication.

ERIC Educational Resources Information Center

Jarvis, Scott; Stephens, Robert

It is proposed that because (1) adult learners of English as a Second Language face great challenges in communicating with native English speakers; and (2) native English-speakers can learn strategies to compensate for some of these difficulties, there is a need for instruction in these strategies and skills for Americans in international…

Five Smart Ways Educators Can Save Money on Benefit Costs

ERIC Educational Resources Information Center

McCullough, Pat

2012-01-01

State and local governments today face significant financial stress from the most recent recession, which makes their need to control benefit costs even greater. Revenues declined 22% from 2008 to 2009, mostly because of reduced tax income. At the same time, state and local government spending on unemployment compensation jumped 86%. It is no…

Facing Learning Disabilities in the Adult Years. Understanding Dyslexia, ADHD, Assessment, Intervention, and Research.

ERIC Educational Resources Information Center

Shapiro, Joan; Rich, Rebecca

This text provides information on learning disabilities in adults and offers practical ways to compensate. Chapters address: (1) definitions of learning disability; (2) etiology of learning disabilities; (3) our cognitive or thinking systems; (4) different assessment settings and some of the tests used to diagnose a learning disability; (5)…

A Study of the Effects of Outsourcing Residence Life Programs on Student Satisfaction

ERIC Educational Resources Information Center

Manley, James H., Jr.

2011-01-01

Institutions of higher education are facing the difficult challenge of meeting increased demands for high quality education and services for students, while keeping costs low, and finding new sources of revenue to compensate for the decrease in funding from state and federal sources. In an attempt to meet these demands new strategies and…

Merits, Demands, and Challenges of VSED.

PubMed

Menzel, Paul T

2016-01-01

VSED demands willful determination from those who do it. The requisite willfulness is an ethical strength, providing greater assurance of voluntariness. Dying by VSED has another major merit: its pace provides time for the person and loved ones to embrace death in a shared appreciation of life. Support from professional caregivers is important in making dying by VSED comfortable. If acknowledged by its providers, this need for professional support has ancillary benefits: accurate information is more likely to be communicated to patients, and professional caregivers help normalize VSED and minimize abuses. VSED faces a moral challenge when it is categorized as suicide. In an obvious sense, VSED is suicide: the person's intention is to die, and the means employed assuredly causes death. Being a form of suicide does not imply that VSED is morally impermissible. Pursued to hasten death in a last stage of life, it is a response to "terminal" situations. This contributes greatly to VSED's moral acceptability when perceived as suicide.

Affirming Life in the Face of Death: Ricoeur's Living Up to Death as a modern ars moriendi and a lesson for palliative care.

PubMed

de Lange, Ds Frits

2014-11-01

In his posthumously published Living Up to Death Paul Ricoeur left an impressive testimony on what it means to live at a high old age with death approaching. In this article I present him as a teacher who reminds us of valuable lessons taught by patients in palliative care and their caretakers who accompany them on their way to death, and also as a guide in our search for a modern ars moriendi, after--what many at least experience as--the breakdown of traditional religious belief in a personal afterlife. These lessons can be summarized in the following theses. 'Living up to death, one cannot experience one's own death. Therefore, never consider someone dying as moribund'. 'Though everybody is alone in dying, nobody should die alone.' 'The preparation for death is an affirmation of life'. 'Life experienced as a gift can be given up'. The plausibility of the last thesis, however, may go beyond the confines of austere philosophical thinking.

Forced Migration and Changing Livelihoods in the Brazilian Amazon.

PubMed

Randell, Heather

2017-09-01

Forced migration due to development projects or environmental change impacts livelihoods, as affected households are faced with new-and often less favorable-environmental, social, and economic conditions. This article examines changing livelihood strategies among a population of rural agricultural households displaced by the Belo Monte Dam in the Brazilian Amazon. Using longitudinal data, I find that many households used compensation payments to concentrate income generation efforts on the most lucrative strategies-cacao and cattle production and business or rental income. Poorer households and those that received the least compensation were more likely to continue relying on agricultural wage labor-a less desirable income source associated with not owning land or with persons needing to supplement income with additional work as a day laborer. Results also indicate that the amount of compensation received by most households was sufficient to enable them to make productive investments beyond attaining replacement land and housing. Many households invested in assets such as agricultural infrastructure, cattle, rental houses, or tractors-all of which directly contribute to future income. Displacement compensation, similar to remittances or conditional cash transfers, can therefore act as an important infusion of capital to promote socioeconomic development and poverty reduction.

Forced Migration and Changing Livelihoods in the Brazilian Amazon*

PubMed Central

Randell, Heather

2018-01-01

Forced migration due to development projects or environmental change impacts livelihoods, as affected households are faced with new—and often less favorable—environmental, social, and economic conditions. This article examines changing livelihood strategies among a population of rural agricultural households displaced by the Belo Monte Dam in the Brazilian Amazon. Using longitudinal data, I find that many households used compensation payments to concentrate income generation efforts on the most lucrative strategies—cacao and cattle production and business or rental income. Poorer households and those that received the least compensation were more likely to continue relying on agricultural wage labor—a less desirable income source associated with not owning land or with persons needing to supplement income with additional work as a day laborer. Results also indicate that the amount of compensation received by most households was sufficient to enable them to make productive investments beyond attaining replacement land and housing. Many households invested in assets such as agricultural infrastructure, cattle, rental houses, or tractors—all of which directly contribute to future income. Displacement compensation, similar to remittances or conditional cash transfers, can therefore act as an important infusion of capital to promote socioeconomic development and poverty reduction. PMID:29720771

Creating beauty: creativity compensates for low physical attractiveness when individuals assess the attractiveness of social and romantic partners

PubMed Central

2017-01-01

Although creativity is attractive in a potential mate, it is unclear (i) whether the effects of creativity on attractiveness generalize to other social contexts and (ii) whether creativity has equivalent effects on men's and women's attractiveness. As social knowledge of creativity may either enhance or ‘offset’ the appeal of social partners who differ in physical attractiveness, three repeated measures experiments were conducted to directly address these issues. Here, participants rated a series of face–text pairs for attractiveness on trials that differed in one of four combinations of facial attractiveness (attractive and less attractive) and creativity (creative and less creative), rating story-tellers in two experiments (short interpretations of an identical painting) and creative ideas in a further experiment (alternative uses for an everyday object). Regardless of the sex of the judge, creativity and facial attractiveness had independent effects on men's overall attractiveness (initial experiment) and, in further experiments, more substantial effects on the attractiveness of men with less attractive faces than men with attractive faces (when using a different measure of creativity) and specific effects on the attractiveness of individuals with less attractive faces (when using different face stimuli). Collectively, across three experiments, these findings suggest that creativity may compensate for putative cues to lower biological ‘quality’ and that the benefits of creativity to social groups more generally enhance attraction to creative men (in two experiments) and creative men and women (one experiment). More broadly, the data suggest that species can integrate knowledge of cognitive intelligence with visual cues to biological ‘quality’ to facilitate mate and/or ally choice. PMID:28484614

Numerical Investigation of the Residual Stress Distribution of Flat-Faced and Convexly Curved Tablets Using the Finite Element Method.

PubMed

Otoguro, Saori; Hayashi, Yoshihiro; Miura, Takahiro; Uehara, Naoto; Utsumi, Shunichi; Onuki, Yoshinori; Obata, Yasuko; Takayama, Kozo

2015-01-01

The stress distribution of tablets after compression was simulated using a finite element method, where the powder was defined by the Drucker-Prager cap model. The effect of tablet shape, identified by the surface curvature, on the residual stress distribution was investigated. In flat-faced tablets, weak positive shear stress remained from the top and bottom die walls toward the center of the tablet. In the case of the convexly curved tablet, strong positive shear stress remained on the upper side and in the intermediate part between the die wall and the center of the tablet. In the case of x-axial stress, negative values were observed for all tablets, suggesting that the x-axial force always acts from the die wall toward the center of the tablet. In the flat tablet, negative x-axial stress remained from the upper edge to the center bottom. The x-axial stress distribution differed between the flat and convexly curved tablets. Weak stress remained in the y-axial direction of the flat tablet, whereas an upward force remained at the center of the convexly curved tablet. By employing multiple linear regression analysis, the mechanical properties of the tablets were predicted accurately as functions of their residual stress distribution. However, the multiple linear regression prediction of the dissolution parameters of acetaminophen, used here as a model drug, was limited, suggesting that the dissolution of active ingredients is not a simple process; further investigation is needed to enable accurate predictions of dissolution parameters.

Image preprocessing study on KPCA-based face recognition

NASA Astrophysics Data System (ADS)

Li, Xuan; Li, Dehua

2015-12-01

Face recognition as an important biometric identification method, with its friendly, natural, convenient advantages, has obtained more and more attention. This paper intends to research a face recognition system including face detection, feature extraction and face recognition, mainly through researching on related theory and the key technology of various preprocessing methods in face detection process, using KPCA method, focuses on the different recognition results in different preprocessing methods. In this paper, we choose YCbCr color space for skin segmentation and choose integral projection for face location. We use erosion and dilation of the opening and closing operation and illumination compensation method to preprocess face images, and then use the face recognition method based on kernel principal component analysis method for analysis and research, and the experiments were carried out using the typical face database. The algorithms experiment on MATLAB platform. Experimental results show that integration of the kernel method based on PCA algorithm under certain conditions make the extracted features represent the original image information better for using nonlinear feature extraction method, which can obtain higher recognition rate. In the image preprocessing stage, we found that images under various operations may appear different results, so as to obtain different recognition rate in recognition stage. At the same time, in the process of the kernel principal component analysis, the value of the power of the polynomial function can affect the recognition result.

Good and bad death: exploring the perspectives of older Mexican Americans.

PubMed

Ko, Eunjeong; Cho, Sunhee; Perez, Ramona L; Yeo, Younsook; Palomino, Helen

2013-01-01

The purpose of this study was to identify and describe the domains that define a good death from the perspectives of healthy Mexican American older adults. Qualitative data from face-to-face interviews with 18 participants residing in Southern California were analyzed. Five categories regarding the concepts of good and bad death include no suffering, living life with faith, having time for closure with family, dying at home, and a natural death. Understanding the meaning of good and bad death within specific cultural contexts is integral to promoting cultural sensitivity when working with older adults, especially in end-of-life care.

Anthrax

DTIC Science & Technology

1984-11-21

acute or subacute, with fever , dullness, anorexia, and inflammatory edema of the face, throat, and neck (1); however, some individuals may die...involvement, blood-stained froth may be discharged from the mouth. Petechial hemorrhages often occur on the skin. With alimentary involvement, there is...which are hot and painful. Other symptoms Include high fever , severe depression, anorexia, and dyspnea which occur over the course of 2 to 4 days. Anthrax

Hundun's Hospitality: Daoist, Derridean and Levinasian Readings of Zhuangzi's Parable

ERIC Educational Resources Information Center

Wu, Meiyao

2014-01-01

At the end "Zhuangzi 7," Hundun (the Middle Sea) invites his two neighbours, the North Sea and South Sea, to visit him. They repay his kindness by drilling seven holes (for seeing, hearing, breathing and eating) in his face to make him more "human" but Hundun dies. This essay pursues Daoist, Derridean and Levinasian readings of…

Sub-Saharan Africa Report.

DTIC Science & Technology

1987-01-14

Crisis Forcing Farmers To Face Change (Editorial; VOLKSBLAD, 24 Oct 86) 65 - c - Use of Nuclear Technology in Agriculture Foreseen (DIE BURGER, 7...requires the participation of all the countries concerned. Even the most enthusiastic supporters of sanctions recognize that the results can only be... result in the asphyxiation of the front-line countries. Objectively speaking, Lesotho, Botswana, and Zimbabwe are forced to compromise. But are Zaire

Helping the Angels

PubMed Central

Mangewala, Vikas; Baron, Richard

2013-01-01

According to the World Health Organization, 53,000 children die every year in United States because of a chronic medical condition. Physicians have to face various ethical and psychological challenges while managing these conditions. These challenges range from disclosure of diagnosis to effective grief counseling to the family. In this article we have discussed some of these challenges and strategies to effectively meet these challenges. PMID:23630648

Dying with Dignity: Difficult Times, Difficult Choices. Hearing before the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

This document contains witness testimonies and prepared statements from the Congressional hearing called to examine the dilemma faced by the terminally ill. Opening statements are included from Congressmen Roybal, Henry, Hughes, Gordon, Wortley, Hammerschmidt, and Snowe. Jacob Javits, former United States Senator, testifies, as a terminally ill…

Sonnet XXX: Love, dignity, and dying.

PubMed

Ely, E Wesley

2016-05-01

All of us in medicine who care for patients who are chronically critically ill, dying of incurable illnesses, will be faced with discussions about the value of their lives and about the appropriateness of ongoing supportive care. Such discussions are good and true, and they must always be done within the context of the sanctity of every human life and the promise of God that we are His children, each and every one of us. In this article, I explore the end-of-life path of a patient with amyotrophic lateral sclerosis (ALS) and the courageous faith that she demonstrated in the face of her illness. I explore with you, the reader, the hard-core conversations that took place at her bedside and their meaning in light of Catholic moral teaching. This story is not meant to indicate that we should always do all interventions at all times for all patients. That would be a teaching counter to Evangelium vitae . This story is meant to help you think through the path of your patients and of you as a physician or other type of healthcare professional in serving your patients. Primum non nocere. Ad majorem Dei gloriam .

Pyramidal-Reflector Solar Heater

NASA Technical Reports Server (NTRS)

1982-01-01

Motor-driven reflector compensates for seasonal changes in Sun's altitude. System has flat-plate absorbers mounted on north side of attic interior. Skylight window on south-facing roof admits Sunlight into attic, lined with mirrors that reflect light to absorbers. Reflectors are inner surfaces of a pyramid lying on its side with window at its base and absorber plates in a cross-sectional plane near its apex.

Strand IV: Environmental and Community Health. Environmental and Public Health, Grades 4-6. Special Edition for Evaluation and Discussion.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Elementary Curriculum Development.

This prototypic curriculum is designed to develop awareness of the challenges man faces in his crowded communities to insure clean water, pest control, waste removal, safe food handling and adequate community health facilities. It distinguishes between the prevention of future environmental abuse and compensation for past abuses. Both the gaining…

Standard Setting in a Small Scale OSCE: A Comparison of the Modified Borderline-Group Method and the Borderline Regression Method

ERIC Educational Resources Information Center

Wood, Timothy J.; Humphrey-Murto, Susan M.; Norman, Geoffrey R.

2006-01-01

When setting standards, administrators of small-scale OSCEs often face several challenges, including a lack of resources, a lack of available expertise in statistics, and difficulty in recruiting judges. The Modified Borderline-Group Method is a standard setting procedure that compensates for these challenges by using physician examiners and is…

Self mobile space manipulator project

NASA Technical Reports Server (NTRS)

Brown, H. Ben; Friedman, Mark; Xu, Yangsheng; Kanade, Takeo

1992-01-01

A relatively simple, modular, low mass, low cost robot is being developed for space EVA that is large enough to be independently mobile on a space station or platform exterior, yet versatile enough to accomplish many vital tasks. The robot comprises two long flexible links connected by a rotary joint, with 2-DOF 'wrist' joints and grippers at each end. It walks by gripping pre-positioned attachment points, such as trusswork nodes, and alternately shifting its base of support from one foot (gripper) to the other. The robot can perform useful tasks such as visual inspection, material transport, and light assembly by manipulating objects with one gripper, while stabilizing itself with the other. At SOAR '90, we reported development of 1/3 scale robot hardware, modular trusswork to serve as a locomotion substrate, and a gravity compensation system to allow laboratory tests of locomotion strategies on the horizontal face of the trusswork. In this paper, we report on project progress including the development of: (1) adaptive control for automatic adjustment to loads; (2) enhanced manipulation capabilities; (3) machine vision, including the use of neural nets, to guide autonomous locomotion; (4) locomotion between orthogonal trusswork faces; and (5) improved facilities for gravity compensation and telerobotic control.

Selbstorganisation: ein neues Paradigma für die Schulpädagogik — oder alter Wein in neuen Schläuchen?

NASA Astrophysics Data System (ADS)

Strobel-Eisele, Gabi

1996-09-01

School education has long been accustomed to accommodating theories from other scientific disciplines. The paradigm of self-organization provides a complex concept which will stimulate reflection on the phenomenon of "schools" within educational science. Analysis of systems in the light of different theory, motivated by this paradigm, can give a clearer view of the potential and limitations of a modern social system, which is what a school now is. By employing this paradigm, answers can be found to the questions whether schools can deliver education that compensates for family systems, and whether teaching can also provide therapy.

Shear zone formation within the billet and metal flow through the die orifice in unlubricated axisymmetric forward and backward extrusion

NASA Astrophysics Data System (ADS)

Valberg, Henry; Costa, Andrè L. M.

2017-10-01

Metal flow inside the billet is known to be completely different in forward (FWE) and backward (BWE) Al-extrusion. A practical implication of this is that contamination near to the surface of the extrusion billet, or on the peripheral surface skin, tends to flow out of the die more readily in BWE than in FWE. It is therefore common in BWE to use a scalping operation on the billet to remove eventual sub-surface contamination that may be present. This additional working operation may be required in order to avoid surface quality problems on BWE profiles. In spite of the importance of metal flow in metals extrusion, there are still lack of knowledge about the topic. With recent progress in FEM-analysis for modelling deformation processing, however, it is now possible to perform accurate studies on metal flow phenomena by simulation on the computer. In our study, we are using the 3D FEM-program DEFORM® to model axisymmetric FWE and BWE in case of non-lubricated extrusion through a flat-faced die. Our primary focus is to consider the difference in appearance of shear zones present inside the extrusion billet for the two processes, including metal flow in the die mouth.

Near infrared and visible face recognition based on decision fusion of LBP and DCT features

NASA Astrophysics Data System (ADS)

Xie, Zhihua; Zhang, Shuai; Liu, Guodong; Xiong, Jinquan

2018-03-01

Visible face recognition systems, being vulnerable to illumination, expression, and pose, can not achieve robust performance in unconstrained situations. Meanwhile, near infrared face images, being light- independent, can avoid or limit the drawbacks of face recognition in visible light, but its main challenges are low resolution and signal noise ratio (SNR). Therefore, near infrared and visible fusion face recognition has become an important direction in the field of unconstrained face recognition research. In order to extract the discriminative complementary features between near infrared and visible images, in this paper, we proposed a novel near infrared and visible face fusion recognition algorithm based on DCT and LBP features. Firstly, the effective features in near-infrared face image are extracted by the low frequency part of DCT coefficients and the partition histograms of LBP operator. Secondly, the LBP features of visible-light face image are extracted to compensate for the lacking detail features of the near-infrared face image. Then, the LBP features of visible-light face image, the DCT and LBP features of near-infrared face image are sent to each classifier for labeling. Finally, decision level fusion strategy is used to obtain the final recognition result. The visible and near infrared face recognition is tested on HITSZ Lab2 visible and near infrared face database. The experiment results show that the proposed method extracts the complementary features of near-infrared and visible face images and improves the robustness of unconstrained face recognition. Especially for the circumstance of small training samples, the recognition rate of proposed method can reach 96.13%, which has improved significantly than 92.75 % of the method based on statistical feature fusion.

Status of the White-faced Ibis: Breeding colony dynamics of the Great Basin population, 1985-1997

USGS Publications Warehouse

Earnst, S.L.; Neel, L.; Ivey, G.L.; Zimmerman, T.

1998-01-01

The status of the White-faced Ibis (Plegadis chihi) in the Great Basin is of concern because of its small population size and the limited and dynamic nature of its breeding habitat. We analyzed existing annual survey data for the White-faced Ibis breeding in the Great Basin and surrounding area for 1985-1997. Methods varied among colonies and included flight-line counts and fixed-wing aircraft and helicopter surveys. The number of White-faced Ibis breeding pairs in the Great Basin area has nearly tripled since 1985, despite years of severe flooding and drought at major breeding areas. This growth is reflected in both peripheral (i.e., Oregon, California, Idaho) and core (i.e., Nevada and Utah) components of the population. Our data on colony dynamics in Oregon and Nevada illustrate the ability of the highly nomadic White-faced Ibis to compensate for poor conditions at traditional colony sites by moving among colonies and rapidly colonizing newly available wetlands. We suggest that the White-faced Ibis would benefit from a landscape mosaic of well-distributed peripheral wetlands and persistent colony sites. The nomadic nature of the White-faced Ibis and the dynamic nature of their breeding habitat necessitates that wetland management decisions and population monitoring be conducted in a regional context.

Status of the white-faced ibis: Breeding colony dynamics of the Great Basin population, 1985-1997

USGS Publications Warehouse

Earnst, Susan L.; Neel, L.; Ivey, G.L.; Zimmerman, T.

1998-01-01

The status of the White-faced Ibis (Plegadis chihi) in the Great Basin is of concern because of its small population size and the limited and dynamic nature of its breeding habitat. We analyzed existing annual survey data for the White-faced Ibis breeding in the Great Basin and surrounding area for 1985-1997. Methods varied among colonies and included flight-line counts and fixed-wing aircraft and helicopter surveys. The number of White-faced Ibis breeding pairs in the Great Basin area has nearly tripled since 1985, despite years of severe flooding and drought at major breeding areas. This growth is reflected in both peripheral (i.e., Oregon, California, Idaho) and core (i.e., Nevada and Utah) components of the population. Our data on colony dynamics in Oregon and Nevada illustrate the ability of the highly nomadic White-faced Ibis to compensate for poor conditions at traditional colony sites by moving among colonies and rapidly colonizing newly available wetlands. We suggest that the White-faced Ibis would benefit from a landscape mosaic of well-distributed peripheral wetlands and persistent colony sites. The nomadic nature of the White-faced Ibis and the dynamic nature of their breeding habitat necessitates that wetland management decisions and population monitoring be conducted in a regional context.

Age-related injury and compensation claim rates in heavy industry.

PubMed

Guest, M; Boggess, M M; Viljoen, D A; Duke, J M; Culvern, C N

2014-03-01

Although ageing workers face specific health and safety concerns, conflicting evidence exists regarding the effects of age on workplace injury rates and workers' compensation claims. To examine injury and workers' compensation claim rates by age and injury type in an aluminium smelter over a 9-year period. Routinely collected data for workplace injuries and workers' compensation claims were retrieved for the period from 1997 to 2005. The study included a total of 709 workers who experienced 2281 at-work injuries and submitted 446 claims. In 1997, 16% of employees were aged 50 or over; by 2005 that proportion had more than doubled to 35%. Injury and claim rates in all age groups did not change significantly during this period. Workers younger than 30 years of age had the highest injury rates, with differences most significant for injuries other than sprains and strains. Claim rates were not significantly different across age groups. These findings do not provide evidence to support the notion that older workers sustain more injuries and are more likely to claim compensation for their injuries. Our findings demonstrate that in this workplace, older workers were able to maintain their ability to work safely. This contrasts with the finding that younger workers had the highest injury and claim rates. While adapting to the needs of an ageing workforce, employers should not lose sight of the need to nurture a strong culture of working safely among their youngest workers.

Enthalpy-entropy compensation: the role of solvation.

PubMed

Dragan, Anatoliy I; Read, Christopher M; Crane-Robinson, Colyn

2017-05-01

Structural modifications to interacting systems frequently lead to changes in both the enthalpy (heat) and entropy of the process that compensate each other, so that the Gibbs free energy is little changed: a major barrier to the development of lead compounds in drug discovery. The conventional explanation for such enthalpy-entropy compensation (EEC) is that tighter contacts lead to a more negative enthalpy but increased molecular constraints, i.e., a compensating conformational entropy reduction. Changes in solvation can also contribute to EEC but this contribution is infrequently discussed. We review long-established and recent cases of EEC and conclude that the large fluctuations in enthalpy and entropy observed are too great to be a result of only conformational changes and must result, to a considerable degree, from variations in the amounts of water immobilized or released on forming complexes. Two systems exhibiting EEC show a correlation between calorimetric entropies and local mobilities, interpreted to mean conformational control of the binding entropy/free energy. However, a substantial contribution from solvation gives the same effect, as a consequence of a structural link between the amount of bound water and the protein flexibility. Only by assuming substantial changes in solvation-an intrinsically compensatory process-can a more complete understanding of EEC be obtained. Faced with such large, and compensating, changes in the enthalpies and entropies of binding, the best approach to engineering elevated affinities must be through the addition of ionic links, as they generate increased entropy without affecting the enthalpy.

Creating a physician network can pay off--with the right tools.

PubMed

1997-09-01

Putting together a physician practice group and then creating the management and administrative structure for that practice to financially succeed is one of the greatest challenges health systems face today. The marriage can work, experts tell Managed Care Strategies, but only with innovation and careful attention to details such as physician compensation design, governance issues, and methods for resolving conflict resolution.

Harmonized sales tax a taxing issue for MDs in Atlantic Canada

PubMed Central

Robb, N

1997-01-01

Physicians in 3 atlantic provinces say the linking of provincial sales taxes with the GST exacerbates the inequity physicians face because it yet again adds to their overhead costs. Physicians in Nova Scotia have already won an annual rebate to compensate them for the heavier tax burden. Doctors in the Maritimes warn that heavier taxes make recruiting there even more difficult. PMID:9371073

Operational Handbook: Working Amongst Different Cultures

DTIC Science & Technology

2014-06-01

take revenge is seen as shameful . However, nanawati (forgiveness) and punishments levied by jirga (council of elders), such as saz (compensation...in Asia and the Pacific locals may have no hesitation in commenting on your weight or calling you fat . This is rarely an insult and sometimes a...point without contradicting your counterparts. The key is to avoid shaming your counterpart and ensuring that face saving opportunities are

Meeting the Challenges of Stakeholder Engagement and Communication: Lessons from Teacher Incentive Fund Grantees. The Harvesting Project

ERIC Educational Resources Information Center

Koppich, Julia E.

2010-01-01

As of August 2010, a total of 33 states, school districts, charter school coalitions, and other education organizations had received Teacher Incentive Funds (TIF) to redesign compensation programs for teachers and principals. The U.S. Department of Education named a new cohort of TIF grantees on September 23, 2010. TIF grantees have faced a number…

Economic rationale for planting less trees in the face of seedling mortality

Treesearch

Thomas J. Dean; S. Joseph Chang

2002-01-01

Simple economic analyses are used to demonstrate that planting extra trees to compensate for initial seedling mortality can actually reduce the profit expected from a pine plantation. At a 6-percent interest rate, the cost of planting 15 or 25 percent additional seedlings compounded to the end of a 30-year rotation exceeds the revenue lost to these rates of seedling...

Pesticide mortality of young white-faced ibis in Texas

USGS Publications Warehouse

Flickinger, Edward L.; Meeker, D.L.

1972-01-01

The combination of the symptoms observed in sick and dying birds and the high brain residues in the three birds collected dying, as well as in two of the four collected dead, implicate dieldrin as at least one of the causes of mortality of young ibis at the Lavaca Bay colony. Mercury residues in the kidneys of all four dead young, including those with low brain residues of dieldrin, suggest that birds were exposed to mercury in rice fields and that mercury may also have contributed to the mortality. Since adult ibis normally feed their young on invertebrates collected in rice fields treated with aldrin and Ceresan L, the use of these rice pesticides appears to be a serious hazard to this species, and probably to other wild birds with similar habits.

Obese children experience more extremity fractures than nonobese children and are significantly more likely to die from traumatic injuries.

PubMed

Kim, Seung-Ju; Ahn, Joonghyun; Kim, Hyung Kook; Kim, Jong Hun

2016-10-01

Two of the most prevalent problems children facing worldwide are injuries and obesity. We conducted a systematic review of published studies that evaluated the effects of obesity on children with traumatic injuries. Six studies published between 2006 and 2014 were identified, comprising a total of 4594 children: 867 were obese and 3727 were not. Obese children were 25% more likely to have extremity fractures than nonobese children (p = 0.003), and their mortality rate was significantly higher at 4.7% versus 2.8% (p = 0.026). Our review showed that obese children were more likely to have extremity fractures and die of traumatic injuries than nonobese children. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

A qualitative study of oncologists' approaches to end-of-life care.

PubMed

Jackson, Vicki A; Mack, Jennifer; Matsuyama, Robin; Lakoma, Mathew D; Sullivan, Amy M; Arnold, Robert M; Weeks, Jane C; Block, Susan D

2008-07-01

To understand how oncologists provide care at the end of life, the emotions they experience in the provision of this care, and how caring for dying patients may impact job satisfaction and burnout. A face-to-face survey and in-depth semistructured interview of 18 academic oncologists who were asked to describe the most recent inpatient death on the medical oncology service. Physicians were asked to describe the details of the patient death, their involvement with the care of the patient, the types and sequence of their emotional reactions, and their methods of coping. Grounded theory qualitative methods were utilized in the analysis of the transcripts. Physicians, who viewed their physician role as encompassing both biomedical and psychosocial aspects of care, reported a clear method of communication about end-of-life (EOL) care, and an ability to positively influence patient and family coping with and acceptance of the dying process. These physicians described communication as a process, made recommendations to the patient using an individualized approach, and viewed the provision of effective EOL care as very satisfying. In contrast, participants who described primarily a biomedical role reported a more distant relationship with the patient, a sense of failure at not being able to alter the course of the disease, and an absence of collegial support. In their descriptions of communication encounters with patients and families, these physicians did not seem to feel they could impact patients' coping with and acceptance of death and made few recommendations about EOL treatment options. Physicians' who viewed EOL care as an important role described communicating with dying patients as a process and reported increased job satisfaction. Further research is necessary to determine if educational interventions to improve physician EOL communication skills could improve physician job satisfaction and decrease burnout.

Factors and Regional Differences Associated with Endometriosis: A Multi-Country, Case-Control Study.

PubMed

Chapron, Charles; Lang, Jing-He; Leng, Jin-Hua; Zhou, Yingfang; Zhang, Xinmei; Xue, Min; Popov, Alexander; Romanov, Vladimir; Maisonobe, Pascal; Cabri, Patrick

2016-08-01

The present study aimed to investigate clinical, lifestyle, and environmental factors associated with endometrioma (OMA) and/or deep infiltrating endometriosis (DIE) as determined by case-control comparison [women with superficial peritoneal endometriosis (SUP) or no endometriosis], and compare differences between factor associated with endometriosis at a national level. This was three countries (China, Russia, and France), case-control study in 1008 patients. Patients were identified and enrolled during their first routine appointment with their physician post-surgery for a benign gynecologic indication, excluding pregnancy. Retrospective information on symptoms and previous medical history was collected via face-to-face interviews; patients also completed a questionnaire to provide information on current habits. For every DIE patient recruited (n = 143), two women without endometriosis (n = 288), two SUP patients (n = 288), and two OMA patients (n = 288) were recruited. For the overall population, factors significantly associated (P ≤ 0.05) with DIE or OMA [Odds ratio (OR) >1] were: previous use of hormonal treatment for endometriosis [OR 6.66; 95% confidence interval (CI) 4.05-10.93]; previous surgery for endometriosis (OR 1.95; 95% CI 1.11-3.43); and living or working in a city or by a busy area (OR 1.66; 95% CI 1.09-2.52). Differences between regions with regard to the diagnosis, symptomatology, and treatment of endometriosis exist. The findings provide insight into potential risk factors for endometriosis and differences between regions in terms of endometriosis management and symptomatology. Further investigations are required to confirm the associations found in this study. ClinicalTrials.gov identifier, NCT01351051. Ipsen.

Clinical impact of leak compensation during non-invasive ventilation.

PubMed

Storre, Jan Hendrik; Bohm, Philipp; Dreher, Michael; Windisch, Wolfram

2009-10-01

This study aimed to assess the impact of leak compensation capabilities during pressure- and volume-limited non-invasive positive-pressure ventilation (NPPV) in COPD patients. Fourteen patients with stable hypercapnic COPD who were receiving long-term NPPV were included in the study. For both modes of NPPV, a full face mask and an artificial leak in the ventilatory circuit were used at three different settings, and applied during daytime NPPV, either without leakage (setting I), with leakage during inspiration only (setting II), and with leakage during inspiration and expiration (setting III). Ventilation pattern was pneumotachy-graphically recorded. NPPV was feasible with negligible leak volumes, indicating optimal mask fitting during the daytime (setting I). In the presence of leakage (settings II and III), the attempt to compensate for leak was only evident during pressure-limited NPPV, since inspiratory volumes delivered by the ventilator increased from 726+/-129 (setting I) to 1104+/-164 (setting II), and to 1257+/-166 (setting III) ml during pressure-limited NPPV, respectively (all p<0.001); however, they remained stable during volume-limited NPPV. Leak compensation resulted in a decrease in leakage-induced dyspnea. However, 83%/87% (setting II/III) of the additionally-delivered inspiratory volume during pressure-limited NPPV was also lost via leakage. Expiratory volume was higher in setting II compared to setting III (both p<0.001), indicating the presence of significant expiratory leakage. The attempt at leak compensation largely feeds the leakage itself and only results in a marginal increase of tidal volume. However, pressure-limited--but not volume-limited--NPPV results in a clinically-important leak compensation in vivo. www.uniklinik-freiburg.de/zks/live/uklregister/Oeffentlich.html Identifier: UKF001272.

Science to support aquatic animal health

USGS Publications Warehouse

Purcell, Maureen K.; Harris, M. Camille

2016-10-18

Healthy aquatic ecosystems are home to a diversity of plants, invertebrates, fish and wildlife. Aquatic animal populations face unprecedented threats to their health and survival from climate change, water shortages, habitat alteration, invasive species and environmental contaminants. These environmental stressors can directly impact the prevalence and severity of disease in aquatic populations. For example, periodic fish kills in the upper Chesapeake Bay Watershed are associated with many different opportunistic pathogens that proliferate in stressed fish populations. An estimated 80 percent of endangered juvenile Puget Sound steelhead trout die within two weeks of entering the marine environment, and a role for disease in these losses is being investigated. The introduction of viral hemorrhagic septicemia virus (VHSV) into the Great Lakes—a fishery worth an estimated 7 billion dollars annually—resulted in widespread fish die-offs and virus detections in 28 different fish species. Millions of dying sea stars along the west coast of North America have led to investigations into sea star wasting disease. U.S. Geological Survey (USGS) scientists are assisting managers with these issues through ecological investigations of aquatic animal diseases, field surveillance, and research to promote the development of mitigation strategies.

Reliable prediction of clinical outcome in patients with chronic HCV infection and compensated advanced hepatic fibrosis: a validated model using objective and readily available clinical parameters.

PubMed

van der Meer, Adriaan J; Hansen, Bettina E; Fattovich, Giovanna; Feld, Jordan J; Wedemeyer, Heiner; Dufour, Jean-François; Lammert, Frank; Duarte-Rojo, Andres; Manns, Michael P; Ieluzzi, Donatella; Zeuzem, Stefan; Hofmann, W Peter; de Knegt, Robert J; Veldt, Bart J; Janssen, Harry L A

2015-02-01

Reliable tools to predict long-term outcome among patients with well compensated advanced liver disease due to chronic HCV infection are lacking. Risk scores for mortality and for cirrhosis-related complications were constructed with Cox regression analysis in a derivation cohort and evaluated in a validation cohort, both including patients with chronic HCV infection and advanced fibrosis. In the derivation cohort, 100/405 patients died during a median 8.1 (IQR 5.7-11.1) years of follow-up. Multivariate Cox analyses showed age (HR=1.06, 95% CI 1.04 to 1.09, p<0.001), male sex (HR=1.91, 95% CI 1.10 to 3.29, p=0.021), platelet count (HR=0.91, 95% CI 0.87 to 0.95, p<0.001) and log10 aspartate aminotransferase/alanine aminotransferase ratio (HR=1.30, 95% CI 1.12 to 1.51, p=0.001) were independently associated with mortality (C statistic=0.78, 95% CI 0.72 to 0.83). In the validation cohort, 58/296 patients with cirrhosis died during a median of 6.6 (IQR 4.4-9.0) years. Among patients with estimated 5-year mortality risks <5%, 5-10% and >10%, the observed 5-year mortality rates in the derivation cohort and validation cohort were 0.9% (95% CI 0.0 to 2.7) and 2.6% (95% CI 0.0 to 6.1), 8.1% (95% CI 1.8 to 14.4) and 8.0% (95% CI 1.3 to 14.7), 21.8% (95% CI 13.2 to 30.4) and 20.9% (95% CI 13.6 to 28.1), respectively (C statistic in validation cohort = 0.76, 95% CI 0.69 to 0.83). The risk score for cirrhosis-related complications also incorporated HCV genotype (C statistic = 0.80, 95% CI 0.76 to 0.83 in the derivation cohort; and 0.74, 95% CI 0.68 to 0.79 in the validation cohort). Prognosis of patients with chronic HCV infection and compensated advanced liver disease can be accurately assessed with risk scores including readily available objective clinical parameters. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Using the stepladder technique to facilitate the performance of audioconferencing groups.

PubMed

Rogelberg, Steven G; O'Connor, Matthew S; Sederburg, Matthew

2002-10-01

Organizational workforces are becoming increasingly dispersed. To facilitate communications among individuals or groups of people located in a number of different locations, teleconferencing technologies, such as audioconferencing, have been developed. The authors examined whether a structural group intervention, the stepladder technique, can facilitate the task performance of 4-person groups (n = 52) when using audioconferencing. Consistent with research conducted on face-to-face groups, the stepladder technique was found to facilitate the decision-making performance of groups interacting via audioconference. The authors postulated that certain structural elements of the stepladder technique compensate for obstacles inherent in nonvisual communications. Supplementary analyses examined best member influence and the existence of order of entry effects into the stepladder process.

Tracking and incentivizing substance abusers in longitudinal research: results of a survey of National Institute on Drug Abuse-funded investigators.

PubMed

Farabee, David; Hawken, Angela; Griffith, Peter

2011-06-01

Increased recognition that addictive behaviors tend to be chronic and relapsing has led to a growing emphasis on longitudinal substance abuse research. The purpose of this study was to identify effective follow-up strategies used by National Institute on Drug Abuse-funded investigators who have conducted at least 1 study involving follow-up data collection from human subjects. A web-based survey was administered to a representative sample of National Institute on Drug Abuse-funded researchers (N = 153) with a history of conducting longitudinal research. Reported study response rates were generally high, although 27% of the studies fell below the 80% benchmark. Face-to-face and telephone-based interviews commanded the largest subject payments-2 to 3 times higher than compensation rates for collection of biologic samples. With regard to the presumed impact of low follow-up rates on the generalizability of study findings, one-third of investigators who compared baseline characteristics of those who did and did not participate in the follow-up found meaningful differences. Support was found for the hypothesis that follow-up rates and total compensation would be positively related, with the mean compensation amounts between studies achieving <80% follow-up rate versus those achieving rates ≥80%, revealing a statistically significant effect in the predicted direction. The majority of respondents reported difficulty in tracking and locating subjects, and study respondents often proved to be quite different from nonrespondents. Incentives improved follow-up rates to a point, although the relationship was not linear. Efforts to improve follow-up rates may be better spent on addressing tracking and locating logistics rather than on strategies to compel participation once the subject has been located.

Cadmium telluride photovoltaic radiation detector

DOEpatents

Agouridis, D.C.; Fox, R.J.

A dosimetry-type radiation detector is provided which employs a polycrystalline, chlorine-compensated cadmium telluride wafer fabricated to operate as a photovoltaic current generator used as the basic detecting element. A photovoltaic junction is formed in the wafer by painting one face of the cadmium telluride wafer with an n-type semi-conductive material. The opposite face of the wafer is painted with an electrically conductive material to serve as a current collector. The detector is mounted in a hermetically sealed vacuum containment. The detector is operated in a photovoltaic mode (zero bias) while DC coupled to a symmetrical differential current amplifier having a very low input impedance. The amplifier converts the current signal generated by radiation impinging upon the barrier surface face of the wafer to a voltage which is supplied to a voltmeter calibrated to read quantitatively the level of radiation incident upon the detecting wafer.

Cadmium telluride photovoltaic radiation detector

DOEpatents

Agouridis, Dimitrios C.; Fox, Richard J.

1981-01-01

A dosimetry-type radiation detector is provided which employs a polycrystalline, chlorine-compensated cadmium telluride wafer fabricated to operate as a photovoltaic current generator used as the basic detecting element. A photovoltaic junction is formed in the wafer by painting one face of the cadmium telluride wafer with an n-type semiconductive material. The opposite face of the wafer is painted with an electrically conductive material to serve as a current collector. The detector is mounted in a hermetically sealed vacuum containment. The detector is operated in a photovoltaic mode (zero bias) while DC coupled to a symmetrical differential current amplifier having a very low input impedance. The amplifier converts the current signal generated by radiation impinging upon the barrier surface face of the wafer to a voltage which is supplied to a voltmeter calibrated to read quantitatively the level of radiation incident upon the detecting wafer.

Career histories as determinants of gendered retirement timing in the Danish and Swedish pension systems.

PubMed

König, Stefanie

2017-12-01

After reforms in pension systems had taken place in most European countries within the last two decades, the concern was raised that women may be disadvantaged by these reforms. It is suggested that they are faced with a higher financial need to work longer. Retrospective data from SHARELIFE are used to run an event history analysis on the timing of the final employment exit, separately for gender, country and exit cohort. This study aims to disentangle the influence of gendered labour markets and pension regulations on retirement timing by investigating conditions in Denmark and Sweden. Some evidence was found that women compensate for lower labour market attachment due to long part-time periods by working longer, especially in younger cohorts. This seems to depend on the pension system. In countries with broad basic pensions, high replacement rates for low-income groups and fewer penalties for early retirement, the compensation is suggested to be less frequent. This study indicates the growing importance of the "compensation hypothesis" compared to the "status maintenance hypothesis" of previous careers in relation with retirement timing.

A Hundred Osamas: Islamist Threats and the Future of Counterinsurgency

DTIC Science & Technology

2005-12-01

to say that despite ongoing Islamization (in places like Pakistan, Egypt, Lebanon, Nigeria, and the Kelantan province of Malaysia ), Islamists had...that should ideally be an international cooperative effort— filming him periodically in captivity, to diminish his allure, and minimize his...generally.87 He faced various charges and escaped to Malaysia . Bas’syir became the JI’s spiritual leader in 1999 when his co-founder died. Ba`syir was

Illinois court seeks new course in AIDS phobia cases.

PubMed

1997-07-25

The Illinois Court of Appeals ruled that plaintiffs cannot be compensated for negligent infliction of emotional distress unless there is a substantial, medically-verifiable possibility of contracting HIV. The new standard will impact a growing body of case law requiring plaintiffs to show that the fear of AIDS was predicated on actual exposure to the virus. Under the actual exposure rule, a plaintiff who injures himself with a hypodermic needle that had been used on an HIV-positive hospital patient could recover damages; another plaintiff whose needle puncture cannot be traced to HIV contamination could not be compensated. In Doe v. Northwestern University, six plaintiffs who received dental care from a university dental student who tested positive for HIV antibodies sued the university, alleging negligence. Although the plaintiff's fears of HIV infection were reasonable, the court found that they were not severe enough to warrant tort compensation since the plaintiffs had nothing to support their claims. In the case of [name removed] v. [Name removed], a medical clinic office manager, cut herself on a bloodstained scalpel left in a trash can by Dr. [name removed]. Eight months following the incident, [name removed] died of AIDS-related causes. Mrs. [Name removed] would have been entitled to recover damages under the actual exposure test; however, the case would not have prevailed under the Northwestern standard because it was known that Mrs. [Name removed] tested negative twice prior to learning of [name removed]'s AIDS diagnosis. Controversy within the Illinois courts about the actual exposure rule continues.

Unnatural sudden infant death

PubMed Central

Meadow, R.

1999-01-01

AIM—To identify features to help paediatricians differentiate between natural and unnatural infant deaths.
METHOD—Clinical features of 81 children judged by criminal and family courts to have been killed by their parents were studied. Health and social service records, court documents, and records from meetings with parents, relatives, and social workers were studied.
RESULTS—Initially, 42 children had been certified as dying from sudden infant death syndrome (SIDS), and 29 were given another cause of natural death. In 24 families, more than one child died; 58died before the age of 6 months and most died in the afternoon or evening. Seventy per cent had experienced unexplained illnesses; over half were admitted to hospital within the previous month, and 15 had been discharged within 24 hours of death. The mother, father, or both were responsible for death in 43, five, and two families, respectively. Most homes were disadvantaged—no regular income, receiving income support—and mothers smoked. Half the perpetrators had a history of somatising or factitious disorder. Death was usually by smothering and 43% of children had bruises, petechiae, or blood on the face.
CONCLUSIONS—Although certain features are indicative of unnatural infant death, some are also associated with SIDS. Despite the recent reduction in numbers of infants dying suddenly, inadequacies in the assessment of their deaths exist. Until a thorough postmortem examination is combined with evaluation of the history and circumstances of death by an experienced paediatrician, most cases of covert fatal abuse will go undetected. The term SIDS requires revision or abandonment.

 PMID:10325752

A randomized controlled trial of four different regimes of biofeedback programme in the treatment of faecal incontinence.

PubMed

Young, C J; Zahid, A; Koh, C E; Young, J M; Byrne, C M; Solomon, M J; Rex, J; Candido, J

2018-04-01

Biofeedback is an established, effective and non-invasive treatment for faecal incontinence (FI). The aim was to compare the effectiveness of four different biofeedback treatment regimes. This was a randomized control trial of patients with FI, stratified into two groups (metropolitan and rural) and then randomized into two subgroups (groups 1 and 2 within metropolitan, groups 3 and 4 within rural) with varying face-to-face and telephone biofeedback components. All patients received standardized counselling and education, dietary modification and the use of anti-diarrhoeal medications. Group 1 received four monthly face-to-face biofeedback treatments, groups 2 and 3 received one face-to-face biofeedback followed by telephone biofeedback and group 4 received a one-off face-to-face biofeedback treatment. Primary outcomes were patient-assessed severity of FI and quality of life as assessed by the 36-item Short Form Health Survey and direct questioning of objectives. Secondary outcomes included St Mark's incontinence score, anxiety, depression and anorectal physiology measures (resting, squeeze pressures; isotonic, isometric fatigue times). Between 2006 and 2012, 351 patients were recruited. One patient died leaving 350 for analysis. 332 (95%) were women. Mean age was 60 (SD = 14). All groups had significant improvements in FI, quality of life, incontinence score and mental status (P < 0.001 each). There were no differences in improvements in FI between groups although patient satisfaction was less with reduced face-to-face contact. There were modest improvements in isotonic and isometric fatigue times suggesting improved sphincter endurance (both P < 0.001). Biofeedback is effective for FI. Although face-to-face and telephone biofeedback is not necessary to improve FI, it is important for patient satisfaction. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

Compensating effect of sap velocity for stand density leads to uniform hillslope-scale forest transpiration across a steep valley cross-section

NASA Astrophysics Data System (ADS)

Renner, Maik; Hassler, Sibylle; Blume, Theresa; Weiler, Markus; Hildebrandt, Anke; Guderle, Marcus; Schymanski, Stan; Kleidon, Axel

2016-04-01

Roberts (1983) found that forest transpiration is relatively uniform across different climatic conditions and suggested that forest transpiration is a conservative process compensating for environmental heterogeneity. Here we test this hypothesis at a steep valley cross-section composed of European Beech in the Attert basin in Luxemburg. We use sapflow, soil moisture, biometric and meteorological data from 6 sites along a transect to estimate site scale transpiration rates. Despite opposing hillslope orientation, different slope angles and forest stand structures, we estimated relatively similar transpiration responses to atmospheric demand and seasonal transpiration totals. This similarity is related to a negative correlation between sap velocity and site-average sapwood area. At the south facing sites with an old, even-aged stand structure and closed canopy layer, we observe significantly lower sap velocities but similar stand-average transpiration rates compared to the north-facing sites with open canopy structure, tall dominant trees and dense understorey. This suggests that plant hydraulic co-ordination allows for flexible responses to environmental conditions leading to similar transpiration rates close to the water and energy limits despite the apparent heterogeneity in exposition, stand density and soil moisture. References Roberts, J. (1983). Forest transpiration: A conservative hydrological process? Journal of Hydrology 66, 133-141.

Trading jobs for health: ionizing radiation, occupational ethics, and the welfare argument.

PubMed

Shrader-Frechette, Kristin

2002-04-01

Blue-collar workers throughout the world generally face higher levels of pollution than the public and are unable to control many health risks that employers impose on them. Economists tend to justify these risky workplaces on the grounds of the compensating wage differential (CWD). The CWD, or hazard-pay premium, is the alleged increment in wages, all things being equal, that workers in hazardous environments receive. According to this theory, employees trade safety for money on the job market, even though they realize some of them will bear the health consequences of their employment in a risky occupational environment. To determine whether the CWD or hazard-pay premium succeeds in justifying alleged environmental injustices in the workplace, this essay (1) surveys the general theory behind the "compensating wage differential"; (2) presents and evaluates the "welfare argument" for the CWD; (3) offers several reasons for rejecting the CWD, as a proposed rationale for allowing apparent environmental injustice in the workplace; and (4) applies the welfare argument to an empirical case, that of US nuclear workers. The essay concludes that this argument fails to provide a justification for the apparent environmental injustice faced by the 600,000 US workers who have labored in government nuclear-weapons plants and laboratories.

Facial transplantation: A concise update

PubMed Central

Barrera-Pulido, Fernando; Gomez-Cia, Tomas; Sicilia-Castro, Domingo; Garcia-Perla-Garcia, Alberto; Gacto-Sanchez, Purificacion; Hernandez-Guisado, Jose-Maria; Lagares-Borrego, Araceli; Narros-Gimenez, Rocio; Gonzalez-Padilla, Juan D.

2013-01-01

Objectives: Update on clinical results obtained by the first worldwide facial transplantation teams as well as review of the literature concerning the main surgical, immunological, ethical, and follow-up aspects described on facial transplanted patients. Study design: MEDLINE search of articles published on “face transplantation” until March 2012. Results: Eighteen clinical cases were studied. The mean patient age was 37.5 years, with a higher prevalence of men. Main surgical indication was gunshot injuries (6 patients). All patients had previously undergone multiple conventional surgical reconstructive procedures which had failed. Altogether 8 transplant teams belonging to 4 countries participated. Thirteen partial face transplantations and 5 full face transplantations have been performed. Allografts are varied according to face anatomical components and the amount of skin, muscle, bone, and other tissues included, though all were grafted successfully and remained viable without significant postoperative surgical complications. The patient with the longest follow-up was 5 years. Two patients died 2 and 27 months after transplantation. Conclusions: Clinical experience has demonstrated the feasibility of facial transplantation as a valuable reconstructive option, but it still remains considered as an experimental procedure with unresolved issues to settle down. Results show that from a clinical, technical, and immunological standpoint, facial transplantation has achieved functional, aesthetic, and social rehabilitation in severely facial disfigured patients. Key words:Face transplantation, composite tissue transplantation, face allograft, facial reconstruction, outcomes and complications of face transplantation. PMID:23229268

Seeing the Talker's Face Improves Free Recall of Speech for Young Adults With Normal Hearing but Not Older Adults With Hearing Loss.

PubMed

Rudner, Mary; Mishra, Sushmit; Stenfelt, Stefan; Lunner, Thomas; Rönnberg, Jerker

2016-06-01

Seeing the talker's face improves speech understanding in noise, possibly releasing resources for cognitive processing. We investigated whether it improves free recall of spoken two-digit numbers. Twenty younger adults with normal hearing and 24 older adults with hearing loss listened to and subsequently recalled lists of 13 two-digit numbers, with alternating male and female talkers. Lists were presented in quiet as well as in stationary and speech-like noise at a signal-to-noise ratio giving approximately 90% intelligibility. Amplification compensated for loss of audibility. Seeing the talker's face improved free recall performance for the younger but not the older group. Poorer performance in background noise was contingent on individual differences in working memory capacity. The effect of seeing the talker's face did not differ in quiet and noise. We have argued that the absence of an effect of seeing the talker's face for older adults with hearing loss may be due to modulation of audiovisual integration mechanisms caused by an interaction between task demands and participant characteristics. In particular, we suggest that executive task demands and interindividual executive skills may play a key role in determining the benefit of seeing the talker's face during a speech-based cognitive task.

Mount assembly for porous transition panel at annular combustor outlet

NASA Technical Reports Server (NTRS)

Sweeney, Ralph B. (Inventor); Verdouw, Albert J. (Inventor)

1980-01-01

A gas turbine engine combustor assembly of annular configuration has outer and inner walls made up of a plurality of axially extending multi-layered porous metal panels joined together at butt joints therebetween and each outer and inner wall including a transition panel of porous metal defining a combustor assembly outlet supported by a combustor mount assembly including a stiffener ring having a side undercut thereon fit over a transition panel end face; and wherein an annular weld joins the ring to the end face to transmit exhaust heat from the end face to the stiffener ring for dissipation from the combustor; a combustor pilot member is located in axially spaced, surrounding relationship to the end face and connector means support the stiffener ring in free floating relationship with the pilot member to compensate for both radial and axial thermal expansion of the transition panel; and said connector means includes a radial gap for maintaining a controlled flow of coolant from outside of the transition panel into cooling relationship with the stiffener ring and said weld to further cool the end face against excessive heat build-up therein during flow of hot gas exhaust through said outlet.

Effects of Aging on the Neural Correlates of Successful Item and Source Memory Encoding

PubMed Central

Dennis, Nancy A.; Hayes, Scott M.; Prince, Steven E.; Madden, David J.; Huettel, Scott A.; Cabeza, Roberto

2009-01-01

To investigate the neural basis of age-related source memory (SM) deficits, young and older adults were scanned with fMRI while encoding faces, scenes, and face-scene pairs. Successful encoding activity was identified by comparing encoding activity for subsequently remembered versus forgotten items or pairs. Age deficits in successful encoding activity in hippocampal and prefrontal regions were more pronounced for SM (pairs) compared to item memory (faces and scenes). Age-related reductions were also found in regions specialized in processing faces (fusiform face area) and scenes (parahippocampal place area), but these reductions were similar for item and SM. Functional connectivity between the hippocampus and the rest of the brain was also affected by aging; whereas connections with posterior cortices were weaker in older adults, connections with anterior cortices including prefrontal regions were stronger in older adults. Taken together, the results provide a link between SM deficits in older adults and reduced recruitment of hippocampal and prefrontal regions during encoding. The functional connectivity findings are consistent with a posterior-anterior shift with aging (PASA), previously reported in several cognitive domains and linked to functional compensation. PMID:18605869

Overwork, stroke, and karoshi-death from overwork.

PubMed

Ke, Der-Shin

2012-06-01

Karoshi, death from over-work, is usually the extreme result of acute cardiovascular events including stroke. Among 203 karoshi cases received worker compensation in Japan, sixty percent died of stroke. Karoshi is a term for social medicine originated form Japan. Literature reviews on karoshi found that long overtime at work, on duty in holidays, attending a new job with no family members around, and working at night shift are risk factors. Work stress increases secretion of catecholamines (epinephrine and norepinephrine) and cortisol which is associated with progression of atherosclerosis and increased risk of cardiovascular diseases and stroke. To avoid long working hours, stress management and treatment of hypertension, diabetes, and hyperlipidemia are key issues in preventing karoshi caused by stroke.

A Comparative Evaluation of the Linear Dimensional Accuracy of Four Impression Techniques using Polyether Impression Material.

PubMed

Manoj, Smita Sara; Cherian, K P; Chitre, Vidya; Aras, Meena

2013-12-01

There is much discussion in the dental literature regarding the superiority of one impression technique over the other using addition silicone impression material. However, there is inadequate information available on the accuracy of different impression techniques using polyether. The purpose of this study was to assess the linear dimensional accuracy of four impression techniques using polyether on a laboratory model that simulates clinical practice. The impression material used was Impregum Soft™, 3 M ESPE and the four impression techniques used were (1) Monophase impression technique using medium body impression material. (2) One step double mix impression technique using heavy body and light body impression materials simultaneously. (3) Two step double mix impression technique using a cellophane spacer (heavy body material used as a preliminary impression to create a wash space with a cellophane spacer, followed by the use of light body material). (4) Matrix impression using a matrix of polyether occlusal registration material. The matrix is loaded with heavy body material followed by a pick-up impression in medium body material. For each technique, thirty impressions were made of a stainless steel master model that contained three complete crown abutment preparations, which were used as the positive control. Accuracy was assessed by measuring eight dimensions (mesiodistal, faciolingual and inter-abutment) on stone dies poured from impressions of the master model. A two-tailed t test was carried out to test the significance in difference of the distances between the master model and the stone models. One way analysis of variance (ANOVA) was used for multiple group comparison followed by the Bonferroni's test for pair wise comparison. The accuracy was tested at α = 0.05. In general, polyether impression material produced stone dies that were smaller except for the dies produced from the one step double mix impression technique. The ANOVA revealed a highly significant difference for each dimension measured (except for the inter-abutment distance between the first and the second die) between any two groups of stone models obtained from the four impression techniques. Pair wise comparison for each measurement did not reveal any significant difference (except for the faciolingual distance of the third die) between the casts produced using the two step double mix impression technique and the matrix impression system. The two step double mix impression technique produced stone dies that showed the least dimensional variation. During fabrication of a cast restoration, laboratory procedures should not only compensate for the cement thickness, but also for the increase or decrease in die dimensions.

Positive facial affect facilitates the identification of famous faces.

PubMed

Gallegos, Diana R; Tranel, Daniel

2005-06-01

Several convergent lines of evidence have suggested that the presence of an emotion signal in a visual stimulus can influence processing of that stimulus. In the current study, we picked up on this idea, and explored the hypothesis that the presence of an emotional facial expression (happiness) would facilitate the identification of familiar faces. We studied two groups of normal participants (overall N=54), and neurological patients with either left (n=8) or right (n=10) temporal lobectomies. Reaction times were measured while participants named familiar famous faces that had happy expressions or neutral expressions. In support of the hypothesis, naming was significantly faster for the happy faces, and this effect obtained in the normal participants and in both patient groups. In the patients with left temporal lobectomies, the effect size for this facilitation was large (d=0.87), suggesting that this manipulation might have practical implications for helping such patients compensate for the types of naming defects that often accompany their brain damage. Consistent with other recent work, our findings indicate that emotion can facilitate visual identification, perhaps via a modulatory influence of the amygdala on extrastriate cortex.

Optimization of Squeeze Casting for Aluminum Alloy Parts

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

David Schwam; John F. Wallace; Qingming Chang

2002-07-30

This study was initiated with the installation of a new production size UBE 350 Ton VSC Squeeze Casting system in the Metal Casting Laboratory at Case Western University. A Lindberg 75k W electrical melting furnace was installed alongside. The challenge of installation and operation of such industrial-size equipment in an academic environment was met successfully. Subsequently, a Sterling oil die heater and a Visi-Track shot monitoring system were added. A significant number of inserts were designed and fabricated over the span of the project, primarily for squeeze casting different configurations of test bars and plates. A spiral ''ribbon insert'' formore » evaluation of molten metal fluidity was also fabricated. These inserts were used to generate a broad range of processing conditions and determine their effect on the quality of the squeeze cast parts. This investigation has studied the influence of the various casting variables on the quality of indirect squeeze castings primarily of aluminum alloys. The variables studied include gating design, fill time and fill patter, metal pressure and die temperature variations. The quality of the die casting was assessed by an analysis of both their surface condition and internal soundness. The primary metal tested was an aluminum 356 alloy. In addition to determining the effect of these casting variables on casting quality as measured by a flat plate die of various thickness, a number of test bar inserts with different gating designs have been inserted in the squeeze casting machine. The mechanical properties of these test bars produced under different squeeze casting conditions were measured and reported. The investigation of the resulting properties also included an analysis of the microstructure of the squeeze castings and the effect of the various structural constituents on the resulting properties. The main conclusions from this investigation are as follows: The ingate size and shape are very important since it must remain open until the casting is solidified and pressure is maintained on the solidifying casting. Fanned gates, particularly on the smaller section castings avoid jetting effects at the ingate end. The fan type ingate helps accomplish a rapid fill without high velocities. The molten metal has to fill the cavity before localized solidification occurs. This is best accomplished with a larger ingate to attain rapid filling without excessive velocity or jetting that occurs at high metal velocities. Straight gates are prone to case jetting of the metal stream even a low velocities. Fanned gates allow use of higher fill velocity without excessive jetting. A higher metal pressure provides a more complete fill of the die including improved compensation for solidification shrinkage. With the proper filling pattern, ingates, overflows and die temperature for a given die, very good tensile properties can be attained in squeeze casting. In general, the smaller squeeze castings require higher die temperatures. Computer models using the UES Procast and MagmaSoft finite element software can, after suitable adjustments, predict the flow pattern in the die cavity.« less

'To die with dignity': an update on Palliative Care.

PubMed

Brennan, Frank

2017-08-01

Significant developments have occurred in the discipline of palliative care in the modern era. This paper shall explore those developments, challenge some widely held misconceptions about the role and daily practice of the discipline, highlight the growing recognition of the role of palliative care in non-malignant diseases, briefly discuss innovations in symptom management and reflect on the underlying principles, maturation and challenges faced by the discipline. © 2017 Royal Australasian College of Physicians.

A dual estimate method for aeromagnetic compensation

NASA Astrophysics Data System (ADS)

Ma, Ming; Zhou, Zhijian; Cheng, Defu

2017-11-01

Scalar aeromagnetic surveys have played a vital role in prospecting. However, before analysis of the surveys’ aeromagnetic data is possible, the aircraft’s magnetic interference should be removed. The extensively adopted linear model for aeromagnetic compensation is computationally efficient but faces an underfitting problem. On the other hand, the neural model proposed by Williams is more powerful at fitting but always suffers from an overfitting problem. This paper starts off with an analysis of these two models and then proposes a dual estimate method to combine them together to improve accuracy. This method is based on an unscented Kalman filter, but a gradient descent method is implemented over the iteration so that the parameters of the linear model are adjustable during flight. The noise caused by the neural model’s overfitting problem is suppressed by introducing an observation noise.

Facing reality: The future of the US nuclear weapons complex

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

Not Available

1992-01-01

Facing Reality is a collaboration by 15 authors from environmental and grass-roots groups. The authors bluntly conclude that whether the inertia, habit, or material interest, the nuclear weapons establishment has proven itself incapable of genuine reform.' They therefore call for government agencies other than the Department of Energy to manage the tasks of decontamination and decommissioning. Just a partial list of what needs to be done to clean up the DOE's mess is daunting: closing, decommissioning, and decontaminating production facilities, dismantling thousands of nuclear warheads, safely storing dangerous radioactive materials, identifying alternative employment for weapons specialists, conducting meaningful health studiesmore » of workers and citizens exposed to radiation, and providng compensation for the victims of the nuclear buildup.« less

High-uniformity centimeter-wide Si etching method for MEMS devices with large opening elements

NASA Astrophysics Data System (ADS)

Okamoto, Yuki; Tohyama, Yukiya; Inagaki, Shunsuke; Takiguchi, Mikio; Ono, Tomoki; Lebrasseur, Eric; Mita, Yoshio

2018-04-01

We propose a compensated mesh pattern filling method to achieve highly uniform wafer depth etching (over hundreds of microns) with a large-area opening (over centimeter). The mesh opening diameter is gradually changed between the center and the edge of a large etching area. Using such a design, the etching depth distribution depending on sidewall distance (known as the local loading effect) inversely compensates for the over-centimeter-scale etching depth distribution, known as the global or within-die(chip)-scale loading effect. Only a single DRIE with test structure patterns provides a micro-electromechanical systems (MEMS) designer with the etched depth dependence on the mesh opening size as well as on the distance from the chip edge, and the designer only has to set the opening size so as to obtain a uniform etching depth over the entire chip. This method is useful when process optimization cannot be performed, such as in the cases of using standard conditions for a foundry service and of short turn-around-time prototyping. To demonstrate, a large MEMS mirror that needed over 1 cm2 of backside etching was successfully fabricated using as-is-provided DRIE conditions.

Factors determining growth and vertical distribution of planktonic algae in extremely acidic mining lakes (pH 2.7)

NASA Astrophysics Data System (ADS)

Bissinger, Vera

2003-04-01

In this thesis, I investigated the factors influencing the growth and vertical distribution of planktonic algae in extremely acidic mining lakes (pH 2-3). In the focal study site, Lake 111 (pH 2.7; Lusatia, Germany), the chrysophyte, Ochromonas sp., dominates in the upper water strata and the chlorophyte, Chlamydomonas sp., in the deeper strata, forming a pronounced deep chlorophyll maximum (DCM). Inorganic carbon (IC) limitation influenced the phototrophic growth of Chlamydomonas sp. in the upper water strata. Conversely, in deeper strata, light limited its phototrophic growth. When compared with published data for algae from neutral lakes, Chlamydomonas sp. from Lake 111 exhibited a lower maximum growth rate, an enhanced compensation point and higher dark respiration rates, suggesting higher metabolic costs due to the extreme physico-chemical conditions. The photosynthetic performance of Chlamydomonas sp. decreased in high-light-adapted cells when IC limited. In addition, the minimal phosphorus (P) cell quota was suggestive of a higher P requirement under IC limitation. Subsequently, it was shown that Chlamydomonas sp. was a mixotroph, able to enhance its growth rate by taking up dissolved organic carbon (DOC) via osmotrophy. Therefore, it could survive in deeper water strata where DOC concentrations were higher and light limited. However, neither IC limitation, P availability nor in situ DOC concentrations (bottom-up control) could fully explain the vertical distribution of Chlamydomonas sp. in Lake 111. Conversely, when a novel approach was adopted, the grazing influence of the phagotrophic phototroph, Ochromonas sp., was found to exert top-down control on its prey (Chlamydomonas sp.) reducing prey abundance in the upper water strata. This, coupled with the fact that Chlamydomonas sp. uses DOC for growth, leads to a pronounced accumulation of Chlamydomonas sp. cells at depth; an apparent DCM. Therefore, grazing appears to be the main factor influencing the vertical distribution of algae observed in Lake 111. The knowledge gained from this thesis provides information essential for predicting the effect of strategies to neutralize the acidic mining lakes on the food-web. Die vorliegende Dissertation beschäftigt sich mit den Faktoren, die das Wachstum und die Vertikalverteilung von Planktonalgen in extrem sauren Tagebaurestseen (TBS; pH 2-3) beeinflussen. Im exemplarisch untersuchten TBS 111 (pH 2.7; Lausitzer Revier) dominiert die Goldalge Ochromonas sp. in oberen und die Grünalge Chlamydomonas sp. in tieferen Wasserschichten, wobei letztere ein ausgeprägtes Tiefenchlorophyll-Maximum (DCM) ausbildet. Es wurde ein deutlicher Einfluss von Limitation durch anorganischen Kohlenstoff (IC) auf das phototrophe Wachstum von Chlamydomonas sp. in oberen Wasserschichten nachgewiesen, die mit zunehmender Tiefe von Lichtlimitation abgelöst wird. Im Vergleich mit Arbeiten aus neutralen Seen zeigte Chlamydomonas sp. erniedrigte maximale Wachstumsraten, einen gesteigerten Kompensationspunkt und erhöhte Dunkelrespirationsraten, was auf gesteigerte metabolische Kosten unter den extremen physikalisch-chemischen Bedingungen hinweist. Die Photosyntheseleistungen von Chlamydomonas sp. waren in Starklicht-adaptierten Zellen durch IC-Limitation deutlich verringert. Außerdem ergaben die ermittelten minimalen Zellquoten für Phosphor (P) einen erhöhten P-Bedarf unter IC-Limitation. Anschließend konnte gezeigt werden, dass Chlamydomonas sp. ein mixotropher Organismus ist, der seine Wachstumsraten über die osmotrophe Aufnahme gelösten organischen Kohlenstoffs (DOC) erhöhen kann. Dadurch ist dieser Organismus fähig, in tieferen, Licht-limitierten Wasserschichten zu überleben, die einen höheren DOC-Gehalt aufweisen. Da die Vertikalverteilung der Algen im TBS 111 jedoch weder durch IC-Limitation, P-Verfügbarkeit noch die in situ DOC-Konzentrationen abschließend erklärt werden konnte (bottom-up Kontrolle), wurde eine neue Theorie zur Entstehung der Vertikalverteilung geprüft. Grazing der phagotrophen und phototrophen Alge Ochromonas sp. auf der phototrophen Alge Chlamydomonas sp. erwies sich als herausragender Faktor, der über top-down Kontrolle die Abundanz der Beute in höheren Wasserschichten beeinflussen kann. Gemeinsam mit der Tatsache, dass Chlamydomonas sp. DOC zur Wachstumssteigerung verwendet, führt dies zu einer Akkumulation von Chlamydomonas sp. in der Tiefe, ausgeprägt als DCM. Daher erscheint grazing als der Hauptfaktor, der die beobachtete Vertikalschichtung der Algen im TBS 111 hervorruft. Die erzielten Ergebnisse liefern grundlegende Informationen, um die Auswirkungen von Strategien zur Neutralisierung der TBS auf das Nahrungsnetz abschätzen zu können.

Familiarity knowledge in student nurses' clinical studies: exemplified by student nurses in palliative care.

PubMed

Haugan, Grethe; Hanssen, Ingrid

2012-01-01

In this article based on a literary study, the form of knowledge named familiarity knowledge is examined. Although rooted in the philosophical tradition of Wittgenstein and Polanyi, the development of familiarity knowledge is tied in with clinical practice and particular patients and contexts while paying attention to the framework factors influencing the setting as a whole as well as with theoretical knowledge relevant to the situation at hand. Palliative care makes a backdrop for some of the discussion. Familiarity knowledge can never be context free and attends to that which is unique in every nurse-patient relationship. Both assertive and familiarity knowledge are needed to care for dying patients in a competent, sensitive, and truly caring manner. Mentors need to help students synthesize assertive knowledge and familiarity knowledge during their clinical studies to enrich both kinds of knowledge and deepen their understanding. Student nurses expertly mentored and tutored while caring for dying patients living at home become, for instance, less apprehensive about facing dying patients than students not so mentored. Nurses need to understand the complexity of nursing care to be able to see the uniqueness of the situation and approach the individual patient on the bases of experience and insight.

Access to Aid-in-Dying in the United States: Shifting the Debate From Rights to Justice.

PubMed

Buchbinder, Mara

2018-06-01

Much of the literature on aid-in-dying (AID) has drawn heavily on rights-based ethical and legal frameworks that emphasize patients' rights of self-determination in end-of-life decision-making. Less attention has focused on how terminally ill people actually experience such putative rights once they are legally authorized. This analytic essay draws on findings from the Vermont Study on Aid-in-Dying, an ethnographic study of the implementation of AID in Vermont (2015-2017). First, I show that terminally ill people can face a range of barriers to accessing AID in permissive jurisdictions, and that access to AID is mediated by various inequalities endemic to US health care, as well as some that are unique to AID. I then build on these findings to examine the utility of the concept of justice for public health scholarship on AID. By integrating empirical, ethical, and policy analysis, I reframe rights-based frameworks that emphasize the role of individual choice and decision-making at the end of life. In doing so, I draw attention to health care justice as a neglected issue in public health perspectives on AID.

Vincent Lambert, Dignity in Dying and the European Court: A Critical Evaluation and the Global Reflections.

PubMed

Kishore, R R

2016-04-01

In this article I analyse the verdict of the European Court of Human Rights in the Case of Lambert and Others v. France, delivered on 5 June 2015, affirming the Conseil d'État's decision holding that the withdrawal of artificial nutrition and hydration from Vincent Lambert, a French national lying in tetraplegia and persistent vegetative state, was consistent with French domestic law and the European Convention for the Protection of Human Rights and Fundamental Freedoms. In order to make a comparative evaluation I give an account of judicial decisions across the world and find that the European Court's decision is an affirmative pronouncement, in the prevailing milieu of judicial heterogeneity, as it recognizes a person's right to die with dignity in the face of conflicting claims and arguments, by giving supremacy to a person's autonomy and right of self-determination over the deep-rooted religious beliefs and undue paternalistic postures. I conclude that right to die with dignity is a profound area where judge-made law is not the answer. The situation calls for greater consensus and uniformity by evolving suitable legislative strategies.

Impact of death and dying on the personal lives and practices of palliative and hospice care professionals

PubMed Central

Sinclair, Shane

2011-01-01

Background Working within the landscape of death and dying, professionals in palliative and hospice care provide insight into the nature of mortality that may be of benefit to individuals facing the end of life. Much less is known about how these professionals incorporate these experiences into their personal lives and clinical practices. Methods This ethnographic inquiry used semi-structured interviews and participant observation to elicit an in-depth understanding of the impact of death and dying on the personal lives of national key leaders (n = 6) and frontline clinicians (n = 24) involved in end-of-life care in Canada. Analysis of findings occurred in the field through constant comparative method and member checking, with more formal levels of analysis occurring after the data-collection phase. Results Eleven specific themes, organized under three overarching categories (past, present and future), were discovered. Early life experiences with death were a common and prominent feature, serving as a major motivator in participants’ career path of end-of-life care. Clinical exposure to death and dying taught participants to live in the present, cultivate a spiritual life, reflect on their own mortality and reflect deeply on the continuity of life. Interpretation Participants reported that their work provided a unique opportunity for them to discover meaning in life through the lessons of their patients, and an opportunity to incorporate these teachings in their own lives. Although Western society has been described as a “death-denying” culture, the participants felt that their frequent exposure to death and dying was largely positive, fostering meaning in the present and curiosity about the continuity of life. PMID:21135081

Invisible losses and the logics of resettlement compensation.

PubMed

Witter, Rebecca; Satterfield, Terre

2014-10-01

The necessity of compensating people negatively affected by conservation and other development projects has been widely acknowledged. It is less widely acknowledged that because conventional compensation assessments focus on material resources and their economic equivalents, many important losses incurred by resettlers are invisible to project authorities. Through ethnographic observations and interviews, we documented losses identified by people facing resettlement from Mozambique's Limpopo National Park. We also examined resettlement planning documents to determine why decision makers' assessments of natural resource use and value neglect losses residents identified as critical. Identifying, preventing, and mitigating invisible losses in resettlement planning necessitates a better understanding of intangible benefits residents derive from resources, which are often as or more important than their readily apparent material properties. These benefits include but are not limited to decision-making authority linked to owning land versus having the use of fields; ancestral identity and social belonging linked to gravesites; the importance of tree roots that provide a powerful sense of security because they suppress hunger in periods of scarcity; and the importance of people's location within social networks and hierarchies as they determine the benefits versus risks that will be incurred through resettlement. © 2014 Society for Conservation Biology.

High-resolution motion-compensated imaging photoplethysmography for remote heart rate monitoring

NASA Astrophysics Data System (ADS)

Chung, Audrey; Wang, Xiao Yu; Amelard, Robert; Scharfenberger, Christian; Leong, Joanne; Kulinski, Jan; Wong, Alexander; Clausi, David A.

2015-03-01

We present a novel non-contact photoplethysmographic (PPG) imaging system based on high-resolution video recordings of ambient reflectance of human bodies that compensates for body motion and takes advantage of skin erythema fluctuations to improve measurement reliability for the purpose of remote heart rate monitoring. A single measurement location for recording the ambient reflectance is automatically identified on an individual, and the motion for the location is determined over time via measurement location tracking. Based on the determined motion information motion-compensated reflectance measurements at different wavelengths for the measurement location can be acquired, thus providing more reliable measurements for the same location on the human over time. The reflectance measurement is used to determine skin erythema fluctuations over time, resulting in the capture of a PPG signal with a high signal-to-noise ratio. To test the efficacy of the proposed system, a set of experiments involving human motion in a front-facing position were performed under natural ambient light. The experimental results demonstrated that skin erythema fluctuations can achieve noticeably improved average accuracy in heart rate measurement when compared to previously proposed non-contact PPG imaging systems.

Mortality Change, the Uncertainty Effect, and Retirement *

PubMed Central

Kalemli-Ozcan, Sebnem; Weil, David N.

2013-01-01

We examine the role of declining mortality in explaining the rise of retirement over the course of the 20th century. We construct a model in which individuals make labor/leisure choices over their lifetimes subject to uncertainty about their dates of death. In an environment with high mortality, an individual who saves for retirement faces a high risk of dying before he can enjoy his planned leisure. In this case, the optimal plan is for people to work until they die. As mortality falls, however, it becomes optimal to plan, and save for, retirement. We analyze our model using two mathematical formulations of the survival function as well as data on actual changes in the US life table over the last century, and show that this “uncertainty effect” of declining mortality would have more than outweighed the “horizon effect” by which rising life expectancy would have led to later retirement. PMID:24363604

When autonomy kills: the case of Sami Mbarka Ben Garci.

PubMed

Garasic, Mirko; Foster, Charles

2012-12-01

Foucault suggested that foreigners and criminals are treated in a particularly unfavourable way by the law. We find arguable support for that proposition in the case of Sami Mbarka Ben Garci. He was a Tunisian Muslim prisoner, charged with rape, held in an Italian prison. He went on a hunger strike, protesting his innocence. He was not force-fed, and was allowed to die. Hunger strikers are commonly force fed. We ask why he was not, and although the reasons in his case are not clear, we suggest that many prisoners perceived as being 'undesirable' (in the sense of being foreigners, or facing particularly serious allegations) are allowed to die (the rhetoric being that their autonomy is being respected), while other prisoners' autonomy would be violated in order to ensure survival. We explore the European and some domestic jurisprudence surrounding force-feeding, and conclude that the law is applied in a worryingly inconsistent way.

What cell death does in development.

PubMed

Zakeri, Zahra; Penaloza, Carlos G; Smith, Kyle; Ye, Yixia; Lockshin, Richard A

2015-01-01

Cell death is prominent in gametogenesis and shapes and sculpts embryos. In non-mammalian embryos one sees little or no cell death prior to the maternal-zygotic transition, but, in mammalian embryos, characteristic deaths of one or two cells occur at the end of compaction and are apparently necessary for the separation of the trophoblast from the inner cell mass. Considerable sculpting of the embryo occurs by cell deaths during organogenesis, and appropriate cell numbers, especially in the CNS and in the immune system, are generated by massive overproduction of cells and selection of a few, with death of the rest. The timing, identity, and genetic control of specific cells that die have been well documented in Caenorhabditis, but in other embryos the stochastic nature of the deaths limit our ability to do more than identify the regions in which cells will die. Complete disruption of the cell death machinery can be lethal, but many mutations of the regulatory machinery yield only modest or no phenotypes, indicating substantial redundancy and compensation of regulatory mechanisms. Most of the deaths are apoptotic and are identified by techniques used to recognize apoptosis, but techniques identifying lysosomes (whether in dying or involuting cells or in the phagocytes that invade the tissue) also reveal patterns of cell death. Aberrant cell deaths that produce known phenotypes are typically localized, indicating that the mechanism of activating a programmed death in a specific region, rather than the mechanism of death, is aberrant. These results lead us to conclude that we need to know much more about the conversations among cells that lead cells to commit suicide.

End-of-life issues: difficult decisions and dealing with grief.

PubMed

Loomis, Beth

2009-06-01

People face many challenging psychosocial and spiritual issues as they approach the end of their lives, and caregivers need advice on how to help them. Choosing among treatment options, handling grief, addressing unfinished business, and coping with loss of self-sufficiency are difficult for the dying person, and caregivers must deal with surrogate decision making, raw emotions in the patient and in family members, and the caregivers' own grief. Listening and coping skills are discussed.

Fear of death.

PubMed

Penson, Richard T; Partridge, Rosamund A; Shah, Muhammad A; Giansiracusa, David; Chabner, Bruce A; Lynch, Thomas J

2005-02-01

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH) founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient and support to caregivers and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. For many, cancer is synonymous with death. Fearing death is a rational response. For too long, medicine has ignored this primeval fear. Increasingly, clinicians recognize and address end-of-life issues, facing patients' and our own emotional vulnerabilities in order to connect and explore problems and fears. Listening and learning from the patient guides us as we acknowledge much of the mystery that still surrounds the dying process. Rarely is there a simple or right answer. An empathetic response to suffering patients is the best support. Support is vital in fostering the adjustment of patients. A silent presence may prove more helpful than well-meant counsel for many patients. Through an examination of eight caregiver narratives of their patients' experiences, the role of the health care provider in the dying process, particularly in regard to challenging fear, is reviewed.

Hybrid generative-discriminative approach to age-invariant face recognition

NASA Astrophysics Data System (ADS)

Sajid, Muhammad; Shafique, Tamoor

2018-03-01

Age-invariant face recognition is still a challenging research problem due to the complex aging process involving types of facial tissues, skin, fat, muscles, and bones. Most of the related studies that have addressed the aging problem are focused on generative representation (aging simulation) or discriminative representation (feature-based approaches). Designing an appropriate hybrid approach taking into account both the generative and discriminative representations for age-invariant face recognition remains an open problem. We perform a hybrid matching to achieve robustness to aging variations. This approach automatically segments the eyes, nose-bridge, and mouth regions, which are relatively less sensitive to aging variations compared with the rest of the facial regions that are age-sensitive. The aging variations of age-sensitive facial parts are compensated using a demographic-aware generative model based on a bridged denoising autoencoder. The age-insensitive facial parts are represented by pixel average vector-based local binary patterns. Deep convolutional neural networks are used to extract relative features of age-sensitive and age-insensitive facial parts. Finally, the feature vectors of age-sensitive and age-insensitive facial parts are fused to achieve the recognition results. Extensive experimental results on morphological face database II (MORPH II), face and gesture recognition network (FG-NET), and Verification Subset of cross-age celebrity dataset (CACD-VS) demonstrate the effectiveness of the proposed method for age-invariant face recognition well.

The long-term benefits of nucleos(t)ide analogs in compensated HBV cirrhotic patients with no or small esophageal varices: A 12-year prospective cohort study.

PubMed

Lampertico, Pietro; Invernizzi, Federica; Viganò, Mauro; Loglio, Alessandro; Mangia, Giampaolo; Facchetti, Floriana; Primignani, Massimo; Jovani, Manol; Iavarone, Massimo; Fraquelli, Mirella; Casazza, Giovanni; de Franchis, Roberto; Colombo, Massimo

2015-11-01

Esophageal varices (EV) are a marker of disease severity in compensated cirrhosis due to hepatitis B virus (HBV) which predicts also the risk of hepatocellular carcinoma (HCC), clinical decompensation and anticipated liver related death. The dynamics and prognostic significance of EV in patients under long-term HBV suppression by nucleos(t)ide analogs (NUC), are poorly known. A standardized protocol (Baveno) including 414 upper gastrointestinal (GI) endoscopies was applied to 107 HBeAg-negative compensated cirrhotic patients (93% Child-Pugh A) during a median of 12 (range 2 to 17) years of NUC therapy. Patients who initially started on lamivudine (LMV) and then developed resistance (LMV-R), were rescued by early administration of adefovir, or were switched to tenofovir. Surveillance included serum HBV DNA every three months and abdominal ultrasound every six months. Twenty-seven patients had baseline F1 EV which regressed in 18, remained unchanged in eight and progressed in one patient; the 12-year cumulative incidence of EV regression was 83% (95% CI: 52-92%). De novo F1/F2 EV developed in 6/80 patients with a 12-year cumulative incidence of 10% (95% CI: 5-20%). Six of seven patients with de novo varices or progression of pre-existing varices had either a clinical breakthrough due to LMV-R and/or developed a HCC. No bleedings from ruptured EV occurred, 12 patients died (9 HCC) and 15 were transplanted (13 HCC): the 12-year cumulative incidence of HCC and overall survival was 33% (95% CI: 24-42%) and 76% (95% CI: 67-83%), respectively. Long-term pharmacological suppression of HBV in HBeAg-seronegative patients with compensated cirrhosis leads to a significant regression of pre-existing EV accompanied by a negligible risk of developing de novo EV. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

A New Measure for Neural Compensation Is Positively Correlated With Working Memory and Gait Speed.

PubMed

Ji, Lanxin; Pearlson, Godfrey D; Hawkins, Keith A; Steffens, David C; Guo, Hua; Wang, Lihong

2018-01-01

Neuroimaging studies suggest that older adults may compensate for declines in brain function and cognition through reorganization of neural resources. A limitation of prior research is reliance on between-group comparisons of neural activation (e.g., younger vs. older), which cannot be used to assess compensatory ability quantitatively. It is also unclear about the relationship between compensatory ability with cognitive function or how other factors such as physical exercise modulates compensatory ability. Here, we proposed a data-driven method to semi-quantitatively measure neural compensation under a challenging cognitive task, and we then explored connections between neural compensation to cognitive engagement and cognitive reserve (CR). Functional and structural magnetic resonance imaging scans were acquired for 26 healthy older adults during a face-name memory task. Spatial independent component analysis (ICA) identified visual, attentional and left executive as core networks. Results show that the smaller the volumes of the gray matter (GM) structures within core networks, the more networks were needed to conduct the task ( r = -0.408, p = 0.035). Therefore, the number of task-activated networks controlling for the GM volume within core networks was defined as a measure of neural compensatory ability. We found that compensatory ability correlated with working memory performance ( r = 0.528, p = 0.035). Among subjects with good memory task performance, those with higher CR used fewer networks than subjects with lower CR. Among poor-performance subjects, those using more networks had higher CR. Our results indicated that using a high cognitive-demanding task to measure the number of activated neural networks could be a useful and sensitive measure of neural compensation in older adults.

Care at the Very End-of-Life: Dying Cancer Patients and Their Chosen Family’s Needs

PubMed Central

Clark, Katherine

2017-01-01

The majority of cancer deaths in countries such as Australia are predictable and most likely to occur in hospital. Despite this, hospitals remain challenged by providing the best care for this fragile cohort, often believing that care with palliative intent at the very end-of-life is not the best approach to care. Given the importance that dying patients place on excellent symptom control, failing to provide good end-of-life care is likely to be contrary to the wishes of the imminently dying patient and their family. This becomes even more significant when the impact of care on the bereavement outcomes of families is considered. Given the rising numbers of predicable hospital deaths, an urgent need to address this exists, requiring health professionals to be cognisant of specific care domains already identified as significant for both patients and those closest to them in knowledge, care and affection. This non-systematic review’s aims are to summarise the symptoms most feared by people imminently facing death which is defined as the terminal phase of life, where death is imminent and likely to occur within hours to days, or very occasionally, weeks. Further, this paper will explore the incidence and management of problems that may affect the dying person which are most feared by their family. The final section of this work includes a brief discussion of the most significant issues that require attention. PMID:28125017

Self-image perception of 171 children and adolescents with cleft lip and palate from 22 countries.

PubMed

Abd-Elsayed, Alaa A; Delgado, Sergio V; Livingstone, Morgan

2013-01-01

Cleft lip (CL) and cleft palate (CP) are among the most common congenital deformities of the head and neck. They are associated with many problems, physical and psychological. We describe 171 children and adolescents with CL/CP from 22 countries who were asked to draw their faces in a self-image perception drawing 2 hours before surgery to repair their deformities. The aim of the study was to explore whether children and adolescents with CL and CP perceived themselves as deformed when given the opportunity to draw their faces before surgery to repair their deformities. Children were asked to lie down on a large piece of paper to have their body outline traced. Subsequently, the children were asked to draw their faces within the outline. All of the children included in this study drew their faces with normal mouths. None of the 171 patients with CL/CP drew their deformity when asked to draw their faces; the reasons are not clear. The children may have wanted to compensate for their disability with the constructive use of fantasy as they anticipated the surgery to repair their CL/CP. An additional hypothesis is that the children felt the need to draw an image that they knew represented their parents' desires.

Self-Image Perception of 171 Children and Adolescents With Cleft Lip and Palate From 22 Countries

PubMed Central

Abd-Elsayed, Alaa A.; Delgado, Sergio V.; Livingstone, Morgan

2013-01-01

Background Cleft lip (CL) and cleft palate (CP) are among the most common congenital deformities of the head and neck. They are associated with many problems, physical and psychological. We describe 171 children and adolescents with CL/CP from 22 countries who were asked to draw their faces in a self-image perception drawing 2 hours before surgery to repair their deformities. Methods The aim of the study was to explore whether children and adolescents with CL and CP perceived themselves as deformed when given the opportunity to draw their faces before surgery to repair their deformities. Children were asked to lie down on a large piece of paper to have their body outline traced. Subsequently, the children were asked to draw their faces within the outline. Results All of the children included in this study drew their faces with normal mouths. Conclusion None of the 171 patients with CL/CP drew their deformity when asked to draw their faces; the reasons are not clear. The children may have wanted to compensate for their disability with the constructive use of fantasy as they anticipated the surgery to repair their CL/CP. An additional hypothesis is that the children felt the need to draw an image that they knew represented their parents' desires. PMID:23789006

Challenges in the surgical management of ectopic pregnancy in a low-resource setting: Mpilo Central Hospital, Bulawayo, Zimbabwe.

PubMed

Ngwenya, Solwayo

2017-10-01

Background Ectopic pregnancy contributes to maternal morbidity and mortality, especially in low-resourced countries with limited facilities for early diagnosis and treatment. It is a very challenging condition to diagnose. Patients may collapse and die while undergoing investigation. Aims To assess surgical treatment given to patients presenting at Mpilo Central Hospital, the challenges that are faced and the outcomes; and also to document how women survive this dangerous condition in a setting challenged by low resources. Results All the patients had prompt life-saving surgery within 48 h of admission despite the challenges faced. The survival rate was 100% during the period of the study. Conclusion It is possible to prevent maternal mortality in low-resource countries by maintaining basic clinical and surgical skills.

The value of job analysis, job description and performance.

PubMed

Wolfe, M N; Coggins, S

1997-01-01

All companies, regardless of size, are faced with the same employment concerns. Efficient personnel management requires the use of three human resource techniques--job analysis, job description and performance appraisal. These techniques and tools are not for large practices only. Small groups can obtain the same benefits by employing these performance control measures. Job analysis allows for the development of a compensation system. Job descriptions summarize the most important duties. Performance appraisals help reward outstanding work.

Facing the malpractice crisis: academic physicians' willingness to accept quick fix solutions.

PubMed

Levine, Rachel B; Kravet, Steven J; Reed, Darcy A; Windish, Donna M; Wolfe, Leah; Wright, Scott M

2006-12-01

We sought to determine the willingness of academic physicians to accept strategies to contain institutional malpractice costs. We surveyed all 270 Department of Medicine physicians at a large academic center. Respondents were asked about their knowledge regarding malpractice premiums, willingness to reduce patient-care activities and accept decreases in compensation. The response rate was 80%. Respondents estimated the annual increase in malpractice premiums from 2004 to 2005 to be 29%. The true increase was 28% (P = 0.55). Almost all opposed eliminating patient care (95%) or providing patient care every other year at double effort and withdrawing from patient care on alternate years (97%). Seventy percent would limit their clinical procedures. Most physicians opposed salary reduction (97%) or decreases in fringe benefits (99%). Few academic physicians are willing to limit patient care or accept decreases in compensation to recoup institutional malpractice costs.

The plight of the not-for-profit.

PubMed

Owens, Bramer

2005-01-01

Recent controversies in the hospital sector have questioned whether the levels of charity care, community benefit, and executive compensation provided by not-for-profit hospitals are consistent with mandates of their tax-exempt status and mission statements. This article demonstrates that these recent controversies stem from a combination of historical influences, regulatory inequities, and competitive disadvantages, which are suffocating many not-for-profit hospitals across the nation. Once the current environment is described, the article discusses each threat and offers actionable recommendations to quell current attacks faced by the industry. First, to address the current probe by the Internal Revenue Service, hospitals must begin to link their executive compensation with their organizational mission. Second, to address recent lawsuits, the article presents a standardized definition of community benefit and recommends an alternative model to classify charity care. Finally, to address recent congressional hearings, the article offers a plan for hospitals to gauge their expected benefit to the community they serve.

The aging nursing workforce: How to retain experienced nurses.

PubMed

Cohen, Jeremye D

2006-01-01

In the face of an anticipated nursing shortage, healthcare organizations must evaluate their culture, operations, and compensation system to ensure that these elements align with organizational efforts to retain nurses who are approaching retirement age. Management should focus on enhancing elements of job satisfaction and job embeddedness that will motivate nurses to remain both in the workforce and with their employer. Although much of this responsibility falls on the nurse manager, nurse managers are often not provided the necessary support by top management and are neither recognized nor held accountable for nurse turnover. Other retention initiatives can include altering working conditions to reduce both physical and mental stress and addressing issues of employee health and safety. As for compensation, organizations may be well-served by offering senior nursing staff flexible working hours, salary structures that reward experience, and benefit programs that hold value for an aging workforce.

Setting up your own business. Facing the future as an entrepreneur.

PubMed

Brent, N J

1990-01-01

Other areas of setting up and running a business also are important to explore, especially if the business plans to use employees. You will become an employer, and you must be familiar with rules and regulations that include areas such as the employee's right to a safe workplace, worker's compensation laws, unemployment compensation laws and tax liabilities, antidiscrimination laws, and wage and tax laws. If independent contractors are going to be used, you must recognize that well-developed contracts are a necessity. If you are going to market a new product, consult with an attorney whose practice concentrates in trademark and patent law before the product is shared with others. Being well informed about the proposed business venture, not only before its establishment but as it develops and grows, can help you be in the best position to have a successful business.

Compensation in the presence of deep turbulence using tiled-aperture architectures

NASA Astrophysics Data System (ADS)

Spencer, Mark F.; Brennan, Terry J.

2017-05-01

The presence of distributed-volume atmospheric aberrations or "deep turbulence" presents unique challenges for beam-control applications which look to sense and correct for disturbances found along the laser-propagation path. This paper explores the potential for branch-point-tolerant reconstruction algorithms and tiled-aperture architectures to correct for the branch cuts contained in the phase function due to deep-turbulence conditions. Using wave-optics simulations, the analysis aims to parameterize the fitting-error performance of tiled-aperture architectures operating in a null-seeking control loop with piston, tip, and tilt compensation of the individual optical beamlet trains. To evaluate fitting-error performance, the analysis plots normalized power in the bucket as a function of the Fried coherence diameter, the log-amplitude variance, and the number of subapertures for comparison purposes. Initial results show that tiled-aperture architectures with a large number of subapertures outperform filled-aperture architectures with continuous-face-sheet deformable mirrors.

Increased fusiform area activation in schizophrenia during processing of spatial frequency-degraded faces, as revealed by fMRI.

PubMed

Silverstein, S M; All, S D; Kasi, R; Berten, S; Essex, B; Lathrop, K L; Little, D M

2010-07-01

People with schizophrenia demonstrate perceptual organization impairments, and these are thought to contribute to their face processing difficulties. We examined the neural substrates of emotionally neutral face processing in schizophrenia by investigating neural activity under three stimulus conditions: faces characterized by the full spectrum of spatial frequencies, faces with low spatial frequency information removed [high spatial frequency (HSF) condition], and faces with high spatial frequency information removed [low spatial frequency (LSF) condition]. Face perception in the HSF condition is more reliant on local feature processing whereas perception in the LSF condition requires greater reliance on global form processing. Past studies of perceptual organization in schizophrenia indicate that patients perform relatively more poorly with degraded stimuli but also that, when global information is absent, patients may perform better than controls because of their relatively increased ability to initially process individual features. Therefore, we hypothesized that people with schizophrenia (n=14) would demonstrate greater face processing difficulties than controls (n=13) in the LSF condition, whereas they would demonstrate a smaller difference or superior performance in the HSF condition. In a gender-discrimination task, behavioral data indicated high levels of accuracy for both groups, with a trend toward an interaction involving higher patient performance in the HSF condition and poorer patient performance in the LSF condition. Patients demonstrated greater activity in the fusiform gyrus compared to controls in both degraded conditions. These data suggest that impairments in basic integration abilities may be compensated for by relatively increased activity in this region.

Determining geometric error model parameters of a terrestrial laser scanner through Two-face, Length-consistency, and Network methods

PubMed Central

Wang, Ling; Muralikrishnan, Bala; Rachakonda, Prem; Sawyer, Daniel

2017-01-01

Terrestrial laser scanners (TLS) are increasingly used in large-scale manufacturing and assembly where required measurement uncertainties are on the order of few tenths of a millimeter or smaller. In order to meet these stringent requirements, systematic errors within a TLS are compensated in-situ through self-calibration. In the Network method of self-calibration, numerous targets distributed in the work-volume are measured from multiple locations with the TLS to determine parameters of the TLS error model. In this paper, we propose two new self-calibration methods, the Two-face method and the Length-consistency method. The Length-consistency method is proposed as a more efficient way of realizing the Network method where the length between any pair of targets from multiple TLS positions are compared to determine TLS model parameters. The Two-face method is a two-step process. In the first step, many model parameters are determined directly from the difference between front-face and back-face measurements of targets distributed in the work volume. In the second step, all remaining model parameters are determined through the Length-consistency method. We compare the Two-face method, the Length-consistency method, and the Network method in terms of the uncertainties in the model parameters, and demonstrate the validity of our techniques using a calibrated scale bar and front-face back-face target measurements. The clear advantage of these self-calibration methods is that a reference instrument or calibrated artifacts are not required, thus significantly lowering the cost involved in the calibration process. PMID:28890607

The growth rates of KDP crystals in solutions with potassium permanganate additives

NASA Astrophysics Data System (ADS)

Egorova, A. E.; Vorontsov, D. A.; Nezhdanov, A. V.; Noskova, A. N.; Portnov, V. N.

2017-01-01

We have found that growth of the {101} faces of a KDP (KH2PO4) crystal is suppressed, and the growth rate of the {100} faces passes through the maximum with increasing addition of KMnO4 to a solution with pH=4.7. We have concluded that the [MnH2PO4]2+ complex and MnO2 particles affect the growth kinetics. The X-ray and electronic paramagnetic resonance data show that manganese is incorporated into the crystal in the form of Mn3+ and Mn4+. The local excess of a positive charge in the area with incorporated [MnH2PO4]2+ complex can be compensated by the shift of the hydrogen atoms in the KDP structure.

Global warming, elevational range shifts, and lowland biotic attrition in the wet tropics.

PubMed

Colwell, Robert K; Brehm, Gunnar; Cardelús, Catherine L; Gilman, Alex C; Longino, John T

2008-10-10

Many studies suggest that global warming is driving species ranges poleward and toward higher elevations at temperate latitudes, but evidence for range shifts is scarce for the tropics, where the shallow latitudinal temperature gradient makes upslope shifts more likely than poleward shifts. Based on new data for plants and insects on an elevational transect in Costa Rica, we assess the potential for lowland biotic attrition, range-shift gaps, and mountaintop extinctions under projected warming. We conclude that tropical lowland biotas may face a level of net lowland biotic attrition without parallel at higher latitudes (where range shifts may be compensated for by species from lower latitudes) and that a high proportion of tropical species soon faces gaps between current and projected elevational ranges.

Hindering factors and suggestions related to organ donation decisions: perspective of the Taiwan Ali-Shan Tsou aboriginal tribe.

PubMed

Chen, A N; Chen, K F; Chang, P C; Shih, F Jong; Chen, C R; Shih, F-Jin; Huang, C-Y

2014-05-01

Ali-San Tsou (AST) is one of leading aboriginal tribes in Taiwan with traditional godly beliefs related to life and death. Lacking related knowledge, health professionals (HPs) often failed to help them reach good dying or organ donation (OD). This study aimed to explore hindering factors and suggestions related to OD for good dying from Taiwan AST's own perspective. An explorative qualitative design was employed using a purposive sample of the AST tribes from Taiwan. Data were collected with AST residents by face-to-face interviews and analyzed by content analysis. Thirty AST residents (16 females and 14 males) with ages ranging from 28 to 78 (mean, 54.5) years completed interviews. Of them, 85% reported various diseases. In this study 73% were Catholics and Christians, 17% held traditional godly believes, and 10% had no religious affiliation. Eight hindering factors were reported: (1) limited information about organs and OD; (2) no qualified organs for donation; (3) worry about lack of forgiveness by ancestors; (4) tribe elders who might not accept concept of OD; (5) intact bodies were required at home during spirit-companion rituals; (6) earth burial with intact bodies was preferred; (7) bodies due to accidental and bad death were impermissible for OD; and (8) worry about possession by the donor's spirit. Seven suggestions were also reported for HPs to enhance AST's OD decisions: (1) starting with friendship and a caring relationship; (2) providing spiritual support from reverent religions; (3) stressing good deeds and honoring tribe folks by OD; (4) avoiding accidental/bad death; (5) providing relevant modern medical knowledge of human organs and OD; (6) introducing OD as part of a good-dying care plan; and (7) demonstrating a respectful discussion mindset about OD. Eight hindering factors and 7 types of suggestions for enhancing AST aboriginal people's OD decisions were first explored in this project. In the future, HPs are encouraged to invite AST to share the concepts of OT and try to clarify the related concerns with respect for their cultural contexts. With mutual respect, the efforts of sharing and integrating OD into good-dying care would be more possible. Copyright © 2014 Elsevier Inc. All rights reserved.

Planar microlens with front-face angle: design, fabrication, and characterization

NASA Astrophysics Data System (ADS)

Al Hafiz, Md. Abdullah; Michael, Aron; Kwok, Chee-Yee

2016-07-01

This paper studies the effect of microlens front-face angle on the performance of an optical system consisting of a planar-graded refractive index (GRIN) lens pair facing each other separated by a free-space region. The planar silica microlens pairs are designed to facilitate low-loss optical signal propagation in the free-space region between the opposing optical waveguides. The planar lens is fabricated from a 38-μm-thick fluorine-doped silica layer on a silicon substrate. It has a parabolic refractive index profile in the vertical direction, which is achieved by controlled fluorine incorporation in the silica film to collimate the optical beam in the vertical direction. Horizontal beam collimation is achieved by incorporating a horizontal curvature at the front face of the lens defined by deep oxide etch. A generalized 3×3 ABCDGH transformation matrix method has been derived to compute the coupling efficiency of such microlens pairs to take front-face angles that may be present due to fabrication variations or limitations and possible input/output optical fiber offset/tilt into considerations. Pairs of such planar GRIN lens with various free-space propagation distances between them ranging from 75 to 2500 μm and with front-face angles of 1.5 deg, 2 deg, and 4 deg have been fabricated and characterized. Beam propagation method simulations have been carried out to substantiate the theoretical and experimental results. The results indicate that the optical loss is reasonably low up to 1.5 deg of front-face angles and increases significantly with further increase in the front-face angle. Analysis shows that for a given system with specific microlens front-face angle, the optical loss can be significantly reduced by properly compensating the vertical position of the input and output fibers.

Apparatus and method to compensate for refraction of radiation

DOEpatents

Allen, Gary R.; Moskowitz, Philip E.

1990-01-01

An apparatus to compensate for refraction of radiation passing through a curved wall of an article is provided. The apparatus of a preferred embodiment is particularly advantageous for use in arc tube discharge diagnostics. The apparatus of the preferred embodiment includes means for pre-refracting radiation on a predetermined path by an amount equal and inverse to refraction which occurs when radiation passes through a first wall of the arc tube such that, when the radiation passes through the first wall of the arc tube and into the cavity thereof, the radiation passes through the cavity approximately on the predetermined path; means for releasably holding the article such that the radiation passes through the cavity thereof; and means for post-refracting radiation emerging from a point of the arc tube opposite its point of entry by an amount equal and inverse to refraction which occurs when radiation emerges from the arc tube. In one embodiment the means for pre-refracting radiation includes a first half tube comprising a longitudinally bisected tube obtained from a tube which is approximately identical to the arc tube's cylindrical portion and a first cylindrical lens, the first half tube being mounted with its concave side facing the radiation source and the first cylindrical lens being mounted between the first half tube and the arc tube and the means for post-refracting radiation includes a second half tube comprising a longitudinally bisected tube obtained from a tube which is approximately identical to the arc tube's cylindrical portion and a second cylindrical lens, the second half tube being mounted with its convex side facing the radiation source and the second cylindrical lens being mounted between the arc tube and the second half tube. Methods to compensate for refraction of radiation passing into and out of an arc tube is also provided.

Apparatus and method to compensate for refraction of radiation

DOEpatents

Allen, G.R.; Moskowitz, P.E.

1990-03-27

An apparatus to compensate for refraction of radiation passing through a curved wall of an article is provided. The apparatus of a preferred embodiment is particularly advantageous for use in arc tube discharge diagnostics. The apparatus of the preferred embodiment includes means for pre-refracting radiation on a predetermined path by an amount equal and inverse to refraction which occurs when radiation passes through a first wall of the arc tube such that, when the radiation passes through the first wall of the arc tube and into the cavity thereof, the radiation passes through the cavity approximately on the predetermined path; means for releasably holding the article such that the radiation passes through the cavity thereof; and means for post-refracting radiation emerging from a point of the arc tube opposite its point of entry by an amount equal and inverse to refraction which occurs when radiation emerges from the arc tube. In one embodiment the means for pre-refracting radiation includes a first half tube comprising a longitudinally bisected tube obtained from a tube which is approximately identical to the arc tube's cylindrical portion and a first cylindrical lens, the first half tube being mounted with its concave side facing the radiation source and the first cylindrical lens being mounted between the first half tube and the arc tube and the means for post-refracting radiation includes a second half tube comprising a longitudinally bisected tube obtained from a tube which is approximately identical to the arc tube's cylindrical portion and a second cylindrical lens, the second half tube being mounted with its convex side facing the radiation source and the second cylindrical lens being mounted between the arc tube and the second half tube. Methods to compensate for refraction of radiation passing into and out of an arc tube is also provided. 4 figs.

Combating Deviants: The Saudi Arabian Approach to Countering Extremism and Terrorism

DTIC Science & Technology

2009-04-09

that this is accomplished.18 In 1801, the Al Saud-Al Wahhab armies advance into Iraq and destroy Karbala, the Shia holy site in Iraq, and the tomb ...Mecca in 630.19 By 1803, they conquer the holy cities of Mecca and Medina, where they destroy shrines and even plunder the tomb of the Prophet...Saud dies and his son Abd Allah becomes Imam. Abd Allah faces the largest threat to the Al Saud in the form of an invading Egyptian Army determined to

A Carcinogenicity Bioassay of Isobutyl 2-Cyanoacrylate (IBC) in Fischer-344 Rats

DTIC Science & Technology

1990-01-23

subcutaneous mass M Control 084 24 Oct 85 Pallor, weak, depressed M Low IBC 080 24 Oct 85 Died in cage M High IBC 203 24 Oct 85 Pallor, large M Low IBC intra...abdominal mass 424 25 Oct 85 Weight loss, dehydrated, F High IBC depressed * Animals were sacrificed to conserve tissues in face of imminent death...bioassays due to its low incidence of spontaneous mammary gland and liver cancer . This strain is recommended by the NCI Carcinogenesis Bioassay Program

Women in the Military. Hearings before the Military Personnel and Compensation Subcommitee of the Committee on Armed Services, House of Representatives. One Hundredth Congress, First and Second Sessions (October 1, November 19, 1987 and February 4, 1988).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Armed Services.

Within this document is the testimony delivered by 15 individuals at congressional hearings. Among the issues spoken to are: the combat exclusion law and its effect on the careers of women in the military; the kinds of jobs open to female armed services personnel; special problems that women in the military face; their promotion and retention…

Solid-state turn coordinator display

NASA Technical Reports Server (NTRS)

Meredith, B. D.; Crouch, R. K.; Kelly, W. L., IV

1975-01-01

A solid state turn coordinator display which employs light emitting diodes (LED's) as the display medium was developed to demonstrate the feasibility of such displays for aircraft applications. The input to the display is supplied by a fluidic inertial rate sensor used in an aircraft wing leveler system. The display is composed of the LED radial display face and the electronics necessary to address and drive the individual lines of LED's. Three levels of brightness are provided to compensate for the different amounts of ambient light present in the cockpit.

[Magical thinking and self development].

PubMed

Resch, F

1994-01-01

Based on a historical survey of the term "magic thinking" structural aspects of primary process and prelogical thinking will be elucidated. Developmental necessities for the emergence of magic interpretations in children of pre-school age are proposed. The thesis will be formulated, that magic interpretations may help the developing self in the management of life-circumstances during a period of cognitive egocentrism: feelings of non-competence may be compensated, and the locus of control may be held in the face of experiences of inferiority.

The SAC Mentality: The Origins of Strategic Air Command’s Organizational Culture, 1948-51

DTIC Science & Technology

2015-04-01

following World War II left SAC in a dire predicament as it faced shortages in several critical areas. In May 1946, the AAF autho- rized the command...convictions. McMullen believed in cross-training crew members and assigning them to multiple billets to compensate for manpower short- ages. The constant...atomic outfit from the Pacific theater. According to LeMay, they cleaned the supply warehouses , stocked the parts and supplies the unit needed, and

Is it safe? Talking to teens with HIV/AIDS about death and dying: a 3-month evaluation of Family Centered Advance Care (FACE) planning – anxiety, depression, quality of life

PubMed Central

Lyon, Maureen E; Garvie, Patricia A; Briggs, Linda; He, Jianping; Malow, Robert; D’Angelo, Lawrence J; McCarter, Robert

2010-01-01

Purpose To determine the safety of engaging HIV-positive (HIV+) adolescents in a Family Centered Advance Care (FACE) planning intervention. Patients and methods We conducted a 2-armed, randomized controlled clinical trial in 2 hospital-based outpatient clinics from 2006–2008 with HIV+ adolescents and their surrogates (n = 76). Three 60–90 minutes sessions were conducted weekly. FACE intervention groups received: Lyon FCACP Survey©, the Respecting Choices® interview, and completion of The Five Wishes©. The Healthy Living Control (HLC) received: Developmental History, Healthy Tips, Future Planning (vocational, school or vocational rehabilitation). Three-month post-intervention outcomes were: completion of advance directive (Five Wishes©); psychological adjustment (Beck Depression, Anxiety Inventories); quality of life (PedsQL™); and HIV symptoms (General Health Self-Assessment). Results Adolescents had a mean age, 16 years; 40% male; 92% African-American; 68% with perinatally acquired HIV, 29% had AIDS diagnosis. FACE participants completed advance directives more than controls, using time matched comparison (P < 0.001). Neither anxiety, nor depression, increased at clinically or statistically significant levels post-intervention. FACE adolescents maintained quality of life. FACE families perceived their adolescents as worsening in their school (P = 0.018) and emotional (P = 0.029) quality of life at 3 months, compared with controls. Conclusions Participating in advance care planning did not unduly distress HIV+ adolescents. PMID:22096382

Family food practices: relationships, materiality and the everyday at the end of life.

PubMed

Ellis, Julie

2018-02-01

This article draws on data from a research project that combined participant observation with in-depth interviews to explore family relationships and experiences of everyday life during life-threatening illness. In it I suggest that death has often been theorised in ways that make its 'mundane' practices less discernible. As a means to foreground the everyday, and to demonstrate its importance to the study of dying, this article explores the (re)negotiation of food and eating in families facing the end of life. Three themes that emerged from the study's broader focus on family life are discussed: 'food talk' and making sense of illness; food, family and identity; and food 'fights'. Together the findings illustrate the material, social and symbolic ways in which food acts relationally in the context of dying, extending conceptual work on materiality in death studies in novel directions. The article also contributes new empirical insights to a limited sociological literature on food, families and terminal illness, building on work that theorises the entanglements of materiality, food, bodies and care. The article concludes by highlighting the analytical value of everyday materialities such as food practices for future research on dying as a relational experience. © 2018 The Author. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

End-of-life mental health assessments for older aged, medically ill persons with expressed desire to die.

PubMed

Weinberger, Linda E; Sreenivasan, Shoba; Garrick, Thomas

2014-01-01

In recent years, assisted suicide has been legalized in four states for those who are terminally ill and wish to end their lives with the assistance of lethal doses of medications prescribed by a physician. The ethics-related and legal questions raised by end-of-life suicide and decisional capacity to refuse treatment assessments are complex. In treating patients with end-stage medical conditions or disorders that severely affect the future quality of their lives, clinicians tend to engage in suicide prevention at all costs. Overriding the patient's expressed desire to die conflicts with another value, however, that of the individual's right to autonomy. We provide a framework for understanding these difficult decisions, by providing a review of the epidemiology of suicide in later life; reviewing findings from a unique dataset of suicides among the elderly obtained from the Los Angeles County Coroner's Office, as well as data from states with legalized assisted suicide; presenting a discussion of the two frameworks of suicidal ideation as a pathological versus an existential reaction; and giving a case example that highlights the dilemmas faced by clinicians addressing decisional capacity to refuse treatment in an elderly, medically ill patient who has expressed the wish to die. © 2014 American Academy of Psychiatry and the Law.

Temporal and spatial patterns in emergence and early survival of perennial plants in the Sonoran Desert

USGS Publications Warehouse

Bowers, Janice E.; Turner, R.M.; Burgess, T.L.

2004-01-01

Seedling emergence and survival of 15 perennial species were studied for six years in a 557-m2 permanent plot at Tumamoc Hill, Arizona, USA, an ungrazed site in the northern Sonoran Desert. The minimum rain required for germination and emergence ranged from 17.5 to 35.6 mm. Few species emerged in every year of the study. First-year survival averaged across all 15 species was 3.7%; only 0.1% of seedlings lived as long as four years. The odds of survival in the first year improved with increased rain. About three times as many seedlings died from predation as desiccation. In 2-m2 subplots, mortality of three woody species in the first 30 days after emergence appeared to be independent of seedling density. Short-, moderate-, and long-lived species displayed distinct survival strategies. Long-lived species compensated for generally poor seedling survival by frequent germination and emergence. Moderate-lived species exhibited highly episodic germination and emergence, a potentially risky behavior that might have been offset to some extent by relatively good long-term survival. Short-lived species had the highest seedling survival. Because these species can bloom in their first year, good early survival meant that some individuals were able to reproduce before they died.

Influence of Random DC Offsets on Burst-Mode Receiver Sensitivity

NASA Astrophysics Data System (ADS)

Ossieur, Peter; de Ridder, Tine; Qiu, Xing-Zhi; Vandewege, Jan

2006-03-01

This paper presents the influence of random direct current (dc) offsets on the sensitivity of dc-coupled burst-mode receivers (BMRxs). It is well known that a BMRx exhibits a noisy decision threshold, resulting in a sensitivity penalty. If the BMRx is dc coupled, an additional penalty is incurred by random dc offsets. This penalty can only be determined for a statistically significant number of fabricated BMRx samples. Using Monte Carlo (MC) simulations and a detailed BMRx model, the relationship between the variance of this random dc offset, the resulting sensitivity penalty, and BMRx yield (the fraction of fabricated BMRx samples that meets a given sensitivity specification) is evaluated as a function of various receiver parameters. The obtained curves can be used to trade off BMRx die area against sensitivity for a given yield. It is demonstrated that a thorough understanding of the relationship between BMRx sensitivity, BMRx yield, and the variance of the random dc offsets is needed to optimize a dc-coupled BMRx with respect to sensitivity and die area for a given yield. It is shown that compensation of dc offsets with a resolution of 8 bits results in a sensitivity penalty of 1 dB for a wide range of random dc offsets.

High-performance serial block-face SEM of nonconductive biological samples enabled by focal gas injection-based charge compensation.

PubMed

Deerinck, T J; Shone, T M; Bushong, E A; Ramachandra, R; Peltier, S T; Ellisman, M H

2018-05-01

A longstanding limitation of imaging with serial block-face scanning electron microscopy is specimen surface charging. This charging is largely due to the difficulties in making biological specimens and the resins in which they are embedded sufficiently conductive. Local accumulation of charge on the specimen surface can result in poor image quality and distortions. Even minor charging can lead to misalignments between sequential images of the block-face due to image jitter. Typically, variable-pressure SEM is used to reduce specimen charging, but this results in a significant reduction to spatial resolution, signal-to-noise ratio and overall image quality. Here we show the development and application of a simple system that effectively mitigates specimen charging by using focal gas injection of nitrogen over the sample block-face during imaging. A standard gas injection valve is paired with a precisely positioned but retractable application nozzle, which is mechanically coupled to the reciprocating action of the serial block-face ultramicrotome. This system enables the application of nitrogen gas precisely over the block-face during imaging while allowing the specimen chamber to be maintained under high vacuum to maximise achievable SEM image resolution. The action of the ultramicrotome drives the nozzle retraction, automatically moving it away from the specimen area during the cutting cycle of the knife. The device described was added to a Gatan 3View system with minimal modifications, allowing high-resolution block-face imaging of even the most charge prone of epoxy-embedded biological samples. © 2017 The Authors Journal of Microscopy © 2017 Royal Microscopical Society.

Compensatory axon sprouting for very slow axonal die-back in a transgenic model of spinal muscular atrophy type III.

PubMed

Udina, Esther; Putman, Charles T; Harris, Luke R; Tyreman, Neil; Cook, Victoria E; Gordon, Tessa

2017-03-01

Smn +/- transgenic mouse is a model of the mildest form of spinal muscular atrophy. Although there is a loss of spinal motoneurons in 11-month-old animals, muscular force is maintained. This maintained muscular force is mediated by reinnervation of the denervated fibres by surviving motoneurons. The spinal motoneurons in these animals do not show an increased susceptibility to death after nerve injury and they retain their regenerative capacity. We conclude that the hypothesized immaturity of the neuromuscular system in this model cannot explain the loss of motoneurons by systematic die-back. Spinal muscular atrophy (SMA) is a common autosomal recessive disorder in humans and is the leading genetic cause of infantile death. Patients lack the SMN1 gene with the severity of the disease depending on the number of copies of the highly homologous SMN2 gene. Although motoneuron death in the Smn +/- transgenic mouse model of the mildest form of SMA, SMA type III, has been reported, we have used retrograde tracing of sciatic and femoral motoneurons in the hindlimb with recording of muscle and motor unit isometric forces to count the number of motoneurons with intact neuromuscular connections. Thereby, we investigated whether incomplete maturation of the neuromuscular system induced by survival motoneuron protein (SMN) defects is responsible for die-back of axons relative to survival of motoneurons. First, a reduction of ∼30% of backlabelled motoneurons began relatively late, at 11 months of age, with a significant loss of 19% at 7 months. Motor axon die-back was affirmed by motor unit number estimation. Loss of functional motor units was fully compensated by axonal sprouting to retain normal contractile force in four hindlimb muscles (three fast-twitch and one slow-twitch) innervated by branches of the sciatic nerve. Second, our evaluation of whether axotomy of motoneurons in the adult Smn +/- transgenic mouse increases their susceptibility to cell death demonstrated that all the motoneurons survived and they sustained their capacity to regenerate their nerve fibres. It is concluded the systematic die-back of motoneurons that innervate both fast- and slow-twitch muscle fibres is not related to immaturity of the neuromuscular system in SMA. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

Device overlay method for high volume manufacturing

NASA Astrophysics Data System (ADS)

Lee, Honggoo; Han, Sangjun; Kim, Youngsik; Kim, Myoungsoo; Heo, Hoyoung; Jeon, Sanghuck; Choi, DongSub; Nabeth, Jeremy; Brinster, Irina; Pierson, Bill; Robinson, John C.

2016-03-01

Advancing technology nodes with smaller process margins require improved photolithography overlay control. Overlay control at develop inspection (DI) based on optical metrology targets is well established in semiconductor manufacturing. Advances in target design and metrology technology have enabled significant improvements in overlay precision and accuracy. One approach to represent in-die on-device as-etched overlay is to measure at final inspection (FI) with a scanning electron microscope (SEM). Disadvantages to this approach include inability to rework, limited layer coverage due to lack of transparency, and higher cost of ownership (CoO). A hybrid approach is investigated in this report whereby infrequent DI/FI bias is characterized and the results are used to compensate the frequent DI overlay results. The bias characterization is done on an infrequent basis, either based on time or triggered from change points. On a per-device and per-layer basis, the optical target overlay at DI is compared with SEM on-device overlay at FI. The bias characterization results are validated and tracked for use in compensating the DI APC controller. Results of the DI/FI bias characterization and sources of variation are presented, as well as the impact on the DI correctables feeding the APC system. Implementation details in a high volume manufacturing (HVM) wafer fab will be reviewed. Finally future directions of the investigation will be discussed.

Experiences and Expressions of Spirituality at the End of Life in the Intensive Care Unit.

PubMed

Swinton, Marilyn; Giacomini, Mita; Toledo, Feli; Rose, Trudy; Hand-Breckenridge, Tracy; Boyle, Anne; Woods, Anne; Clarke, France; Shears, Melissa; Sheppard, Robert; Cook, Deborah

2017-01-15

The austere setting of the intensive care unit (ICU) can suppress expressions of spirituality. To describe how family members and clinicians experience and express spirituality during the dying process in a 21-bed medical-surgical ICU. Reflecting the care of 70 dying patients, we conducted 208 semistructured qualitative interviews with 76 family members and 150 clinicians participating in the Three Wishes Project. Interviews were recorded and transcribed verbatim. Data were analyzed by three investigators using qualitative interpretive description. Participants characterize dying as a spiritual event. Spirituality is an integral part of the life narrative of the patient before, during, and after death. Experiences and expressions of spirituality for patients, families, and clinicians during end-of-life care in the ICU are supported by eliciting and implementing wishes in several ways. Eliciting wishes stimulates conversations for people of diverse spiritual orientations to respond to death in personally meaningful ways that facilitate continuity and closure, and ease emotional trauma. Soliciting wishes identifies positive aspirations, which provide comfort in the face of death. The act of soliciting wishes brings clinician humanity to the fore. Wishing makes individual spiritual preferences and practices more accessible. Wishes may be grounded in spiritual goals, such as peace, comfort, connections, and tributes; they may seek a spiritually enhanced environment or represent specific spiritual interventions. Family members and clinicians consider spirituality an important dimension of end-of-life care. The Three Wishes Project invites and supports the expression of myriad forms of spirituality during the dying process in the ICU.

Dying cancer patients talk about euthanasia.

PubMed

Eliott, Jaklin A; Olver, Ian N

2008-08-01

Within developed nations, there is increasing public debate about and apparent endorsement of the appropriateness of euthanasia as an autonomous choice to die in the face of intolerable suffering. Surveys report socio-demographic differences in rates of acceptance of euthanasia, but there is little in-depth analysis of how euthanasia is understood and positioned within the social and moral lives of individuals, particularly those who might be considered suitable candidates-for example, terminally-ill cancer patients. During discussions with 28 such patients in Australia regarding medical decisions at the end of life, euthanasia was raised by 13 patients, with the others specifically asked about it. Twenty-four patients spoke positively of euthanasia, 19 of these voicing some concerns. None identified euthanasia as a currently favoured option. Four were completely against it. Endorsement for euthanasia was in the context of a hypothetical future or for a hypothetical other person, or temporally associated with acute pain. Arguments supporting euthanasia framed the issue as a matter of freedom of choice, as preserving dignity in death, and as curbing intolerable pain and suffering, both of the patient and of those around them. A common analogy featured was that of euthanising a dog. These arguments were typically presented as self-evident justification for euthanasia, construed as an appropriate choice to die, with opposers positioned as morally inferior or ignorant. The difficulties of ensuring 'choice' and the moral connotations of 'choosing to die,' however, worked to problematise the appropriateness of euthanising specific individuals. We recommend further empirical investigation of the moral and social meanings associated with euthanasia.

Caregivers’ perspectives on decision making about lung transplantation in cystic fibrosis

PubMed Central

Dellon, Elisabeth P.; Shores, Mitchell D.; Nelson, Katherine I.; Wolfe, Joanne; Noah, Terry L.; Hanson, Laura C.

2013-01-01

Context Lung transplantation extends survival for some patients with advanced cystic fibrosis, but it is complicated, has many potential risks, and its outcomes are difficult to predict. No standards exist for informed decision making about transplantation. Objective To assess decision making from the perspective of caregivers of patients who faced the transplant decision before dying of cystic fibrosis or transplant complications. Design Semistructured interviews with descriptive and qualitative content analysis. Participants Twenty-eight caregivers of patients with cystic fibrosis who received care at our center and died between 1996 and 2006. Results Of 28 patients who considered lung transplantation, 19 (68%) received transplants, 6 (21%) died while waiting for transplant, and 3 (11%) declined transplant. Three caregivers (11%) thought that the patient did not fully understand the reason for transplant referral. Five (18%) thought that the patient did not fully understand potential risks. Ten (36%) thought that alternatives were not fully understood. The only alternatives to transplant identified, progressive illness and the possibility of earlier death without transplant, were unacceptable to most. Thirteen caregivers (46%) reported that the patient thought that declining transplant was not an option. Caregivers described the decision as “easy” for 19 (68%), often expressing a sentiment of “do or die.” Those who described the decision as “easy” recalled fewer elements of informed decision making. Conclusions From caregivers’ reports, patients with cystic fibrosis may not fully understand risks of and alternatives to lung transplantation. Because a strong desire to prolong life necessitates honest communication about potential outcomes, interventions are needed to facilitate high-quality decision making. PMID:20050454

Face recognition system for set-top box-based intelligent TV.

PubMed

Lee, Won Oh; Kim, Yeong Gon; Hong, Hyung Gil; Park, Kang Ryoung

2014-11-18

Despite the prevalence of smart TVs, many consumers continue to use conventional TVs with supplementary set-top boxes (STBs) because of the high cost of smart TVs. However, because the processing power of a STB is quite low, the smart TV functionalities that can be implemented in a STB are very limited. Because of this, negligible research has been conducted regarding face recognition for conventional TVs with supplementary STBs, even though many such studies have been conducted with smart TVs. In terms of camera sensors, previous face recognition systems have used high-resolution cameras, cameras with high magnification zoom lenses, or camera systems with panning and tilting devices that can be used for face recognition from various positions. However, these cameras and devices cannot be used in intelligent TV environments because of limitations related to size and cost, and only small, low cost web-cameras can be used. The resulting face recognition performance is degraded because of the limited resolution and quality levels of the images. Therefore, we propose a new face recognition system for intelligent TVs in order to overcome the limitations associated with low resource set-top box and low cost web-cameras. We implement the face recognition system using a software algorithm that does not require special devices or cameras. Our research has the following four novelties: first, the candidate regions in a viewer's face are detected in an image captured by a camera connected to the STB via low processing background subtraction and face color filtering; second, the detected candidate regions of face are transmitted to a server that has high processing power in order to detect face regions accurately; third, in-plane rotations of the face regions are compensated based on similarities between the left and right half sub-regions of the face regions; fourth, various poses of the viewer's face region are identified using five templates obtained during the initial user registration stage and multi-level local binary pattern matching. Experimental results indicate that the recall; precision; and genuine acceptance rate were about 95.7%; 96.2%; and 90.2%, respectively.

Care and companionship in an isolating environment: Inmates attending to dying peers

PubMed Central

Hollenbeak, Christopher S.; Penrod, Janice; Smith, Carol A.; Kitt-Lewis, Erin; Crouse, Sarah B.

2013-01-01

The purpose of this study was to examine the values, beliefs, and perceptions of end-of-life (EOL) care held by inmates caring for peers approaching end of life. The study is part of a broader participatory action research project to infuse enhanced EOL care into state prisons. Face-to-face interviews using a semi-structured discussion guide were conducted with 17 male prisoners who were providing care for peers with advanced chronic illness and approaching end of life. Qualitative data were analyzed using content and thematic analyses. Key themes were: getting involved; living the role; and transforming self through caring for others. As well, contextual features at the organizational, peer, and personal levels were identified that either facilitated or impeded inmate caregiving. Provision of enhanced EOL care by inmate peers shows promise for improving prison community relations and morale, reducing suffering, and demonstrating care and compassion within the harsh prison environment. This study provides clear evidence that providing compassionate care for dying peers may result in transformative experiences for inmate caregivers. Implications for correctional nursing practice include providing training for inmate caregivers, including them in team meetings, and implementing grief support programs. Also, upholding nursing’s code of ethics and watching for predatory behavior are critical. “Prisons in the United States contain an ever growing number of aging men and women who…are incontinent, forgetful, suffering chronic illnesses, extremely ill, and dying” (Human Rights Watch, 2012, p. 4) PMID:24158099

Repeatable reference for positioning sensors and transducers in drill pipe

DOEpatents

Hall, David R.; Fox, Joe; Pixton, David S.; Hall, Jr., H. Tracy

2005-05-03

A drill pipe having a box end having a tapered thread, and an internal shoulder and an external face for engagement with a drill pipe pin end having a tapered mating thread, and an external shoulder and an external face adapted for data acquisition or transmission. The relative dimensions of the box and pin ends are precisely controlled so that when the tool joint is made up, a repeatable reference plane is established for transmitting power and tuning downhole sensors, transducers, and means for sending and receiving data along the drill string. When the power or data acquisition and transmission means are located in the tool joint, the dimensions of the tool joint are further proportioned to compensate for the loss of cross-sectional area in order maintain the joints ability to sustain nominal makeup torque.

The contribution of occupation to health inequality

PubMed Central

Ravesteijn, Bastian; van Kippersluis, Hans; van Doorslaer, Eddy

2014-01-01

Health is distributed unequally by occupation. Workers on a lower rung of the occupational ladder report worse health, have a higher probability of disability and die earlier than workers higher up the occupational hierarchy. Using a theoretical framework that unveils some of the potential mechanisms underlying these disparities, three core insights emerge: (i) there is selection into occupation on the basis of initial wealth, education, and health, (ii) there will be behavioural responses to adverse working conditions, which can have compensating or reinforcing effects on health, and (iii) workplace conditions increase health inequalities if workers with initially low socioeconomic status choose harmful occupations and don’t offset detrimental health effects. We provide empirical illustrations of these insights using data for the Netherlands and assess the evidence available in the economics literature. PMID:24899789

Evaluating the expected effects of disclosure of patient safety incidents using hypothetical cases in Korea.

PubMed

Ock, Minsu; Choi, Eun Young; Jo, Min-Woo; Lee, Sang-Il

2018-01-01

To introduce disclosure of patient safety incidents (DPSI) into a specific country, evidence of the effectiveness of DPSI is essential. Since such a disclosure policy has not been adopted in South Korea, hypothetical cases can be used to measure the effectiveness of DPSI. We evaluated the effectiveness of DPSI using hypothetical cases in a survey with a sample of the Korean general public. We used 8 hypothetical cases reflecting 3 conditions: the clarity of medical errors, the severity of harm, and conducting DPSI. Face-to-face interviews with 700 people using structured questionnaires were conducted. Participants were asked to read each hypothetical case and give remarks on the following: their judgment of a situation as a medical error and of the requirement for an apology, the willingness to revisit or recommend physicians, the intention to file a medical lawsuit and commence criminal proceedings against physicians, the level of trust in physicians, and the expected amount of compensation. The results indicated favorable findings in support of DPSI; DPSI reduced the likelihood of perceiving a situation as a medical error, promoted willingness to revisit and recommend physicians, and discouraged the intention to file a medical lawsuit and take commence criminal proceedings against physicians. Furthermore, DPSI increased patients' trust scores in physicians and reduced the expected amount of compensation. The general public had positive attitudes towards DPSI in South Korea. This result provides empirical evidence for reducing the psychological burden that the introduction of DPSI may have on health professionals.

Disease management programs: barriers and benefits.

PubMed

Magnezi, Racheli; Kaufman, Galit; Ziv, Arnona; Kalter-Leibovici, Ofra; Reuveni, Haim

2013-04-01

The healthcare system in Israel faces difficulties similar to those of most industrialized countries, including limited resources, a growing chronically ill population, and demand for high quality care. Disease management programs (DMPs) for patients with a chronic illness aim to alleviate some of these problems, primarily by improving patient self-management skills and quality of care. This study surveyed the opinions of senior healthcare administrators regarding barriers, benefits, and support for implementing DMPs. Cross-sectional survey. A 21-item questionnaire was self-completed by 87 of 105 (83%) healthcare administrators included in the study. Participants were 65.5% male and 47% physicians, 25.3% nurses, 17.3% administrators, and 10.3% other healthcare professionals. The main perceived benefit of DMPs among all respondents was improving quality of care. Other benefits noted were better contact with patients (81.6%) and better compliance with treatment (75.9%). Efficient long-term utilization of system resources was perceived as a benefit by only 58.6%. The main perceived barriers to implementing DMPs were lack of budgetary resources (69%) and increased time required versus financial compensation received (63.2%). The benefits of DMPs were patient oriented; barriers were perceived as financial and limiting professional autonomy. Information regarding long-term benefits (better patient outcomes) that ultimately provide better value for the system versus short-term barriers (increased costs and expenditures of time without compensation) might encourage the implementation of DMPs in countries faced with a growing population of patients with at least 1 chronic illness.

An unstructured-mesh finite-volume MPDATA for compressible atmospheric dynamics

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

Kühnlein, Christian, E-mail: christian.kuehnlein@ecmwf.int; Smolarkiewicz, Piotr K., E-mail: piotr.smolarkiewicz@ecmwf.int

An advancement of the unstructured-mesh finite-volume MPDATA (Multidimensional Positive Definite Advection Transport Algorithm) is presented that formulates the error-compensative pseudo-velocity of the scheme to rely only on face-normal advective fluxes to the dual cells, in contrast to the full vector employed in previous implementations. This is essentially achieved by expressing the temporal truncation error underlying the pseudo-velocity in a form consistent with the flux-divergence of the governing conservation law. The development is especially important for integrating fluid dynamics equations on non-rectilinear meshes whenever face-normal advective mass fluxes are employed for transport compatible with mass continuity—the latter being essential for flux-formmore » schemes. In particular, the proposed formulation enables large-time-step semi-implicit finite-volume integration of the compressible Euler equations using MPDATA on arbitrary hybrid computational meshes. Furthermore, it facilitates multiple error-compensative iterations of the finite-volume MPDATA and improved overall accuracy. The advancement combines straightforwardly with earlier developments, such as the nonoscillatory option, the infinite-gauge variant, and moving curvilinear meshes. A comprehensive description of the scheme is provided for a hybrid horizontally-unstructured vertically-structured computational mesh for efficient global atmospheric flow modelling. The proposed finite-volume MPDATA is verified using selected 3D global atmospheric benchmark simulations, representative of hydrostatic and non-hydrostatic flow regimes. Besides the added capabilities, the scheme retains fully the efficacy of established finite-volume MPDATA formulations.« less

Can individuals who are specialists in death, dying, and bereavement contribute to the prevention and/or mitigation of armed conflicts and cycles of violence?

PubMed

Parkes, Colin Murray; Attig, Thomas; Bendiksen, Robert; Cabrera, Fernando; Corr, Charles; Cox, Gerry; Faust, Susanna; Fulton, Robert; Jupp, Peter; Kallenberg, Kjell; Lamers, Elizabeth; Lamers, William; Long, Scott; McKissock, Diane; McKissock, Mal; Morgan, Mary Ann; Papadatou, Danai; Stevenson, Robert; Stoddard, Sandol; Weiss, Robert; Wrenn, Marcy

2011-01-01

Specialists in death, dying, and bereavement and their consequences for individuals, families, and communities have experience and research findings that are relevant to an understanding of the reactions of individuals faced by deadly violence. At such times, powerful emotions and ingrained patterns of thought and behavior can given rise to disproportionate responses that may feed into cycles of violence. An extended table shows how professionals helping individuals and families faced with violent death share common aims with those aiming to help larger social units faced with armed attacks. It follows that these professionals should work together to improve death education, to prepare people for possible deadly violence and, where possible, to suggest alternatives, to create secure places and relationships in which communication becomes possible, bad news can be broken and understood, feelings examined, differences reconciled, and people can redirect anger into the prevention of escalation rather than its perpetuation. All of these activities hold out hope that cycles of deadly violence can be broken as well as mitigating the consequences when they are not. The undoubted success of the worldwide palliative care movement resulted from the recognition of serious deficiencies in existing services, the provision of an inclusive, holistic, program that extends across medical, social psychological, and spiritual realms of discourse, providing care for patients and their families, irrespective of wealth, race, religion, and political persuasion, by dedicated leaders and teams backed by education and information services and organized across geographical boundaries. It is argued here that the time is ripe for a similar commitment to bring to an end the scandal of armed conflict by a similarly multidisciplinary, multicultural effort to relieve the suffering that both causes and results from armed conflict. This must remain independent of race, religion, political persuasion, and opposing sides and could build upon the leadership, educational models, information services, and international organizations that already exist for the provision of palliative and bereavement care.

Informal Caregiver Challenges for Advanced Cancer Patients During End-of-Life Care in Johannesburg, South Africa and Distinctions Based on Place of Death.

PubMed

O'Neil, Daniel S; Prigerson, Holly G; Mmoledi, Keletso; Sobekwa, Mfanelo; Ratshikana-Moloko, Mpho; Tsitsi, Jacob M; Cubasch, Herbert; Wong, Michelle L; Omoshoro-Jones, Jones A O; Sackstein, Paul E; Blinderman, Craig D; Jacobson, Judith S; Joffe, Maureen; Ruff, Paul; Neugut, Alfred I; Blanchard, Charmaine L

2018-03-28

In sub-Saharan Africa, late diagnosis with cancer is common. Many dying patients rely on family members for care; little is known about the challenges African informal caregivers face. To better understand the challenges of informal caregivers at the end of life in South Africa, both at home and in inpatient facilities. We included advanced cancer patients and caregivers from a public hospital in Johannesburg, South Africa. Study nurses interviewed patients and caregivers about their experiences. Using univariate and multivariate analyses, we determined the factors associated with greater caregiver difficulty, focusing on patients dying at home vs. in inpatient facilities. Among 174 informal caregivers, 62 (36%) reported "a lot" of challenges. These caregivers struggled most with keeping the patient clean (16%) and with patient interactions (34%). Symptoms associated with greater difficulty included pain (odds ratio [OR] 2.4 [95% CI 1.2-4.7]), urinary incontinence (OR 2.3 [95% CI 1.1-4.9]), fecal incontinence (OR 2.4 [95% CI 1.0-5.7]), insomnia (OR 2.9 [95% CI 1.3-6.9]), fatigue (OR 6.3 [95% CI 1.8-21.6]), extremity weakness (OR 2.9 [95% CI 1.3-6.9]), shame (OR 4.2 [95% CI 1.5-12.0]), and sadness (OR 2.3 [95% CI 1.1-4.8]). Caregivers of patients dying at home reported the greatest difficulty with patients' physical symptoms; caregivers of those dying in facilities reported the greatest difficulty with emotional symptoms. Informal caregivers of patients dying at home reported challenges with practical functional care; this effect was reduced in the inpatient setting. Skills training for these caregivers could relieve some of this burden. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

"Wenn die Erde bebt", an educational public exhibition in Vienna

NASA Astrophysics Data System (ADS)

Parithusta, Rizkita; Brueckl, Ewald; Heuer, Rudolf; Mitterbauer, Ulrike

2010-05-01

Natural disasters can cause the loss of human lives, an economic crisis and also the loss of irreplaceable cultural heritage. Earthquakes can mean instantaneous destruction without warning, causing extensive and often irreparable damage to our heritage. An exhibition with the title "Wenn die Erde bebt" (i.e. "When the Earth shakes") which was held at the Natural History Museum, Vienna; in an effort to introduce understanding, awareness, and preparedness to the public, facing earthquake phenomenon. The exhibition compiled and classified examples of large earthquakes and introduces into the basic principles of seismology. It further addresses earthquake impact and how to live with earthquakes, giving access to the most suitable procedure of safety education. The idea of the exhibition is communicated by the means of posters, videos, and physical models which support the understanding of seismometry, elastic rebound theory and earthquake resistant construction. The exhibition is an Austrian contribution to IYPE - International Year of Planet Earth and is now on tour through Austria.

Development of beryllium honeycomb sandwich composite for structural and other related applications

NASA Technical Reports Server (NTRS)

Vogan, J. W.; Grant, L. A.

1972-01-01

The feasibility of fabricating large beryllium honeycomb panels was demonstrated. Both flat and curved sandwich structures were manufactured using practical, braze bonding techniques. The processes developed prove that metallurgically assembled beryllium honeycomb panels show decided potential where rigid, lightweight structures are required. Three panels, each 10 square feet in surface area, were fabricated, and radiographically inspected to determine integrity. This examination revealed a 97 percent braze in the final panel. It is believed that ceramic dies for forming and brazing would facilitate the fabrication techniques for higher production rates. Ceramic dies would yield a lower thermal gradient in the panel during the braze cycle. This would eliminate the small amount of face sheet wrinkling present in the panels. Hot forming the various panel components demonstrated efficient manufacturing techniques for scaling up and producing large numbers of hot formed beryllium components and panels. The beryllium honeycomb panel demonstrated very good vibrational loading characteristics under test with desirable damping characteristics.

The risk of death by age, sex, and smoking status in the United States: putting health risks in context.

PubMed

Woloshin, Steven; Schwartz, Lisa M; Welch, H Gilbert

2008-06-18

To make sense of the disease risks they face, people need basic facts about the magnitude of a particular risk and how one risk compares with other risks. Unfortunately, this fundamental information is not readily available to patients or physicians. We created simple one-page charts that present the 10-year chance of dying from various causes according to age, sex, and smoking status. We used the National Center for Health Statistics Multiple Cause of Death Public Use File for 2004 and data from the 2004 US Census to calculate age- and sex-specific death rates for various causes of death. We then combined data on smoking prevalence (from the National Health Interview Survey) and the relative risks of death from various causes for smokers vs never smokers (from the American Cancer Society's Cancer Prevention Study-II) to determine age-, sex-, and smoking-specific death rates. Finally, we accumulated these risks for various starting ages in a series of 10-year life tables. The charts present the 10-year risks of dying from heart disease; stroke; lung, colon, breast, cervical, ovarian, and prostate cancer; pneumonia; influenza; AIDS; chronic obstructive pulmonary disease; accidents; and all causes. At all ages, the 10-year risk of death from all causes combined is higher for men than women. The effect of smoking on the chance of dying is similar to the effect of adding 5 to 10 years of age: for example, a 55-year-old man who smokes has about the same 10-year risk of death from all causes as a 65-year-old man who never smoked (ie, 178 vs 176 of 1000 men, respectively). For men who never smoked, heart disease death represents the single largest cause of death from age 50 on and the chance of dying from heart disease exceeds the chances of dying from lung, colon, and prostate cancers combined at every age. For men who currently smoke, the chance of dying from lung cancer is of the same order of magnitude as the chance dying from heart disease and after age 50 it is about 10 times greater than the chance of dying from prostate or colon cancer. For women who have never smoked, the magnitudes of the 10-year risks of death from breast cancer and heart disease are similar until age 60; from this age on, heart disease represents the single largest cause of death. For women who currently smoke, the chance of dying from heart disease or lung cancer exceeds the chance of dying from breast cancer from age 40 on (and does so by at least a factor of 5 after age 55). The availability of simple charts with consistent data presentations of important causes of death may facilitate discussion about disease risk between physicians and their patients and help highlight the dangers of smoking.

The Risk of Death by Age, Sex, and Smoking Status in the United States: Putting Health Risks in Context

PubMed Central

Woloshin, Steven; Welch, H. Gilbert

2008-01-01

Background To make sense of the disease risks they face, people need basic facts about the magnitude of a particular risk and how one risk compares with other risks. Unfortunately, this fundamental information is not readily available to patients or physicians. We created simple one-page charts that present the 10-year chance of dying from various causes according to age, sex, and smoking status. Methods We used the National Center for Health Statistics Multiple Cause of Death Public Use File for 2004 and data from the 2004 US Census to calculate age- and sex-specific death rates for various causes of death. We then combined data on smoking prevalence (from the National Health Interview Survey) and the relative risks of death from various causes for smokers vs never smokers (from the American Cancer Society’s Cancer Prevention Study-II) to determine age-, sex-, and smoking-specific death rates. Finally, we accumulated these risks for various starting ages in a series of 10-year life tables. The charts present the 10-year risks of dying from heart disease; stroke; lung, colon, breast, cervical, ovarian, and prostate cancer; pneumonia; influenza; AIDS; chronic obstructive pulmonary disease; accidents; and all causes. Results At all ages, the 10-year risk of death from all causes combined is higher for men than women. The effect of smoking on the chance of dying is similar to the effect of adding 5 to 10 years of age: for example, a 55-year-old man who smokes has about the same 10-year risk of death from all causes as a 65-year-old man who never smoked (ie, 178 vs 176 of 1000 men, respectively). For men who never smoked, heart disease death represents the single largest cause of death from age 50 on and the chance of dying from heart disease exceeds the chances of dying from lung, colon, and prostate cancers combined at every age. For men who currently smoke, the chance of dying from lung cancer is of the same order of magnitude as the chance dying from heart disease and after age 50 it is about 10 times greater than the chance of dying from prostate or colon cancer. For women who have never smoked, the magnitudes of the 10-year risks of death from breast cancer and heart disease are similar until age 60; from this age on, heart disease represents the single largest cause of death. For women who currently smoke, the chance of dying from heart disease or lung cancer exceeds the chance of dying from breast cancer from age 40 on (and does so by at least a factor of 5 after age 55). Conclusion The availability of simple charts with consistent data presentations of important causes of death may facilitate discussion about disease risk between physicians and their patients and help highlight the dangers of smoking. PMID:18544745

Resettlement, Regroupment, Reconcentration: Deliberate Government- Directed Population Relocation in Support of Counter-Insurgency Operations

DTIC Science & Technology

1992-06-01

raaged the inte..e.es. , culintin g cholera ,.,u, 1n" 1,,.. A,,.t "lea3L 11,000 Filipino non-combatants died in Bell’s "reconcentration camps, ൱ and...34reconcentration camp" failed in the face of media reports and persistent rumors to the contrary.86 EDCOR was so strongly touted as a success throughout...and confiscation to false reporting, to achieve the quantitative goals set.193 Many analysts submit that a well-planned and resourced Strategic Hamlet

The Face of Women's Health: Helen Rodriguez-Trias

PubMed Central

Wilcox, Joyce

2002-01-01

The American Public Health Association has announced that it will establish an award in the name of Helen Rodriguez-Trias, MD, its first Latina president, who died of lung cancer on December 27, 2002. Rodriguez-Trias, a nationally known advocate for underserved communities, was awarded the Presidential Citizens Medal by President Clinton in January 2001 for her work on behalf of children, women, people with AIDS, and the poor. This article is based on a dialogue with Rodriguez-Trias that began in September 2001 and ended December 12, 2001. PMID:11919054

Hallerman-Streiff syndrome.

PubMed

Nicholson, A D; Menon, S

1995-01-01

A 3 day old female neonate with Hallerman Streiff Syndrome presented with white spots in both the eyes. Both eyebrows and eyelashes were found to be sparse. Anterior chamber was found to be shallow. Total cataract was detected with posterior synechiae. Fundus could not be viewed. General examination revealed other features of Hallerman-Streiff Syndrome--short stature, bird like face, atrophy of skin and natal teeth. Lensectomy was carried out for left eye at the age of 10 weeks. However, the child had repeated respiratory tract infections and died at the age of 22 weeks.

[Effects of planning and executive functions on young children's script change strategy: A developmental perspective].

PubMed

Yanaoka, Kaichi

2016-02-01

This research examined the effects of planning and executive functions on young children's (ages 3-to 5-years) strategies in changing scripts. Young children (N = 77) performed a script task (doll task), three executive function tasks (DCCS, red/blue task, and nine box task), a planning task, and a receptive vocabulary task. In the doll task, young children first enacted a "changing clothes" script, and then faced a situation in which some elements of the script were inappropriate. They needed to enact a script by compensating inappropriate items for the other-script items or by changing to the other script in advance. The results showed that shifting, a factor of executive function, had a positive influence on whether young children could compensate inappropriate items. In addition, planning was also an important factor that helped children to change to the other script in advance. These findings suggest that shifting and planning play different roles in using the two strategies appropriately when young children enact scripts in unexpected situations.

Advancing knowledge of right ventricular pathophysiology in chronic pressure overload: Insights from experimental studies.

PubMed

Guihaire, Julien; Noly, Pierre Emmanuel; Schrepfer, Sonja; Mercier, Olaf

2015-10-01

The right ventricle (RV) has to face major changes in loading conditions due to cardiovascular diseases and pulmonary vascular disorders. Clinical experience supports evidence that the RV better compensates for volume than for pressure overload, and for chronic than for acute changes. For a long time, right ventricular (RV) pathophysiology has been restricted to patterns extrapolated from left heart studies. However, the two ventricles are anatomically, haemodynamically and functionally distinct. RV metabolic properties may also result in a different behaviour in response to pathological conditions compared with the left ventricle. In this review, current knowledge of RV pathophysiology is reported in the setting of chronic pressure overload, including recent experimental findings and emerging concepts. After a time-varying compensated period with preserved cardiac output despite overload conditions, RV failure finally occurs, leading to death. The underlying mechanisms involved in the transition from compensatory hypertrophy to maladaptive remodelling are not completely understood. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Applying crash data to injury claims - an investigation of determinant factors in severe motor vehicle accidents.

PubMed

Shannon, Darren; Murphy, Finbarr; Mullins, Martin; Eggert, Julian

2018-04-01

An extensive number of research studies have attempted to capture the factors that influence the severity of vehicle impacts. The high number of risks facing all traffic participants has led to a gradual increase in sophisticated data collection schemes linking crash characteristics to subsequent severity measures. This study serves as a departure from previous research by relating injuries suffered in road traffic accidents to expected trauma compensation payouts and deriving a quantitative cost function. Data from the National Highway Traffic Safety Administration's (NHTSA) Crash Injury Research (CIREN) database for the years 2005-2014 is combined with the Book of Quantum, an Irish governmental document that offers guidelines on the appropriate compensation to be awarded for injuries sustained in accidents. A multiple linear regression is carried out to identify the crash factors that significantly influence expected compensation costs and compared to ordered and multinomial logit models. The model offers encouraging results given the inherent variation expected in vehicular incidents and the subjectivity influencing compensation payout judgments, attaining an adjusted-R 2 fit of 20.6% when uninfluential factors are removed. It is found that relative speed at time of impact and dark conditions increase the expected costs, while rear-end incidents, incident sustained in van-based trucks and incidents sustained while turning result in lower expected compensations. The number of airbags available in the vehicle is also a significant factor. The scalar-outcome approach used in this research offers an alternative methodology to the discrete-outcome models that dominate traffic safety analyses. The results also raise queries on the future development of claims reserving (capital allocations earmarked for future expected claims payments) as advanced driver assistant systems (ADASs) seek to eradicate the most frequent types of crash factors upon which insurance mathematics base their assumptions. Copyright © 2018 Elsevier Ltd. All rights reserved.

The role of managed care in work-related injuries.

PubMed

Shor, M J; Miller, J C

1996-10-01

Many opportunities exist today for orthopedic surgeons in the treatment and management of work-related injuries. Physicians wishing to enter or participate in this market must realize that the role of the physician in the treatment of the injured worker has expanded from one of being solely the care giver to being a patient manager, a problem solver, and a communicator. A number of years ago, many orthopedic surgeons missed out on managed care contracting for health maintenance organizations because they thought they could survive without it. They soon learned the challenges of sitting on the sidelines. Whether we like it or not, managed care for work-related injuries is here and its likelihood for going away is about zero. If your state has not yet adopted utilization management standards or managed care for workers' compensation-enabling legislation, when you wake up tomorrow they may have done so. Because of its relative embryonic development, there are exceptional opportunities for practitioners to take active roles in shaping the models that will serve employees and employers in the year 2000. Physicians who are interested in the treatment of injured workers have a unique opportunity right now to develop relationships in the managed workers' compensation arena. Payment and patient referrals for workers' compensation may turn out to be more attractive financially than many of the contracts currently in place with health maintenance organizations and other general health plans. Physicians willing to partner with employers and other players in the workers' compensation arena currently face some challenging, rewarding, and exciting opportunities. In the immortal words of Hippocrates, "Healing is a matter of time, but it is sometimes a matter of opportunity."3 It is unclear whether Hippocrates ever imagined our current level of science, practice, and organization, but it is clear the opportunities to be an active participant in the changes occurring in workers' compensation are as real today as they were in 1973 when then President Nixon passed the Health Maintenance Organization Act.

Temperate Mountain Forest Biodiversity under Climate Change: Compensating Negative Effects by Increasing Structural Complexity

PubMed Central

Braunisch, Veronika; Coppes, Joy; Arlettaz, Raphaël; Suchant, Rudi; Zellweger, Florian; Bollmann, Kurt

2014-01-01

Species adapted to cold-climatic mountain environments are expected to face a high risk of range contractions, if not local extinctions under climate change. Yet, the populations of many endothermic species may not be primarily affected by physiological constraints, but indirectly by climate-induced changes of habitat characteristics. In mountain forests, where vertebrate species largely depend on vegetation composition and structure, deteriorating habitat suitability may thus be mitigated or even compensated by habitat management aiming at compositional and structural enhancement. We tested this possibility using four cold-adapted bird species with complementary habitat requirements as model organisms. Based on species data and environmental information collected in 300 1-km2 grid cells distributed across four mountain ranges in central Europe, we investigated (1) how species’ occurrence is explained by climate, landscape, and vegetation, (2) to what extent climate change and climate-induced vegetation changes will affect habitat suitability, and (3) whether these changes could be compensated by adaptive habitat management. Species presence was modelled as a function of climate, landscape and vegetation variables under current climate; moreover, vegetation-climate relationships were assessed. The models were extrapolated to the climatic conditions of 2050, assuming the moderate IPCC-scenario A1B, and changes in species’ occurrence probability were quantified. Finally, we assessed the maximum increase in occurrence probability that could be achieved by modifying one or multiple vegetation variables under altered climate conditions. Climate variables contributed significantly to explaining species occurrence, and expected climatic changes, as well as climate-induced vegetation trends, decreased the occurrence probability of all four species, particularly at the low-altitudinal margins of their distribution. These effects could be partly compensated by modifying single vegetation factors, but full compensation would only be achieved if several factors were changed in concert. The results illustrate the possibilities and limitations of adaptive species conservation management under climate change. PMID:24823495

Temperate mountain forest biodiversity under climate change: compensating negative effects by increasing structural complexity.

PubMed

Braunisch, Veronika; Coppes, Joy; Arlettaz, Raphaël; Suchant, Rudi; Zellweger, Florian; Bollmann, Kurt

2014-01-01

Species adapted to cold-climatic mountain environments are expected to face a high risk of range contractions, if not local extinctions under climate change. Yet, the populations of many endothermic species may not be primarily affected by physiological constraints, but indirectly by climate-induced changes of habitat characteristics. In mountain forests, where vertebrate species largely depend on vegetation composition and structure, deteriorating habitat suitability may thus be mitigated or even compensated by habitat management aiming at compositional and structural enhancement. We tested this possibility using four cold-adapted bird species with complementary habitat requirements as model organisms. Based on species data and environmental information collected in 300 1-km2 grid cells distributed across four mountain ranges in central Europe, we investigated (1) how species' occurrence is explained by climate, landscape, and vegetation, (2) to what extent climate change and climate-induced vegetation changes will affect habitat suitability, and (3) whether these changes could be compensated by adaptive habitat management. Species presence was modelled as a function of climate, landscape and vegetation variables under current climate; moreover, vegetation-climate relationships were assessed. The models were extrapolated to the climatic conditions of 2050, assuming the moderate IPCC-scenario A1B, and changes in species' occurrence probability were quantified. Finally, we assessed the maximum increase in occurrence probability that could be achieved by modifying one or multiple vegetation variables under altered climate conditions. Climate variables contributed significantly to explaining species occurrence, and expected climatic changes, as well as climate-induced vegetation trends, decreased the occurrence probability of all four species, particularly at the low-altitudinal margins of their distribution. These effects could be partly compensated by modifying single vegetation factors, but full compensation would only be achieved if several factors were changed in concert. The results illustrate the possibilities and limitations of adaptive species conservation management under climate change.

Challenges Facing Families at the End of Life in Three Settings

PubMed Central

Kehl, Karen A.; Kirchhoff, Karin T.; Kramer, Betty J.; Hovland-Scafe, Cyndi

2010-01-01

This study examined the challenges faced by family members at the end of life in different care settings and how those challenges compare across settings. A total of 30 participants, who had a family member die in inpatient hospice, a skilled nursing facility or a community support program were interviewed. Semi-structured interviews were recorded and transcribed. Text was coded using qualitative thematic analysis. Themes were determined by consensus. Twelve challenges were identified across care sites. Two themes emerged in all three settings: bearing witness and the experience of loss. The study findings contribute to our knowledge of family perceptions of care in different settings and raises awareness of the need for further research describing the experiences at the end of life in different settings and the importance of creating and testing interventions for both setting specific needs and universal issues. PMID:20563315

Psychopathology 8 1/2 years post parasuicide.

PubMed

Curran, S; Fitzgerald, M; Greene, V T

1999-01-01

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8 1/2 years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five and died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

Compensation of Handicap and Autonomy Loss through e-Technologies and Home Automation for Elderly People in Rural Regions: An Actual Need for International Initiatives Networks

NASA Astrophysics Data System (ADS)

Billonnet, Laurent; Dumas, Jean-Michel; Desbordes, Emmanuel; Lapôtre, Bertrand

To face the problems of elderly and disabled people in a rural environment, the district of Guéret (department of Creuse, France) has set up the "Home automation and Health Pole". In association with the University of Limoges, this structure is based on the use of e-technologies together with home automation techniques. In this frame, many international collaborations attempts have started through a BSc diploma. This paper sums up these different collaborations and directions.

Improved tool grinding machine

DOEpatents

Dial, C.E. Sr.

The present invention relates to an improved tool grinding mechanism for grinding single point diamond cutting tools to precise roundness and radius specifications. The present invention utilizes a tool holder which is longitudinally displaced with respect to the remainder of the grinding system due to contact of the tool with the grinding surface with this displacement being monitored so that any variation in the grinding of the cutting surface such as caused by crystal orientation or tool thicknesses may be compensated for during the grinding operation to assure the attainment of the desired cutting tool face specifications.

Tool grinding machine

DOEpatents

Dial, Sr., Charles E.

1980-01-01

The present invention relates to an improved tool grinding mechanism for grinding single point diamond cutting tools to precise roundness and radius specifications. The present invention utilizes a tool holder which is longitudinally displaced with respect to the remainder of the grinding system due to contact of the tool with the grinding surface with this displacement being monitored so that any variation in the grinding of the cutting surface such as caused by crystal orientation or tool thickness may be compensated for during the grinding operation to assure the attainment of the desired cutting tool face specifications.

Influence of Compensating Defect Formation on the Doping Efficiency and Thermoelectric Properties of Cu2ySe1xBrx

DTIC Science & Technology

2015-09-24

level spectra (Figure S3b). The relative contents of Cu to Se were determined using a Thermo- Finnigan ELEMENT2 single collector sector field...has a wide range of stoichiometric deviation (Cu2−δSe). 17,22,23 Above 410 K, the compound has an average cubic structure with Se ions forming a face...extrinsically, and a single parabolic band model can be applied to analyze the transport and predict the optimum carrier densities for a maximum figure of

"They don't care what happens to us." The situation of double orphans heading households in Rakai District, Uganda

PubMed Central

Dalen, Nina; Nakitende, Ann Jacqueline; Musisi, Seggane

2009-01-01

Background This article is based on information collected about the situation of double orphans who are heading households in Rakai District, Uganda. The information will be used as justification and guidance for planning actions to improve the situation of these and similar children. This research is thus the first step in an Action Research approach leading to specific interventions. The aim of this article is to describe the situation of these orphaned children, with an emphasis on the psychosocial challenges they face. Methods The study involved interviews, focus group discussions, observations and narratives. Forty-three heads of sibling-headed households participated. Information derived from informal discussions with local leaders is also included. The responses were analyzed using a modified version of Giorgi's psychological phenomenological method as described by Malterud [1]. Results Factors such as lack of material resources, including food and clothes, limited possibilities to attend school on a regular basis, vast responsibilities and reduced possibilities for social interaction all contribute to causing worries and challenges for the child heads of households. Most of the children claimed that they were stigmatized and, to a great extent, ignored and excluded from their community. The Local Council Secretary ("Chairman") seemed to be the person in the community most responsible and helpful, but some chairmen seemed not to care at all. The children requested counseling for themselves as well as for community members because they experienced lack of understanding from other children and from adult community members. Conclusion The children experienced their situation as a huge and complex problem for themselves as well as for people in their villages. However, the situation might improve if actions focused on practical and psychological issues as well as on sensitization about the children's situation could be initiated. In addition to the fact that these children need adult guidance to become citizens who act in accordance with the expectations in their communities, material aid is important in order to reduce the children's experiences of being "different" and constantly experiencing survival anxieties. Before my parents died, I was schooling without facing any problems and my heart was at rest. When they died I went to live with Jjajja [grandmother]. She fell very sick and I came out of school for a full term to look after her. I was treating Jjajja but she was not getting better. She died...so...I got my schoolmates' books and copied notes that they had taken while I was away from school...I face the problem of not having good friends. Some see me as a disease...other people are not bad. Some call me names and say that I am stupid, that I probably inherited the stupidity from my mother or father...Ever since my parents died, I have not had peace. I spend most of the time thinking, crying and struggling within myself asking God why He really had to do such a thing and saying to myself that: "God, help me overcome these problems!" Girl, 15. PMID:19732430

Investigation of Particle Sampling Bias in the Shear Flow Field Downstream of a Backward Facing Step

NASA Technical Reports Server (NTRS)

Meyers, James F.; Kjelgaard, Scott O.; Hepner, Timothy E.

1990-01-01

The flow field about a backward facing step was investigated to determine the characteristics of particle sampling bias in the various flow phenomena. The investigation used the calculation of the velocity:data rate correlation coefficient as a measure of statistical dependence and thus the degree of velocity bias. While the investigation found negligible dependence within the free stream region, increased dependence was found within the boundary and shear layers. Full classic correction techniques over-compensated the data since the dependence was weak, even in the boundary layer and shear regions. The paper emphasizes the necessity to determine the degree of particle sampling bias for each measurement ensemble and not use generalized assumptions to correct the data. Further, it recommends the calculation of the velocity:data rate correlation coefficient become a standard statistical calculation in the analysis of all laser velocimeter data.

Visual attention: low-level and high-level viewpoints

NASA Astrophysics Data System (ADS)

Stentiford, Fred W. M.

2012-06-01

This paper provides a brief outline of the approaches to modeling human visual attention. Bottom-up and top-down mechanisms are described together with some of the problems that they face. It has been suggested in brain science that memory functions by trading measurement precision for associative power; sensory inputs from the environment are never identical on separate occasions, but the associations with memory compensate for the differences. A graphical representation for image similarity is described that relies on the size of maximally associative structures (cliques) that are found to reflect between pairs of images. This is applied to the recognition of movie posters, the location and recognition of characters, and the recognition of faces. The similarity mechanism is shown to model popout effects when constraints are placed on the physical separation of pixels that correspond to nodes in the maximal cliques. The effect extends to modeling human visual behaviour on the Poggendorff illusion.

Clock-drawing test and unilateral spatial neglect.

PubMed

Ishiai, S; Sugishita, M; Ichikawa, T; Gono, S; Watabiki, S

1993-01-01

We investigated the ability of 25 patients with left unilateral spatial neglect to make a clock face by putting numbers inside a printed circle. Impairment seen in this clock-drawing test did not parallel neglect severity as judged by results of the line-cancellation and line-bisection tests, as well as the copying of a daisy. The score for clock drawing correlated highly with the verbal WAIS score. Most neglect patients with a verbal IQ of 87 or more could draw a clock face fairly well and used planning in placing the numbers 12, 3, 6, and 9 before the others. In clock drawing, verbal intelligence may compensate for left unilateral spatial neglect. We therefore recommend use of the line-cancellation and line-bisection tests, as well as the copying test, but do not recommend use of the clock-drawing test in the diagnosis of left unilateral spatial neglect.

Care of the dying: a Catholic perspective. Part IV: Theological, moral, and pastoral response--the transformation of suffering. Catholic Health Association.

PubMed

1993-06-01

People struggle to find meaning in suffering and death. In a culture that cannot depend on religious insights into suffering to address the deeper questions (e.g., Why me?), all kinds of interventions, even euthanasia and assisted suicide, may seem inevitable. Catholic healthcare providers can respond by offering patients, families, and care givers a vision of how suffering can be understood. Based on the power of divine love to transform suffering and death from absolute evils to personal triumphs, the moral principles the Catholic Church upholds can provide a hopeful perspective for healthcare professionals who care for the dying. Three principles support Roman Catholic teaching on conserving health and life: sanctity of life, God's dominion and human stewardship, and the prohibition against killing. These principles by themselves are insufficient as a moral or pastoral response to the care of the suffering and dying. Action is also required. Moral virtues must be reflected in ethical behavior and in pastoral practice so that we may enact our Christian vision in the face of suffering and death. Attention to our character as providers and our ethical practices is of grave importance in these days when euthanasia and assisted suicide are being promoted so aggressively. To carry on Jesus' healing mission by responding to human suffering and death, healing communities must embody virtues that bear convincing witness in both a personal and a corporate manner regarding the care of the dying. Three characteristics of a virtuous community stand out: interdependence, care, and hospitality. By being a virtuous community, we may be able to address many of the concerns that motivate people to consider euthanasia.(ABSTRACT TRUNCATED AT 250 WORDS)

"Bernardino Ramazzini, three hundred years after his death", Padua (Italy), October 18th, 2014.

PubMed

Riva, Michele Augusto; Zampieri, Fabio

2015-01-29

The year 2014 has marked the tercentenary from the death of Bernardino Ramazzini (1633-1714), universally credited as the founder of Occupational Health (5, 9, 10, 11). Indeed, the renowned physician died on November 5th 1714 in Padua, where he had been appointed as Professor of Practical Medicine at the local prestigious University from the year 1700. To commemorate this anniversary, the professors of Occupational Health of the University of Padua, the Italian Society of Occupational Health and Industrial Hygiene (Società Italiana di Medicina del Lavoro eIgiene Industriale, SIMLII), the International Commission on Occupational Health (ICOH) and the University of Padua organized a conference in the wonderful location of Palazzo Bo (Main Hall) under the patronage of the Padua Municipality, the Workers' Compensation Authority (INAIL), the Venetian Region and the Societas Internationalis Historiae Medicinae.[...].

Ethical challenges faced by healthcare professionals who care for suicidal patients: a scoping review.

PubMed

Saigle, Victoria; Racine, Eric

2018-04-17

For each one of the approximately 800,000 people who die from suicide every year, an additional twenty people attempt suicide. Many of these attempts result in hospitalization or in contact with other healthcare services. However, many personal, educational, and institutional barriers make it difficult for healthcare professionals to care for suicidal individuals. We reviewed literature that discusses suicidal patients in healthcare settings in order to highlight common ethical issues and to identify knowledge gaps. A sample was generated via PubMed using keywords "[(ethics OR *ethic*) AND suicid*] AND [English (Language) OR French (Language)]" (final N = 52), ethics content was extracted according to scoping review methodology, and categorized thematically. We identified three main areas posing ethical challenges for health professionals caring for suicidal individuals and their families. These were: (1) making clinical decisions for patients in acute care or when presented with specific circumstances; (2) issues arising from therapeutic relationships in chronic care, and (3) organizational factors. There is considerable uncertainty about how to resolve ethical issues when caring for someone who is suicidal. The stigma associated with suicide and mental illness, problems associated with risk-benefit assessments, and the fear of being held liable for malpractice should a patient die by suicide were overarching themes present across these three categories. Caring for suicidal patients is clinically and ethically challenging. The current literature highlights the complexity and range of decisions that need to be made. More attention should be paid to the difficulties faced by healthcare professionals and the development of solutions.

The desire to hasten death: Using Grounded Theory for a better understanding "When perception of time tends to be a slippery slope".

PubMed

Pestinger, Martina; Stiel, Stephanie; Elsner, Frank; Widdershoven, Guy; Voltz, Raymond; Nauck, Friedemann; Radbruch, Lukas

2015-09-01

Some patients with advanced and progressive diseases express a desire to hasten death. This study evaluated the motivations of patients expressing such a desire in a country with prohibitive legislation on euthanasia and physician-assisted suicide. A modified form of Grounded Theory was used. Patients from the departments of palliative medicine in three hospitals in Germany were recruited when they had made a statement or request to hasten death. Participants were interviewed face to face. Recruitment was stopped with 12 participants because of data saturation. Thematic analysis revealed three main motivational themes: self-determination, agony, and time. Expectations toward health professionals, attitudes toward death, and secureness related to the end of life were additional main themes emerging from the analysis. The desire to hasten death may be used as an extreme coping strategy to maintain control against anticipated agony. Patients expected health professionals to listen to and respect their experiences. Emerging hypotheses included the following: (a) patients try to balance life time and anticipated agony, and the perception of time is distressing in this balancing act; (b) anticipated images of agony and suffering in the dying process occur frequently and are experienced by patients as intrusive; (c) patients expressing a desire to hasten death are in need of more information about the dying process; and (d) patients wanted their caregivers to listen to and respect their wish to hasten death, and they did not expect the caregivers to understand this as an order to actually hasten their death. © The Author(s) 2015.

[End-of-life in specialized medical pediatrics department: A French national survey].

PubMed

Ravanello, Alice; Desguerre, Isabelle; Frache, Sandra; Hubert, Philippe; Orbach, Daniel; Aubry, Régis

2017-03-01

In France, most of children die in the hospital. This national survey aimed to achieve better understanding of end-of life care in specialized medical pediatrics departments for children facing the end-of-life, identify the available resources, put forward the difficulties encountered by professionals and describe end-of-life paths of children who died in these departments. This study is based on a nationwide survey conducted among all existing specialized medical pediatrics departments (onco-haematology, neurology, reanimation) in France in 2015. Among 94 specialized medical pediatrics departments in France, 53 participated in our survey (response rate=56%). At the time of the survey, 13% of inpatients were facing the end-of-life. Regarding training, 13% of departments did not have personnel trained in palliative care and 21% did not set up any professional support. However, when taking care of a child's end of life in 2014, 77% of these departments solicited a regional resource team of pediatric palliative care. This survey helps describe 225 end-of-life paths of children decease of a terminal illness in the specialized pediatrics departments. Seventy-two percent suffered from refractory symptoms before their death, 64% were concerned by a terminal sedation and 75% by a limitation of life-sustaining treatment decision. End-of-life care is a reality for specialized pediatrics departments. The frequency of major and refractory symptoms often requires the completion of sedation. The resources of service are acceptable but some deficiencies have been noted especially concerning training and support for caregivers, adaptation of premises or family support. Copyright © 2017. Published by Elsevier SAS.

The wish to hasten death: a review of clinical studies.

PubMed

Monforte-Royo, Cristina; Villavicencio-Chávez, Christian; Tomás-Sábado, Joaquín; Balaguer, Albert

2011-08-01

It is common for patients who are faced with physical or psychological suffering, particularly those in the advanced stages of a disease, to have some kind of wish to hasten death (WTHD). This paper reviews and summarises the current state of knowledge about the WTHD among people with end-stage disease, doing so from a clinical perspective and on the basis of published clinical research. Studies were identified through a search strategy applied to the main scientific databases. Clinical studies show that the WTHD has a multi-factor aetiology. The literature review suggests-perhaps in line with better management of physical pain-that psychological and spiritual aspects, including social factors, are the most important cause of such a wish. One of the difficulties facing clinical research is the lack of terminological and conceptual precision in defining the construct. Indeed, studies frequently blur the distinction between a generic wish to die, a WTDH (whether sporadic or persistent over time), the explicit expression of a wish to die, and a request for euthanasia or physician-assisted suicide. A notable contribution to knowledge in this field has been made by scales designed to evaluate the WTHD, although the problems of conceptual definition may once again limit the conclusions, which can be drawn from the results. Studies using qualitative methodology have also provided new information that can help in understanding such wishes. Further clinical research is needed to provide a complete understanding of this phenomenon and to foster the development of suitable care plans. Copyright © 2010 John Wiley & Sons, Ltd.

Women's health is a community issue.

PubMed

Irvin, A

1997-01-01

When a member of the Community Life Project in Nigeria led a group of women in a discussion about HIV/AIDS, the women reported that they understood that condom use is the best means of protection but that they were unable to negotiate condom use with their husbands. Even if the women were economically independent, they would rather face the risk of HIV/AIDS than divorce. Thus, efforts to improve women's health have not generated much change on the local level. This can also be seen by the facts that current programs have failed to reduce the numbers of women dying from pregnancy-related causes each year, nearly 3000 women die from tuberculosis each day, women suffer occupational health risks, and domestic violence is an important determinant of health problems for women. Because women lack power in many societies, efforts to effect individual change may be blocked by a woman's particular circumstances. Thus, the involvement of entire communities is necessary to improve the conditions affecting women's health. Community-level discussions may open the door for couples to discuss sexuality and gender-based issues as well as safer sex behavior. Despite the important role they can play, women's community health groups face stiff challenges because of a lack of knowledge or training and because of the difficulty in overcoming gender-based discrimination. The Hesperian Foundation's publication, "Where Women Have No Doctor," is an excellent resource for understanding how poverty and gender issues affect women's health. The book contains practical information, promotes a model of community-based responses to problems with social origins, and shares experiences of grassroots groups world-wide.

Pupil Tracking for Real-Time Motion Corrected Anterior Segment Optical Coherence Tomography

PubMed Central

Carrasco-Zevallos, Oscar M.; Nankivil, Derek; Viehland, Christian; Keller, Brenton; Izatt, Joseph A.

2016-01-01

Volumetric acquisition with anterior segment optical coherence tomography (ASOCT) is necessary to obtain accurate representations of the tissue structure and to account for asymmetries of the anterior eye anatomy. Additionally, recent interest in imaging of anterior segment vasculature and aqueous humor flow resulted in application of OCT angiography techniques to generate en face and 3D micro-vasculature maps of the anterior segment. Unfortunately, ASOCT structural and vasculature imaging systems do not capture volumes instantaneously and are subject to motion artifacts due to involuntary eye motion that may hinder their accuracy and repeatability. Several groups have demonstrated real-time tracking for motion-compensated in vivo OCT retinal imaging, but these techniques are not applicable in the anterior segment. In this work, we demonstrate a simple and low-cost pupil tracking system integrated into a custom swept-source OCT system for real-time motion-compensated anterior segment volumetric imaging. Pupil oculography hardware coaxial with the swept-source OCT system enabled fast detection and tracking of the pupil centroid. The pupil tracking ASOCT system with a field of view of 15 x 15 mm achieved diffraction-limited imaging over a lateral tracking range of +/- 2.5 mm and was able to correct eye motion at up to 22 Hz. Pupil tracking ASOCT offers a novel real-time motion compensation approach that may facilitate accurate and reproducible anterior segment imaging. PMID:27574800

Multi-volumetric registration and mosaicking using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography

NASA Astrophysics Data System (ADS)

Bozic, Ivan; El-Haddad, Mohamed T.; Malone, Joseph D.; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.

2017-02-01

Ophthalmic diagnostic imaging using optical coherence tomography (OCT) is limited by bulk eye motions and a fundamental trade-off between field-of-view (FOV) and sampling density. Here, we introduced a novel multi-volumetric registration and mosaicking method using our previously described multimodal swept-source spectrally encoded scanning laser ophthalmoscopy and OCT (SS-SESLO-OCT) system. Our SS-SESLO-OCT acquires an entire en face fundus SESLO image simultaneously with every OCT cross-section at 200 frames-per-second. In vivo human retinal imaging was performed in a healthy volunteer, and three volumetric datasets were acquired with the volunteer moving freely and refixating between each acquisition. In post-processing, SESLO frames were used to estimate en face rotational and translational motions by registering every frame in all three volumetric datasets to the first frame in the first volume. OCT cross-sections were contrast-normalized and registered axially and rotationally across all volumes. Rotational and translational motions calculated from SESLO frames were applied to corresponding OCT B-scans to compensate for interand intra-B-scan bulk motions, and the three registered volumes were combined into a single interpolated multi-volumetric mosaic. Using complementary information from SESLO and OCT over serially acquired volumes, we demonstrated multivolumetric registration and mosaicking to recover regions of missing data resulting from blinks, saccades, and ocular drifts. We believe our registration method can be directly applied for multi-volumetric motion compensation, averaging, widefield mosaicking, and vascular mapping with potential applications in ophthalmic clinical diagnostics, handheld imaging, and intraoperative guidance.

Perspectives of transplant physicians and surgeons on reimbursement, compensation, and incentives for living kidney donors.

PubMed

Tong, Allison; Chapman, Jeremy R; Wong, Germaine; Craig, Jonathan C

2014-10-01

The shortage of donors for organ transplantation has stimulated debate on financial incentives for living kidney donors. This study aims to describe the range of attitudes and opinions of transplant physicians on financial reimbursement, compensation, and incentives in living kidney donation. Qualitative study. 110 transplant nephrologists and surgeons from 12 countries across 43 transplantation units in Europe, Australasia, and North America. Face-to-face semistructured interviews were conducted. Transcripts were thematically analyzed. We identified 7 major themes. Prioritizing the removal of disincentives for living kidney donors was largely deemed acceptable. By contrast, provision of financial incentives raised concerns about undermining benevolence, compromising human dignity and value, and traversing market forces. Some contended that financial incentives potentially were legitimate if regulated, arguing that this would maximize utility in transplantation, but most also acknowledged the difficulty and that operational feasibility of a regulated system of financial incentivization may be limited. Participants were English speaking and from Western high-income countries; therefore, the transferability of our findings may be limited. Transplantation specialists believed that minimizing disincentives would support equity and justice in living kidney donation. Direct financial incentivization for living kidney donors, even in the context of a regulated market, was regarded by most as unjustified because of the potential moral consequences and uncertain feasibility. Removing financial disincentives and safeguarding the intrinsic volunteerism, value, and meaning of donation were viewed to uphold integrity in living kidney donation. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Compensation for Blur Requires Increase in Field of View and Viewing Time

PubMed Central

Kwon, MiYoung; Liu, Rong; Chien, Lillian

2016-01-01

Spatial resolution is an important factor for human pattern recognition. In particular, low resolution (blur) is a defining characteristic of low vision. Here, we examined spatial (field of view) and temporal (stimulus duration) requirements for blurry object recognition. The spatial resolution of an image such as letter or face, was manipulated with a low-pass filter. In experiment 1, studying spatial requirement, observers viewed a fixed-size object through a window of varying sizes, which was repositioned until object identification (moving window paradigm). Field of view requirement, quantified as the number of “views” (window repositions) for correct recognition, was obtained for three blur levels, including no blur. In experiment 2, studying temporal requirement, we determined threshold viewing time, the stimulus duration yielding criterion recognition accuracy, at six blur levels, including no blur. For letter and face recognition, we found blur significantly increased the number of views, suggesting a larger field of view is required to recognize blurry objects. We also found blur significantly increased threshold viewing time, suggesting longer temporal integration is necessary to recognize blurry objects. The temporal integration reflects the tradeoff between stimulus intensity and time. While humans excel at recognizing blurry objects, our findings suggest compensating for blur requires increased field of view and viewing time. The need for larger spatial and longer temporal integration for recognizing blurry objects may further challenge object recognition in low vision. Thus, interactions between blur and field of view should be considered for developing low vision rehabilitation or assistive aids. PMID:27622710

The Influence of Parameters on the Generatrix of the Helicoid Form Guide of Geokhod Bar Working Body

NASA Astrophysics Data System (ADS)

Aksenov, Vladimir; Sadovets, Vladimir; Pashkov, Dmitriy

2017-11-01

Influence of geometrical parameters of generatrix of helicoid on a guide of geokhod bar working body is proved in article. The relevance of the conducted research is considered and proved. General characteristics of the geokhod are presented. Features of geokhod working body, in particular formation of irregular shape of a surface of a face and working body are formulated and also it is told that at screw movement of geokhod working body of a face, points of working body will be formed a helicoid (screw) surface of a face. For establishing of die goals and objectives of research general geometrical parameters of generatrix is marked and justified which treat length of generatrix, width of generatrix of helicoid. pitch of hehcoid and it's form. Forms of guides of geokhod bar working body based on basis parameters of geokhod and accepted general geometrical parameters of geokhod working body are received and presented. In virtue of the conducted research the dependence of a form of a guide of bar on general geometrical parameters of helicoid is defined and also basis parameters of hehcoid in influencing a form of guide of working body.

Simultaneous multimodal ophthalmic imaging using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography

PubMed Central

Malone, Joseph D.; El-Haddad, Mohamed T.; Bozic, Ivan; Tye, Logan A.; Majeau, Lucas; Godbout, Nicolas; Rollins, Andrew M.; Boudoux, Caroline; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.

2016-01-01

Scanning laser ophthalmoscopy (SLO) benefits diagnostic imaging and therapeutic guidance by allowing for high-speed en face imaging of retinal structures. When combined with optical coherence tomography (OCT), SLO enables real-time aiming and retinal tracking and provides complementary information for post-acquisition volumetric co-registration, bulk motion compensation, and averaging. However, multimodality SLO-OCT systems generally require dedicated light sources, scanners, relay optics, detectors, and additional digitization and synchronization electronics, which increase system complexity. Here, we present a multimodal ophthalmic imaging system using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (SS-SESLO-OCT) for in vivo human retinal imaging. SESLO reduces the complexity of en face imaging systems by multiplexing spatial positions as a function of wavelength. SESLO image quality benefited from single-mode illumination and multimode collection through a prototype double-clad fiber coupler, which optimized scattered light throughput and reduce speckle contrast while maintaining lateral resolution. Using a shared 1060 nm swept-source, shared scanner and imaging optics, and a shared dual-channel high-speed digitizer, we acquired inherently co-registered en face retinal images and OCT cross-sections simultaneously at 200 frames-per-second. PMID:28101411

Face to (face)book: the two faces of social behavior?

PubMed

Ivcevic, Zorana; Ambady, Nalini

2013-06-01

Social networking sites such as Facebook represent a unique and dynamic social environment. This study addresses three theoretical issues in personality psychology in the context of online social networking sites: (a) the temporal consistency of Facebook activity, (b) people's awareness of their online behavior, and (c) comparison of social behavior on Facebook with self- and informant-reported behavior in real life. Facebook Wall pages of 99 college students (mean age = 19.72) were downloaded six times during 3 weeks and coded for quantity and quality of activity. Everyday social interactions were assessed by self- and friend report. Facebook activity showed significant consistency across time, and people demonstrated awareness of their online behavior. There was significant similarity between everyday traits and interactions and Facebook behavior (e.g., more posts by friends are related to Agreeableness). Some differences between online and everyday interactions warrant further research (e.g., individuals with more positive offline relationships are less likely to engage in back-and-forth conversations on Facebook). The results indicate substantial similarity between online and offline social behavior and identify avenues for future research on the possible use of Facebook to compensate for difficulty in everyday interactions. © 2012 Wiley Periodicals, Inc.

A method for determining spiral-bevel gear tooth geometry for finite element analysis

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.; Litvin, Faydor L.

1991-01-01

An analytical method was developed to determine gear tooth surface coordinates of face-milled spiral bevel gears. The method uses the basic gear design parameters in conjunction with the kinematical aspects of spiral bevel gear manufacturing machinery. A computer program, SURFACE, was developed. The computer program calculates the surface coordinates and outputs 3-D model data that can be used for finite element analysis. Development of the modeling method and an example case are presented. This analysis method could also find application for gear inspection and near-net-shape gear forging die design.

Crack-Free, Nondistorting Can For Hot Isostatic Pressing

NASA Technical Reports Server (NTRS)

Juhas, John J.

1991-01-01

New method of canning specimens made of composites of arc-sprayed and plasma-sprayed tape reduces outgassing and warping during hot isostatic pressing. Produces can having reliable, crack-free seal and thereby helps to ensure pressed product of high quality. Specimen placed in ring of refractory metal between two face sheets, also of refractory metal. Assembly placed in die in vacuum hot press, where simultaneously heated and pressed until plates become diffusion-welded to ring, forming sealed can around specimen. Specimen becomes partially densified, and fits snugly within can. Ready for further densification by hot isostatic pressing.

Adaptation of the membrane in Archaea.

PubMed

Oger, Philippe M; Cario, Anaïs

2013-12-15

Microbes often face contrasted and fluctuating environmental conditions, to which they need to adapt or die. Because membranes play a central role in regulating fluxes inward and outward from the cells, maintaining the appropriate structure of the membrane is crucial to maintain cellular integrity and functions. This is achieved in bacteria and eucarya by a modification of the membrane lipid compositions, a strategy termed homeoviscous adaptation. We review here evidence for homeoviscous adaptation in Archaea, and discuss the limits of this strategy and our knowledge in this very peculiar domain of life. © 2013 Elsevier B.V. All rights reserved.

Cheating "death" profiteers.

PubMed

1998-01-01

Viatical benefits have helped many AIDS patients who need immediate cash, but a recent case demonstrated the negative side of viaticals. Kendall Morrison, a 35-year-old with AIDS, discovered his life insurance policy was sold to a Michigan investor for half of its $350,000 face value. Because of Morrison's poor health, the investor assumed Morrison would die soon. However, Morrison began treatment with protease inhibitors and returned to stable health. The investor, expecting to collect on his investment long ago, sued the viatical benefits firm for breach of contract. The broker who sold the policy settled out of court.

Effect of young’s modulus on springback for low, medium and high carbon steels during cold drawing of seamless tubes

NASA Astrophysics Data System (ADS)

Karanjule, D. B.; Bhamare, S. S.; Rao, T. H.

2018-04-01

Cold drawing is widely used deformation process for seamless tube manufacturing. Springback is one of the major problem faced in tube drawing. Springback is due to the elastic energy stored in the tubes during forming process. It is found that this springback depends upon Young’s modulus of the material. This paper reports mechanical testing of three grades of steels viz. low carbon steel, medium carbon steel and high carbon steel to measure their Young’s modulus and corresponding springback. The results shows that there is 10-20 % variation in the Young’s modulus and inverse proportion between the springback and Young’s modulus. More the percentage of carbon, more the strength, less the value of Young’s modulus and more will springback. The study further leads to identify optimum die semi angle of 15 degree, land width of 10 mm and drawing speed of 8, 6 and 4 m/min for least springback in all the three grades respectively and die semi angle as a most dominant factor causing springback.

[Intercultural competence. Management of foreignness in intensive care medicine].

PubMed

Bein, T

2015-08-01

Living in a multicultural society is characterized by different attitudes caused by a variety of religions and cultures. In intensive care medicine such a variety of cultural aspects with respect to pain, shame, bodiliness, dying and death is of importance in this scenario. To assess the importance of cultural and religious attitudes in the face of foreignness in intensive care medicine and nursing. Notification of misunderstandings and misinterpretations in communication and actions. An analysis of the scientific literature was carried out and typical intercultural conflict burden situations regarding the management of brain death, organ donation and end of life decisions are depicted. Specific attitudes are found in various religions or cultures regarding the change of a therapeutic target, the value of the patient's living will and the organization of rituals for dying. Intercultural conflicts are mostly due to misunderstandings, assessment differences, discrimination and differences in values. Intercultural competence is crucial in intensive care medicine and includes knowledge of social and cultural influences of different attitudes on health and illness, the abstraction from own attitudes and the acceptance of other or foreign attitudes.

Hydraulic Function in Australian Tree Species during Drought-Induced Mortality

NASA Astrophysics Data System (ADS)

Tissue, D.; Maier, C.; Creek, D.; Choat, B.

2016-12-01

Drought induced tree mortality and decline are key issues facing forest ecology and management. Here, we primarily investigated the hydraulic limitations underpinning drought-induced mortality in three Australian tree species. Using field-based large rainout shelters, three angiosperm species (Casuarina cunninghamiana, Eucalyptus sideroxylon, Eucalyptus tereticornis) were subjected to two successive drought and recovery cycles, prior to a subsequent long and extreme drought to mortality; total duration of experiment was 2.5 years. Leaf gas exchange, leaf and stem hydraulics, and carbon reserves were monitored during the experiment. Trees died as a result of failure in the hydraulic transport system, primarily related to water stress induced embolism. Stomatal closure occurred prior to the induction of significant embolism in the stem xylem of all species. Nonetheless, trees suffered a rapid decline in xylem water potential and increase in embolism during the severe drought treatment. Trees died at water potentials causing greater than 90% loss of hydraulic conductivity in the stem, providing support for the theory that lethal water potential is correlated with complete loss of hydraulic function in the stem xylem of angiosperms.

The concentration principle applied to spaceborne solar arrays. AGORA mission: Studies synthesis

NASA Astrophysics Data System (ADS)

Laget, R.

1986-01-01

Studies that led to selection of the distributed 25 kW SARA LOUVRE concept for the solar cell generator to be flown on the AGORA asteroid mission, and the major characteristics of such a spaceborne solar array are summarized. In the SARA LOUVRE concept, a parabolic cross section reflector concentrates incident light over the rear face of the identical, preceding reflector dish. The whole set of reflectors is pivotally commanded, thus compensating the effects of depointing. Geometric concentration factor is 10. End of life power level at 2.5 AU is 4.5 kW.

Acceleration Sensitivity Compensation of Crystal Resonators.

DTIC Science & Technology

1980-03-01

M . Onoe, K. Furusawa , S. Ishigami, T. Sase, and M . Sato, "Quartz Crystal Accelerometer Insensitive to...C" M L0) 40 &i 𔃼~ wat.A,~i ~ !’ ;~ 4 $. .4, 13 4 B: I r ’K4 ’K p.Is r C,- & C C) ~,-1 4-) z Ce N -4-’ U, -c a enC) 0 mIw L V a) LL p...bars") are shown as line drawings in Figures 25 and 26, respectively;77 also indicat- ed are the natural "r", " m ", and "z" faces, and the

Maxillary advancement using distraction osteogenesis with intraoral device.

PubMed

Takigawa, Yoko; Uematsu, Setsuko; Takada, Kenji

2010-11-01

This article describes the surgical orthodontic treatment of maxillary hypoplasia in a patient with cleft lip and palate using maxillary distraction osteogenesis with internal maxillary distractors. Maxillary advancement was performed to correct the retrusive maxillary facial profile and Class III malocclusion. Rotational movement of the distraction segment was made to correct the upper dental midline. Although maxillary advancement was insufficient because of unexpected breakage of the intraoral distractor after completion of the distraction, skeletal traction with a face mask compensated for the shortage. Successful esthetic improvement and posttreatment occlusal stability were achieved with no discernible relapse after 2 years of retention.

Chronic Kidney Disease and Exposure to Nephrotoxic Metals

PubMed Central

Orr, Sarah E.; Bridges, Christy C.

2017-01-01

Chronic kidney disease (CKD) is a common progressive disease that is typically characterized by the permanent loss of functional nephrons. As injured nephrons become sclerotic and die, the remaining healthy nephrons undergo numerous structural, molecular, and functional changes in an attempt to compensate for the loss of diseased nephrons. These compensatory changes enable the kidney to maintain fluid and solute homeostasis until approximately 75% of nephrons are lost. As CKD continues to progress, glomerular filtration rate decreases, and remaining nephrons are unable to effectively eliminate metabolic wastes and environmental toxicants from the body. This inability may enhance mortality and/or morbidity of an individual. Environmental toxicants of particular concern are arsenic, cadmium, lead, and mercury. Since these metals are present throughout the environment and exposure to one or more of these metals is unavoidable, it is important that the way in which these metals are handled by target organs in normal and disease states is understood completely. PMID:28498320

Right ventricular rupture after lateral thoracotomy for removal of rib-associated telangiectatic osteosarcoma in a dog.

PubMed

Barmettler, Reto; Spreng, David E; Gorgas, Daniela; Scharf, Gernot; Posthaus, Horst; Sigrist, Nadja E

2009-06-01

To describe a case of a focal right ventricular rupture following removal of a rib-associated telangiectatic osteosarcoma (TOS) in a dog. A 2-year-old spayed female mixed-breed dog, weighing 20 kg, was presented in compensated hypovolemic shock due to active bleeding into the thoracic cavity. The dog was stabilized with appropriate fluid administration. Subsequent computed tomographic examination revealed a large mineralized mass originating from the body of a rib and displacing the heart. Two days after surgical removal of this mass, focal right ventricular rupture occurred and the dog died. The mass was later identified as a TOS. Although hemothorax secondary to TOS has been described previously, this report describes for the first time, spontaneous focal right ventricular rupture as a rare complication of thoracotomy and rib resection for the removal of a rib-associated, intrathoracic TOS.

Cardioverter-defibrillator implantation in myeloma-associated cardiac amyloidosis

PubMed Central

Campanile, Alfonso; Sozzi, Fabiola B; Canetta, Ciro; Danzi, Gian Battista

2013-01-01

A 62-year-old woman with multiple myeloma and light-chain amyloidosis with significant heart involvement developed an in-hospital cardiac arrest. After cardiopulmonary resuscitation, a stable sinus rhythm without any cerebral damage was restored, and the patient was admitted to the coronary care unit. A cardioverter-defibrillator was implanted, and it successfully intervened in two sustained ventricular tachycardia episodes and one ventricular fibrillation episode, which were recorded during hospitalization. After achieving discrete cardiac compensation, the patient was transferred to the emergency medicine department where she underwent chemotherapy for multiple myeloma. The patient died 40 days after admission from refractory heart failure. In the literature, there are studies that describe the use of cardioverter-defibrillator implantation in cardiac amyloidosis; however, at present, there is no evidence of a beneficial effect on survival with the use of this intervention. A high index of suspicion for amyloid heart disease and early diagnosis are critical to improving outcomes. PMID:24294034

Cardioverter-defibrillator implantation in myeloma-associated cardiac amyloidosis.

PubMed

Campanile, Alfonso; Sozzi, Fabiola B; Canetta, Ciro; Danzi, Gian Battista

2013-01-01

A 62-year-old woman with multiple myeloma and light-chain amyloidosis with significant heart involvement developed an in-hospital cardiac arrest. After cardiopulmonary resuscitation, a stable sinus rhythm without any cerebral damage was restored, and the patient was admitted to the coronary care unit. A cardioverter-defibrillator was implanted, and it successfully intervened in two sustained ventricular tachycardia episodes and one ventricular fibrillation episode, which were recorded during hospitalization. After achieving discrete cardiac compensation, the patient was transferred to the emergency medicine department where she underwent chemotherapy for multiple myeloma. The patient died 40 days after admission from refractory heart failure. In the literature, there are studies that describe the use of cardioverter-defibrillator implantation in cardiac amyloidosis; however, at present, there is no evidence of a beneficial effect on survival with the use of this intervention. A high index of suspicion for amyloid heart disease and early diagnosis are critical to improving outcomes.

[Collective memories of women who have experienced maternal near miss: health needs and human rights].

PubMed

Aguiar, Cláudia de Azevedo; Tanaka, Ana Cristina dʼAndretta

2016-09-19

The collective memories of women that have experienced maternal near miss can help elucidate serious obstetric events, like maternal death. Their experience is authentic and representative, with the construction of a common identity. This identity lends quality to a group's memory, and such memory is thus a social phenomenon. The study analyzed the experience of twelve women who nearly died during the gestational and postpartum cycle. The thematic oral history method was used, from the perspective of health needs and human rights. Six collective memories comprised the discourses: unmet health needs; healthcare deficiencies; denial of contact with the newborn child; violation of rights; absence of demand for rights; and compensation for unmet rights and needs. To understand these women's health needs is to acknowledge the women as bearers of rights and to individualize care, respecting their autonomy, guaranteeing access to technologies, and establishing an effective bond with health professionals.

Development of a low-noise, 4th-order readout ASIC for CdZnTe detectors in gamma spectrometer applications

NASA Astrophysics Data System (ADS)

Wang, Jia; Su, Lin; Wei, Xiaomin; Zheng, Ran; Hu, Yann

2016-09-01

This paper presents an ASIC readout circuit development, which aims to achieve low noise. In order to compensate the leakage current and improve gain, a dual-stage CSA has been utilized. A 4th-order high-linearity shaper is proposed to obtain a Semi-Gaussian wave and further decrease the noise induced by the leakage current. The ASIC has been designed and fabricated in a standard commercial 2P4M 0.35 μm CMOS process. Die area of one channel is about 1190 μm×147 μm. The input charge range is 1.8 fC. The peaking time can be adjusted from 1 μs to 3 μs. Measured ENC is about 55e- (rms) at input capacitor of 0 F. The gain is 271 mV/fC at the peaking time of 1 μs.

More than one way to be happy: a typology of marital happiness.

PubMed

Rauer, Amy; Volling, Brenda

2013-09-01

This study utilized observational and self-report data from 57 happily married couples to explore assumptions regarding marital happiness. Suggesting that happily married couples are not a homogeneous group, cluster analyses revealed the existence of three types of couples based on their observed behaviors in a problem-solving task: (1) mutually engaged couples (characterized by both spouses' higher negative and positive problem-solving); (2) mutually supportive couples (characterized by both spouses' higher positivity and support); and (3) wife compensation couples (characterized by high wife positivity). Although couples in all three clusters were equally happy with and committed to their marriages, these clusters were differentially associated with spouses' evaluations of their marriage. Spouses in the mutually supportive cluster reported greater intimacy and maintenance and less conflict and ambivalence, although this was more consistently the case in comparison to the wife compensation cluster, as opposed to the mutually engaged cluster. The implications of these typologies are discussed as they pertain to efforts on the part of both practitioners to promote marital happiness and repair marital relations when couples are faced with difficulties. © FPI, Inc.

Discourse intervention strategies in Alzheimer's disease: Eye-tracking and the effect of visual cues in conversation.

PubMed

Brandão, Lenisa; Monção, Ana Maria; Andersson, Richard; Holmqvist, Kenneth

2014-01-01

The goal of this study was to investigate whether on-topic visual cues can serve as aids for the maintenance of discourse coherence and informativeness in autobiographical narratives of persons with Alzheimer's disease (AD). The experiment consisted of three randomized conversation conditions: one without prompts, showing a blank computer screen; an on-topic condition, showing a picture and a sentence about the conversation; and an off-topic condition, showing a picture and a sentence which were unrelated to the conversation. Speech was recorded while visual attention was examined using eye tracking to measure how long participants looked at cues and the face of the listener. Results suggest that interventions using visual cues in the form of images and written information are useful to improve discourse informativeness in AD. This study demonstrated the potential of using images and short written messages as means of compensating for the cognitive deficits which underlie uninformative discourse in AD. Future studies should further investigate the efficacy of language interventions based in the use of these compensation strategies for AD patients and their family members and friends.

Resistivity Changes Due to Precipitation Effects in Fibre Reinforced Mg-Al-Zn-Mn Alloy

NASA Astrophysics Data System (ADS)

Kiehn, J.; Kainer, K. U.; Vostrý, P.; Stulíková, I.

1997-05-01

The change of electrical properties of alumina short fibre reinforced Mg-Al-Zn-Mn alloy AZ91D during isochronal annealing up to 300 °C is discussed. The Saffil® fibres were incorporated into the magnesium alloy by direct squeeze casting. The fibre distribution is random planar parallel to the flat faces of the dc four-point resistivity specimens machined from the solution treated castings. A sharp drop of resistivity between 140 and 260 °C is explained by the formation of incoherent -phase particles. Some practical recommendations concerning the use of alumina short fibre reinforced AZ91 alloy are made on the basis of the results obtained. Es werden die Änderungen der elektrischen Eigenschaften der aluminiumoxid-kurzfaserverstärkten Mg-Al-Zn-Mn Legierung AZ91D während isochroner Wärmebehandlungen bis 300 °C diskutiert. Das direkte Preßgießverfahren diente zur Herstellung der Saffil®-Faser Magnesium Verbundwerkstoffe. Die Proben zur Widerstandsmessung nach der Vier-Punkt Methode wurden durch spanende Bearbeitung aus den lösungsgeglühten Preßgußstücken herausgearbeitet, so daß sie regellose Faserverteilung in den Ebenen parallel zu den flachen Probenseiten aufwiesen. Ein starker Abfall des elektrischen Widerstands im Temperaturbereich zwischen 140 und 260 °C wird durch die Bildung inkohärenter β-Phase erklärt. Auf Grundlage der Ergebnisse werden einige Empfehlungen zur Anwendung der kurzfaserverstärkten Legierung AZ91 gegeben.

Transcatheter Potts shunt creation in patients with severe pulmonary arterial hypertension: initial clinical experience.

PubMed

Esch, Jesse J; Shah, Pinak B; Cockrill, Barbara A; Farber, Harrison W; Landzberg, Michael J; Mehra, Mandeep R; Mullen, Mary P; Opotowsky, Alexander R; Waxman, Aaron B; Lock, James E; Marshall, Audrey C

2013-04-01

Patients with severe pulmonary arterial hypertension (PAH) face significant morbidity and death as a consequence of progressive right heart failure. Surgical shunt placement between the left PA and descending aorta (Potts shunt) appears promising for PAH palliation in children; however, surgical mortality is likely to be unacceptably high in adults with PAH. We describe a technique for transcatheter Potts shunt (TPS) creation by fluoroscopically guided retrograde needle perforation of the descending aorta at the site of apposition to the left PA to create a tract for deployment of a covered stent between these vessels. This covered stent-anchored by the vessel walls and surrounding tissue-serves as the shunt. TPS creation was considered in 7 patients and performed in 4. The procedure was technically successful in 3 patients; 1 patient died during the procedure as a result of uncontrolled hemothorax. One acute survivor, critically ill at the time of TPS creation, later died of comorbidities. The 2 mid-term survivors (follow-up of 10 and 4 months) are well at home, with symptomatic improvement and no late complications. The 3 candidate patients in whom the procedure was not performed died within 1 month of consideration, underscoring the tenuous nature of this population. TPS creation is feasible and may offer symptomatic relief to select patients with refractory PAH. Further study of this innovative approach is warranted. Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Physics-based process modeling, reliability prediction, and design guidelines for flip-chip devices

NASA Astrophysics Data System (ADS)

Michaelides, Stylianos

Flip Chip on Board (FCOB) and Chip-Scale Packages (CSPs) are relatively new technologies that are being increasingly used in the electronic packaging industry. Compared to the more widely used face-up wirebonding and TAB technologies, flip-chips and most CSPs provide the shortest possible leads, lower inductance, higher frequency, better noise control, higher density, greater input/output (I/O), smaller device footprint and lower profile. However, due to the short history and due to the introduction of several new electronic materials, designs, and processing conditions, very limited work has been done to understand the role of material, geometry, and processing parameters on the reliability of flip-chip devices. Also, with the ever-increasing complexity of semiconductor packages and with the continued reduction in time to market, it is too costly to wait until the later stages of design and testing to discover that the reliability is not satisfactory. The objective of the research is to develop integrated process-reliability models that will take into consideration the mechanics of assembly processes to be able to determine the reliability of face-down devices under thermal cycling and long-term temperature dwelling. The models incorporate the time and temperature-dependent constitutive behavior of various materials in the assembly to be able to predict failure modes such as die cracking and solder cracking. In addition, the models account for process-induced defects and macro-micro features of the assembly. Creep-fatigue and continuum-damage mechanics models for the solder interconnects and fracture-mechanics models for the die have been used to determine the reliability of the devices. The results predicted by the models have been successfully validated against experimental data. The validated models have been used to develop qualification and test procedures for implantable medical devices. In addition, the research has helped develop innovative face-down devices without the underfill, based on the thorough understanding of the failure modes. Also, practical design guidelines for material, geometry and process parameters for reliable flip-chip devices have been developed.

Retention of esthetic veneers on primary stainless steel crowns.

PubMed

Baker, L H; Moon, P; Mourino, A P

1996-01-01

The purpose of this study was to ascertain the amount of shearing force necessary to fracture, dislodge or deform the esthetic veneer facings of four commercially available veneered primary incisor stainless steel crowns. The four types tested were: Cheng Crowns, [Peter Cheng Orthodontic Laboratory]; Whiter Biter Crown II, [White Bite Inc.]; Kinder Krowns, [Mayclin Dental Studio, Inc]; and NuSmile Primary Crowns, [Orthodontic Technologies, Inc]. The crowns (#4 right central incisor) from each manufacturer were obtained with the facings attached. The crowns were soaked for ninety days and thermocycled at 4 degrees C and 55 degrees C for 500 45-second cycles. The crowns were cemented to standardized chromium cobalt metal dies. Each die was placed in to a custom holder on the Instron Universal testing machine. A force was applied at the incisal edge of the veneer at 148 degrees, (the primary interincisal angle), with a crosshead speed of 0.05 inches/minute until the veneer either fractured, dislodged or deformed. The mean force (Ibs) required +/- SD to produce failure, in descending order, was as follows: Cheng (107.8 +/- 17.3); NuSmile (100.2 +/- 18.2); KinderKrown (91.3 +/- 27.4)d Whiter Biter (81.5 +/- 21.7). To test the hypothesis of no difference among the four manufacturers, an analysis of variance was performed using PROC GLM. The resultant F statistic was 2.79 (p < 0.0543), indicating a marginally statistically significant difference in the response variable "pressure" among the four groups. A posthoc test was then performed to ascertain where these differences occurred. These results, using Turkey's studentized range test for pairwise comparisons, suggested that the only difference was between the Cheng and Whiter Biter manufacturers.

Impact of the terrorist bombings of the Neve Shalom and Beth Israel Synagogues on a hospital in Istanbul, Turkey.

PubMed

Rodoplu, Ulkümen; Arnold, Jeffrey L; Tokyay, Rifat; Ersoy, Gurkan; Cetiner, Serkan; Yücel, Tayfun

2005-02-01

The authors sought to estimate the impact of the open-air mass-casualty terrorist bombings of the Neve Shalom and Beth Israel Synagogues in Istanbul, Turkey, on November 15, 2003, on the American Hospital (AH) in terms of resource utilization, epidemiologic outcomes, and time course of emergency needs. A retrospective descriptive study using data from hospital records of injured survivors who used the emergency department at AH on November 15, 2003, to determine the number and percentage of injured survivors who were hospitalized, received operative care, had specific injury types, had an Injury Severity Score >/=16, died, and arrived within certain time intervals. AH received 69 (91%) injured survivors from the scene, of which nine (12%) were hospitalized and three (4%) received operative care. Starting four hours after the initial blast, seven (9%) injured survivors were transferred to AH from other hospitals, of which five (7%) were hospitalized and four (5%) received operative care. Of the 49 injured survivors from the scene with documented injuries, 43 (88%) had injuries to the head or face, 42 (86%) had lacerations, five (10%) had fractures, one (2%) had a penetrating eye injury, one (2%) had a serious intracranial injury, and none had primary blast injuries. Four (5%) injured survivors at AH had an Injury Severity Score >/=16, and none died. Seventy-six injured survivors used the emergency department at AH, including a delayed wave of injured survivors transferred from other hospitals. The majority of injured survivors with documented injuries had non-life-threatening lacerations of the head or face, and relatively few injured survivors were hospitalized or received operative care.

Less impairment in face imagery than face perception in early prosopagnosia.

PubMed

Michelon, Pascale; Biederman, Irving

2003-01-01

There have been a number of reports of preserved face imagery in prosopagnosia. We put this issue to experimental test by comparing the performance of MJH, a 34-year-old prosopagnosic since the age of 5, to controls on tasks where the participants had to judge faces of current celebrities, either in terms of overall similarity (Of Bette Midler, Hillary Clinton, and Diane Sawyer, whose face looks least like the other two?) or on individual features (Is Ronald Reagan's nose pointy?). For each task, a performance measure reflecting the degree of agreement of each participant with the average of the others (not including MJH) was calculated. On the imagery versions of these tasks, MJH was within the lower range of the controls for the agreement measure (though significantly below the mean of the controls). When the same tasks were performed from pictures, agreement among the controls markedly increased whereas MJH's performance was virtually unaffected, placing him well below the range of the controls. This pattern was also apparent with a test of facial features of emotion (Are the eyes wrinkled when someone is surprised?). On three non-face imagery tasks assessing color (What color is a football?), relative lengths of animal's tails (Is a bear's tail long in proportion to its body?), and mental size comparisons (What is bigger, a camel or a zebra?), MJH was within or close to the lower end of the normal range. As most of the celebrities became famous after the onset of MJH's prosopagnosia, our confirmation of the reports of less impaired face imagery in some prosopagnosics cannot be attributed to pre-lesion storage. We speculate that face recognition, in contrast to object recognition, relies more heavily on a representation that describes the initial spatial filter values so the metrics of the facial surface can be specified. If prosopagnosia is regarded as a form of simultanagnosia in which some of these filter values cannot be registered on any one encounter with a face, then multiple opportunities for repeated storage may partially compensate for the degraded representation on that single encounter. Imagery may allow access to this more complete representation.

Structures and properties of molecular torsion balances to decipher the nature of substituent effects on the aromatic edge-to-face interaction.

PubMed

Gardarsson, Haraldur; Schweizer, W Bernd; Trapp, Nils; Diederich, François

2014-04-14

Various recent computational studies initiated this systematic re-investigation of substituent effects on aromatic edge-to-face interactions. Five series of Tröger base derived molecular torsion balances (MTBs), initially introduced by Wilcox and co-workers, showing an aromatic edge-to-face interaction in the folded, but not in the unfolded form, were synthesized. A fluorine atom or a trifluoromethyl group was introduced onto the edge ring in ortho-, meta-, and para-positions to the C-H group interacting with the face component. The substituents on the face component were varied from electron-donating to electron-withdrawing. Extensive X-ray crystallographic data allowed for a discussion on the conformational behavior of the torsional balances in the solid state. While most systems adopt the folded conformation, some were found to form supramolecular intercalative dimers, lacking the intramolecular edge-to-face interaction, which is compensated by the gain of aromatic π-stacking interactions between four aryl rings of the two molecular components. This dimerization does not take place in solution. The folding free enthalpy ΔG(fold) of all torsion balances was determined by (1)H NMR measurements by using 10 mM solutions of samples in CDCl3 and C6D6. Only the ΔG(fold) values of balances bearing an edge-ring substituent in ortho-position to the interacting C-H show a steep linear correlation with the Hammett parameter (σ(meta)) of the face-component substituent. Thermodynamic analysis using van't Hoff plots revealed that the interaction is enthalpy-driven. The ΔG(fold) values of the balances, in addition to partial charge calculations, suggest that increasing the polarization of the interacting C-H group makes a favorable contribution to the edge-to-face interaction. The largest contribution, however, seems to originate from local direct interactions between the substituent in ortho-position to the edge-ring C-H and the substituted face ring. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Mechanical model testing of rebreathing potential in infant bedding materials

PubMed Central

Carleton, J.; Donoghue, A.; Porter, W.

1998-01-01

Rebreathing of expired air may be a lethal hazard for prone sleeping infants. This paper describes a mechanical model to simulate infant breathing, and examines the effects of bedding on exhaled air retention. Under simulated rebreathing conditions, the model allows the monitoring of raised carbon dioxide (CO2) inside an artificial lung-trachea system. Resulting levels of CO2 (although probably exaggerated in the mechanical model compared with an infant, due to the model's fixed breathing rate and volume) suggest that common bedding materials vary widely in inherent rebreathing potential. In face down tests, maximum airway CO2 ranged from less than 5% on sheets and waterproof mattresses to over 25% on sheepskins, bean bag cushions, and some pillows and comforters. Concentrations of CO2 decreased with increasing head angle of the doll, away from the face down position. Recreations of 29infant death scenes also showed large CO2 increases on some bedding materials, suggesting these infants could have died while rebreathing.

 PMID:9623394

Awful face of the war-impacted smoke bomb capsule in the face and systemic toxicity: reports from the conflict in Syria.

PubMed

Yilmaz, Bahar; Yeşiloğlu, Nebil; Firincioğullari, Remzi; Gökkaya, Ali; Özbey, Rafet; Özgür, Mustafa

2015-01-01

In this study, a rare kind of injury due to smoke bomb capsule impaction to midface and under the cranial base is presented, and maneuvers to reduce mortality are discussed. Three male patients were presented with impacted smoke bomb capsules into the midface and under the cranial base structures. Midface structures, anterior cranial base, and, in 2 patients, unilateral eye were severely damaged. Two patients died after the initial emergency operations because their lung disease progressed to acute respiratory distress syndrome. One of the patients lived, and soft tissue reconstruction was achieved by using temporal transposition and cheek advancement skin flaps with split-thickness skin graft from donor site. However, craniofacial destruction is important in these patients; a multidisciplinary approach is needed for the treatment of direct smoke bomb injuries because the patients experienced chemical burn and acute trauma. The timing of maxillofacial reconstruction is also a question in these specific patients.

Gender Differences Related to Attitudes Toward Suicide and Suicidal Behavior.

PubMed

Poreddi, Vijayalakshmi; Thimmaiah, Rohini; Ramu, Rajalakshmi; Selvi, Sugavana; Gandhi, Sailaxmi; Ramachandra; Math, Suresh Bada

2016-02-01

This descriptive study examined gender differences related to attitudes toward suicide among randomly selected urban residents. Data was collected using a standardized questionnaire through face-to-face interview. Our findings revealed that men hold more pro preventive attitudes to help persons with suicidal thoughts (80.3 %, p = 0.05) and agreed that suicidal attempts are impulsive (78.6 %, p = 0.01). However, they hold permissive attitude to help persons with incurable diseases and expressing death wishes to die (66 %, p = 0.05). A majority of men (78.6 %) than women agreed that "suicidal attempt is essentially a cry for help" (χ (2) = 11.798, p = 0.05). These gender differences need to be taken into consideration when developing appropriate programs to prevent suicide. Further, decriminalizing the law, high-quality research and raising awareness about suicide prevention among the general population is crucial in developing countries like India.

A Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact With Children in Relation to End-of-Life Care.

PubMed

O'Mahony, Sean; Gerhart, James; Abrams, Ira; Greene, Michelle; McFadden, Rory; Tamizuddin, Sara; Levy, Mitchell M

2017-11-01

Medical providers may face unique emotional challenges when confronted with the suffering of chronically ill, dying, and bereaved children. This study assessed the preliminary outcomes of participation in a group-based multimodal mindfulness training pilot designed to reduce symptoms of burnout and mental health symptoms in providers who interact with children in the context of end-of-life care. A total of 13 medical providers who care for children facing life-threatening illness or bereaved children participated in a 9-session multimodal mindfulness session. Mental health symptoms and burnout were assessed prior to the program, at the program midpoint, and at the conclusion of the program. Participation in the pilot was associated with significant reductions in depressive and posttraumatic stress disorder (PTSD) symptoms among providers ( P < .05). Mindfulness-based programs may help providers recognize and address symptoms of depression and PTSD. Additional research is needed to enhance access and uptake of programming among larger groups of participants.

The effect of Medicaid wage pass-through programs on the wages of direct care workers.

PubMed

Baughman, Reagan A; Smith, Kristin

2010-05-01

Despite growing demand for nursing and home health care as the US population ages, compensation levels in the low-skill nursing labor market that provides the bulk of long-term care remain quite low. The challenge facing providers of long-term care is that Medicaid reimbursement rates for nursing home and home health care severely restrict the wage growth that is necessary to attract workers, resulting in high turnover and labor shortages. Almost half of US states have responded by enacting "pass-through" provisions in their Medicaid programs, channeling additional long-term care funding directly to compensation of lower-skill nursing workers. We test the effect of Medicaid wage pass-through programs on hourly wages for direct care workers. We estimate several specifications of wage models using employment data from the 1996 and 2001 panels of the Survey of Income and Program Participation for nursing, home health, and personal care aides. The effect of pass-through programs is identified by an indicator variable for states with programs; 20 states adopted pass-throughs during the sample period. Workers in states with pass-through programs earn as much as 12% more per hour than workers in other states after those programs are implemented. Medicaid wage pass-through programs appear to be a viable policy option for raising compensation levels of direct care workers, with an eye toward improving recruitment and retention in long-term care settings.

The new economics of labour migration and the role of remittances in the migration process.

PubMed

Taylor, J E

1999-01-01

This analysis considers international migration remittances and their impact on development in migrant-sending areas. The new economics of labor migration (NELM) posit that remittances lessen production and market constraints faced by households in poor developing countries. The article states that remittances may be a positive factor in economic development, which should be nurtured by economic policies. The impact of remittances and migration on development varies across locales and is influenced by migrants' remittance behavior and by economic contexts. Criteria for measuring development gains may include assessments of income growth, inequity, and poverty alleviation. It is hard to gauge the level of remittances, especially when remittances may not flow through formal banking systems. The International Monetary Fund distinguishes between worker remittances sent home for over 1 year; employee compensation including the value of in-kind benefits for under 1 year; and the net worth of migrants who move between countries. This sum amounted to under $2 billion in 1970 and $70 billion in 1995. The cumulative sum of remittances, employee compensation, and transfers was almost $1 trillion, of which almost 66% was worker remittances, 25% was employee compensation, and almost 10% was transfers during 1980-95. Total world remittances surpass overseas development assistance. Remittances are unequally distributed across and between countries. Migration research does not adequately reveal the range and complexity of impacts. Push factors can limit options for use of remittances to stimulate development.

Minimal complexity control law synthesis

NASA Technical Reports Server (NTRS)

Bernstein, Dennis S.; Haddad, Wassim M.; Nett, Carl N.

1989-01-01

A paradigm for control law design for modern engineering systems is proposed: Minimize control law complexity subject to the achievement of a specified accuracy in the face of a specified level of uncertainty. Correspondingly, the overall goal is to make progress towards the development of a control law design methodology which supports this paradigm. Researchers achieve this goal by developing a general theory of optimal constrained-structure dynamic output feedback compensation, where here constrained-structure means that the dynamic-structure (e.g., dynamic order, pole locations, zero locations, etc.) of the output feedback compensation is constrained in some way. By applying this theory in an innovative fashion, where here the indicated iteration occurs over the choice of the compensator dynamic-structure, the paradigm stated above can, in principle, be realized. The optimal constrained-structure dynamic output feedback problem is formulated in general terms. An elegant method for reducing optimal constrained-structure dynamic output feedback problems to optimal static output feedback problems is then developed. This reduction procedure makes use of star products, linear fractional transformations, and linear fractional decompositions, and yields as a byproduct a complete characterization of the class of optimal constrained-structure dynamic output feedback problems which can be reduced to optimal static output feedback problems. Issues such as operational/physical constraints, operating-point variations, and processor throughput/memory limitations are considered, and it is shown how anti-windup/bumpless transfer, gain-scheduling, and digital processor implementation can be facilitated by constraining the controller dynamic-structure in an appropriate fashion.

Photoplethysmographic imaging via spectrally demultiplexed erythema fluctuation analysis for remote heart rate monitoring

NASA Astrophysics Data System (ADS)

Deglint, Jason; Chung, Audrey G.; Chwyl, Brendan; Amelard, Robert; Kazemzadeh, Farnoud; Wang, Xiao Yu; Clausi, David A.; Wong, Alexander

2016-03-01

Traditional photoplethysmographic imaging (PPGI) systems use the red, green, and blue (RGB) broadband measurements of a consumer digital camera to remotely estimate a patients heart rate; however, these broadband RGB signals are often corrupted by ambient noise, making the extraction of subtle fluctuations indicative of heart rate difficult. Therefore, the use of narrow-band spectral measurements can significantly improve the accuracy. We propose a novel digital spectral demultiplexing (DSD) method to infer narrow-band spectral information from acquired broadband RGB measurements in order to estimate heart rate via the computation of motion- compensated skin erythema fluctuation. Using high-resolution video recordings of human participants, multiple measurement locations are automatically identified on the cheeks of an individual, and motion-compensated broadband reflectance measurements are acquired at each measurement location over time via measurement location tracking. The motion-compensated broadband reflectance measurements are spectrally demultiplexed using a non-linear inverse model based on the spectral sensitivity of the camera's detector. A PPG signal is then computed from the demultiplexed narrow-band spectral information via skin erythema fluctuation analysis, with improved signal-to-noise ratio allowing for reliable remote heart rate measurements. To assess the effectiveness of the proposed system, a set of experiments involving human motion in a front-facing position were performed under ambient lighting conditions. Experimental results indicate that the proposed system achieves robust and accurate heart rate measurements and can provide additional information about the participant beyond the capabilities of traditional PPGI methods.

Comprehensive ecosystem model-experiment synthesis using multiple datasets at two temperate forest free-air CO2 enrichment experiments: model performance and compensating biases

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

Walker, Anthony P; Hanson, Paul J; DeKauwe, Martin G

2014-01-01

Free Air CO2 Enrichment (FACE) experiments provide a remarkable wealth of data to test the sensitivities of terrestrial ecosystem models (TEMs). In this study, a broad set of 11 TEMs were compared to 22 years of data from two contrasting FACE experiments in temperate forests of the south eastern US the evergreen Duke Forest and the deciduous Oak Ridge forest. We evaluated the models' ability to reproduce observed net primary productivity (NPP), transpiration and Leaf Area index (LAI) in ambient CO2 treatments. Encouragingly, many models simulated annual NPP and transpiration within observed uncertainty. Daily transpiration model errors were often relatedmore » to errors in leaf area phenology and peak LAI. Our analysis demonstrates that the simulation of LAI often drives the simulation of transpiration and hence there is a need to adopt the most appropriate of hypothesis driven methods to simulate and predict LAI. Of the three competing hypotheses determining peak LAI (1) optimisation to maximise carbon export, (2) increasing SLA with canopy depth and (3) the pipe model the pipe model produced LAI closest to the observations. Modelled phenology was either prescribed or based on broader empirical calibrations to climate. In some cases, simulation accuracy was achieved through compensating biases in component variables. For example, NPP accuracy was sometimes achieved with counter-balancing biases in nitrogen use efficiency and nitrogen uptake. Combined analysis of parallel measurements aides the identification of offsetting biases; without which over-confidence in model abilities to predict ecosystem function may emerge, potentially leading to erroneous predictions of change under future climates.« less

Contingent valuation of health and mood impacts of PM2.5 in Beijing, China.

PubMed

Yin, Hao; Pizzol, Massimo; Jacobsen, Jette Bredahl; Xu, Linyu

2018-07-15

Air pollution from PM 2 . 5 affects many cities worldwide, causing both health impacts and mood depression. One of the obstacles to implementing environmental regulations for PM 2 . 5 reduction is that there are limited studies of PM 2 . 5 welfare loss and few investigations of mood depression caused by PM 2 . 5 . This article describes a survey study conducted in Beijing, China to estimate the welfare loss due to PM 2 . 5 . In total, 1709 participants completed either a face-to-face or online survey. A contingent valuation method was applied to elicit people's willingness to pay to avoid PM 2 . 5 pollution and willingness to accept a compensation for such pollution. The payment/compensation was evaluated for two outcome variables: perceived health impacts and mood depression caused by PM 2 . 5 pollution. This is one of few papers that explicitly studies the effects of PM 2 . 5 on subjective well-being, and to the authors' knowledge, the first to estimate welfare loss from PM 2 . 5 using a random forest model. Compared to the standard Turnbull, probit, and two-part models, the random forest model gave the best fit to the data, suggesting that this may be a useful tool for future studies too. The welfare loss due to health impacts and mood depression is CNY 1388.4/person/year and CNY 897.7/person/year respectively, indicating that the public attaches great importance to mood, feelings and happiness. The study provides scientific support to the development of economic policy instruments for PM 2 . 5 control in China. Copyright © 2018. Published by Elsevier B.V.

Job satisfaction among neonatal nurses.

PubMed

Archibald, Cynthia

2006-01-01

The purpose of this study was to understand the job satisfaction of nurses who work in intensive care nurseries. The design used a convenience sample of eight nurses with an average of 11 years of active and current experience as neonatal intensive care nurses. METHOD/DATA COLLECTION: Human rights were protected according to the institutional guidelines. Data collection included semi-structured, intensive face-to-face interviews, observation, and field notes. The interviews were tape recorded and transcribed. Collaizzi's (1978) interpretation method was used to interpret and analyze the data using significant statements, formulated meanings, and clustering. Each participant was allowed to review the typed interview as one means of credibility. Analysis of the described experiences revealed that nurses were able to identify enough satisfying situations that compelled them to continue working in the neonatal intensive care unit (NICU). These rewards included compensation, team spirit, support from physicians, and advocacy. Knowledge of the factors that contribute to nurses' job satisfaction can provide a useful framework to implement policies to improve working conditions for nurses.

New perspectives in face correlation: discrimination enhancement in face recognition based on iterative algorithm

NASA Astrophysics Data System (ADS)

Wang, Q.; Alfalou, A.; Brosseau, C.

2016-04-01

Here, we report a brief review on the recent developments of correlation algorithms. Several implementation schemes and specific applications proposed in recent years are also given to illustrate powerful applications of these methods. Following a discussion and comparison of the implementation of these schemes, we believe that all-numerical implementation is the most practical choice for application of the correlation method because the advantages of optical processing cannot compensate the technical and/or financial cost needed for an optical implementation platform. We also present a simple iterative algorithm to optimize the training images of composite correlation filters. By making use of three or four iterations, the peak-to-correlation energy (PCE) value of correlation plane can be significantly enhanced. A simulation test using the Pointing Head Pose Image Database (PHPID) illustrates the effectiveness of this statement. Our method can be applied in many composite filters based on linear composition of training images as an optimization means.

Full face transplant: the first case report.

PubMed

Barret, Juan P; Gavaldà, Joan; Bueno, Javier; Nuvials, Xavier; Pont, Teresa; Masnou, Nuria; Colomina, Maria J; Serracanta, Jordi; Arno, Anna; Huguet, Pere; Collado, Jose M; Salamero, Pere; Moreno, Carlos; Deulofeu, Roser; Martínez-Ibáñez, Vicenç

2011-08-01

Since 2005, 11 human face transplants have been performed. In each, varying amounts of tissue have been transplanted. Herein we report a "full" face transplant including all intact aesthetic and functional units. On March 27, 2010, we performed a full face transplant, including all the soft tissues and part of the underlaying bony structure, at the University Hospital Vall d'Hebron, Barcelona, Spain. The donor was a 41-year-old male, who died from a massive brain hemorrhage. The recipient was a 30-year-old male with a severe facial deformity caused by a ballistic trauma in 2005. Harvest and subsequent implant took 24 hours. The patient received initial induction (Thymoglobulin 2 mg/kg/iv; Prednisone 1 gm/iv) and maintenance (Prednisone 1 mg/kg/24hours, Tacrolimus 10-15 ng/mL/PO, and Mycophenolate mofetil 2g/daily/PO) immunosuppression and Infection prophylaxis (Valganciclovir and Co-trimoxazole). There were no intraoperative complications. Postoperative complications included; venous anastomoses thrombosis, acute oro-cutaneous fistula, right parotid sialocele and 2 acute rejection episodes, which were resolved by revision of the anastomosis, profuse irrigation and immunotherapy adjustment, respectively. The patient was discharged from the hospital at 4 months posttransplant with; near-total sensation and partial-motor recovery, no psychological complications and excellent acceptance of his new facial appearance. The early success described in this case report demonstrates the technical and clinical feasibility of transplanting all the tissues of the with all its aesthetic and functional units intact.

[Controversy in the treatment of a critically ill neonate in a rural health service].

PubMed

Márquez-González, Horacio; Valdez-Martínez, Edith

2015-01-01

Cardiopulmonary resuscitation of newborns with perinatal hypoxia faces serious ethical, moral, medical and legal problems, particularly in rural areas. Ethical and moral issues have to do with the medical-parents relationship; with values, preferences and priorities of each of these groups; and with the scarce resources situation. Medical-technical problems are related to asphyxia complications, and their prognostic and therapeutic implications. Legal considerations arising from the fact of killing or letting die. In this article is analyzed the real case of a neonate with severe perinatal hypoxia in order to enhance the understanding of the incorporation of ethics in everyday clinical practice.

'Round-table' ethical debate: is a suicide note an authoritative 'living will'?

PubMed

Chalfin, D B; Crippen, D; Franklin, C; Kelly, D F; Kilcullen, J K; Streat, S; Truog, R D; Whetstine, L M

2001-01-01

Living wills are often considered by physicians who are faced with a dying patient. Although popular with the general public, they remain problems of authenticity and authority. It is difficult for the examining physician to know whether the patient understood the terms of the advance directive when they signed it, and whether they still consider it authoritative at the time that it is produced. Also, there is little consensus on what spectrum of instruments constitutes a binding advance directive in real life. Does a 'suicide note' constitute an authentic and authoritative 'living will'? Our panel of authorities considers this problem in a round-table discussion.

Severe intrauterine growth retardation with increased mitomycin C sensitivity: a further chromosome breakage syndrome.

PubMed Central

Woods, C G; Leversha, M; Rogers, J G

1995-01-01

We report an infant with pre- and postnatal microcephaly and growth retardation, a distinctive face, and developmental delay. The initial diagnosis was of Seckel syndrome. He became pancytopenic at 16 months and died soon after. His bone marrow was of normal cellularity but had a small lymphocyte infiltration. Increased spontaneous chromosome breakage was seen in blood and fibroblasts. Mitomycin C induced chromosome damage was increased and comparable to that seen in Fanconi anaemia. Reports of similar patients are reviewed. This entity of severe intrauterine growth retardation and increased mitomycin C sensitivity is hypothesised to be a distinct chromosome breakage syndrome. Images PMID:7643362

Rational suicide in the terminally ill.

PubMed

Fontana, Joyce S

2002-01-01

To examine the current debate over the right to die specific to the rational suicide of terminally ill patients. Literature was reviewed for information concerning historical end-of-life practices and the past acceptance of suicide. Another review showed philosophical opinions and perspectives that spanned from ancient Greece and the Roman Empire to modern philosophical discourse. A case study of a terminally ill woman who chose suicide is presented to apply the history and philosophy to nursing care today. As more nursing care is delivered in patients' homes, nurses will face this situation with increasing frequency. A call is made for organizations to provide guidelines for nursing practice.

Lethal pallister-killian syndrome: Phenotypic similarity with fryns syndrome

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

Ignacio Rodriquez, J.; Garcia, I.; Alvarez, J.

1994-11-01

The Pallister-Killian syndrome is a sporadic multiple congenital anomaly syndrome characterized by {open_quotes}coarse{close_quotes} face, profound mental retardation, and epilepsy. Chromosomes of peripheral lymphocytes are usually normal, but tissue cultures show varying degrees of mosaicism for isochromosome 12p. In babies who die neonatally of severe malformations, including diaphragmatic hernia, and who also have a {open_quotes}coarse{close_quotes} face, acral hypoplasia, and other internal anomalies, Fryns syndrome is more likely to be suspected than Pallister-Killian syndrome, especially if karyotyping is unavailable or if peripheral lumphocytes have a normal chromosome constitution. An initial diagnosis of Fryns syndrome had to be modified in 3 successive newbornmore » infants since chromosome analysis or in situ hybridization with a chromosome 12 probe on kidney tissue demonstrated the mosaic aneuploidy characteristic of Pallister-Killian syndrome. These 3 patients confirm that a similar pattern of malformations can be present in both conditions at birth. It consists of {open_quotes}coarse{close_quotes} face, acral hypoplasia, diaphragmatic hernia, and other defects. Newborn infants who present this phenotype, but lack a conclusively normal chromosome test, may not have Fryns syndrome. A diagnosis of Fryns syndrome should be made carefully to avoid the risk of inappropriate genetic counseling. 31 refs., 10 figs., 1 tab.« less

Issues in access to safe drinking water and basic hygiene for persons with physical disabilities in rural Cambodia.

PubMed

MacLeod, Marin; Pann, Mala; Cantwell, Ray; Moore, Spencer

2014-12-01

An estimated 1.6 million people die from diarrheal diseases each year due to lack of access to safe water and sanitation, and persons with physical disabilities face additional barriers. In Cambodia, approximately 5% of the population is disabled, presenting substantial obstacles in accessing these basic services. The purpose of this study was twofold: first, to identify the challenges facing persons with physical disabilities in accessing safe household water and basic hygiene in rural Cambodia; and, second, to use these results to generate policy and practice recommendations for the water and sanitation hygiene sector implementing water treatment system interventions in rural settings. Fifteen field interviews were conducted with persons with physical disabilities. Thematic analysis was used to identify six main themes. The results indicated that environmental barriers to access were greater in the workplace than household settings and those persons with disabilities had greater awareness about safe drinking water compared to basic hygiene. Additionally, lack of physical strength, distance to water, and lack of financial means were noted as common access barriers. The findings support ongoing research and offer insight into the particular challenges facing persons with physical disabilities in rural areas in accessing safe drinking water and basic hygiene.

Birefringence measurement of retinal nerve fiber layer using polarization-sensitive spectral domain optical coherence tomography with Jones matrix based analysis

NASA Astrophysics Data System (ADS)

Yamanari, Masahiro; Miura, Masahiro; Makita, Shuichi; Yatagai, Toyohiko; Yasuno, Yoshiaki

2007-02-01

Birefringence of retinal nerve fiber layer is measured by polarization-sensitive spectral domain optical coherence tomography using the B-scan-oriented polarization modulation method. Birefringence of the optical fiber and the cornea is compensated by Jones matrix based analysis. Three-dimensional phase retardation map around the optic nerve head and en-face phase retardation map of the retinal nerve fiber layer are shown. Unlike scanning laser polarimetry, our system can measure the phase retardation quantitatively without using bow-tie pattern of the birefringence in the macular region, which enables diagnosis of glaucoma even if the patients have macular disease.

[Many faces of deinstitutionalization--sociological interpretation].

PubMed

Forster, R

2000-09-01

The article summarizes in an international perspective what kind of results psychiatric deinstitutionalization has brought so far: a profound change of size and functions of the psychiatric hospital; better services for people with less severe problems; and the failing of community services to compensate for some of the functions of the former asylums, resulting in trans-institutionalization and/or neglect for many chronic patients. Three different sociological versions to explain the background and typical outcomes of psychiatric deinstitutionalization have been brought forward so far: political economy, professional dominance and post-structuralism. They are confronted with an approach using the concept of medicalisation which offers a more comprehensive understanding of the process.

Sleights of Hand: South Africa's Gold Mines and Occupational Disease.

PubMed

McCulloch, Jock

2016-02-01

South Africa's gold mines were the first to compensate silicosis and tuberculosis as occupational diseases. They were also the first mines to introduce a state-sanctioned regime of medical surveillance. Despite those innovations, the major mining houses are currently facing class actions by former miners with occupational lung disease. The obvious reason for this medical and legislative failure is to be found in the economic fabric of South Africa's gold industry. In this article, I will argue that it is also found in the system of mine medicine, which was designed to hide rather than reveal the actual disease rates. © The Author(s) 2016.

Walking the Line: Navigating Market and Gift Economies of Care in a Consumer-Directed Home-Based Care Program for Older Adults

PubMed Central

Torres, Jacqueline M; Kietzman, Kathryn G; Wallace, Steven P

2015-01-01

Context Paid caregivers of low-income older adults navigate their role at what Hochschild calls the “market frontier”: the fuzzy line between the “world of the market,” in which services are exchanged for monetary compensation, and the “world of the gift,” in which caregiving is uncompensated and motivated by emotional attachment. We examine how political and economic forces, including the reduction of long-term services and supports, shape the practice of “walking the line” among caregivers of older adults. Methods We used data from a longitudinal qualitative study with related and nonrelated caregivers (n = 33) paid through California’s In-Home Supportive Services (IHSS) program and consumers of IHSS care (n = 49). We analyzed the semistructured interviews (n = 330), completed between 2010 and 2014, using a constructivist grounded theory approach. Findings Related and nonrelated caregivers are often expected to “gift” hours of care above and beyond what is compensated by formal services. Cuts in formal services and lapses in pay push caregivers to further “walk the line” between market and gift economies of care. Both related and nonrelated caregivers who choose to stay on and provide more care without pay often face adverse economic and health consequences. Some, including related caregivers, opt out of caregiving altogether. While some consumers expect that caregivers would be willing to “walk the line” in order to meet their needs, most expressed sympathy for them and tried to alter their schedules or go without care in order to limit the caregivers’ burden. Conclusions Given economic and health constraints, caregivers cannot always compensate for cuts in formal supports by providing uncompensated time and resources. Similarly, low-income older adults are not competitive in the caregiving marketplace and, given the inadequacy of compensated hours, often depend on unpaid care. Policies that restrict formal long-term services and supports thus leave the needs of both caregivers and consumers unmet. PMID:26626984

Walking the Line: Navigating Market and Gift Economies of Care in a Consumer-Directed Home-Based Care Program for Older Adults.

PubMed

Torres, Jacqueline M; Kietzman, Kathryn G; Wallace, Steven P

2015-12-01

Paid caregivers of low-income older adults navigate their role at what Hochschild calls the "market frontier": the fuzzy line between the "world of the market," in which services are exchanged for monetary compensation, and the "world of the gift," in which caregiving is uncompensated and motivated by emotional attachment. We examine how political and economic forces, including the reduction of long-term services and supports, shape the practice of "walking the line" among caregivers of older adults. We used data from a longitudinal qualitative study with related and nonrelated caregivers (n = 33) paid through California's In-Home Supportive Services (IHSS) program and consumers of IHSS care (n = 49). We analyzed the semistructured interviews (n = 330), completed between 2010 and 2014, using a constructivist grounded theory approach. Related and nonrelated caregivers are often expected to "gift" hours of care above and beyond what is compensated by formal services. Cuts in formal services and lapses in pay push caregivers to further "walk the line" between market and gift economies of care. Both related and nonrelated caregivers who choose to stay on and provide more care without pay often face adverse economic and health consequences. Some, including related caregivers, opt out of caregiving altogether. While some consumers expect that caregivers would be willing to "walk the line" in order to meet their needs, most expressed sympathy for them and tried to alter their schedules or go without care in order to limit the caregivers' burden. Given economic and health constraints, caregivers cannot always compensate for cuts in formal supports by providing uncompensated time and resources. Similarly, low-income older adults are not competitive in the caregiving marketplace and, given the inadequacy of compensated hours, often depend on unpaid care. Policies that restrict formal long-term services and supports thus leave the needs of both caregivers and consumers unmet. © 2015 Milbank Memorial Fund.

Measuring Scale Errors in a Laser Tracker’s Horizontal Angle Encoder Through Simple Length Measurement and Two-Face System Tests

PubMed Central

Muralikrishnan, B.; Blackburn, C.; Sawyer, D.; Phillips, S.; Bridges, R.

2010-01-01

We describe a method to estimate the scale errors in the horizontal angle encoder of a laser tracker in this paper. The method does not require expensive instrumentation such as a rotary stage or even a calibrated artifact. An uncalibrated but stable length is realized between two targets mounted on stands that are at tracker height. The tracker measures the distance between these two targets from different azimuthal positions (say, in intervals of 20° over 360°). Each target is measured in both front face and back face. Low order harmonic scale errors can be estimated from this data and may then be used to correct the encoder’s error map to improve the tracker’s angle measurement accuracy. We have demonstrated this for the second order harmonic in this paper. It is important to compensate for even order harmonics as their influence cannot be removed by averaging front face and back face measurements whereas odd orders can be removed by averaging. We tested six trackers from three different manufacturers. Two of those trackers are newer models introduced at the time of writing of this paper. For older trackers from two manufacturers, the length errors in a 7.75 m horizontal length placed 7 m away from a tracker were of the order of ± 65 μm before correcting the error map. They reduced to less than ± 25 μm after correcting the error map for second order scale errors. Newer trackers from the same manufacturers did not show this error. An older tracker from a third manufacturer also did not show this error. PMID:27134789

Why most workers with occupational repetitive trauma do not file for workers' compensation.

PubMed

Rosenman, K D; Gardiner, J C; Wang, J; Biddle, J; Hogan, A; Reilly, M J; Roberts, K; Welch, E

2000-01-01

Despite the availability of no fault insurance for wage replacement and medical care costs, the majority of workers diagnosed with an occupational disease do not apply for workers' compensation. The objective of the study was to determine the reasons why workers diagnosed with work-related musculoskeletal disease did not apply for workers' compensation benefits. A cross-sectional study of 1598 individuals diagnosed with neck, upper extremity, and low back work-related musculoskeletal disease from April to June 1996 was performed. All individuals were interviewed over the telephone using a standardized questionnaire. The questionnaire included questions about the precipitating event; demographics; health limitations; mood; pain level; and attitudes toward their health care provider, fellow workers, management, work environment, and filing for workers' compensation. Whenever possible, standardized questions from previous surveys were used. The interviewed individuals with work-related musculoskeletal disease were reported by health care practitioners as required by the state of Michigan's occupational disease reporting law. Workers reported during 12 weeks in the spring of 1996 by a Michigan health care professional as having a neck, back, or upper extremity musculoskeletal disorder were eligible to participate. Among the 2703 reports received, 490 individuals could not be reached, 22 did not speak English, 12 had died or were too incapacitated by other medical conditions, and 581 refused. We interviewed 59% of all eligible workers and 73% of all workers who were reachable and capable of responding in English. Only 25% of workers diagnosed with musculoskeletal disease filed a workers' compensation claim. The factors significantly associated with filing a claim were (1) increased length of employment (> 21 years: odds ratio [OR], 3.01, 95% confidence interval [CI], 1.31 to 6.90); 11 to 20 years: OR, 2.34, 95% CI, 1.01 to 5.47; 6 to 10 years: OR, 1.76, 95% CI, 0.73 to 4.25; 1 to 5 years: OR, 2.36, 95% CI, 1.03 to 5.42; < 1 year: OR, 1.00; (2) lower annual income (< $40,000: OR, 1.75, 95% CI, 1.06 to 2.88 vs > or = $80,000: OR, 1.00); (3) workers' dissatisfaction with coworkers (OR, 1.76, 95% CI, 1.01 to 3.06); (4) physician restrictions on activity (OR, 2.16, 95% CI, 1.55 to 3.00); (5) type of physician providing treatment (specialist, including surgeon or orthopedist: OR, 3.63, 95% CI, 2.37 to 5.55); physical and occupational therapist: OR, 2.15, 95% CI, 1.35 to 3.43); family practitioner: OR, 1.33, 95% CI = 0.89 to 2.01; company physician: OR = 1.00); (6) off work > or = 7 days (OR, 14.85, 95% CI, 10.57 to 20.85); (7) decreased current health status (OR, 0.82, 95% CI, 0.70 to 0.96); and (8) increased severity of illness (OR, 1.24, 95% CI, 1.06 to 20.88). This study showed that only 25% of workers with a work-related musculoskeletal condition filed for workers' compensation and refutes the common perception that an individual with a work-related problem is likely to file a workers' compensation claim. The strongest predictors of who would file were those factors associated with the severity of the condition. Other factors were increasing length of employment, lower annual income, and worker dissatisfaction with coworkers. Our study population consisted mainly of unionized autoworkers, and our findings may not be generalizable to the total workforce.

Causes of death in long-term survivors of non-small cell lung cancer: A regional Surveillance, Epidemiology, and End Results study.

PubMed

Kanitkar, Amaraja A; Schwartz, Ann G; George, Julie; Soubani, Ayman O

2018-01-01

Survival from lung cancer is improving. There are limited data on the causes of death in 5-year survivors of lung cancer. The aim of this study is to explore the causes of death in long-term survivors of non-small cell lung cancer (NSCLC) and describe the odds of dying from causes other than lung cancer in this patient population. An analysis of 5-year survivors of newly diagnosed NSCLC from 1996 to 2007, in Metropolitan Detroit included in Surveillance, Epidemiology, and End Results program, was done. Of 23,059 patients identified, 3789 (16.43%) patients were alive at 5-year period (long-term survivors) and 1897 (50.06%) patients died in the later follow-up period (median 88 months; range 1-219 months). The causes of death besides lung cancer were observed in 55.2% of these patients. The most common causes of death were cardiovascular diseases (CVDs) (16%), chronic obstructive pulmonary diseases (11%), and other malignancies (8%). Patients older than 65 years, males, and those who underwent surgery for treatment of lung cancer faced a greater likelihood of death by other causes as compared to lung cancer (OR: 1.45, 95% confidence interval [CI]: 1.18-1.77; OR: 1.24, 95% CI: 1.02-1.51; and OR: 1.39, 95% CI: 1.06-1.82, respectively). Five-year survivors of NSCLC more commonly die from causes such as CVDs, lung diseases, and other malignancies. Aggressive preventive and therapeutic measures of these diseases may further improve the outcome in this patient population.

Maslow's hierarchy of needs: a framework for achieving human potential in hospice.

PubMed

Zalenski, Robert J; Raspa, Richard

2006-10-01

Although the widespread implementation of hospice in the United States has led to tremendous advances in the care of the dying, there has been no widely accepted psychological theory to drive needs assessment and intervention design for the patient and family. The humanistic psychology of Abraham Maslow, especially his theory of motivation and the hierarchy of needs, has been widely applied in business and social science, but only sparsely discussed in the palliative care literature. In this article we review Maslow's original hierarchy, adapt it to hospice and palliative care, apply the adaptation to a case example, and then discuss its implications for patient care, education, and research. The five levels of the hierarchy of needs as adapted to palliative care are: (1) distressing symptoms, such as pain or dyspnea; (2) fears for physical safety, of dying or abandonment; (3) affection, love and acceptance in the face of devastating illness; (4) esteem, respect, and appreciation for the person; (5) selfactualization and transcendence. Maslow's modified hierarchy of palliative care needs could be utilized to provide a comprehensive approach for the assessment of patients' needs and the design of interventions to achieve goals that start with comfort and potentially extend to the experience of transcendence.

Assisted or Hastened Death: The Healthcare Practitioner’s Dilemma

PubMed Central

MacLeod, Rod D; Wilson, Donna M; Malpas, Phillipa

2012-01-01

Assisting or hastening death is a dilemma with many ethical as well as practical issues facing healthcare practitioners in most countries worldwide now. Various arguments for and against assisted dying have been made over time but the call from the public for the legalisation of euthanasia and assisted suicide has never been stronger. While some studies have documented the reluctance of medical and other healthcare professionals to be involved in the practice of assisted dying or euthanasia, there is still much open debate in the public domain. Those who have the most experience of palliative care are strongest in their opposition to hastening death. This paper explores salient practical and ethical considerations for healthcare practitioners associated with assisting death, including a focus on examining the concepts of autonomy for patients and healthcare practitioners. The role of the healthcare practitioner has clearly and undoubtedly changed over time with advances in healthcare practices but the duty of care has not changed. The dilemmas for healthcare practitioners thus who have competent patients requesting hastened death extends far beyond acting within a country’s laws as they go to the very heart of the relationship between the practitioner and patient. PMID:23121745

Nurse leaders' role in medical assistance in dying: A relational ethics approach.

PubMed

Thiele, Tracy; Dunsford, Jennifer

2017-01-01

Recent changes to the Criminal Code of Canada have resulted in the right of competent adult Canadians to request medical assistance in dying (MAID). Healthcare professionals now can participate if the individual meets specific outlined criteria. There remains confusion and lack of knowledge about the specific role of nurses in MAID. MAID is a controversial topic and nurses may be faced with the challenge of balancing the duty to provide routine care, with moral reservations about MAID. The role of a nursing leader is to support nurses by ensuring they have the knowledge they require to care for patients requesting the service, whether or not the nurse is directly involved in the MAID process. The moral dilemmas raised by MAID provide an opportunity to look at a relational ethics approach to nursing leadership both for MAID and other difficult situations that arise in nursing practice. Relational ethics is a framework that proposes that the ethical moments in healthcare are based on relationships and fostering growth, healing, and health through the foundational concepts of mutual respect, engagement, embodiment, and environment. This article will use a relational ethics framework to examine how nursing leadership can support nurses who care for patients requesting MAID.

An invitation to die: initiators of sociality in a social amoeba become selfish spores

PubMed Central

Kuzdzal-Fick, Jennie J.; Queller, David C.; Strassmann, Joan E.

2010-01-01

Greater size and strength are common attributes of contest winners. Even in social insects with high cooperation, the right to reproduce falls to the well-fed queens rather than to poorly fed workers. In Dictyostelium discoideum, formerly solitary amoebae aggregate when faced with starvation, and some cells die to form a stalk which others ride up to reach a better location to sporulate. The first cells to starve have lower energy reserves than those that starve later, and previous studies have shown that the better-fed cells in a mix tend to form disproportionately more reproductive spores. Therefore, one might expect that the first cells to starve and initiate the social stage should act altruistically and form disproportionately more of the sterile stalk, thereby enticing other better-fed cells into joining the aggregate. This would resemble caste determination in social insects, where altruistic workers are typically fed less than reproductive queens. However, we show that the opposite result holds: the first cells to starve become reproductive spores, presumably by gearing up for competition and outcompeting late starvers to become prespore first. These findings pose the interesting question of why others would join selfish organizers. PMID:20504816

Time savings--realized and potential--and fair compensation for community health workers in Kenyan health facilities: a mixed-methods approach.

PubMed

Sander, Laura D; Holtzman, David; Pauly, Mark; Cohn, Jennifer

2015-01-30

Sub-Saharan Africa faces a severe health worker shortage, which community health workers (CHWs) may fill. This study describes tasks shifted from clinicians to CHWs in Kenya, places monetary valuations on CHWs' efforts, and models effects of further task shifting on time demands of clinicians and CHWs. Mixed methods were used for this study. Interviews were conducted with 28 CHWs and 19 clinicians in 17 health facilities throughout Kenya focusing on task shifting involving CHWs, time savings for clinicians as a result of task shifting, barriers and enabling factors to CHWs' work, and appropriate CHW compensation. Twenty CHWs completed task diaries over a 14-day period to examine current CHW tasks and the amount of time spent performing them. A modeling exercise was conducted examining a current task-shifting example and another scenario in which additional task shifting to CHWs has occurred. CHWs worked an average of 5.3 hours per day and spent 36% of their time performing tasks shifted from clinicians. We estimated a monthly valuation of US$ 117 per CHW. The modeling exercise demonstrated that further task shifting would reduce the number of clinicians needed while maintaining clinic productivity by significantly increasing the number of CHWs. CHWs are an important component of healthcare delivery in Kenya. Our monetary estimates of current CHW contributions provide starting points for further discussion, research and planning regarding CHW compensation and programs. Additional task shifting to CHWs may further offload overworked clinicians while maintaining overall productivity.

Analysis and experiments for delay compensation in attitude control of flexible spacecraft

NASA Astrophysics Data System (ADS)

Sabatini, Marco; Palmerini, Giovanni B.; Leonangeli, Nazareno; Gasbarri, Paolo

2014-11-01

Space vehicles are often characterized by highly flexible appendages, with low natural frequencies which can generate coupling phenomena during orbital maneuvering. The stability and delay margins of the controlled system are deeply affected by the presence of bodies with different elastic properties, assembled to form a complex multibody system. As a consequence, unstable behavior can arise. In this paper the problem is first faced from a numerical point of view, developing accurate multibody mathematical models, as well as relevant navigation and control algorithms. One of the main causes of instability is identified with the unavoidable presence of time delays in the GNC loop. A strategy to compensate for these delays is elaborated and tested using the simulation tool, and finally validated by means of a free floating platform, replicating the flexible spacecraft attitude dynamics (single axis rotation). The platform is equipped with thrusters commanded according to the on-off modulation of the Linear Quadratic Regulator (LQR) control law. The LQR is based on the estimate of the full state vector, i.e. including both rigid - attitude - and elastic variables, that is possible thanks to the on line measurement of the flexible displacements, realized by processing the images acquired by a dedicated camera. The accurate mathematical model of the system and the rigid and elastic measurements enable a prediction of the state, so that the control is evaluated taking the predicted state relevant to a delayed time into account. Both the simulations and the experimental campaign demonstrate that by compensating in this way the time delay, the instability is eliminated, and the maneuver is performed accurately.

Trends in disability and program participation among U.S. veterans.

PubMed

Ben-Shalom, Yonatan; Tennant, Jennifer R; Stapleton, David C

2016-07-01

Disability is increasingly part of the lives of veterans and more research is needed to understand its impact on veterans' participation in disability benefit programs. We examine how recent trends in receipt of service-connected disability compensation from the Department of Veterans Affairs (VA) compare to trends in self-reported disability and participation in Social Security Disability Insurance (DI) and Supplemental Security Income (SSI) among veterans. We use 2002-2013 data from the Current Population Survey to describe trends in receipt of VA disability compensation and to compare between trends in self-reported disability and DI/SSI participation for veterans versus nonveterans. The percentage of veterans reporting they receive VA disability compensation increased substantially from 2002 to 2013 and was especially notable among younger (ages 18-39) and older (ages 50-64) veterans. From 2009 to 2013, self-reported disability increased among the younger and older veterans but not among middle-age veterans and nonveterans, and self-reported cognitive disability increased substantially among young veterans. DI/SSI participation among older veterans increased more than for nonveterans over the period examined. Effective policies are needed to incentivize work among young veterans and to help them obtain both the skills they need to succeed in the labor force and the supports (such as psychiatric health services) they need to do so. Older veterans are facing increasing challenges in the labor market, and further research is needed to determine whether these challenges are primarily related to health, a growing skills gap, or poorly-aligned incentives. Copyright © 2016 Elsevier Inc. All rights reserved.

Simple method for self-referenced and lable-free biosensing by using a capillary sensing element.

PubMed

Liu, Yun; Chen, Shimeng; Liu, Qiang; Liu, Zigeng; Wei, Peng

2017-05-15

We demonstrated a simple method for self-reference and label free biosensing based on a capillary sensing element and common optoelectronic devices. The capillary sensing element is illuminated by a light-emitting diode (LED) light source and detected by a webcam. Part of gold film that deposited on the tubing wall is functionalized to carry on the biological information in the excited SPR modes. The end face of the capillary was monitored and separate regions of interest (ROIs) were selected as the measurement channel and the reference channel. In the ROIs, the biological information can be accurately extracted from the image by simple image processing. Moreover, temperature fluctuation, bulk RI fluctuation, light source fluctuation and other factors can be effectively compensated during detection. Our biosensing device has a sensitivity of 1145%/RIU and a resolution better than 5.287 × 10 -4 RIU, considering a 0.79% noise level. We apply it for concanavalin A (Con A) biological measurement, which has an approximately linear response to the specific analyte concentration. This simple method provides a new approach for multichannel SPR sensing and reference-compensated calibration of SPR signal for label-free detection.

Ecosystems, ecological restoration, and economics: does habitat or resource equivalency analysis mean other economic valuation methods are not needed?

PubMed

Shaw, W Douglass; Wlodarz, Marta

2013-09-01

Coastal and other area resources such as tidal wetlands, seagrasses, coral reefs, wetlands, and other ecosystems are often harmed by environmental damage that might be inflicted by human actions, or could occur from natural hazards such as hurricanes. Society may wish to restore resources to offset the harm, or receive compensation if this is not possible, but faces difficult choices among potential compensation projects. The optimal amount of restoration efforts can be determined by non-market valuation methods, service-to-service, or resource-to-resource approaches such as habitat equivalency analysis (HEA). HEA scales injured resources and lost services on a one-to-one trade-off basis. Here, we present the main differences between the HEA approach and other non-market valuation approaches. Particular focus is on the role of the social discount rate, which appears in the HEA equation and underlies calculations of the present value of future damages. We argue that while HEA involves elements of economic analysis, the assumption of a one-to-one trade-off between lost and restored services sometimes does not hold, and then other non-market economic valuation approaches may help in restoration scaling or in damage determination.

The radio-frequency fluctuation effect on the floating harmonic method

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

Lee, Jaewon; Kim, Kyung-Hyun; Kim, Dong-Hwan

2016-08-15

The radio-frequency (RF) plasma diagnostics with an electrical probe facing a challenge, because the RF fluctuation oscillates the plasma potential and distorts the current-voltage (I-V) curve. As Langmuir probe is widely used in plasma diagnostics, many researchers have been studying the effect of RF fluctuation on probe and compensation methods. On the other hand, there have not been enough studies on the fluctuation effect on the floating harmonic method. Therefore, we investigated the impact of RF fluctuation on the floating harmonic method theoretically and experimentally. When the electrons are in ideal Maxwellian distribution, the floating potential is negatively shifted bymore » the RF fluctuation, but the fluctuation does not distort I-V curve around the floating potential. However, in practical plasmas, the I-V curve and their harmonic components are distorted. This RF fluctuation effect becomes more significant in a low density plasma with a high impedance sheath. The second harmonic current decreases with the RF fluctuation while the first harmonic current is merely affected. Therefore, the electron temperatures measured with the floating harmonic method under low density plasma with uncompensated probe are overestimated than the results obtained with the compensated probe.« less

Discourse intervention strategies in Alzheimer's disease: Eye-tracking and the effect of visual cues in conversation

PubMed Central

Brandão, Lenisa; Monção, Ana Maria; Andersson, Richard; Holmqvist, Kenneth

2014-01-01

Objective The goal of this study was to investigate whether on-topic visual cues can serve as aids for the maintenance of discourse coherence and informativeness in autobiographical narratives of persons with Alzheimer's disease (AD). Methods The experiment consisted of three randomized conversation conditions: one without prompts, showing a blank computer screen; an on-topic condition, showing a picture and a sentence about the conversation; and an off-topic condition, showing a picture and a sentence which were unrelated to the conversation. Speech was recorded while visual attention was examined using eye tracking to measure how long participants looked at cues and the face of the listener. Results Results suggest that interventions using visual cues in the form of images and written information are useful to improve discourse informativeness in AD. Conclusion This study demonstrated the potential of using images and short written messages as means of compensating for the cognitive deficits which underlie uninformative discourse in AD. Future studies should further investigate the efficacy of language interventions based in the use of these compensation strategies for AD patients and their family members and friends. PMID:29213914

The Impact of Rate Design and Net Metering on the Bill Savings from Distributed PV for Residential Customers in California

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

Energy and Resources Group, University of California, Berkeley; Darghouth, Naim R.; Barbose, Galen

2011-06-01

Net metering has become a widespread mechanism in the U.S. for supporting customer adoption of distributed photovoltaics (PV), but has faced challenges as PV installations grow to a larger share of generation in a number of states. This paper examines the value of the bill savings that customers receive under net metering, and the associated role of retail rate design, based on a sample of approximately two hundred residential customers of California's two largest electric utilities. We find that the bill savings per kWh of PV electricity generated varies by more than a factor of four across the customers inmore » the sample, which is largely attributable to the inclining block structure of the utilities' residential retail rates. We also compare the bill savings under net metering to that received under three potential alternative compensation mechanisms, based on California's Market Price Referent (MPR). We find that net metering provides significantly greater bill savings than a full MPR-based feed-in tariff, but only modestly greater savings than alternative mechanisms under which hourly or monthly net excess generation is compensated at the MPR rate.« less

Electromigration process for the purification of molten silicon during crystal growth

DOEpatents

Lovelace, Alan M. Administrator of the National Aeronautics and Space; Shlichta, Paul J.

1982-01-01

A process for the purification of molten materials during crystal growth by electromigration of impurities to localized dirty zones. The process has particular applications for silicon crystal growth according to Czochralski techniques and edge-defined film-fed growth (EFG) conditions. In the Czochralski crystal growing process, the impurities are electromigrated away from the crystallization interface by applying a direct electrical current to the molten silicon for electromigrating the charged impurities away from the crystal growth interface. In the EFG crystal growth process, a direct electrical current is applied between the two faces which are used in forming the molten silicon into a ribbon. The impurities are thereby migrated to one side only of the crystal ribbon. The impurities may be removed or left in place. If left in place, they will not adversely affect the ribbon when used in solar collectors. The migration of the impurity to one side only of the silicon ribbon is especially suitable for use with asymmetric dies which preferentially crystallize uncharged impurities along one side or face of the ribbon.

Codou Bop: Francophone Africa and beyond.

PubMed

Querido, M

1998-11-01

In Senegal, Codou Bop, regional coordinator for the upcoming "Women of the World Francophone Africa" report and Executive Secretary of Groupe de Recherche Femmes et Lois au Senegal (an affiliate of the International Solidarity Network of Women Living Under Muslim Laws), has dedicated her life to the promotion of reproductive rights and the opposition of violence against women. Bop notes that the impact of women's status upon their health is profound and that women, particularly those living in rural areas, face major obstacles in obtaining health care. Bop believes that governments must educate people about existing laws pertaining to women and ensure that these laws are respected. Bop also asserted that the Global Gag Rule proposed by conservatives in the US Congress to restrict recipients of foreign aid from discussing abortion with clients would mean that many women could die. She is particularly concerned about adolescents who will try to self-abort when faced with an unwanted pregnancy. The Gag Rule would mean that women could not even be counseled about the dangers of using local remedies to abort.

The changing face of cardiovascular disease 2000-2012: An analysis of the world health organisation global health estimates data.

PubMed

McAloon, Christopher J; Boylan, Luke M; Hamborg, Thomas; Stallard, Nigel; Osman, Faizel; Lim, Phang B; Hayat, Sajad A

2016-12-01

The pattern and global burden of disease has evolved considerably over the last two decades, from primarily communicable, maternal, and perinatal causes to non-communicable disease (NCD). Cardiovascular disease (CVD) has become the single most important and largest cause of NCD deaths worldwide at over 50%. The World Health Organisation (WHO) estimates that 17.6 million people died of CVD worldwide in 2012. Proportionally, this accounts for an estimated 31.43% of global mortality, with ischaemic heart disease (IHD) accounting for approximately 7.4 million deaths, 13.2% of the total. IHD was also the greatest single cause of death in 2000, accounting for an estimated 6.0 million deaths. The global burden of CVD falls, principally, on the low and middle-income (LMI) countries, accounting for over 80% of CVD deaths. Individual populations face differing challenges and each population has unique health burdens, however, CVD remains one of the greatest health challenges both nationally and worldwide. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Advanced process and defect characterization methodology to support process development of advanced patterning structures

NASA Astrophysics Data System (ADS)

Ketkar, Supriya; Lee, Junhan; Asokamani, Sen; Cho, Winston; Mishra, Shailendra

2018-03-01

This paper discusses the approach and solution adopted by GLOBALFOUNDRIES, a high volume manufacturing (HVM) foundry, for dry-etch related edge-signature surface particle defects issue facing the sub-nm node in the gate-etch sector. It is one of the highest die killers for the company in the 14-nm node. We have used different approaches to attack and rectify the edge signature surface particle defect. Several process-related & hardware changes have been successively implemented to achieve defect reduction improvement by 63%. Each systematic process and/or hardware approach has its own unique downstream issues and they have been dealt in a route-cause-effect technique to address the issue.

The risks and rewards of speed: Restorative retelling compressed into a three-day retreat.

PubMed

Blakley, Theresa; Mehr, Nita; Jordan, Donald

2018-01-01

This article chronicles the process of reducing the 10 week restorative retelling (RR) group model (Rynearson & Correa, Accommodation to violent dying: A guide to restorative retelling and support, Violent Death Bereavement Society, 2006) into a 3 day retreat for families of homicide loss. Strategies used to address the intensity of the condensed version of the treatment model are described for both the participants and treatment team. The twists and turns of how the therapeutic retreat unfolded are presented through case examples. The authors explicate the risks and rewards of conducting the RR model at speed, identify the challenges they faced, and give impressions for overall treatment efficacy.

Deep brain stimulation of the internal pallidum in multiple system atrophy.

PubMed

Santens, Patrick; Patrick, Santens; Vonck, Kristl; Kristl, Vonck; De Letter, Miet; Miet, De Letter; Van Driessche, Katya; Katya, Van Driessche; Sieben, Anne; Anne, Sieben; De Reuck, Jacques; Jacques, De Reuck; Van Roost, Dirk; Dirk, Van Roost; Boon, Paul; Paul, Boon

2006-04-01

We describe the outcome of deep brain stimulation of the internal pallidum in a 57-year old patient with multiple system atrophy. Although the prominent dystonic features of this patient were markedly attenuated post-operatively, the outcome was to be considered unfavourable. There was a severe increase in akinesia resulting in overall decrease of mobility in limbs as well as in the face. As a result, the patient was anarthric and displayed dysphagia. A laterality effect of stimulation on oro-facial movements was demonstrated. The patient died 7 months post-operatively. This report adds to the growing consensus that multiple system atrophy patients are unsuitable candidates for deep brain stimulation.

Statins in influenza: time for a controlled clinical study.

PubMed

Carrillo-Esper, Raúl

2009-01-01

Mexico recently experienced the impact of an influenza epidemic. This outbreak, the H1N1 strain, affected a large number of citizens and caused panic, economic instability and increased health care costs to the federal government and public and private institutions. Influenza outbreaks are periodic. They may or may not be seasonal, and severity of the disease is linked to host immunity and to the virus strain. In the event of a pandemic as happened in 1918, it is estimated that approximately 175-350 million people may die, and health systems would face a catastrophic situation due to the insufficiency of antivirals and vaccines, as well as affecting hospital infrastructure.

Manufacturing development of pultruded composite panels

NASA Technical Reports Server (NTRS)

Meade, L. E.

1989-01-01

The weight savings potential, of graphite-epoxy composites for secondary and medium primary aircraft structures, was demonstrated. One of the greatest challenges facing the aircraft industry is to reduce the acquisition costs for composite structures to a level below that of metal structures. The pultrusion process, wherein reinforcing fibers, after being passed through a resin bath are drawn through a die to form and cure the desired cross-section, is an automated low cost manufacturing process for composite structures. The Lockheed Aeronautical Systems Company (LASC) Composites Development Center designed, characterizated materials for, fabricated and tested a stiffened cover concept compatible with the continuous pultrusion process. The procedures used and the results obtained are presented.

Electrical stimulation of transplanted motoneurons improves motor unit formation

PubMed Central

Liu, Yang; Grumbles, Robert M.

2014-01-01

Motoneurons die following spinal cord trauma and with neurological disease. Intact axons reinnervate nearby muscle fibers to compensate for the death of motoneurons, but when an entire motoneuron pool dies, there is complete denervation. To reduce denervation atrophy, we have reinnervated muscles in Fisher rats from local transplants of embryonic motoneurons in peripheral nerve. Since growth of axons from embryonic neurons is activity dependent, our aim was to test whether brief electrical stimulation of the neurons immediately after transplantation altered motor unit numbers and muscle properties 10 wk later. All surgical procedures and recordings were done in anesthetized animals. The muscle consequences of motoneuron death were mimicked by unilateral sciatic nerve section. One week later, 200,000 embryonic day 14 and 15 ventral spinal cord cells, purified for motoneurons, were injected into the tibial nerve 10–15 mm from the gastrocnemii muscles as the only neuron source for muscle reinnervation. The cells were stimulated immediately after transplantation for up to 1 h using protocols designed to examine differential effects due to pulse number, stimulation frequency, pattern, and duration. Electrical stimulation that included short rests and lasted for 1 h resulted in higher motor unit counts. Muscles with higher motor unit counts had more reinnervated fibers and were stronger. Denervated muscles had to be stimulated directly to evoke contractions. These results show that brief electrical stimulation of embryonic neurons, in vivo, has long-term effects on motor unit formation and muscle force. This muscle reinnervation provides the opportunity to use patterned electrical stimulation to produce functional movements. PMID:24848463

Dynamic Motor Compensations with Permanent, Focal Loss of Forelimb Force after Cervical Spinal Cord Injury

PubMed Central

López-Dolado, Elisa; Lucas-Osma, Ana M.

2013-01-01

Abstract Incomplete cervical lesion is the most common type of human spinal cord injury (SCI) and causes permanent paresis of arm muscles, a phenomenon still incompletely understood in physiopathological and neuroanatomical terms. We performed spinal cord hemisection in adult rats at the caudal part of the segment C6, just rostral to the bulk of triceps brachii motoneurons, and analyzed the forces and kinematics of locomotion up to 4 months postlesion to determine the nature of motor function loss and recovery. A dramatic (50%), immediate and permanent loss of extensor force occurred in the forelimb but not in the hind limb of the injured side, accompanied by elbow and wrist kinematic impairments and early adaptations of whole-body movements that initially compensated the balance but changed continuously over the follow-up period to allow effective locomotion. Overuse of both contralateral legs and ipsilateral hind leg was evidenced since 5 days postlesion. Ipsilateral foreleg deficits resulted mainly from interruption of axons that innervate the spinal cord segments caudal to the lesion, because chronic loss (about 35%) of synapses was detected at C7 while only 14% of triceps braquii motoneurons died, as assessed by synaptophysin immunohistochemistry and retrograde neural tracing, respectively. We also found a large pool of propriospinal neurons projecting from C2–C5 to C7 in normal rats, with topographical features similar to the propriospinal premotoneuronal system of cats and primates. Thus, concurrent axotomy at C6 of brain descending axons and cervical propriospinal axons likely hampered spontaneous recovery of the focal neurological impairments. PMID:23249275

Transforming Growth Factor Beta (TGFβ1, TGFβ2 and TGFβ3) Null-Mutant Phenotypes in Embryonic Gonadal Development

PubMed Central

Memon, Mushtaq A.; Anway, Matthew D.; Covert, Trevor R.; Uzumcu, Mehmet; Skinner, Michael K.

2008-01-01

The role transforming growth factor beta (TGFb) isoforms TGFb1, TGFb2 and TGFb3 have in the regulation of embryonic gonadal development was investigated with the use of null-mutant (i.e. knockout) mice for each of the TGFb isoforms. Late embryonic gonadal development was investigated because homozygote TGFb null-mutant mice generally die around birth, with some embryonic loss as well. In the testis, the TGFb1 null-mutant mice had a decrease in the number of germ cells at birth, postnatal day 0 (P0). In the testis, the TGFb2 null-mutant mice had a decrease in the number of seminiferous cords at embryonic day 15 (E15). In the ovary, the TGFb2 null-mutant mice had an increase in the number of germ cells at P0. TGFb isoforms appear to have a role in gonadal development, but interactions between the isoforms is speculated to compensate in the different TGFb isoform null-mutant mice. PMID:18790002

Apparent climatically induced increase of tree mortality rates in a temperate forest

USGS Publications Warehouse

van Mantgem, P.J.; Stephenson, N.L.

2007-01-01

We provide a first detailed analysis of long-term, annual-resolution demographic trends in a temperate forest. After tracking the fates of 21 338 trees in a network of old-growth forest plots in the Sierra Nevada of California, we found that mortality rate, but not the recruitment rate, increased significantly over the 22 years of measurement (1983-2004). Mortality rates increased in both of two dominant taxonomic groups (Abies and Pinus) and in different forest types (different elevational zones). The increase in overall mortality rate resulted from an increase in tree deaths attributed to stress and biotic causes, and coincided with a temperature-driven increase in an index of drought. Our findings suggest that these forests (and by implication, other water-limited forests) may be sensitive to temperature-driven drought stress, and may be poised for die-back if future climates continue to feature rising temperatures without compensating increases in precipitation. ?? 2007 Blackwell Publishing Ltd/CNRS.

The Eluana Englaro Case: cause of death after the withdrawal of artificial nutrition and hydration in a subject in a permanent vegetative state and with quadriplegia.

PubMed

Moreschi, Carlo; Da Broi, Ugo; Rodriguez, Daniele; Froldi, Rino; Porzionato, Andrea; Macchi, Veronica; De Caro, Raffaele

2013-09-10

A 38-year-old woman, who had been in a permanent vegetative state with quadriplegia for 17 years following a motor vehicle accident, died 87 h after the judicially authorised suspension of artificial nutrition and hydration. Medico-legal investigations, requested by the Judicial Authorities and focusing on the evaluation of clinical and necroscopic data, aimed to explain the cause of death, to exclude any lethal cause other than one deriving from the withdrawal of artificial nutrition and hydration and to verify the level of perceived discomfort and the correctness in the application of the supportive protocol during the end of life phase. The inability of quadriplegic patients to compensate critical hyperthermic and haemodynamic disturbances induced by dehydration was considered to be the cause of a rapid demise after the withdrawal of artificial sustenance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Assessment of psychosocial risks faced by workers in Almería-type greenhouses, using the Mini Psychosocial Factor method.

PubMed

Montoya-García, M E; Callejón-Ferre, A J; Pérez-Alonso, J; Sánchez-Hermosilla, J

2013-03-01

This work reports the use of the Mini Psychosocial Factor (MPF) method for assessing the psychosocial risks faced by agricultural workers in the greenhouses of Almería (Spain) with the aim of improving their health. The variables Rhythm, Mobbing, Relationships, Health, Recognition, Autonomy, Emotional Involvement, Support, Compensation, Control, Demands, and Mental Load were recorded using a pre-validated questionnaire containing 15 questions. The sex, age, and nationality of the respondents (n = 310) were also recorded, as were the type of greenhouse in which each worked, the size of the greenhouse, and the crop grown. The results showed psychosocial risks to exist for the workers. Multiple correspondence analysis, however, showed that moderate risks can be offset by new prevention programmes that improve Spanish legislation in terms of workers' salaries, worker-employer social days, work timetables to facilitate family life, and training courses. This could improve the work environment and health of Almería's greenhouse workers as well as their productivity. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Perceived safety and biomechanical stress to the lower limbs when stepping down from fire fighting vehicles.

PubMed

Giguère, Denis; Marchand, Denis

2005-01-01

Injuries related to emergency vehicles represent 19% of compensated work accidents for fire fighters, 37% of which occur while stepping down from their vehicles. This study compared the impact forces, the use of upper limbs and the perception of danger of fire fighters as they step down from five different locations on fire trucks. The results show that stepping down from the crew cab facing the street produces impact forces averaging 3.2 times the subject's body weight, but is also perceived as the safest way to descend in one of the two groups of fire fighters that participated in the study. Stepping down from the same location, but facing the truck, produced significantly less impact force and a better distribution of the energy over time. This may be achieved through better control of the descending leg, ankle flexion, and the use of grab bars. A re-design of the access to emergency vehicles should take into account both the safety needs and reduction in biomechanical stress of fire fighters.

[A Method Research on Environmental Damage Assessment of a Truck Rollover Pollution Incident].

PubMed

Cai, Feng; Zhao, Shi-ho; Chen, Gang-cai; Xian, Si-shu; Yang, Qing-ling; Zhou, Xian-jie; Yu, Hai

2015-05-01

With high occurrence of sudden water pollution incident, China faces an increasingly severe situation of water environment. In order to deter the acts of environmental pollution, ensure the damaged resources of environment can be restored and compensated, it is very critical to quantify the economic losses caused by the sudden water pollution incident. This paper took truck rollover pollution incidents in Chongqing for an example, established a set of evaluation method for quantifying the environmental damage, and then assessed the environmental damage by the method from four aspects, including the property damage, ecological environment and resources damages, the costs of administrative affairs in emergency disposal, and the costs of investigation and evaluation.

Apcocynum Pictum and Sustainable Agriculture Along the Tarim River In Arid Northwest, China

NASA Astrophysics Data System (ADS)

Aihemaitijiang, R.

2014-12-01

Water scarcity and population increase have been a major limiting factor in oasis development along the Tarim River in Xinjiang, Northwest China which has very continental and dry climate, and all the agriculture and livelihoods depend on glacier melt water from Tarim River. Due to vast land reclamation along the Tarim River to grow cotton, native plant species are facing a severe competition for water, which is essential for their survival. Decreasing river runoff and inefficient water use practices by agriculture and industry has exacerbated already serious situation even worse. In addition, a large influx of migrant famers from Eastern China is being settled in this region to cultivate new agricultural lands that consumed even more water. Under those conditions, the natural riparian vegetation and the irrigation agriculture, especially along the lower reaches, suffers water shortage leading the degradation and economic losses, respectively. Along with the enlargement of irrigation area and periods of water shortage, soil salinization has become a major concern for farmers in the area. Alternative cash crops are much needed to reduce water use, so both native vegetation and human demand for water would be fulfilled. We hypothesized Apocynum Pictum, perennial herb species with multiple uses as potential substitute. Multidisciplinary approach is being used in this study to investigate three related issues to offer a basis for Apocynum's role in sustainable agriculture, such as Biomass production of Apocynum; Water budget of Apocynum; and Economic utilization of Apocynum. A.Pictum is perennial plant distributed in Central Asia and China, which its roots are perennial, while the stems die every year. Thus, A.pictum grow under the arid climate of Central Asia and provide utilization options without irrigation. We initially estimate water requirement for this plant is much less than cotton. In order to validate our hypothesis, we have measured water consumption of the plant. Mean while, leaves of A.pictum can be used to produce tea and stems can be used to produce fiber. It could compensate farmer's loss from potential land use switch. Finally we believe that A.pctum offers viable alternative to reduce water demand and ensure long-term sustainability of oasis along the Tarim River.

Randomized controlled trials and meta-analysis in medical education: what role do they play?

PubMed

Cook, David A

2012-01-01

Education researchers seek to understand what works, for whom, in what circumstances. Unfortunately, educational environments are complex and research itself is highly context dependent. Faced with these challenges, some have argued that qualitative methods should supplant quantitative methods such as randomized controlled trials (RCTs) and meta-analysis. I disagree. Good qualitative and mixed-methods research are complementary to, rather than exclusive of, quantitative methods. The complexity and challenges we face should not beguile us into ignoring methods that provide strong evidence. What, then, is the proper role for RCTs and meta-analysis in medical education? First, the choice of study design depends on the research question. RCTs and meta-analysis are appropriate for many, but not all, study goals. They have compelling strengths but also numerous limitations. Second, strong methods will not compensate for a pointless question. RCTs do not advance the science when they make confounded comparisons, or make comparison with no intervention. Third, clinical medicine now faces many of the same challenges we encounter in education. We can learn much from other fields about how to handle complexity in RCTs. Finally, no single study will definitively answer any research question. We need carefully planned, theory-building, programmatic research, reflecting a variety of paradigms and approaches, as we accumulate evidence to change the art and science of education.

Annoyance, Sleep and Concentration Problems due to Combined Traffic Noise and the Benefit of Quiet Side

PubMed Central

Bodin, Theo; Björk, Jonas; Ardö, Jonas; Albin, Maria

2015-01-01

Background: Access to a quiet side in one’s dwelling is thought to compensate for higher noise levels at the most exposed façade. It has also been indicated that noise from combined traffic sources causes more noise annoyance than equal average levels from either road traffic or railway noise separately. Methods: 2612 persons in Malmö, Sweden, answered to a residential environment survey including questions on outdoor environment, noise sensitivity, noise annoyance, sleep quality and concentration problems. Road traffic and railway noise was modeled using Geographic Information System. Results: Access to a quiet side, i.e., at least one window facing yard, water or green space, was associated with reduced risk of annoyance OR (95%CI) 0.47 (0.38–0.59), and concentration problems 0.76 (0.61–0.95). Bedroom window facing the same environment was associated to reduced risk of reporting of poor sleep quality 0.78 (0.64–1.00). Railway noise was associated with reduced risk of annoyance below 55 dB(A) but not at higher levels of exposure. Conclusions: Having a window facing a yard, water or green space was associated to a substantially reduced risk of noise annoyance and concentration problems. If this window was the bedroom window, sleeping problems were less likely. PMID:25642690

Thin hybrid pixel assembly with backside compensation layer on ROIC

NASA Astrophysics Data System (ADS)

Bates, R.; Buttar, C.; McMullen, T.; Cunningham, L.; Ashby, J.; Doherty, F.; Gray, C.; Pares, G.; Vignoud, L.; Kholti, B.; Vahanen, S.

2017-01-01

The entire ATLAS inner tracking system will be replaced for operation at the HL-LHC . This will include a significantly larger pixel detector of approximately 15 m2. For this project, it is critical to reduce the mass of the hybrid pixel modules and this requires thinning both the sensor and readout chips to about 150 micrometres each. The thinning of the silicon chips leads to low bump yield for SnAg bumps due to bad co-planarity of the two chips at the solder reflow stage creating dead zones within the pixel array. In the case of the ATLAS FEI4 pixel readout chip thinned to 100 micrometres, the chip is concave, with the front side in compression, with a bow of +100 micrometres at room temperature which varies to a bow of -175 micrometres at the SnAg solder reflow temperature, caused by the CTE mismatch between the materials in the CMOS stack and the silicon substrate. A new wafer level process to address the issue of low bump yield be controlling the chip bow has been developed. A back-side dielectric and metal stack of SiN and Al:Si has been deposited on the readout chip wafer to dynamically compensate the stress of the front side stack. In keeping with a 3D process the materials used are compatible with Through Silicon Via (TSV) technology with a TSV last approach which is under development for this chip. It is demonstrated that the amplitude of the correction can be manipulated by the deposition conditions and thickness of the SiN/Al:Si stack. The bow magnitude over the temperature range for the best sample to date is reduced by almost a factor of 4 and the sign of the bow (shape of the die) remains constant. Further development of the backside deposition conditions is on-going with the target of close to zero bow at the solder reflow temperature and a minimal bow magnitude throughout the temperature range. Assemblies produced from FEI4 readout wafers thinned to 100 micrometres with the backside compensation layer have been made for the first time and demonstrate bond yields close to 100%.

Threatened with death but growing: changes in and determinants of posttraumatic growth over the dying process for Taiwanese terminally ill cancer patients.

PubMed

Tang, Siew Tzuh; Lin, Kuan-Chia; Chen, Jen-Shi; Chang, Wen-Cheng; Hsieh, Chia-Hsun; Chou, Wen-Chi

2015-02-01

Posttraumatic growth at end of life, a positive psychological consequence of dealing with a life crisis, may be catalyzed by the trauma of facing mortality. Studies on cancer patients' posttraumatic growth have overwhelmingly examined early-stage survivors. Of the few studies on advanced cancer patients, none anchored posttraumatic growth with the patient's death. Therefore, the purposes of this study were to describe longitudinal changes in and to identify determinants of posttraumatic growth over the dying process. A convenience sample of 313 cancer patients was recruited and followed until death. Posttraumatic growth was measured by the Posttraumatic Growth Inventory. Determinants were evaluated from sociodemographics, cancer characteristics, social context variables, and coping strategies using a multiple linear regression model. The dying process may be too threatening and stressful for cancer patients to experience profound posttraumatic growth as manifested by low Posttraumatic Growth Inventory scores (26.13 ± 21.59 to 40.33 ± 27.71 on a 0-105 scale) without significant changes as death approached. However, terminally ill cancer patients who were not defeated by the initial threat of death experienced posttraumatic growth. Patients were at risk for low-level posttraumatic growth if they were male, were non-middle aged, had low educational attainment, had a non-metastatic disease, recently recognized terminally ill status, had severe symptom distress, had high functional dependence and weak social support, and were unaware or had low acceptance of their prognosis. Interventions are needed to appropriately relieve symptom distress, facilitate functional independence, enhance social support, and improve prognostic awareness and acceptance to inspire positive changes for cancer patients at end of life. Copyright © 2014 John Wiley & Sons, Ltd.

Foil Gas Thrust Bearings for High-Speed Turbomachinery

NASA Technical Reports Server (NTRS)

Edmonds, Brian; DellaCorte, Christopher; Dykas, Brian

2010-01-01

A methodology has been developed for the design and construction of simple foil thrust bearings intended for parametric performance testing and low marginal costs, supporting continued development of oil-free turbomachinery. A bearing backing plate is first machined and surface-ground to produce flat and parallel faces. Partial-arc slots needed to retain the foil components are then machined into the plate by wire electrical discharge machining. Slot thicknesses achievable by a single wire pass are appropriate to accommodate the practical range of foil thicknesses, leaving a small clearance in this hinged joint to permit limited motion. The backing plate is constructed from a nickel-based superalloy (Inconel 718) to allow heat treatment of the entire assembled bearing, as well as to permit hightemperature operation. However, other dimensionally stable materials, such as precipitation-hardened stainless steel, can also be used for this component depending on application. The top and bump foil blanks are cut from stacks of annealed Inconel X-750 foil by the same EDM process. The bump foil has several azimuthal slits separating it into five individual bump strips. This configuration allows for variable bump spacing, which helps to accommodate the effects of the varying surface velocity, thermal crowning, centrifugal dishing, and misalignment. Rectangular tabs on the foil blanks fit into the backing plate slots. For this application, a rather traditional set of conventionally machined dies is selected, and bump foil blanks are pressed into the dies for forming. This arrangement produces a set of bump foil dies for foil thrust bearings that provide for relatively inexpensive fabrication of various bump configurations, and employing methods and features from the public domain.

The Transformation Process in Nurses Caring for Dying Patients.

PubMed

Huang, Ching-Chi; Chen, Jih-Yuan; Chiang, Hsien-Hsien

2016-06-01

Despite the recent increase in attention to end-of-life hospice care, little empirical evidence regarding the process of emotional or mental transformation in caregivers is available. This study explores the transformative process that occurs in nurses because of the spiritual suffering and conflict associated with after caring for dying patients. A phenomenological approach was used to investigate eight nurses (27-40 years old) working in the hospice ward of a medical center in Taipei. Data were collected through open-ended questions using semistructured interviews and were analyzed reflectively. A three-stage transformation in the emotional processes of participants was observed. In the first stage, the participants experienced acute emotional suffering because of facing the death of their patients, potentially exacerbated by their own memories of losing family members. In the second stage, the participants adopted coping strategies to improve self-care. These strategies included attempting to soothe patients, helping patients face or deal with unfulfilled business, and participating in funeral or memorial services. In the third stage, the participants learned to provide better care through emancipatory reflection and a reassertion of responsibilities toward the self, patients, and patient families. After the third stage, the initial emotional impact morphed into a medium for self-strengthening, and participants became more adept at detecting patient needs and at providing care to complete the transformational process fully. Emotional suffering was the primary factor that induced participants to transform their personal and professional selves. Adequate emotional self-management, dialogue with other nurses, and personal reflection are crucial actions that nurses may use to cultivate personal growth, implement ethical practice, interact with other nurses, and engage in personal reflection. Strategies such as caring for patients, implementing reflective nursing practices, focusing on patient needs, and utilizing past experiences enable nurses to develop a heightened sense of responsibility and awareness, thus empowering them to take better care of themselves and their patients.

End-of-life care decisions in the pediatric intensive care unit: roles professionals play

PubMed Central

Michelson, Kelly Nicole; Patel, Rachna; Haber-Barker, Natalie; Emanuel, Linda; Frader, Joel

2014-01-01

Objective Describe the roles and respective responsibilities of pediatric intensive care unit (PICU) health care professionals (HCPs) in end-of-life care decisions faced by PICU parents. Design Retrospective qualitative study Setting University based tertiary care children’s hospital Participants Eighteen parents of children who died in the PICU and 48 PICU HCPs (physicians, nurses, social workers, child-life specialists, chaplains, and case managers). Interventions In depth, semi-structured focus groups and one-on-one interviews designed to explore experiences in end-of-life care decision making. Measurements and Main Results We identified end-of-life care decisions that parents face based on descriptions by parents and HCPs. Participants described medical and non-medical decisions addressed toward the end of a child’s life. From the descriptions, we identified seven roles HCPs play in end-of-life care decisions. The family supporter addresses emotional, spiritual, environmental, relational and informational family needs in a nondirective way. The family advocate helps families articulate their views and needs to HCPs. The information giver provides parents with medical information, identifies decisions or describes available options, and clarifies parents’ understanding. The general care coordinator helps facilitate interactions among HCPs in the PICU, among HCPs from different subspecialty teams, and between HCPs and parents. The decision maker makes or directly influences the defined plan of action. The end-of-life care coordinator organizes and executes functions occurring directly before, during and after dying/death. The point person develops a unique trusting relationship with parents. Conclusions Our results describe a framework for HCPs’ roles in parental end-of-life care decision making in the PICU that includes directive, value-neutral and organizational roles. More research is needed to validate these roles. Actively ensuring attention to these roles during the decision-making process could improve parents’ experiences at the end of a child’s life. PMID:23249788

The role of gender in the association between self-rated health and mortality among older adults in Santiago, Chile: A cohort study

PubMed Central

Moreno, Ximena; Albala, Cecilia; Lera, Lydia; Sánchez, Hugo; Fuentes-García, Alejandra; Dangour, Alan D.

2017-01-01

Background Previous studies on the role of gender in the association between self-rated health and mortality have shown contrasting results. This study was aimed to determine the importance of gender in the association between self-rated health and mortality among older people in Santiago, Chile. Methods A 10 year follow-up of 1066 people aged 60 or more, from the Chilean cohort of the Study of Health, Ageing and Well-Being. Self-rated health was assessed in face to face interviews through a single general question, along with socio-demographic and health status information. Cox proportional hazards and flexible parametric models for survival analyses were employed. Results By the end of follow-up, 30.7% of women and 39.4% of men died. Adjusted hazard ratio of poor self-rated health, compared to good self-rated health, was 1.92(95% CI 1.29–2.86). In models stratified by gender, an increased risk of mortality was observed among women who rated their health as poor (HR = 2.21, 95% CI 1.43–3.40), but not among men (HR = 1.04, 95% CI 0.58–1.86). Age was associated with mortality in both groups; for men, functional limitation and underweight were also risk factors and obesity was a protective factor. Conclusions Compared to older women who rated their health as good, older women who rated their health as poor had a 2 fold increased risk of mortality over the subsequent 10 years. These findings stress the importance of considering a gender perspective into health programmes, including those focused on older people, in order to address the different elements that increase, on the long run, the risk of dying among older women and men. PMID:28719627

Barriers and outcomes: TB patients co-infected with HIV accessing antiretroviral therapy in rural Zambia.

PubMed

Chileshe, Muatale; Bond, Virginia Anne

2010-01-01

The vulnerabilities that underlie barriers faced by the rural poor whilst trying to access and adhere to "free" antiretroviral treatment (ART) demand more attention. This paper highlights barriers that poor rural Zambians co-infected with tuberculosis (TB) and HIV and their households faced in accessing ART between September 2006 and July 2007, and accounts for patient outcomes by the end of TB treatment and (more sporadically) beyond October 2009. The analysis draws on findings from wider anthropological fieldwork on the converging impact of TB, HIV and food insecurity, focusing for the purpose of this paper on ethnographic case-studies of seven newly diagnosed TB patients co-infected with HIV and their six households (one household had two TB patients). Economic barriers included being pushed into deeper poverty by managing TB, rural location, absence of any external assistance, and mustering time and extended funds for transport and "special food" during and beyond the end of TB. In the case of death, funeral costs were astronomical. Social barriers included translocation, broken marriages, a sub-ordinate household position, gender relations, denial, TB/HIV stigma and the difficulty of disclosure. Health facility barriers involved understaffing, many steps, lengthy procedures and inefficiencies (lost blood samples, electricity cuts). By the end of TB treatment, outcomes were mixed; two co-infected patients had died, three had started ART and two had yet to start ART. The three on ART underwent a striking transformation in the short term. By October 2009, two more had died and three were doing well. The study advocates nutritional support and other material support (especially transport funds) for co-infected TB patients until ART is accessed and livelihood regained. More prompt diagnosis of TB and reducing steps and increasing the reach of the ART programme in rural areas are also recommended.

Ethics committees and the changed clinical research environment in India in 2016: A perspective!

PubMed

Davis, Sanish; Sule, Poonam; Bughediwala, Murtuza; Pandya, Vrunda; Sinha, Shilpi

2017-01-01

Institutional and Independent Ethics Committees (ECs) have as their primary mission the protection of human research subjects. The Central Drugs Standard Control Organization has in the period 2013-2016 introduced several new regulations and amendments to existing regulations overseeing the conduct of Research in India. Several of these have direct effect on the functioning of the EC from a review, approval, and oversight mechanism. The Ethics Council of Indian Society for Clinical Research conducted a questionnaire survey among EC members to understand the impact of these changes in their functioning. The domains surveyed included awareness about recent changes/amendments and impacts, serious adverse events (SAEs) and compensation, informed consent and audio-video recording, monitoring and auditing of research, and future working of ECs. Seventy-nine percent of ECs are of the opinion that the new regulations/guidelines will add to their existing burden in the process of review and approval, providing subject protection and research oversight. Even though 68% of ECs stated that they are comfortable with SAE assessment and compensation determination, they state that there is variability in calculation of compensation amount using the formulae. An overwhelming majority (80%) of ECs stated that they were not in favor of centralized EC for providing review, approval, and oversight of clinical studies. Ethics Committees act as local regulator for clinical trials at sites providing Human Subject protection. The survey captures the contemporary issues faced by the ECs and also raises important questions on the ease of doing research, oversight of approved research, and administrative burden on the EC. Recent changes in regulations have on the one hand empowered Ethics committees but brought in challenges in the way that they provide oversight and monitor research carried out at the site.

Model, analysis, and evaluation of the effects of analog VLSI arithmetic on linear subspace-based image recognition.

PubMed

Carvajal, Gonzalo; Figueroa, Miguel

2014-07-01

Typical image recognition systems operate in two stages: feature extraction to reduce the dimensionality of the input space, and classification based on the extracted features. Analog Very Large Scale Integration (VLSI) is an attractive technology to achieve compact and low-power implementations of these computationally intensive tasks for portable embedded devices. However, device mismatch limits the resolution of the circuits fabricated with this technology. Traditional layout techniques to reduce the mismatch aim to increase the resolution at the transistor level, without considering the intended application. Relating mismatch parameters to specific effects in the application level would allow designers to apply focalized mismatch compensation techniques according to predefined performance/cost tradeoffs. This paper models, analyzes, and evaluates the effects of mismatched analog arithmetic in both feature extraction and classification circuits. For the feature extraction, we propose analog adaptive linear combiners with on-chip learning for both Least Mean Square (LMS) and Generalized Hebbian Algorithm (GHA). Using mathematical abstractions of analog circuits, we identify mismatch parameters that are naturally compensated during the learning process, and propose cost-effective guidelines to reduce the effect of the rest. For the classification, we derive analog models for the circuits necessary to implement Nearest Neighbor (NN) approach and Radial Basis Function (RBF) networks, and use them to emulate analog classifiers with standard databases of face and hand-writing digits. Formal analysis and experiments show how we can exploit adaptive structures and properties of the input space to compensate the effects of device mismatch at the application level, thus reducing the design overhead of traditional layout techniques. Results are also directly extensible to multiple application domains using linear subspace methods. Copyright © 2014 Elsevier Ltd. All rights reserved.

Understanding drug-related mortality in released prisoners: a review of national coronial records.

PubMed

Andrews, Jessica Y; Kinner, Stuart A

2012-04-04

The prisoner population is characterised by a high burden of disease and social disadvantage, and ex-prisoners are at increased risk of death following release. Much of the excess mortality can be attributed to an increased risk of unnatural death, particularly from drug overdose; however, relatively few studies have investigated the circumstances surrounding drug-related deaths among released prisoners. This study aimed to explore and compare the circumstances of death for those who died from accidental drug-related causes to those who died from all other reportable causes. A nationwide search of the Australian National Coroners Information System (NCIS) was conducted to identify reportable deaths among ex-prisoners from 2000 to 2007. Using a structured coding form, NCIS records for these cases were interrogated to explore causes and circumstances of death. Coronial records for 388 deceased ex-prisoners were identified. Almost half of these deaths were a result of accidental drug-related causes (45%). The majority of accidental drug-related deaths occurred in a home environment, and poly-substance use at or around the time of death was common, recorded in 72% of drug-related deaths. Ex-prisoners who died of accidental drug-related causes were on average younger and less likely to be Indigenous, born in Australia, married, or living alone at or around the time of death, compared with those who died from all other reportable causes. Evidence of mental illness or self-harm was less common among accidental drug-related deaths, whereas evidence of previous drug overdose, injecting drug use, history of heroin use and history of drug withdrawal in the previous six months were more common. Drug-related deaths are common among ex-prisoners and often occur in a home (vs. public) setting. They are often associated with use of multiple substances at or around the time of death, risky drug-use patterns, and even among this markedly disadvantaged group, extreme social disadvantage. These findings reflect the complex challenges facing prisoners upon release from custody and indicate a need to consider drug overdose within the wider framework of ex-prisoner experiences, so that preventive programmes can be appropriately structured and targeted.

Oncology nurses’ communication challenges with patients and families: A qualitative study

PubMed Central

Banerjee, Smita C.; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A.; Parker, Patricia A.; Bylund, Carma L.

2016-01-01

The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions. PMID:26278636

Enhancing Care of Aged and Dying Prisoners: Is e-Learning a Feasible Approach?

PubMed

Loeb, Susan J; Penrod, Janice; Myers, Valerie H; Baney, Brenda L; Strickfaden, Sophia M; Kitt-Lewis, Erin; Wion, Rachel K

Prisons and jails are facing sharply increased demands in caring for aged and dying inmates. Our Toolkit for Enhancing End-of-life Care in Prisons effectively addressed end-of-life (EOL) care; however, geriatric content was limited, and the product was not formatted for broad dissemination. Prior research adapted best practices in EOL care and aging; but, delivery methods lacked emerging technology-focused learning and interactivity. Our purposes were to uncover current training approaches and preferences and to ascertain the technological capacity of correctional settings to deliver computer-based and other e-learning training. An environmental scan was conducted with 11 participants from U.S. prisons and jails to ensure proper fit, in terms of content and technology capacity, between an envisioned computer-based training product and correctional settings. Environmental scan findings focused on content of training, desirable qualities of training, prominence of "homegrown" products, and feasibility of commercial e-learning. This study identified qualities of training programs to adopt and pitfalls to avoid and revealed technology-related issues to be mindful of when designing computer-based training for correctional settings, and participants spontaneously expressed an interest in geriatrics and EOL training using this learning modality as long as training allowed for tailoring of materials.

"Atypical" chronic wasting disease in PRNP genotype 225FF mule deer.

PubMed

Wolfe, Lisa L; Fox, Karen A; Miller, Michael W

2014-07-01

We compared mule deer (Odocoileus hemionus) of two different PRNP genotypes (225SS, 225FF) for susceptibility to chronic wasting disease (CWD) in the face of environmental exposure to infectivity. All three 225SS deer had immunohistochemistry (IHC)-positive tonsil biopsies by 710 days postexposure (dpe), developed classic clinical signs by 723-1,200 dpe, and showed gross and microscopic pathology, enzyme-linked immunosorbent assay (ELISA) results, and IHC staining typical of prion disease in mule deer. In contrast, although all three 225FF deer also became infected, the two individuals surviving >720 dpe had consistently negative biopsies, developed more-subtle clinical signs of CWD, and died 924 or 1,783 dpe. The 225FF deer were "suspect" by ELISA postmortem but showed negative or equivocal IHC staining of lymphoid tissues; both clinically affected 225FF deer had spongiform encephalopathy in the absence of IHC staining in the brain tissue. The experimental cases resembled three cases encountered among five additional captive 225FF deer that were not part of our experiment but also died from CWD. Aside from differences in clinical disease presentation and detection, 225FF mule deer also showed other, more-subtle, atypical traits that may help to explain the rarity of this genotype in natural populations, even in the presence of enzootic CWD.

[The corvette "Nordstjernen's" voyage to the opening of the Suez Canal--naval medicine in 1869].

PubMed

Ongre, Aksel; Pettersen, Jan Sommerfelt; Munch, Johan Storm

2002-06-30

When the Norwegian corvette Nordstjernen was in the North Sea bound for Port Said to be present at the opening of the Suez Canal on 17 November 1869, an officer suffered a rupture of m. triceps brachii when he was drawn into the machinery during a storm. He was put ashore in Harwich; four days after the injury he was hospitalized in Colchester. The voyage was eventful in other ways too. Another officer died from typhoid fever in Ismailia. On the Swedish frigate Vanadis, also present at the opening of the Suez Canal, one of the doctors died from lung infection and was buried in Smyrna; a twelve-feet high column of white marble was taken from the ruins of Aesculap's temple and put on his grave. Denmark was represented by the frigate Sjaelland. During a storm in the North Sea, one seaman fell down on the deck from the foresail yard and suffered contusions and a fracture of the left clavicle. These cases illustrate challenges that faced our ancestors. The accident happened when the ship was in the Netherlands sector of the North Sea as we know it today. Today the Coast Guard could have arranged transport by helicopter and hospitalized the patient in about two hours.

Oncology nurses' communication challenges with patients and families: A qualitative study.

PubMed

Banerjee, Smita C; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A; Parker, Patricia A; Bylund, Carma L

2016-01-01

The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions. Copyright © 2015 Elsevier Ltd. All rights reserved.

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2011 CFR

2011-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2012 CFR

2012-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2014 CFR

2014-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2010 CFR

2010-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2013 CFR

2013-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

The Occupational Cost of Being Illegal in the United States: Legal Status, Job Hazards, and Compensating Differentials1

PubMed Central

Hall, Matthew; Greenman, Emily

2014-01-01

Considerable research and pervasive cultural narratives suggest that undocumented immigrant workers are concentrated in the most dangerous, hazardous, and otherwise unappealing jobs in U.S. labor markets. Yet, owing largely to data limitations, little empirical work has addressed this topic. Using data from the 2004 and 2008 panels of the Survey of Income and Program Participation, we impute legal status for Mexican and Central American immigrants and link their occupations to BLS data on occupational fatalities and occupational hazard data from the Department of Labor to explore racial and legal status differentials on several specific measures of occupational risk. Results indicate that undocumented workers face heightened exposure to numerous dimensions of occupational hazard – including higher levels of physical strain, exposure to heights, and repetitive motions – but are less exposed than native workers to some of the potentially most dangerous environments. We also show that undocumented workers are rewarded less for employment in hazardous settings, receiving low or no compensating differential for working in jobs with high fatality, toxic materials, or exposure to heights. Overall, this study suggests that legal status plays an important role in determining exposure to job hazard and in structuring the wage returns to risky work. PMID:26190867

The Occupational Cost of Being Illegal in the United States: Legal Status, Job Hazards, and Compensating Differentials.

PubMed

Hall, Matthew; Greenman, Emily

2015-01-01

Considerable research and pervasive cultural narratives suggest that undocumented immigrant workers are concentrated in the most dangerous, hazardous, and otherwise unappealing jobs in U.S. labor markets. Yet, owing largely to data limitations, little empirical work has addressed this topic. Using data from the 2004 and 2008 panels of the Survey of Income and Program Participation, we impute legal status for Mexican and Central American immigrants and link their occupations to BLS data on occupational fatalities and occupational hazard data from the Department of Labor to explore racial and legal status differentials on several specific measures of occupational risk. Results indicate that undocumented workers face heightened exposure to numerous dimensions of occupational hazard - including higher levels of physical strain, exposure to heights, and repetitive motions - but are less exposed than native workers to some of the potentially most dangerous environments. We also show that undocumented workers are rewarded less for employment in hazardous settings, receiving low or no compensating differential for working in jobs with high fatality, toxic materials, or exposure to heights. Overall, this study suggests that legal status plays an important role in determining exposure to job hazard and in structuring the wage returns to risky work.

Sustainable business models: systematic approach toward successful ambulatory care pharmacy practice.

PubMed

Sachdev, Gloria

2014-08-15

This article discusses considerations for making ambulatory care pharmacist services at least cost neutral and, ideally, generate a margin that allows for service expansion. The four pillars of business sustainability are leadership, staffing, information technology, and compensation. A key facet of leadership in ambulatory care pharmacy practice is creating and expressing a clear vision for pharmacists' services. Staffing considerations include establishing training needs, maximizing efficiencies, and minimizing costs. Information technology is essential for efficiency in patient care delivery and outcomes assessment. The three domains of compensation are cost savings, pay for performance, and revenue generation. The following eight steps for designing and implementing an ambulatory care pharmacist service are discussed: (1) prepare a needs assessment, (2) analyze existing strengths, weaknesses, opportunities, and threats, (3) analyze service gaps and feasibility, (4) consider financial opportunities, (5) consider stakeholders' interests, (6) develop a business plan, (7) implement the service, and (8) measure outcomes. Potential future changes in national healthcare policy (such as pharmacist provider status and expanded pay for performance) could enhance the opportunities for sustainable ambulatory care pharmacy practice. The key challenges facing ambulatory care pharmacists are developing sustainable business models, determining which services yield a positive return on investment, and demanding payment for value-added services. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Facing fears and sadness: cognitive-behavioral therapy for childhood traumatic grief.

PubMed

Brown, Elissa J; Pearlman, Michelle Y; Goodman, Robin F

2004-01-01

The term childhood traumatic grief (CTG) is being increasingly used to refer to the particular reaction in children that may follow the death of a loved one during a traumatic event. The goal of this case study is to describe the theoretical argument and framework for, as well as a clinical example of, cognitive-behavioral therapy (CBT) for CTG. We present a case of a five-year-old boy whose father, a firefighter, died in the line of duty at the World Trade Center on September 11, 2001. This specific case will highlight the steps of CBT for CTG, the value of assessment during the therapeutic process, and the need to consider developmental and family factors in treatment.

An ethical dilemma: when the family wants the withdrawal of care.

PubMed

Wagle, Rinata K; Ede, Kekoa; Craig, Jana; Bottum, Kathleen

2004-09-01

The ethical principles of beneficence, nonmaleficence, and respect for the dignity and autonomy of the patient provide the moral-ethical foundation for the doctor-patient relationship. However, inability to obtain informed consent in the absence of advance directives as well as conflicting family sentiments can give rise to ethical dilemmas. We present a case of a 59-year-old man who survived a near fatal suicide attempt by shooting himself in the face and whose family communicated their desire for the patient to have medical care withheld. The ethical issues that emerged from this suicide attempt, including the family's perspective on the patient's right to die, are discussed in the context of a consultation-liaison psychiatrist's recommendations to a multi-specialty treatment team.

Bioengineering Kidneys for Transplantation

PubMed Central

Madariaga, Maria Lucia L.; Ott, Harald C.

2014-01-01

One in ten Americans suffer from chronic kidney disease, and close to 90,000 people die each year from causes related to kidney failure. Patients with end-stage renal disease are faced with two options: hemodialysis or transplantation. Unfortunately, the reach of transplantation is limited because of the shortage of donor organs and the need for immunosuppression. Bioengineered kidney grafts theoretically present a novel solution to both problems. Herein we discuss the history of bioengineering organs, the current status of bioengineered kidneys, considerations for the future of the field, and challenges to clinical translation. We hope that by integrating principles of tissue engineering, and stem cell and developmental biology, bioengineered kidney grafts will advance the field of regenerative medicine while meeting a critical clinical need. PMID:25217267