Perpetrators of Domestic Violence Abuse within Intellectual Disability Services: A Hidden Population?

ERIC Educational Resources Information Center

Swift, Charlotte; Waites, Erin; Goodman, Wendy

2018-01-01

Background: Domestic violence abuse (DVA) has been identified by the UK Government as a priority to address. Whilst there is a growing body of research into perpetrators of DVA from the mainstream population, there is scant research into perpetrators of DVA who have an intellectual disability. This lack of an evidence base suggests there may be a…

Exposure to Domestic Violence and Abuse: Evidence of Distinct Physical and Psychological Dimensions.

PubMed

Naughton, Catherine M; O'Donnell, Aisling T; Muldoon, Orla T

2017-05-01

Recent literature on exposure to domestic violence (DV) highlights the need for increased understanding of the dynamics of domestic violence and abuse (DVA). The current aims were to explore whether two separate dimensions, physical and psychological DVA, were evident in adult children's reports of their exposure to DVA in their family of origin, and whether these dimensions affected psychological well-being and perceived satisfaction with emotional support (hereafter referred to as social support satisfaction). Young adults ( N = 465, aged 17-25, 70% female) reported their experiences of DVA as perpetrated by their parents/caregivers, as well as psychological well-being and social support satisfaction, in an online survey. Using confirmatory factor analysis (CFA), we verified the presence of a two-factor model (physical and psychological DVA). Hierarchical linear regression analysis demonstrated the differing impact of these two factors: Specifically, although exposure to psychological DVA (domestic abuse [DA]) was related to reduced psychological well-being, there was no significant effect of exposure to physical DVA (DV). However, mediation analysis suggested the presence of a suppression effect; there was a magnification of the negative relationship between exposure to psychological DA and social support satisfaction when exposure to physical DV was accounted for. Although findings are preliminary, they provide strong evidence to support theoretical arguments regarding the need for future research to conceptualize exposure to DVA in terms of both physical and psychological dimensions. Our findings also highlight that to improve service response and provide effective interventions, it is essential to include exposure to psychological DA in risk assessments of such young adults.

Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention

PubMed Central

Sohal, Alex Hardip; Pathak, Neha; Blake, Sarah; Apea, Vanessa; Berry, Judith; Bailey, Jayne; Griffiths, Chris; Feder, Gene

2018-01-01

Objectives Sexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA). Most sexual health professionals have had minimal DVA training despite English National Institute for Health and Care Excellence recommendations. We sought to determine the feasibility of an evidence-based complex DVA training intervention in female sexual health walk-in services (IRIS ADViSE: Identification and Referral to Improve Safety whilst Assessing Domestic Violence in Sexual Health Environments). Methods An adaptive mixed method pilot study in the female walk-in service of two sexual health clinics. Following implementation and evaluation at site 1, the intervention was refined before implementation at site 2. The intervention comprised electronic prompts, multidisciplinary training sessions, clinic materials and simple referral pathways to IRIS ADViSE advocate-educators (AEs). The pilot lasted 7 weeks at site 1 and 12 weeks at site 2. Feasibility outcomes were to assign a supportive DVA clinical lead, an IRIS ADViSE AE employed by a local DVA service provider, adapt electronic records, develop local referral pathways, assess whether enquiry, identification and referral rates were measurable. Results Both sites achieved all feasibility outcomes: appointing a supportive DVA clinical lead and IRIS ADViSE AE, establishing links with a local DVA provider, adapting electronic records, developing local referral pathways and rates of enquiry, identification and referral were found to be measurable. Site 1: 10% enquiry rate (n=267), 4% identification rate (n=16) and eight AE referrals. Site 2: 61% enquiry rate (n=1090), a 7% identification rate (n=79) and eight AE referrals. Conclusions IRIS ADViSE can be successfully developed and implemented in sexual health clinics. It fulfils

Psychological advocacy toward healing (PATH): study protocol for a randomized controlled trial.

PubMed

Brierley, Gwen; Agnew-Davies, Roxane; Bailey, Jayne; Evans, Maggie; Fackrell, Morgan; Ferrari, Giulia; Hollinghurst, Sandra; Howard, Louise; Howarth, Emma; Malpass, Alice; Metters, Carol; Peters, Tim J; Saeed, Fayeza; Sardhina, Lynnmarie; Sharp, Debbie; Feder, Gene S

2013-07-17

Domestic violence and abuse (DVA), defined as threatening behavior or abuse by adults who are intimate partners or family members, is a key public health and clinical priority. The prevalence of DVA in the United Kingdom and worldwide is high, and its impact on physical and mental health is detrimental and persistent. There is currently little support within healthcare settings for women experiencing DVA. Psychological problems in particular may be difficult to manage outside specialist services, as conventional forms of therapy such as counseling that do not address the violence may be ineffective or even harmful. The aim of this study is to assess the overall effectiveness and cost-effectiveness of a novel psychological intervention tailored specifically for survivors of DVA and delivered by domestic violence advocates based in third-sector organizations. This study is an open, pragmatic, parallel group, individually randomized controlled trial. Women ages 16 years and older experiencing domestic violence are being enrolled and randomly allocated to receive usual DVA agency advocacy support (control) or usual DVA agency support plus psychological intervention (intervention). Those in the intervention group will receive eight specialist psychological advocacy (SPA) sessions weekly or fortnightly, with two follow-up sessions, 1 month and then 3 months later. This will be in addition to any advocacy support sessions each woman receives. Women in the control group will receive usual DVA agency support but no additional SPA sessions. The aim is to recruit 250 women to reach the target sample size. The primary outcomes are psychological well-being and depression severity at 1 yr from baseline, as measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) and the Patient Health Questionnaire (PHQ-9), respectively. Secondary outcome measures include anxiety, posttraumatic stress, severity and frequency of abuse, quality of life and cost

Distal anastomotic vein adjunct usage in infrainguinal prosthetic bypasses.

PubMed

McPhee, James T; Goodney, Philip P; Schanzer, Andres; Shaykevich, Shimon; Belkin, Michael; Menard, Matthew T

2013-04-01

Single-segment saphenous vein remains the optimal conduit for infrainguinal revascularization. In its absence, prosthetic conduit may be used. Existing data regarding the significance of anastomotic distal vein adjunct (DVA) usage with prosthetic grafts are based on small series. This is a retrospective cohort analysis derived from the regional Vascular Study Group of New England as well as the Brigham and Women's hospital database. A total of 1018 infrainguinal prosthetic bypass grafts were captured in the dataset from 73 surgeons at 15 participating institutions. Propensity scoring and 3:1 matching was performed to create similar exposure groups for analysis. Outcome measures of interest included: primary patency, freedom from major adverse limb events (MALEs), and amputation free survival at 1 year as a function of vein patch utilization. Time to event data were compared with the log-rank test; multivariable Cox proportional hazard models were used to evaluate the adjusted association between vein cuff usage and the primary end points. DVA was defined as a vein patch, cuff, or boot in any configuration. Of the 1018 bypass operations, 94 (9.2%) had a DVA whereas 924 (90.8%) did not (no DVA). After propensity score matching, 88 DVAs (25%) and 264 no DVAs (75%) were analyzed. On univariate analysis of the matched cohort, the DVA and no DVA groups were similar in terms of mean age (70.0 vs 69.0; P = .55), male sex (58.0% vs 58.3%; P > .99), and preoperative characteristics such as living at home (93.2% vs 94.3%; P = .79) and independent ambulatory status (72.7% vs 75.7%; P = .64). The DVA and no DVA groups had similar rates of major comorbidities such as hypertension chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and dialysis dependence (P > .05 for all). Likewise, they had similar rates of distal origin grafts (13.6% vs 12.5%; P = .85), critical limb ischemia indications (P = .53), and prior arterial bypass (58% vs 47%; P = .08

General practice clinicians' perspectives on involving and supporting children and adult perpetrators in families experiencing domestic violence and abuse.

PubMed

Larkins, Cath; Drinkwater, Jessica; Hester, Marianne; Stanley, Nicky; Szilassy, Eszter; Feder, Gene

2015-12-01

Government and professional guidance encourages general practice clinicians to identify and refer children who experience domestic violence and abuse (DVA) but there is scant understanding of how general practice clinicians currently work with DVA in families. The study explored general practice clinicians' practice with children and their parents experiencing DVA and reflected on the findings in the light of current research and policy guidelines. Semi-structured interviews with 54 clinicians (42 GPs and 12 practice nurses/nurse practitioners) were conducted across six sites in England. Data were analysed using current literature and emerging themes. Data presented here concern clinicians' perspectives on engaging with family members when a parent discloses that she is experiencing DVA. When a parent disclosed DVA, clinicians were more likely to consider talking to abusive fathers than talking to children about the abuse. Perspectives varied according to whether consultation opportunities arose, risks, consent and confidentiality. Perceptions of 'patienthood', relationships and competence shaped clinicians' engagement. Perpetrators were seen as competent informers and active service users, with potential for accepting advice and support. Clinicians were more hesitant in talking with children. Where this was considered, children tended to be seen as passive informants, only two GPs described direct and ongoing consultations with children and providing them with access to support. Clinicians appear more inclined to engage directly with abusive fathers than children experiencing DVA. Clinician skills and confidence to talk directly with children experiencing DVA, in child sensitive ways, should be developed through appropriate training. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention.

PubMed

Sohal, Alex Hardip; Pathak, Neha; Blake, Sarah; Apea, Vanessa; Berry, Judith; Bailey, Jayne; Griffiths, Chris; Feder, Gene

2018-03-01

Sexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA). Most sexual health professionals have had minimal DVA training despite English National Institute for Health and Care Excellence recommendations. We sought to determine the feasibility of an evidence-based complex DVA training intervention in female sexual health walk-in services (IRIS ADViSE: Identification and Referral to Improve Safety whilst Assessing Domestic Violence in Sexual Health Environments). An adaptive mixed method pilot study in the female walk-in service of two sexual health clinics. Following implementation and evaluation at site 1, the intervention was refined before implementation at site 2. The intervention comprised electronic prompts, multidisciplinary training sessions, clinic materials and simple referral pathways to IRIS ADViSE advocate-educators (AEs). The pilot lasted 7 weeks at site 1 and 12 weeks at site 2. Feasibility outcomes were to assign a supportive DVA clinical lead, an IRIS ADViSE AE employed by a local DVA service provider, adapt electronic records, develop local referral pathways, assess whether enquiry, identification and referral rates were measurable. Both sites achieved all feasibility outcomes: appointing a supportive DVA clinical lead and IRIS ADViSE AE, establishing links with a local DVA provider, adapting electronic records, developing local referral pathways and rates of enquiry, identification and referral were found to be measurable. Site 1: 10% enquiry rate (n=267), 4% identification rate (n=16) and eight AE referrals. Site 2: 61% enquiry rate (n=1090), a 7% identification rate (n=79) and eight AE referrals. IRIS ADViSE can be successfully developed and implemented in sexual health clinics. It fulfils the unmet need for DVA training. Longer

Psychological advocacy toward healing (PATH): study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Domestic violence and abuse (DVA), defined as threatening behavior or abuse by adults who are intimate partners or family members, is a key public health and clinical priority. The prevalence of DVA in the United Kingdom and worldwide is high, and its impact on physical and mental health is detrimental and persistent. There is currently little support within healthcare settings for women experiencing DVA. Psychological problems in particular may be difficult to manage outside specialist services, as conventional forms of therapy such as counseling that do not address the violence may be ineffective or even harmful. The aim of this study is to assess the overall effectiveness and cost-effectiveness of a novel psychological intervention tailored specifically for survivors of DVA and delivered by domestic violence advocates based in third-sector organizations. Methods and study design This study is an open, pragmatic, parallel group, individually randomized controlled trial. Women ages 16 years and older experiencing domestic violence are being enrolled and randomly allocated to receive usual DVA agency advocacy support (control) or usual DVA agency support plus psychological intervention (intervention). Those in the intervention group will receive eight specialist psychological advocacy (SPA) sessions weekly or fortnightly, with two follow-up sessions, 1 month and then 3 months later. This will be in addition to any advocacy support sessions each woman receives. Women in the control group will receive usual DVA agency support but no additional SPA sessions. The aim is to recruit 250 women to reach the target sample size. The primary outcomes are psychological well-being and depression severity at 1 yr from baseline, as measured by the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) and the Patient Health Questionnaire (PHQ-9), respectively. Secondary outcome measures include anxiety, posttraumatic stress, severity and frequency of abuse

Inter-method agreement in retinal blood vessels diameter analysis between Dynamic Vessel Analyzer and optical coherence tomography.

PubMed

Benatti, Lucia; Corvi, Federico; Tomasso, Livia; Mercuri, Stefano; Querques, Lea; Ricceri, Fulvio; Bandello, Francesco; Querques, Giuseppe

2017-06-01

To analyze the inter-methods agreement in arteriovenous ratio (AVR) evaluation between spectral-domain optical coherence tomography (SD-OCT) and Dynamic Vessel Analyzer (DVA). Healthy volunteers underwent DVA and SD-OCT examination. AVR was measured by SD-OCT using the four external lines of the optic nerve head-centered 7-line cube and by DVA using an automated AVR estimation. The mean AVR was calculated, twice, separately by two independent readers for each tool. Twenty-two eyes of 11 healthy subjects (five women and six men, mean age 35) were included. AVR analysis by DVA showed high inter-observer agreement between reader 1 and 2, and high intra-observer agreement for both reader 1 and reader 2. With regard to AVR analysis on SD-OCT, we found high inter-observer agreement between reader 1 and 2, and low intra-observer agreement for reader 2 but high intra-observer agreement for reader 1. Overall, the mean AVR measured on SD-OCT turned out to be significantly higher than mean AVR measured through DVA (reader 1, 0.9023 ± 0.06 vs 0.8036 ± 0.08; p < 0.001, and reader 2, 0.9067 ± 0.06 vs 0.8083 ± 0.05; p= 0.003). No inter-method agreement in AVR could be detected in the present study due to bias in measurements (shift between DVA and SD-OCT). We found significant difference in the two noninvasive methods for AVR measurement, with a tendency for SD-OCT to overestimate retinal vascular caliber in comparison to DVA. This may be useful for achieving greater accuracy in the evaluation of retinal vessel in ocular as well as systemic diseases.

Use of the Dynamic Visual Acuity Test as a screener for community-dwelling older adults who fall.

PubMed

Honaker, Julie A; Shepard, Neil T

2011-01-01

Adequate function of the peripheral vestibular system, specifically the vestibulo-ocular reflex (VOR; a network of neural connections between the peripheral vestibular system and the extraocular muscles) is essential for maintaining stable vision during head movements. Decreased visual acuity resulting from an impaired peripheral vestibular system may impede balance and postural control and place an individual at risk of falling. Therefore, sensitive measures of the vestibular system are warranted to screen for the tendency to fall, alerting clinicians to recommend further risk of falling assessment and referral to a falling risk reduction program. Dynamic Visual Acuity (DVA) testing is a computerized VOR assessment method to evaluate the peripheral vestibular system during head movements; reduced visual acuity as documented with DVA testing may be sensitive to screen for falling risk. This study examined the sensitivity and specificity of the computerized DVA test with yaw plane head movements for identifying community-dwelling adults (58-78 years) who are prone to falling. A total of 16 older adults with a history of two or more unexplained falls in the previous twelve months and 16 age and gender matched controls without a history of falls in the previous twelve months participated. Computerized DVA with horizontal head movements at a fixed velocity of 120 deg/sec was measured and compared with the Dynamic Gait Index (DGI) a gold standard gait assessment measurement for identifying falling risk. Receiver operating characteristics (ROC) curve analysis and area under the ROC curve (AUC) were used to assess the sensitivity and specificity of the computerized DVA as a screening measure for falling risk as determined by the DGI. Results suggested a link between computerized DVA and the propensity to fall; DVA in the yaw plane was found to be a sensitive (92%) and accurate screening measure when using a cutoff logMAR value of >0.25.

Epileptogenic developmental venous anomaly: insights from simultaneous EEG/fMRI.

PubMed

Scheidegger, Olivier; Wiest, Roland; Jann, Kay; König, Thomas; Meyer, Klaus; Hauf, Martinus

2013-04-01

Developmental venous anomalies (DVAs) are associated with epileptic seizures; however, the role of DVA in the epileptogenesis is still not established. Simultaneous interictal electroencephalogram/functional magnetic resonance imaging (EEG/fMRI) recordings provide supplementary information to electroclinical data about the epileptic generators, and thus aid in the differentiation of clinically equivocal epilepsy syndromes. The main objective of our study was to characterize the epileptic network in a patient with DVA and epilepsy by simultaneous EEG/fMRI recordings. A 17-year-old woman with recently emerging generalized tonic-clonic seizures, and atypical generalized discharges, was investigated using simultaneous EEG/fMRI at the university hospital. Previous high-resolution MRI showed no structural abnormalities, except a DVA in the right frontal operculum. Interictal EEG recordings showed atypical generalized discharges, corresponding to positive focal blood oxygen level dependent (BOLD) correlates in the right frontal operculum, a region drained by the DVA. Additionally, widespread cortical bilateral negative BOLD correlates in the frontal and parietal lobes were delineated, resembling a generalized epileptic network. The EEG/fMRI recordings support a right frontal lobe epilepsy, originating in the vicinity of the DVA, propagating rapidly to both frontal and parietal lobes, as expressed on the scalp EEG by secondary bilateral synchrony. The DVA may be causative of focal epilepsies in cases where no concomitant epileptogenic lesions can be detected. Advanced imaging techniques, such as simultaneous EEG/fMRI, may thus aid in the differentiation of clinically equivocal epilepsy syndromes.

A review on the temporal pattern of deer-vehicle accidents: impact of seasonal, diurnal and lunar effects in cervids.

PubMed

Steiner, Wolfgang; Leisch, Friedrich; Hackländer, Klaus

2014-05-01

The increasing number of deer-vehicle-accidents (DVAs) and the resulting economic costs have promoted numerous studies on behavioural and environmental factors which may contribute to the quantity, spatiotemporal distribution and characteristics of DVAs. Contrary to the spatial pattern of DVAs, data of their temporal pattern is scarce and difficult to obtain because of insufficient accuracy in available datasets, missing standardization in data aquisition, legal terms and low reporting rates to authorities. Literature of deer-traffic collisions on roads and railways is reviewed to examine current understanding of DVA temporal trends. Seasonal, diurnal and lunar peak accident periods are identified for deer, although seasonal pattern are not consistent among and within species or regions and data on effects of lunar cycles on DVAs is almost non-existent. Cluster analysis of seasonal DVA data shows nine distinct clusters of different seasonal DVA pattern for cervid species within the reviewed literature. Studies analyzing the relationship between time-related traffic predictors and DVAs yield mixed results. Despite the seasonal dissimilarity, diurnal DVA pattern are comparatively constant in deer, resulting in pronounced DVA peaks during the hours of dusk and dawn frequently described as bimodal crepuscular pattern. Behavioural aspects in activity seem to have the highest impact in DVAs temporal trends. Differences and variations are related to habitat-, climatic- and traffic characteristics as well as effects of predation, hunting and disturbance. Knowledge of detailed temporal DVA pattern is essential for prevention management as well as for the application and evaluation of mitigation measures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Outcomes of an Innovative Evidence-Based Practice Project: Building a Difficult-Access Team in the Emergency Department.

PubMed

Whalen, Madeleine; Maliszewski, Barbara; Sheinfeld, Rebecca; Gardner, Heather; Baptiste, Diana

2018-04-25

Difficult venous access is a common problem in health care-especially in the emergency setting-that relies on quick diagnostics to differentiate patient acuities and administer critical medications. The creation of a dedicated team to address difficult venous access (DVA) is a possible solution to the problems of delayed venous access, yet no studies have been published on implementing such a team in the emergency department. This was a quasi-experimental study in an urban emergency department. Researchers performed chart audits of staff-identified patients with DVA to gather baseline data. A DVA team was subsequently implemented 16 hours a day, 7 days a week. Data were recorded on patients referred to the team and included time, number of IV attempts, and patient characteristics. Baseline data were collected on 53 patients, and postintervention data included 135 patients. The implementation of a DVA team decreased the mean lab order-to-lab completion time by 115 minutes (P < 0.0001). Decreases in the number of attempts were not statistically significant. Patients requiring increased numbers of IV attempts also had many common characteristics including history of multiple attempts, poor skin quality, and IV drug use. The use of a dedicated team for DVA reduces the lag time from physician orders to actionable diagnostics or administration of medication. A dedicated DVA technician is a concrete solution to threats of patient safety, as well as ED crowding, and has the potential to affect both patient- and department-level care. Copyright © 2018 Elsevier Inc. All rights reserved.

Mental health service use: comparing people who served in the military or received Veterans' Affairs benefits and the general population.

PubMed

McGuire, Annabel; Dobson, Annette; Mewton, Louise; Varker, Tracey; Forbes, David; Wade, Darryl

2015-12-01

To compare the lifetime prevalence of affective, anxiety and substance use disorders and the use of mental health services between people who had served in the Australian Defence Force (ADF) or received Department of Veterans' Affairs (DVA) benefits and the general population. The 2007 National Survey of Mental Health and Wellbeing obtained data from a nationally representative household survey of 8,841 respondents. Fewer than 20% of men who had served in the ADF reported receiving benefits from DVA. ADF men were older and more likely to report poorer health than other men. They were 50% more likely to be diagnosed with any lifetime mental disorder, any affective disorder, depression, PTSD, any substance use and alcohol disorder. Almost 90% of women who received DVA benefits had not served in the ADF. DVA women were older, and more likely to report moderate/severe psychological distress and less life satisfaction than other women. There was no evidence of greater lifetime use of mental health services by ADF men or DVA women compared to the general population. Health care providers should ask their patients if they have connections with the military in order to better detect and treat potential mental health problems. © 2015 Public Health Association of Australia.

Effectiveness of off-the-shelf footwear in reducing foot pain in Australian Department of Veterans' Affairs recipients not eligible for medical grade footwear: study protocol for a randomized controlled trial.

PubMed

Menz, Hylton B; Frescos, Nicoletta; Munteanu, Shannon E

2013-04-23

Foot pain is highly prevalent in older people, and in many cases is associated with wearing inadequate footwear. In Australia, the Department of Veterans' Affairs (DVA) covers the costs of medical grade footwear for veterans who have severe foot deformity. However, there is a high demand for footwear by veterans with foot pain who do not meet this eligibility criterion. Therefore, this article describes the design of a randomized controlled trial to evaluate the effectiveness of low cost, off-the-shelf footwear in reducing foot pain in DVA recipients who are currently not eligible for medical grade footwear. One hundred and twenty DVA clients with disabling foot pain residing in Melbourne, Australia, who are not eligible for medical grade footwear will be recruited from the DVA database, and will be randomly allocated to an intervention group or a 'usual care' control group. The intervention group will continue to receive their usual DVA-subsidized podiatry care in addition to being provided with low-cost, supportive footwear (Dr Comfort®, Vasyli Medical, Labrador, Queensland, Australia). The control group will also continue to receive DVA-subsidized podiatry care, but will not be provided with the footwear until the completion of the study. The primary outcome measure will be pain subscale on the Foot Health Status Questionnaire (FHSQ), measured at baseline and 4, 8, 12 and 16 weeks. Secondary outcome measures measured at baseline and 16 weeks will include the function subscale of the FHSQ, the Manchester Foot Pain and Disability Index, the number of DVA podiatry treatments required during the study period, general health-related quality of life (using the Short Form 12® Version 2.0), the number of falls experienced during the follow-up period, the Timed Up and Go test, the presence of hyperkeratotic lesions (corns and calluses), the number of participants using co-interventions to relieve foot pain, and participants' perception of overall treatment effect. Data

Effectiveness of off-the-shelf footwear in reducing foot pain in Australian Department of Veterans’ Affairs recipients not eligible for medical grade footwear: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Foot pain is highly prevalent in older people, and in many cases is associated with wearing inadequate footwear. In Australia, the Department of Veterans’ Affairs (DVA) covers the costs of medical grade footwear for veterans who have severe foot deformity. However, there is a high demand for footwear by veterans with foot pain who do not meet this eligibility criterion. Therefore, this article describes the design of a randomized controlled trial to evaluate the effectiveness of low cost, off-the-shelf footwear in reducing foot pain in DVA recipients who are currently not eligible for medical grade footwear. Methods One hundred and twenty DVA clients with disabling foot pain residing in Melbourne, Australia, who are not eligible for medical grade footwear will be recruited from the DVA database, and will be randomly allocated to an intervention group or a ‘usual care’ control group. The intervention group will continue to receive their usual DVA-subsidized podiatry care in addition to being provided with low-cost, supportive footwear (Dr Comfort®, Vasyli Medical, Labrador, Queensland, Australia). The control group will also continue to receive DVA-subsidized podiatry care, but will not be provided with the footwear until the completion of the study. The primary outcome measure will be pain subscale on the Foot Health Status Questionnaire (FHSQ), measured at baseline and 4, 8, 12 and 16 weeks. Secondary outcome measures measured at baseline and 16 weeks will include the function subscale of the FHSQ, the Manchester Foot Pain and Disability Index, the number of DVA podiatry treatments required during the study period, general health-related quality of life (using the Short Form 12® Version 2.0), the number of falls experienced during the follow-up period, the Timed Up and Go test, the presence of hyperkeratotic lesions (corns and calluses), the number of participants using co-interventions to relieve foot pain, and participants’ perception of

Sports can protect dynamic visual acuity from aging: A study with young and older judo and karate martial arts athletes.

PubMed

Muiños, Mónica; Ballesteros, Soledad

2015-08-01

A major topic of current research in aging has been to investigate ways to promote healthy aging and neuroplasticity in order to counteract perceptual and cognitive declines. The aim of the present study was to investigate the benefits of intensive, sustained judo and karate martial arts training in young and older athletes and nonathletes of the same age for attenuating age-related dynamic visual acuity (DVA) decline. As a target, we used a moving stimulus similar to a Landolt ring that moved horizontally, vertically, or obliquely across the screen at three possible contrasts and three different speeds. The results indicated that (1) athletes had better DVA than nonathletes; (2) the older adult groups showed a larger oblique effect than the younger groups, regardless of whether or not they practiced a martial art; and (3) age modulated the results of sport under the high-speed condition: The DVA of young karate athletes was superior to that of nonathletes, while both judo and karate older athletes showed better DVA than did sedentary older adults. These findings suggest that in older adults, the practice of a martial art in general, rather than the practice of a particular type of martial art, is the crucial thing. We concluded that the sustained practice of a martial art such as judo or karate attenuates the decline of DVA, suggesting neuroplasticity in the aging human brain.

Decision Vulnerability Analysis (DVA) Program

DTIC Science & Technology

2014-05-01

the external entities. For example, the chief financial officer can say that the organization will be buying back stock to make stockholders more...financial success Reichheld (2001) points out that a key component of success is “doing what you say you are going to do.” This applies to...that run counter to the explicit and implicit expectations expressed by the organization (e.g., do as I say , not as I do). Relevant Research Literature

A study of static, kinetic, and dynamic visual acuity in 102 Japanese professional baseball players

PubMed Central

Hoshina, Kohji; Tagami, Yuichi; Mimura, Osamu; Edagawa, Hiroshi; Matsubara, Masao; Nakayama, Teiichi

2013-01-01

Background It seemed that visual functions might have some effects on the performance of baseball players. We measured static, kinetic, and dynamic visual acuity (SVA, KVA, and DVA, respectively) of Japanese professional baseball players to ascertain whether there would be any difference in SVA, KVA, and DVA among player groups stratified according to their performance level. Methods The subjects were 102 male professional baseball players with a mean age of 26 years who were members of a Japanese professional baseball club from 2000 to 2009. They were stratified into three groups according to their performance level: A (players who were on the roster of the top-level team all the time throughout the study period), B (players who were on the roster of the top-level team sometimes but not all the time), and C (players who were never on the roster of the top-level team). They were interviewed for the use of corrective visual aids, and examined for SVA, KVA, and DVA. The measurements of these parameters were compared among groups A, B, and C. We also investigated and analyzed the association of KVA or DVA with player position (pitchers or fielders) and with hand dominance for batting. KVA was compared between the pitchers and the fielders because they each require different playing skills. DVA was compared between the right-handed and the left-handed batters. Results There was no statistically significant difference among groups A, B, and C. There was a statistically significant difference in KVA between the pitchers and the fielders (t-test; P < 0.05) There was no statistically significant difference in DVA between the right-handed and the left-handed batters. Conclusions There was no significant difference in the examined visual functions among player groups with different performance levels. PMID:23569356

Use of administrative records to describe longitudinal patterns of health services use among veterans.

PubMed Central

Williams, B C; Mehr, D R; Fries, B E

1994-01-01

Administrative records of the Department of Veterans Affairs (DVA) and the National Death Index were linked to create a four-year longitudinal database that describes the clinical status, hospital and nursing home use, and mortality for a nationwide cohort of persons admitted to DVA nursing homes (n = 23,039). Using Social Security Numbers as identifiers, the records of only 6% of these persons had logically inconsistent or implausible patterns. Nineteen percent of the remaining records had correctable logical errors. Information on the creation, consistency, and potential uses of this database may prove useful to health services researchers interested in describing longitudinal patterns of health care use across multiple settings within and outside the DVA. PMID:7719818

Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children.

PubMed

Drinkwater, Jessica; Stanley, Nicky; Szilassy, Eszter; Larkins, Cath; Hester, Marianne; Feder, Gene

2017-06-01

Domestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family. To explore how and why general practice clinicians document DVA in families with children. A qualitative interview study using vignettes with GPs and practice nurses (PNs) in England. Semi-structured telephone interviews with 54 clinicians (42 GPs and 12 PNs) were conducted across six sites in England. Data were analysed thematically using a coding frame incorporating concepts from the literature and emerging themes. Most clinicians recognised DVA and its impact on child safeguarding, but struggled to work out the best way to document it. They described tensions among the different roles of the EPR: a legal document; providing continuity of care; information sharing to improve safety; and a patient-owned record. This led to strategies to hide information, so that it was only available to other clinicians. Managing DVA in families with children is complex and challenging for general practice clinicians. National integrated guidance is urgently needed regarding how clinicians should manage the competing roles of the EPR, while maintaining safety of the whole family, especially in the context of online EPRs and patient access. © British Journal of General Practice 2017.

Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children

PubMed Central

Drinkwater, Jessica; Stanley, Nicky; Szilassy, Eszter; Larkins, Cath; Hester, Marianne; Feder, Gene

2017-01-01

Background Domestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family. Aim To explore how and why general practice clinicians document DVA in families with children. Design and setting A qualitative interview study using vignettes with GPs and practice nurses (PNs) in England. Method Semi-structured telephone interviews with 54 clinicians (42 GPs and 12 PNs) were conducted across six sites in England. Data were analysed thematically using a coding frame incorporating concepts from the literature and emerging themes. Results Most clinicians recognised DVA and its impact on child safeguarding, but struggled to work out the best way to document it. They described tensions among the different roles of the EPR: a legal document; providing continuity of care; information sharing to improve safety; and a patient-owned record. This led to strategies to hide information, so that it was only available to other clinicians. Conclusion Managing DVA in families with children is complex and challenging for general practice clinicians. National integrated guidance is urgently needed regarding how clinicians should manage the competing roles of the EPR, while maintaining safety of the whole family, especially in the context of online EPRs and patient access. PMID:28137783

Design and synthesis of multifunctional poly(ethylene glycol)s using enzymatic catalysis for multivalent cancer drug delivery

NASA Astrophysics Data System (ADS)

Seo, Kwang Su

The objective of this research was to design and synthesize multifunctional poly(ethylene glycol)s (PEG)s using enzyme-catalyzed reactions for multivalent targeted drug delivery. Based on computer simulation for optimum folate binding, a four-arm PEG star topology with Mn = 1000 g/mol was proposed. First, a four-functional core based on tetraethylene glycol (TEG) was designed and synthesized using transesterification and Michael addition reactions in the presence of Candida antarctica lipase B (CALB) as a biocatalyst. The four-functional core (HO)2-TEG-(OH)2 core was successfully prepared by the CALB-catalyzed transesterification of vinyl acrylate (VA) with TEG and then Michael addition of diethanolamine to the resulting TEG diacrylate with/without the use of solvent. The functional PEG arms with fluorescein isothiocyanate (FITC) and folic acid (FA) were prepared using both traditional organic chemistry and enzyme-catalyzed reactions. FITC was reacted with the amine group of H2N-PEG-OH in the presence of triethylamine via nucleophilic addition onto the isothiocyanate group. Then, divinyl adipate (DVA) was transesterified with the FITC-PEG-OH product in the presence of CALB to produce the FITC-PEG vinyl ester that will be attached to the four-functional core via CALC-catalyzed transesterification. For the synthesis of FA-PEG vinyl ester arm, DVA was first reacted with PEG-monobenzyl ether (BzPEG-OH) in bulk in the presence of CALB. The BzPEG vinyl ester was then transesterified with 12-bromo-1-dodecanol in the presence of CALB. Finally, BzPEG-Br was attached to FA exclusively in the gamma position using a new method. The thesis also discusses fundamental studies that were carried out in order to get better understanding of enzyme catalyzed transesterification and Michael addition reactions. First, in an effort to investigate the effects of reagent and enzyme concentrations in transesterification, vinyl methacrylate (VMA) was reacted with 2-(hydroxyethyl) acrylate (2

The Use of Dynamic Visual Acuity as a Functional Test of Gaze Stabilization Following Space Flight

NASA Technical Reports Server (NTRS)

Peters, B. T.; Mulavara, A. P.; Brady, R.; Miller, C. A.; Richards, J. T.; Warren, L. E.; Cohen, H. S.; Bloomberg, J. J.

2006-01-01

After prolonged exposure to a given gravitational environment the transition to another is accompanied by adaptations in the sensorimotor subsystems, including the vestibular system. Variation in the adaptation time course of these subsystems, and the functional redundancies that exist between them make it difficult to accurately assess the functional capacity and physical limitations of astro/cosmonauts using tests on individual subsystems. While isolated tests of subsystem performance may be the only means to address where interventions are required, direct measures of performance may be more suitable for assessing the operational consequences of incomplete adaptation to changes in the gravitational environment. A test of dynamic visual acuity (DVA) is currently being used in the JSC Neurosciences Laboratory as part of a series of measures to assess the efficacy of a countermeasure to mitigate postflight locomotor dysfunction. In the current protocol, subjects visual acuity is determined using Landolt ring optotypes presented sequentially on a computer display. Visual acuity assessments are made both while standing and while walking at 1.8 m/s on a motorized treadmill. The use of a psychophysical threshold detection algorithm reduces the required number of optotype presentations and the results can be presented immediately after the test. The difference between the walking and standing acuity measures provides a metric of the change in the subject s ability to maintain gaze fixation on the visual target while walking. This functional consequence is observable regardless of the underlying subsystem most responsible for the change. Data from 15 cosmo/astronauts have been collected following long-duration (approx. 6 months) stays in space using a visual target viewing distance of 4.0 meters. An investigation of the group mean shows a change in DVA soon after the flight that asymptotes back to baseline approximately one week following their return to earth. The

Assessing for domestic violence in sexual health environments: a qualitative study.

PubMed

Horwood, Jeremy; Morden, Andrew; Bailey, Jayne E; Pathak, Neha; Feder, Gene

2018-03-01

Domestic violence and abuse (DVA) is a major clinical challenge and public health issue. Sexual health services are an important potential site of DVA intervention. The Assessing for Domestic Violence in Sexual Health Environments (ADViSE) intervention aimed to improve identification and management of DVA in sexual healthcare settings and is a modified version of the Identification and Referral to Improve Safety (IRIS) general practice programme. Our qualitative evaluation aimed to explore the experiences of staff participating in an IRIS ADViSE pilot. Interviews were conducted with 17 sexual health clinic staff and DVA advocate workers. Interviews were audio recorded, transcribed, anonymised and analysed thematically. Staff prioritised enquiring about DVA and tailored their style of enquiry to the perceived characteristics of patients, current workload and individual clinical judgements. Responding to disclosures of abuse was divided between perceived low-risk cases (with quick onwards referral) and high-risk cases (requiring deployment of institution safeguarding procedures), which were viewed as time consuming and could create tensions with patients. Ongoing training and feedback, commissioner recognition, adequate service-level agreements and reimbursements are required to ensure sustainability and wider implementation of IRIS ADViSE. Challenges of delivering and sustaining IRIS ADViSE included the varied styles of enquiry, as well as tensions and additional time pressure arising from disclosure of abuse. These can be overcome by modifying initial training, providing regular updates and stronger recognition (and resources) at policy and commissioning levels. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Bolden STEM Event

NASA Image and Video Library

2011-01-28

NASA Administrator Charles Bolden speaks to students from Albert Hill Middle School during a visit to the MathScience Innovation Center, Friday, Jan. 28, 2011, in Richmond, Va., as U.S. Sen. Mark Warner, D-Va., U.S. Rep. Bobby Scott, D-Va., seated, look on. During his talk, Administrator Bolden highlighted the importance of science, technology, engineering and math, or STEM, as he shared his life experiences with the students. (Photo Credit:NASA/Paul E. Alers)

Bolden STEM Event

NASA Image and Video Library

2011-01-28

NASA Administrator Charles Bolden, right, shares a laugh with U.S. Sen. Mark Warner, D-Va., center and U.S. Rep. Bobby Scott, D-Va., prior to an event at the MathScience Innovation Center, Friday, Jan. 28, 2011, in Richmond, Va. Bolden later spoke to students from Albert Hill Middle School highlighting the importance of science, technology, engineering and math, or STEM, as he shared his life experiences with the students. (Photo Credit:NASA/Paul E. Alers)

Vestibular Assessments in Children With Global Developmental Delay: An Exploratory Study.

PubMed

Dannenbaum, Elizabeth; Horne, Victoria; Malik, Farwa; Villeneuve, Myriam; Salvo, Lora; Chilingaryan, Gevorg; Lamontagne, Anouk

2016-01-01

To compare results of 3 clinical vestibular tests between children with global developmental delay (GDD) and children with typical development (TD) and investigate the test-retest reliability. Twenty children with GDD (aged 4.1-12.1 years) and 11 age-matched controls with TD participated. Participants with GDD underwent 2 sessions of testing. Each session consisted of the Clinical Test of Sensory Interaction and Balance (CTSIB), Dynamic Visual Acuity (DVA) test, and the modified Emory Clinical Vestibular Chair Test (m-ECVCT). Up to 33% of the children with GDD had abnormal DVA scores. m-ECVCT results of children with GDD demonstrated larger variance than children with TD. The CTSIB score was significantly reduced in the group with GDD. The test-retest reliability varied, with good reliability for the m-ECVCT and CTSIB, and fair reliability for the DVA. Findings suggest vestibular involvement in children in GDD. The clinical tests demonstrated moderate test-retest reliability.

Predicting the 'where' and resolving the 'what' of a moving target: a dichotomy of abilities.

PubMed

Long, G M; Vogel, C A

1998-01-01

Anticipation timing (AT) and dynamic visual acuity (DVA) were assessed in a group of college students (n = 60) under a range of velocity and duration conditions. Subjects participated in two identical sessions 1 week apart. Consistently with previous work, DVA performance worsened as velocity increased and as target duration decreased; and there was a significant improvement from the first to the second session. In contrast, AT performance improved as velocity increased, whereas no improvement from the first to the second session was indicated; but increasing duration again benefited performance. Correlational analyses comparing DVA and AT did not reveal any systematic relationship between the two visual tasks. A follow-up study with different instructions on the AT task revealed the same pattern of AT performance, suggesting the generalizability of the obtained stimulus relationships for the AT task. The importance of the often-overlooked role of stimulus variables on the AT task is discussed.

Bolden STEM Event

NASA Image and Video Library

2011-01-28

NASA Administrator Charles Bolden, right, counts down along with others as U.S. Sen. Mark Warner, D-Va., readies to launch a paper rocket as U.S. Rep. Bobby Scott, D-Va., third right, looks on, Friday, Jan. 28, 2011, at the MathScience Innovation Center in Richmond, Va. Earlier, Bolden, spoke to students from Albert Hill Middle School where he highlighted the importance of science, technology, engineering and math, or STEM, as he shared his life experiences with the students. (Photo Credit:NASA/Paul E. Alers)

Experimental studies of tuned particle damper: Design and characterization

NASA Astrophysics Data System (ADS)

Zhang, Kai; Xi, Yanhui; Chen, Tianning; Ma, Zhihao

2018-01-01

To better suppress the structural vibration in the micro vibration and harsh environment, a new type of damper, tuned particle damper (TPD), was designed by combining the advantage of classical dynamic vibration absorber (DVA) and particle damper (PD). An equivalent theoretical model was established to describe the dynamic behavior of a cantilever system treated with TPD. By means of a series of sine sweep tests, the dynamic characteristic of TPD under different excitation intensity was explored and the damping performance of TPD was investigated by comparing with classical DVA and PD with the same mass ratio. Experimental results show that with the increasing of excitation intensity TPD shows two different dynamic characteristics successively, i.e., PD-like and DVA-like. TPD shows a wider suppression frequency band than classical DVA and better practicability than PD in the micro vibration environment. Moreover, to characterize the dynamic characteristic of TPD, a simple evaluation of the equivalent dynamic mass and equivalent dynamic damping of the cantilever system treated with TPD was performed by fitting the experimental data to the presented theoretical model. Finally, based on the rheology behaviors of damping particles reported by the previous research results, an approximate phase diagram which shows the motion states of damping particles in TPD was employed to analyze the dynamic characteristic of TPD and several motion states of damping particles in TPD were presented via a high-speed camera.

Fog scavenging of organic and inorganic aerosol in the Po Valley

NASA Astrophysics Data System (ADS)

Gilardoni, S.; Massoli, P.; Giulianelli, L.; Rinaldi, M.; Paglione, M.; Pollini, F.; Lanconelli, C.; Poluzzi, V.; Carbone, S.; Hillamo, R.; Russell, L. M.; Facchini, M. C.; Fuzzi, S.

2014-07-01

The interaction of aerosol with atmospheric water affects the processing and wet removal of atmospheric particles. Understanding such interaction is mandatory to improve model description of aerosol lifetime and ageing. We analyzed the aerosol-water interaction at high relative humidity during fog events in the Po Valley within the framework of the Agenzia Regionale per la Prevenzione e l'Ambiente (ARPA) - Emilia Romagna supersite project. For the first time in this area, the changes in particle chemical composition caused by fog are discussed along with changes in particle microphysics. During the experiment, 14 fog events were observed. The average mass scavenging efficiency was 70% for nitrate, 68% for ammonium, 61% for sulfate, 50% for organics, and 39% for black carbon. After fog formation, the interstitial aerosol was dominated by particles smaller than 200 nm Dva (vacuum aerodynamic diameter) and enriched in carbonaceous aerosol, mainly black carbon and water-insoluble organic aerosol. For each fog event, the size-segregated scavenging efficiency of nitrate and organic aerosol (OA) was calculated by comparing chemical species size distribution before and after fog formation. For both nitrate and OA, the size-segregated scavenging efficiency followed a sigmoidal curve, with values close to zero below 100 nm Dva and close to 1 above 700 nm Dva. OA was able to affect scavenging efficiency of nitrate in particles smaller than 300 nm Dva. A linear correlation between nitrate scavenging and particle hygroscopicity (κ) was observed, indicating that 44-51% of the variability of nitrate scavenging in smaller particles (below 300 nm Dva) was explained by changes in particle chemical composition. The size-segregated scavenging curves of OA followed those of nitrate, suggesting that organic scavenging was controlled by mixing with water-soluble species. In particular, functional group composition and OA elemental analysis indicated that more oxidized OA was scavenged

Analytically optimal parameters of dynamic vibration absorber with negative stiffness

NASA Astrophysics Data System (ADS)

Shen, Yongjun; Peng, Haibo; Li, Xianghong; Yang, Shaopu

2017-02-01

In this paper the optimal parameters of a dynamic vibration absorber (DVA) with negative stiffness is analytically studied. The analytical solution is obtained by Laplace transform method when the primary system is subjected to harmonic excitation. The research shows there are still two fixed points independent of the absorber damping in the amplitude-frequency curve of the primary system when the system contains negative stiffness. Then the optimum frequency ratio and optimum damping ratio are respectively obtained based on the fixed-point theory. A new strategy is proposed to obtain the optimum negative stiffness ratio and make the system remain stable at the same time. At last the control performance of the presented DVA is compared with those of three existing typical DVAs, which were presented by Den Hartog, Ren and Sims respectively. The comparison results in harmonic and random excitation show that the presented DVA in this paper could not only reduce the peak value of the amplitude-frequency curve of the primary system significantly, but also broaden the efficient frequency range of vibration mitigation.

A Conserved Dopamine-Cholecystokinin Signaling Pathway Shapes Context–Dependent Caenorhabditis elegans Behavior

PubMed Central

Bhattacharya, Raja; Touroutine, Denis; Barbagallo, Belinda; Climer, Jason; Lambert, Christopher M.; Clark, Christopher M.; Alkema, Mark J.; Francis, Michael M.

2014-01-01

An organism's ability to thrive in changing environmental conditions requires the capacity for making flexible behavioral responses. Here we show that, in the nematode Caenorhabditis elegans, foraging responses to changes in food availability require nlp-12, a homolog of the mammalian neuropeptide cholecystokinin (CCK). nlp-12 expression is limited to a single interneuron (DVA) that is postsynaptic to dopaminergic neurons involved in food-sensing, and presynaptic to locomotory control neurons. NLP-12 release from DVA is regulated through the D1-like dopamine receptor DOP-1, and both nlp-12 and dop-1 are required for normal local food searching responses. nlp-12/CCK overexpression recapitulates characteristics of local food searching, and DVA ablation or mutations disrupting muscle acetylcholine receptor function attenuate these effects. Conversely, nlp-12 deletion reverses behavioral and functional changes associated with genetically enhanced muscle acetylcholine receptor activity. Thus, our data suggest that dopamine-mediated sensory information about food availability shapes foraging in a context-dependent manner through peptide modulation of locomotory output. PMID:25167143

A neuropeptide-mediated stretch response links muscle contraction to changes in neurotransmitter release

PubMed Central

Hu, Zhitao; Pym, Edward C.G.; Babu, Kavita; Vashlishan Murray, Amy B.; Kaplan, Joshua M.

2011-01-01

Although C. elegans has been utilized extensively to study synapse formation and function, relatively little is known about synaptic plasticity in C. elegans. We show that a brief treatment with the cholinesterase inhibitor aldicarb induces a form of presynaptic potentiation whereby ACh release at neuromuscular junctions (NMJs) is doubled. Aldicarb-induced potentiation was eliminated by mutations that block processing of pro-neuropeptides, by mutations inactivating a single pro-neuropeptide (NLP-12), and by those inactivating an NLP-12 receptor (CKR-2). NLP-12 expression is limited to a single stretch-activated neuron, DVA. Analysis of a YFP-tagged NLP-12 suggests that aldicarb stimulates DVA secretion of NLP-12. Mutations disrupting the DVA mechanoreceptor (TRP-4) decreased aldicarb-induced NLP-12 secretion and blocked aldicarb-induced synaptic potentiation. Mutants lacking NLP-12 or CKR-2 have decreased locomotion rates. Collectively, these results suggest that NLP-12 mediates a mechanosensory feedback loop that couples muscle contraction to changes in presynaptic release, thereby providing a mechanism for proprioceptive control of locomotion. PMID:21745640

Stroboscopic Goggles as a Countermeasure for Dynamic Visual Acuity and Landing Sickness in Crewmembers Returning from Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Rosenberg, M. J. F.; Kreutzberg, G. A.; Peters, B. T.; Reschke, M. F.

2017-01-01

Long-term exposure to microgravity causes sensorimotor adaptations that result in functional deficits upon returning to a gravitational environment. At landing, the vestibular system and the central nervous system, responsible for coordinating head and eye movements via the vestibulo-occular reflex (VOR), are adapted to microgravity and must re-adapt to the Earth's gravitational environment. This re-adaptation causes decrements in gaze control and dynamic visual acuity, with astronauts reporting oscillopsia and blurred vision. These effects are caused by retinal slip, or the inability to keep an image focused on their retina, which is thought to drive motion sickness symptoms experienced upon landing. Retinal slip can be estimated by dynamic visual acuity (DVA); visual acuity while in motion. Peters et al. (2011) find that DVA is worsened in astronauts by an average of 0.75 eye-chart lines one day after landing. Previously, the use of stroboscopic goggles has shown to be effective in minimizing motion sickness symptoms due to retinal slip (Reschke et al. 2007). In this study, we simulated the decrement in DVA caused by sensorimotor re-adaptation by using minifying lenses and then testing the efficacy of stroboscopic goggles in preventing retinal slip and improving DVA. Dynamic visual acuity is assessed using an oscillating chair developed in the Neuroscience Laboratory at JSC. This chair is motor-driven and oscillates vertically at 2 Hz with a vertical displacement of +/- 2 cm to simulate the vertical translations that occur while walking. As the subject is being oscillated, they are asked to discern the direction of Landolt-C optotypes of varying sizes and record their direction using a gamepad. The visual acuity thresholds are determined using an algorithm that alters the size of the optotype based on the previous responses of the subject using a forced-choice best parameter estimation that is able to rapidly converge on the threshold value. Visual acuity

Vestibular function assessment using the NIH Toolbox

PubMed Central

Schubert, Michael C.; Whitney, Susan L.; Roberts, Dale; Redfern, Mark S.; Musolino, Mark C.; Roche, Jennica L.; Steed, Daniel P.; Corbin, Bree; Lin, Chia-Cheng; Marchetti, Greg F.; Beaumont, Jennifer; Carey, John P.; Shepard, Neil P.; Jacobson, Gary P.; Wrisley, Diane M.; Hoffman, Howard J.; Furman, Gabriel; Slotkin, Jerry

2013-01-01

Objective: Development of an easy to administer, low-cost test of vestibular function. Methods: Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was completed to identify and develop appropriate software and hardware. More than 300 subjects between the ages of 3 and 85 years, with and without vestibular dysfunction, were recruited and tested. Currently accepted gold standard measures of static visual acuity, vestibular function, dynamic visual acuity, and balance were performed to determine validity. Repeat testing was performed to examine reliability. Results: The DVA and BAM tests are affordable and appropriate for use for individuals 3 through 85 years of age. The DVA had fair to good reliability (0.41–0.94) and sensitivity and specificity (50%–73%), depending on age and optotype chosen. The BAM test was moderately correlated with center of pressure (r = 0.42–0.48) and dynamic posturography (r = −0.48), depending on age and test condition. Both tests differentiated those with and without vestibular impairment and the young from the old. Each test was reliable. Conclusion: The newly created DVA test provides a valid measure of visual acuity with the head still and moving quickly. The novel BAM is a valid measure of balance. Both tests are sensitive to age-related changes and are able to screen for impairment of the vestibular system. PMID:23479540

Validation of a Manually Oscillating Chair for In-The-Field Assessment of Dynamic Visual Acuity on Crewmembers Within Hours of Returning From Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Kreutzberg, G. A.; Rosenberg, M. J. F.; Peters, B. T.; Reschke,M. F.

2017-01-01

Long-duration spaceflight results in sensorimotor adaptations, which cause functional deficits during gravitational transitions, such as landing on a planetary surface after long-duration microgravity exposure. Both the vestibular system and the central nervous system are affected by gravitational transitions. These systems are responsible for coordinating head and eye movements via the vestibulo-ocular reflex (VOR) and go through an adaptation period upon exposure to microgravity. Consequently, they must also re-adapt to Earth's gravitational environment upon landing. This re-adaptation causes decrements in gaze control and dynamic visual acuity, with crewmembers reporting oscillopsia and blurred vision caused by retinal slip, or the inability to keep an image focused on their retina. This is thought to drive motion sickness symptoms experienced by most crewmembers following landing. Retinal slip can be estimated by dynamic visual acuity (DVA); visual acuity while in motion. Previously, DVA has been assessed in the laboratory where subjects walked at 6.4 km/hr on a motorized treadmill. Using this method, Peters et al. (2011) found that DVA is worsened in astronauts by an average of 0.75 eye-chart lines one day after landing. However, it is believed that re-adaptation occurs quickly and that DVA might be worse immediately upon re-exposure to a gravitational environment. Since many crewmembers are unable to walk safely upon landing, it was necessary to develop a method for replicating the vertical head movements associated with walking. In addition, the use of a chair to imitate the head displacement caused by walking isolates eye-head interactions without allowing for trunk and lower-body compensation, as seen with treadmill walking (Mulavara & Bloomberg 2003). Therefore, a modality for assessing DVA in the field within a few hours of landing was developed. In this study, we validated the ability of a manually operated oscillating chair to reproduce the oscillatory

Reduction in Dynamic Visual Acuity Reveals Gaze Control Changes Following Spaceflight

NASA Technical Reports Server (NTRS)

Peters, Brian T.; Brady, Rachel A.; Miller, Chris; Lawrence, Emily L.; Mulavara Ajitkumar P.; Bloomberg, Jacob J.

2010-01-01

INTRODUCTION: Exposure to microgravity causes adaptive changes in eye-head coordination that can lead to altered gaze control. This could affect postflight visual acuity during head and body motion. The goal of this study was to characterize changes in dynamic visual acuity after long-duration spaceflight. METHODS: Dynamic Visual Acuity (DVA) data from 14 astro/cosmonauts were collected after long-duration (6 months) spaceflight. The difference in acuity between seated and walking conditions provided a metric of change in the subjects ability to maintain gaze fixation during self-motion. In each condition, a psychophysical threshold detection algorithm was used to display Landolt ring optotypes at a size that was near each subject s acuity threshold. Verbal responses regarding the orientation of the gap were recorded as the optotypes appeared sequentially on a computer display 4 meters away. During the walking trials, subjects walked at 6.4 km/h on a motorized treadmill. RESULTS: A decrement in mean postflight DVA was found, with mean values returning to baseline within 1 week. The population mean showed a consistent improvement in DVA performance, but it was accompanied by high variability. A closer examination of the individual subject s recovery curves revealed that many did not follow a pattern of continuous improvement with each passing day. When adjusted on the basis of previous long-duration flight experience, the population mean shows a "bounce" in the re-adaptation curve. CONCLUSION: Gaze control during self-motion is altered following long-duration spaceflight and changes in postflight DVA performance indicate that vestibular re-adaptation may be more complex than a gradual return to normal.

Use of the retrograde limb of the internal mammary vein to avoid venous congestion in DIEP flap breast reconstruction: Further evidences of a reliable and time-sparing procedure.

PubMed

La Padula, Simone; Hersant, Barbara; Noel, Warren; Niddam, Jeremy; Hermeziu, Oana; Bouhassira, Jonathan; Bosc, Romain; Meningaud, Jean Paul

2016-09-01

Venous congestion is a common cause of DIEP flap failure. When identified intraoperatively, an additional venous anastomosis can improve the venous outflow and prevent flap failure. The aim of this study was to assess if the retrograde limb of the internal mammary vein (IMV) could be considered a good recipient vessel to be used when persistent flap congestion is present, and a second venous anastomosis is required. A retrospective study was conducted in 74 patients who had undergone DIEP flap breast reconstruction. Patients were classified into two groups: SVA (single venous anastomosis) and DVA (dual venous anastomosis). In the SVA group (n = 38), the IMV antegrade limb was used for venous drainage. A single DIEV (Deep Inferior Epigastric Vein) was anastomosed to the superior arm of the IMV. In the DVA group (n = 36), both the antegrade (superior) and retrograde (inferior) stumps of the IMV were used, connecting the larger DIEV to the antegrade IMV and the other DIEV or the SIEV (Superficial Inferior Epigastric Vein) to the IMV retrograde limb. No venous congestion or flap loss was observed when two venous anastomoses were performed using both the IMV antegrade and retrograde limbs (P = 0.3271). In the DVA group, no major complication occurred (P = 0.0453). Operative explorations were significantly reduced in the DVA group (P = 0.0242). These findings suggest that when an additional venous outflow is required, the use of the IMV retrograde limb may help to avoid flap venous congestion. © 2016 Wiley Periodicals, Inc. Microsurgery 36:447-452, 2016. © 2016 Wiley Periodicals, Inc.

Motion perception and driving: predicting performance through testing and shortening braking reaction times through training.

PubMed

Wilkins, Luke; Gray, Rob; Gaska, James; Winterbottom, Marc

2013-12-30

A driving simulator was used to examine the relationship between motion perception and driving performance. Although motion perception test scores have been shown to be related to driving safety, it is not clear which combination of tests are the best predictors and whether motion perception training can improve driving performance. In experiment 1, 60 younger drivers (22.4 ± 2.5 years) completed three motion perception tests (2-dimensional [2D] motion-defined letter [MDL] identification, 3D motion in depth sensitivity [MID], and dynamic visual acuity [DVA]) followed by two driving tests (emergency braking [EB] and hazard perception [HP]). In experiment 2, 20 drivers (21.6 ± 2.1 years) completed 6 weeks of motion perception training (using the MDL, MID, and DVA tests), while 20 control drivers (22.0 ± 2.7 years) completed an online driving safety course. The EB performance was measured before and after training. In experiment 1, MDL (r = 0.34) and MID (r = 0.46) significantly correlated with EB score. The change in DVA score as a function of target speed (i.e., "velocity susceptibility") was correlated most strongly with HP score (r = -0.61). In experiment 2, the motion perception training group had a significant decrease in brake reaction time on the EB test from pre- to posttreatment, while there was no significant change for the control group: t(38) = 2.24, P = 0.03. Tests of 3D motion perception are the best predictor of EB, while DVA velocity susceptibility is the best predictor of hazard perception. Motion perception training appears to result in faster braking responses.

Mass-Mobility Characterization of Flame-made ZrO2 Aerosols: Primary Particle Diameter & Extent of Aggregation

PubMed Central

Eggersdorfer, M.L.; Gröhn, A.J.; Sorensen, C.M.; McMurry, P.H.; Pratsinis, S.E.

2013-01-01

Gas-borne nanoparticles undergoing coagulation and sintering form irregular or fractal-like structures affecting their transport, light scattering, effective surface area and density. Here, zirconia (ZrO2) nanoparticles are generated by scalable spray combustion, and their mobility diameter and mass are obtained nearly in-situ by differential mobility analyzer (DMA) and aerosol particle mass (APM) measurements. Using these data, the density of ZrO2 and a power law between mobility and primary particle diameters, the structure of fractal-like particles is determined (mass-mobility exponent, prefactor and average number and surface area mean diameter of primary particles, dva). The dva determined by DMA-APM measurements and this power law is in good agreement with the dva obtained by ex-situ nitrogen adsorption and microscopic analysis. Using this combination of measurements and above power law, the effect of flame spray process parameters (e.g. precursor solution and oxygen flow rate as well as zirconium concentration) on fractal-like particle structure characteristics is investigated in detail. This reveals that predominantly agglomerates (physically-bonded particles) and aggregates (chemically- or sinter-bonded particles) of nanoparticles are formed at low and high particle concentrations, respectively. PMID:22959835

Does government subsidy for costs of medical and pharmaceutical services result in higher service utilization by older widowed women in Australia?

PubMed

Tooth, Leigh R; Hockey, Richard; Treloar, Susan; McClintock, Christine; Dobson, Annette

2012-06-27

In Australia, Medicare, the national health insurance system which includes the Medical Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS), provides partial coverage for most medical services and pharmaceuticals. For war widows, the Department of Veterans' Affairs (DVA) covers almost the entire cost of their health care. The objective of this study was to test whether war widows have higher usage of medical services and pharmaceuticals. Data were from 730 women aged 70-84 years (mostly World War II widows) participating in the Australian Longitudinal Study on Women's Health who consented to data linkage to Medicare Australia. The main outcome measures were PBS costs, claims, co-payments and scripts presented, and MBS total costs, claims and gap payments for medical services in 2005. There was no difference between the war widows and similarly aged widows in the Australian population without DVA support on use of medical services. While war widows had more pharmaceutical prescriptions filled they generated equivalent total costs, number of claims and co-payments for pharmaceuticals than widows without DVA support. Older war widows are not using more medical services and pharmaceuticals than other older Australian women despite having financial incentives to do so.

Occurrence and impact of negative behaviour, including domestic violence and abuse, in men attending UK primary care health clinics: a cross-sectional survey

PubMed Central

Hester, M; Ferrari, G; Jones, S K; Williamson, E; Bacchus, L J; Peters, T J; Feder, G

2015-01-01

Objective To measure the experience and perpetration of negative behaviour, including domestic violence and abuse (DVA), and investigate its associations with health conditions and behaviours in men attending general practice. Design Cross-sectional questionnaire-based study conducted between September 2010 and June 2011. Setting 16 general practices in the south west of England. Participants Male patients aged 18 or older, attending alone, who could read and write English. A total of 1403 of eligible patients (58%) participated in the survey and 1368 (56%) completed the questions relevant to this paper. 97% of respondents reported they were heterosexual. Main outcome measures Lifetime occurrence of negative behaviour consistent with DVA, perceived health impact of negative behaviours, associations with anxiety and depression symptoms, and cannabis use in the past 12 months and binge drinking. Results 22.7% (95% CI 20.2% to 24.9%) of men reported ever experiencing negative behaviour (feeling frightened, physically hurt, forced sex, ask permission) from a partner. All negative behaviours were associated with a twofold to threefold increased odds of anxiety and depression symptoms in men experiencing or perpetrating negative behaviours or both. 34.9% (95% CI 28.7% to 41.7%) of men who reported experiencing negative behaviour from a partner, and 30.8% (95% CI 23.7% to 37.8%) of men who perpetrated negative behaviours said they had been in a domestically violent or abusive relationship. No associations with problematic drinking were found; there was a weak association with cannabis use. Conclusions DVA is experienced or perpetrated by a large minority of men presenting to general practice, and these men were more likely to have current symptoms of depression and anxiety. Presentation of anxiety or depression to clinicians may be an indicator of male experience or perpetration of DVA victimisation. PMID:25991450

Crystalens HD intraocular lens analysis using an adaptive optics visual simulator.

PubMed

Pérez-Vives, Cari; Montés-Micó, Robert; López-Gil, Norberto; Ferrer-Blasco, Teresa; García-Lázaro, Santiago

2013-12-01

To compare visual and optical quality of the Crystalens HD intraocular lens (IOL) with that of a monofocal IOL. The wavefront aberration patterns of the monocular Akreos Adapt AO IOL and the single-optic accommodating Crystalens HD IOL were measured in a model eye. The Crystalens IOL was measured in its nonaccommodative state and then, after flexing the haptic to produce 1.4 mm of movement, in its accommodative state. Using an adaptive optics system, subjects' aberrations were removed and replaced with those of pseudophakes viewing with either lens. Monocular distance visual acuity (DVA) at high (100%), medium (50%), and low (10%) contrast and contrast sensitivity (CS) were measured for both IOL optics. Near VA (NVA) and CS were measured for the Crystalens HD IOL in its accommodative state. Depth of focus around the distance and near focus was also evaluated for the Crystalens HD IOL. Modulation transfer function (MTF), point spread function (PSF), and Strehl ratio were also calculated. All measures were taken for 3- and 5-mm pupils. The MTF, PSF, and Strehl ratio showed comparable values between IOLs (p > 0.05). There were no significant differences in DVA and CS between IOLs for all contrasts and pupils (p > 0.05). When spherically focused, mean DVA and NVA with the Crystalens HD IOL were ≥20/20 at 100 and 50% contrasts for both pupils. Monocular DVA, NVA, and CS were slightly better with 3- than 5-mm pupils, but without statistically significant differences. The Crystalens HD IOL showed about 0.75 and 0.50 D of depth of focus in its accommodative state and nonaccommodative state, respectively. The optical and visual quality with the nonaccommodatied Crystalens HD IOL was comparable to that of a monofocal IOL. If this lens can move 1.4 mm in the eye, it will provide high-quality optics for near vision as well.

Comparing sports vision among three groups of soft tennis adolescent athletes: Normal vision, refractive errors with and without correction.

PubMed

Chang, Shih-Tsun; Liu, Yen-Hsiu; Lee, Jiahn-Shing; See, Lai-Chu

2015-09-01

The effect of correcting static vision on sports vision is still not clear. To examine whether sports vision (depth perception [DP], dynamic visual acuity [DVA], eye movement [EM], peripheral vision [PV], and momentary vision [MV],) were different among soft tennis adolescent athletes with normal vision (Group A), with refractive error and corrected with (Group B) and without eyeglasses (Group C). A cross-section study was conducted. Soft tennis athletes aged 10-13 who played softball tennis for 2-5 years, and who were without any ocular diseases and without visual training for the past 3 months were recruited. DPs were measured in an absolute deviation (mm) between a moving rod and fixing rod (approaching at 25 mm/s, receding at 25 mm/s, approaching at 50 mm/s, receding at 50 mm/s) using electric DP tester. A smaller deviation represented better DP. DVA, EM, PV, and MV were measured on a scale from 1 (worse) to 10 (best) using ATHLEVISION software. Chi-square test and Kruskal-Wallis test was used to compare the data among the three study groups. A total of 73 athletes (37 in Group A, 8 in Group B, 28 in Group C) were enrolled in this study. All four items of DP showed significant difference among the three study groups (P = 0.0051, 0.0004, 0.0095, 0.0021). PV displayed significant difference among the three study groups (P = 0.0044). There was no significant difference in DVA, EM, and MV among the three study groups. Significant better DP and PV were seen among soft tennis adolescent athletes with normal vision than those with refractive error regardless whether they had eyeglasses corrected. On the other hand, DVA, EM, and MV were similar among the three study groups.

Comparing sports vision among three groups of soft tennis adolescent athletes: Normal vision, refractive errors with and without correction

PubMed Central

Chang, Shih-Tsun; Liu, Yen-Hsiu; Lee, Jiahn-Shing; See, Lai-Chu

2015-01-01

Background: The effect of correcting static vision on sports vision is still not clear. Aim: To examine whether sports vision (depth perception [DP], dynamic visual acuity [DVA], eye movement [EM], peripheral vision [PV], and momentary vision [MV],) were different among soft tennis adolescent athletes with normal vision (Group A), with refractive error and corrected with (Group B) and without eyeglasses (Group C). Setting and Design: A cross-section study was conducted. Soft tennis athletes aged 10–13 who played softball tennis for 2–5 years, and who were without any ocular diseases and without visual training for the past 3 months were recruited. Materials and Methods: DPs were measured in an absolute deviation (mm) between a moving rod and fixing rod (approaching at 25 mm/s, receding at 25 mm/s, approaching at 50 mm/s, receding at 50 mm/s) using electric DP tester. A smaller deviation represented better DP. DVA, EM, PV, and MV were measured on a scale from 1 (worse) to 10 (best) using ATHLEVISION software. Statistical Analysis: Chi-square test and Kruskal–Wallis test was used to compare the data among the three study groups. Results: A total of 73 athletes (37 in Group A, 8 in Group B, 28 in Group C) were enrolled in this study. All four items of DP showed significant difference among the three study groups (P = 0.0051, 0.0004, 0.0095, 0.0021). PV displayed significant difference among the three study groups (P = 0.0044). There was no significant difference in DVA, EM, and MV among the three study groups. Conclusions: Significant better DP and PV were seen among soft tennis adolescent athletes with normal vision than those with refractive error regardless whether they had eyeglasses corrected. On the other hand, DVA, EM, and MV were similar among the three study groups. PMID:26632127

Agent Orange exposure and attributed health effects in Vietnam veterans.

PubMed

Young, Alvin L; Cecil, Paul F

2011-07-01

Serum dioxin studies of Vietnam (VN) veterans, military historical records of tactical herbicide use in Vietnam, and the compelling evidence of the photodegradation of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and other aspects of environmental fate and low bioavailability of TCDD are consistent with few, if any, ground troop veterans being exposed to Agent Orange. That conclusion, however, is contrary to the presumption by the Department of Veterans Affairs (DVA) that military service in Vietnam anytime from January 9, 1962 to May 7, 1975 is a proxy for exposure to Agent Orange. The DVA assumption is inconsistent with the scientific principles governing determinations of disease causation. The DVA has nonetheless awarded Agent Orange-related benefits and compensation to an increasing number of VN veterans based on the presumption of exposure and the published findings of the Institute of Medicine that there is sufficient evidence of a "statistical association" (a less stringent standard than "causal relationship") between exposure to tactical herbicides or TCDD and 15 different human diseases. A fairer and more valid approach for VN veterans would have been to enact a program of "Vietnam experience" benefits for those seriously ill, rather than benefits based on the dubious premise of injuries caused by Agent Orange.

Dynamic visual acuity using "far" and "near" targets

NASA Technical Reports Server (NTRS)

Peters, Brian T.; Bloomberg, Jacob J.

2005-01-01

CONCLUSIONS: DVA may be useful for assessing the functional consequences of an impaired gaze stabilization mechanism or for testing the effectiveness of a rehabilitation paradigm. Because target distance influences the relative contributions of canal and otolith inputs, the ability to measure DVA at near and far viewing distances may also lead to tests that will independently assess canal and otolith function. OBJECTIVE: To present and test a methodology that uses dynamic visual acuity (DVA) to assess the efficacy of compensatory gaze mechanisms during a functionally relevant activity that differentially measures canal and otolith function. MATERIAL AND METHODS: The effect of treadmill walking at a velocity of 1.79 m/s on subjects' visual acuity was assessed at each of two viewing distances. A custom-written threshold determination program was used to display Landolt C optotypes on a laptop computer screen during a "far" (4 m) target condition and on a micro-display for a "near" (50 cm) target condition. The walking acuity scores for each target distance were normalized by subtracting a corresponding acuity measure obtained while standing still on the treadmill belt. RESULTS: As predicted by subjective reports of relative target motion, the decrease in visual acuity was significantly greater (p < 0.00001) for the near compared to the far condition.

Reducing symbolic-violence in the research encounter: collaborating with a survivor of domestic abuse in a qualitative study in UK primary care.

PubMed

Malpass, Alice; Sales, Kim; Feder, Gene

2016-03-01

This paper explores ideas of symbolic violence inherent in the research encounter (Bourdieu 1999). After defining symbolic violence and how the concept enters into domestic violence and abuse (DVA) research, we discuss the challenges arising from a (DVA) survivor taking on the role of interviewer in a qualitative study nested within a UK primary care based trial: IRIS (Identification and Referral to Improve Safety). KS, a survivor of DVA, conducted interviews with 12 women who had been referred to a domestic violence agency by primary care clinicians taking part in the IRIS trial in two UK cities (Bristol and east London) during 2009. Field notes were kept during all of the research meetings with KS and these were included in analysis. Our analysis maps the research pathway of 'non-violent communication' and discusses the role of social symmetry and proximity in the research encounter. We conclude that while a welcoming disposition, empathy and active listening are all generic skills to qualitative research; if a researcher can enter fieldwork with a claim of social proximity and symmetry, their use of these generic skills is enhanced through a process of shared objectification and empowerment talk. We explore the limitations of social proximity, its relationship to feminist and anthropological theories of 'insider' research and its relevance to primary care research. © 2015 Foundation for the Sociology of Health & Illness.

Occurrence and impact of negative behaviour, including domestic violence and abuse, in men attending UK primary care health clinics: a cross-sectional survey.

PubMed

Hester, M; Ferrari, G; Jones, S K; Williamson, E; Bacchus, L J; Peters, T J; Feder, G

2015-05-19

To measure the experience and perpetration of negative behaviour, including domestic violence and abuse (DVA), and investigate its associations with health conditions and behaviours in men attending general practice. Cross-sectional questionnaire-based study conducted between September 2010 and June 2011. 16 general practices in the south west of England. Male patients aged 18 or older, attending alone, who could read and write English. A total of 1403 of eligible patients (58%) participated in the survey and 1368 (56%) completed the questions relevant to this paper. 97% of respondents reported they were heterosexual. Lifetime occurrence of negative behaviour consistent with DVA, perceived health impact of negative behaviours, associations with anxiety and depression symptoms, and cannabis use in the past 12 months and binge drinking. 22.7% (95% CI 20.2% to 24.9%) of men reported ever experiencing negative behaviour (feeling frightened, physically hurt, forced sex, ask permission) from a partner. All negative behaviours were associated with a twofold to threefold increased odds of anxiety and depression symptoms in men experiencing or perpetrating negative behaviours or both. 34.9% (95% CI 28.7% to 41.7%) of men who reported experiencing negative behaviour from a partner, and 30.8% (95% CI 23.7% to 37.8%) of men who perpetrated negative behaviours said they had been in a domestically violent or abusive relationship. No associations with problematic drinking were found; there was a weak association with cannabis use. DVA is experienced or perpetrated by a large minority of men presenting to general practice, and these men were more likely to have current symptoms of depression and anxiety. Presentation of anxiety or depression to clinicians may be an indicator of male experience or perpetration of DVA victimisation. 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.

A new strategic neurosurgical planning tool for brainstem cavernous malformations using interactive computer graphics with multimodal fusion images.

PubMed

Kin, Taichi; Nakatomi, Hirofumi; Shojima, Masaaki; Tanaka, Minoru; Ino, Kenji; Mori, Harushi; Kunimatsu, Akira; Oyama, Hiroshi; Saito, Nobuhito

2012-07-01

In this study, the authors used preoperative simulation employing 3D computer graphics (interactive computer graphics) to fuse all imaging data for brainstem cavernous malformations. The authors evaluated whether interactive computer graphics or 2D imaging correlated better with the actual operative field, particularly in identifying a developmental venous anomaly (DVA). The study population consisted of 10 patients scheduled for surgical treatment of brainstem cavernous malformations. Data from preoperative imaging (MRI, CT, and 3D rotational angiography) were automatically fused using a normalized mutual information method, and then reconstructed by a hybrid method combining surface rendering and volume rendering methods. With surface rendering, multimodality and multithreshold techniques for 1 tissue were applied. The completed interactive computer graphics were used for simulation of surgical approaches and assumed surgical fields. Preoperative diagnostic rates for a DVA associated with brainstem cavernous malformation were compared between conventional 2D imaging and interactive computer graphics employing receiver operating characteristic (ROC) analysis. The time required for reconstruction of 3D images was 3-6 hours for interactive computer graphics. Observation in interactive mode required approximately 15 minutes. Detailed anatomical information for operative procedures, from the craniotomy to microsurgical operations, could be visualized and simulated three-dimensionally as 1 computer graphic using interactive computer graphics. Virtual surgical views were consistent with actual operative views. This technique was very useful for examining various surgical approaches. Mean (±SEM) area under the ROC curve for rate of DVA diagnosis was significantly better for interactive computer graphics (1.000±0.000) than for 2D imaging (0.766±0.091; p<0.001, Mann-Whitney U-test). The authors report a new method for automatic registration of preoperative imaging data

Interventions to Improve the Response of Professionals to Children Exposed to Domestic Violence and Abuse: A Systematic Review.

PubMed

Turner, William; Hester, Marianne; Broad, Jonathan; Szilassy, Eszter; Feder, Gene; Drinkwater, Jessica; Firth, Adam; Stanley, Nicky

2017-01-01

Exposure of children to domestic violence and abuse (DVA) is a form of child maltreatment with short- and long-term behavioural and mental health impact. Health care professionals are generally uncertain about how to respond to domestic violence and are particularly unclear about best practice with regards to children's exposure and their role in a multiagency response. In this systematic review, we report educational and structural or whole-system interventions that aim to improve professionals' understanding of, and response to, DVA survivors and their children. We searched 22 bibliographic databases and contacted topic experts for studies reporting quantitative outcomes for any type of intervention aiming to improve professional responses to disclosure of DVA with child involvement. We included interventions for physicians, nurses, social workers and teachers. Twenty-one studies met the inclusion criteria: three randomised controlled trials (RCTs), 18 pre-post intervention surveys. There were 18 training and three system-level interventions. Training interventions generally had positive effects on participants' knowledge, attitudes towards DVA and clinical competence. The results from the RCTs were consistent with the before-after surveys. Results from system-level interventions aimed to change organisational practice and inter-organisational collaboration demonstrates the benefit of coordinating system change in child welfare agencies with primary health care and other organisations. Implications for policy and research are discussed. © 2015 The Authors. Child Abuse Review published by John Wiley & Sons Ltd. 'We searched 22 bibliographic databases and contacted topic experts'. We reviewed published evidence on interventions aimed at improving professionals' practice with domestic violence survivors and their children.Training programmes were found to improve participants' knowledge, attitudes and clinical competence up to a year after delivery.Key elements of

Interventions to Improve the Response of Professionals to Children Exposed to Domestic Violence and Abuse: A Systematic Review

PubMed Central

Hester, Marianne; Broad, Jonathan; Szilassy, Eszter; Feder, Gene; Drinkwater, Jessica; Firth, Adam; Stanley, Nicky

2015-01-01

Exposure of children to domestic violence and abuse (DVA) is a form of child maltreatment with short‐ and long‐term behavioural and mental health impact. Health care professionals are generally uncertain about how to respond to domestic violence and are particularly unclear about best practice with regards to children's exposure and their role in a multiagency response. In this systematic review, we report educational and structural or whole‐system interventions that aim to improve professionals' understanding of, and response to, DVA survivors and their children. We searched 22 bibliographic databases and contacted topic experts for studies reporting quantitative outcomes for any type of intervention aiming to improve professional responses to disclosure of DVA with child involvement. We included interventions for physicians, nurses, social workers and teachers. Twenty‐one studies met the inclusion criteria: three randomised controlled trials (RCTs), 18 pre‐post intervention surveys. There were 18 training and three system‐level interventions. Training interventions generally had positive effects on participants' knowledge, attitudes towards DVA and clinical competence. The results from the RCTs were consistent with the before‐after surveys. Results from system‐level interventions aimed to change organisational practice and inter‐organisational collaboration demonstrates the benefit of coordinating system change in child welfare agencies with primary health care and other organisations. Implications for policy and research are discussed. © 2015 The Authors. Child Abuse Review published by John Wiley & Sons Ltd. ‘We searched 22 bibliographic databases and contacted topic experts’ Key Practitioner Messages We reviewed published evidence on interventions aimed at improving professionals' practice with domestic violence survivors and their children.Training programmes were found to improve participants' knowledge, attitudes and clinical

Effect of Target Location on Dynamic Visual Acuity During Passive Horizontal Rotation

NASA Technical Reports Server (NTRS)

Appelbaum, Meghan; DeDios, Yiri; Kulecz, Walter; Peters, Brian; Wood, Scott

2010-01-01

The vestibulo-ocular reflex (VOR) generates eye rotation to compensate for potential retinal slip in the specific plane of head movement. Dynamic visual acuity (DVA) has been utilized as a functional measure of the VOR. The purpose of this study was to examine changes in accuracy and reaction time when performing a DVA task with targets offset from the plane of rotation, e.g. offset vertically during horizontal rotation. Visual acuity was measured in 12 healthy subjects as they moved a hand-held joystick to indicate the orientation of a computer-generated Landolt C "as quickly and accurately as possible." Acuity thresholds were established with optotypes presented centrally on a wall-mounted LCD screen at 1.3 m distance, first without motion (static condition) and then while oscillating at 0.8 Hz (DVA, peak velocity 60 deg/s). The effect of target location was then measured during horizontal rotation with the optotypes randomly presented in one of nine different locations on the screen (offset up to 10 deg). The optotype size (logMar 0, 0.2 or 0.4, corresponding to Snellen range 20/20 to 20/50) and presentation duration (150, 300 and 450 ms) were counter-balanced across five trials, each utilizing horizontal rotation at 0.8 Hz. Dynamic acuity was reduced relative to static acuity in 7 of 12 subjects by one step size. During the random target trials, both accuracy and reaction time improved proportional to optotype size. Accuracy and reaction time also improved between 150 ms and 300 ms presentation durations. The main finding was that both accuracy and reaction time varied as a function of target location, with greater performance decrements when acquiring vertical targets. We conclude that dynamic visual acuity varies with target location, with acuity optimized for targets in the plane of motion. Both reaction time and accuracy are functionally relevant DVA parameters of VOR function.

Arteriovenous fistulas among incident hemodialysis patients in Department of Defense and Veterans Affairs facilities.

PubMed

Hurst, Frank P; Abbott, Kevin C; Raj, Dominic; Krishnan, Mahesh; Palant, Carlos E; Agodoa, Lawrence Y; Jindal, Rahul M

2010-09-01

A higher proportion of patients initiate hemodialysis (HD) with an arteriovenous fistula (AVF) in countries with universal health care systems compared with the United States. Because federally sponsored national health care organizations in the United States, such as the Department of Veterans Affairs (DVA) and the Department of Defense (DoD), are similar to a universal health care model, we studied AVF use within these organizations. We used the US Renal Data System database to perform a cross-sectional analysis of patients who initiated HD between 2005 and 2006. Patients who received predialysis nephrology care had 10-fold greater odds of initiating dialysis with an AVF (adjusted odds ratio [aOR] 10.3; 95% confidence interval [CI] 9.6 to 11.1). DVA/DoD insurance also independently associated with initiating HD with an AVF (aOR 1.4; 95% CI 1.2 to 1.5). Fewer patients initiated HD at a DoD facility, but these patients were also approximately twice as likely to use an AVF (aOR 2.3; 95% CI 1.2 to 4.6). In conclusion, patients in DVA/DoD systems are significantly more likely to use an AVF at initiation of HD than patients with other insurance types, including Medicare. Further study of these federal systems may identify practices that could improve processes of care across health care systems to increase the number of patients who initiate HD with an AVF.

"Even 'Daily' is Not Enough": How Well Do We Measure Domestic Violence and Abuse?-A Think-Aloud Study of a Commonly Used Self-Report Scale.

PubMed

Evans, Maggie; Gregory, Alison; Feder, Gene; Howarth, Emma; Hegarty, Kelsey

2016-01-01

This article explores the challenges of providing a quantitative measure of domestic violence and abuse (DVA), illustrated by the Composite Abuse Scale, a validated multidimensional measure of frequency and severity of abuse, used worldwide for prevalence studies and intervention trials. Cognitive "think-aloud" and qualitative interviewing with a sample of women who had experienced DVA revealed a tendency toward underreporting their experience of abuse, particularly of coercive control, threatening behavior, restrictions to freedom, and sexual abuse. Underreporting was linked to inconsistency and uncertainty in item interpretation and response, fear of answering truthfully, and unwillingness to identify with certain forms of abuse. Suggestions are made for rewording or reconceptualizing items and the inclusion of a distress scale to measure the individual impact of abuse. The importance of including qualitative methods in questionnaire design and in the interpretation of quantitative findings is highlighted.

Supporting Australia's new veterans.

PubMed

Gill, Gerard F; Bain, Roderick; Seidl, Isaac

2016-03-01

The recent period of instability and conflict in parts of the world has exposed a new generation of Australian service members to conflict and its associated traumas. The aim of this article is to assist general practitioners (GPs) in engaging with younger veterans who have served in the Australian Defence Force (ADF) since 1990 and acquired health problems as a result of this service. It provides abbreviated advice on the resources available from the Department of Veterans' Affairs (DVA), particularly for mental health problems, and how to efficiently access DVA-funded services for newer veterans. Early detection of and attention to health problems (especially mental ill health) arising from military service, particularly from conflict or peacekeeping missions, has been found to improve veterans' health, their functioning and family happiness. GPs are ideally situated to arrange and coordinate this care.

Differences in vision between clinic and home and the effect of lighting in older adults with and without glaucoma

PubMed Central

Bhorade, Anjali M.; Perlmutter, Monica S.; Wilson, Brad; Kambarian, Jamie; Chang, Sidney; Pekmezci, Melike; Gordon, Mae

2015-01-01

Importance Patients often report greater visual difficulties at home than expected from vision testing in the clinic. Such discordance may be due to worse vision in the home than measured in clinic. Objective To compare vision measured between clinic and home and evaluate factors, including lighting, associated with these differences. Design Cross-sectional, between years 2005–2009. Setting Participants recruited from the Glaucoma and Comprehensive Eye Clinics at Washington University, St. Louis, MO underwent a clinic and home visit. Participants 126 glaucoma and 49 non-glaucoma patients, ages 55–90 years, consecutively recruited and met inclusion criteria for this report; 166 eligible patients refused participation. Exposure Participants underwent a clinic and home visit randomized to order of completion. At each visit, masked and certified examiners measured binocular distance visual acuity (DVA) with a non-backlit chart, near visual acuity (NVA), contrast sensitivity (CS), CS with glare, and lighting. Main Outcome Measure Differences in vision between clinic and home. Results Mean scores for all vision tests were significantly better in the clinic than home for glaucoma and non-glaucoma patients (p<0.05, matched pair t-tests). For DVA, 29% of glaucoma participants read ≥2 lines better in clinic than home and 39% with advanced glaucoma read ≥3 lines better. For the entire sample, 21% of participants read ≥2 lines better in clinic than home for NVA and 49% read ≥2 triplets better in clinic for CS with glare. Lighting was the most significant factor associated with differences in vision between clinic and home for DVA, NVA, and CS with glare testing (p<0.05 multiple regression model). Median home lighting was 4.3 times and 2.8 times lower than clinic lighting in areas tested for DVA and NVA, respectively. Home lighting was below that recommended in ≥ 85% of participants. Conclusions and Relevance Vision measured in the clinic is generally better than

32 CFR 65.6 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Institution of Higher Learning (IHL) This includes graduate and undergraduate training, and some vocational/technical training programs. DVA is the final authority on program eligibility. (vii) Individuals may... education and/or training at half time or less or to some individuals taking distance learning. Individuals...

32 CFR 65.6 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Institution of Higher Learning (IHL) This includes graduate and undergraduate training, and some vocational/technical training programs. DVA is the final authority on program eligibility. (vii) Individuals may...-State undergraduate tuition and fees at a public institution of higher learning (tuition and fees paid...

32 CFR 65.6 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Institution of Higher Learning (IHL) This includes graduate and undergraduate training, and some vocational/technical training programs. DVA is the final authority on program eligibility. (vii) Individuals may...-State undergraduate tuition and fees at a public institution of higher learning (tuition and fees paid...

32 CFR 65.6 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Institution of Higher Learning (IHL) This includes graduate and undergraduate training, and some vocational/technical training programs. DVA is the final authority on program eligibility. (vii) Individuals may...-State undergraduate tuition and fees at a public institution of higher learning (tuition and fees paid...

Patient Outcomes in Varying Length Post Traumatic Stress Disorder Programs at the Denver VA Medical Center

DTIC Science & Technology

1998-06-16

Post Traumatic Stress Disorder ( PTSD ...Outcomes 2 Abstract The Department of Veterans Affairs (DVA) has provided a number of treatment programs for Post Traumatic Stress Disorder ( PTSD ) including...D.C. Department of Veterans Affairs (1991). A Program Evaluation of the Department of Veterans Affairs Post Traumatic Stress Disorder ( PTSD )

Experimental Studies on Dynamic Vibration Absorber using Shape Memory Alloy (NiTi) Springs

NASA Astrophysics Data System (ADS)

Kumar, V. Raj; Kumar, M. B. Bharathi Raj; Kumar, M. Senthil

2011-10-01

Shape memory alloy (SMA) springs have been used as actuators in many applications although their use in the vibration control area is very recent. Since shape memory alloys differ from conventional alloy materials in many ways, the traditional design approach for springs is not completely suitable for designing SMA springs. Some vibration control concepts utilizing unique characteristics of SMA's will be presented in this paper. A dynamic vibration absorber (DVA) using shape memory alloy (SMA) actuator is developed for attenuation of vibration in a cantilever beam. The design procedure of the DVA is presented. The system consists of a cantilever beam which is considered to generate the real-time vibration using shaker. A SMA spring is used with a mass attached to its end. The stiffness of the SMA spring is dynamically varied in such a way to attenuate the vibration. Both simulation and experimentation are carried out using PID controller. The experiments were carried out by interfacing the experimental setup with a computer using LabVIEW software, Data acquisition and control are implemented using a PCI data acquisition card. Standard PID controllers have been used to control the vibration of the beam. Experimental results are used to demonstrate the effectiveness of the controllers designed and the usefulness of the proposed test platform by exciting the structure at resonance. In experimental setup, an accelerometer is used to measure the vibration which is fed to computer and correspondingly the SMA spring is actuated to change its stiffness to control the vibration. The results obtained illustrate that the developed DVA using SMA actuator is very effective in reducing structural response and have great potential to be an active vibration control medium.

Management of Arteriovenous Malformations Associated with Developmental Venous Anomalies: A Literature Review and Report of 2 Cases.

PubMed

Zhang, Michael; Connolly, Ian D; Teo, Mario K; Yang, George; Dodd, Robert; Marks, Michael; Zuccarello, Mario; Steinberg, Gary K

2017-10-01

Classification of cerebrovascular malformations has revealed intermediary lesions that warrant further review owing to their unusual presentation and management. We present 2 cases of arteriovenous malformation (AVM) associated with a developmental venous anomaly (DVA), and discuss the efficacy of previously published management strategies. Two cases of AVMs associated with DVA were identified, and a literature search for published cases between 1980 and 2016 was conducted. Patient demographic data and clinical features were documented. In case 1, a 29-year-old female presenting with parenchymal hemorrhage and left homonymous hemianopia was found to have a right parieto-occipital AVM fed from the anterior cerebral, middle cerebral, and posterior cerebral arteries, with major venous drainage to the superior sagittal sinus. In case 2, imaging in a 34-year-old female evaluated for night tremors and incontinence revealed a left parietal AVM with venous drainage to the superior sagittal sinus. Including our 2 cases, 22 cases of coexisting AVMs and DVAs have been reported in the literature. At presentation, 68% had radiographic evidence of hemorrhage. Stereotactic radiosurgery was performed in 7 cases, embolization in 6 cases, surgical resection in 4 cases, and multimodal therapy in 5 cases. Radiography at follow-up demonstrated successful AVM obliteration in 67% of cases (12 of 18). Patients with coexisting AVMs and DVAs tend to have a hemorrhagic presentation. Contrary to traditional AVM management, in these cases it is important to preserve the draining vein via the DVA to ensure a safe, sustained circulatory outflow of the associated brain parenchyma while achieving safe AVM obliteration. Copyright © 2017 Elsevier Inc. All rights reserved.

The use and impact of cancer medicines in routine clinical care: methods and observations in a cohort of elderly Australians

PubMed Central

Pearson, Sallie-Anne; Schaffer, Andrea

2014-01-01

Introduction After medicines have been subsidised in Australia we know little about their use in routine clinical practice, impact on resource utilisation, effectiveness or safety. Routinely collected administrative health data are available to address these issues in large population-based pharmacoepidemiological studies. By bringing together cross-jurisdictional data collections that link drug exposure to real-world outcomes, this research programme aims to evaluate the use and impact of cancer medicines in a subset of elderly Australians in the real-world clinical setting. Methods and analysis This ongoing research programme involves a series of retrospective cohort studies of Australian Government Department of Veterans’ Affairs (DVA) clients. The study population includes 104 635 veterans who reside in New South Wales, Australia, and were aged 65 years and over as of 1 July 2004. We will investigate trends in cancer medicines use according to cancer type and other sociodemographic characteristics as well as predictors of the initiation of cancer medicines and other treatment modalities, survival and adverse outcomes among patients with cancer. The programme is underpinned by the linkage of eight health administrative databases under the custodianship of the DVA and the New South Wales Ministry of Health, including cancer notifications, medicines dispensing data, hospitalisation data and health services data. The cancer notifications database is available from 1994 with all other databases available from 2005 onwards. Ethics and dissemination Ethics approval has been granted by the DVA and New South Wales Population and Health Service Research Ethics Committees. Results Results will be reported in peer-reviewed publications, conference presentations and policy forums. The programme has high translational potential, providing invaluable evidence about cancer medicines in an elderly population who are under-represented in clinical trials. PMID:24793244

[Functional assessment of patients with vertigo and dizziness in occupational medicine].

PubMed

Zamysłowska-Szmytke, Ewa; Szostek-Rogula, Sylwia; Śliwińska-Kowalska, Mariola

2018-03-09

Balance assessment relies on symptoms, clinical examination and functional assessment and their verification in objective tests. Our study was aimed at calculating the assessment compatibility between questionnaires, functional scales and objective vestibular and balance examinations. A group of 131 patients (including 101 women; mean age: 59±14 years) of the audiology outpatient clinic was examined. Benign paroxysmal positional vertigo, phobic vertigo and central dizziness were the most common diseases observed in the study group. Patients' symptoms were tested using the questionnaire on Cawthworne-Cooksey exercises (CC), Dizziness Handicap Inventory (DHI) and Duke Anxiety-Depression Scale. Berg Balance Scale (BBS), Dynamic Gait Index (DGI), the Tinetti test, Timed Up and Go test (TUG), and Dynamic Visual Acuity (DVA) were used for the functional balance assessment. Objective evaluation included: videonystagmography caloric test and static posturography. The study results revealed statistically significant but moderate compatibility between functional tests BBS, DGI, TUG, DVA and caloric results (Kendall's W = 0.29) and higher for posturography (W = 0.33). The agreement between questionnaires and objective tests were very low (W = 0.08-0.11).The positive predictive values of BBS were 42% for caloric and 62% for posturography tests, of DGI - 46% and 57%, respectively. The results of functional tests (BBS, DGI, TUG, DVA) revealed statistically significant correlations with objective balance tests but low predictive values did not allow to use these tests in vestibular damage screening. Only half of the patients with functional disturbances revealed abnormal caloric or posturography tests. The qualification to work based on objective tests ignore functional state of the worker, which may influence the ability to work. Med Pr 2018;69(2):179-189. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Dynamic Visual Acuity: a Functionally Relevant Research Tool

NASA Technical Reports Server (NTRS)

Peters, Brian T.; Brady, Rachel A.; Miller, Chris A.; Mulavara, Ajitkumar P.; Wood, Scott J.; Cohen, Helen S.; Bloomberg, Jacob J.

2010-01-01

Coordinated movements between the eyes and head are required to maintain a stable retinal image during head and body motion. The vestibulo-ocular reflex (VOR) plays a significant role in this gaze control system that functions well for most daily activities. However, certain environmental conditions or interruptions in normal VOR function can lead to inadequate ocular compensation, resulting in oscillopsia, or blurred vision. It is therefore possible to use acuity to determine when the environmental conditions, VOR function, or the combination of the two is not conductive for maintaining clear vision. Over several years we have designed and tested several tests of dynamic visual acuity (DVA). Early tests used the difference between standing and walking acuity to assess decrements in the gaze stabilization system after spaceflight. Supporting ground-based studies measured the responses from patients with bilateral vestibular dysfunction and explored the effects of visual target viewing distance and gait cycle events on walking acuity. Results from these studies show that DVA is affected by spaceflight, is degraded in patients with vestibular dysfunction, changes with target distance, and is not consistent across the gait cycle. We have recently expanded our research to include studies in which seated subjects are translated or rotated passively. Preliminary results from this work indicate that gaze stabilization ability may differ between similar active and passive conditions, may change with age, and can be affected by the location of the visual target with respect to the axis of motion. Use of DVA as a diagnostic tool is becoming more popular but the functional nature of the acuity outcome measure also makes it ideal for identifying conditions that could lead to degraded vision. By doing so, steps can be taken to alter the problematic environments to improve the man-machine interface and optimize performance.

Experimental Studies on Dynamic Vibration Absorber using Shape Memory Alloy (NiTi) Springs

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

Kumar, V. Raj; Kumar, M. B. Bharathi Raj; Kumar, M. Senthil

2011-10-20

Shape memory alloy (SMA) springs have been used as actuators in many applications although their use in the vibration control area is very recent. Since shape memory alloys differ from conventional alloy materials in many ways, the traditional design approach for springs is not completely suitable for designing SMA springs. Some vibration control concepts utilizing unique characteristics of SMA's will be presented in this paper.A dynamic vibration absorber (DVA) using shape memory alloy (SMA) actuator is developed for attenuation of vibration in a cantilever beam. The design procedure of the DVA is presented. The system consists of a cantilever beammore » which is considered to generate the real-time vibration using shaker. A SMA spring is used with a mass attached to its end. The stiffness of the SMA spring is dynamically varied in such a way to attenuate the vibration. Both simulation and experimentation are carried out using PID controller. The experiments were carried out by interfacing the experimental setup with a computer using LabVIEW software, Data acquisition and control are implemented using a PCI data acquisition card. Standard PID controllers have been used to control the vibration of the beam. Experimental results are used to demonstrate the effectiveness of the controllers designed and the usefulness of the proposed test platform by exciting the structure at resonance. In experimental setup, an accelerometer is used to measure the vibration which is fed to computer and correspondingly the SMA spring is actuated to change its stiffness to control the vibration. The results obtained illustrate that the developed DVA using SMA actuator is very effective in reducing structural response and have great potential to be an active vibration control medium.« less

Perceptual Learning in Children With Infantile Nystagmus: Effects on Visual Performance.

PubMed

Huurneman, Bianca; Boonstra, F Nienke; Goossens, Jeroen

2016-08-01

To evaluate whether computerized training with a crowded or uncrowded letter-discrimination task reduces visual impairment (VI) in 6- to 11-year-old children with infantile nystagmus (IN) who suffer from increased foveal crowding, reduced visual acuity, and reduced stereopsis. Thirty-six children with IN were included. Eighteen had idiopathic IN and 18 had oculocutaneous albinism. These children were divided in two training groups matched on age and diagnosis: a crowded training group (n = 18) and an uncrowded training group (n = 18). Training occurred two times per week during 5 weeks (3500 trials per training). Eleven age-matched children with normal vision were included to assess baseline differences in task performance and test-retest learning. Main outcome measures were task-specific performance, distance and near visual acuity (DVA and NVA), intensity and extent of (foveal) crowding at 5 m and 40 cm, and stereopsis. Training resulted in task-specific improvements. Both training groups also showed uncrowded and crowded DVA improvements (0.10 ± 0.02 and 0.11 ± 0.02 logMAR) and improved stereopsis (670 ± 249″). Crowded NVA improved only in the crowded training group (0.15 ± 0.02 logMAR), which was also the only group showing a reduction in near crowding intensity (0.08 ± 0.03 logMAR). Effects were not due to test-retest learning. Perceptual learning with or without distractors reduces the extent of crowding and improves visual acuity in children with IN. Training with distractors improves near vision more than training with single optotypes. Perceptual learning also transfers to DVA and NVA under uncrowded and crowded conditions and even stereopsis. Learning curves indicated that improvements may be larger after longer training.

42 CFR 447.505 - Determination of best price.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., discounts, or other price concessions that adjust prices either directly or indirectly— (1) Prices to... excludes: (1) Any prices on or after October 1, 1992, charged to the IHS, the DVA, a State home receiving... Part D of title XVIII, by any MA-PD plan under Part C of such title with respect to covered Part D...

42 CFR 447.505 - Determination of best price.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., discounts, or other price concessions that adjust prices either directly or indirectly— (1) Prices to... excludes: (1) Any prices on or after October 1, 1992, charged to the IHS, the DVA, a State home receiving... Part D of title XVIII, by any MA-PD plan under Part C of such title with respect to covered Part D...

77 FR 1027 - Approval and Promulgation of State Implementation Plans; State of Colorado; Interstate Transport...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-09

...)(xi).... A-I.B.10 D-II.A.5 Baseline Area definition. Yes 51.166(b)(15)....... EPA is approving this... Certain Nonattainment Area Requirements). N/A D-V.A.7.d Documents available for No 51.165(a)(7... Exemptions from Certain Yes 51.165, Appx. EPA is approving this Nonattainment Area S.IV.B... section...

Dynamic Visual Acuity and Landing Sickness in Crewmembers Returning from Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Rosenberg, M.J.F; Peters, B.T.; Reschke, M. F.

2016-01-01

Long-term exposure to microgravity causes sensorimotor adaptations that result in functional deficits upon returning to a gravitational environment. At landing the vestibular system and the central nervous system, responsible for coordinating head and eye movements, are adapted to microgravity and must re-adapt to the gravitational environment. This re-adaptation causes decrements in gaze control and dynamic visual acuity, with astronauts reporting oscillopsia and blurred vision. Dynamic visual acuity (DVA) is assessed using an oscillating chair developed in the Neuroscience Laboratory at JSC. This chair is lightweight and easily portable for quick deployment in the field. The base of the chair is spring-loaded and allows for manual oscillation of the subject. Using a metronome, the chair is vertically oscillated plus or minus 2 cm at 2 Hz by an operator, to simulate walking. While the subject is being oscillated, they are asked to discern the direction of Landolt-C optotypes of varying sizes and record their direction using a gamepad. The visual acuity thresholds are determined using an algorithm that alters the size of the optotype based on the previous response of the subject using a forced-choice best parameter estimation that is able to rapidly converge on the threshold value. Visual acuity thresholds were determined both for static (seated) and dynamic (oscillating) conditions. Dynamic visual acuity is defined as the difference between the dynamic and static conditions. Dynamic visual acuity measures will be taken prior to flight (typically L-180, L-90, and L-60) and up to eight times after landing, including up to 3 times on R plus 0. Follow up measurements will be taken at R plus 1 (approximately 36 hours after landing). Long-duration International Space Station crewmembers will be tested once at the refueling stop in Europe and once again upon return to Johnson Space Center. In addition to DVA, subjective ratings of motion sickness will be recorded

Visual acuity in young elite motorsport athletes: a preliminary report.

PubMed

Schneiders, Anthony G; Sullivan, S John; Rathbone, Emma J; Louise Thayer, A; Wallis, Laura M; Wilson, Alexandra E

2010-05-01

To determine whether elite motorsport athletes demonstrate superior levels of Visual Acuity than age and sex-matched controls. A cross-sectional observational study. A University vision and balance laboratory. Young male motorsport athletes from the New Zealand Elite Motorsport Academy and healthy age and sex-matched controls. Vision performance tests comprising; Static Visual Acuity (SVA), Dynamic Visual Acuity (DVA), Gaze Stabilization Test (GST), and the Perception Time Test (PTT). Motorsport athletes demonstrated superior visual acuity compared to age and sex-matched controls for all measures, and while this was not statistically significant for SVA, GST and DVA, it reached statistical significance for the PTT (p

The Link Between Domestic Violence and Abuse and Animal Cruelty in the Intimate Relationships of People of Diverse Genders and/or Sexualities: A Binational Study.

PubMed

Riggs, Damien W; Taylor, Nik; Fraser, Heather; Donovan, Catherine; Signal, Tania

2018-04-01

Over the past three decades, a growing body of research has focused on experiences of domestic violence and abuse (DVA) among people of diverse genders and/or sexualities. Missing, however, has been a focus on what is known as "the link" between DVA and animal cruelty with regard to people of diverse genders and/or sexualities. The present article reports on a study of 503 people living in either Australia or the United Kingdom, who reported on both their intimate human relationships and their relationships with animals, including relationships that were abusive. In terms of "the link," a fifth of respondents who had experienced violence or abuse also reported that animal cruelty had been perpetuated by the violent or abusive partner. Statistical interactions were found between having witnessed animal cruelty perpetrated by a partner, gender and sexuality, and both psychological distress and social connectedness. Female participants who had witnessed animal cruelty reported greater psychological distress and lower levels of social support, and both lesbian and bisexual participants who had witnessed animal cruelty reported lower levels of social support. The article concludes by considering the implications of these findings for future research and service provision.

Validation of a Manually Oscillating Chair for In-The-Field Assessment of Dynamic Visual Acuity on Crewmembers Within Hours of Returning from Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Kreutzberg, G. A.; Rosenberg, M. J. F.; Peters, B. T.; Reschke, M. F.

2017-01-01

Due to the deconditioned state of crewmembers in the initial hours after landing, it is safer and more practical to perform a vision test while seated in a chair versus walking on a treadmill. The purpose of this study was to validate the ability of a manually operated oscillating chair to produce the oscillatory frequency and displacement equivalent of walking on a treadmill at a 4 mph pace. A fast Fourier transform (FFT)was performed on the vertical trunk acceleration to compare the peak and spread of the distribution of oscillation frequencies for each oscillating condition. Peak oscillation frequencies achieved with the manual chair were lower and more variable than those of treadmill walking and the automatic chair. This can mostly be attributed to operator fatigue. However, DVA scores across conditions were not significantly different, indicating that the manual chair can provide adequate vertical oscillation frequency and displacement with the added advantage of being portable enough for testing outside a laboratory. Furthermore the automatic chair very closely matches the oscillation frequency of treadmill walking, making it an ideal method for testing DVA in a laboratory setting.

A One-Dimensional, Noniterative Trajectory Model (With a C++ Implementation)

DTIC Science & Technology

2014-03-01

maF = (6) 2 2 1 AvC m a Dρ−=⇒ (7) Next, the definitions of speed and acceleration can be used to find acceleration as a function of speed and...position: dt dxv ≡ (8) and dt dx dx dv dt dva =≡ (9) dx dvva =⇒ (10) Combining equations 7 and 10, AvC mdx dv Dρ2 1 −= (11) Next

Fund allocation within Australian dental care: an innovative approach to output based funding.

PubMed

Tennant, M; Carrello, C; Kruger, E

2005-12-01

Over the last 15 years in Australia the process of funding government health care has changed significantly. The development of dental funding models that transparently meet both the service delivery needs for data at the treatment level and policy makers' need for health condition data is critical to the continued integration of dentistry into the wider health system. This paper presents a model of fund allocation that provides a communication construct that addresses the needs of both policy makers and service providers. In this model, dental treatments (dental item numbers) have been grouped into eight broad dental health conditions. Within each dental health condition, a weighted average price is determined using the Department of Veterans Affairs' (DVA) fee schedule as the benchmark, adjusted for the mix of care. The model also adjusts for the efficiency differences between sectors providing government funded dental care. In summary, the price to be applied to a dental health condition category is determined by the weighted average DVA price adjusted by the sector efficiency. This model allows governments and dental service providers to develop funding agreements that both quantify and justify the treatment to be provided. Such a process facilitates the continued integration of dental care into the wider health system.

Transient vibration analytical modeling and suppressing for vibration absorber system under impulse excitation

NASA Astrophysics Data System (ADS)

Wang, Xi; Yang, Bintang; Yu, Hu; Gao, Yulong

2017-04-01

The impulse excitation of mechanism causes transient vibration. In order to achieve adaptive transient vibration control, a method which can exactly model the response need to be proposed. This paper presents an analytical model to obtain the response of the primary system attached with dynamic vibration absorber (DVA) under impulse excitation. The impulse excitation which can be divided into single-impulse excitation and multi-impulse excitation is simplified as sinusoidal wave to establish the analytical model. To decouple the differential governing equations, a transform matrix is applied to convert the response from the physical coordinate to model coordinate. Therefore, the analytical response in the physical coordinate can be obtained by inverse transformation. The numerical Runge-Kutta method and experimental tests have demonstrated the effectiveness of the analytical model proposed. The wavelet of the response indicates that the transient vibration consists of components with multiple frequencies, and it shows that the modeling results coincide with the experiments. The optimizing simulations based on genetic algorithm and experimental tests demonstrate that the transient vibration of the primary system can be decreased by changing the stiffness of the DVA. The results presented in this paper are the foundations for us to develop the adaptive transient vibration absorber in the future.

The value of advocacy in promoting social change: implementing the new Domestic Violence Act in South Africa.

PubMed

Usdin, S; Christofides, N; Malepe, L; Maker, A

2000-11-01

South Africa's first democratic government passed the Domestic Violence Act (DVA) into law in 1998 as part of local and international commitments to protecting the human rights of women. Although the Act was welcomed as groundbreaking legislation, delays in implementing it led to increasing frustration. This paper describes an advocacy campaign conducted by the Soul City Institute for Health and Development Communication in partnership with the National Network on Violence against Women, to ensure the effective implementation of the DVA. Lessons from the campaign stress the importance of coalition building to draw on diverse strengths, and the use of a combination of advocacy tools, including lobbying, media advocacy and social mobilisation to achieve campaign goals. Given the critical role NGOs dealing with victims/survivors of domestic violence and the justice system played in lobbying for change and drafting the new law, their exclusion from the implementation process was ironic. While many advocacy efforts focus on the development of policy and legislation, ongoing efforts are needed to ensure effective implementation, the commitment of adequate resources and monitoring to identify gaps and propose new solutions. Our experience highlights the important role of policy advocates in connecting the multiple streams at play in the policy and legislative arena.

Military Construction, Veterans Affairs, and Related Agencies: FY2009 Appropriations

DTIC Science & Technology

2009-02-25

between the houses, a method known as the “ping pong ” procedure, before being cleared for the White House.3 The first portion...enacted into law, see CRS Report 98-812, Amendments Between the Houses, by Elizabeth Rybicki. 3 A detailed description of the ping pong method of...subcommittee, chaired by Senator Tim Johnson (South Dakota), held two hearings. The first, concerned with the DVA request, convened on April 10. The

A Gearless Safe and Arming Device for Artillery Firing (Program Summary and Mathematical Analysis)

DTIC Science & Technology

1975-09-01

not return it to the originator. The findings in this report are not to be constued as an official De - partment of the Army position unless so...MECHANICS OF THE GEARLESS S&A MECHANISM 72 Friction Not Considered 17 Friction Considerations 7 3 Mesh Friction 73 Bearing Friction Other System ...Size) 18 5 DVA Gearless Booster (M572E2 Size) 20 6 Gearless S&A: Design 2; Configuration 3 29 7 Returnable Setback System 31 8 Lower Lever

Differential voltage analysis as a tool for analyzing inhomogeneous aging: A case study for LiFePO4|Graphite cylindrical cells

NASA Astrophysics Data System (ADS)

Lewerenz, Meinert; Marongiu, Andrea; Warnecke, Alexander; Sauer, Dirk Uwe

2017-11-01

In this work the differential voltage analysis (DVA) is evaluated for LiFePO4|Graphite cylindrical cells aged in calendaric and cyclic tests. The homogeneity of the active lithium distribution and the loss of anode active material (LAAM) are measured by the characteristic shape and peaks of the DVA. The results from this analysis exhibit an increasing homogeneity of the lithium-ion distribution during aging for all cells subjected to calendaric aging. At 60 °C, LAAM is found additionally and can be associated with the deposition of dissolved Fe from the cathode on the anode, where it finally leads to the clogging of pores. For cells aged under cyclic conditions, several phenomena are correlated to degradation, such as loss of active lithium and local LAAM for 100% DOD. Moreover, the deactivation of certain parts of anode and cathode due to a lithium-impermeable covering layer on top of the anode is observed for some cells. While the 100% DOD cycling is featured by a continuous LAAM, the LAAM due to deactivation by a covering layer of both electrodes starts suddenly. The homogeneity of the active lithium distribution within the cycled cells is successively reduced with deposited passivation layers and with LAAM that is lost locally at positions with lower external pressure on the electrode.

Decline in semicircular canal and otolith function with age

PubMed Central

Agrawal, Yuri; Zuniga, M. Geraldine; Davalos-Bichara, Marcela; Schubert, Michael C.; Walston, Jeremy D.; Hughes, Jennifer; Carey, John P.

2012-01-01

Objective To characterize the physiologic nature of the vestibular dysfunction that occurs with the normative aging process. Study design Cross-sectional study. Setting Tertiary care academic medical center. Patients Fifty individuals age 70 and above. Interventions Head thrust dynamic visual acuity testing (htDVA) and cervical and ocular vestibular-evoked myogenic potential (VEMP) testing. Main Outcome Measures Semicircular canal function measured by htDVA in each of the three semicircular canal planes, and saccular and utricular function measured by cVEMP and oVEMP testing, respectively. Results We observed significant declines in semicircular canal function in each of the canal planes as well as otolith function associated with aging. We found that individuals with impaired horizontal and superior semicircular canal function were likely to also have concomitant deficits in utricular but not saccular function. Overall, we noted that the prevalence of semicircular canal dysfunction was highest followed by saccular then utricular impairment, although we did observe individuals with isolated otolith deficits. Conclusions These data suggest an overall decline in semicircular canal as well as otolith function associated with aging, although the magnitude of impairment was greater for the semicircular canals than the otoliths in this elderly population. A better understanding of the specific vestibular deficits that occur with aging can inform the development of rational screening, vestibular rehabilitation and fall risk reduction strategies in older individuals. PMID:22699991

Authentication of digital video evidence

NASA Astrophysics Data System (ADS)

Beser, Nicholas D.; Duerr, Thomas E.; Staisiunas, Gregory P.

2003-11-01

In response to a requirement from the United States Postal Inspection Service, the Technical Support Working Group tasked The Johns Hopkins University Applied Physics Laboratory (JHU/APL) to develop a technique tha will ensure the authenticity, or integrity, of digital video (DV). Verifiable integrity is needed if DV evidence is to withstand a challenge to its admissibility in court on the grounds that it can be easily edited. Specifically, the verification technique must detect additions, deletions, or modifications to DV and satisfy the two-part criteria pertaining to scientific evidence as articulated in Daubert et al. v. Merrell Dow Pharmaceuticals Inc., 43 F3d (9th Circuit, 1995). JHU/APL has developed a prototype digital video authenticator (DVA) that generates digital signatures based on public key cryptography at the frame level of the DV. Signature generation and recording is accomplished at the same time as DV is recorded by the camcorder. Throughput supports the consumer-grade camcorder data rate of 25 Mbps. The DVA software is implemented on a commercial laptop computer, which is connected to a commercial digital camcorder via the IEEE-1394 serial interface. A security token provides agent identification and the interface to the public key infrastructure (PKI) that is needed for management of the public keys central to DV integrity verification.

Reproducibility of the retinal vascular response to flicker light in Asians.

PubMed

Nguyen, Thanh T; Kreis, Andreas J; Kawasaki, Ryo; Wang, Jie Jin; Seifert, Bernd-U; Vilser, Walthard; Nagel, Edgar; Wong, Tien Y

2009-12-01

Dilation of retinal vessels in response to diffuse luminance flicker may reflect endothelial function. Although this has previously been shown to be reproducible in whites, there have been no similar data in Asians. We assess the reproducibility of repeated measurements of this response in Asians. Healthy Asians (n = 33) with normal vision and no history of glaucoma, age-related macular degeneration, cataract, or retinal arterial/venous occlusion participated in this study. Repeated measures from the same subjects were taken 30-60 min apart using the Dynamic Vessel Analyser (DVA, IMEDOS, Jena, Germany). Modification was made to the shape of the light source for Asian participants. Correlations of the first and second measures were assessed using Pearson correlation (R(2)), and agreement between the two measures was shown using Bland-Altman plots. After modification to the shape of the light source, almost perfect correlation was found between the 1st and 2nd measurements of baseline arteriolar (R(2) = 0.95) and venular diameters (R(2) = 0.98) of arteriolar maximum dilation (R(2) = 0.85). Substantially high correlation between the 1st and 2nd measurements of venular maximum dilation was found (R(2) = 0.80). Measurements of the dilation response of retinal vessels to diffuse luminance flicker an Asian sample using the DVA show high reproducibility for repeated measures over a short period of time. Such measurements may allow non-invasive quantification of endothelial function to study its association with systemic and ocular diseases.

The Right Place at the Right Time: Priming Facial Expressions with Emotional Face Components in Developmental Visual Agnosia

PubMed Central

Aviezer, Hillel; Hassin, Ran. R.; Perry, Anat; Dudarev, Veronica; Bentin, Shlomo

2012-01-01

The current study examined the nature of deficits in emotion recognition from facial expressions in case LG, an individual with a rare form of developmental visual agnosia (DVA). LG presents with profoundly impaired recognition of facial expressions, yet the underlying nature of his deficit remains unknown. During typical face processing, normal sighted individuals extract information about expressed emotions from face regions with activity diagnostic for specific emotion categories. Given LG’s impairment, we sought to shed light on his emotion perception by examining if priming facial expressions with diagnostic emotional face components would facilitate his recognition of the emotion expressed by the face. LG and control participants matched isolated face components with components appearing in a subsequently presented full-face and then categorized the face’s emotion. Critically, the matched components were from regions which were diagnostic or non-diagnostic of the emotion portrayed by the full face. In experiment 1, when the full faces were briefly presented (150 ms), LG’s performance was strongly influenced by the diagnosticity of the components: His emotion recognition was boosted within normal limits when diagnostic components were used and was obliterated when non-diagnostic components were used. By contrast, in experiment 2, when the face-exposure duration was extended (2000 ms), the beneficial effect of the diagnostic matching was diminished as was the detrimental effect of the non-diagnostic matching. These data highlight the impact of diagnostic facial features in normal expression recognition and suggest that impaired emotion recognition in DVA results from deficient visual integration across diagnostic face components. PMID:22349446

The right place at the right time: priming facial expressions with emotional face components in developmental visual agnosia.

PubMed

Aviezer, Hillel; Hassin, Ran R; Perry, Anat; Dudarev, Veronica; Bentin, Shlomo

2012-04-01

The current study examined the nature of deficits in emotion recognition from facial expressions in case LG, an individual with a rare form of developmental visual agnosia (DVA). LG presents with profoundly impaired recognition of facial expressions, yet the underlying nature of his deficit remains unknown. During typical face processing, normal sighted individuals extract information about expressed emotions from face regions with activity diagnostic for specific emotion categories. Given LG's impairment, we sought to shed light on his emotion perception by examining if priming facial expressions with diagnostic emotional face components would facilitate his recognition of the emotion expressed by the face. LG and control participants matched isolated face components with components appearing in a subsequently presented full-face and then categorized the face's emotion. Critically, the matched components were from regions which were diagnostic or non-diagnostic of the emotion portrayed by the full face. In experiment 1, when the full faces were briefly presented (150 ms), LG's performance was strongly influenced by the diagnosticity of the components: his emotion recognition was boosted within normal limits when diagnostic components were used and was obliterated when non-diagnostic components were used. By contrast, in experiment 2, when the face-exposure duration was extended (2000 ms), the beneficial effect of the diagnostic matching was diminished as was the detrimental effect of the non-diagnostic matching. These data highlight the impact of diagnostic facial features in normal expression recognition and suggest that impaired emotion recognition in DVA results from deficient visual integration across diagnostic face components. Copyright © 2012 Elsevier Ltd. All rights reserved.

A prediction model of compressor with variable-geometry diffuser based on elliptic equation and partial least squares.

PubMed

Li, Xu; Yang, Chuanlei; Wang, Yinyan; Wang, Hechun

2018-01-01

To achieve a much more extensive intake air flow range of the diesel engine, a variable-geometry compressor (VGC) is introduced into a turbocharged diesel engine. However, due to the variable diffuser vane angle (DVA), the prediction for the performance of the VGC becomes more difficult than for a normal compressor. In the present study, a prediction model comprising an elliptical equation and a PLS (partial least-squares) model was proposed to predict the performance of the VGC. The speed lines of the pressure ratio map and the efficiency map were fitted with the elliptical equation, and the coefficients of the elliptical equation were introduced into the PLS model to build the polynomial relationship between the coefficients and the relative speed, the DVA. Further, the maximal order of the polynomial was investigated in detail to reduce the number of sub-coefficients and achieve acceptable fit accuracy simultaneously. The prediction model was validated with sample data and in order to present the superiority of compressor performance prediction, the prediction results of this model were compared with those of the look-up table and back-propagation neural networks (BPNNs). The validation and comparison results show that the prediction accuracy of the new developed model is acceptable, and this model is much more suitable than the look-up table and the BPNN methods under the same condition in VGC performance prediction. Moreover, the new developed prediction model provides a novel and effective prediction solution for the VGC and can be used to improve the accuracy of the thermodynamic model for turbocharged diesel engines in the future.

Directional variance adjustment: bias reduction in covariance matrices based on factor analysis with an application to portfolio optimization.

PubMed

Bartz, Daniel; Hatrick, Kerr; Hesse, Christian W; Müller, Klaus-Robert; Lemm, Steven

2013-01-01

Robust and reliable covariance estimates play a decisive role in financial and many other applications. An important class of estimators is based on factor models. Here, we show by extensive Monte Carlo simulations that covariance matrices derived from the statistical Factor Analysis model exhibit a systematic error, which is similar to the well-known systematic error of the spectrum of the sample covariance matrix. Moreover, we introduce the Directional Variance Adjustment (DVA) algorithm, which diminishes the systematic error. In a thorough empirical study for the US, European, and Hong Kong stock market we show that our proposed method leads to improved portfolio allocation.

Modeling locomotor dysfunction following spaceflight with Galvanic vestibular stimulation.

PubMed

Moore, Steven T; MacDougall, Hamish G; Peters, Brian T; Bloomberg, Jacob J; Curthoys, Ian S; Cohen, Helen S

2006-10-01

In this study locomotor and gaze dysfunction commonly observed in astronauts following spaceflight were modeled using two Galvanic vestibular stimulation (GVS) paradigms: (1) pseudorandom, and (2) head-coupled (proportional to the summed vertical linear acceleration and yaw angular velocity obtained from a head-mounted Inertial Measurement Unit). Locomotor and gaze function during GVS were assessed by tests previously used to evaluate post-flight astronaut performance; dynamic visual acuity (DVA) during treadmill locomotion at 80 m/min, and navigation of an obstacle course. During treadmill locomotion with pseudorandom GVS there was a 12% decrease in coherence between head pitch and vertical translation at the step frequency relative to the no GVS condition, which was not significantly different to the 15% decrease in coherence observed in astronauts following shuttle missions. This disruption in head stabilization likely resulted in a decrease in DVA equivalent to the reduction in acuity observed in astronauts 6 days after return from extended missions aboard the International Space Station (ISS). There were significant increases in time-to-completion of the obstacle course during both pseudorandom (21%) and head-coupled (14%) GVS, equivalent to an ISS astronaut 5 days post-landing. An attempt to suppress head movement was evident during both pseudorandom and head-coupled GVS while negotiating the obstacle course, with a 20 and 16%, decrease in head pitch and yaw velocity, respectively. The results of this study demonstrate that pseudorandom GVS generates many of the salient features of post-flight locomotor dysfunction observed in astronauts following short and long duration missions. An ambulatory GVS system may prove a useful adjunct to the current pre-flight astronaut training regimen.

A prediction model of compressor with variable-geometry diffuser based on elliptic equation and partial least squares

PubMed Central

Yang, Chuanlei; Wang, Yinyan; Wang, Hechun

2018-01-01

To achieve a much more extensive intake air flow range of the diesel engine, a variable-geometry compressor (VGC) is introduced into a turbocharged diesel engine. However, due to the variable diffuser vane angle (DVA), the prediction for the performance of the VGC becomes more difficult than for a normal compressor. In the present study, a prediction model comprising an elliptical equation and a PLS (partial least-squares) model was proposed to predict the performance of the VGC. The speed lines of the pressure ratio map and the efficiency map were fitted with the elliptical equation, and the coefficients of the elliptical equation were introduced into the PLS model to build the polynomial relationship between the coefficients and the relative speed, the DVA. Further, the maximal order of the polynomial was investigated in detail to reduce the number of sub-coefficients and achieve acceptable fit accuracy simultaneously. The prediction model was validated with sample data and in order to present the superiority of compressor performance prediction, the prediction results of this model were compared with those of the look-up table and back-propagation neural networks (BPNNs). The validation and comparison results show that the prediction accuracy of the new developed model is acceptable, and this model is much more suitable than the look-up table and the BPNN methods under the same condition in VGC performance prediction. Moreover, the new developed prediction model provides a novel and effective prediction solution for the VGC and can be used to improve the accuracy of the thermodynamic model for turbocharged diesel engines in the future. PMID:29410849

Directional Variance Adjustment: Bias Reduction in Covariance Matrices Based on Factor Analysis with an Application to Portfolio Optimization

PubMed Central

Bartz, Daniel; Hatrick, Kerr; Hesse, Christian W.; Müller, Klaus-Robert; Lemm, Steven

2013-01-01

Robust and reliable covariance estimates play a decisive role in financial and many other applications. An important class of estimators is based on factor models. Here, we show by extensive Monte Carlo simulations that covariance matrices derived from the statistical Factor Analysis model exhibit a systematic error, which is similar to the well-known systematic error of the spectrum of the sample covariance matrix. Moreover, we introduce the Directional Variance Adjustment (DVA) algorithm, which diminishes the systematic error. In a thorough empirical study for the US, European, and Hong Kong stock market we show that our proposed method leads to improved portfolio allocation. PMID:23844016

The impact of preload reduction with head-up tilt testing on longitudinal and transverse left ventricular mechanics: a study utilizing deformation volume analysis

PubMed Central

Schneider, Caroline; Forsythe, Lynsey; Somauroo, John; George, Keith

2018-01-01

Background Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function; however, the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change. Methods A focused transthoracic echocardiogram was performed on 10 healthy male participants (23 ± 3 years) in the supine position and following 1 min and 5 min of HUT testing. Raw temporal longitudinal ε (Ls) and transverse ε (Ts) values were exported and divided into 5% increments across the cardiac cycle and corresponding LV volumes were traced at each 5% increment. This provided simultaneous LV longitudinal and transverse ε and volume loops (deformation volume analysis – DVA). Results There was a leftward shift of the ε-volume loop from supine to 1 min and 5 min of HUT (P < 0.001). Moreover, longitudinal shortening was reduced (P < 0.001) with a concomitant increase in transverse thickening from supine to 1 min, which was further augmented at 5 min (P = 0.018). Conclusions Preload reduction occurs within 1 min of HUT but does not further reduce at 5 min. This decline is associated with a decrease in longitudinal ε and concomitant increase in transverse ε. Consequently, augmented transverse relaxation appears to be an important factor in the maintenance of LV filling in the setting of reduced preload. DVA provides information on the relative contribution of mechanics to a change in LV volume and may have a role in the assessment of clinical populations. PMID:29339401

The impact of preload reduction with head-up tilt testing on longitudinal and transverse left ventricular mechanics.

PubMed

Schneider, Caroline; Forsythe, Lynsey; Somauroo, John; George, Keith; Oxborough, David

2018-01-03

Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function however the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change. A focused transthoracic echocardiogram was performed on 10 healthy male participants (23 ± 3 years,) in the supine position and following 1 min and 5 min of HUT testing. Raw temporal longitudinal ε (Ls) and transverse ε (Ts) values were exported and divided into 5% increments across the cardiac cycle and corresponding LV volumes were traced at each 5% increment. This provided simultaneous LV longitudinal and transverse ε and volume-loops (deformation-volume analysis - DVA). There was a leftward- shift of the ε -volume loop from supine to 1 min and 5 min of HUT, p<0.001). Moreover, longitudinal shortening was reduced (p<0.001) with a concomitant increase in transverse thickening from supine to 1min, which was further augmented at 5min (p=0.018). Preload reduction occurs within 1 minute of HUT but does not further reduce at 5 minutes. This decline is associated with a decrease in longitudinal ε and concomitant increase in transverse ε. Consequently, augmented transverse relaxation appears to be an important factor in the maintenance of LV filling in the setting of reduced preload. DVA provides information on the relative contribution of mechanics to a change in LV volume and may have a role in the assessment of clinical populations. © 2018 The authors.

The impact of preload reduction with head-up tilt testing on longitudinal and transverse left ventricular mechanics: a study utilizing deformation volume analysis.

PubMed

Schneider, Caroline; Forsythe, Lynsey; Somauroo, John; George, Keith; Oxborough, David

2018-03-01

Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function; however, the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change. A focused transthoracic echocardiogram was performed on 10 healthy male participants (23 ± 3 years) in the supine position and following 1 min and 5 min of HUT testing. Raw temporal longitudinal ε (Ls) and transverse ε (Ts) values were exported and divided into 5% increments across the cardiac cycle and corresponding LV volumes were traced at each 5% increment. This provided simultaneous LV longitudinal and transverse ε and volume loops (deformation volume analysis - DVA). There was a leftward shift of the ε-volume loop from supine to 1 min and 5 min of HUT ( P  < 0.001). Moreover, longitudinal shortening was reduced ( P  < 0.001) with a concomitant increase in transverse thickening from supine to 1 min, which was further augmented at 5 min ( P  = 0.018). Preload reduction occurs within 1 min of HUT but does not further reduce at 5 min. This decline is associated with a decrease in longitudinal ε and concomitant increase in transverse ε. Consequently, augmented transverse relaxation appears to be an important factor in the maintenance of LV filling in the setting of reduced preload. DVA provides information on the relative contribution of mechanics to a change in LV volume and may have a role in the assessment of clinical populations. © 2018 The authors.

Sensory Neurons Arouse C. elegans Locomotion via Both Glutamate and Neuropeptide Release

PubMed Central

Chatzigeorgiou, Marios; Hu, Zhitao; Schafer, William R.; Kaplan, Joshua M.

2015-01-01

C. elegans undergoes periods of behavioral quiescence during larval molts (termed lethargus) and as adults. Little is known about the circuit mechanisms that establish these quiescent states. Lethargus and adult locomotion quiescence is dramatically reduced in mutants lacking the neuropeptide receptor NPR-1. Here, we show that the aroused locomotion of npr-1 mutants results from the exaggerated activity in multiple classes of sensory neurons, including nociceptive (ASH), touch sensitive (ALM and PLM), and stretch sensing (DVA) neurons. These sensory neurons accelerate locomotion via both neuropeptide and glutamate release. The relative contribution of these sensory neurons to arousal differs between larval molts and adults. Our results suggest that a broad network of sensory neurons dictates transitions between aroused and quiescent behavioral states. PMID:26154367

SU-E-T-148: Benchmarks and Pre-Treatment Reviews: A Study of Quality Assurance Effectiveness

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

Lowenstein, J; Nguyen, H; Roll, J

Purpose: To determine the impact benchmarks and pre-treatment reviews have on improving the quality of submitted clinical trial data. Methods: Benchmarks are used to evaluate a site’s ability to develop a treatment that meets a specific protocol’s treatment guidelines prior to placing their first patient on the protocol. A pre-treatment review is an actual patient placed on the protocol in which the dosimetry and contour volumes are evaluated to be per protocol guidelines prior to allowing the beginning of the treatment. A key component of these QA mechanisms is that sites are provided timely feedback to educate them on howmore » to plan per the protocol and prevent protocol deviations on patients accrued to a protocol. For both benchmarks and pre-treatment reviews a dose volume analysis (DVA) was performed using MIM softwareTM. For pre-treatment reviews a volume contour evaluation was also performed. Results: IROC Houston performed a QA effectiveness analysis of a protocol which required both benchmarks and pre-treatment reviews. In 70 percent of the patient cases submitted, the benchmark played an effective role in assuring that the pre-treatment review of the cases met protocol requirements. The 35 percent of sites failing the benchmark subsequently modified there planning technique to pass the benchmark before being allowed to submit a patient for pre-treatment review. However, in 30 percent of the submitted cases the pre-treatment review failed where the majority (71 percent) failed the DVA. 20 percent of sites submitting patients failed to correct their dose volume discrepancies indicated by the benchmark case. Conclusion: Benchmark cases and pre-treatment reviews can be an effective QA tool to educate sites on protocol guidelines and to minimize deviations. Without the benchmark cases it is possible that 65 percent of the cases undergoing a pre-treatment review would have failed to meet the protocols requirements.Support: U24-CA-180803.« less

Congressional Black Caucus meets with NASA

NASA Image and Video Library

2010-01-13

NASA Administrator Charles Bolden, space shuttle crew STS-129 and members of the Congressional Black Caucus pose for a group photo at the Capitol Building, Wednesday, Jan. 13, 2010, in Washington. Back row from left to right: U.S. Rep Donna Edwards (D-MD), U.S. Rep Diane Watson (D-CA), NASA Administrator Charles Bolden, astronauts Leland Melvin, Mike Foreman, Robert Satcher, Barry Wilmore, Randy Breznik, and U.S. Rep Mel Watt (D-NC). Front row from left to right: U.S. Rep Robert Scott (D-VA), U.S. Rep. Corrine Brown (D-Fla), U.S. Rep. Barbara Lee (D-CA), U.S. Rep. Donna Christensen (D-VI) and U.S. Rep. Donald Payne (D-NJ). The crew of STS-129 presented the CBC with a montage commemorating their mission. Photo Credit: (NASA/Paul E. Alers)

Dynamic Visual Acuity While Walking in Normals and Labyrinthine-Deficient Patients

NASA Technical Reports Server (NTRS)

Hillman, Edward J.; Bloomberg, Jacob J.; McDonald, P. Vernon; Cohen, Helen S.

1996-01-01

We describe a new, objective, easily administered test of dynamic visual acuity (DVA) while walking. Ten normal subjects and five patients with histories of severe bilateral vestibular dysfunctions participated in this study. Subjects viewed a visual display of numerals of different font sizes presented on a laptop computer while they stood still and while they walked on a motorized treadmill. Treadmill speed was adapted for 4 of 5 patients. Subjects were asked to identify the numerals as they appeared on the computer screen. Test results were reasonably repeatable in normals. The percent correct responses at each font size dropped slightly while walking in normals and dropped significantly more in patients. Patients performed significantly worse than normals while standing still and while walking. This task may be useful for evaluating post-flight astronauts and vestibularly impaired patients.

The Advanced Glaucoma Intervention Study (AGIS): 4. Comparison of treatment outcomes within race. Seven-year results.

PubMed

1998-07-01

The purpose of this report is to present separately for black and white patients with advanced glaucoma 7-year results of two alternative surgical intervention sequences. A randomized controlled trial. A total of 332 black patients (451 eyes), 249 white patients (325 eyes), and 10 patients of other races (13 eyes) participated. Potential follow-up ranged from 4 to 7 years. Eyes were randomly assigned to either an argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy (ATT) sequence or a trabeculectomy-ALT-trabeculectomy (TAT) sequence. The second and third interventions were offered after failure of the first and second interventions, respectively. Average percent of eyes with decrease of visual field (APDVF), average percent of eyes with decrease of visual acuity (APDVA), and average percent of eyes with decrease of vision (APDV) are the outcome measures. Decrease of visual field (DVF) is an increase from baseline of at least 4 points on a glaucoma visual field defect scale ranging from 0 to 20, decrease of visual acuity (DVA) is a decrease from baseline of at least 15 letters (3 lines), and decrease of vision (DV) is the occurrence of either DVF or DVA. The averages are of percent decreases observed at 6-month intervals from the first 6-month visit to the end of the specified observation period. In both black and white patients throughout 7-year follow-up, the mean decrease in intraocular pressure was greater in eyes assigned to TAT, and the cumulative probability of failure of the first intervention was greater in eyes assigned to ATT. In black patients, APDVF, APDVA, and APDV are less for the ATT sequence than for the TAT sequence throughout the 7 years. In white patients, APDVF also favors the ATT sequence but only for the first year, after which it favors the TAT sequence through the seventh year; APDVA also favors the ATT sequence, but the ATT-TAT difference progressively diminishes over 7 years; and APDV favors ATT over TAT initially, but after 4

Differential Variance Analysis: a direct method to quantify and visualize dynamic heterogeneities

NASA Astrophysics Data System (ADS)

Pastore, Raffaele; Pesce, Giuseppe; Caggioni, Marco

2017-03-01

Many amorphous materials show spatially heterogenous dynamics, as different regions of the same system relax at different rates. Such a signature, known as Dynamic Heterogeneity, has been crucial to understand the nature of the jamming transition in simple model systems and is currently considered very promising to characterize more complex fluids of industrial and biological relevance. Unfortunately, measurements of dynamic heterogeneities typically require sophisticated experimental set-ups and are performed by few specialized groups. It is now possible to quantitatively characterize the relaxation process and the emergence of dynamic heterogeneities using a straightforward method, here validated on video microscopy data of hard-sphere colloidal glasses. We call this method Differential Variance Analysis (DVA), since it focuses on the variance of the differential frames, obtained subtracting images at different time-lags. Moreover, direct visualization of dynamic heterogeneities naturally appears in the differential frames, when the time-lag is set to the one corresponding to the maximum dynamic susceptibility. This approach opens the way to effectively characterize and tailor a wide variety of soft materials, from complex formulated products to biological tissues.

The Use of Deer Vehicle Accidents as a Proxy for Measuring the Degree of Interaction Between Human and Deer Populations and Its Correlation With the Incidence Rate of Lyme Disease

PubMed Central

Wiznia, Daniel H.; Christos, Paul J.; LaBonte, Andrew M.

2014-01-01

The study described in this article examined the relationship between the incidence rate of deer vehicle accidents (DVAs), a proxy for measuring the interaction between populations of humans and deer, and human Lyme disease incidence rate. The authors also examined the relationship between deer population density and human Lyme incidence rate. They analyzed data from Connecticut’s Department of Environmental Protection and the Department of Public Health from 1999 through 2008 by deer management zone (DMZ) and town. For DVA incidence rate versus Lyme incidence rate for both DMZs and towns, most of the correlation coefficients computed yearly were moderate to strong and all of the p-values were significant. A weak correlation was observed between deer population density and Lyme disease incidence rate by DMZ. The authors propose DVAs as a proxy for measuring the interaction between coexisting populations of humans and deer. The authors’ study suggests that additional investigations of DVAs and their relationship to Lyme disease to further assess the utility of public health interventions are warranted. PMID:23621054

Regulation of two motor patterns enables the gradual adjustment of locomotion strategy in Caenorhabditis elegans

PubMed Central

Hums, Ingrid; Riedl, Julia; Mende, Fanny; Kato, Saul; Kaplan, Harris S; Latham, Richard; Sonntag, Michael; Traunmüller, Lisa; Zimmer, Manuel

2016-01-01

In animal locomotion a tradeoff exists between stereotypy and flexibility: fast long-distance travelling (LDT) requires coherent regular motions, while local sampling and area-restricted search (ARS) rely on flexible movements. We report here on a posture control system in C. elegans that coordinates these needs. Using quantitative posture analysis we explain worm locomotion as a composite of two modes: regular undulations versus flexible turning. Graded reciprocal regulation of both modes allows animals to flexibly adapt their locomotion strategy under sensory stimulation along a spectrum ranging from LDT to ARS. Using genetics and functional imaging of neural activity we characterize the counteracting interneurons AVK and DVA that utilize FLP-1 and NLP-12 neuropeptides to control both motor modes. Gradual regulation of behaviors via this system is required for spatial navigation during chemotaxis. This work shows how a nervous system controls simple elementary features of posture to generate complex movements for goal-directed locomotion strategies. DOI: http://dx.doi.org/10.7554/eLife.14116.001 PMID:27222228

Active vibration control of a thin walled beam by neural networks and piezo-actuators

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

Lecce, L.; Sorrentino, A.; Concilio, A.

1994-12-31

In turboprop aircraft, vibration of the fuselage frame (typically a thin-walled beam) has been identified as the main cause of interior noise. Passive methods, based essentially on the use of DVA (Dynamic Vibration Absorbers) have been shown to be not entirely satisfactory, due to the significant weight increase. The use of active control systems based on piezoceramic sensors and actuators integrated into the frame seems to be a valid alternative to attenuate interior noise. In this paper, the use of a MIMO feedforward active control system with piezoceramic actuators is proposed, in order to reduce the vertical vibration levels ofmore » a rectified, typical fuselage frame. A numerical FEM model of the rectified frame has been experimentally validated and has been used in order to evaluate the dynamic response of the beam, both with regard to piezoceramic actuators and to a point force, representing the primary disturbance. A neural network (NN) controller has been used to simultaneously compute amplitudes and phases of the control force for the 6 piezo actuators, so as to minimize the accelerometric responses acquired in 30 points of the beam (6 at each of 5 different transversal sections).« less

In vitro bioactivity investigations of Ti-15Mo alloy after electrochemical surface modification.

PubMed

Kazek-Kęsik, Alicja; Kuna, Karolina; Dec, Weronika; Widziołek, Magdalena; Tylko, Grzegorz; Osyczka, Anna M; Simka, Wojciech

2016-07-01

Titanium and its aluminum and vanadium-free alloys have especially great potential for medical applications. Electrochemical surface modification improves their surface bioactivity and stimulates osseointegration process. In this work, the effect of plasma electrolytic oxidation of the β-type alloy Ti-15Mo surface on its bioactivity is presented. Bioactivity of the modified alloy was investigated by immersion in simulated body fluid (SBF). Biocompatibility of the modified alloys were tested using human bone marrow stromal cells (hBMSC) and wild intestinal strains (DV/A, DV/B, DV/I/1) of Desulfovibrio desulfuricans bacteria. The particles of apatite were formed on the anodized samples. Human BMSC cells adhered well on all the examined surfaces and expressed ALP, collagen, and produced mineralized matrix as determined after 10 and 21 days of culture. When the samples were inoculated with D. desulfuricans bacteria, only single bacteria were visible on selected samples. There were no obvious changes in surface morphology among samples. Colonization and bacterial biofilm formation was observed on as-ground sample. In conclusion, the surface modification improved the Ti-15Mo alloy bioactivity and biocompatibility and protected surface against colonization of the bacteria. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 903-913, 2016. © 2015 Wiley Periodicals, Inc.

α-Pinene secondary organic aerosol at low temperature: chemical composition and implications for particle viscosity

NASA Astrophysics Data System (ADS)

Huang, Wei; Saathoff, Harald; Pajunoja, Aki; Shen, Xiaoli; Naumann, Karl-Heinz; Wagner, Robert; Virtanen, Annele; Leisner, Thomas; Mohr, Claudia

2018-02-01

Chemical composition, size distributions, and degree of oligomerization of secondary organic aerosol (SOA) from α-pinene (C10H16) ozonolysis were investigated for low-temperature conditions (223 K). Two types of experiments were performed using two simulation chambers at the Karlsruhe Institute of Technology: the Aerosol Preparation and Characterization (APC) chamber, and the Aerosol Interaction and Dynamics in the Atmosphere (AIDA) chamber. Experiment type 1 simulated SOA formation at upper tropospheric conditions: SOA was generated in the AIDA chamber directly at 223 K at 61 % relative humidity (RH; experiment termed cold humid, CH) and for comparison at 6 % RH (experiment termed cold dry, CD) conditions. Experiment type 2 simulated SOA uplifting: SOA was formed in the APC chamber at room temperature (296 K) and < 1 % RH (experiment termed warm dry, WD) or 21 % RH (experiment termed warm humid, WH) conditions, and then partially transferred to the AIDA chamber kept at 223 K, and 61 % RH (WDtoCH) or 30 % RH (WHtoCH), respectively. Precursor concentrations varied between 0.7 and 2.2 ppm α-pinene, and between 2.3 and 1.8 ppm ozone for type 1 and type 2 experiments, respectively. Among other instrumentation, a chemical ionization mass spectrometer (CIMS) coupled to a filter inlet for gases and aerosols (FIGAERO), deploying I- as reagent ion, was used for SOA chemical composition analysis. For type 1 experiments with lower α-pinene concentrations and cold SOA formation temperature (223 K), smaller particles of 100-300 nm vacuum aerodynamic diameter (dva) and higher mass fractions (> 40 %) of adducts (molecules with more than 10 carbon atoms) of α-pinene oxidation products were observed. For type 2 experiments with higher α-pinene concentrations and warm SOA formation temperature (296 K), larger particles ( ˜ 500 nm dva) with smaller mass fractions of adducts (< 35 %) were produced. We also observed differences (up to 20 °C) in

Adaptive Helmholtz resonators and passive vibration absorbers for cylinder interior noise control

NASA Astrophysics Data System (ADS)

Estève, Simon J.; Johnson, Marty E.

2005-12-01

This paper presents an adaptive-passive solution to control the broadband sound transmission into rocket payload fairings. The treatment is composed of passive distributed vibration absorbers (DVAs) and adaptive Helmholtz resonators (HR). Both the frequency domain and time-domain model of a simply supported cylinder excited by an external plane wave are developed. To tune vibration absorbers to tonal excitation, a tuning strategy, based on the phase information between the velocity of the absorber mass and the velocity of the host structure is used here in a new fashion to tune resonators to peaks in the broadband acoustic spectrum of a cavity. This tuning law, called the dot-product method, only uses two microphone signals local to each HR, which allows the adaptive Helmholtz resonator (AHR) to be manufactured as an autonomous device with power supply, sensor, actuator and controller integrated. Numerical simulations corresponding to a 2.8 m long 2.5 m diameter composite cylinder prototype demonstrate that, as long as the structure modes, which strongly couple to the acoustic cavity, are damped with a DVA treatment, the dot-product method tune multiple HRs to a near-optimal solution over a broad frequency range (40-160 Hz). An adaptive HR prototype with variable opening is built and characterized. Experiments conducted on the cylinder prototype with eight AHRs demonstrate the ability of resonators adapted with the dot-product method to converge to near-optimal noise attenuation in a frequency band including multiple resonances.

Submicron particles influenced by mixed biogenic and anthropogenic emissions: high-resolution aerosol mass spectrometry results from the Carbonaceous Aerosols and Radiative Effects Study (CARES)

NASA Astrophysics Data System (ADS)

Setyan, A.; Zhang, Q.; Merkel, M.; Knighton, W. B.; Sun, Y.; Song, C.; Shilling, J. E.; Onasch, T. B.; Herndon, S. C.; Worsnop, D. R.; Fast, J. D.; Zaveri, R. A.; Berg, L. K.; Wiedensohler, A.; Flowers, B. A.; Dubey, M. K.; Subramanian, R.

2012-02-01

The Carbonaceous Aerosols and Radiative Effects Study (CARES) took place in the Sacramento Valley of California in summer 2010. We present results obtained at Cool, CA, the T1 site of the project (~40 km downwind of urban emissions from Sacramento), where we deployed an Aerodyne high resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS) in parallel with complementary instrumentation to characterize the sources and processes of submicron particles (PM1). Cool is located at the foothill of the Sierra Nevada Mountains, where intense biogenic emissions are periodically mixed with urban outflow transported by daytime southwesterly winds from the Sacramento metropolitan area. The particle mass loading was low (3.0 μg m-3 on average) and dominated by organics (80 % of the PM1 mass) followed by sulfate (9.9 %). Organics and sulfate appeared to be externally mixed, as suggested by their different time series (r2 = 0.13) and size distributions. Sulfate showed a bimodal distribution with a droplet mode peaking at ˜400 nm in vacuum aerodynamic diameter (Dva), and a condensation mode at ~150 nm, while organics generally displayed a broad distribution in 60-600 nm (Dva). New particle formation and growth events were observed almost every day, emphasizing the roles of organics and sulfate in new particle growth, especially that of organics. The organic aerosol (OA) had a~nominal formula of C1H1.38N0.004O0.44, thus an average organic mass-to-carbon (OM/OC) ratio of 1.70. Two different oxygenated OA (OOA, 90 % of total OA mass) and a hydrocarbon-like OA (HOA, 10 %) were identified by Positive matrix factorization (PMF) of the high-resolution mass spectra. The more oxidized MO-OOA (O/C = 0.54) corresponded to secondary OA (SOA) primarily influenced by biogenic emissions, while the less oxidized LO-OOA (O/C = 0.42) corresponded to SOA associated with urban transport. The HOA factor corresponded to primary emissions mainly due to local traffic. Twenty three periods of

Interactive wiimote gaze stabilization exercise training system for patients with vestibular hypofunction.

PubMed

Chen, Po-Yin; Hsieh, Wan-Ling; Wei, Shun-Hwa; Kao, Chung-Lan

2012-10-09

Peripheral vestibular hypofunction is a major cause of dizziness. When complicated with postural imbalance, this condition can lead to an increased incidence of falls. In traditional clinical practice, gaze stabilization exercise is commonly used to rehabilitate patients. In this study, we established a computer-aided vestibular rehabilitation system by coupling infrared LEDs to an infrared receiver. This system enabled the subjects' head-turning actions to be quantified, and the training was performed using vestibular exercise combined with computer games and interactive video games that simulate daily life activities. Three unilateral and one bilateral vestibular hypofunction patients volunteered to participate in this study. The participants received 30 minutes of computer-aided vestibular rehabilitation training 2 days per week for 6 weeks. Pre-training and post-training assessments were completed, and a follow-up assessment was completed 1 month after the end of the training period. After 6 weeks of training, significant improvements in balance and dynamic visual acuity (DVA) were observed in the four participants. Self-reports of dizziness, anxiety and depressed mood all decreased significantly. Significant improvements in self-confidence and physical performance were also observed. The effectiveness of this training was maintained for at least 1 month after the end of the training period. Real-time monitoring of training performance can be achieved using this rehabilitation platform. Patients demonstrated a reduction in dizziness symptoms after 6 weeks of training with this short-term interactive game approach. This treatment paradigm also improved the patients' balance function. This system could provide a convenient, safe and affordable treatment option for clinical practitioners.

Refractive errors and binocular dysfunctions in a population of university students.

PubMed

Risovic, D J; Misailovic, K R; Eric-Marinkovic, J M; Kosanovic-Jakovic, N G; Milenkovic, S M; Petrovic, L Z

2008-01-01

This clinical study was performed to determine the presence of refractive errors and binocular dysfunctions in a population of university students. Refraction and binocular function were evaluated in a young patient population (230 students and 234 nonstudent subjects, aged 18-27 years). Distance visual acuity (DVA) and near visual acuity (NVA), refraction, cover test (CT), ocular motility, near-point of convergence, horizontal phoria measurement by Maddox wing, negative and positive vergence amplitude in prism diopters, fusion amplitude in synoptophore, as well as stereoacuity (Titmus test) were tested. Emmetropia was the most frequent refractive status in our student and nonstudent groups (78.7%). Myopia was the most frequent refractive disorder in the whole population (13.1%). Myopia and hypermetropia were significantly more frequent in the students than in nonstudents (chi-square emp 47.55). Exophoria is significantly more frequent in myopic subjects. Vergence amplitude (t test 0.000) and fusion amplitude (t test 0.005) show significantly lower values in student population. Results of Titmus test in the student group is significantly worse than in the nonstudent group (t test 0.000). Maddox wing resulted in significantly higher degree of heterophoria in the student population (t test 0.000). Myopic subjects, in the student group (t test 0.002) as well as in the nonstudent group (t test 0.001), show significantly better results in Titmus test. High near visual demand could be the most important factor for higher incidence of myopia, worse convergence and fusion amplitude, higher degree of exophoria, and worse results in Titmus test in the student population.

Strategies for Cd accumulation in Dittrichia viscosa (L.) Greuter: role of the cell wall, non-protein thiols and organic acids.

PubMed

Fernández, R; Fernández-Fuego, D; Bertrand, A; González, A

2014-05-01

Dittrichia viscosa (L.) Greuter is plant species commonly found in degraded zones of Asturias (Spain), where it accumulates high levels of Cd, but the mechanisms involved in this response in non-model plants have not been elucidated. In this way, we analysed the fraction of the total Cd bound to the cell walls, the ultrastructural localization of this metal, and non-protein thiol and organic acid concentrations of two clones of D. viscosa: DV-A (from a metal-polluted soil) and DV-W (from a non-polluted area). After 10 days of hydroponic culture with Cd, fractionation and ultrastructural localisation studies showed that most of the Cd accumulated by D. viscosa was kept in the cell wall. The non-protein thiol content rose in D. viscosa with Cd exposure, especially in the non-metallicolous DV-W clone, and in both clones we found with Cd exposure a synthesis de novo of phytochelatins PC2 and PC3 in shoots and roots and also of other phytochelatin-related compounds, particularly in roots. Regarding organic acids, their concentration in both clones decreased in shoots after Cd treatment, but increased in roots, mainly due to changes in the citric acid concentration. Thus, retention of Cd in the cell wall seems to be the first strategy in response to metal entry in D. viscosa and once inside cells non-protein thiols and organic acids might also participate in Cd tolerance. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Flicker-induced retinal vasodilatation is not dependent on complement factor H polymorphism in healthy young subjects.

PubMed

Told, Reinhard; Palkovits, Stefan; Boltz, Agnes; Schmidl, Doreen; Napora, Katarzyna J; Werkmeister, René M; Haslacher, Helmuth; Frantal, Sophie; Popa-Cherecheanu, Alina; Schmetterer, Leopold; Garhöfer, Gerhard

2014-11-01

The complement factor H (CFH) tyrosine 402 histidine (Y402H, rs1061170) variant is known to be significantly associated with age-related macular degeneration (AMD). Whether this genetic variant may impact retinal blood flow regulation is largely unknown. This study investigated whether flicker-induced vasodilation, an indicator for the coupling between neural activity and blood flow, is altered in subjects carrying the rs1061170 risk allele. One hundred healthy subjects (aged between 18 and 45 years) were included in this study. Retinal blood flow regulation was tested by assessing retinal vessel calibres in response to stimulation with diffuse flicker light. Retinal vascular flicker responses were determined with a Dynamic Vessel Analyzer (DVA). In addition, genotyping for rs1061170 was performed. Eighteen subjects were homozygous for the risk allele C, 50 were homozygous for the ancestral allele T, and 31 subjects were heterozygous (CT). One subject had to be excluded from data evaluation, as no genetic analysis could be performed due to technical difficulties. Baseline diameters of retinal arteries (p = 0.39) and veins (p = 0.64) were comparable between the three groups. Flicker-induced vasodilation in both retinal arteries (p = 0.38) and retinal veins (p = 0.62) was also comparable between the three studied groups. Our data indicate that homozygous healthy young carriers of the C risk allele at rs1061170 do not show abnormal flicker-induced vasodilation in the retina. This suggests that the high-risk genetic variant of CFH polymorphism does not impact neuro-vascular coupling in healthy subjects. © 2014 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

Interactive wiimote gaze stabilization exercise training system for patients with vestibular hypofunction

PubMed Central

2012-01-01

Background Peripheral vestibular hypofunction is a major cause of dizziness. When complicated with postural imbalance, this condition can lead to an increased incidence of falls. In traditional clinical practice, gaze stabilization exercise is commonly used to rehabilitate patients. In this study, we established a computer-aided vestibular rehabilitation system by coupling infrared LEDs to an infrared receiver. This system enabled the subjects’ head-turning actions to be quantified, and the training was performed using vestibular exercise combined with computer games and interactive video games that simulate daily life activities. Methods Three unilateral and one bilateral vestibular hypofunction patients volunteered to participate in this study. The participants received 30 minutes of computer-aided vestibular rehabilitation training 2 days per week for 6 weeks. Pre-training and post-training assessments were completed, and a follow-up assessment was completed 1 month after the end of the training period. Results After 6 weeks of training, significant improvements in balance and dynamic visual acuity (DVA) were observed in the four participants. Self-reports of dizziness, anxiety and depressed mood all decreased significantly. Significant improvements in self-confidence and physical performance were also observed. The effectiveness of this training was maintained for at least 1 month after the end of the training period. Conclusion Real-time monitoring of training performance can be achieved using this rehabilitation platform. Patients demonstrated a reduction in dizziness symptoms after 6 weeks of training with this short-term interactive game approach. This treatment paradigm also improved the patients’ balance function. This system could provide a convenient, safe and affordable treatment option for clinical practitioners. PMID:23043886

Primary and secondary organic aerosols in Fresno, California during wintertime: Results from high resolution aerosol mass spectrometry

NASA Astrophysics Data System (ADS)

Ge, Xinlei; Setyan, Ari; Sun, Yele; Zhang, Qi

2012-10-01

Organic aerosols (OA) were studied in Fresno, California, in winter 2010 with an Aerodyne High Resolution Time-of-Flight Aerosol Mass Spectrometer (HR-ToF-AMS). OA dominated the submicron aerosol mass (average = 67%) with an average concentration of 7.9μg m-3 and a nominal formula of C1H1.59N0.014O0.27S0.00008, which corresponds to an average organic mass-to-carbon ratio of 1.50. Three primary OA (POA) factors and one oxygenated OA factor (OOA) representative of secondary OA (SOA) were identified via Positive Matrix Factorization of the high-resolution mass spectra. The three POA factors, which include a traffic-related hydrocarbon-like OA (HOA), a cooking OA (COA), and a biomass burning OA (BBOA) released from residential heating, accounted for an average 57% of the OA mass and up to 80% between 6 - 9 P.M., during which enhanced emissions from evening rush hour traffic, dinner cooking, and residential wood burning were exacerbated by low mixed layer height. The mass-based size distributions of the OA factors were estimated based on multilinear analysis of the size-resolved mass spectra of organics. Both HOA and BBOA peaked at ˜140 nm in vacuum aerodynamic diameter (Dva) while OOA peaked at an accumulation mode of ˜460 nm. COA exhibited a unique size distribution with two size modes centering at ˜200 nm and 450 nm respectively. This study highlights the leading roles played by anthropogenic POA emissions, primarily from traffic, cooking and residential heating, in aerosol pollution in Fresno in wintertime.

Use of proton pump inhibitors among older Australians: national quality improvement programmes have led to sustained practice change.

PubMed

Pratt, Nicole L; Kalisch Ellett, Lisa M; Sluggett, Janet K; Gadzhanova, Svetla V; Ramsay, Emmae N; Kerr, Mhairi; LeBlanc, Vanessa T; Barratt, John D; Roughead, Elizabeth E

2017-02-01

To evaluate the impact of national multifaceted initiatives to improve use of proton pump inhibitors (PPIs) on the use of PPIs among older Australians. Interrupted time series analysis using administrative health claims data from the Australian Government Department of Veterans' Affairs (DVA). Australia. All veterans and dependents who received PPIs between January 2003 and December 2013. National, multifaceted interventions to improve PPI use were conducted by the Australian Government Department of Veterans' Affairs Veterans' MATES programme and Australia's NPS MedicineWise in April 2004, June 2006, May 2009 and August 2012. Trends in monthly rate of use of any PPI among the veteran population, and the monthly rate of use of low strength PPIs among all veterans dispensed a PPI. Interventions in 2004, 2006, 2009 and 2012 slowed the rate of increase in PPI use significantly, with the 2012 intervention resulting in a sustained 0.04% decrease in PPI use each month. The combined effect of all four interventions was a 20.9% (95% CI 7.8-33.9%) relative decrease in PPI use 12 months after the final intervention. The four interventions also resulted in a 42.2% (95% CI 19.9-64.5%) relative increase in low strength PPI use 12 months after the final intervention. National multifaceted programmes targeting clinicians and consumers were effective in reducing overall PPI use and increasing use of low strength PPIs. Interventions to improve PPI use should incorporate regular repetition of key messages to sustain practice change. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Improving cardiovascular disease management in Australia: NPS MedicineWise.

PubMed

Gadzhanova, Svetla V; Roughead, Elizabeth E; Bartlett, Mark J

2013-08-05

To determine the impact of four NPS MedicineWise programs targeting quality use of medicines in cardiovascular management in primary care. Interrupted time-series analysis using the Department of Veterans' Affairs (DVA) claims dataset from 1 January 2002 to 31 August 2010. We examined the use of antithrombotics in people with atrial fibrillation and in those who had had a stroke, and the use of echocardiography and spironolactone in the population with heart failure. All veterans and their dependants in Australia who had received cardiovascular medicines or health services related to the targeted intervention. NPS MedicineWise national programs to improve cardiovascular management in primary care, which included prescriber feedback, academic detailing, case studies and audits as well as printed educational materials. Changes in medication and health service use before and after the interventions. All national programs were positively associated with significant improvements in related prescribing or test request practice. The interventions to improve the use of antithrombotics resulted in a 1.27% (95% CI, 1.26%-1.28%) and 0.63% (95% CI, 0.62%-0.64%) relative increase in the use of aspirin or warfarin in the population with atrial fibrillation 6 and 12 months after the program, respectively, and in a 1.51% (95% CI, 1.49%-1.53%) relative increase in the use of aspirin as monotherapy for secondary stroke prevention 12 months after the intervention. The heart failure programs resulted in a 3.69% (95% CI, 3.67%-3.71%) relative increase in the use of low-dose spironolactone and a 4.31% (95% CI, 4.27%-4.35%) relative increase in the use of echocardiogram tests 12 months after the intervention. NPS MedicineWise programs were effective in achieving positive changes in medicine and health service use for patients with cardiovascular diseases.

[Phylogenetic relationships and intraspecific variation of D-genome Aegilops L. as revealed by RAPD analysis].

PubMed

Goriunova, S V; Kochieva, E Z; Chikida, N N; Pukhal'skiĭ, V A

2004-05-01

RAPD analysis was carried out to study the genetic variation and phylogenetic relationships of polyploid Aegilops species, which contain the D genome as a component of the alloploid genome, and diploid Aegilops tauschii, which is a putative donor of the D genome for common wheat. In total, 74 accessions of six D-genome Aegilops species were examined. The highest intraspecific variation (0.03-0.21) was observed for Ae. tauschii. Intraspecific distances between accessions ranged 0.007-0.067 in Ae. cylindrica, 0.017-0.047 in Ae. vavilovii, and 0.00-0.053 in Ae. juvenalis. Likewise, Ae. ventricosa and Ae. crassa showed low intraspecific polymorphism. The among-accession difference in alloploid Ae. ventricosa (genome DvNv) was similar to that of one parental species, Ae. uniaristata (N), and substantially lower than in the other parent, Ae. tauschii (D). The among-accession difference in Ae. cylindrica (CcDc) was considerably lower than in either parent, Ae. tauschii (D) or Ae. caudata (C). With the exception of Ae. cylindrica, all D-genome species--Ae. tauschii (D), Ae. ventricosa (DvNv), Ae. crassa (XcrDcrl and XcrDcrlDcr2), Ae. juvenalis (XjDjUj), and Ae. vavilovii (XvaDvaSva)--formed a single polymorphic cluster, which was distinct from clusters of other species. The only exception, Ae. cylindrica, did not group with the other D-genome species, but clustered with Ae. caudata (C), a donor of the C genome. The cluster of these two species was clearly distinct from the cluster of the other D-genome species and close to a cluster of Ae. umbellulata (genome U) and Ae. ovata (genome UgMg). Thus, RAPD analysis for the first time was used to estimate and to compare the interpopulation polymorphism and to establish the phylogenetic relationships of all diploid and alloploid D-genome Aegilops species.

Post-hypoxic constriction of retinal arterioles is impaired during nitric oxide and cyclo-oxygenase inhibition and in diabetic patients without retinopathy.

PubMed

Petersen, Line; Bek, Toke

2017-10-01

Occlusion of retinal vessels leads to retinal ischaemia and hypoxia, which induces vasodilatation in adjacent retinal areas in order to normalize retinal oxygenation. Previous studies have shown that NO and COX products are involved in hypoxia-induced dilatation of retinal arterioles in vitro and in vivo, and that this response is disturbed in patients with diabetes mellitus. However, it is unknown to what extent post-hypoxic recovery of the diameter of retinal arterioles depends on NO and COX products in normal persons and in diabetic patients. The Dynamic Vessel Analyzer (DVA) was used to study the post-hypoxic diameter changes of larger retinal vessels in 20 normal persons, 20 diabetic patients without diabetic retinopathy, and in 18 patients with diabetic maculopathy before and after inhibition of the synthesis of nitric oxide and COX products. In normal persons, the arterioles had re-constricted (p > 0.99) 2 minutes after termination of hypoxia in the absence of antagonists, but not after treatment with L-NMMA and diclofenac (p < 0.01 for all comparisons). In diabetic patients without retinopathy, the arterioles showed no diameter changes after termination of hypoxia during any of the interventions. In patients with diabetic maculopathy hypoxia had not dilated retinal arterioles (p > 0.1 for all comparisons) to allow the study of re-constriction. In all groups, the dilatation of venules remained significantly increased during the post-hypoxic observation period, both in the absence and in the presence of L-NMMA and diclofenac.Post-hypoxic constriction of retinal arterioles depends on NO and COX products, and is impaired in diabetic patients before the development of retinopathy. This disturbance may contribute to the development of diabetic retinopathy, and should be the target of future interventional studies aimed at preventing and treating the disease.ClinicalTrials.gov identifier: NCT01689090.

The Advanced Glaucoma Intervention Study (AGIS): 9. Comparison of glaucoma outcomes in black and white patients within treatment groups.

PubMed

2001-09-01

To compare in eyes of black and white patients the progression of glaucoma after failure of medical therapy and upon start of surgical intervention. Cohort study analysis of data from a randomized clinical trial. This multicenter study included open-angle glaucoma patients who had failed medical therapy: 451 eyes of 332 black patients, 325 eyes of 249 white patients. Eyes were randomly assigned to an argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy (ATT) sequence or a trabeculectomy-ALT-trabeculectomy (TAT) sequence; they had been followed for 7 to 11 years at database closure. Main outcome measures were decrease of visual field (DVF), sustained decrease of visual field (SDVF), decrease of visual acuity (DVA), sustained decrease of visual acuity (SDVA), and failure of first surgical glaucoma intervention. Statistical methods included logistic regression to obtain average adjusted black-white odds ratios for binary outcomes, and Cox regression to estimate adjusted black-white risk ratios for time-to-event outcomes. In the ATT sequence blacks were at lower risk than whites of failure of first intervention (ALT, RR = 0.68, P = 0.040). In the TAT sequence blacks were at higher risk than whites of failure of the first intervention (trabeculectomy, RR = 1.79, P = 0.033), of intraocular pressure > or =18 mm Hg (average OR = 1.41, P = 0.026), and of DVF (average OR = 1.78, P = 0.007). In both treatment sequences, the average number of prescribed medications was greater for blacks than whites (P < or = 0.002). The results support the hypothesis that after failure of medical therapy and upon initiation of surgical intervention, an initial intervention with trabeculectomy retards the progression of glaucoma more effectively in white than in black patients. The data provide a weak suggestion that an initial surgical intervention with ALT retards the progression of glaucoma more effectively in black than in white patients.

Feasibility of vibro-acoustography with a quasi-2D ultrasound array transducer for detection and localizing of permanent prostate brachytherapy seeds: A pilot ex vivo study

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

Mehrmohammadi, Mohammad; Kinnick, Randall R.; Fatemi, Mostafa, E-mail: fatemi.mostafa@mayo.edu

2014-09-15

Purpose: Effective permanent prostate brachytherapy (PPB) requires precise placement of radioactive seeds in and around the prostate. The impetus for this research is to examine a new ultrasound-based imaging modality, vibro-acoustography (VA), which may serve to provide a high rate of PPB seed detection while also effecting enhanced prostate imaging. The authors investigate the ability of VA, implemented on a clinical ultrasound (US) scanner and equipped with a quasi-2D (Q2D) array US transducer, to detect and localize PPB seeds in excised prostate specimens. Methods: Nonradioactive brachytherapy seeds were implanted into four excised cadaver prostates. A clinical US scanner equipped withmore » a Q2D array US transducer was customized to acquire both US and C-scan VA images at various depths. The VA images were then used to detect and localize the implanted seeds in prostate tissue. To validate the VA results, computed tomography (CT) images of the same tissue samples were obtained to serve as the reference by which to evaluate the performance of VA in PPB seed detection. Results: The results indicate that VA is capable of accurately identifying the presence and distribution of PPB seeds with a high imaging contrast. Moreover, a large ratio of the PPB seeds implanted into prostate tissue samples could be detected through acquired VA images. Using CT-based seed identification as the standard, VA was capable of detecting 74%–92% of the implanted seeds. Additionally, the angular independency of VA in detecting PPB seeds was demonstrated through a well-controlled phantom experiment. Conclusions: Q2DVA detected a substantial portion of the seeds by using a 2D array US transducer in excised prostate tissue specimens. While VA has inherent advantages associated with conventional US imaging, it has the additional advantage of permitting detection of PPB seeds independent of their orientation. These results suggest the potential of VA as a method for PPB imaging that

Bridging evidence-practice gaps: improving use of medicines in elderly Australian veterans.

PubMed

Roughead, Elizabeth E; Kalisch Ellett, Lisa M; Ramsay, Emmae N; Pratt, Nicole L; Barratt, John D; LeBlanc, Vanessa T; Ryan, Philip; Peck, Robert; Killer, Graeme; Gilbert, Andrew L

2013-12-12

The Australian Government Department of Veterans' Affairs (DVA) funds an ongoing health promotion based program to improve use of medicines and related health services, which implements interventions that include audit and feedback in the form of patient-specific feedback generated from administrative claims records. We aimed to determine changes in medicine use as a result of the program. The program provides targeted patient-specific feedback to medical practitioners. The feedback is supported with educational material developed by a clinical panel, subject to peer review and overseen by a national editorial committee. Veterans who meet target criteria also receive educational brochures. The program is supported by a national call centre and ongoing national consultation. Segmented regression analyses (interrupted time series) were undertaken to assess changes in medication use in targeted veterans pre and post each intervention. 12 interventions were included; three to increase medicine use, seven which aimed to reduce use, and two which had combination of messages to change use. All programs that aimed to increase medicine use were effective, with relative effect sizes at the time of the intervention ranging from 1% to 8%. Mixed results were seen with programs aiming to reduce inappropriate medicine use. Highly specific programs were effective, with relative effect sizes at the time of the intervention of 10% decline in use of NSAIDs in high risk groups and 14% decline in use of antipsychotics in dementia. Interventions targeting combinations of medicines, including medicine interactions and potentially inappropriate medicines in the elderly did not change practice significantly. Interventions with combinations of messages targeting multiple components of practice had an impact on one component, but not all components targeted. The Veterans' MATES program showed positive practice change over time, with interventions increasing use of appropriate medicines where

Cancer screening literature in the period 2000-2002: pointers to future research avenues.

PubMed

Moore, Malcolm A; Kunimoto, Takehiko; Tsuda, Hiroyuki

2003-01-01

In order to determine which areas of cancer screening are currently receiving greatest emphasis in different parts of the world a Medline search of the literature for the period 2000-2002 was performed, concentrating attention on research into all aspects of efforts for early detection of tumours, with especial attention to methodology, motivation (including awareness of utility in the general populace and in minority groups), and intervention (professional training and general education). Focus on the skin, lung, cervix, breast, ovary + endometrium, oral cavity-oesophagus, gastric, colorectal, kidney + urinary tract and prostate, demonstrated large numbers of journals to be publishing papers in the field, with 10, 33, 130, 53, 24, 21, 6, 81, 12 and 58, respectively, in the period investigated, the grand total being 259. The average numbers of papers/journal ranged from 1.0-2.4 with only 15-35% appearing in journals with wide coverage. With the exception of oral, oesophageal and gastric cancer screening, an approximately 50% contribution in all areas was made by scientists in the US, followed by Europe (31% overall,) Asia (11%) then Australasia, Central and South America and Africa (3%, 2% and 1%, respectively). Clear differences were evident with the organ regarding specific topics receiving attention, most publications concerning the lung, ovary and urological tract dealing with detection methods. With the cervix and colorectum this topic accounted for half of the papers with especial attention to the relative advantages of the PAP smear, HPV testing and direct visual acetic acid (DVA) in the one, and FOBT and endoscopy in the other. Another major focus was found to be minority attitudes to breast, prostate and cervical screening in the US, whereas only few papers were found dealing with practical intervention, targeting professionals or screenees to increase participation in screening programs. The present approach suggested a number of areas requiring more

Feasibility of vibro-acoustography with a quasi-2D ultrasound array transducer for detection and localizing of permanent prostate brachytherapy seeds: A pilot ex vivo study

PubMed Central

Mehrmohammadi, Mohammad; Alizad, Azra; Kinnick, Randall R.; Davis, Brian J.; Fatemi, Mostafa

2014-01-01

Purpose: Effective permanent prostate brachytherapy (PPB) requires precise placement of radioactive seeds in and around the prostate. The impetus for this research is to examine a new ultrasound-based imaging modality, vibro-acoustography (VA), which may serve to provide a high rate of PPB seed detection while also effecting enhanced prostate imaging. The authors investigate the ability of VA, implemented on a clinical ultrasound (US) scanner and equipped with a quasi-2D (Q2D) array US transducer, to detect and localize PPB seeds in excised prostate specimens. Methods: Nonradioactive brachytherapy seeds were implanted into four excised cadaver prostates. A clinical US scanner equipped with a Q2D array US transducer was customized to acquire both US and C-scan VA images at various depths. The VA images were then used to detect and localize the implanted seeds in prostate tissue. To validate the VA results, computed tomography (CT) images of the same tissue samples were obtained to serve as the reference by which to evaluate the performance of VA in PPB seed detection. Results: The results indicate that VA is capable of accurately identifying the presence and distribution of PPB seeds with a high imaging contrast. Moreover, a large ratio of the PPB seeds implanted into prostate tissue samples could be detected through acquired VA images. Using CT-based seed identification as the standard, VA was capable of detecting 74%–92% of the implanted seeds. Additionally, the angular independency of VA in detecting PPB seeds was demonstrated through a well-controlled phantom experiment. Conclusions: Q2DVA detected a substantial portion of the seeds by using a 2D array US transducer in excised prostate tissue specimens. While VA has inherent advantages associated with conventional US imaging, it has the additional advantage of permitting detection of PPB seeds independent of their orientation. These results suggest the potential of VA as a method for PPB imaging that

The Diurnal Cycle of Particle Sizes, Compositions, and Densities observed in Sacramento, CA during CARES Field Campaign

NASA Astrophysics Data System (ADS)

Beránek, J.; Vaden, T.; Imre, D. G.; Zelenyuk, A.

2010-12-01

A central objective of the Carbonaceous Aerosol and Radiative Effects Study (CARES) was to characterize unequivocally all aspects related to organics in aerosols. To this end, a range of instruments measured loadings, size distributions, compositions, densities, CCN activities, and optical properties of aerosol sampled in Sacramento, CA over the month of June 2010. We present the results of measurements conducted by our single particle mass spectrometer, SPLAT. SPLAT was used to measure the size, composition, and density of individual particles with diameters between 50 to 2000 nm. SPLAT measured the vacuum aerodynamic diameters (dva) of more than 2 million particles and the compositions of ~350,000 particles, each day. In addition, SPLAT was used in combination with a differential mobility analyzer to measure the density, or effective density of individual particles. These measurements were typically conducted twice per day: in the morning, and mid-afternoon. Preliminary analysis of the data shows that under most conditions, the particles were relatively small (below 200 nm), and the vast majority of them were composed of oxygenated organics mixed with various amounts of sulfates. Analysis of the mass spectra shows that the oxygenated organics in these particles are the oxidized products of biogenic volatile organic precursors. In addition to particles composed of SOA mixed with sulfates, we detected and characterized fresh and processed soot particles, biomass burning aerosol, organic amines, sea salt - fresh and processed - and a small number of dust and other inorganic particles, commonly found in urban environment. SOA mixed with sulfates were the vast majority of particles at all times, while the other particle types exhibited episodic behavior. The data shows a reproducible diurnal pattern in SOA size distributions, number concentrations, and compositions. Early in the morning the particle number concentrations are relatively low, and the particle size

Characterization of the sources and processes of organic and inorganic aerosols in New York City with a high-resolution time-of-flight aerosol mass spectrometer

NASA Astrophysics Data System (ADS)

Sun, Y.-L.; Zhang, Q.; Schwab, J. J.; Demerjian, K. L.; Chen, W.-N.; Bae, M.-S.; Hung, H.-M.; Hogrefe, O.; Frank, B.; Rattigan, O. V.; Lin, Y.-C.

2010-10-01

Submicron aerosol particles (PM1) were measured in-situ using a High-Resolution Time-of-Flight Aerosol Mass Spectrometer (HR-ToF-AMS) during the summer 2009 Field Intensive Study at Queens College in New York City. Organic aerosol (OA) and sulfate are the two dominant species, accounting for 54% and 24%, respectively, of total PM1 mass on average. The average mass size distribution of OA presents a small mode peaking at ~150 nm (Dva) in addition to an accumulation mode (~550 nm) that is internally mixed with sulfate, nitrate, and ammonium. The diurnal cycles of sulfate and OA both show pronounced peaks between 01:00-02:00 p.m. EST due to photochemical production. The average (±1σ) oxygen-to-carbon (O/C), hydrogen-to-carbon (H/C), and nitrogen-to-carbon (N/C) ratios of OA in NYC are 0.36 (±0.09), 1.49 (±0.08), and 0.012(±0.005), respectively, corresponding to an average organic mass-to-carbon (OM/OC) ratio of 1.62(±0.11). Positive matrix factorization (PMF) of the high resolution mass spectra identified five OA components: a hydrocarbon-like OA (HOA), two types of oxygenated OA (OOA) including a low-volatility OOA (LV-OOA) and a semi-volatile OOA (SV-OOA), a cooking-emission related OA (COA), and a unique nitrogen-enriched OA (NOA). HOA appears to represent primary OA (POA) from urban traffic emissions. It comprises primarily of reduced species (H/C=1.83; O/C=0.06) and shows a mass spectral pattern very similar to those of POA from fossil fuel combustion, and correlates tightly with traffic emission tracers including elemental carbon and NOx. LV-OOA, which is highly oxidized (O/C=0.63) and correlates well with sulfate, appears to be representative for regional, aged secondary OA (SOA). SV-OOA, which is less oxidized (O/C=0.38) and correlates well with non-refractory chloride, likely represents less photo-chemically aged, semi-volatile SOA. COA shows a similar spectral pattern to the reference spectra of POA from cooking emissions and a distinct diurnal pattern