Sample records for longer term effect

  1. Massed versus Spaced Practice in Vocology: Effect of a Short-Term Intensive Voice Training versus a Longer-Term Traditional Voice Training

    ERIC Educational Resources Information Center

    Meerschman, Iris; Van Lierde, Kristiane; Van Puyvelde, Caro; Bostyn, Astrid; Claeys, Sofie; D'haeseleer, Evelien

    2018-01-01

    Background: In contrast with most medical and pharmaceutical therapies, the optimal dosage for voice therapy or training is unknown. Aims: The aim of this study was to compare the effect of a short-term intensive voice training (IVT) with a longer-term traditional voice training (TVT) on the vocal quality and vocal capacities of vocally healthy…

  2. Effect of drug-related cues on response inhibition through abstinence: A pilot study in male heroin abstainers.

    PubMed

    Su, Bobo; Yang, Ling; Wang, Grace Y; Wang, Sha; Li, Shaomei; Cao, Hua; Zhang, Yan

    2017-11-01

    Chronic heroin use can cause a deficit of inhibitory function, leading to a loss of control over drug use. Exposure to drug-related cues is considered as one of the contributing factors. However, it is unclear whether there are dynamic changes on the effect of drug-related cues on response inhibition following prolonged abstinence. The present study investigated the effect of drug-related cues on response inhibition in heroin abstainers at different abstinent phases. 26 shorter-term (2-6 months) and 26 longer-term (19-24 months) male heroin abstainers performed on a modified two-choice Oddball task, which included two conditions: in the cued condition, neutral pictures served as the background of standard stimuli (yellow frame) and heroin-related pictures served as the background of deviant stimuli (blue frame), reversed in the controlled conditions. Compared to longer-term abstainers, mean reaction time (RT) for drug deviants in shorter-term abstainers was significantly longer. Shorter-term abstainers also showed markedly slower response to neutral deviants relative to drug deviants, but this tendency was not observed in longer-term abstainers. Nevertheless, both groups had similar RT for standard stimuli regardless of their paired background pictures. Effect of drug-related cues on response inhibition remains at the early stage of abstinence; however, this effect may be reduced following a longer period of drug abstinence. Our findings highlight the importance of assessing and improving the ability of inhibiting drug-related cue reactivity during treatment.

  3. Innovation in health economic modelling of service improvements for longer-term depression: demonstration in a local health community.

    PubMed

    Tosh, Jonathan; Kearns, Ben; Brennan, Alan; Parry, Glenys; Ricketts, Thomas; Saxon, David; Kilgarriff-Foster, Alexis; Thake, Anna; Chambers, Eleni; Hutten, Rebecca

    2013-04-26

    The purpose of the analysis was to develop a health economic model to estimate the costs and health benefits of alternative National Health Service (NHS) service configurations for people with longer-term depression. Modelling methods were used to develop a conceptual and health economic model of the current configuration of services in Sheffield, England for people with longer-term depression. Data and assumptions were synthesised to estimate cost per Quality Adjusted Life Years (QALYs). Three service changes were developed and resulted in increased QALYs at increased cost. Versus current care, the incremental cost-effectiveness ratio (ICER) for a self-referral service was £11,378 per QALY. The ICER was £2,227 per QALY for the dropout reduction service and £223 per QALY for an increase in non-therapy services. These results were robust when compared to current cost-effectiveness thresholds and accounting for uncertainty. Cost-effective service improvements for longer-term depression have been identified. Also identified were limitations of the current evidence for the long term impact of services.

  4. Long-term effectiveness and cost-effectiveness of high versus low-to-moderate intensity resistance and endurance exercise interventions among cancer survivors.

    PubMed

    Kampshoff, C S; van Dongen, J M; van Mechelen, W; Schep, G; Vreugdenhil, A; Twisk, J W R; Bosmans, J E; Brug, J; Chinapaw, M J M; Buffart, Laurien M

    2018-06-01

    This study aimed to evaluate the long-term effectiveness and cost-effectiveness of high intensity (HI) versus low-to-moderate intensity (LMI) exercise on physical fitness, fatigue, and health-related quality of life (HRQoL) in cancer survivors. Two hundred seventy-seven cancer survivors participated in the Resistance and Endurance exercise After ChemoTherapy (REACT) study and were randomized to 12 weeks of HI (n = 139) or LMI exercise (n = 138) that had similar exercise types, durations, and frequencies, but different intensities. Measurements were performed at baseline (4-6 weeks after primary treatment), and 12 (i.e., short term) and 64 (i.e., longer term) weeks later. Outcomes included cardiorespiratory fitness, muscle strength, self-reported fatigue, HRQoL, quality-adjusted life years (QALYs) and societal costs. Linear mixed models were conducted to study (a) differences in effects between HI and LMI exercise at longer term, (b) within-group changes from short term to longer term, and (c) the cost-effectiveness from a societal perspective. At longer term, intervention effects on role (β = 5.9, 95% CI = 0.5; 11.3) and social functioning (β = 5.7, 95%CI = 1.7; 9.6) were larger for HI compared to those for LMI exercise. No significant between-group differences were found for physical fitness and fatigue. Intervention-induced improvements in cardiorespiratory fitness and HRQoL were maintained between weeks 12 and 64, but not for fatigue. From a societal perspective, the probability that HI was cost-effective compared to LMI exercise was 0.91 at 20,000€/QALY and 0.95 at 52,000€/QALY gained, mostly due to significant lower healthcare costs in HI exrcise. At longer term, we found larger intervention effects on role and social functioning for HI than for LMI exercise. Furthermore, HI exercise was cost-effective with regard to QALYs compared to LMI exercise. This study is registered at the Netherlands Trial Register [NTR2153 [ http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2153

  5. Longer-term effects of selective thinning on microarthropod communities in a late-successional coniferous forest.

    Treesearch

    Robert W. Peck; Christine G. Niwa

    2005-01-01

    Microarthropod densities within late-successional coniferous forests thinned 16-41 yr before sampling were compared with adjacent unthinned stands to identify longer term effects of thinning on this community. Soil and forest floor layers were sampled separately on eight paired sites. Within the forest floor oribatid, mesostigmatid, and to a marginal extent,...

  6. How Are They Now? Longer Term Effects of eCoaching through Online Bug-in-Ear Technology

    ERIC Educational Resources Information Center

    Rock, Marcia L.; Schumacker, Randall E.; Gregg, Madeleine; Howard, Pamela W.; Gable, Robert A.; Zigmond, Naomi

    2014-01-01

    In this study, using mixed methods, we investigated the longer term effects of eCoaching through advanced online bug-in-ear (BIE) technology. Quantitative data on five dependent variables were extracted from 14 participants' electronically archived video files at three points in time--Spring 1 (i.e., baseline, which was the first semester of…

  7. Oral ketamine for the treatment of pain and treatment-resistant depression†.

    PubMed

    Schoevers, Robert A; Chaves, Tharcila V; Balukova, Sonya M; Rot, Marije Aan Het; Kortekaas, Rudie

    2016-02-01

    Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications. To review the literature about the dosing regimen, duration, effects and side-effects of oral, intravenous, intranasal and subcutaneous routes of administration of ketamine for treatment-resistant depression and pain. Searches in PubMed with the terms 'oral ketamine', 'depression', 'chronic pain', 'neuropathic pain', 'intravenous ketamine', 'intranasal ketamine' and 'subcutaneous ketamine' yielded 88 articles. We reviewed all papers for information about dosing regimen, number of individuals who received ketamine, number of ketamine days per study, results and side-effects, as well as study quality. Overall, the methodological strength of studies investigating the antidepressant effects of ketamine was considered low, regardless of the route of administration. The doses for depression were in the lower range compared with studies that investigated analgesic use. Studies on pain suggested that oral ketamine may be acceptable for treatment-resistant depression in terms of tolerability and side-effects. Oral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials. © The Royal College of Psychiatrists 2016.

  8. Effects of full-day kindergarten on the long-term health prospects of children in low-income and racial/ethnic-minority populations: a community guide systematic review.

    PubMed

    Hahn, Robert A; Rammohan, Veda; Truman, Benedict I; Milstein, Bobby; Johnson, Robert L; Muntañer, Carles; Jones, Camara P; Fullilove, Mindy T; Chattopadhyay, Sajal K; Hunt, Pete C; Abraido-Lanza, Ana F

    2014-03-01

    Children from low-income and minority families are often behind higher-income and majority children in language, cognitive, and social development even before they enter school. Because educational achievement has been shown to improve long-term health, addressing these delays may foster greater health equity. This systematic review assesses the extent to which full-day kindergarten (FDK), compared with half-day kindergarten (HDK), prepares children, particularly those from low-income and minority families, to succeed in primary and secondary school and improve lifelong health. A meta-analysis (2010) on the effects of FDK versus HDK among U.S. children measured educational achievement at the end of kindergarten. The meta-analysis was concordant with Community Guide criteria. Findings on the longer-term effects of FDK suggested "fade-out" by third grade. The present review used evidence on the longer-term effects of pre-K education to explore the loss of FDK effects over time. FDK improved academic achievement by an average of 0.35 SDs (Cohen's d; 95% CI=0.23, 0.46). The effect on verbal achievement was 0.46 (Cohen's d; 95% CI=0.32, 0.61) and that on math achievement was 0.24 (Cohen's d; 95% CI=0.06, 0.43). Evidence of "fade-out" from pre-K education found that better-designed studies indicated both residual benefits over multiple years and the utility of educational boosters to maintain benefits, suggesting analogous longer-term effects of FDK. There is strong evidence that FDK improves academic achievement, a predictor of longer-term health benefits. To sustain early benefits, intensive elementary school education is needed. If targeted to low-income and minority communities, FDK can advance health equity. Published by Elsevier Inc.

  9. THE LONG-TERM EFFICACY OF ACUTE-PHASE PSYCHOTHERAPY FOR DEPRESSION: A META-ANALYSIS OF RANDOMIZED TRIALS.

    PubMed

    Karyotaki, Eirini; Smit, Yolba; de Beurs, Derek P; Henningsen, Kirsten Holdt; Robays, Jo; Huibers, Marcus J H; Weitz, Erica; Cuijpers, Pim

    2016-05-01

    Understanding the effectiveness of treatment for depression in both the short term and long term is essential for clinical decision making. The present meta-analysis examined treatment effects on depression and quality of life in acute-phase psychotherapeutic interventions compared to no treatment control groups for adult depression at 6 months or longer postrandomization. A systematic literature search resulted in 44 randomized controlled trials with 6,096 participants. Acute-phase psychotherapy was compared to control groups at 6-month or longer postrandomization. Odds ratios of a positive outcome were calculated. Psychotherapy outperformed control groups at 6 months or longer postrandomization (OR = 1.92, 95% CI: 1.60-2.31, P < .001). Heterogeneity was moderate (I²: 65, 95% CI: 53-74, P < .001). However, effects significantly decreased with longer follow-up periods. Additionally, a small positive effect of psychotherapy was observed for quality of life, while similar effects were obtained in separate analyses of each type of psychotherapy, with the exception of nondirective supportive therapy. Studies that provided booster sessions had better treatment results compared with studies that did not provide any further sessions. Finally, we found that trials on psychotherapy aimed at major depressive disorder (MDD) had better outcomes than those that were aimed at elevated depressive symptoms. There is substantial evidence that acute-phase psychotherapy results in a better treatment effects on depression and quality of life in the long term for adult patients with depression. © 2016 Wiley Periodicals, Inc.

  10. 12-Month Follow-Up of Fluoxetine and Cognitive Behavioral Therapy for Binge Eating Disorder

    ERIC Educational Resources Information Center

    Grilo, Carlos M.; Crosby, Ross D.; Wilson, G. Terence; Masheb, Robin M.

    2012-01-01

    Objective: The longer term efficacy of medication treatments for binge-eating disorder (BED) remains unknown. This study examined the longer term effects of fluoxetine and cognitive behavioral therapy (CBT) either with fluoxetine (CBT + fluoxetine) or with placebo (CBT + placebo) for BED through 12-month follow-up after completing treatments.…

  11. Perceptual learning of degraded speech by minimizing prediction error.

    PubMed

    Sohoglu, Ediz; Davis, Matthew H

    2016-03-22

    Human perception is shaped by past experience on multiple timescales. Sudden and dramatic changes in perception occur when prior knowledge or expectations match stimulus content. These immediate effects contrast with the longer-term, more gradual improvements that are characteristic of perceptual learning. Despite extensive investigation of these two experience-dependent phenomena, there is considerable debate about whether they result from common or dissociable neural mechanisms. Here we test single- and dual-mechanism accounts of experience-dependent changes in perception using concurrent magnetoencephalographic and EEG recordings of neural responses evoked by degraded speech. When speech clarity was enhanced by prior knowledge obtained from matching text, we observed reduced neural activity in a peri-auditory region of the superior temporal gyrus (STG). Critically, longer-term improvements in the accuracy of speech recognition following perceptual learning resulted in reduced activity in a nearly identical STG region. Moreover, short-term neural changes caused by prior knowledge and longer-term neural changes arising from perceptual learning were correlated across subjects with the magnitude of learning-induced changes in recognition accuracy. These experience-dependent effects on neural processing could be dissociated from the neural effect of hearing physically clearer speech, which similarly enhanced perception but increased rather than decreased STG responses. Hence, the observed neural effects of prior knowledge and perceptual learning cannot be attributed to epiphenomenal changes in listening effort that accompany enhanced perception. Instead, our results support a predictive coding account of speech perception; computational simulations show how a single mechanism, minimization of prediction error, can drive immediate perceptual effects of prior knowledge and longer-term perceptual learning of degraded speech.

  12. Perceptual learning of degraded speech by minimizing prediction error

    PubMed Central

    Sohoglu, Ediz

    2016-01-01

    Human perception is shaped by past experience on multiple timescales. Sudden and dramatic changes in perception occur when prior knowledge or expectations match stimulus content. These immediate effects contrast with the longer-term, more gradual improvements that are characteristic of perceptual learning. Despite extensive investigation of these two experience-dependent phenomena, there is considerable debate about whether they result from common or dissociable neural mechanisms. Here we test single- and dual-mechanism accounts of experience-dependent changes in perception using concurrent magnetoencephalographic and EEG recordings of neural responses evoked by degraded speech. When speech clarity was enhanced by prior knowledge obtained from matching text, we observed reduced neural activity in a peri-auditory region of the superior temporal gyrus (STG). Critically, longer-term improvements in the accuracy of speech recognition following perceptual learning resulted in reduced activity in a nearly identical STG region. Moreover, short-term neural changes caused by prior knowledge and longer-term neural changes arising from perceptual learning were correlated across subjects with the magnitude of learning-induced changes in recognition accuracy. These experience-dependent effects on neural processing could be dissociated from the neural effect of hearing physically clearer speech, which similarly enhanced perception but increased rather than decreased STG responses. Hence, the observed neural effects of prior knowledge and perceptual learning cannot be attributed to epiphenomenal changes in listening effort that accompany enhanced perception. Instead, our results support a predictive coding account of speech perception; computational simulations show how a single mechanism, minimization of prediction error, can drive immediate perceptual effects of prior knowledge and longer-term perceptual learning of degraded speech. PMID:26957596

  13. Long-Term Effects of a Home-Visiting Intervention for Depressed Mothers and Their Infants

    ERIC Educational Resources Information Center

    Kersten-Alvarez, Laura E.; Hosman, Clemens M. H.; Riksen-Walraven, J. Marianne; Van Doesum, Karin T. M.; Hoefnagels, Cees

    2010-01-01

    Background: Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term effects of an intervention for mothers with postpartum…

  14. Violation of eating expectancies does not reduce conditioned desires for chocolate.

    PubMed

    van den Akker, Karolien; van den Broek, Myrr; Havermans, Remco C; Jansen, Anita

    2016-05-01

    Although eating desires can be easily learned, their extinction appears more difficult. The present two-session study aimed to investigate the role of eating expectancies in the short and longer-term extinction of eating desires. In addition, the relationship between eating desires and conditioned evaluations was examined to test whether they might share a similar mechanism. It was hypothesized that the short-term extinction of eating desires would be more successful after the disconfirmation of eating expectancies (instructed extinction or IE), while resulting in worse longer-term extinction because omission of the food reward during extinction is not surprising. In contrast to the hypotheses, it was found that IE had no effect on the short-term and longer-term extinction of eating desires. Eating desires correlated with conditioned evaluations only to some extent. It is concluded that eating expectancies do not mediate the short-term extinction of conditioned eating desires. In addition, their longer-term extinction does not appear to be facilitated by a greater violation of eating expectancies. This suggests that it might not be necessary to focus on expectancy violation in cue exposure therapy to reduce eating desires. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Parental distress in response to childhood medical trauma: A mediation model.

    PubMed

    Currie, Roseanne; Anderson, Vicki A; McCarthy, Maria C; Burke, Kylie; Hearps, Stephen Jc; Muscara, Frank

    2018-04-01

    This study explored the relationship between individual and family-level risk in predicting longer-term parental distress following their child's unexpected diagnosis of serious illness. A mediation model was tested, whereby parents' pre-existing psychosocial risk predicts longer-term posttraumatic stress symptoms, indirectly through parents' acute stress response. One hundred and thirty-two parents of 104 children participated. Acute stress response partially mediated the relationship between psychosocial risk and posttraumatic stress symptoms, with a moderate indirect effect ( r 2 = .20, P M = .56, p < .001). Findings demonstrated that cumulative psychosocial risk factors predispose parents to acute stress and longer-term posttraumatic stress symptoms, highlighting the need for psychosocial screening in this population.

  16. Effects of Exposures on Superalloys for Space Applications

    NASA Technical Reports Server (NTRS)

    Gabb, Tim; Garg, Anita; Gayda, John

    2007-01-01

    The industry is demanding longer term service at high temperatures for nickel-base superalloys in gas turbine engine as well as potential space applications. However, longer term service can severely tax alloy phase stability, to the potential detriment of mechanical properties. Cast Mar-M247LC and wrought Haynes 230 superalloys were exposed and creep tested for extended times at elevated temperature. Microstructure and phase evaluations were then undertaken for comparisons.

  17. Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review

    PubMed Central

    Morad, Anna; Sathe, Nila A.; Francis, David O.; McPheeters, Melissa L.

    2017-01-01

    CONTEXT: The effectiveness of tonsillectomy or adenotonsillectomy (“tonsillectomy”) for recurrent throat infection compared with watchful waiting is uncertain. OBJECTIVE: To compare sleep, cognitive, behavioral, and health outcomes of tonsillectomy versus watchful waiting in children with recurrent throat infections. DATA SOURCES: MEDLINE, Embase, and the Cochrane Library. STUDY SELECTION: Two investigators independently screened studies against predetermined criteria. DATA EXTRACTION: One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE) and confidence in the estimate of effects. RESULTS: Seven studies including children with ≥3 infections in the previous 1 to 3 years addressed this question. In studies reporting baseline data, number of infections/sore throats decreased from baseline in both groups, with greater decreases in sore throat days, clinician contacts, diagnosed group A streptococcal infections, and school absences in tonsillectomized children in the short term (<12 months). Quality of life was not markedly different between groups at any time point. LIMITATIONS: Few studies fully categorized infection/sore throat severity; attrition was high. CONCLUSIONS: Throat infections, utilization, and school absences improved in the first postsurgical year in tonsillectomized children versus children not receiving surgery. Benefits did not persist over time; longer-term outcomes are limited. SOE is moderate for reduction in short-term throat infections and insufficient for longer-term reduction. SOE is low for no difference in longer-term streptococcal infection reduction. SOE is low for utilization and missed school reduction in the short term, low for no difference in longer-term missed school, and low for no differences in quality of life. PMID:28096515

  18. Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review.

    PubMed

    Morad, Anna; Sathe, Nila A; Francis, David O; McPheeters, Melissa L; Chinnadurai, Sivakumar

    2017-02-01

    The effectiveness of tonsillectomy or adenotonsillectomy ("tonsillectomy") for recurrent throat infection compared with watchful waiting is uncertain. To compare sleep, cognitive, behavioral, and health outcomes of tonsillectomy versus watchful waiting in children with recurrent throat infections. MEDLINE, Embase, and the Cochrane Library. Two investigators independently screened studies against predetermined criteria. One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE) and confidence in the estimate of effects. Seven studies including children with ≥3 infections in the previous 1 to 3 years addressed this question. In studies reporting baseline data, number of infections/sore throats decreased from baseline in both groups, with greater decreases in sore throat days, clinician contacts, diagnosed group A streptococcal infections, and school absences in tonsillectomized children in the short term (<12 months). Quality of life was not markedly different between groups at any time point. Few studies fully categorized infection/sore throat severity; attrition was high. Throat infections, utilization, and school absences improved in the first postsurgical year in tonsillectomized children versus children not receiving surgery. Benefits did not persist over time; longer-term outcomes are limited. SOE is moderate for reduction in short-term throat infections and insufficient for longer-term reduction. SOE is low for no difference in longer-term streptococcal infection reduction. SOE is low for utilization and missed school reduction in the short term, low for no difference in longer-term missed school, and low for no differences in quality of life. Copyright © 2017 by the American Academy of Pediatrics.

  19. Effect of Treatment Modality on Long-Term Outcomes in Attention-Deficit/Hyperactivity Disorder: A Systematic Review

    PubMed Central

    Arnold, L. Eugene; Hodgkins, Paul; Caci, Hervé; Kahle, Jennifer; Young, Susan

    2015-01-01

    Background Evaluation of treatments for attention-deficit/hyperactivity disorder (ADHD) previously focused on symptom control, but attention has shifted to functional outcomes. The effect of different ADHD treatment periods and modalities (pharmacological, non-pharmacological, and combination) on long-term outcomes needs to be more comprehensively understood. Methods A systematic search of 12 literature databases using Cochrane’s guidelines yielded 403 English-language peer-reviewed, primary studies reporting long-term outcomes (≥2 years). We evaluated relative effects of treatment modalities and durations and effect sizes of outcomes reported as statistically significantly improved with treatment. Results The highest proportion of improved outcomes was reported with combination treatment (83% of outcomes). Among significantly improved outcomes, the largest effect sizes were found for combination treatment. The greatest improvements were associated with academic, self-esteem, or social function outcomes. A majority of outcomes improved regardless of age of treatment initiation (60%–75%) or treatment duration (62%–72%). Studies with short treatment duration had shorter follow-up times (mean 3.2 years total study length) than those with longer treatment durations (mean 7.1 years total study length). Studies with follow-up times <3 years reported benefit with treatment for 93% of outcomes, whereas those with follow-up times ≥3 years reported treatment benefit for 57% of outcomes. Post-hoc analysis indicated that this result was related to the measurement of outcomes at longer periods (3.2 versus 0.4 years) after treatment cessation in studies with longer total study length. Conclusions While the majority of long-term outcomes of ADHD improve with all treatment modalities, the combination of pharmacological and non-pharmacological treatment was most consistently associated with improved long-term outcomes and large effect sizes. Older treatment initiation age or longer durations did not markedly affect proportion of improved outcomes reported, but measurement of outcomes long periods after treatment cessation may attenuate results. PMID:25714373

  20. Long-term precommercial thinning effects on Larix occidentalis (western larch) tree and stand characteristics

    Treesearch

    Michael S. Schaedel; Andrew J. Larson; David L. R. Affleck; R. Travis Belote; John M. Goodburn; David K. Wright; Elaine Kennedy Sutherland

    2017-01-01

    Precommercial thinning (PCT) is used to increase tree size and shorten harvest rotation time. Short-term results from PCT studies often show a trade-off between individual-tree growth and net stand yield, while longer-term effects of PCT on tree growth and stand yield are less well documented. We used a 54-year-old PCT study to test long-term effects of forest density...

  1. The effect of preterm birth on brainstem, middle latency and cortical auditory evoked responses (BMC AERs).

    PubMed

    Pasman, J W; Rotteveel, J J; de Graaf, R; Stegeman, D F; Visco, Y M

    1992-12-01

    Recent studies on the maturation of auditory brainstem evoked responses (ABRs) present conflicting results, whereas only sparse reports exist with respect to the maturation of middle latency auditory evoked responses (MLRs) and auditory cortical evoked responses (ACRs). The present study reports the effect of preterm birth on the maturation of auditory evoked responses in low risk preterm infants (27-34 weeks conceptional age). The ABRs indicate a consistent trend towards longer latencies for all individual ABR components and towards longer interpeak latencies in preterm infants. The MLR shows longer latencies for early component P0 in preterm infants. The ACRs show a remarkable difference between preterm and term infants. At 40 weeks CA the latencies of ACR components Na and P2 are significantly longer in term infants, whereas at 52 weeks CA the latencies of the same ACR components are shorter in term infants. The results support the hypothesis that retarded myelination of the central auditory pathway is partially responsible for differences found between preterm infants and term infants with respect to late ABR components and early MLR component P0. Furthermore, mild conductive hearing loss in preterm infants may also play its role. A more complex mechanism is implicated to account for the findings noted with respect to MLR component Na and ACR components Na and P2.

  2. Crisaborole Ointment 2%: A Review in Mild to Moderate Atopic Dermatitis.

    PubMed

    Hoy, Sheridan M

    2017-12-01

    Crisaborole ointment 2% (Eucrisa™) is a novel, anti-inflammatory inhibitor of phosphodiesterase 4 (PDE4) that is available in the USA for the topical treatment of mild to moderate atopic dermatitis in patients aged ≥ 2 years. In two short-term (28 days), identically designed, multicentre, phase III studies in this patient population, topical therapy with crisaborole ointment 2% reduced disease severity and pruritus severity compared with vehicle, with the effect established early and sustained over the course of treatment. Improvements in the other signs of atopic dermatitis (erythema, exudation, excoriation, induration/papulation, and lichenification) were also seen. Crisaborole ointment 2% was generally well tolerated in the short-term studies, with its favorable safety profile maintained over the longer term (up to 52 weeks) in a multicentre, extension study. Most treatment-emergent adverse events (TEAEs) were of mild to moderate severity and considered unrelated to the study medication. Moreover, the incidence of application-site pain following short- and longer-term topical therapy with crisaborole ointment 2% was low. In conclusion, crisaborole ointment 2% is an effective and generally well tolerated new topical option for the management of mild to moderate atopic dermatitis in patients aged ≥ 2 years, with the potential to effectively treat this patient population over the longer term without the safety concerns associated with other current topical anti-inflammatory agents.

  3. Gun control saves lives.

    PubMed

    Matzopoulos, Richard

    2016-05-19

    Reducing firearm mortality by means of stricter gun control is one of the most important short- to medium-term measures to address the burden of violence in South Africa, while longer-term interventions and policy measures take effect.

  4. Amitraz

    EPA Science Inventory

    Amitraz (CAS 33089-61-1) is a formamidine insecticide and acaricide used on crops, livestock, and pets. Neurotoxicity is the primary endpoint of concern for short-term exposures in nontarget species. Amitraz has hepatic, reproductive, and developmental effects with longer-term...

  5. The longer term experiences of parent training: a qualitative analysis.

    PubMed

    Furlong, M; McGilloway, S

    2015-09-01

    Child conduct problems are a major public health priority. Group-based parenting programmes are popular in addressing such problems, but evidence for their longer-term effectiveness is limited. Moreover, process evaluations are rare and little is understood about the key facilitative and inhibitive factors associated with maintaining outcomes in the longer term. This study involved the use of qualitative methods as part of a larger process evaluation to explore the longer-term experiences of parents who participated in a randomized controlled trial (RCT) of the Incredible Years Parenting Programme (IYPP) in disadvantaged settings in Ireland. A series of one-to-one in-depth interviews was conducted with parents at 12- (n = 20) and 18-month follow-up (n = 8) and analysed using constructivist grounded theory. Most parents reported positive child behaviour despite several challenges, but a substantial subset reported periods of relapse in positive outcomes. A relapse in child behaviour was linked to relinquishing skills in stressful times, the negative influence of an unsupportive environment, and the perceived ineffectiveness of parenting skills. Resilience in implementing skills despite adversity, and the utilization of available social supports, were associated with the maintenance of positive outcomes. Strengthening resilience and social support capacities may be important factors in maintaining positive longer-term outcomes. Those who design, research and deliver parenting programmes might consider the possibility of including a relapse-prevention module and/or the provision of post-intervention supports for more vulnerable families. © 2014 John Wiley & Sons Ltd.

  6. Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter?

    PubMed Central

    Zenk, Shannon N.; Tarlov, Elizabeth; Wing, Coady; Tong, Hao; Jones, Kelly K.; Powell, Lisa M.

    2018-01-01

    This study examined whether community food environments altered the longer-term effects of a nationwide behavioral weight management program on body mass index (BMI). The sample was comprised of 98,871 male weight management program participants and 15,385 female participants, as well as 461,302 and 37,192 inverse propensity-score weighted matched male and female controls. We measured the community food environment by counting the number of supermarkets, convenience stores, and fast food restaurants within a 1-mile radius around each person’s home address. We used difference-in-difference regression models with person and calendar time fixed effects to estimate MOVE! effects over time in sub-populations defined by community food environment attributes. Among men, after an initial decrease in BMI at 6 months, the effect of the program decreased over time, with BMI increasing incrementally at 12 months (0.098 kg/m2, p < 0.001), 18 months (0.069 kg/m2, p < 0.001), and 24 months (0.067 kg/m2, p < 0.001). Among women, the initial effects of the program decreased over time as well. Women had an incremental BMI change of 0.099 kg/m2 at 12 months (p < 0.05) with non-significant incremental changes at 18 months and 24 months. We found little evidence that these longer-term effects of the weight management program differed depending on the community food environment. Physiological adaptations may overwhelm environmental influences on adherence to behavioral regimens in affecting longer-term weight loss outcomes. PMID:29373556

  7. Learning and the Spiral Illusion

    ERIC Educational Resources Information Center

    Houtman, S. D.

    1974-01-01

    The purpose of the experiment was to ascertain whether the duration of the spiral illusion could be extended by a 'learning procedure' which would distinguish a longer-term learning effect from short-term adaptive changes due to inhibition. (Author)

  8. Computer-Delivered Interventions to Reduce College Student Drinking: A Meta-Analysis

    PubMed Central

    Carey, Kate B.; Scott-Sheldon, Lori A. J.; Elliott, Jennifer C.; Bolles, Jamie R.; Carey, Michael P.

    2009-01-01

    Aims This meta-analysis evaluates the efficacy and moderators of computer-delivered interventions (CDIs) to reduce alcohol use among college students. Methods We included 35 manuscripts with 43 separate interventions, and calculated both between-group and within-group effect sizes for alcohol consumption and alcohol-related problems. Effects sizes were calculated for short-term (≤ 5 weeks) and longer-term (≥ 6 weeks) intervals. All studies were coded for study descriptors, participant characteristics, and intervention components. Results The effects of CDIs depended on the nature of the comparison condition: CDIs reduced quantity and frequency measures relative to assessment-only controls, but rarely differed from comparison conditions that included alcohol content. Small-to-medium within-group effect sizes can be expected for CDIs at short- and longer-term follow-ups; these changes are less than or equivalent to the within-group effect sizes observed for more intensive interventions. Conclusions CDIs reduce the quantity and frequency of drinking among college students. CDIs are generally equivalent to alternative alcohol-related comparison interventions. PMID:19744139

  9. An Assessment of the Effects of the Endocrine Disrupting Chemical 17ß-Trenbolone on Japanese Medaka Fish in a Multigenerational Exposure

    EPA Science Inventory

    Presently the research emphasis for endocrine disrupting chemicals has been on the development of short-term screening assays. However, assessing effect concentrations of the most sensitive developmental stages impacted in longer-term and multi-generation tests remains to be det...

  10. 26 CFR 1.7702B-2 - Special rules for pre-1997 long-term care insurance contracts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... defined in section 4 of the National Association of Insurance Commissioners (NAIC) Long-Term Care Insurance Model Act, as in effect on August 21, 1996), regardless of the terminology used by the State in... actually becomes effective is substantially longer than under the insurance company's usual business...

  11. Cluster Randomized Controlled Trial: Clinical and Cost-Effectiveness of a System of Longer-Term Stroke Care.

    PubMed

    Forster, Anne; Young, John; Chapman, Katie; Nixon, Jane; Patel, Anita; Holloway, Ivana; Mellish, Kirste; Anwar, Shamaila; Breen, Rachel; Knapp, Martin; Murray, Jenni; Farrin, Amanda

    2015-08-01

    We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers, linked to evidence-based treatment algorithms and reference guides (the longer-term stroke care system of care) to address the poor longer-term recovery experienced by many patients with stroke. A pragmatic, multicentre, cluster randomized controlled trial of this system of care. Eligible patients referred to community-based Stroke Care Coordinators were randomized to receive the new system of care or usual practice. The primary outcome was improved patient psychological well-being (General Health Questionnaire-12) at 6 months; secondary outcomes included functional outcomes for patients, carer outcomes, and cost-effectiveness. Follow-up was through self-completed postal questionnaires at 6 and 12 months. Thirty-two stroke services were randomized (29 participated); 800 patients (399 control; 401 intervention) and 208 carers (100 control; 108 intervention) were recruited. In intention to treat analysis, the adjusted difference in patient General Health Questionnaire-12 mean scores at 6 months was -0.6 points (95% confidence interval, -1.8 to 0.7; P=0.394) indicating no evidence of statistically significant difference between the groups. Costs of Stroke Care Coordinator inputs, total health and social care costs, and quality-adjusted life year gains at 6 months, 12 months, and over the year were similar between the groups. This robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice. URL: http://www.controlled-trials.com. Unique identifier: ISRCTN 67932305. © 2015 Bradford Teaching Hospitals NHS Foundation Trust.

  12. Persistent effects of wildfire and debris flows on the invertebrate prey base of rainbow trout in Idaho streams

    Treesearch

    Amanda E. Rosenberger; Jason B. Dunham; John M. Buffington; Mark S. Wipfli

    2011-01-01

    Wildfire and debris flows are important physical and ecological drivers in headwater streams of western North America. Past research has primarily examined short-term effects of these disturbances; less is known about longer-term impacts. We investigated wildfire effects on the invertebrate prey base for drift-feeding rainbow trout (Oncorhynchus mykiss, Walbaum) in...

  13. Wheat response to CO2 enrichment: CO2 exchanges transpiration and mineral uptakes

    NASA Technical Reports Server (NTRS)

    Andre, M.; Ducloux, H.; Richaud, C.

    1986-01-01

    When simulating canopies planted in varied densities, researchers were able to demonstrate that increase of dry matter production by enhancing CO2 quickly becomes independant of increase of leaf area, especially above leaf area index of 2; dry matter gain results mainly from photosynthesis stimulation per unit of surface (primary CO2 effect). When crop density is low (the plants remaining alone a longer time), the effects of increasing leaf surface (tillering, leaf elongation here, branching for other plants etc.) was noticeable and dry matter simulation factor reached 1.65. This area effect decreased when canopy was closed in, as the effect of different surfaces no longer worked. The stimulation of photosynthesis reached to the primary CO2 effect. The accumulation in dry matter which was fast during that phase made the original weight advantage more and more neglectible. Comparison with short term measurements showed that first order long term effect of CO2 in wheat is predictible with short term experiment, from the effect of CO2 on photosynthesis measured on reference sample.

  14. Implications of longer term rest from grazing in the sagebrush steppe

    Treesearch

    K.W. Davies; M. Vavra; B. Schultz; N. Rimbey

    2014-01-01

    Longer term grazing rest has occurred or been proposed in large portions of the sagebrush steppe based on the assumption that it will improve ecosystem properties. However, information regarding the influence of longer term rest from grazing is limited and has not been summarized. We synthesized the scientific literature on long-term rest in the sagebrush steppe to...

  15. 75 FR 47465 - Pymetrozine; Regulation Denying NRDC's Objections on Remand

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... adverse effects are caused by either short-term (e.g., acute) or longer-term (e.g., chronic) pesticide... correspondingly levels of concern, for both short and long exposure periods as well as for the different routes of..., short-term, chronic, and cancer risks and EPA quantitatively assessed these risks in making its safety...

  16. Immediate and Longer-Term Stressors and the Mental Health of Hurricane Ike Survivors

    PubMed Central

    Lowe, Sarah R.; Tracy, Melissa; Cerdá, Magdalena; Norris, Fran H.; Galea, Sandro

    2014-01-01

    Previous research has documented that individuals exposed to more stressors during disasters and their immediate aftermath (immediate stressors) are at risk of experiencing longer-term postdisaster stressors. Longer-term stressors, in turn, have been found to play a key role in shaping postdisaster psychological functioning. Few studies have simultaneously explored the links from immediate to longer-term stressors, and from longer-term stressors to psychological functioning, however. Additionally, studies have inadequately explored whether postdisaster psychological symptoms influence longer-term stressors. In the current study, we aimed to fill these gaps. Participants (N = 448) were from population-based study of Hurricane Ike survivors and completed assessments 2–5 months (Wave 1), 5–9 months (Wave 2) and 14–18 months (Wave 3) postdisaster. Through path analysis, we found that immediate stressors, assessed at Wave 1, were positively associated with Wave 2 and Wave 3 stressors, which in turn were positively associated with Wave 2 and Wave 3 posttraumatic stress and depressive symptoms. Wave 2 posttraumatic stress symptoms were positively associated with Wave 3 stressors, and Wave 1 depressive symptoms were positively associated with Wave 2 stressors. The findings suggest that policies and interventions can reduce the impact of disasters on mental health by preventing and alleviating both immediate and longer-term postdisaster stressors. PMID:24343752

  17. Lacosamide: A Review in Focal-Onset Seizures in Patients with Epilepsy.

    PubMed

    Hoy, Sheridan M

    2018-05-01

    Lacosamide (Vimpat ® ) is a functionalized amino acid (available orally and intravenously) approved in the EU and the USA for use as monotherapy and adjunctive therapy for the treatment of focal-onset seizures in adults, adolescents and children aged ≥ 4 years with epilepsy. In adults and adolescents (aged ≥ 16 years), oral lacosamide as adjunctive therapy to other antiepileptic drugs was generally effective in reducing seizure frequency during short-term (up to 18 weeks) treatment, with efficacy sustained over the longer-term (up to 8 years). Moreover, patients were effectively switched from adjunctive oral lacosamide to the same dosage of intravenous lacosamide. Oral lacosamide was an effective conversion to monotherapy agent in this patient population and as monotherapy demonstrated noninferiority to carbamazepine controlled release in terms of seizure freedom. Antiepileptic benefits were maintained during longer-term (≤ 2 years) monotherapy. The antiepileptic efficacy of lacosamide in children aged ≥ 4 years has been extrapolated from data from adults and adolescents, with a similar response expected provided paediatric dosage adaptations are used and safety is demonstrated. Indeed, preliminary data demonstrated the efficacy of short-term (16 weeks) adjunctive lacosamide in patients aged ≥ 4 to < 17 years. Oral lacosamide was generally well tolerated over the short- and longer-term when administered as adjunctive therapy, a conversion to monotherapy agent and monotherapy in adults and adolescents and when administered as adjunctive therapy in children aged ≥ 4 years. Thus, lacosamide is a useful option for the management of focal-onset seizures across a broad age range, starting as early as 4 years of age.

  18. Long-term outcomes of children undergoing video-assisted gastrostomy.

    PubMed

    Salö, Martin; Santimano, Ana; Helmroth, Sofia; Stenström, Pernilla; Arnbjornsson, Einar Ólafur

    2017-01-01

    The aims of this study were to assess the short- and long-term complication rates after video-assisted gastrostomy (VAG), the effects of age and gender on long-term complications and the effect of duration of gastrostomy tube retention on the need for gastroraphy when the gastrostomy device was removed. This was a retrospective study of children undergoing VAG at a single institution. Children who died or moved from the area were excluded. The rates of short- and long-term complications developing at 3-6 months or 2 or more years, respectively, were compared. A total of 170 children were studied, out of a cohort of 303 children. The median age at surgery was 2 years. The median duration of postoperative long-term follow-up was 5 years (2-9 years). The complications at the respective short and long-term follow-ups were as follows: granulation tissue, leakage, infection and vomiting. There were no differences in the short- versus long-term complication rates for gender and age. Children needing gastroraphy had used a gastrostomy device significantly longer compared with children with spontaneous closure. Complications after VAG decrease over time. A longer duration of gastrostomy device retention leads to increased need for gastroraphy.

  19. Fires: Pushing the Reset Button or a Flash in the Pan?

    NASA Astrophysics Data System (ADS)

    MacDonald, L. H.; Wagenbrenner, J. W.; Robichaud, P. R.; Nelson, P. A.; Kampf, S. K.; Brogan, D. J.

    2016-12-01

    High and moderate severity wildfires can reduce infiltration rates to less than 10 mm/hr, and the resulting surface runoff can increase small-scale peak flows by one or more orders of magnitude. Fires can increase hillslope erosion rates by several orders of magnitude, but this increase is less linear with rainfall intensity because it also depends on sediment supply and detachment processes as well as transport capacity. These localized and shorter-term effects have been relatively well documented, but there is much more uncertainty in how these fire-induced changes can lead to larger-scale and/or longer-term effects. The goal of this presentation is to provide a process-based analysis of how, where, and when wildfires can cause either longer-term or larger-scale changes, effectively resetting the system as opposed to a more transient "flash in the pan". An understanding of vegetation, climatic, and geomorphic dynamics are are critical for predicting larger-scale and longer-term effects. First is the potential for the vegetation to return to pre-fire conditions, and this depends on vegetation type, spatial extent of the fire, and if the pre-fire vegetation is marginalized by climate change, land use, or other factors. The trajectory of post-fire regrowth controls the duration of increased runoff and erosion as well as the size and severity of future fires, which then sets the scene for longer-term hydrologic and geomorphic change. Climate defines the dominant storm type and how they match up with the spatial extent of a fire. Historic data help estimate the extent and magnitude of post-fire rainfall, but there is a strong stochastic component and the more extreme events are of greatest concern. Geomorphic controls on larger-scale effects include the valley and drainage network characteristics that help govern the storage and delivery of water and sediment. Assessing each component involves multiple site factors, but the biggest problem is understanding their complex interactions to predict resource impacts, landscape change over different temporal and spatial scales, and the potential to ameliorate adverse impacts. Data from multiple field studies are used to illustrate the range of post-fire effects, selected interactions of the different components, and identify key research needs.

  20. Long-term effects of prescribed fire on mixed conifer forest structure in the Sierra Nevada, California

    Treesearch

    Phillip J. Van Mantgem; Nathan L. Stephenson; Eric Knapp; John Barrles; Jon E. Keeley

    2011-01-01

    The capacity of prescribed fire to restore forest conditions is often judged by changes in forest structure within a few years following burning. However, prescribed fire might have longer-term effects on forest structure, potentially changing treatment assessments. We examined annual changes in forest structure in five 1 ha old-growth plots immediately before...

  1. Auditory-Cortex Short-Term Plasticity Induced by Selective Attention

    PubMed Central

    Jääskeläinen, Iiro P.; Ahveninen, Jyrki

    2014-01-01

    The ability to concentrate on relevant sounds in the acoustic environment is crucial for everyday function and communication. Converging lines of evidence suggests that transient functional changes in auditory-cortex neurons, “short-term plasticity”, might explain this fundamental function. Under conditions of strongly focused attention, enhanced processing of attended sounds can take place at very early latencies (~50 ms from sound onset) in primary auditory cortex and possibly even at earlier latencies in subcortical structures. More robust selective-attention short-term plasticity is manifested as modulation of responses peaking at ~100 ms from sound onset in functionally specialized nonprimary auditory-cortical areas by way of stimulus-specific reshaping of neuronal receptive fields that supports filtering of selectively attended sound features from task-irrelevant ones. Such effects have been shown to take effect in ~seconds following shifting of attentional focus. There are findings suggesting that the reshaping of neuronal receptive fields is even stronger at longer auditory-cortex response latencies (~300 ms from sound onset). These longer-latency short-term plasticity effects seem to build up more gradually, within tens of seconds after shifting the focus of attention. Importantly, some of the auditory-cortical short-term plasticity effects observed during selective attention predict enhancements in behaviorally measured sound discrimination performance. PMID:24551458

  2. Long-Term Biological Consequences of Nuclear War.

    ERIC Educational Resources Information Center

    Ehrlich, Paul R.; And Others

    1983-01-01

    Presents evidence suggesting that the longer-term biological effects resulting from climactic changes may be at least as serious as the immediate ones. Primarily considers results of a nuclear war in which sufficient dust/soot are injected into the atmosphere to attenuate most incident solar radiation. (JN)

  3. Clinical outcomes of a 2-y soy isoflavone supplementation in menopausal women

    USDA-ARS?s Scientific Manuscript database

    Soy isoflavones are naturally occurring phytochemicals with weak estrogenic cellular effects. Despite numerous clinical trials of short-term isoflavone supplementation, there is a paucity of data regarding longer-term outcomes and safety. Our aim was to evaluate the clinical outcomes of soy hypocoty...

  4. Breast feeding and child behaviour in the Millennium Cohort Study.

    PubMed

    Heikkilä, Katriina; Sacker, Amanda; Kelly, Yvonne; Renfrew, Mary J; Quigley, Maria A

    2011-07-01

    To examine whether breast feeding is associated with behavioural development in children aged 5 years. The authors used data from a large, prospective, nationally representative UK cohort, the Millennium Cohort Study. 10 037 mother-child pairs from white ethnic background (9525 term and 512 preterm children) were included in the analyses. Duration of breast feeding (at all or exclusively) was ascertained from parental interview at study baseline, when the children were aged 9 months. Child behaviour was assessed using a parent-completed questionnaire, the Strengths and Difficulties Questionnaire (SDQ). The authors used logistic regression to investigate the associations of breastfeeding duration with abnormal parent-rated SDQ total and subscores at age 5 in term and preterm children separately. Abnormal SDQ scores were less common in term children (n=1129/9525, 12%) than pre-term (n=78/512, 15%) children. Term children breast fed for 4 months or longer (n=2741/9525, 29%) had lower odds of an abnormal total SDQ score (multivariable-adjusted OR compared with never breastfed children (n=3292/9525, 35%) 0.67, 95% CI: 0.54 to 0.83). This effect was similar for all the SDQ subscores. In preterm children, longer duration of breast feeding was generally associated with lower odds of abnormal SDQ total and subscores but the effect estimates were imprecise. The associations between exclusive breast feeding and abnormal SDQ scores were similar to those of any breast feeding and abnormal SDQ scores. The findings suggest that, at least in term children, longer duration of breast feeding is associated with fewer parent-rated behavioural problems in children aged 5 years.

  5. Effects of Early Bilingual Experience with a Tone and a Non-Tone Language on Speech-Music Integration

    PubMed Central

    Asaridou, Salomi S.; Hagoort, Peter; McQueen, James M.

    2015-01-01

    We investigated music and language processing in a group of early bilinguals who spoke a tone language and a non-tone language (Cantonese and Dutch). We assessed online speech-music processing interactions, that is, interactions that occur when speech and music are processed simultaneously in songs, with a speeded classification task. In this task, participants judged sung pseudowords either musically (based on the direction of the musical interval) or phonologically (based on the identity of the sung vowel). We also assessed longer-term effects of linguistic experience on musical ability, that is, the influence of extensive prior experience with language when processing music. These effects were assessed with a task in which participants had to learn to identify musical intervals and with four pitch-perception tasks. Our hypothesis was that due to their experience in two different languages using lexical versus intonational tone, the early Cantonese-Dutch bilinguals would outperform the Dutch control participants. In online processing, the Cantonese-Dutch bilinguals processed speech and music more holistically than controls. This effect seems to be driven by experience with a tone language, in which integration of segmental and pitch information is fundamental. Regarding longer-term effects of linguistic experience, we found no evidence for a bilingual advantage in either the music-interval learning task or the pitch-perception tasks. Together, these results suggest that being a Cantonese-Dutch bilingual does not have any measurable longer-term effects on pitch and music processing, but does have consequences for how speech and music are processed jointly. PMID:26659377

  6. Effects of Early Bilingual Experience with a Tone and a Non-Tone Language on Speech-Music Integration.

    PubMed

    Asaridou, Salomi S; Hagoort, Peter; McQueen, James M

    2015-01-01

    We investigated music and language processing in a group of early bilinguals who spoke a tone language and a non-tone language (Cantonese and Dutch). We assessed online speech-music processing interactions, that is, interactions that occur when speech and music are processed simultaneously in songs, with a speeded classification task. In this task, participants judged sung pseudowords either musically (based on the direction of the musical interval) or phonologically (based on the identity of the sung vowel). We also assessed longer-term effects of linguistic experience on musical ability, that is, the influence of extensive prior experience with language when processing music. These effects were assessed with a task in which participants had to learn to identify musical intervals and with four pitch-perception tasks. Our hypothesis was that due to their experience in two different languages using lexical versus intonational tone, the early Cantonese-Dutch bilinguals would outperform the Dutch control participants. In online processing, the Cantonese-Dutch bilinguals processed speech and music more holistically than controls. This effect seems to be driven by experience with a tone language, in which integration of segmental and pitch information is fundamental. Regarding longer-term effects of linguistic experience, we found no evidence for a bilingual advantage in either the music-interval learning task or the pitch-perception tasks. Together, these results suggest that being a Cantonese-Dutch bilingual does not have any measurable longer-term effects on pitch and music processing, but does have consequences for how speech and music are processed jointly.

  7. The Longer School Day and Five Term Year in CTCs: Some Initial Observations.

    ERIC Educational Resources Information Center

    Hagedorn, Julia

    To satisfy the requirements of the British national curriculum and to provide greater emphasis on the teaching of mathematics, science, and technology, city technical colleges (CTCs) have adopted a longer working week and, in several cases, a longer school year. This document examines outcomes of the longer school day and the five-term year, 4…

  8. Immune thrombocytopenia: No longer ‘idiopathic’

    PubMed Central

    McCRAE, KEITH

    2012-01-01

    Immune thrombocytopenia (ITP) is a common hematologic disorder. Its pathogenesis involves both accelerated platelet destruction and impaired platelet production. First-line agents are usually effective initially but do not provide long-term responses. Splenectomy remains an effective long-term therapy, as does rituximab (Rituxan) in a subset of patients. Thrombopoietic agents offer a new alternative, although their place in the overall management of ITP remains uncertain. PMID:21632906

  9. Effects of red-cell storage duration on patients undergoing cardiac surgery.

    PubMed

    Steiner, Marie E; Ness, Paul M; Assmann, Susan F; Triulzi, Darrell J; Sloan, Steven R; Delaney, Meghan; Granger, Suzanne; Bennett-Guerrero, Elliott; Blajchman, Morris A; Scavo, Vincent; Carson, Jeffrey L; Levy, Jerrold H; Whitman, Glenn; D'Andrea, Pamela; Pulkrabek, Shelley; Ortel, Thomas L; Bornikova, Larissa; Raife, Thomas; Puca, Kathleen E; Kaufman, Richard M; Nuttall, Gregory A; Young, Pampee P; Youssef, Samuel; Engelman, Richard; Greilich, Philip E; Miles, Ronald; Josephson, Cassandra D; Bracey, Arthur; Cooke, Rhonda; McCullough, Jeffrey; Hunsaker, Robert; Uhl, Lynne; McFarland, Janice G; Park, Yara; Cushing, Melissa M; Klodell, Charles T; Karanam, Ravindra; Roberts, Pamela R; Dyke, Cornelius; Hod, Eldad A; Stowell, Christopher P

    2015-04-09

    Some observational studies have reported that transfusion of red-cell units that have been stored for more than 2 to 3 weeks is associated with serious, even fatal, adverse events. Patients undergoing cardiac surgery may be especially vulnerable to the adverse effects of transfusion. We conducted a randomized trial at multiple sites from 2010 to 2014. Participants 12 years of age or older who were undergoing complex cardiac surgery and were likely to undergo transfusion of red cells were randomly assigned to receive leukocyte-reduced red cells stored for 10 days or less (shorter-term storage group) or for 21 days or more (longer-term storage group) for all intraoperative and postoperative transfusions. The primary outcome was the change in Multiple Organ Dysfunction Score (MODS; range, 0 to 24, with higher scores indicating more severe organ dysfunction) from the preoperative score to the highest composite score through day 7 or the time of death or discharge. The median storage time of red-cell units provided to the 1098 participants who received red-cell transfusion was 7 days in the shorter-term storage group and 28 days in the longer-term storage group. The mean change in MODS was an increase of 8.5 and 8.7 points, respectively (95% confidence interval for the difference, -0.6 to 0.3; P=0.44). The 7-day mortality was 2.8% in the shorter-term storage group and 2.0% in the longer-term storage group (P=0.43); 28-day mortality was 4.4% and 5.3%, respectively (P=0.57). Adverse events did not differ significantly between groups except that hyperbilirubinemia was more common in the longer-term storage group. The duration of red-cell storage was not associated with significant differences in the change in MODS. We did not find that the transfusion of red cells stored for 10 days or less was superior to the transfusion of red cells stored for 21 days or more among patients 12 years of age or older who were undergoing complex cardiac surgery. (Funded by the National Heart, Lung, and Blood Institute; RECESS ClinicalTrials.gov number, NCT00991341.).

  10. The War on Poverty’s Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans†

    PubMed Central

    Bailey, Martha J.; Goodman-Bacon, Andrew

    2015-01-01

    This paper uses the rollout of the first Community Health Centers (CHCs) to study the longer-term health effects of increasing access to primary care. Within ten years, CHCs are associated with a reduction in age-adjusted mortality rates of 2 percent among those 50 and older. The implied 7 to 13 percent decrease in one-year mortality risk among beneficiaries amounts to 20 to 40 percent of the 1966 poor/non-poor mortality gap for this age group. Large effects for those 65 and older suggest that increased access to primary care has longer-term benefits, even for populations with near universal health insurance. (JEL H75, I12, I13, I18, I32, I38, J14) PMID:25999599

  11. Effect of Retention in First Grade on Children's Achievement Trajectories over 4 Years: A Piecewise Growth Analysis Using Propensity Score Matching

    ERIC Educational Resources Information Center

    Wu, Wei; West, Stephen G.; Hughes, Jan N.

    2008-01-01

    The authors investigated the relatively short-term and longer term effects of grade retention in 1st grade on the growth of mathematics and reading achievement over 4 years. The authors initially identified a large multiethnic sample (n = 784) of children who were below the median in literacy at school entrance. From this sample, the authors…

  12. The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low- and middle-income countries: a systematic review and meta-analysis.

    PubMed

    Stevens, Briony; Buettner, Petra; Watt, Kerrianne; Clough, Alan; Brimblecombe, Julie; Judd, Jenni

    2015-10-01

    The beneficial effect of balanced protein energy supplementation during pregnancy on subsequent child growth is unclear and may depend upon the mother entering pregnancy adequately nourished or undernourished. Systematic reviews to-date have included studies from high-, middle- and low-income countries. However, the effect of balanced protein energy supplementation should not be generalised. This review assesses the effect of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries on child growth. A systematic review of articles published in English (1970-2015) was conducted via MEDLINE, Scopus, the Cochrane Register and hand searching. Only peer-reviewed experimental studies analysing the effects of balanced protein energy supplementation in undernourished pregnant women from low- and middle-income countries with measures of physical growth as the primary outcome were included. Two reviewers independently assessed full-text articles against inclusion criteria. Validity of eligible studies was ascertained using the Quality Assessment Tool for Quantitative Studies (EPHPP QAT). In total, seven studies met the inclusion criteria. All studies reported on birthweight, five on birth length, three on birth head circumference, and one on longer-term growth. Standardised mean differences were calculated using a random-effects meta-analysis. Balanced protein energy supplementation significantly improved birthweight (seven randomised controlled trials, n = 2367; d = 0.20, 95% confidence interval, 0.03-0.38, P = 0.02). No significant benefit was observed on birth length or birth head circumference. Impact of intervention could not be determined for longer-term physical growth due to limited evidence. Additional research is required in low- and middle-income countries to identify impacts on longer-term infant growth. © 2015 John Wiley & Sons Ltd.

  13. Acute and Chronic Stress: The Effects of Loss of Control

    DTIC Science & Technology

    1996-07-31

    stressor affecting the health and well-being of the unemployed and their families. This study was designed to test how loss of control associated with...status: short-term ( unemployed for less than two months); long-term ( unemployed for longer than two months); and, employed controls. Perceptions of...the laboratory stressor resulting in performance deficits and helpless behavior. As predicted. compared to the other two groups. long-term unemployed

  14. Maintenance of smoking cessation in the postpartum period: which interventions work best in the long-term?

    PubMed

    Su, Anny; Buttenheim, Alison M

    2014-04-01

    Smoking during pregnancy has been linked to a variety of adverse outcomes for both maternal and child health. Decades of studies have sought to increase cessation antepartum and reduce relapse postpartum. A number of effective interventions exist to significantly reduce smoking rates during pregnancy; however, less is known about how to prevent relapse in the postpartum period. This review investigates interventions to prevent relapse in the long-term postpartum period. We focus specifically on nonspontaneous quitters (individuals who quit smoking as a result of an external intervention) to reveal differences in long-term response to interventions for this population compared to spontaneous quitters. A systematic literature search yielded 32 relevant studies of pharmacological, behavioral, and incentives-based interventions. Results were compiled, analyzed, and compared in order to evaluate success factors in maintaining cessation postpartum. Though intervention groups showed consistently higher quit rates during pregnancy than control groups, none of the intervention types were effective at preventing relapse in the longer-term postpartum period. One study maintained significantly higher abstinence in the longer-term period postpartum using a mix of behavioral and incentives strategies. Additional research in this area is needed to identify optimal intervention strategies to reduce long-term postpartum relapse, particularly for nonspontaneous quitters.

  15. U.S. - African Partnerships: Advancing Common Interests

    DTIC Science & Technology

    2017-12-01

    discussions on: – Governance, institutions, and effective partnerships – Prospects for enhancing economic partnerships – Opportunities and challenges in...U.S. administrations, emphasizing peace and security, countering terrorism, increasing economic growth, and promoting democracy and good governance...often focused on short- term security or economic objectives, while neglecting infrastructure projects and longer term programs that would empower

  16. Schools as Incubators of Democratic Participation: Building Long-Term Political Efficacy with Civic Education

    ERIC Educational Resources Information Center

    Pasek, Josh; Feldman, Lauren; Romer, Daniel; Jamieson, Kathleen Hall

    2008-01-01

    Despite a growing consensus that civic education is an important aspect of political socialization, little research has prospectively examined how gains made during civics courses are maintained after high school. This study used a quasi-experimental design to examine longer-term effects of the Student Voices program, which was originally…

  17. Effects of Subependymal and Mild Intraventricular Lesions on Visual Attention and Memory in Premature Infants.

    ERIC Educational Resources Information Center

    Ross, Gail; And Others

    1992-01-01

    Premature infants with subependymal or intraventricular hemorrhage took longer to habituate on a habituation task, and scored lower on a measure of mental development, than did other premature infants or full-term infants. Both groups of premature infants were less successful than full-term infants on an object permanence task. (BC)

  18. Long-Term Priming of Visual Search Prevails against the Passage of Time and Counteracting Instructions

    ERIC Educational Resources Information Center

    Kruijne, Wouter; Meeter, Martijn

    2016-01-01

    Studies on "intertrial priming" have shown that in visual search experiments, the preceding trial automatically affects search performance: facilitating it when the target features repeat and giving rise to switch costs when they change--so-called (short-term) intertrial priming. These effects also occur at longer time scales: When 1 of…

  19. Preface: long-term response of a forest watershed ecosystem, clearcutting in the Southern Appalachians

    Treesearch

    Wayne Swank; Jackson Webster

    2014-01-01

    Our North American forests are no longer the wild areas of past centuries; they are an economic and ecological resource undergoing changes from both natural and management disturbances. A watershed-scale and long-term perspective of forest ecosystem responses is requisite to understanding and predicting cause and effect relationships. This book synthesizes...

  20. The Treatment for Adolescents with Depression Study (TADS): Methods and Message at 12 Weeks

    ERIC Educational Resources Information Center

    March, John; Silva, Susan; Vitiello, Benedetto

    2006-01-01

    Funded by the National Institute of Mental Health, the Treatment for Adolescents With Depression Study (TADS) is intended to evaluate the short-term (12 weeks) and longer-term (36 weeks) effectiveness of four treatments for adolescents with DSM-IV major depressive disorder: clinical management with fluoxetine (FLX), cognitive-behavioral therapy…

  1. Short- and long-term efficacy of forest thinning to mitigate drought impacts in mountain forests in the European Alps.

    PubMed

    Elkin, Ché; Giuggiola, Arnaud; Rigling, Andreas; Bugmann, Harald

    2015-06-01

    In many regions of the world, drought is projected to increase under climate change, with potential negative consequences for forests and their ecosystem services (ES). Forest thinning has been proposed as a method for at least temporarily mitigating drought impacts, but its general applicability and longer-term impacts are unclear. We use a process-based forest model to upscale experimental data for evaluating the impacts of forest thinning in a drought-susceptible valley in the interior of the European Alps, with the specific aim of assessing (1) when and where thinning may be most effective and (2) the longer-term implications for forest dynamics. Simulations indicate that forests will be impacted by climate-induced increases in drought across a broad elevation range. At lower elevations, where drought is currently prevalent, thinning is projected to temporarily reduce tree mortality, but to have minor impacts on forest dynamics in the longer term. Thinning may be particularly useful at intermediate and higher elevations as a means of temporarily reducing mortality in drought-sensitive species such as Norway spruce and larch, which currently dominate these elevations. However, in the longer term, even intense thinning will likely not be sufficient to prevent a climate change induced dieback of these species, which is projected to occur under even moderate climate change. Thinning is also projected to have the largest impact on long-term forest dynamics at intermediate elevations, with the magnitude of the impact depending on the timing and intensity of thinning. More intense thinning that is done later is projected to more strongly promote a transition to more drought-tolerant species. We conclude that thinning is a viable option for temporarily reducing the negative drought impacts on forests, but that efficient implementation of thinning should be contingent on a site-specific evaluation of the near term risk of significant drought, and how thinning will impact the rate and direction of climate driven forest conversion.

  2. Examining the Sustained Effects of Reading Recovery

    ERIC Educational Resources Information Center

    D'Agostino, Jerome V.; Lose, Mary K.; Kelly, Robert H.

    2017-01-01

    Though the immediate effect of Reading Recovery (RR) is both strong and well established, the longer term or sustained effect has been less studied and the evidence regarding it has been less conclusive. Michigan Reading Recovery students (n = 328) were compared to control students (n = 264) while in first (2009-2010), third (2011), and fourth…

  3. The Effects of College on Weight: Examining the "Freshman 15" Myth and Other Effects of College Over the Life Cycle.

    PubMed

    Baum, Charles L

    2017-02-01

    This study examines the effects of college on weight over much of the life cycle. I compare weights for college students with their weights before and after college and with the weights of noncollege peers using data from the National Longitudinal Survey of Youth (NLSY). I also examine the longer-term effects of college measured almost three decades later. I find that college freshmen gain substantially less than the 15 pounds rumored to be typical for freshmen. Using difference models, individual-specific fixed-effects models, and instrumental variables models to control for various sources of potential bias, I find that freshman year college attendance is estimated to cause only about a one-pound increase. Supplemental results show that those from lower socioeconomic backgrounds gain more weight during the freshman college year. Longer term, having a college education consistently decreases weight. These negative effects have faded over the last 20 years, and they diminish as respondents approach middle age. These trends are more prevalent for whites and Hispanics than for blacks.

  4. Development of an engineering model atmosphere for Mars

    NASA Technical Reports Server (NTRS)

    Justus, C. G.

    1988-01-01

    An engineering model atmosphere for Mars is being developed with many of the same features and capabilities for the highly successful Global Reference Atmospheric Model (GRAM) program for Earth's atmosphere. As an initial approach, the model is being built around the Martian atmosphere model computer subroutine (ATMOS) of Culp and Stewart (1984). In a longer-term program of research, additional refinements and modifications will be included. ATMOS includes parameterizations to stimulate the effects of solar activity, seasonal variation, diurnal variation magnitude, dust storm effects, and effects due to the orbital position of Mars. One of the current shortcomings of ATMOS is the neglect of surface variation effects. The longer-term period of research and model building is to address some of these problem areas and provide further improvements in the model (including improved representation of near-surface variations, improved latitude-longitude gradient representation, effects of the large annual variation in surface pressure because of differential condensation/sublimation of the CO2 atmosphere in the polar caps, and effects of Martian atmospheric wave perturbations on the magnitude of the expected density perturbation.

  5. Long-term effects of transference interpretation in dynamic psychotherapy of personality disorders.

    PubMed

    Høglend, P; Dahl, H-S; Hersoug, A G; Lorentzen, S; Perry, J C

    2011-10-01

    Only a few treatment studies of personality disorders (PD) patients are on longer-term psychotherapy, general outcome measures are used, and follow-up periods are usually short. More studies of long-term therapies, using outcome measures of core psychopathology, are needed. This study is a dismantling randomized controlled clinical trial, specifically designed to study long-term effects of transference interpretation. Forty-six patients with mainly cluster C personality disorders were randomly assigned to 1 year of dynamic psychotherapy with or without transference interpretations. The outcome measures were remission from PD, improvement in interpersonal functioning, and use of mental health resources in the 3-year period after treatment termination. After therapy with transference interpretation PD-patients improved significantly more in core psychopathology and interpersonal functioning, the drop-out rate was reduced to zero, and use of health services was reduced to 50%, compared to therapy without this ingredient. Three years after treatment termination, 73% no longer met diagnostic criteria for any PD in the transference group, compared to 44% in the comparison group. PD-patients with co-morbid disorders improved in both treatment arms in this study. However, transference interpretation improved outcome substantially more. Long-term psychotherapy that includes transference interpretation is an effective treatment for cluster C personality disorders and milder cluster B personality disorders. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  6. The effect of malathion on the activity, performance, and microbial ecology of activated sludge

    PubMed Central

    Rauglas, Erik; Martin, Seth; Bailey, Kandace; Magnuson, Matthew; Phillips, Rebecca; Harper, Willie F.

    2018-01-01

    This study evaluated the effect of a VX (O-ethyl S-[2-(diisopropylamino)ethyl] methylphosphonothioate) surrogate (malathion) on the activity, performance, and ecology of activated sludge bioreactors. In the presence of malathion, the maximum observed respiration rates varied between 43 and 53 μg/O2 min, generally similar to the 49 μg O2/min rates observed in controls. Malathion did not alter the respiration ratio of O2 consumed-to-CO2 produced nor did it impact the shape of the oxygen consumption curves during respirometry. Shorter term (12 h) batch tests showed that both chemical oxygen demand (COD) and ammonia removal were not negatively impacted by the presence of 0.1–3 mg/L malathion. Longer term continuous addition (i.e. 40 days) of 0.1 mg/L of malathion also had no effect on COD and ammonia removal. In contrast to shorter term exposures, longer term continuous addition of 3 mg/L of malathion negatively impacted both COD and nitrogen removal and was associated with shifts in the abundance of species that are common to activated sludge. These results illustrate the impact that chemicals like malathion may have on COD removal, and nitrification, as well as the robustness of activated sludge microbial communities. PMID:27594690

  7. Effects of Juvenile Court Exposure on Crime in Young Adulthood

    ERIC Educational Resources Information Center

    Petitclerc, Amelie; Gatti, Uberto; Vitaro, Frank; Tremblay, Richard E.

    2013-01-01

    Background: The juvenile justice system's interventions are expected to help reduce recidivism. However, previous studies suggest that official processing in juvenile court fails to reduce adolescents' criminal behavior in the following year. Longer term effects have not yet been investigated with a rigorous method. This study used propensity…

  8. Inpatient Cognitive Behavior Therapy for Adolescents with Anorexia Nervosa: Immediate and Longer-Term Effects

    PubMed Central

    Dalle Grave, Riccardo; Calugi, Simona; El Ghoch, Marwan; Conti, Maddalena; Fairburn, Christopher G.

    2014-01-01

    Introduction: Inpatient treatment for anorexia nervosa is often successful in restoring body weight, but a high percentage of patients relapse following discharge. The aim of the present study was to establish the immediate and longer-term effects of a novel inpatient program for adolescents that was designed to produce enduring change. Method: Twenty-seven consecutive patients with severe anorexia nervosa were admitted to a 20-week inpatient treatment program based on the enhanced cognitive behavior therapy (CBT-E). The patients were assessed before and after hospitalization, and 6 and 12 months later. Results: Twenty-six patients (96%) completed the program. In these patients, there was a substantial improvement in weight, eating disorder features, and general psychopathology that was well maintained at 12-month follow-up. Conclusion: These findings suggest that inpatient CBT-E is a promising approach to the treatment of adolescents with severe anorexia nervosa. PMID:24575055

  9. Woody plant regeneration after blowdown, salvage logging, and prescribed fire in a northern Minnesota forest

    Treesearch

    Brian J. Palik; Doug Kastendick

    2009-01-01

    Salvage logging after natural disturbance has received increased scrutiny in recent years because of concerns over detrimental effects on tree regeneration and increased fine fuel levels. Most research on tree regeneration after salvage logging comes from fire-prone systems and is short-term in scope. Limited information is available on longer term responses to salvage...

  10. Optimizing Fire Department Operations Through Work Schedule Analysis, Alternative Staffing, and Nonproductive Time Reduction

    DTIC Science & Technology

    2014-09-01

    hour work shift. A longer shift offers more time off between shifts, which can improve the employee’s family life , and personal emotional stress . On...Enhancing Work / Life Balance ,” Conn.L.Rev. 42 (2010): 1081–1527. 19 Nicole Jansen et al., “Need for Recovery from Work : Evaluating Short-Term Effects...24-hour work shift. A longer shift offers more time off between shifts that can improve the employee’s family life and personal emotional stress

  11. The impact of parental death on child well-being: evidence from the Indian Ocean tsunami.

    PubMed

    Cas, Ava Gail; Frankenberg, Elizabeth; Suriastini, Wayan; Thomas, Duncan

    2014-04-01

    Identifying the impact of parental death on the well-being of children is complicated because parental death is likely to be correlated with other, unobserved factors that affect child well-being. Population-representative longitudinal data collected in Aceh, Indonesia, before and after the December 2004 Indian Ocean tsunami are used to identify the impact of parental deaths on the well-being of children aged 9-17 at the time of the tsunami. Exploiting the unanticipated nature of parental death resulting from the tsunami in combination with measuring well-being of the same children before and after the tsunami, models that include child fixed effects are estimated to isolate the causal effect of parental death. Comparisons are drawn between children who lost one or both parents and children whose parents survived. Shorter-term impacts on school attendance and time allocation one year after the tsunami are examined, as well as longer-term impacts on education trajectories and marriage. Shorter- and longer-term impacts are not the same. Five years after the tsunami, there are substantial deleterious impacts of the tsunami on older boys and girls, whereas the effects on younger children are more muted.

  12. The Impact of Parental Death on Child Well-being: Evidence From the Indian Ocean Tsunami

    PubMed Central

    Cas, Ava Gail; Frankenberg, Elizabeth; Suriastini, Wayan; Thomas, Duncan

    2014-01-01

    Identifying the impact of parental death on the well-being of children is complicated because parental death is likely to be correlated with other, unobserved factors that affect child well-being. Population-representative longitudinal data collected in Aceh, Indonesia, before and after the December 2004 Indian Ocean tsunami are used to identify the impact of parental deaths on the well-being of children aged 9–17 at the time of the tsunami. Exploiting the unanticipated nature of parental death resulting from the tsunami in combination with measuring well-being of the same children before and after the tsunami, models that include child fixed effects are estimated to isolate the causal effect of parental death. Comparisons are drawn between children who lost one or both parents and children whose parents survived. Shorter-term impacts on school attendance and time allocation one year after the tsunami are examined, as well as longer-term impacts on education trajectories and marriage. Shorter- and longer-term impacts are not the same. Five years after the tsunami, there are substantial deleterious impacts of the tsunami on older boys and girls, whereas the effects on younger children are more muted. PMID:24573765

  13. The Self-Sufficiency Project at 36 Months: Effects of a Financial Work Incentive on Employment and Income.

    ERIC Educational Resources Information Center

    Michalopoulos, Charles; Card, David; Gennetian, Lisa A.; Harknett, Kristen; Robins, Philip K.

    This report previews the Self-Sufficiency Project's (SSP's) longer-term effects by looking at these four related issues: wage progression, job retention, marital status, and attitudes toward work. A companion report, available separately, examines SSP's effects on children. Chapter 1 discusses the SSP research and demonstration project that…

  14. Effectiveness and Retention of Teaching Memory Strategy Use to Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Bebko, James M.; Rhee, Thomas; Ncube, Busisiwe L.; Dahary, Hadas

    2017-01-01

    Although low levels of memory strategy use have been found in children with autism spectrum disorders (ASDs), few studies have explored the effectiveness of interventions for improving strategy use with this population. In two studies, we examined the short- and longer term effectiveness of rehearsal strategy training. In Study 1, children with…

  15. Does extended proactive telephone support increase smoking cessation among low-income women using nicotine patches?

    PubMed

    Solomon, Laura J; Marcy, Theodore W; Howe, Kathleen D; Skelly, Joan M; Reinier, Kyndaron; Flynn, Brian S

    2005-03-01

    It is unclear whether proactive telephone support enhances smoking cessation beyond the provision of nicotine replacement therapy alone. We randomly assigned 330 low-income women smokers to receive either free nicotine patches (control condition) or free nicotine patches with up to 16 weeks of proactive telephone support (experimental condition). All participants were assessed by telephone at baseline and at 2 weeks, 3 months, and 6 months post-baseline to determine smoking status. Results revealed a significant effect for the telephone support at 3 months, with 43% of experimental versus 26% of control condition women reporting 30-day point prevalent abstinence (P = 0.002). The difference was no longer significant at 6 months. A metaanalysis conducted with five randomized studies revealed a slight but non-significant long-term benefit of proactive telephone support when added to the provision of free nicotine patches for smoking cessation. This is the second study to demonstrate a short-term effect for proactive telephone support added to free nicotine replacement therapy; however, neither the current study, nor the metaanalysis including the four other published trials, confirmed a longer-term benefit.

  16. Making the hard work of recovery more attractive for those with substance use disorders

    PubMed Central

    McKay, James R.

    2016-01-01

    Background Research has led to improvements in the effectiveness of interventions for substance use disorders (SUD), but for the most part progress has been modest, particularly with regard to longer-term outcomes. Moreover, most individuals with SUD do not seek out treatment. Argument/analysis This paper presents two recommendations on how to improve treatment engagement and long-term outcomes for those with SUD. First, treatments should go beyond a focus on reducing or eliminating substance use to target greater access to and more time spent in experiences that will be enjoyable or otherwise rewarding to clients. Second, there must be sufficient incentives in the environment to justify the effort needed to sustain long-term abstinence for individuals who often have limited access to such incentives. Conclusions To increase rates of long-term recovery from substance misuse, treatments should link clients to reinforcers that will make continued abstinence more appealing. This work needs to extend beyond interventions focused on the individual or family to include the local community and national policy in an effort to more strongly incentivize longer-term recoveries. PMID:27535787

  17. Making the hard work of recovery more attractive for those with substance use disorders.

    PubMed

    McKay, James R

    2017-05-01

    Research has led to improvements in the effectiveness of interventions for substance use disorders (SUD), but for the most part progress has been modest, particularly with regard to longer-term outcomes. Moreover, most individuals with SUD do not seek out treatment. This paper presents two recommendations on how to improve treatment engagement and long-term outcomes for those with SUD. First, treatments should go beyond a focus on reducing or eliminating substance use to target greater access to and more time spent in experiences that will be enjoyable or otherwise rewarding to clients. Secondly, there must be sufficient incentives in the environment to justify the effort needed to sustain long-term abstinence for individuals who often have limited access to such incentives. To increase rates of long-term recovery from substance misuse, treatments should link clients to reinforcers that will make continued abstinence more appealing. This work needs to extend beyond interventions focused on the individual or family to include the local community and national policy in an effort to incentivize longer-term recoveries more strongly. © 2016 Society for the Study of Addiction.

  18. Effects of a 1-Day Environmental Education Intervention on Environmental Attitudes and Connectedness with Nature

    ERIC Educational Resources Information Center

    Sellmann, Daniela; Bogner, Franz X.

    2013-01-01

    Besides cognitive learning effects, short-term environmental education (EE) is often regarded as ineffective in intervening with participants' environmental attitudes and behaviour. However, in Germany, school classes often participate in such 1-day EE programmes because they better match the school curriculum in contrast to longer (residential)…

  19. From the Cradle to the Labour Market? The Effect of Birth Weight on Adult Outcomes. CEE DP 61

    ERIC Educational Resources Information Center

    Black, Sandra E.; Devereux, Paul; Salvanes, Kjell

    2006-01-01

    Lower birth weight babies have worse outcomes, both short-run in terms of one year mortality rates and longer run in terms of educational attainment and earnings. However, recent research has called into question whether birth weight itself is important or whether it simply reflects other hard-to-measure characteristics. By applying within twin…

  20. Effects of the "great recession" on the forest products sector in the northern region of the United States

    Treesearch

    Christopher W. Woodall; William G. Luppold; Peter J. Ince; Ronald J. Piva; Kenneth E. Skog

    2012-01-01

    The forest industry within the northern region of the United States has demonstrated a notable decline in terms of employment, number of mills, wood consumption, and forest harvests since 2000--a downturn exacerbated by the "Great Recession" of 2007-2009. Longer term industrial decline (since 2000) has been evidenced by reductions in secondary product (e.g.,...

  1. Response of overstory and understory vegetation 37 years after prescribed burning in an aspen-dominated forest in northern Minnesota, USA – a case study

    Treesearch

    A. Dhar; C.D. Baker; H.B. Massicotte; Brian J. Palik; C.D.B. Hawkins

    2016-01-01

    Many studies have examined short-term changes in understory vegetation following prescribed burning. However, knowledge concerning longer term effects on both forest understory and overstory vegetation is lacking. This investigation was initiated to examine changes in understory (herbaceous and shrub) and overstory species composition almost four decades after logging...

  2. Management of knee osteoarthritis with cupping therapy.

    PubMed

    Khan, Asim Ali; Jahangir, Umar; Urooj, Shaista

    2013-10-01

    The study aimed to evaluate the effect of cupping therapy at a clinical setting for knee osteoarthritis. A randomized, controlled clinical trial was conducted. Cupping was performed on 0-6(th) day; 9-11(th) day and 14(th) day, i.e., 11 sittings follow-up to determine longer term carryover of treatment effects utilizing both objective and subjective assessment. The assessment was performed before and after treatment spreading over a period of 15 days. The results of this study shows significant and better results in the overall management of knee osteoarthritis, particularly in relieving pain, edema, stiffness and disability. The efficacy of treatment with cupping therapy in relieving signs and symptoms of knee osteoarthritis is comparable to that of acetaminophen 650 mg thrice a day orally, in terms of analgesia, anti-inflammatory and resolution of edema with minimal and temporary side-effects like echymosis and blister formation while as control drug has greater side-effects particularly on upper gastrointestinal tract. It is recommended that further studies are conducted with a larger study samples and of longer duration.

  3. Mediation of Short and Longer Term Effects of an Intervention Program to Enhance Resilience in Immigrants from Mainland China to Hong Kong

    PubMed Central

    Yu, Nancy X.; Lam, T. H.; Liu, Iris K. F.; Stewart, Sunita M.

    2015-01-01

    Few clinical trials report on the active intervention components that result in outcome changes, although this is relevant to further improving efficacy and adapting effective programs to other populations. This paper presents follow-up analyses of a randomized controlled trial to enhance adaptation by increasing knowledge and personal resilience in two separate brief interventions with immigrants from Mainland China to Hong Kong (Yu et al., 2014b). The present paper extends our previous one by reporting on the longer term effect of the interventions on personal resilience, and examining whether the Resilience intervention worked as designed to enhance personal resilience. The four-session intervention targeted at self-efficacy, positive thinking, altruism, and goal setting. In this randomized controlled trial, 220 immigrants were randomly allocated to three arms: Resilience, Information (an active control arm), and Control arms. Participants completed measures of the four active components (self-efficacy, positive thinking, altruism, and goal setting) at baseline and immediately after the intervention. Personal resilience was assessed at baseline, post-intervention, and 3- and 6-month follow-ups. The results showed that the Resilience arm had greater increases in the four active components post-intervention. Changes in each of the four active components at the post-intervention assessment mediated enhanced personal resilience at the 3-month follow-up in the Resilience arm. Changes in self-efficacy and goal setting showed the largest effect size, and altruism showed the smallest. The arm effects of the Resilience intervention on enhanced personal resilience at the 6-month follow-up were mediated by increases of personal resilience post-intervention (Resilience vs. Control) and at the 3-month follow-up (Resilience vs. Information). These findings showed that these four active components were all mediators in this Resilience intervention. Our results of the effects of short term increases in personal resilience on longer term increase in personal resilience in some models suggest how changes in intervention outcomes might persist over time. PMID:26640446

  4. 30 CFR 250.180 - What am I required to do to keep my lease term in effect?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... longer period is in the national interest, and it conserves resources, prevents waste, or protects... production. (2) Cessation of production—within 15 days after the first full month of zero production. (3...

  5. An exploration of factors affecting the long term psychological impact and deterioration of mental health in flooded households.

    PubMed

    Lamond, Jessica Elizabeth; Joseph, Rotimi D; Proverbs, David G

    2015-07-01

    The long term psychological effect of the distress and trauma caused by the memory of damage and losses associated with flooding of communities remains an under researched impact of flooding. This is particularly important for communities that are likely to be repeatedly flooded where levels of mental health disorder will damage long term resilience to future flooding. There are a variety of factors that affect the prevalence of mental health disorders in the aftermath of flooding including pre-existing mental health, socio-economic factors and flood severity. However previous research has tended to focus on the short term impacts immediately following the flood event and much less focus has been given to the longer terms effects of flooding. Understanding of factors affecting the longer term mental health outcomes for flooded households is critical in order to support communities in improving social resilience. Hence, the aim of this study was to explore the characteristics associated with psychological distress and mental health deterioration over the longer term. The research examined responses from a postal survey of households flooded during the 2007 flood event across England. Descriptive statistics, correlation analysis and binomial logistic regression were applied to data representing household characteristics, flood event characteristics and post-flood stressors and coping strategies. These factors were related to reported measures of stress, anxiety, depression and mental health deterioration. The results showed that household income, depth of flooding; having to move out during reinstatement and mitigating actions are related to the prevalence of psycho-social symptoms in previously flooded households. In particular relocation and household income were the most predictive factors. The practical implication of these findings for recovery after flooding are: to consider the preferences of households in terms of the need to move out during restorative building works and the financial resource constraints that may lead to severe mental hardship. In addition the findings suggest that support with installing mitigation measures may lead to improved mental health outcomes for communities at risk. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Effectiveness of Supplemental Kindergarten Vocabulary Instruction for English Learners: A Randomized Study of Immediate and Longer-Term Effects of Two Approaches

    ERIC Educational Resources Information Center

    Vadasy, Patricia F.; Sanders, Elizabeth A.; Nelson, J. Ron

    2015-01-01

    A two-cohort cluster randomized trial was conducted to estimate effects of small-group supplemental vocabulary instruction for at-risk kindergarten English learners (ELs). "Connections" students received explicit instruction in high-frequency decodable root words, and interactive book reading (IBR) students were taught the same words in…

  7. Effectiveness of mobile health (mHealth) interventions for promoting healthy eating in adults: A systematic review.

    PubMed

    McCarroll, Rebecca; Eyles, Helen; Ni Mhurchu, Cliona

    2017-12-01

    Unhealthy eating is a major risk factor for chronic disease. However, many current strategies to promote healthy eating are not sustainable over the longer-term. More cost-effective wide-reaching initiatives are urgently needed. Mobile health (mHealth) interventions, delivered via mobile devices, could provide a solution. This systematic review summarized the evidence on the effect of mHealth interventions for promoting healthy eating in adults. A comprehensive systematic search of five scientific databases was conducted using methods adapted from the Cochrane Handbook. Eligible studies were randomized controlled trials (RCTs), published up to 1 July 2016, which examined healthy eating interventions delivered via mobile device. Of 879 articles identified, 84 full text articles were potentially eligible and further assessed, and 23 included. Narrative review results indicated small positive effects of mHealth interventions on healthy eating (5/8 trials) and weight loss (5/13 trials). However, the current evidence base is insufficient (studies are of poor quality) to determine conclusive positive effects. More rigorous RCTs with longer-term (>6months) follow-up are warranted to determine if effects are maintained. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Foot orthoses for plantar heel pain: a systematic review and meta-analysis.

    PubMed

    Whittaker, Glen A; Munteanu, Shannon E; Menz, Hylton B; Tan, Jade M; Rabusin, Chantel L; Landorf, Karl B

    2018-03-01

    To investigate the effectiveness of foot orthoses for pain and function in adults with plantar heel pain. Systematic review and meta-analysis. The primary outcome was pain or function categorised by duration of follow-up as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks). Medline, CINAHL, SPORTDiscus, Embase and the Cochrane Library from inception to June 2017. Studies must have used a randomised parallel-group design and evaluated foot orthoses for plantar heel pain. At least one outcome measure for pain or function must have been reported. A total of 19 trials (1660 participants) were included. In the short term , there was very low-quality evidence that foot orthoses do not reduce pain or improve function. In the medium term , there was moderate-quality evidence that foot orthoses were more effective than sham foot orthoses at reducing pain (standardised mean difference -0.27 (-0.48 to -0.06)). There was no improvement in function in the medium term. In the longer term , there was very low-quality evidence that foot orthoses do not reduce pain or improve function. A comparison of customised and prefabricated foot orthoses showed no difference at any time point. There is moderate-quality evidence that foot orthoses are effective at reducing pain in the medium term, however it is uncertain whether this is a clinically important change. © 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.

  9. The effect of malathion on the activity, performance, and microbial ecology of activated sludge.

    PubMed

    Rauglas, Erik; Martin, Seth; Bailey, Kandace; Magnuson, Matthew; Phillips, Rebecca; Harper, Willie F

    2016-12-01

    This study evaluated the effect of a VX (O-ethyl S-[2-(diisopropylamino)ethyl] methylphosphonothioate) surrogate (malathion) on the activity, performance, and ecology of activated sludge bioreactors. In the presence of malathion, the maximum observed respiration rates varied between 43 and 53 μg/O2 min, generally similar to the 49 μg O2/min rates observed in controls. Malathion did not alter the respiration ratio of O2 consumed-to-CO2 produced nor did it impact the shape of the oxygen consumption curves during respirometry. Shorter term (12 h) batch tests showed that both chemical oxygen demand (COD) and ammonia removal were not negatively impacted by the presence of 0.1-3 mg/L malathion. Longer term continuous addition (i.e. 40 days) of 0.1 mg/L of malathion also had no effect on COD and ammonia removal. In contrast to shorter term exposures, longer term continuous addition of 3 mg/L of malathion negatively impacted both COD and nitrogen removal and was associated with shifts in the abundance of species that are common to activated sludge. These results illustrate the impact that chemicals like malathion may have on COD removal, and nitrification, as well as the robustness of activated sludge microbial communities. Published by Elsevier Ltd.

  10. Long Term Follow-up of Botulinum Toxin Therapy for Focal Hand Dystonia: Outcome at 10 or More Years

    PubMed Central

    Lungu, Codrin; Karp, Barbara I; Alter, Katharine; Zolbrod, Regina; Hallett, Mark

    2010-01-01

    Background Prior studies have explored the efficacy and safety of BoNT treatment for FHD, but none have followed a large number of patients for 10 or more years. Methods Retrospective study, with benefit and weakness assessed on a 0-4 subjective scale. Demographic, clinical and treatment characteristics were analyzed using t-tests and Pearson correlations. Results 20 FHD patients had 10 years or longer treatment. Inter-injection intervals were variable. Musicians were more likely to wait longer between injections and had less complex dystonia. There was a trend for larger benefit in women and with shorter intervals. The dose increased over time. Dystonia characteristics did not predict response or side-effects, but benefit magnitude predicted longer compliance. No serious side-effects or antibody-mediated resistance occurred. Conclusion This is the longest reported period of BoNT treatment in the largest FHD cohort. BoNT therapy for FHD remains safe and effective after more than a decade of treatment. PMID:21506157

  11. Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study.

    PubMed

    Dobbie, Fiona; Hiscock, Rosemary; Leonardi-Bee, Jo; Murray, Susan; Shahab, Lion; Aveyard, Paul; Coleman, Tim; McEwen, Andy; McRobbie, Hayden; Purves, Richard; Bauld, Linda

    2015-11-01

    NHS Stop Smoking Services (SSSs) provide free at the point of use treatment for smokers who would like to stop. Since their inception in 1999 they have evolved to offer a variety of support options. Given the changes that have happened in the provision of services and the ongoing need for evidence on effectiveness, the Evaluating Long-term Outcomes for NHS Stop Smoking Services (ELONS) study was commissioned. The main aim of the study was to explore the factors that determine longer-term abstinence from smoking following intervention by SSSs. There were also a number of additional objectives. The ELONS study was an observational study with two main stages: secondary analysis of routine data collected by SSSs and a prospective cohort study of service clients. The prospective study had additional elements on client satisfaction, well-being and longer-term nicotine replacement therapy (NRT) use. The setting for the study was SSSs in England. For the secondary analysis, routine data from 49 services were obtained. For the prospective study and its added elements, nine services were involved. The target population was clients of these services. There were 202,804 cases included in secondary analysis and 3075 in the prospective study. A combination of behavioural support and stop smoking medication delivered by SSS practitioners. Abstinence from smoking at 4 and 52 weeks after setting a quit date, validated by a carbon monoxide (CO) breath test. Just over 4 in 10 smokers (41%) recruited to the prospective study were biochemically validated as abstinent from smoking at 4 weeks (which was broadly comparable with findings from the secondary analysis of routine service data, where self-reported 4-week quit rates were 48%, falling to 34% when biochemical validation had occurred). At the 1-year follow-up, 8% of prospective study clients were CO validated as abstinent from smoking. Clients who received specialist one-to-one behavioural support were twice as likely to have remained abstinent than those who were seen by a general practitioner (GP) practice and pharmacy providers [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.2 to 4.6]. Clients who received group behavioural support (either closed or rolling groups) were three times more likely to stop smoking than those who were seen by a GP practice or pharmacy providers (OR 3.4, 95% CI 1.7 to 6.7). Satisfaction with services was high and well-being at baseline was found to be a predictor of abstinence from smoking at longer-term follow-up. Continued use of NRT at 1 year was rare, but no evidence of harm from longer-term use was identified from the data collected. Stop Smoking Services in England are effective in helping smokers to move away from tobacco use. Using the 52-week CO-validated quit rate of 8% found in this study, we estimate that in the year 2012-13 the services supported 36,249 clients to become non-smokers for the remainder of their lives. This is a substantial figure and provides one indicator of the ongoing value of the treatment that the services provide. The study raises a number of issues for future research including (1) examining the role of electronic cigarettes (e-cigarettes) in smoking cessation for service clients [this study did not look at e-cigarette use (except briefly in the longer-term NRT study) but this is a priority for future studies]; (2) more detailed comparisons of rolling groups with other forms of behavioural support; (3) further exploration of the role of practitioner knowledge, skills and use of effective behaviour change techniques in supporting service clients to stop smoking; (4) surveillance of the impact of structural and funding changes on the future development and sustainability of SSSs; and (5) more detailed analysis of well-being over time between those who successfully stop smoking and those who relapse. Further research on longer-term use of non-combustible nicotine products that measures a wider array of biomarkers of smoking-related harm such as lung function tests or carcinogen metabolites. The National Institute for Health Research Health Technology Assessment programme. The UK Centre for Tobacco and Alcohol Studies provided funding for the longer-term NRT study.

  12. Potential cost effectiveness of intravenous tissue plasminogen activator versus streptokinase for acute myocardial infarction.

    PubMed

    Goel, V; Naylor, C D

    1992-01-01

    An economic evaluation of the potential incremental benefits of intravenous tissue plasminogen activator (tPA) versus streptokinase (SK) for treatment of acute myocardial infarction. Cost effectiveness analysis from a third-party payer perspective (Ontario Ministry of Health). ECONOMIC INPUTS: Fully allocated costs for cardiovascular procedures and hospitalization for myocardial infarction were obtained anonymously for four Ontario teaching hospitals and converted to 1988 Canadian dollars. Professional charges were taken from the provincial health insurance fee schedule and drug costs obtained from the manufacturers. CLINICAL INPUTS: The baseline analysis was for nonelderly patients with uncomplicated myocardial infarctions; sensitivity analyses allowed extrapolation to higher risk subgroups. Short and longer term mortality and short term invasive procedure rates were estimated using data from clinical trials. If tPA achieves a 1% short term mortality advantage over SK with no advantages for other survivors, cost per life-year gained can be comparable to other cardiovascular interventions at $58,600. In the absence of immediate survival advantages, but assuming greater left ventricular preservation, the constant annual hazard rate advantage must be about 0.5% per year for competitive cost effectiveness ratios. A full range of projections is presented to help guide the policy decisions that will arise in the wake of the Global Utilization of SK and tPA for Occluded Coronary Arteries (GUSTO) trial. The analysis also illustrates the general importance of considering longer term effects of in-hospital therapies for acute myocardial infarction.

  13. Better exercise adherence after treatment for cancer (BEAT Cancer) study: Rationale, design, and methods

    PubMed Central

    Rogers, Laura Q.; McAuley, Edward; Anton, Philip M.; Courneya, Kerry S.; Vicari, Sandra; Hopkins-Price, Patricia; Verhulst, Steven; Mocharnuk, Robert; Hoelzer, Karen

    2011-01-01

    Most breast cancer survivors do not engage in regular physical activity. Our physical activity behavior change intervention for breast cancer survivors significantly improved physical activity and health outcomes post-intervention during a pilot, feasibility study. Testing in additional sites with a larger sample and longer follow-up is warranted to confirm program effectiveness short and longer term. Importantly, the pilot intervention resulted in changes in physical activity and social cognitive theory constructs, enhancing our potential for testing mechanisms mediating physical activity behavior change. Here, we report the rationale, design, and methods for a two-site, randomized controlled trial comparing the effects of the BEAT Cancer physical activity behavior change intervention to usual care on short and longer term physical activity adherence among breast cancer survivors. Secondary aims include examining social cognitive theory mechanisms of physical activity behavior change and health benefits of the intervention. Study recruitment goal is 256 breast cancer survivors with a history of ductal carcinoma in situ or Stage I, II, or IIIA disease who have completed primary cancer treatment. Outcome measures are obtained at baseline, 3 months (i.e., immediately post-intervention), 6 months, and 12 months and include physical activity, psychosocial factors, fatigue, sleep quality, lower extremity joint dysfunction, cardiorespiratory fitness, muscle strength, and waist-to-hip ratio. Confirming behavior change effectiveness, health effects, and underlying mechanisms of physical activity behavior change interventions will facilitate translation to community settings for improving the health and well-being of breast cancer survivors. PMID:21983625

  14. 30 CFR 250.180 - What am I required to do to keep my lease term in effect?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... the longer period is in the National interest, and it conserves resources, prevents waste, or protects... production. (2) Cessation of production—within 15 days after the first full month of zero production. (3...

  15. 30 CFR 250.180 - What am I required to do to keep my lease term in effect?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the longer period is in the National interest, and it conserves resources, prevents waste, or protects... production. (2) Cessation of production—within 15 days after the first full month of zero production. (3...

  16. 30 CFR 250.180 - What am I required to do to keep my lease term in effect?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the longer period is in the National interest, and it conserves resources, prevents waste, or protects... production. (2) Cessation of production—within 15 days after the first full month of zero production. (3...

  17. Occupational repetitive strain injuries and gender in Ontario, 1986 to 1991.

    PubMed

    Ashbury, F D

    1995-04-01

    Repetitive strain injuries (RSIs) in Ontario were examined with respect to gender for the period 1986 to 1991, using data from Ontario Workers' Compensation Board systems. Technical issues surrounding analysis of workplace injuries and theoretical suggestions raised by the data are discussed. Analyses revealed that the risk of RSIs for women is greater than that for men. Furthermore, women receive compensation benefits because of RSIs for a longer period than do their male counterparts, which may indicate a longer-term effect of RSIs on women.

  18. Evaluating the longer-term cognitive effects of adjunctive perampanel compared to lacosamide in a naturalistic outpatient setting.

    PubMed

    Meschede, Carolin; Witt, Juri-Alexander; Rademacher, Michael; von Wrede, Randi D; Elger, Christian E; Helmstaedter, Christoph

    2018-04-22

    This retrospective longitudinal study aims to compare the longer-term cognitive and behavioral side effects of adjunctive antiepileptic treatment with perampanel (PER) and lacosamide (LCM), two third generation antiepileptic drugs with suggested favorable cognitive profiles. The two drugs were monitored according to a previously established routine diagnostic protocol (Helmstaedter et al. E&B 2013;26:182-7) which facilitates the retrospective comparison of antiepileptic drug tolerability in a naturalistic outpatient setting. Records from 94 patients were evaluated who underwent neuropsychological assessment before and under adjunctive treatment with either PER (n = 57) or LCM (n = 37). Cognition was assessed using the EpiTrack screening for executive functions and a VLMT short form for verbal memory. Subjective assessments included a German QOLIE-10 adaptation (quality of life) and an extended Adverse Events Profile (AEP). The median follow-up interval was 36 weeks. Multivariate repeated measures statistics revealed a non-significant trend towards an interaction effect "time - treatment arm" on both executive function and memory. When analyzed separately executive functions and memory scores significantly improved under LCM (t = -2.76 p < 0.01 and t = -2.44 p < 0.05 respectively). Subjectively, PER was associated with improvements in 2/18 physiological domains and in the LCM group 1/9 cognitive domains deteriorated. Seizure freedom was achieved for five patients treated with LCM (14%) and 15 treated with PER (26%, χ 2  = 2.2, n.s.). In a naturalistic outpatient setting, chronic adjunctive treatment with PER and LCM did not negatively affect cognition and LCM may even improve cognition. Neither drug increased self-reported irritability or aggression. This suggests favorable longer-term tolerability. Copyright © 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  19. Length, Lexicality, and Articulatory Suppression in Immediate Recall: Evidence against the Articulatory Loop

    ERIC Educational Resources Information Center

    Romani, C.; McAlpine, S.; Olson, A.; Tsouknida, E.; Martin, R.

    2005-01-01

    Influential models of short-term memory have attributed the fact that short words are recalled better than longer words in serial recall (the length effect) to articulatory rehearsal. Crucial for this link is the finding that the length effect disappears under articulatory suppression. We show, instead, that, under suppression, the length effect…

  20. Lack of regulation of 11β-hydroxysteroid dehydrogenase type 1 during short-term manipulation of GH in patients with hypopituitarism

    PubMed Central

    Sigurjonsdottir, Helga A; Andrew, Ruth; Stimson, Roland H; Johannsson, Gudmundur; Walker, Brian R

    2009-01-01

    Objective Evidence from long-term clinical studies measuring urinary steroid ratios, and from in vitro studies, suggests that GH administered for longer than 2 months down-regulates 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), thereby reducing cortisol regeneration in liver and adipose tissue. We aimed to measure acute effects of GH on 11β-HSD1 in liver and adipose tissue in vivo, including using a stable isotope tracer. Design Observational studies of GH withdrawal and reintroduction in patients with hypopituitarism. Methods Twelve men with benign pituitary disease causing GH and ACTH deficiency on stable replacement therapy for >6 months were studied after GH withdrawal for 3 weeks, and after either placebo or GH injections were reintroduced for another 3 weeks. We measured cortisol kinetics during 9,11,12,12-2H4-cortisol (d4-cortisol) infusion, urinary cortisol/cortisone metabolite ratios, liver 11β-HSD1 by appearance of plasma cortisol after oral cortisone, and 11β-HSD1 mRNA levels in subcutaneous adipose biopsies. Results GH withdrawal and reintroduction had no effect on 9,12,12-[2H]3-cortisol (d3-cortisol) appearance, urinary cortisol/cortisone metabolite ratios, initial appearance of cortisol after oral cortisone, or adipose 11β-HSD1 mRNA. GH withdrawal increased plasma cortisol 30–180 min after oral cortisone, increased d4-cortisol clearance, and decreased relative excretion of 5α-reduced cortisol metabolites. Conclusions In this setting, GH did not regulate 11β-HSD1 rapidly in vivo in humans. Altered cortisol metabolism with longer term changes in GH may reflect indirect effects on 11β-HSD1. These data do not suggest that glucocorticoid replacement doses need to be increased immediately after introducing GH therapy to compensate for reduced 11β-HSD1 activity, although dose adjustment may be required in the longer term. PMID:19549748

  1. Effects of long-term cryopreservation on peripheral blood progenitor cells.

    PubMed

    Vosganian, Gregory S; Waalen, Jill; Kim, Kevin; Jhatakia, Sejal; Schram, Ethan; Lee, Tracey; Riddell, Dan; Mason, James R

    2012-11-01

    The long-term stability of cryopreserved peripheral blood progenitor cells is an important issue for patients experiencing disease relapse. However, there is no consensus on how to evaluate the long-term effects of cryopreservation. We describe the effect of cryopreservation on viability and progenitor colony activity from 87 individual samples processed at the Scripps Green Hospital Stem Cell Processing Center (La Jolla, CA, USA). We randomly selected 87 peripheral blood hematopoietic stem cell (PBHSC) samples from 60 patients and evaluated the effect of cryopreservation on sample viability and red and white cell colony activity after < 24 h and 7, 10 and 15 years of cryopreservation. Viability was assayed via trypan blue dye exclusion and activity was measured following 14 days of culture. An age at collection older than 50 years may result in suboptimal activity and viability following long-term cryopreservation, while gender and disease status had no effect. Cryopreservation did not significantly affect white or red cell activity following 10 years of cryopreservation. However, for samples stored longer than 10 years, viability and activity significantly decreased. We noted a positive association between higher pre-cryopreservation %CD34 count and colony activity. Cryopreservation of peripheral blood progenitor cells for up to 10 years results in no loss of clonogenic capacity, as determined by culture activity, although longer durations of storage may affect activity. Until validated methods are developed, cryopreserved grafts should be evaluated based on pre-freeze CD34(+) cell counts as assayed by flow cytometry, and post-thaw sample evaluation should be reserved for patients identified as poor mobilizers.

  2. Seattle's Law Enforcement Assisted Diversion (LEAD): Program effects on recidivism outcomes.

    PubMed

    Collins, Susan E; Lonczak, Heather S; Clifasefi, Seema L

    2017-10-01

    Drug users and dealers frequently cycle through the criminal justice system in what is sometimes referred to as a "revolving door." Arrest, incarceration and prosecution have not deterred this recidivism. Seattle's Law Enforcement Assisted Diversion (LEAD) program was established to divert these individuals to case management and supportive services instead of jail and prosecution. A nonrandomized controlled evaluation was conducted to examine LEAD effects on criminal recidivism (i.e., arrests, criminal charges). The sample included 318 people suspected of low-level drug and prostitution activity in downtown Seattle: 203 received LEAD, and 115 experienced the system-as-usual control condition. Analyses were conducted using logistic generalized estimating equation models over both the shorter term (i.e., six months prior and subsequent to evaluation entry) and longer term (i.e., two years prior to the LEAD start date through July 2014). Compared to controls, LEAD participants had 60% lower odds of arrest during the six months subsequent to evaluation entry; and both a 58% lower odds of arrest and 39% lower odds of being charged with a felony over the longer term. These statistically significant differences in arrests and felony charges for LEAD versus control participants indicated positive effects of the LEAD program on recidivism. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Testing mediators hypothesized to account for the effects of a dissonance-based eating disorder prevention program over longer term follow-up.

    PubMed

    Stice, Eric; Marti, C Nathan; Rohde, Paul; Shaw, Heather

    2011-06-01

    Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Data were drawn from a randomized effectiveness trial in which 306 female high school students (mean age = 15.7 years, SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Dissonance-intervention participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Findings provided support for the intervention theory of this eating disorder prevention program over longer term follow-up, extending the evidence base for this effective intervention. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  4. Testing Mediators Hypothesized to Account for the Effects of a Dissonance Eating Disorder Prevention Program Over Longer-Term Follow-Up

    PubMed Central

    Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

    2011-01-01

    Objective Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method Data were drawn from a randomized effectiveness trial in which 306 female high school students (M age = 15.7 SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Results Dissonance participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Conclusions Findings provided support for the intervention theory of this eating disorder prevention program over longer-term follow-up, extending the evidence base for this effective intervention. PMID:21500884

  5. Fire effects in southwestern forests: Proceedings of the second La Mesa Fire Symposium

    Treesearch

    Craig D. Allen

    1996-01-01

    In 1977, the La Mesa Fire burned across 15,444 acres of ponderosa pine forests on the adjoining lands of Bandelier National Monument, the Santa Fe National Forest, and Los Alamos National Laboratory. Following this event, several fire effects studies were initiated. The 16 papers herein document longer-term knowledge gained about the ecological effects of the fire and...

  6. Testing Mediators Hypothesized to Account for the Effects of a Dissonance-Based Eating Disorder Prevention Program over Longer Term Follow-Up

    ERIC Educational Resources Information Center

    Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

    2011-01-01

    Objective: Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method: Data were drawn from a randomized effectiveness trial in which 306 female high school students…

  7. Cattle grazing and vegetation succession on burned sagebrush steppe

    USDA-ARS?s Scientific Manuscript database

    There is limited information on the effects of cattle grazing to longer-term plant community composition and productivity following fire in big sagebrush steppe. This study evaluated vegetation response to cattle grazing over seven years (2007-2013) on burned Wyoming big sagebrush (Artemisia triden...

  8. Long-term effects of potato cropping system strategies on soilborne diseases and soil microbial communities

    USDA-ARS?s Scientific Manuscript database

    Cropping systems incorporating soil health management practices, such as longer rotations, disease-suppressive crops, reduced tillage, and/or organic amendments can substantially affect soil microbial communities, and potentially reduce soilborne potato diseases and increase productivity, but long-t...

  9. Promoting Declines in the Prevalence of Late-Life Disability: Comparisons of Three Potentially High-Impact Interventions

    PubMed Central

    Freedman, Vicki A; Hodgson, Nancy; Lynn, Joanne; Spillman, Brenda C; Waidmann, Timothy; Wilkinson, Anne M; Wolf, Douglas A

    2006-01-01

    Although the prevalence of late-life disability has been declining, how best to promote further reductions remains unclear. This article develops and then demonstrates an approach for comparing the effects of interventions on the prevalence of late-life disability. We review evidence for three potentially high-impact strategies: physical activity, depression screening and treatment, and fall prevention. Because of the large population at risk for falling, the demonstrated efficacy of multi-component interventions in preventing falls, and the strong links between falls and disability, we conclude that, in the short run, multi-component fall-prevention efforts would likely have a higher impact than either physical activity or depression screening and treatment. However, longer-term comparisons cannot be made based on the current literature and may differ from short-run conclusions, since increases in longevity may temper the influences of these interventions on prevalence. Additional research is needed to evaluate longer-term outcomes of interventions, including effects on length and quality of life. PMID:16953808

  10. Fostering and Inspiring Research Engagement (FIRE): program logic of a research incubator scheme for allied health students.

    PubMed

    Ziviani, Jenny; Feeney, Rachel; Schabrun, Siobhan; Copland, David; Hodges, Paul

    2014-08-01

    The purpose of this study was to present the application of a logic model in depicting the underlying theory of an undergraduate research scheme for occupational therapy, physiotherapy, and speech pathology university students in Queensland, Australia. Data gathered from key written documents on the goals and intended operation of the research incubator scheme were used to create a draft (unverified) logic model. The major components of the logic model were inputs and resources, activities/outputs, and outcomes (immediate/learning, intermediate/action, and longer term/impacts). Although immediate and intermediate outcomes chiefly pertained to students' participation in honours programs, longer-term outcomes (impacts) concerned their subsequent participation in research higher-degree programs and engagement in research careers. Program logic provided an effective means of clarifying program objectives and the mechanisms by which the research incubator scheme was designed to achieve its intended outcomes. This model was developed as the basis for evaluation of the effectiveness of the scheme in achieving its stated goals.

  11. Workshop: Theory an Applications of Coupled Cell Networks

    DTIC Science & Technology

    2006-03-22

    physical location and environment and the scientific inter- actions with the longer term participants in the PFD programme. Furthermore, the Institute...in generating a tangible air of excitement about the challenges posed by coupled cell systems, both in terms of the mathematical questions, and in the...longer term visitors interacted with the workshop participants, and by focusing on a slightly different collection of themes, the workshop participants

  12. Do we care about sustainability? An analysis of time sensitivity of social preferences under environmental time-persistent effects.

    PubMed

    Faccioli, Michela; Hanley, Nick; Torres, Cati; Font, Antoni Riera

    2016-07-15

    Environmental cost-benefit analysis has traditionally assumed that the value of benefits is sensitive to their timing and that outcomes are valued higher, the sooner in time they occur following implementation of a project or policy. Though, this assumption might have important implications especially for the social desirability of interventions aiming at counteracting time-persistent environmental problems, whose impacts occur in the long- and very long-term, respectively involving the present and future generations. This study analyzes the time sensitivity of social preferences for preservation policies of adaptation to climate change stresses. Results show that stated preferences are time insensitive, due to sustainability issues: individuals show insignificant differences in benefits they can experience within their own lifetimes compared to those which occur in the longer term, and which will instead be enjoyed by future generations. Whilst these results may be specific to the experimental design employed here, they do raise interesting questions regarding choices over time-persistent environmental problems, particularly in terms of the desirability of interventions which produce longer-term benefits. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Deficits in verbal long-term memory and learning in children with poor phonological short-term memory skills.

    PubMed

    Gathercole, Susan E; Briscoe, Josie; Thorn, Annabel; Tiffany, Claire

    2008-03-01

    Possible links between phonological short-term memory and both longer term memory and learning in 8-year-old children were investigated in this study. Performance on a range of tests of long-term memory and learning was compared for a group of 16 children with poor phonological short-term memory skills and a comparison group of children of the same age with matched nonverbal reasoning abilities but memory scores in the average range. The low-phonological-memory group were impaired on longer term memory and learning tasks that taxed memory for arbitrary verbal material such as names and nonwords. However, the two groups performed at comparable levels on tasks requiring the retention of visuo-spatial information and of meaningful material and at carrying out prospective memory tasks in which the children were asked to carry out actions at a future point in time. The results are consistent with the view that poor short-term memory function impairs the longer-term retention and ease of learning of novel verbal material.

  14. Effect of low-level copper and pentachlorophenol exposure on various early life stages of Xenopus laevis

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

    Fort, D.J.; Stover, E.L.

    1996-12-31

    An evaluation of the effects of low-level copper and pentachlorophenol exposure on various early life stages of the South African clawed frog, Xenopus laevis, was performed using stage-specific and long-term continuous exposures. Stage-specific exposure experiments were conducted such that separate subsets of embryos and larvae from the same clutch were exposed to two toxicants, copper and pentachlorphenol, from 0 d to 4 d (standard Frog Embryo Teratogenesis Assay--Xenopus [FETAX]), 4 d to 8 d, 8 d to 12 d, and 12 d to 16 d. Results from two separate concentration-response experiments indicated that sensitivity to either toxicant increased in eachmore » successive time period. Longer-term exposure studies conducted for 60 to 75 days indicated that copper, but not pentachlorophenol induced reduction deficiency malformations of the hind limb at concentrations as low as 0.05 mg/L. Pentachlorophenol concentrations as low as 0.5 {micro}g/L inhibited tail resorption. However, copper did not adversely affect the process of tail resorption. These results indicated that studies evaluating longer-term developmental processes are important in ecological hazard evaluation.« less

  15. A neonicotinoid impairs olfactory learning in Asian honey bees (Apis cerana) exposed as larvae or as adults

    PubMed Central

    Tan, Ken; Chen, Weiwen; Dong, Shihao; Liu, Xiwen; Wang, Yuchong; Nieh, James C.

    2015-01-01

    Xenobiotics such as the neonicotinoid pesticide, imidacloprid, are used globally, but their effects on native bee species are poorly understood. We studied the effects of sublethal doses of imidacloprid on olfactory learning in the native honey bee species, Apis cerana, an important pollinator of agricultural and native plants throughout Asia. We provide the first evidence that imidacloprid can impair learning in A. cerana workers exposed as adults or as larvae. Adults that ingested a single imidacloprid dose as low as 0.1 ng/bee had significantly reduced olfactory learning acquisition, which was 1.6-fold higher in control bees. Longer-term learning (1-17 h after the last learning trial) was also impaired. Bees exposed as larvae to a total dose of 0.24 ng/bee did not have reduced survival to adulthood. However, these larval-treated bees had significantly impaired olfactory learning when tested as adults: control bees exhibited up to 4.8-fold better short-term learning acquisition, though longer-term learning was not affected. Thus, sublethal cognitive deficits elicited by neonicotinoids on a broad range of native bee species deserve further study. PMID:26086769

  16. Thrombopoietin treatment of one graft in a double cord blood transplant provides early platelet recovery while contributing to long-term engraftment in NSG mice.

    PubMed

    van der Garde, Mark; van Hensbergen, Yvette; Brand, Anneke; Slot, Manon C; de Graaf-Dijkstra, Alice; Mulder, Arend; Watt, Suzanne M; Zwaginga, Jaap Jan

    2015-01-01

    Human cord blood (CB) hematopoietic stem cell (HSC) transplants demonstrate delayed early neutrophil and platelet recovery and delayed longer term immune reconstitution compared to bone marrow and mobilized peripheral blood transplants. Despite advances in enhancing early neutrophil engraftment, platelet recovery after CB transplantation is not significantly altered when compared to contemporaneous controls. Recent studies have identified a platelet-biased murine HSC subset, maintained by thrombopoietin (TPO), which has enhanced capacity for short- and long-term platelet reconstitution, can self-renew, and can give rise to myeloid- and lymphoid-biased HSCs. In previous studies, we have shown that transplantation of human CB CD34(+) cells precultured in TPO as a single graft accelerates early platelet recovery as well as yielding long-term repopulation in immune-deficient mice. In this study, using a double CB murine transplant model, we investigated whether TPO cultured human CB CD34(+) cells have a competitive advantage or disadvantage over untreated human CB CD34(+) cells in terms of (1) short-term and longer term platelet recovery and (2) longer term hematological recovery. Our studies demonstrate that the TPO treated graft shows accelerated early platelet recovery without impairing the platelet engraftment of untreated CD34(+) cells. Notably, this was followed by a dominant contribution to platelet production through the untreated CD34(+) cell graft over the intermediate to longer term. Furthermore, although the contribution of the TPO treated graft to long-term hematological engraftment was reduced, the TPO treated and untreated grafts both contributed significantly to long-term chimerism in vivo.

  17. Long-term efficacy of polyethylene glycol 3350 for the treatment of chronic constipation in children with and without encopresis.

    PubMed

    Pashankar, Dinesh S; Bishop, Warren P; Loening-Baucke, Vera

    2003-01-01

    Seventy-four children (43 with chronic constipation, 31 with constipation and encopresis) treated with polyethylene glycol 3350 (PEG) for longer than 3 months were studied to assess long-term efficacy. The mean duration of PEG therapy was 8.4 months (range, 3-30). Weekly stool frequency, stool consistency, and symptoms associated with constipation improved significantly with PEG therapy in all 74 patients. In 31 children with encopresis, soiling ceased completely in 16 patients and frequency of soiling decreased significantly in all others. The average effective long-term dose of PEG was 0.7 g/kg/day. Long-term PEG therapy is effective for the treatment of chronic constipation with and without encopresis in children.

  18. Orlistat. No hurry....

    PubMed Central

    1999-01-01

    Treatments for obesity are disappointing. None has yet shown an effect on morbidity and mortality. Nondrug treatments are poorly assessed. Stable long-term weight loss necessitates long-term management. Orlistat (Xenical, Hoffman-La Roche), a gastrointestinal lipase inhibitor, is indicated, in combination with a low-calorie diet, for management of obesity. The assessment file is bulky and methodologically sound, at least in terms of the weight loss end point. During medium-term trials (12 to 24 months), orlistat administered at a dose of 120 mg three times daily and combined with dietary intervention had a moderate positive effect on body weight (-3.5 kg on average). No longer-term trials have been done. It is unknown whether this drug affects morbidity and mortality linked to obesity. In clinical trials, patients treated with orlistat had an increased frequency of breast cancer. This potential risk is currently being assessed in a specific trial. Gastrointestinal adverse effects are frequent. Treatment is costly. PMID:10540693

  19. Burnout intervention studies for inpatient elderly care nursing staff: systematic literature review.

    PubMed

    Westermann, Claudia; Kozak, Agnessa; Harling, Melanie; Nienhaus, Albert

    2014-01-01

    Staff providing inpatient elderly and geriatric long-term care are exposed to a large number of factors that can lead to the development of burnout syndrome. Burnout is associated with an increased risk of absence from work, low work satisfaction, and an increased intention to leave. Due to the fact that the number of geriatric nursing staff is already insufficient, research on interventions aimed at reducing work-related stress in inpatient elderly care is needed. The aim of this systematic review was to identify and analyse burnout intervention studies among nursing staff in the inpatient elderly and geriatric long-term care sector. A systematic search of burnout intervention studies was conducted in the databases Embase, Medline and PsycNet published from 2000 to January 2012. We identified 16 intervention studies. Interventions were grouped into work-directed (n=2), person-directed (n=9) and combined approaches (work- and person-directed, n=5). Seven out of 16 studies observed a reduction in staff burnout. Among them are two studies with a work-directed, two with a person-directed and three with a combined approach. Person-directed interventions reduced burnout in the short term (up to 1 month), while work-directed interventions and those with a combined approach were able to reduce burnout over a longer term (from 1 month to more than 1 year). In addition to staff burnout, three studies observed positive effects relating to the client outcomes. Only three out of ten Randomised Control Trials (RCT) found that interventions had a positive effect on staff burnout. Work-directed and combined interventions are able to achieve beneficial longer-term effects on staff burnout. Person-directed interventions achieve short-term results in reducing staff burnout. However, the evidence is limited. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Knowledge Brokers, Entrepreneurs and Markets

    ERIC Educational Resources Information Center

    Caswill, Chris; Lyall, Catherine

    2013-01-01

    This paper expands the discussion of knowledge brokerage by connecting it to long-standing debates within the social sciences about the effective transmission of scientifically produced knowledge into the worlds of policy and practice. This longer-term perspective raises some different questions about intermediary roles which are then tested…

  1. Reward, Punishment, and Cooperation: A Meta-Analysis

    ERIC Educational Resources Information Center

    Balliet, Daniel; Mulder, Laetitia B.; Van Lange, Paul A. M.

    2011-01-01

    How effective are rewards (for cooperation) and punishment (for noncooperation) as tools to promote cooperation in social dilemmas or situations when immediate self-interest and longer term collective interest conflict? What variables can promote the impact of these incentives? Although such questions have been examined, social and behavioral…

  2. Duloxetine: a review of its use in the treatment of generalized anxiety disorder.

    PubMed

    Carter, Natalie J; McCormack, Paul L

    2009-01-01

    Duloxetine (Cymbalta(R)) is a potent serotonin and noradrenaline (norepinephrine) reuptake inhibitor (SNRI) in the CNS. It is indicated for the treatment of generalized anxiety disorder (GAD) as well as other indications. In patients with GAD of at least moderate severity, oral duloxetine 60-120 mg once daily was effective with regard to improvement from baseline in assessments of anxiety and functional impairment, and numerous other clinical endpoints. Longer-term duloxetine 60-120 mg once daily also demonstrated efficacy in preventing or delaying relapse in responders among patients with GAD. In addition, duloxetine was generally well tolerated, with most adverse events being of mild to moderate severity in patients with GAD in short- and longer-term trials. Additional comparative and pharmacoeconomic studies are required to position duloxetine among other selective serotonin reuptake inhibitors and SNRIs. However, available clinical data, and current treatment guidelines, indicate that duloxetine is an effective first-line treatment option for the management of GAD. Duloxetine is a potent and selective inhibitor of serotonin and noradrenaline transporters, and a weak inhibitor of dopamine transporters. It has a low affinity for neuronal receptors, such as alpha(1)- and alpha(2)-adrenergic, dopamine D(2), histamine H(1), muscarinic, opioid and serotonin receptors, as well as ion channel binding sites and other neurotransmitter transporters, such as choline and GABA transporters. It does not inhibit monoamine oxidase types A or B. The pharmacokinetics of duloxetine in healthy volunteers were dose proportional over the range of 40-120 mg once daily. Steady state was typically reached by day 3 of administration. Duloxetine may be administered without regard to food or time of day. Duloxetine is highly protein bound and is widely distributed throughout tissues. It is rapidly and extensively metabolized in the liver by cytochrome P450 (CYP) 1A2 and 2D6, and its numerous metabolites, which are inactive, are mainly excreted in the urine. The mean elimination half-life of duloxetine is approximately 12 hours. Duloxetine is a substrate for CYP1A2 and CYP2D6 and a moderate inhibitor of CYP2D6. Concomitant use of duloxetine and potent CYP1A2 inhibitors should be avoided and duloxetine should be used with caution in patients receiving drugs that are extensively metabolized by CYP2D6, particularly those with a narrow therapeutic index. Duloxetine was effective in the short-term treatment of patients with primary GAD of at least moderate severity. In four randomized, double-blind, placebo-controlled, multicentre, phase III trials, duloxetine 60-120 mg once daily for 9 or 10 weeks was significantly more effective than placebo with regard to the primary endpoint of mean change in Hamilton Anxiety Rating Scale (HAM-A) total score from baseline to study endpoint. In addition, all other endpoints were generally improved from baseline to a greater extent with duloxetine 60-120 mg once daily than with placebo. Duloxetine also improved patient role functioning (assessed using Sheehan Disability Scale global impairment functioning scores), health-related quality of life and patient well-being compared with placebo. Duloxetine was effective in patients with GAD who were aged >/=65 years. Pooled results of data from the two short-term efficacy trials that also included an active comparator arm showed that the mean change in HAM-A scores with duloxetine relative to placebo were of the same magnitude as those with venlafaxine extended release versus placebo. Duloxetine 60-120 mg once daily was also more effective than placebo in preventing or delaying relapse in responders to duloxetine in a longer-term study. In this study, patients with GAD received duloxetine during a 26-week, open-label, acute treatment phase and responders were then randomized to continue on duloxetine or receive placebo during a 26-week, double-blind, continuation phase. Time to relapse was significantly longer in duloxetine recipients than in placebo recipients. In addition, significantly fewer duloxetine recipients than placebo recipients relapsed during the double-blind phase of the trial and more duloxetine recipients achieved remission. Short- (9-10 weeks) and longer-term (52 weeks) treatment with duloxetine 60-120 mg once daily was generally well tolerated in patients with GAD, with the majority of adverse events being of mild to moderate severity. Nausea, dry mouth, headache, constipation, dizziness and fatigue were among the most common treatment-emergent adverse events. The adverse event profile of duloxetine did not differ with dose or treatment duration. Significantly more patients receiving short-term duloxetine than placebo discontinued treatment because of an adverse event, with nausea being the only event that resulted in significantly more treatment discontinuations in duloxetine recipients than in placebo recipients. Serious adverse events were uncommon with both short- and longer-term duloxetine treatment. Two episodes of attempted suicide and one episode of completed suicide occurred in duloxetine recipients during the 24-week open-label phase of a longer-term trial. No deaths or suicides were reported in any of the short-term trials. Discontinuation-emergent adverse events, most commonly nausea and dizziness, occurred in up to one-third of duloxetine recipients in the short-term trials.

  3. Water, Hydration and Health

    PubMed Central

    Popkin, Barry M.; D’Anci, Kristen E.; Rosenberg, Irwin H.

    2010-01-01

    This review attempts to provide some sense of our current knowledge of water including overall patterns of intake and some factors linked with intake, the complex mechanisms behind water homeostasis, the effects of variation in water intake on health and energy intake, weight, and human performance and functioning. Water represents a critical nutrient whose absence will be lethal within days. Water’s importance for prevention of nutrition-related noncommunicable diseases has emerged more recently because of the shift toward large proportions of fluids coming from caloric beverages. Nevertheless, there are major gaps in knowledge related to measurement of total fluid intake, hydration status at the population level, and few longer-term systematic interventions and no published random-controlled longer-term trials. We suggest some ways to examine water requirements as a means to encouraging more dialogue on this important topic. PMID:20646222

  4. Examining the Use of Spacing Effect to Increase the Efficiency of Incremental Rehearsal

    ERIC Educational Resources Information Center

    Swehla, Sarah E.; Burns, Matthew K.; Zaslofsky, Anne F.; Hall, Matthew S.; Varma, Sashank; Volpe, Robert J.

    2016-01-01

    Incremental rehearsal (IR) is a highly effective intervention that uses high repetition and a high ratio of known to unknown items with linearly spaced known items between the new items. It has been hypothesized that narrowly spaced practice would result in quick learning, whereas items that are widely spaced would result in longer-term retention.…

  5. Spruce aphid, Elatobium abietinum (Walker): Life history and damage to Engelmann spruce in the Pinaleno Mountains, Arizona

    Treesearch

    Ann M. Lynch

    2009-01-01

    Spruce aphid is an exotic insect recently introduced to the Pinaleno Mountains. It feeds on dormant Engelmann spruce, and possible effects include tree-growth suppression, tree mortality, and reduction in seed and cone production. Potential longer-term effects include changes in forest structure and species composition - primarily through reduction in Engelmann spruce...

  6. Initial abstinence status and contingency management treatment outcomes: does race matter?

    PubMed

    Montgomery, LaTrice; Carroll, Kathleen M; Petry, Nancy M

    2015-06-01

    Limited research has evaluated African American substance users' response to evidence-based treatments. This study examined the efficacy of contingency management (CM) in African American and White cocaine users. A secondary analysis evaluated effects of race, treatment condition, and baseline cocaine urine sample results on treatment outcomes of African American (n = 444) and White (n = 403) cocaine abusers participating in one of six randomized clinical trials comparing CM to standard care. African American and White patients who initiated treatment with a cocaine-negative urine sample remained in treatment for similar durations and submitted a comparable proportion of negative samples during treatment regardless of treatment type; CM was efficacious in both races in terms of engendering longer durations of abstinence in patients who began treatment abstinent. Whites who began treatment with a cocaine positive sample remained in treatment longer and submitted a higher proportion of negative samples when assigned to CM than standard care. African Americans who initiated treatment with a cocaine positive sample, however, did not remain in treatment longer with CM compared with standard care, and gains in terms of drug use outcomes were muted in nature relative to Whites. This interaction effect persisted through the 9-month follow-up period. CM is not equally effective in reducing drug use among all subgroups, specifically African American patients who are using cocaine upon treatment entry. Future research on improving treatment outcomes in this population is needed. (c) 2015 APA, all rights reserved).

  7. Out-of-School-Time Academic Programs to Improve School Achievement: A Community Guide Health Equity Systematic Review.

    PubMed

    Knopf, John A; Hahn, Robert A; Proia, Krista K; Truman, Benedict I; Johnson, Robert L; Muntaner, Carles; Fielding, Jonathan E; Jones, Camara Phyllis; Fullilove, Mindy T; Hunt, Pete C; Qu, Shuli; Chattopadhyay, Sajal K; Milstein, Bobby

    2015-01-01

    Low-income and minority status in the United States are associated with poor educational outcomes, which, in turn, reduce the long-term health benefits of education. This systematic review assessed the extent to which out-of-school-time academic (OSTA) programs for at-risk students, most of whom are from low-income and racial/ethnic minority families, can improve academic achievement. Because most OSTA programs serve low-income and ethnic/racial minority students, programs may improve health equity. Methods of the Guide to Community Preventive Services were used. An existing systematic review assessing the effects of OSTA programs on academic outcomes (Lauer et al 2006; search period 1985-2003) was supplemented with a Community Guide update (search period 2003-2011). Standardized mean difference. Thirty-two studies from the existing review and 25 studies from the update were combined and stratified by program focus (ie, reading-focused, math-focused, general academic programs, and programs with minimal academic focus). Focused programs were more effective than general or minimal academic programs. Reading-focused programs were effective only for students in grades K-3. There was insufficient evidence to determine effectiveness on behavioral outcomes and longer-term academic outcomes. OSTA programs, particularly focused programs, are effective in increasing academic achievement for at-risk students. Ongoing school and social environments that support learning and development may be essential to ensure the longer-term benefits of OSTA programs.

  8. Out-of-School-Time Academic Programs to Improve School Achievement: A Community Guide Health Equity Systematic Review

    PubMed Central

    Knopf, John A.; Hahn, Robert A.; Proia, Krista K.; Truman, Benedict I.; Johnson, Robert L.; Muntaner, Carles; Fielding, Jonathan E.; Jones, Camara Phyllis; Fullilove, Mindy T.; Hunt, Pete C.; Qu, Shuli; Chattopadhyay, Sajal K.; Milstein, Bobby

    2015-01-01

    Context Low-income and minority status in the United States are associated with poor educational outcomes, which, in turn, reduce the long-term health benefits of education. Objective This systematic review assessed the extent to which out-of-school-time academic (OSTA) programs for at-risk students, most of whom are from low-income and racial/ethnic minority families, can improve academic achievement. Because most OSTA programs serve low-income and ethnic/racial minority students, programs may improve health equity. Design Methods of the Guide to Community Preventive Services were used. An existing systematic review assessing the effects of OSTA programs on academic outcomes (Lauer et al 2006; search period 1985–2003) was supplemented with a Community Guide update (search period 2003–2011). Main Outcome Measure Standardized mean difference. Results Thirty-two studies from the existing review and 25 studies from the update were combined and stratified by program focus (ie, reading-focused, math-focused, general academic programs, and programs with minimal academic focus). Focused programs were more effective than general or minimal academic programs. Reading-focused programs were effective only for students in grades K-3. There was insufficient evidence to determine effectiveness on behavioral outcomes and longer-term academic outcomes. Conclusions OSTA programs, particularly focused programs, are effective in increasing academic achievement for at-risk students. Ongoing school and social environments that support learning and development may be essential to ensure the longer-term benefits of OSTA programs. PMID:26062096

  9. National Study of Chronic Disease Self-Management: Age Comparison of Outcome Findings

    ERIC Educational Resources Information Center

    Ory, Marcia G.; Smith, Matthew Lee; Ahn, SangNam; Jiang, Luohua; Lorig, Kate; Whitelaw, Nancy

    2014-01-01

    Introduction: The adult population is increasingly experiencing one or more chronic illnesses and living with such conditions longer. The Chronic Disease Self-Management Program (CDSMP) helps participants cope with chronic disease-related symptomatology and improve their health-related quality of life. Nevertheless, the long-term effectiveness of…

  10. A decision support tool for vehicle infrastructure integration : understanding information effects and advancing data fusion algorithms for traffic management applications.

    DOT National Transportation Integrated Search

    2009-10-15

    This research seeks to explore vehicle-to-vehicle information networks to understand the interplay : between the information communicated and traffic conditions on the network. A longer-term goal is to : develop a decision support tool for processing...

  11. Altered neurotransmission and signal transduction: targets for nicergoline treatment.

    PubMed

    Winblad, B

    1997-01-01

    Although we do not yet have a complete understanding of the molecular mechanisms responsible for the pathophysiology of Alzheimer's disease, it is clear that a drug such as nicergoline, which may have both acute and longer-term effects on the disease, could offer a beneficial and worthwhile approach to treatment.

  12. Long-term follow-up of botulinum toxin therapy for focal hand dystonia: outcome at 10 years or more.

    PubMed

    Lungu, Codrin; Karp, Barbara I; Alter, Katharine; Zolbrod, Regina; Hallett, Mark

    2011-03-01

    Previous studies have explored the efficacy and safety of botulinum neurotoxin (BoNT) treatment for Focal hand dystonia (FHD), but none have followed a large number of patients for 10 years or more. Retrospective study, with benefit and weakness assessed on a 0 to 4 subjective scale. Demographic, clinical and treatment characteristics were analyzed using t tests and Pearson correlations. Twenty FHD patients had 10 years or longer treatment. Interinjection intervals were variable. Musicians were more likely to wait longer between injections and had less complex dystonia. There was a trend for larger benefit in women and with shorter intervals. The dose increased over time. Dystonia characteristics did not predict response or side-effects, but benefit magnitude predicted longer compliance. No serious side-effects or antibody-mediated resistance occurred. This is the longest reported period of BoNT treatment in the largest FHD cohort. BoNT therapy for FHD remains safe and effective after more than a decade of treatment. Copyright © 2011 Movement Disorder Society.

  13. Long-term and short-term action-effect links and their impact on effect monitoring.

    PubMed

    Wirth, Robert; Steinhauser, Robert; Janczyk, Markus; Steinhauser, Marco; Kunde, Wilfried

    2018-04-23

    People aim to produce effects in the environment, and according to ideomotor theory, actions are selected and executed via anticipations of their effects. Further, to ensure that an action has been successful and an effect has been realized, we must be able to monitor the consequences of our actions. However, action-effect links might vary between situations, some might apply for a majority of situations, while others might only apply to special occasions. With a combination of behavioral and electrophysiological markers, we show that monitoring of self-produced action effects interferes with other tasks, and that the length of effect monitoring is determined by both, long-term action-effect links that hold for most situations, and short-term action-effect links that emerge from a current setting. Effect monitoring is fast and frugal when these action-effect links allow for valid anticipation of action effects, but otherwise effect monitoring takes longer and delays a subsequent task. Specific influences of long-term and short-term links on the P1/N1 and P3a further allow to dissect the temporal dynamics of when these links interact for the purpose of effect monitoring. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  14. Changes in racial identity among African American college students following the election of Barack Obama.

    PubMed

    Fuller-Rowell, Thomas E; Burrow, Anthony L; Ong, Anthony D

    2011-11-01

    The current study considered the influence of the 2008 presidential election on the racial identity of African American college students (M(age) = 19.3 years; 26.3% male). The design of the study consisted of 2 components: longitudinal and daily. The longitudinal component assessed 3 dimensions of racial identity (centrality, private regard, and public regard) 2 weeks before and 5 months after the election, and the daily diary component assessed racial identity and identity exploration on the days immediately before and after the election. Daily items measuring identity exploration focused on how much individuals thought about issues relating to their race. Analyses considered the immediate effects of the election on identity exploration and the extent to which changes in exploration were shaped by racial identity measured prior to the election. We also considered immediate and longer term changes in racial identity following the election and the extent to which longer term changes were conditioned by identity exploration. Findings suggest that the election served as an "encounter" experience (Cross, 1991, 1995, pp. 60-61), which led to increases in identity exploration. Moreover, analyses confirmed that changes in identity exploration were most pronounced among those with higher levels of racial centrality. Results also suggest that the election had both an immediate and a longer term influence on racial identity, which in some instances was conditioned by identity exploration.

  15. Preschool Affects Longer Term Literacy and Numeracy: Results from a General Population Longitudinal Study in Northern Ireland

    ERIC Educational Resources Information Center

    Melhuish, Edward; Quinn, Louise; Sylva, Kathy; Sammons, Pam; Siraj-Blatchford, Iram; Taggart, Brenda

    2013-01-01

    The Effective Pre-school Provision in Northern Ireland (EPPNI) project is a longitudinal study of child development from 3 to 11 years. It is one of the first large-scale UK projects to investigate the effects of different kinds of preschool provision, and to relate experience in preschool to child development. In EPPNI, 683 children were randomly…

  16. Pleasure to play, arousal to stay: the effect of player emotions on digital game preferences and playing time.

    PubMed

    Poels, Karolien; van den Hoogen, Wouter; Ijsselsteijn, Wijnand; de Kort, Yvonne

    2012-01-01

    This study investigated how player emotions during game-play, measured through self-report and physiological recordings, predict playing time and game preferences. We distinguished between short-term (immediately after game-play) and long-term (after 3 weeks) playing time and game preferences. While pleasure was most predictive for short-term playing time and game preferences, arousal, particularly for game preferences, was most predictive on the longer term. This result was found through both self-report and physiological emotion measures. This study initiates theorizing about digital gaming as a hedonic consumer product and sketches future research endeavors of this topic.

  17. Mutual Adaptation: Enhancing Longer-Term Sustainability of Cross-Cultural In-Service Teacher Training Initiatives in China

    ERIC Educational Resources Information Center

    Yan, Chunmei

    2008-01-01

    This paper reports on a study that examines decisive factors for longer-term sustainability of cross-cultural teacher training initiatives in China. It focuses on teacher trainees' perspectives of a Sino-British adult education English language teaching project based in Central China. Questionnaires and semi-structured interviews were employed to…

  18. Healthier food choices as a result of the revised healthy diet programme Krachtvoer for students of prevocational schools.

    PubMed

    Bessems, Kathelijne M H H; van Assema, Patricia; Martens, Marloes K; Paulussen, Theo G W M; Raaijmakers, Lieke G M; de Rooij, Mark; de Vries, Nanne K

    2012-05-24

    Krachtvoer is a Dutch healthy diet programme for prevocational schools, developed in 2001 and revised for a broader target group in 2007, based on the findings of an evaluation of the first version. The goal of this study was to report on the short- and longer-term total and subgroup effects of the revised programme on students' fruit, fruit juice, breakfast, and snack consumption. Schools were randomized to the experimental condition, teaching the Krachtvoer programme, or to the control condition teaching the regular nutrition lessons. Self-reported consumption of fruit, fruit juice, breakfast and snacks was measured at baseline directly before programme implementation, one to four weeks after finishing programme implementation, and after six months. Mixed linear and logistic regression analyses were conducted. In total 1117 students of 13 experimental schools and 758 students of 11 control schools participated in the study. Short- and longer-term favourable intervention effects were found on fruit consumption (mean difference between experimental and control group 0.15 servings at both posttests). Regarding fruit juice consumption, only short-term favourable effects were revealed (mean difference between experimental and control group 0.05 glasses). Intervention effects on breakfast intakes were limited. No changes in snack frequency were reported, but students made healthier snack choices as a result of the programme. Some favourable as well as unfavourable effects occurred in subgroups of students. The effects on fruit consumption and snack choices justify the current nationwide dissemination of the programme. Achieving changes in breakfast consumption may, however, require other strategies.

  19. Effectiveness and cost-effectiveness of sentinel lymph node biopsy compared with axillary node dissection in patients with early-stage breast cancer: a decision model analysis.

    PubMed

    Verry, H; Lord, S J; Martin, A; Gill, G; Lee, C K; Howard, K; Wetzig, N; Simes, J

    2012-03-13

    Sentinel lymph node biopsy (SLNB) is less invasive than axillary lymph node dissection (ALND) for staging early breast cancer, and has a lower risk of arm lymphoedema and similar rates of locoregional recurrence up to 8 years. This study estimates the longer-term effectiveness and cost-effectiveness of SLNB. A Markov decision model was developed to estimate the incremental quality-adjusted life years (QALYs) and costs of an SLNB-based staging and management strategy compared with ALND over 20 years' follow-up. The probability and quality-of-life weighting (utility) of outcomes were estimated from published data and population statistics. Costs were estimated from the perspective of the Australian health care system. The model was used to identify key factors affecting treatment decisions. The SLNB was more effective and less costly than the ALND over 20 years, with 8 QALYs gained and $883,000 saved per 1000 patients. The SLNB was less effective when: SLNB false negative (FN) rate >13%; 5-year incidence of axillary recurrence after an SLNB FN>19%; risk of an SLNB-positive result >48%; lymphoedema prevalence after ALND <14%; or lymphoedema utility decrement <0.012. The long-term advantage of SLNB over ALND was modest and sensitive to variations in key assumptions, indicating a need for reliable information on lymphoedema incidence and disutility following SLNB. In addition to awaiting longer-term trial data, risk models to better identify patients at high risk of axillary metastasis will be valuable to inform decision-making.

  20. Between Pleasure and Contentment: Evolutionary Dynamics of Some Possible Parameters of Happiness.

    PubMed

    Gao, Yue; Edelman, Shimon

    2016-01-01

    We offer and test a simple operationalization of hedonic and eudaimonic well-being ("happiness") as mediating variables that link outcomes to motivation. In six evolutionary agent-based simulation experiments, we compared the relative performance of agents endowed with different combinations of happiness-related traits (parameter values), under four types of environmental conditions. We found (i) that the effects of attaching more weight to longer-term than to momentary happiness and of extending the memory for past happiness are both stronger in an environment where food is scarce; (ii) that in such an environment "relative consumption," in which the agent's well-being is negatively affected by that of its neighbors, is more detrimental to survival when food is scarce; and (iii) that having a positive outlook, under which agents' longer-term happiness is increased by positive events more than it is decreased by negative ones, is generally advantageous.

  1. Empirical observations on longer-term use of incentives for weight loss.

    PubMed

    John, Leslie K; Loewenstein, George; Volpp, Kevin G

    2012-11-01

    Behavioral economic-based interventions are emerging as powerful tools to help individuals accomplish their own goals, including weight loss. Deposit contract incentive systems give participants the opportunity to put their money down toward losing weight, which they forfeit if they fail to lose weight; lottery incentive systems enable participants to win money if they attain weight loss goals. In this paper, we pool data from two prior studies to examine a variety of issues that unpublished data from those studies allow us to address. First, examining data from the deposit contract treatments in greater depth, we investigate factors affecting deposit frequency and size, and discuss possible ways of increasing deposits. Next, we compare the effectiveness of both deposit contract and lottery interventions as a function of participant demographic characteristics. These observations may help to guide the design of future, longer-term, behavioral economic-based interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Between Pleasure and Contentment: Evolutionary Dynamics of Some Possible Parameters of Happiness

    PubMed Central

    Gao, Yue; Edelman, Shimon

    2016-01-01

    We offer and test a simple operationalization of hedonic and eudaimonic well-being (“happiness”) as mediating variables that link outcomes to motivation. In six evolutionary agent-based simulation experiments, we compared the relative performance of agents endowed with different combinations of happiness-related traits (parameter values), under four types of environmental conditions. We found (i) that the effects of attaching more weight to longer-term than to momentary happiness and of extending the memory for past happiness are both stronger in an environment where food is scarce; (ii) that in such an environment “relative consumption,” in which the agent’s well-being is negatively affected by that of its neighbors, is more detrimental to survival when food is scarce; and (iii) that having a positive outlook, under which agents’ longer-term happiness is increased by positive events more than it is decreased by negative ones, is generally advantageous. PMID:27144982

  3. Effects of government spending on research workforce development: evidence from biomedical postdoctoral researchers.

    PubMed

    Hur, Hyungjo; Ghaffarzadegan, Navid; Hawley, Joshua

    2015-01-01

    We examine effects of government spending on postdoctoral researchers' (postdocs) productivity in biomedical sciences, the largest population of postdocs in the US. We analyze changes in the productivity of postdocs before and after the US government's 1997 decision to increase NIH funding. In the first round of analysis, we find that more government spending has resulted in longer postdoc careers. We see no significant changes in researchers' productivity in terms of publication and conference presentations. However, when the population is segmented by citizenship, we find that the effects are heterogeneous; US citizens stay longer in postdoc positions with no change in publications and, in contrast, international permanent residents (green card holders) produce more conference papers and publications without significant changes in postdoc duration. Possible explanations and policy implications of the analysis are discussed.

  4. Effects of Government Spending on Research Workforce Development: Evidence from Biomedical Postdoctoral Researchers

    PubMed Central

    Hur, Hyungjo; Ghaffarzadegan, Navid; Hawley, Joshua

    2015-01-01

    We examine effects of government spending on postdoctoral researchers’ (postdocs) productivity in biomedical sciences, the largest population of postdocs in the US. We analyze changes in the productivity of postdocs before and after the US government’s 1997 decision to increase NIH funding. In the first round of analysis, we find that more government spending has resulted in longer postdoc careers. We see no significant changes in researchers’ productivity in terms of publication and conference presentations. However, when the population is segmented by citizenship, we find that the effects are heterogeneous; US citizens stay longer in postdoc positions with no change in publications and, in contrast, international permanent residents (green card holders) produce more conference papers and publications without significant changes in postdoc duration. Possible explanations and policy implications of the analysis are discussed. PMID:25932942

  5. Predictors of adalimumab drug survival in psoriasis differ by reason for discontinuation: long-term results from the Bio-CAPTURE registry.

    PubMed

    van den Reek, J M P A; Tummers, M; Zweegers, J; Seyger, M M B; van Lümig, P P M; Driessen, R J B; van de Kerkhof, P C M; Kievit, W; de Jong, E M G J

    2015-03-01

    Drug survival is an indicator for treatment success; insight in predictors associated with drug survival is important. To analyse the long-term drug survival for adalimumab in patients with psoriasis treated in daily practice and (II) to identify predictors of prolonged drug survival for adalimumab split for different reasons of discontinuation. Data were extracted from a prospective psoriasis cohort and analysed using Kaplan-Meier survival curves split for reasons of discontinuation. Baseline predictors associated with longer drug survival were identified using multivariate Cox-regression analysis. One hundred and sixteen patients were included with a total of 208 patient-years. Overall drug survival was 76% after 1 year and 52% after 4.5 years. In patients who stopped due to ineffectiveness, longer drug survival was associated with the absence of specific comorbidities (P = 0.03). In patients who stopped due to side-effects, longer drug survival was associated with male gender (P = 0.02). Predictors of adalimumab drug survival in psoriasis differ by reason for discontinuation. Strong, specific predictors can lead to patient-tailored treatment. © 2014 European Academy of Dermatology and Venereology.

  6. Optimizing home dialysis: role of hemodiafiltration.

    PubMed

    Vilar, Enric; Farrington, Ken; Bates, Chris; Mumford, Carol; Greenwood, Roger

    2011-01-01

    Over the last 40 years the technical obstacles which prevented a convective contribution to diffusive dialysis have been overcome. Hemodiafiltration represents a natural evolution of intermittent extracorporeal blood purification and the technology is now available to offer this as standard treatment in-center. The first randomized control trial of dialysis dose (National Cooperative Dialysis Study) showed that for three times weekly dialysis a critical level of urea clearance was necessary to ensure complication-free survival, the effect being noticeable by 3 months. Following this, observational studies suggested that higher doses improved longer term outcome. In a second large randomized controlled study (HEMO), higher small molecule clearance did not further improve outcome, but high-flux membranes, which permitted enhanced clearance of middle molecules, appeared to confer survival benefit in patients who had already been on dialysis > 3.7 years. Recently, outcomes from the Membrane Permeability Outcome study confirmed a survival benefit of high-flux membranes in high-risk patients. These studies indicate that in the medium term survival is critically dependent on achieving a minimum level of small solute removal. However, longer term survival (measured in years or decades) not only requires better small solute clearance but also enhanced clearance of middle molecules, the toxicity of which manifest over longer time scales. The rationale for convective treatment is strongest, therefore in those patients who have the greatest potential for long-term survival. Patients who opt for self-care at home to allow frequent dialysis generally are constituents of this group. Hemodiafiltration is likely to become standard therapy in-center and in the home. Copyright © 2011 S. Karger AG, Basel.

  7. Evidence for early disease-modifying drugs in rheumatoid arthritis

    PubMed Central

    Scott, David L

    2004-01-01

    Some research evidence supports early aggressive treatment of rheumatoid arthritis (RA) using combination therapy with two or more disease modifying anti-rheumatic drugs (DMARDs) plus steroids, or even DMARDs plus an anti-TNF. By contrast, conservatively delayed DMARD monotherapy, given after non-steroidal anti-inflammatory drugs have failed, has been criticised. However, recent long-term studies highlight the complexities in evaluating whether to abandon pyramidal treatment in favour of early DMARDs. Although patients given early DMARD therapy show short-term benefits, longer-term results show no prolonged clinical advantages from early DMARDs. By 5 years patients receiving early DMARDs had similar disease activity and comparable health assessment questionnaire scores to patients who received DMARDs later in their disease course. X-ray progression was persistent and virtually identical in both groups. These negative findings do not invalidate the case for early DMARD therapy, as it is gives sustained reductions in disease activity in the early years of treatment without excessive risks from adverse effects. However, early DMARDs alone do not adequately control RA in the longer term. This may require starting with very aggressive therapy or treating patients more aggressively after early DMARD therapy has been initiated. PMID:14979927

  8. NICU management and outcomes of infants with trisomy 21 without major anomalies.

    PubMed

    McAndrew, Sarah; Acharya, Krishna; Nghiem-Rao, T Hang; Leuthner, Steven; Clark, Reese; Lagatta, Joanne

    2018-05-25

    To describe how trisomy 21 affects neonatal intensive care management and outcomes of full-term infants without congenital anomalies. Retrospective cohort of full-term infants without anomalies with and without trisomy 21 admitted to Pediatrix NICUs from 2005 to 2012. We compared diagnoses, management, length of stay, and discharge outcomes. In all, 4623 infants with trisomy 21 and 606 770 infants without trisomy 21 were identified. One-third of infants in the NICU with and without trisomy 21 were full term without major anomalies. Trisomy 21 infants had more respiratory distress, thrombocytopenia, feeding problems, and pulmonary hypertension. They received respiratory support for a longer period of time and had a longer length of stay. One-third of infants with trisomy 21 admitted to the NICU are full term without major anomalies. Common diagnoses and greater respiratory needs place infants with trisomy 21 at risk for longer length of stay.

  9. Cluster Randomized Controlled Trial

    PubMed Central

    Young, John; Chapman, Katie; Nixon, Jane; Patel, Anita; Holloway, Ivana; Mellish, Kirste; Anwar, Shamaila; Breen, Rachel; Knapp, Martin; Murray, Jenni; Farrin, Amanda

    2015-01-01

    Background and Purpose— We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers, linked to evidence-based treatment algorithms and reference guides (the longer-term stroke care system of care) to address the poor longer-term recovery experienced by many patients with stroke. Methods— A pragmatic, multicentre, cluster randomized controlled trial of this system of care. Eligible patients referred to community-based Stroke Care Coordinators were randomized to receive the new system of care or usual practice. The primary outcome was improved patient psychological well-being (General Health Questionnaire-12) at 6 months; secondary outcomes included functional outcomes for patients, carer outcomes, and cost-effectiveness. Follow-up was through self-completed postal questionnaires at 6 and 12 months. Results— Thirty-two stroke services were randomized (29 participated); 800 patients (399 control; 401 intervention) and 208 carers (100 control; 108 intervention) were recruited. In intention to treat analysis, the adjusted difference in patient General Health Questionnaire-12 mean scores at 6 months was −0.6 points (95% confidence interval, −1.8 to 0.7; P=0.394) indicating no evidence of statistically significant difference between the groups. Costs of Stroke Care Coordinator inputs, total health and social care costs, and quality-adjusted life year gains at 6 months, 12 months, and over the year were similar between the groups. Conclusions— This robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice. Clinical Trial Registration— URL: http://www.controlled-trials.com. Unique identifier: ISRCTN 67932305. PMID:26152298

  10. In situ treatment with activated carbon reduces bioaccumulation in aquatic food chains.

    PubMed

    Kupryianchyk, D; Rakowska, M I; Roessink, I; Reichman, E P; Grotenhuis, J T C; Koelmans, A A

    2013-05-07

    In situ activated carbon (AC) amendment is a new direction in contaminated sediment management, yet its effectiveness and safety have never been tested on the level of entire food chains including fish. Here we tested the effects of three different AC treatments on hydrophobic organic chemical (HOC) concentrations in pore water, benthic invertebrates, zooplankton, and fish (Leuciscus idus melanotus). AC treatments were mixing with powdered AC (PAC), mixing with granular AC (GAC), and addition-removal of GAC (sediment stripping). The AC treatments resulted in a significant decrease in HOC concentrations in pore water, benthic invertebrates, zooplankton, macrophytes, and fish. In 6 months, PAC treatment caused a reduction of accumulation of polychlorobiphenyls (PCB) in fish by a factor of 20, bringing pollutant levels below toxic thresholds. All AC treatments supported growth of fish, but growth was inhibited in the PAC treatment, which was likely explained by reduced nutrient concentrations, resulting in lower zooplankton (i.e., food) densities for the fish. PAC treatment may be advised for sites where immediate ecosystem protection is required. GAC treatment may be equally effective in the longer term and may be adequate for vulnerable ecosystems where longer-term protection suffices.

  11. Longer-term Stream Nitrogen Dynamics after Wildfire and Salvage Harvesting: Implications for Management Concepts based on Trajectories of Post-disturbance Watershed Recovery.

    NASA Astrophysics Data System (ADS)

    Silins, U.; Emelko, M. B.; Bladon, K. D.; Stone, M.; Williams, C.; Martens, A. M.; Wagner, M. J.

    2015-12-01

    Biogeochemical processes reflecting interaction of vegetation and hydrology govern long-term export of nutrients such as nitrogen, phosphorus, and carbon over successional time scales. While management concepts of watershed "recovery" from disturbance back towards pre-disturbance conditions are often considered over much shorter timescales, few studies have directly explored watershed biogeochemical responses to disturbance long enough to directly document the longer-term trajectory of responses to severe land disturbance on nitrogen export. The objectives of this study were to document both the initial magnitude and patterns of longer-term recovery of stream nitrogen after the 2003 Lost Creek wildfire over nine years in front ranges of the Rocky Mountains in south-west Alberta, Canada. The study was conducted in seven instrumented catchments (4-14 km2), including burned, burned and salvage logged, and unburned (reference) conditions since 2004. Total nitrogen (TN) and nitrate (NO3-) concentrations and area-normalized yields were greater and more variable in burned and post-fire salvage logged catchments when compared with unburned catchments. Large initial increases in stream TN and NO3- production 1-3 years after both wildfire and post-fire salvage logging declined strongly to levels similar to, or below that of unburned watersheds 4-6 years after the fire, and continued to decline (although more slowly) 7-9 years after the wildfire. Post-fire salvage logging produced lower impacts on TN and NO3- in streams and these effects declined even more rapidly compared to the effects of wildfire alone. These changes closely corresponded to the early trajectory of establishment and rapid juvenile growth of post-fire regenerating forest vegetation in both catchment groups. While the concept of hydrologic recovery from disturbance is both a practical and meaningful concept for integrated landscape management for protection of forest water resources, the benchmark for "recovery" based on present conditions in undisturbed forests may vary widely depending on forest age and successional status.

  12. The Response of the Alpine Dwarf Shrub Salix herbacea to Altered Snowmelt Timing: Lessons from a Multi-Site Transplant Experiment.

    PubMed

    Sedlacek, Janosch; Wheeler, Julia A; Cortés, Andrés J; Bossdorf, Oliver; Hoch, Guenter; Lexer, Christian; Wipf, Sonja; Karrenberg, Sophie; van Kleunen, Mark; Rixen, Christian

    2015-01-01

    Climate change is altering spring snowmelt patterns in alpine and arctic ecosystems, and these changes may alter plant phenology, growth and reproduction. To predict how alpine plants respond to shifts in snowmelt timing, we need to understand trait plasticity, its effects on growth and reproduction, and the degree to which plants experience a home-site advantage. We tested how the common, long-lived dwarf shrub Salix herbacea responded to changing spring snowmelt time by reciprocally transplanting turfs of S. herbacea between early-exposure ridge and late-exposure snowbed microhabitats. After the transplant, we monitored phenological, morphological and fitness traits, as well as leaf damage, during two growing seasons. Salix herbacea leafed out earlier, but had a longer development time and produced smaller leaves on ridges relative to snowbeds. Longer phenological development times and smaller leaves were associated with reduced sexual reproduction on ridges. On snowbeds, larger leaves and intermediate development times were associated with increased clonal reproduction. Clonal and sexual reproduction showed no response to altered snowmelt time. We found no home-site advantage in terms of sexual and clonal reproduction. Leaf damage probability depended on snowmelt and thus exposure period, but had no short-term effect on fitness traits. We conclude that the studied populations of S. herbacea can respond to shifts in snowmelt by plastic changes in phenology and leaf size, while maintaining levels of clonal and sexual reproduction. The lack of a home-site advantage suggests that S. herbacea may not be adapted to different microhabitats. The studied populations are thus unlikely to react to climate change by rapid adaptation, but their responses will also not be constrained by small-scale local adaptation. In the short term, snowbed plants may persist due to high stem densities. However, in the long term, reduction in leaf size and flowering, a longer phenological development time and increased exposure to damage may decrease overall performance of S. herbacea under earlier snowmelt.

  13. Enzyme replacement therapy with velmanase alfa (human recombinant alpha-mannosidase): Novel global treatment response model and outcomes in patients with alpha-mannosidosis.

    PubMed

    Harmatz, Paul; Cattaneo, Federica; Ardigò, Diego; Geraci, Silvia; Hennermann, Julia B; Guffon, Nathalie; Lund, Allan; Hendriksz, Christian J; Borgwardt, Line

    2018-06-01

    Alpha-mannosidosis is an ultra-rare monogenic disorder resulting from a deficiency in the lysosomal enzyme alpha-mannosidase, with a prevalence estimated to be as low as 1:1,000,000 live births. The resulting accumulation of mannose-rich oligosaccharides in all tissues leads to a very heterogeneous disorder with a continuum of clinical manifestations with no distinctive phenotypes. Long-term enzyme replacement therapy (ERT) with velmanase alfa is approved in Europe for the treatment of non-neurological manifestations in patients with mild to moderate alpha-mannosidosis. The clinical heterogeneity and rarity of the disease limit the sensitivity of single parameters to detect clinically relevant treatment effects. Thus, we propose a novel multiple variable responder analysis to evaluate the efficacy of ERT for alpha-mannosidosis and present efficacy analyses for velmanase alfa using this method. Global treatment response to velmanase alfa (defined by response to ≥2 domains comprising pharmacodynamic, functional, and quality of life outcomes) was applied post hoc to data from the pivotal placebo-controlled rhLAMAN-05 study and to the longer-term integrated data from all patients in the clinical development program (rhLAMAN-10). After 12 months of treatment, a global treatment response was achieved by 87% of patients receiving velmanase alfa (n = 15) compared with 30% of patients receiving placebo (n = 10). Longer-term data from all patients in the clinical program (n = 33) showed 88% of patients were global responders, including all (100%) pediatric patients (n = 19) and the majority (71%) of adult patients (n = 14). The responder analysis model demonstrates a clinically meaningful treatment effect with velmanase alfa and supports the early initiation and continued benefit of longer-term treatment of all patients with alpha-mannosidosis with this ERT. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Contrasting effects of climate on juvenile body size in a Southern Hemisphere passerine bird.

    PubMed

    Kruuk, Loeske E B; Osmond, Helen L; Cockburn, Andrew

    2015-08-01

    Despite extensive research on the topic, it has been difficult to reach general conclusions as to the effects of climate change on morphology in wild animals: in particular, the effects of warming temperatures have been associated with increases, decreases or stasis in body size in different populations. Here, we use a fine-scale analysis of associations between weather and offspring body size in a long-term study of a wild passerine bird, the cooperatively breeding superb fairy-wren, in south-eastern Australia to show that such variation in the direction of associations occurs even within a population. Over the past 26 years, our study population has experienced increased temperatures, increased frequency of heatwaves and reduced rainfall - but the mean body mass of chicks has not changed. Despite the apparent stasis, mass was associated with weather across the previous year, but in multiple counteracting ways. Firstly, (i) chick mass was negatively associated with extremely recent heatwaves, but there also positive associations with (ii) higher maximum temperatures and (iii) higher rainfall, both occurring in a period prior to and during the nesting period, and finally (iv) a longer-term negative association with higher maximum temperatures following the previous breeding season. Our results illustrate how a morphological trait may be affected by both short- and long-term effects of the same weather variable at multiple times of the year and that these effects may act in different directions. We also show that climate within the relevant time windows may not be changing in the same way, such that overall long-term temporal trends in body size may be minimal. Such complexity means that analytical approaches that search for a single 'best' window for one particular weather variable may miss other relevant information, and is also likely to make analyses of phenotypic plasticity and prediction of longer-term population dynamics difficult. © 2015 John Wiley & Sons Ltd.

  15. Augmenting College Students' Study of Speech-Language Pathology Using Computer-Based Mini Quiz Games.

    PubMed

    Vinney, Lisa A; Howles, Les; Leverson, Glen; Connor, Nadine P

    2016-08-01

    This study examined whether undergraduate college students' immediate recall and longer-term retention of introductory voice disorder concepts improved by using mini quiz games (MQGs; interactive knowledge tests in game format) compared with (a) traditional study alone, (b) MQGs and traditional study together, or (c) a no-study control condition. Ninety-three college students participated in proctored sessions in which they were given a pretest, viewed an online lecture on introductory voice disorder concepts, and then engaged in either no intervention or interventions including traditional study, MQG play, or both MQG play and traditional study, followed by an immediate recall posttest and longer-term retention follow-up test. Analyses suggested that the effects of all interventions (traditional study, MQG play, and the combination of the 2) were equivalent and resulted in significantly greater improvements from pretest to immediate recall posttest performance than the control condition. In contrast, MQGs and MQGs with traditional study, but not traditional study alone, showed better results for long-term retention than no study. Results provide preliminary support for the idea that there may be multiple effective learning modes, beyond traditional study, that enhance recall and retention of knowledge foundational to speech-language pathology clinical training and practice.

  16. Evidence for oral agmatine sulfate safety--a 95-day high dosage pilot study with rats.

    PubMed

    Gilad, Gad M; Gilad, Varda H

    2013-12-01

    Agmatine, decarboxylated arginine, exerts beneficial effects in various experimental disease models. Clinical trials indicate the safety and effectiveness of short-term (up to 21 days) high dose regimens of oral agmatine sulfate, but longer term studies are lacking. This pilot study undertook to assess the safety of a longer term high dosage oral agmatine sulfate in laboratory rats. Adult Wistar rats consumed 5.3 g/l agmatine sulfate in their drinking water for 95 days, a regimen estimated to result in a daily dosage of absorbed agmatine of about 100mg/kg. Animals' body weight, water consumption and blood pressure were periodically measured, and general cage behavior, fur appearance, urination and feces appearance monitored. These parameters were also determined at 20 days after treatment cessation (day 115). On days 95 and 115, animals were euthanized for gross necropsy assessment. Agmatine-treated rats showed slight, but significant reductions in body weight and blood pressure, and reduced water consumption during treatment, which recovered completely within 20 days after treatment cessation. Otherwise, no abnormal behaviors or organ pathologies were observed. These findings are first to suggest apparent safety of sub-chronic high dosage dietary agmatine sulfate in laboratory rats, thus lending further support to the therapeutic applications of agmatine. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Teacher Evaluation in Practice: Exploring Relationships between School Characteristics & Evaluation Scores

    ERIC Educational Resources Information Center

    Sporte, Susan E.; Jiang, Jennie Y.; Luppescu, Stuart

    2016-01-01

    Decades of research evidence have consistently suggested teachers are the most important in-school factor related to student learning and achievement. Being taught by an effective teacher has important consequences for students' academic outcomes as well as longer-term impacts on postsecondary success and lifetime earnings. Yet how to measure…

  18. 78 FR 6033 - Safety Zone; MODU KULLUK; Sitkalidak Island to Kiliuda Bay, AK

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-29

    ... immediately following the MODU KULLUK grounding and provides a longer effective period in anticipation of... impact of regulations on small entities during rulemaking. The term ``small entities'' comprises small... being hailed by a U.S. Coast Guard vessel by siren, radio, flashing light or other means, the operator...

  19. Social Justice Activism: Feminism and Strategies for Action

    ERIC Educational Resources Information Center

    Fernflores, Rachel

    2016-01-01

    Success in social justice activism often hinges on judging when to employ the most effective strategy for action. Strategies for action include militancy, peaceful protest, and sometimes, engaging in a longer term program of "marginal gains." The militant feminism of many 19th century suffragettes, such as Emmeline Pankhurst, is a good…

  20. Xenopus laevis Müllerian ducts are sensitive indicators of estrogenic or androgenic chemical exposure in vivo

    EPA Science Inventory

    The Larval Amphibian Growth and Development Assay (LAGDA) is one of a series of Tier 2 test guidelines being developed by the US EPA under the Endocrine Disruptor Screening Program. The LAGDA was designed to evaluate effects of lower-dose, longer-term chemical exposure on (a) am...

  1. Center for International Earth Science Information Network

    Science.gov Websites

    Posts Addressing Climate Migration Within Borders Helps Countries Plan, Mitigate Effects A new report is the first to focus on longer-term climate impacts on crop and water resources, and the ways in which they may influence internal migration. More Blog Posts In the Spotlight Available for the First Time

  2. PCB remediation in schools: a review.

    PubMed

    Brown, Kathleen W; Minegishi, Taeko; Cummiskey, Cynthia Campisano; Fragala, Matt A; Hartman, Ross; MacIntosh, David L

    2016-02-01

    Growing awareness of polychlorinated biphenyls (PCBs) in legacy caulk and other construction materials of schools has created a need for information on best practices to control human exposures and comply with applicable regulations. A concise review of approaches and techniques for management of building-related PCBs is the focus of this paper. Engineering and administrative controls that block pathways of PCB transport, dilute concentrations of PCBs in indoor air or other exposure media, or establish uses of building space that mitigate exposure can be effective initial responses to identification of PCBs in a building. Mitigation measures also provide time for school officials to plan a longer-term remediation strategy and to secure the necessary resources. These longer-term strategies typically involve removal of caulk or other primary sources of PCBs as well as nearby masonry or other materials contaminated with PCBs by the primary sources. The costs of managing PCB-containing building materials from assessment through ultimate disposal can be substantial. Optimizing the efficacy and cost-effectiveness of remediation programs requires aligning a thorough understanding of sources and exposure pathways with the most appropriate mitigation and abatement methods.

  3. Pay modernisation and healthcare governance.

    PubMed

    Benton, David C

    Policies interact and have direct and indirect consequences resulting in both short-term and longer-term effects on the working lives of professionals, the care they offer and the education needed by future generations of staff. This article explores how pay modernisation could result in benefits and risks for corporate, clinical and staff governance. It is argued that if pay modernisation as a major enabler of service redesign is to succeed then far greater understanding of how various policies interact and their potential consequences is required.

  4. Atrioventricular node functional remodeling induced by atrial fibrillation.

    PubMed

    Zhang, Youhua; Mazgalev, Todor N

    2012-09-01

    The atrioventricular node (AVN) plays a vital role in determining the ventricular rate during atrial fibrillation (AF). AF results in profound electrophysiological and structural remodeling in the atria as well as the sinus node. However, it is unknown whether AVN undergoes remodeling during AF. To determine whether AVN undergoes functional remodeling during AF. AVN conduction properties were studied in vitro in 9 rabbits with AF and 10 normal controls. A previously validated index of AVN dual-pathway electrophysiology, His-electrogram alternans, was used to monitor fast-pathway or slow-pathway (SP) AVN conduction in these experiments. AVN conduction properties were further studied in vivo in 7 dogs with chronic AF and 8 controls. Compared with the control rabbits, the rabbits with AF had a longer AVN conduction time (83 ± 16 ms vs 68 ± 7 ms; P <.01), longer AVN effective refractory period (141 ± 27 ms vs 100 ± 9 ms; P <.01), an earlier transition from fast-pathway to SP conduction (at a longer prematurity, 249 ± 60 ms vs 171 ± 24 ms; P <.01), and a slower ventricular rate during simulated AF (RR interval 249 ± 42 ms vs 202 ± 12 ms; P <.01). Notably, a larger proportion of conducted beats utilized the SP in AF preparations (92% ± 12% vs 63% ± 32%; P <.05). Long-term AF in dogs resulted in a longer atrioventricular conduction time and AVN effective refractory period and a slower ventricular rate during AF compared with the controls. Pronounced AVN functional electrophysiological remodeling occurs after long-term AF, which could lead to a spontaneous slowing of the ventricular rate. Furthermore, the SP dominance during AF underscores the effectiveness of its modification by ablation for ventricular rate control during AF. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  5. Longer-term effects of home-based exercise interventions on exercise capacity and physical activity in coronary artery disease patients: A systematic review and meta-analysis.

    PubMed

    Claes, Jomme; Buys, Roselien; Budts, Werner; Smart, Neil; Cornelissen, Véronique A

    2017-02-01

    Background Exercise-based cardiovascular rehabilitation (CR) improves exercise capacity (EC), lowers cardiovascular risk profile and increases physical functioning in the short term. However, uptake of and adherence to a physically active lifestyle in the long run remain problematic. Home-based (HB) exercise programmes have been introduced in an attempt to enhance long-term adherence to recommended levels of physical activity (PA). The current systematic review and meta-analysis aimed to compare the longer-term effects of HB exercise programmes with usual care (UC) or centre-based (CB) CR in patients referred for CR. Design Systematic review and meta-analysis. Methods Non-randomised controlled trials (RCTs) or randomised trials comparing the effects of HB exercise programmes with UC or CB rehabilitation on EC and/or PA, with a follow-up period of ≥12 months and performed in coronary artery disease patients, were searched in four databases (PubMed, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Cochrane Central Register of Controlled trials (CENTRAL)) from their inception until September 7, 2016. Standardised mean differences (SMDs) were calculated and pooled by means of random effects models. Risk of bias, publication bias and heterogeneity among trials were also assessed. Results Seven studies could be included in the meta-analysis on EC, but only two studies could be included in the meta-analysis on PA (total number of 1440 patients). The results showed no significant differences in EC between HB rehabilitation and UC (SMD 0.10, 95% confidence interval (CI) -0.13 to 0.33). There was a small but significant difference in EC in favour of HB compared to CB rehabilitation (SMD 0.25, 95% CI 0.02-0.48). No differences were found for PA (SMD 0.37, 95% CI -0.18 to 0.92). Conclusions HB exercise is slightly more effective than CB rehabilitation in terms of maintaining EC. The small number of studies warrants the need for more RCTs evaluating the long-term effects of different CR interventions on EC and PA behaviour, as this is the ultimate goal of CR.

  6. A Mixed-Methods Evaluation of the Longer-Term Implementation and Utility of a Teacher Classroom Management Training Programme in Irish Primary Schools

    ERIC Educational Resources Information Center

    Leckey, Yvonne; Hyland, Lynda; Hickey, Gráinne; Lodge, Anne; Kelly, Paul; Bywater, Tracey; Comiskey, Catherine; Donnelly, Michael; McGilloway, Sinéad

    2016-01-01

    Inappropriate, aggressive and disruptive behaviour in the classroom can be detrimental to child and teacher well-being. This study involved a longer-term evaluation of the "Incredible Years Teacher [Classroom Management]" programme (IYTP) undertaken mainly within disadvantaged schools in south-west Ireland. The IYTP is designed to…

  7. The Future Is More than Just Tomorrow: Higher Education, the Economy and the Longer Term

    ERIC Educational Resources Information Center

    Crossick, Geoffrey

    2010-01-01

    In this commentary the author reflects on longer-term issues facing higher education in the context of recession and crisis in public finance. The views expressed are written from a personal perspective with the aim of stimulating and encouraging a wider and ongoing debate around the themes presented. The author draws upon the findings of three…

  8. A Reanalysis for the Seasonal and Longer-Period Cycles and the Trends in Middle Atmosphere Temperature from the HALOE

    NASA Technical Reports Server (NTRS)

    Remsberg, Ellis E.

    2007-01-01

    Previously published analyses for the seasonal and longer-period cycles in middle atmosphere temperature versus pressure (or T(p)) from the Halogen Occultation Experiment (HALOE) are extended to just over 14 years and updated to properly account for the effects of autocorrelation in its time series of zonally-averaged data. The updated seasonal terms and annual averages are provided, and they can be used to generate temperature distributions that are representative of the period 1991-2005. QBO-like terms have also been resolved and are provided, and they exhibit good consistency across the range of latitudes and pressure-altitudes. Further, exploratory analyses of the residuals from each of the 221 time series have yielded significant 11-yr solar cycle (or SC-like) and linear trend terms at a number of latitudes and levels. The amplitudes of the SC-like terms for the upper mesosphere agree reasonably with calculations of the direct solar radiative effects for T(p). Those SC amplitudes increase by about a factor of 2 from the lower to the upper mesosphere and are also larger at the middle than at the low latitudes. The diagnosed cooling trends for the subtropical latitudes are in the range, -0.5 to -1.0 K/decade, which is in good agreement with the findings from models of the radiative effects on pressure surfaces due to known increases in atmospheric CO2. The diagnosed trends are somewhat larger than predicted with models for the upper mesosphere of the northern hemisphere middle latitudes.

  9. The course of Neuropsychological Performance and Functional Capacity in Older Patients with Schizophrenia: Influences of Previous history of long-term institutional Stay

    PubMed Central

    Harvey, Philip D.; Reichenberg, Abraham; Bowie, Christopher R.; Patterson, Thomas L.; Heaton, Robert K.

    2010-01-01

    Background Chronically institutionalized patients with schizophrenia have been reported to manifest cognitive and functional decline. Previous studies were limited by the fact that current environment could not be separated from life-time illness course. The present study examined older outpatients who varied in their lifetime history of long-term psychiatric inpatient stay. Methods Community dwelling patients with schizophrenia (n=111) and healthy comparison subjects (n=76) were followed up to 45 months and examined two or more times with a neuropsychological (NP) battery and performance-based measures of everyday living skills (UCSD Performance-based skills assessment; UPSA) and social competence. A mixed-effects model repeated-measures method was used to examine changes. Results There was a significant effect of institutional stay on the course of the UPSA. When the schizophrenia patients who completed all three assessments were divided on the basis of length of institutional stay and compared to healthy comparison subjects, patients with longer stays worsened on the UPSA and social competence while patients with shorter stays improved. For NP performance, both patient samples worsened slightly while the HC group manifested a practice effect. Reliable change index (RCI) analyses showed that worsening on the UPSA for longer stay patients was definitely nonrandom. Conclusions Life-time history of institutional stay was associated with worsening on measures of social and everyday living skills. NP performance in schizophrenia did not evidence the practice effect seen in the HC sample. These data suggest that schizophrenia patients with a history of long institutional stay may worsen even if they are no longer institutionalized. PMID:20202624

  10. Long-term effect of set potential on biocathodes in microbial fuel cells: electrochemical and phylogenetic characterization.

    PubMed

    Xia, Xue; Sun, Yanmei; Liang, Peng; Huang, Xia

    2012-09-01

    The long-term effect of set potential on oxygen reducing biocathodes was investigated in terms of electrochemical and biological characteristics. Three biocathodes were poised at 200, 60 and -100 mV vs. saturated calomel electrode (SCE) for 110 days, including the first 17 days for startup. Electrochemical analyses showed that 60 mV was the optimum potential during long-term operation. The performance of all the biocathodes kept increasing after startup, suggesting a period longer than startup time needed to make potential regulation more effective. The inherent characteristics without oxygen transfer limitation were studied. Different from short-term regulation, the amounts of biomass were similar while the specific electrochemical activity was significantly influenced by potential. Moreover, potential showed a strong selection for cathode bacteria. Clones 98% similar with an uncultured Bacteroidetes bacterium clone CG84 accounted for 75% to 80% of the sequences on the biocathodes that showed higher electrochemical activity (60 and -100 mV). Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. An intervention to support stroke survivors and their carers in the longer term (LoTS2Care): study protocol for a cluster randomised controlled feasibility trial.

    PubMed

    Forster, Anne; Hartley, Suzanne; Barnard, Lorna; Ozer, Seline; Hardicre, Natasha; Crocker, Tom; Fletcher, Marie; Moreau, Lauren; Atkinson, Ross; Hulme, Claire; Holloway, Ivana; Schmitt, Laetitia; House, Allan; Hewison, Jenny; Richardson, Gillian; Farrin, Amanda

    2018-06-11

    Despite the evidence that many stroke survivors report longer term unmet needs, the provision of longer term care is limited. To address this, we are conducting a programme of research to develop an evidence-based and replicable longer term care strategy. The developed complex intervention (named New Start), which includes needs identification, exploration of social networks and components of problem solving and self-management, was designed to improve quality of life by addressing unmet needs and increasing participation. A multicentre, cluster randomised controlled feasibility trial designed to inform the design of a possible future definitive cluster randomised controlled trial (cRCT) and explore the potential clinical and cost-effectiveness of New Start. Ten stroke services across the UK will be randomised on a 1:1 basis either to implement New Start or continue with usual care only. New Start will be delivered by trained facilitators and will be offered to all stroke survivors within the services allocated to the intervention arm. Stroke survivors will be eligible for the trial if they are 4-6 months post-stroke and residing in the community. Carers (if available) will also be invited to take part. Invitation to participate will be initiated by post and outcome measures will be collected via postal questionnaires at 3, 6 and 9 months after recruitment. Outcome data relating to perceived health and disability, wellbeing and quality of life as well as unmet needs will be collected. A 'study within a trial' (SWAT) is planned to determine the most acceptable format in which to provide the postal questionnaires. Details of health and social care service usage will also be collected to inform the economic evaluation. The feasibility of recruiting services and stroke survivors to the trial and of collecting postal outcomes will be assessed and the potential for effectiveness will be investigated. An embedded process evaluation (reported separately) will assess implementation fidelity and explore and clarify causal assumptions regarding implementation. This feasibility trial with embedded process evaluation will allow us to gather important and detailed data regarding methodological and implementation issues to inform the design of a possible future definitive cRCT of this complex intervention. ISRCTN38920246 . Registered 22 June 2016.

  12. Mapping patterns of change in emotion-focused psychotherapy: Implications for theory, research, practice, and training.

    PubMed

    Watson, Jeanne C

    2018-05-01

    An important objective in humanistic-experiential psychotherapies and particularly emotion-focused psychotherapy (EFT) is to map patterns of change. Effective mapping of the processes and pathways of change requires that in-session processes be linked to in-session resolutions, immediate post-session changes, intermediate outcome, final therapy outcome, and longer-term change. This is a challenging and long-term endeavour. Fine-grained descriptions of in-session processes that lead to resolution of specific interpersonal and intrapersonal issues linked with longer-term outcomes are the foundation of EFT, the process-experiential approach. In this paper, evidence in support of EFT as a treatment approach will be reviewed along with research on two mechanisms of change, viewed as central to EFT, clients' emotional processing and the therapeutic relationship conditions. The implications for psychotherapy research are discussed. Given the methodological constraints, there is a need for more innovative methodologies and strategies to investigate specific psychotherapy processes within and across different approaches to map patterns and mechanisms of change to enhance theory, research, practice, and training.

  13. Elaborative rehearsal of nontemporal information interferes with temporal processing of durations in the range of seconds but not milliseconds.

    PubMed

    Rammsayer, Thomas; Ulrich, Rolf

    2011-05-01

    The distinct timing hypothesis suggests a sensory mechanism for processing of durations in the range of milliseconds and a cognitively controlled mechanism for processing of longer durations. To test this hypothesis, we employed a dual-task approach to investigate the effects of maintenance and elaborative rehearsal on temporal processing of brief and long durations. Unlike mere maintenance rehearsal, elaborative rehearsal as a secondary task involved transfer of information from working to long-term memory and elaboration of information to enhance storage in long-term memory. Duration discrimination of brief intervals was not affected by a secondary cognitive task that required either maintenance or elaborative rehearsal. Concurrent elaborative rehearsal, however, impaired discrimination of longer durations as compared to maintenance rehearsal and a control condition with no secondary task. These findings endorse the distinct timing hypothesis and are in line with the notion that executive functions, such as continuous memory updating and active transfer of information into long-term memory interfere with temporal processing of durations in the second, but not in the millisecond range. 2011 Elsevier B.V. All rights reserved.

  14. Economic conditions, hypertension, and cardiovascular disease: analysis of the Icelandic economic collapse.

    PubMed

    Birgisdóttir, Kristín Helga; Jónsson, Stefán Hrafn; Ásgeirsdóttir, Tinna Laufey

    2017-12-01

    Previous research has found a positive short-term relationship between the 2008 collapse and hypertension in Icelandic males. With Iceland's economy experiencing a phase of economic recovery, an opportunity to pursue a longer-term analysis of the collapse has emerged. Using data from a nationally representative sample, fixed-effect estimations and mediation analyses were performed to explore the relationship between the Icelandic economic collapse in 2008 and the longer-term impact on hypertension and cardiovascular health. A sensitivity analysis was carried out with pooled logit models estimated as well as an alternative dependent variable. Our attrition analysis revealed that results for cardiovascular diseases were affected by attrition, but not results from estimations on the relationship between the economic crisis and hypertension. When compared to the boom year 2007, our results point to an increased probability of Icelandic women having hypertension in the year 2012, when the Icelandic economy had recovered substantially from the economic collapse in 2008. This represents a deviation from pre-crisis trends, thus suggesting a true economic-recovery impact on hypertension.

  15. Effects of Multisystemic Therapy through Midlife: A 21.9-Year Follow-Up to a Randomized Clinical Trial with Serious and Violent Juvenile Offenders

    ERIC Educational Resources Information Center

    Sawyer, Aaron M.; Borduin, Charles M.

    2011-01-01

    Objective: Although current evidence suggests that the positive effects of multisystemic therapy (MST) on serious crime reach as far as young adulthood, the longer term impact of MST on criminal and noncriminal outcomes in midlife has not been evaluated. In the present study, the authors examined a broad range of criminal and civil court outcomes…

  16. Impact Evaluation of a School-Based Counselling Intervention in Northern Ireland: Is It Effective for Pupils Who Have Been Bullied?

    ERIC Educational Resources Information Center

    McElearney, Aisling; Adamson, Gary; Shevlin, Mark; Bunting, Brendan

    2013-01-01

    Bullying remains a significant issue in the lives of many children and young people at school and can have serious negative implications for emotional health and well-being in the short and longer term. This paper reports on an impact evaluation of the effectiveness of a school counselling intervention in promoting positive change in the peer…

  17. Effect of local cooling on short-term, intense exercise.

    PubMed

    Kwon, Young S; Robergs, Robert A; Schneider, Suzanne M

    2013-07-01

    The widespread belief that local cooling impairs short-term, strenuous exercise performance is controversial. Eighteen original investigations involving cooling before and intermittent cooling during short-term, intensive exercise are summarized in this review. Previous literature examining short-term intensive exercise and local cooling primarily has been limited to the effects on muscle performance immediately or within minutes following cold application. Most previous cooling studies used equal and longer than 10 minutes of pre-cooling, and found that cooling reduced strength, performance and endurance. Because short duration, high intensity exercise requires adequate warm-up to prepare for optimal performance, prolonged pre-cooling is not an effective method to prepare for this type of exercise. The literature related to the effect of acute local cooling immediately before short duration, high intensity isotonic exercise such as weight lifting is limited. However, local intermittent cooling during short-term, high intense exercise may provide possible beneficial effects; first, by pain reduction, caused by an "irritation effect" from hand thermal receptors which block pain sensation, or second, by a cooling effect, whereby stimulation of hand thermal receptors or a slight lowering of blood temperature might alter central fatigue.

  18. [Effect of a synthetic detergent (Syndet) on the pH of the skin of infants].

    PubMed

    Braun, F; Lachmann, D; Zweymüller, E

    1986-06-01

    The long- and short-term effects on the skin of infants of a synthetic detergent (syndet) with an acid pH were investigated and compared to ordinary soap. The short-term effect was determined by measuring the skin pH on different parts of the body before and 20 min after washing with syndet. The long-term effect was tested in a second group, in which the infants were washed either with ordinary soap or with syndet for 3 days. The skin pH was measured 4-5 h after washing. The results were evaluated statistically. The results show that for a short time syndet displaces the skin pH towards acid pH in younger infants; however, the skin pH is not influenced in older infants. Syndet keeps the skin pH in the physiological range for a longer time after washing than ordinary soap.

  19. Embeddedness and well-being in the United States and Singapore: the mediating effects of work-to-family and family-to-work conflict.

    PubMed

    Ng, Thomas W H; Feldman, Daniel C

    2014-07-01

    Guided by conservation of resources theory, we propose that both organizational and community embeddedness are associated with increased work-to-family conflict (WFC) and family to-work conflict (FWC), which in turn are associated with strain-related outcomes. Because stress can have both short-term and long-term consequences, we examined negative mood as an immediate reaction to stress and chronic insomnia as a longer-term reaction to stress. We examined these relationships in 2-career couples in both the United States (n = 416) and Singapore (n = 400). Results provided full support for the mediating effects of WFC and FWC in the U.S. sample, with only limited support for those mediating effects in the Singaporean sample. In addition, we found that the effects of community embeddedness on FWC were significantly stronger in the U.S. sample than in the Singaporean sample.

  20. Matrix dominated stress/strain behavior in polymeric composites: Effects of hold time, nonlinearity and rate dependency

    NASA Technical Reports Server (NTRS)

    Gates, Thomas S.

    1992-01-01

    In order to understand matrix dominated behavior in laminated polymer matrix composites, an elastic/viscoplastic constitutive model was developed and used to predict stress strain behavior of off-axis and angle-ply symmetric laminates under in-plane, tensile axial loading. The model was validated for short duration tests at elevated temperatures. Short term stress relaxation and short term creep, strain rate sensitivity, and material nonlinearity were accounted for. The testing times were extended for longer durations, and periods of creep and stress relaxation were used to investigate the ability of the model to account for long term behavior. The model generally underestimated the total change in strain and stress for both long term creep and long term relaxation respectively.

  1. Prevalence of NRT use and associated nicotine intake in smokers, recent ex-smokers and longer-term ex-smokers.

    PubMed

    Shahab, Lion; Beard, Emma; Brown, Jamie; West, Robert

    2014-01-01

    Nicotine replacement therapy (NRT) is used by smokers wanting to reduce their smoking and to quit. However, there are very little data on nicotine intake associated with NRT use in representative population samples. This study aimed to provide estimates for NRT use and associated nicotine exposure among smokers, recent and longer-term ex-smokers in England, a country with a permissive regulatory regime for nicotine substitution. In the Smoking Toolkit Study, a monthly series of representative household surveys of adults aged 16+ in England, current and recent ex-smokers who agreed to be re-contacted were followed up 6 months later and standard socio-demographic and smoking characteristics assessed (N = 5,467, response rate 25.1%). A random sub-sample (N = 1,614; 29.5%) also provided saliva, analysed for cotinine. The sample followed up was broadly representative of the original sample. At follow-up, 11.8% (95%CI 10.9-12.8, N = 565) of current smokers, 34.8% (95%CI 28.9-41.3, N = 77) of recent (≤ 3 months) ex-smokers, and 7.8% (95%CI 5.6-10.6, N = 36) of longer-term (> 3 months) ex-smokers reported using NRT. Smokers who used NRT had similar saliva cotinine concentrations to smokers who did not use NRT (mean ± sd  = 356.0 ± 198.6 ng/ml vs. 313.1 ± 178.4 ng/ml). Recent ex-smokers who used NRT had levels that were somewhat lower, but not significantly so, than current smokers (216.7 ± 179.3 ng/ml). Longer-term ex-smokers using NRT had still lower levels (157.3 ± 227.1 ng/ml), which differed significantly from smokers using NRT (p = 0.024). Concurrent use of nicotine replacement therapy while smoking is relatively uncommon and is not associated with higher levels of nicotine intake. Among ex-smokers, NRT use is common in the short but not longer-term and among longer-term users is associated with lower nicotine intake than in smokers.

  2. Grammar Predicts Procedural Learning and Consolidation Deficits in Children with Specific Language Impairment

    PubMed Central

    Hedenius, Martina; Persson, Jonas; Tremblay, Antoine; Adi-Japha, Esther; Veríssimo, João; Dye, Cristina D.; Alm, Per; Jennische, Margareta; Tomblin, J. Bruce; Ullman, Michael T.

    2011-01-01

    The Procedural Deficit Hypothesis (PDH) posits that Specific Language Impairment (SLI) can be largely explained by abnormalities of brain structures that subserve procedural memory. The PDH predicts impairments of procedural memory itself, and that such impairments underlie the grammatical deficits observed in the disorder. Previous studies have indeed reported procedural learning impairments in SLI, and have found that these are associated with grammatical difficulties. The present study extends this research by examining the consolidation and longer-term procedural sequence learning in children with SLI. The Alternating Serial Reaction Time (ASRT) task was given to children with SLI and typically-developing (TD) children in an initial learning session and an average of three days later to test for consolidation and longer-term learning. Although both groups showed evidence of initial sequence learning, only the TD children showed clear signs of consolidation, even though the two groups did not differ in longer-term learning. When the children were re-categorized on the basis of grammar deficits rather than broader language deficits, a clearer pattern emerged. Whereas both the grammar impaired and normal grammar groups showed evidence of initial sequence learning, only those with normal grammar showed consolidation and longer-term learning. Indeed, the grammar-impaired group appeared to lose any sequence knowledge gained during the initial testing session. These findings held even when controlling for vocabulary or a broad non-grammatical language measure, neither of which were associated with procedural memory. When grammar was examined as a continuous variable over all children, the same relationships between procedural memory and grammar, but not vocabulary or the broader language measure, were observed. Overall, the findings support and further specify the PDH. They suggest that consolidation and longer-term procedural learning are impaired in SLI, but that these impairments are specifically tied to the grammatical deficits in the disorder. The possibility that consolidation and longer-term learning are problematic in the disorder suggests a locus of potential study for therapeutic approaches. In sum, this study clarifies our understanding of the underlying deficits in SLI, and suggests avenues for further research. PMID:21840165

  3. Effects of age, gender, and stimulus presentation period on visual short-term memory.

    PubMed

    Kunimi, Mitsunobu

    2016-01-01

    This study focused on age-related changes in visual short-term memory using visual stimuli that did not allow verbal encoding. Experiment 1 examined the effects of age and the length of the stimulus presentation period on visual short-term memory function. Experiment 2 examined the effects of age, gender, and the length of the stimulus presentation period on visual short-term memory function. The worst memory performance and the largest performance difference between the age groups were observed in the shortest stimulus presentation period conditions. The performance difference between the age groups became smaller as the stimulus presentation period became longer; however, it did not completely disappear. Although gender did not have a significant effect on d' regardless of the presentation period in the young group, a significant gender-based difference was observed for stimulus presentation periods of 500 ms and 1,000 ms in the older group. This study indicates that the decline in visual short-term memory observed in the older group is due to the interaction of several factors.

  4. New Antiresorptive Therapies for Postmenopausal Osteoporosis

    PubMed Central

    2015-01-01

    Osteoporosis is a systemic skeletal disease whose risk increases with age and it is common among postmenopausal women. Currently, almost all pharmacological agents for osteoporosis target the bone resorption component of bone remodeling activity. Current antiresorptive agents are effective, but the effectiveness of some agents is limited by real or perceived intolerance, longterm adverse events (AEs), coexisting comorbidities, and inadequate long-term adherence. New antiresorptive therapies that may expand options for the prevention and treatment of osteoporosis include denosumab, combination of conjugated estrogen/bazedoxifene and cathepsin K inhibitors. However, the long-term efficacy and AEs of these antiresorptive therapies need to be confirmed in studies with a longer follow-up period. PMID:26046031

  5. The Immediate and Longer-Term Effectiveness of a Speech-Rhythm-Based Reading Intervention for Beginning Readers

    ERIC Educational Resources Information Center

    Harrison, Emily; Wood, Clare; Holliman, Andrew J.; Vousden, Janet I.

    2018-01-01

    Despite empirical evidence of a relationship between sensitivity to speech rhythm and reading, there have been few studies that have examined the impact of rhythmic training on reading attainment, and no intervention study has focused on speech rhythm sensitivity specifically to enhance reading skills. Seventy-three typically developing 4- to…

  6. Longer Term Impact of Cigarette Package Warnings in Australia Compared with the United Kingdom and Canada

    ERIC Educational Resources Information Center

    Li, Lin; Borland, Ron; Yong, Hua; Cummings, Kenneth M.; Thrasher, James F.; Hitchman, Sara C.; Fong, Geoffrey T.; Hammond, David; Bansal-Travers, Maansi

    2015-01-01

    This study examines the effects of different cigarette package warnings in Australia, Canada and the United Kingdom up to 5 years post-implementation. The data came from the International Tobacco Control Surveys. Measures included salience of warnings, cognitive responses, forgoing cigarettes and avoiding warnings. Although salience of the UK…

  7. The British Chinese Adoption Study: Orphanage Care, Adoption and Mid-Life Outcomes

    ERIC Educational Resources Information Center

    Rushton, Alan; Grant, Margaret; Feast, Julia; Simmonds, John

    2013-01-01

    Background: While studies of ex-orphanage care show adverse effects on development, the longer-term impact on mid-life psychosocial functioning and physical health has not been established. Methods: Orphanage records provided baseline data on a sample of 100 Hong Kong Chinese girls who were subsequently adopted into the UK. A mid-life follow-up…

  8. Polarimetric Interferometry

    DTIC Science & Technology

    2007-02-01

    frequency radio wave propagation through the ionosphere , where the earths magnetic field lines break this reciprocity symmetry and as a result the cross...polarisation terms are no longer equal. This observation can be used to calibrate the effects of Faraday rotation due to trans- ionospheric ...currently under investigation is polarimetric SAR tomography , which is the extension of conventional two-dimensional SAR imaging principle to three

  9. Early Childhood Behavior Problems and the Gender Gap in Educational Attainment in the United States

    ERIC Educational Resources Information Center

    Owens, Jayanti

    2016-01-01

    Why do men in the United States today complete less schooling than women? One reason may be gender differences in early self-regulation and prosocial behaviors. Scholars have found that boys' early behavioral disadvantage predicts their lower average academic achievement during elementary school. In this study, I examine longer-term effects: Do…

  10. New Light on a "Forgotten War": The Diplomacy of the Korean Conflict.

    ERIC Educational Resources Information Center

    Roberts, Priscilla

    2000-01-01

    Considers issues involved in the Korean War. Examines who was responsible for the war's onset, Soviet and Chinese involvement in North Korea's plan for war, the reasons why the United States and China entered the war, the effects on the rapprochement between the United States and China, and longer-term implications. (CMK)

  11. Weighting the Benefits of Part-Time Employment in College: Perspectives from Indigenous Undergraduates

    ERIC Educational Resources Information Center

    Wang, Chin-Fah; Chen, Shan-Hua

    2013-01-01

    Although many scholars assert that students' job involvement is beneficial, there is no consensus on the effect of part-time employment taken by term-time undergraduates. Since more and more indigenous students are participating in part-time employment, and most of them are involved in disadvantaged jobs-longer hours, heavier workload, and smaller…

  12. The legacy effects of keystone individuals on collective behaviour scale to how long they remain within a group

    PubMed Central

    Pruitt, Jonathan N.; Pinter-Wollman, Noa

    2015-01-01

    The collective behaviour of social groups is often strongly influenced by one or few individuals, termed here ‘keystone individuals’. We examined whether the influence of keystone individuals on collective behaviour lingers after their departure and whether these lingering effects scale with their tenure in the group. In the social spider, Stegodyphus dumicola, colonies' boldest individuals wield a disproportionately large influence over colony behaviour. We experimentally manipulated keystones' tenure in laboratory-housed colonies and tracked their legacy effects on collective prey capture following their removal. We found that bolder keystones caused more aggressive collective foraging behaviour and catalysed greater inter-individual variation in boldness within their colonies. The longer keystones remained in a colony, the longer both of these effects lingered after their departure. Our data demonstrate that, long after their disappearance, keystones have large and lasting effects on social dynamics at both the individual and colony levels. PMID:26336171

  13. Long-term effects of glucocorticoids on function, quality of life, and survival in patients with Duchenne muscular dystrophy: a prospective cohort study.

    PubMed

    McDonald, Craig M; Henricson, Erik K; Abresch, Richard T; Duong, Tina; Joyce, Nanette C; Hu, Fengming; Clemens, Paula R; Hoffman, Eric P; Cnaan, Avital; Gordish-Dressman, Heather

    2018-02-03

    Glucocorticoid treatment is recommended as a standard of care in Duchenne muscular dystrophy; however, few studies have assessed the long-term benefits of this treatment. We examined the long-term effects of glucocorticoids on milestone-related disease progression across the lifespan and survival in patients with Duchenne muscular dystrophy. For this prospective cohort study, we enrolled male patients aged 2-28 years with Duchenne muscular dystrophy at 20 centres in nine countries. Patients were followed up for 10 years. We compared no glucocorticoid treatment or cumulative treatment duration of less than 1 month versus treatment of 1 year or longer with regard to progression of nine disease-related and clinically meaningful mobility and upper limb milestones. We used Kaplan-Meier analyses to compare glucocorticoid treatment groups for time to stand from supine of 5 s or longer and 10 s or longer, and loss of stand from supine, four-stair climb, ambulation, full overhead reach, hand-to-mouth function, and hand function. Risk of death was also assessed. This study is registered with ClinicalTrials.gov, number NCT00468832. 440 patients were enrolled during two recruitment periods (2006-09 and 2012-16). Time to all disease progression milestone events was significantly longer in patients treated with glucocorticoids for 1 year or longer than in patients treated for less than 1 month or never treated (log-rank p<0·0001). Glucocorticoid treatment for 1 year or longer was associated with increased median age at loss of mobility milestones by 2·1-4·4 years and upper limb milestones by 2·8-8·0 years compared with treatment for less than 1 month. Deflazacort was associated with increased median age at loss of three milestones by 2·1-2·7 years in comparison with prednisone or prednisolone (log-rank p<0·012). 45 patients died during the 10-year follow-up. 39 (87%) of these deaths were attributable to Duchenne-related causes in patients with known duration of glucocorticoids usage. 28 (9%) deaths occurred in 311 patients treated with glucocorticoids for 1 year or longer compared with 11 (19%) deaths in 58 patients with no history of glucocorticoid use (odds ratio 0·47, 95% CI 0·22-1·00; p=0·0501). In patients with Duchenne muscular dystrophy, glucocorticoid treatment is associated with reduced risk of losing clinically meaningful mobility and upper limb disease progression milestones across the lifespan as well as reduced risk of death. US Department of Education/National Institute on Disability and Rehabilitation Research; US Department of Defense; National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases; and Parent Project Muscular Dystrophy. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Dietary long-chain unsaturated fatty acids acutely and differently reduce the activities of lipogenic enzymes and of citrate carrier in rat liver.

    PubMed

    Gnoni, Antonio; Giudetti, Anna M

    2016-09-01

    The activities of lipogenic enzymes appear to fluctuate with changes in the level and type of dietary fats. Polyunsaturated fatty acids (PUFAs) are known to induce on hepatic de novo lipogenesis (DNL) the highest inhibitory effect, which occurs through a long-term adaptation. Data on the acute effects of dietary fatty acids on DNL are lacking. In this study with rats, the acute 1-day effect of high-fat (15 % w/w) diets (HFDs) enriched in saturated fatty acids (SFAs) or unsaturated fatty acids (UFAs), i.e., monounsaturated (MUFA) and PUFA, of the ω-6 and ω-3 series on DNL and plasma lipid level was investigated; a comparison with a longer time feeding (21 days) was routinely carried out. After 1-day HFD administration UFA, when compared to SFA, reduced plasma triacylglycerol (TAG) level and the activities of the lipogenic enzymes acetyl-CoA carboxylase (ACC) and fatty acid synthase (FAS), a decreased activity of the citrate carrier (CIC), a mitochondrial protein linked to lipogenesis, was also detected. In this respect, ω-3 PUFA was the most effective. On the other hand, PUFA maintained the effects at longer times, and the acute inhibition induced by MUFA feeding on DNL enzyme and CIC activities was almost nullified at 21 days. Mitochondrial fatty acid composition was slightly but significantly changed both at short- and long-term treatment, whereas the early changes in mitochondrial phospholipid composition vanished in long-term experiments. Our results suggest that in the early phase of administration, UFA coordinately reduced both the activities of de novo lipogenic enzymes and of CIC. ω-3 PUFA showed the greatest effect.

  15. Developing principles of sustainability and stakeholder engagement for "gentle" remediation approaches: the European context.

    PubMed

    Cundy, A B; Bardos, R P; Church, A; Puschenreiter, M; Friesl-Hanl, W; Müller, I; Neu, S; Mench, M; Witters, N; Vangronsveld, J

    2013-11-15

    Gentle Remediation Options (GRO) are risk management strategies or techniques for contaminated sites that result in no gross reduction in soil functionality (or a net gain) as well as risk management. Intelligently applied GROs can provide: (a) rapid risk management via pathway control, through containment and stabilisation, coupled with a longer term removal or immobilisation/isolation of the contaminant source term; and (b) a range of additional economic (e.g. biomass generation), social (e.g. leisure and recreation) and environmental (e.g. CO2 sequestration) benefits. In order for these benefits to be optimised or indeed realised, effective stakeholder engagement is required. This paper reviews current sector practice in stakeholder engagement and its importance when implementing GRO and other remediation options. From this, knowledge gaps are identified, and strategies to promote more effective stakeholder engagement during GRO application are outlined. Further work is required on integrating stakeholder engagement strategies into decision support systems and tools for GRO (to raise the profile of the benefits of effective stakeholder engagement and participation, particularly with sector professionals), and developing criteria for the identification of different stakeholder profiles/categories. Demonstrator sites can make a significant contribution to stakeholder engagement via providing evidence on the effectiveness of GRO under varying site contexts and conditions. Effective and sustained engagement strategies however will be required to ensure that site risk is effectively managed over the longer-term, and that full potential benefits of GRO (e.g. CO2 sequestration, economic returns from biomass generation and "leverage" of marginal land, amenity and educational value, ecosystem services) are realised and communicated to stakeholders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. The effects of chloroquine and verapamil on digestive vacuolar pH of P. falciparum either sensitive or resistant to chloroquine.

    PubMed

    Ursos, L M; Dzekunov, S M; Roepe, P D

    2000-09-01

    In the preceding paper, we present a novel method for measuring the digestive vacuolar pH (pH(vac)) of the malarial parasite Plasmodium falciparum, and show that, surprisingly, pH(vac) is lower for chloroquine resistant (CQR) Dd2 parasites relative to chloroquine sensitive (CQS) HB3. These data may have important consequences for elucidating mechanisms of antimalarial drug resistance and for developing new antimalarial therapy. Additional issues central to a better understanding of antimalarial pharmacology and antimalarial drug resistance require detailed comparative data on the effects of key drugs and other compounds on parasite biophysical parameters such as pH(vac), measured under close-to-physiologic conditions. Since the methods we develop in the previous paper allow us to record fluorescence signals from spatially well-defined regions of the living parasite while they are under continuous perfusion, it is relatively straightforward for us to test how antimalarial drugs (e. g. chloroquine, CQ) and other compounds (e.g. the chemoreversal agent verapamil [VPL]) affect pH(vac). In this paper, we measure both short term (i.e. initial perfusion conditions) and longer-term effects of CQ and VPL for living, intraerythrocytic CQS (HB3) and CQR (Dd2) malarial parasites under constant perfusion with physiologically relevant buffers. We find that VPL normalizes pH(vac) for Dd2 to a value near that measured for HB3, but has no effect on pH(vac) for HB3. Longer term CQ exposure is found to alter pH(vac) for HB3 but not Dd2, and short-term exposure to the drug has no significant effect in either strain. The results may help resolve longstanding debate regarding the effects of CQ and VPL on parasite physiology, and further support our evolving hypothesis for the mechanism of CQ resistance.

  17. Intrathecal baclofen for treating spasticity in children with cerebral palsy.

    PubMed

    Hasnat, Monika J; Rice, James E

    2015-11-13

    Cerebral palsy is a disorder of movement and posture arising from a non-progressive lesion in the developing brain. Spasticity, a disorder of increased muscle tone, is the most common motor difficulty and is associated with activity limitation to varying degrees in mobility and self care.Oral baclofen, a gamma-aminobutyric acid (GABA) agonist, has been used in oral form to treat spasticity for some time, but it has a variable effect on spasticity and the dose is limited by the unwanted effect of excessive sedation. Intrathecal baclofen produces higher local concentrations in cerebrospinal fluid at a fraction of the equivalent oral dose and avoids this excessive sedation. To determine whether intrathecal baclofen is an effective treatment for spasticity in children with cerebral palsy. We searched the CENTRAL, MEDLINE, EMBASE and CINAHL databases, handsearched recent conference proceedings, and communicated with researchers in the field and pharmaceutical and drug delivery system companies. We included studies which compared the effect of intrathecal baclofen treatment on spasticity, gross motor function or other areas of function with controls. Two authors selected studies, two authors extracted data and two authors assessed the methodological quality of included studies. Six studies met the inclusion criteria. The data obtained were unsuitable for the conduct of a meta-analysis; we have completed a qualitative summary.All studies were found to have high or unclear risk of bias in some aspects of their methodology.Five of the six studies reported data collected in the randomised controlled phase of the study. A sixth study did not report sufficient results to determine the effect of intrathecal baclofen versus placebo. Of these five studies, four were conducted using lumbar puncture or other short-term means of delivering intrathecal baclofen. One study assessed the effectiveness of implantable intrathecal baclofen pumps over six months.The four short-term studies demonstrated that intrathecal baclofen therapy reduces spasticity in children with cerebral palsy. However, two of these studies utilised inappropriate techniques for statistical analysis of results. The single longer-term study demonstrated minimal reduction in spasticity with the use of intrathecal baclofen therapy.One of the short-term studies and the longer term study showed improvement in comfort and ease of care. The longer term study found a small improvement in gross motor function and also in some domains of health-related quality of life.Some caution is required in interpreting the findings of the all the studies in the review due to methodological issues. In particular, there was a high risk of bias in the methodology of the longer term study due to the lack of placebo use in the control group and the absence of blinding to the intervention after randomisation for both participants and investigators. There is some limited short-term evidence that intrathecal baclofen is an effective therapy for reducing spasticity in children with cerebral palsy. The effect of intrathecal baclofen on long-term spasticity outcomes is less certain.The validity of the evidence for the effectiveness of intrathecal baclofen in treating spasticity in children with cerebral palsy from the studies in the review is constrained by the small sample sizes of the studies and methodological issues in some studies.Spasticity is a impairment in the domain of body structure and function. Consideration must also be given to the broader context in determining whether intrathecal baclofen therapy is effective. The aim of therapy may be, for example, to improve gross motor function, to increase participation at a social role level, to improve comfort, to improve the ease of care by others or to improve the overall quality of life of the individual. Intrathecal baclofen may improve gross motor function in children with cerebral palsy, but more reliable evidence is needed to determine this.There is some evidence that intrathecal baclofen improves ease of care and the comfort and quality of life of the individuals receiving it, but again small sample sizes and methodological issues in the studies mean that these results should be interpreted with caution.Further evidence of the effectiveness of intrathecal baclofen for treating spasticity, increasing gross motor function and improving comfort, ease of care and quality of life is needed from other investigators in order to validate these results.The short duration of the controlled studies included in this review did not allow for the exploration of questions regarding whether the subsequent need for orthopaedic surgery in children receiving intrathecal baclofen therapy is altered, or the safety and the economic implications of intrathecal baclofen treatment when long-term therapy is administered via an implanted device. Controlled studies are not the most appropriate study design to address these questions, cohort studies may be more appropriate.

  18. Protective Effect of Daikenchuto on Dextran Sulfate Sodium-Induced Colitis in Mice

    PubMed Central

    Matsunaga, Takaharu; Yamamoto, Naoki; Kawasato, Ryo; Shirasawa, Tomohiro; Goto, Atsushi; Fujisawa, Koichi; Takami, Taro; Okamoto, Takeshi; Nishikawa, Jun; Sakaida, Isao

    2017-01-01

    Aim. To investigate the effect of daikenchuto (TJ-100; DKT) for ulcerative colitis (UC) model mouse and assess its anti-inflammatory mechanisms. Methods. We evaluated the effects of DKT on dextran sulfate sodium- (DSS-) induced experimental colitis. First, we assessed the short-term effects of DKT using two groups: 5% DSS group and 5% DSS with DKT group. Colon length; histological scores; and interleukin- (IL-) 10, IL-1β, and tumor necrosis factor-α mRNA expression profiles were analyzed using real-time PCR. Second, we assessed the long-term effects of DKT, by comparing survival time between 2% DSS and 2% DSS with DKT groups. Results. After 7 days, the colon lengths of DSS + DKT group were longer than those of the DSS group (mean values: 6.11 versus 5.69 cm, p < 0.05). Furthermore, compared to DSS group, the DSS + DKT group maintained significantly higher levels of serum hemoglobin (13.1 versus 10.7 g/dL, p < 0.05) and exhibited significantly higher expression levels of IL-10 (p < 0.05). The 2% DSS + DKT group exhibited significantly longer survival time than the 2% DSS group (70 versus 44 days, p < 0.01). Conclusion. Our results indicate that DKT prevented inflammation in the colon, indicating its potential as a new therapeutic agent for UC. PMID:28210268

  19. Protective Effect of Daikenchuto on Dextran Sulfate Sodium-Induced Colitis in Mice.

    PubMed

    Matsunaga, Takaharu; Hashimoto, Shinichi; Yamamoto, Naoki; Kawasato, Ryo; Shirasawa, Tomohiro; Goto, Atsushi; Fujisawa, Koichi; Takami, Taro; Okamoto, Takeshi; Nishikawa, Jun; Sakaida, Isao

    2017-01-01

    Aim . To investigate the effect of daikenchuto (TJ-100; DKT) for ulcerative colitis (UC) model mouse and assess its anti-inflammatory mechanisms. Methods . We evaluated the effects of DKT on dextran sulfate sodium- (DSS-) induced experimental colitis. First, we assessed the short-term effects of DKT using two groups: 5% DSS group and 5% DSS with DKT group. Colon length; histological scores; and interleukin- (IL-) 10, IL-1 β , and tumor necrosis factor- α mRNA expression profiles were analyzed using real-time PCR. Second, we assessed the long-term effects of DKT, by comparing survival time between 2% DSS and 2% DSS with DKT groups. Results . After 7 days, the colon lengths of DSS + DKT group were longer than those of the DSS group (mean values: 6.11 versus 5.69 cm, p < 0.05). Furthermore, compared to DSS group, the DSS + DKT group maintained significantly higher levels of serum hemoglobin (13.1 versus 10.7 g/dL, p < 0.05) and exhibited significantly higher expression levels of IL-10 ( p < 0.05). The 2% DSS + DKT group exhibited significantly longer survival time than the 2% DSS group (70 versus 44 days, p < 0.01). Conclusion . Our results indicate that DKT prevented inflammation in the colon, indicating its potential as a new therapeutic agent for UC.

  20. Direct versus indirect psychosocial and behavioural interventions to prevent suicide and suicide attempts: a systematic review and meta-analysis.

    PubMed

    Meerwijk, Esther L; Parekh, Amrita; Oquendo, Maria A; Allen, I Elaine; Franck, Linda S; Lee, Kathryn A

    2016-06-01

    Psychosocial and behavioural interventions that address suicidal thoughts and behaviour during treatment (direct interventions) might be more effective in preventing suicide and suicide attempts than indirect interventions that address symptoms associated with suicidal behaviour only (eg, hopelessness, depression, anxiety, quality of life). To test this hypothesis, we did a systematic review and meta-analysis of psychosocial and behavioural interventions aimed at preventing suicide and suicide attempts. For this systematic review and meta-analysis, we searched MEDLINE and PsycINFO from inception to Dec 25, 2015, for randomised controlled trials that reported suicides or suicide attempts as an outcome, irrespective of participants' diagnoses or the publication language. We excluded studies with pharmacological or device-based interventions, those that targeted communities or clinicians, primary prevention trials, and trials that reported events of non-suicidal self-injury as suicide attempts. Trials that had no suicides or suicide attempts in both groups were also excluded. Data were extracted by one investigator and independently verified by a second investigator. We used random-effects models of the odds ratio (OR) based on a pooled measure of suicides and the number of individuals who attempted suicide, immediately post-treatment and at longer-term follow-up. Of 2024 unique abstracts screened, 53 articles met eligibility criteria and reported on 44 studies; 31 studies provided post-treatment data with 6658 intervention group participants and 6711 control group participants at baseline, and 29 studies provided follow-up data. The post-treatment difference between direct interventions and indirect interventions did not reach statistical significance at the 0·05 level (OR 0·62 [95% CI 0·45-0·87] vs 0·93 [0·77-1·12], p=0·06) and represented a large effect size (Cohen's d=0·77). At longer-term follow-up, the difference was not significant (OR 0·65 [0·46-0·91] vs 0·82 [0·70-0·96], p=0·25) but still represented a medium effect size (Cohen's d=0·47). These effect sizes emphasise the clinical importance of direct interventions. Post-hoc subgroup and sensitivity analyses showed that our results are robust and unlikely to be notably affected by between-study heterogeneity or publication bias. Psychosocial and behavioural interventions that directly address suicidal thoughts and behaviour are effective immediately post-treatment and long term, whereas treatments indirectly addressing these components are only effective long term. Moreover, although the differences shown between direct and indirect strategies were non-significant, the difference in favour of direct interventions represented a large post-treatment improvement and medium improvement at longer-term follow-up. On the basis of these findings, clinicians working with patients at risk of suicide should address suicidal thoughts and behaviours with the patient directly. Although direct interventions are effective, they are not sufficient, and additional efforts are needed to further reduce death by suicide and suicide attempts. Continued patient contact might be necessary to retain long-term effectiveness. National Institute of Nursing Research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Effect of CPAP in a Mouse Model of Hyperoxic Neonatal Lung Injury

    PubMed Central

    Reyburn, Brent; Fiore, Juliann M. Di; Raffay, Thomas; Martin, Richard J.; Y.S., Prakash; Jafri, Anjum; MacFarlane, Peter M.

    2015-01-01

    Background Continuous positive airway pressure [CPAP] and supplemental oxygen have become the mainstay of neonatal respiratory support in preterm infants. Although oxygen therapy is associated with respiratory morbidities including bronchopulmonary dysplasia [BPD], the long-term effects of CPAP on lung function are largely unknown. We used a hyperoxia-induced mouse model of BPD to explore the effects of daily CPAP during the first week of life on later respiratory system mechanics. Objective To test the hypothesis that daily CPAP in a newborn mouse model of BPD improves longer term respiratory mechanics. Methods Mouse pups from C57BL/6 pregnant dams were exposed to room air [RA] or hyperoxia [50% O2, 24hrs/day] for the first postnatal week with or without exposure to daily CPAP [6cmH2O, 3hrs/day]. Respiratory system resistance [Rrs] and compliance [Crs] were measured following a subsequent 2 week period of room RA recovery. Additional measurements included radial alveolar counts and macrophage counts. Results Mice exposed to hyperoxia had significantly elevated Rrs, decreased Crs, reduced alveolarization, and increased macrophage counts at three weeks compared to RA treated mice. Daily CPAP treatment significantly improved Rrs, Crs and alveolarization, and decreased lung macrophage infiltration in hyperoxia-exposed pups. Conclusions We have demonstrated that daily CPAP had a longer term benefit on baseline respiratory system mechanics in a neonatal mouse model of BPD. We speculate that this beneficial effect of CPAP was the consequence of a decrease in the inflammatory response and resultant alveolar injury associated with hyperoxic newborn lung injury. PMID:26394387

  2. THE EFFECTS OF FIXED VERSUS ESCALATING REINFORCEMENT SCHEDULES ON SMOKING ABSTINENCE

    PubMed Central

    Romanowich, Paul; Lamb, R. J.

    2015-01-01

    Studies indicate that when abstinence is initiated, escalating reinforcement schedules maintain continuous abstinence longer than fixed reinforcement schedules. However, these studies were conducted for shorter durations than most clinical trials and also resulted in larger reinforcer value for escalating participants during the 1st week of the experiment. We tested whether escalating reinforcement schedules maintained abstinence longer than fixed reinforcement schedules in a 12-week clinical trial. Smokers (146) were randomized to an escalating reinforcement schedule, a fixed reinforcement schedule, or a control condition. Escalating reinforcement participants received $5.00 for their first breath carbon monoxide (CO) sample <3 ppm, with a $0.50 increase for each consecutive sample. Fixed reinforcement participants received $19.75 for each breath CO sample <3 ppm. Control participants received payments only for delivering a breath CO sample. Similar proportions of escalating and fixed reinforcement participants met the breath CO criterion at least once. Escalating reinforcement participants maintained criterion breath CO levels longer than fixed reinforcement and control participants. Similar to previous short-term studies, escalating reinforcement schedules maintained longer durations of abstinence than fixed reinforcement schedules during a clinical trial. PMID:25640764

  3. 42 CFR 137.78 - May a Self-Governance Tribe negotiate a funding agreement for a term longer or shorter than one...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May a Self-Governance Tribe negotiate a funding agreement for a term longer or shorter than one year? 137.78 Section 137.78 Public Health PUBLIC HEALTH... SERVICES TRIBAL SELF-GOVERNANCE Funding General § 137.78 May a Self-Governance Tribe negotiate a funding...

  4. The impact of interventions to prevent obesity or improve obesity related behaviours in children (0-5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review.

    PubMed

    Laws, Rachel; Campbell, Karen J; van der Pligt, Paige; Russell, Georgina; Ball, Kylie; Lynch, John; Crawford, David; Taylor, Rachael; Askew, Deborah; Denney-Wilson, Elizabeth

    2014-08-01

    Children from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families. Searches of major electronic databases identified articles published from 1993-2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity. Thirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m(2) to -0.54 kg/m(2) for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3-5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery. There is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required. PROSPERO Registration no: CRD42013006536.

  5. Conventional intensive logging promotes loss of organic carbon from the mineral soil.

    PubMed

    Dean, Christopher; Kirkpatrick, James B; Friedland, Andrew J

    2017-01-01

    There are few data, but diametrically opposed opinions, about the impacts of forest logging on soil organic carbon (SOC). Reviews and research articles conclude either that there is no effect, or show contradictory effects. Given that SOC is a substantial store of potential greenhouse gasses and forest logging and harvesting is routine, resolution is important. We review forest logging SOC studies and provide an overarching conceptual explanation for their findings. The literature can be separated into short-term empirical studies, longer-term empirical studies and long-term modelling. All modelling that includes major aboveground and belowground biomass pools shows a long-term (i.e. ≥300 years) decrease in SOC when a primary forest is logged and then subjected to harvesting cycles. The empirical longer-term studies indicate likewise. With successive harvests the net emission accumulates but is only statistically perceptible after centuries. Short-term SOC flux varies around zero. The long-term drop in SOC in the mineral soil is driven by the biomass drop from the primary forest level but takes time to adjust to the new temporal average biomass. We show agreement between secondary forest SOC stocks derived purely from biomass information and stocks derived from complex forest harvest modelling. Thus, conclusions that conventional harvests do not deplete SOC in the mineral soil have been a function of their short time frames. Forest managers, climate change modellers and environmental policymakers need to assume a long-term net transfer of SOC from the mineral soil to the atmosphere when primary forests are logged and then undergo harvest cycles. However, from a greenhouse accounting perspective, forest SOC is not the entire story. Forest wood products that ultimately reach landfill, and some portion of which produces some soil-like material there rather than in the forest, could possibly help attenuate the forest SOC emission by adding to a carbon pool in landfill. © 2016 John Wiley & Sons Ltd.

  6. Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies

    PubMed Central

    Clarke, David

    2017-01-01

    Objective To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Design Systematic review and thematic synthesis. Method We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Results Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Conclusions Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such approaches must be designed to help survivors to manage the unique psychosocial consequences of poststroke communication difficulties. PMID:28988185

  7. Ventromedial prefrontal and anterior cingulate cortex adopt choice and default reference frames during sequential multialternative choice

    PubMed Central

    Boorman, Erie D; Rushworth, Matthew F; Behrens, Tim E

    2013-01-01

    Although damage to medial frontal cortex causes profound decision-making impairments, it has been difficult to pinpoint the relative contributions of key anatomical subdivisions. Here we use fMRI to examine the contributions of human ventromedial prefrontal cortex (vmPFC) and dorsal anterior cingulate cortex (dACC) during sequential choices between multiple alternatives – two key features of choices made in ecological settings. By carefully constructing options whose current value at any given decision was dissociable from their longer-term value, we were able to examine choices in current and long-term frames of reference. We present evidence showing that activity at choice and feedback in vmPFC and dACC was tied to the current choice and the best long-term option, respectively. vmPFC, mid-cingulate, and PCC encoded the relative value between the chosen and next-best option at each sequential decision, whereas dACC encoded the relative value of adapting choices from the option with the highest value in the longer-term. Furthermore, at feedback we identify temporally dissociable effects that predict repetition of the current choice and adaptation away from the long-term best option in vmPFC and dACC, respectively. These functional dissociations at choice and feedback suggest that sequential choices are subject to competing cortical mechanisms. PMID:23392656

  8. Post-fire ecosystem recovery trajectories along burn severity gradients

    NASA Astrophysics Data System (ADS)

    Newingham, B. A.; Hudak, A. T.; Bright, B. C.; Smith, A. G.; Henareh Khalyani, A.

    2017-12-01

    Burn severity is a term used to describe the longer-term, second-order effects of fire on ecosystems. Plant communities are assumed to recover more slowly at higher burn severities; however, this likely depends on plant community type and climate. We assessed vegetation recovery approximately a decade post-fire across North American forests (moist mixed conifer, dry mixed conifer, ponderosa pine) and shrublands (mountain big sagebrush and Wyoming big sagebrush) distributed across climate and burn severity gradients. We assessed vegetation recovery across these ecosystems as indicated by the differenced Normalized Burn Ratio derived from 1984-2016 Landsat time series imagery (LandTrendr). Additionally, we used field vegetation measurements to examine local topographic controls on burn severity and post-fire vegetation recovery. Ecosystem responses were related to climate predictors derived from downscaled 1993-2011 climate normals. We hypothesized that drier and hotter ecosystems would take longer to recover. We also predicted areas with higher burn severity to have slower recovery. We found post-fire recovery to be strongly predicted by precipitation with the slowest recovery in shrublands and ponderosa pine forest, the driest vegetation types considered. We conclude that climate and burn severity interact to determine ecosystem recovery trajectories after fire, with burn severity having larger influence in the short term, and climate having larger influence in the long term.

  9. Studying the Earth from space

    USGS Publications Warehouse

    ,

    1977-01-01

    Pictures of the Earth's surface obtained from satellites are providing scientists with new tools to investigate the Earth and its environment. At the same time, a growing population and an ever-expanding technology place unprecedented demands on natural resources. Man can no longer treat his resources strictly according to immediate economic dictates; a balance must be struck between the short-term demands of technological and industrial development and the long-term effects on the environment. Intelligent development, management, and conservation of resources are goals that represent a challenge in the acquisition and use of information.

  10. Studying the Earth from space

    USGS Publications Warehouse

    ,

    1974-01-01

    Pictures of the Earth's surface obtained from satellites are providing scientists with new tools to investigate tne Earth and its environment. A growing population and an everexpanding technology place demands on our natural resources. However, man can no longer treat his resources strictly according to immediate economic dictates; a balance must be struck between the short-term demands of technological and industrial development and the long-term effects on the environment. Intelligent development, management, and conservation of resources are goals that represent an unprecedented challenge in the acquisition and use of information.

  11. Exercise benefits for the aging brain depend on the accompanying cognitive load: insights from sleep electroencephalogram.

    PubMed

    Horne, Jim

    2013-11-01

    Although exercise clearly offsets aging effects on the body, its benefits for the aging brain are likely to depend on the extent that physical activity (especially locomotion) facilitates multisensory encounters, curiosity, and interactions with novel environments; this is especially true for exploratory activity, which occupies much of wakefulness for most mammals in the wild. Cognition is inseparable from physical activity, with both interlinked to promote neuroplasticity and more successful brain aging. In these respects and for humans, exercising in a static, featureless, artificially lit indoor setting contrasts with exploratory outdoor walking within a novel environment during daylight. However, little is known about the comparative benefits for the aging brain of longer-term daily regimens of this latter nature including the role of sleep, to the extent that sleep enhances neuroplasticity as shown in short-term laboratory studies. More discerning analyses of sleep electroencephalogram (EEG) slow-wave activity especially 0.5-2-Hz activity would provide greater insights into use-dependent recovery processes during longer-term tracking of these regimens and complement slower changing waking neuropsychologic and resting functional magnetic resonance imaging (fMRI) measures, including those of the brain's default mode network. Although the limited research only points to ephemeral small sleep EEG effects of pure exercise, more enduring effects seem apparent when physical activity incorporates cognitive challenges. In terms of "use it or lose it," curiosity-driven "getting out and about," encountering, interacting with, and enjoying novel situations may well provide the brain with its real exercise, further reflected in changes to the dynamics of sleep. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Long-term influence of asteroids on planet longitudes and chaotic dynamics of the solar system

    NASA Astrophysics Data System (ADS)

    Woillez, E.; Bouchet, F.

    2017-11-01

    Over timescales much longer than an orbital period, the solar system exhibits large-scale chaotic behavior and can thus be viewed as a stochastic dynamical system. The aim of the present paper is to compare different sources of stochasticity in the solar system. More precisely we studied the importance of the long term influence of asteroids on the chaotic dynamics of the solar system. We show that the effects of asteroids on planets is similar to a white noise process, when those effects are considered on a timescale much larger than the correlation time τϕ ≃ 104 yr of asteroid trajectories. We computed the timescale τe after which the effects of the stochastic evolution of the asteroids lead to a loss of information for the initial conditions of the perturbed Laplace-Lagrange secular dynamics. The order of magnitude of this timescale is precisely determined by theoretical argument, and we find that τe ≃ 104 Myr. Although comparable to the full main-sequence lifetime of the sun, this timescale is considerably longer than the Lyapunov time τI ≃ 10 Myr of the solar system without asteroids. This shows that the external sources of chaos arise as a small perturbation in the stochastic secular behavior of the solar system, rather due to intrinsic chaos.

  13. Impact of fetal gender on the labor curve.

    PubMed

    Cahill, Alison G; Roehl, Kimberly A; Odibo, Anthony O; Zhao, Qiuhong; Macones, George A

    2012-04-01

    We sought to estimate the association between fetal gender and first-stage labor curve at term. Within a large, retrospective cohort study of consecutive, singleton term labor patients who delivered in the second stage, we compared the active phase of first-stage labor by fetal gender. The primary outcome was length of active stage 1. Interval-censored regression was used to estimate the effect of fetal gender on the duration of active first stage (4-10 cm) and was adjusted for relevant covariates. Of 2400 women, 2373 women had complete labor information and were available for this analysis. Male gender was associated with both a statistically significantly longer active first stage of labor (4.6 vs 4.0 hours; P = .002) and stratified analyses by parity and labor type. Male fetuses are associated with longer active phase of the first stage of labor and, specifically, may need to be considered in the setting of arrest diagnoses. Copyright © 2012 Mosby, Inc. All rights reserved.

  14. The effects of a song-singing programme on the affective speaking intonation of people with traumatic brain injury.

    PubMed

    Baker, F; Wigram, T; Gold, C

    2005-07-01

    To examine changes in the relationship between intonation, voice range and mood following music therapy programmes in people with traumatic brain injury. Data from four case studies were pooled and effect size, ANOVA and correlation calculations were performed to evaluate the effectiveness of treatment. Subjects sang three self-selected songs for 15 sessions. Speaking fundamental frequency, fundamental frequency variability, slope, voice range and mood were analysed pre- and post-session. Immediate treatment effects were not found. Long-term improvements in affective intonation were found in three subjects, especially in fundamental frequency. Voice range improved over time and was positively correlated with the three intonation components. Mood scale data showed that immediate effects were in the negative direction whereas there weres increases in positive mood state in the longer-term. Findings suggest that, in the long-term, song singing can improve vocal range and mood and enhance the affective intonation styles of people with TBI.

  15. Behavioral and Physiological Response of Baleen Whales to Ships and Ship Noise

    DTIC Science & Technology

    2014-09-30

    student Angela Szesciorka) on tag designs to provide longer term deployments of archival tags especially for work with humpback whales off northern...California. 2. Conduct test deployments of dart-attached archival tags in 2014 on humpback whales in Monterey Bay and the Gulf of the Farallones on... humpback whales to tests different dart attachment configurations and develop a new longer term dart-attached archival tag system. 3. Successfully

  16. Characteristics of women with continued use of vaginal pessaries.

    PubMed

    Lewthwaite, Barbara J; Staley, Doug; Girouard, Lise; Maslow, Ken

    2013-01-01

    Vaginal pessaries have been shown to be a safe, effective treatment for pelvic organ prolapse, and in some cases, female urinary incontinence. There are limited data that predict long-term pessary use; therefore, the aim of this retrospective, exploratory study was to describe selected characteristics of women using a pessary for 12 months or longer in a nurse-run clinic.

  17. Launching Kindergarten Math Clubs: The Implementation of High 5s in New York City

    ERIC Educational Resources Information Center

    Jacob, Robin; Erickison, Anna; Mattera, Shira K.

    2018-01-01

    Early math has been shown to predict not only longer-term math achievement, but also future reading achievement, high school completion, and college attendance. Yet effects from early math programs often fade out as children move into more varied instructional contexts in elementary school. This fade-out suggests the need for an alignment of math…

  18. Can Sector Strategies Promote Longer-Term Effects? Three-Year Impacts from the WorkAdvance Demonstration

    ERIC Educational Resources Information Center

    Schaberg, Kelsey

    2017-01-01

    Individuals with low incomes often struggle to advance in the labor market, yet at the same time, some employers report difficulty finding workers with the necessary skills. WorkAdvance is a workforce development model that seeks to address the needs of both of these groups through its "dual customer" approach. The model offers training…

  19. Mid­west. Climate change impacts in the United States: The third national climate assessment

    Treesearch

    Sara C. Pryor; Donald Scavia; Charles Downer; Marc Gaden; Louis Iverson; Rolf Nordstrom; Jonathan Patz; G. Phillip Robertson

    2014-01-01

    In the next few decades, longer growing seasons and rising carbon dioxide levels will increase yields of some crops, though those benefits will be progressively offset by extreme weather events. Though adaptation options can reduce some of the detrimental effects, in the long term, the combined stresses associated with climate change are expected to decrease...

  20. Match and mismatch: conservation physiology, nutritional ecology and the timescales of biological adaptation

    PubMed Central

    Raubenheimer, David; Simpson, Stephen J.; Tait, Alice H.

    2012-01-01

    Conservation physiology (CP) and nutritional ecology (NE) are both integrative sciences that share the fundamental aim of understanding the patterns, mechanisms and consequences of animal responses to changing environments. Here, we explore the high-level similarities and differences between CP and NE, identifying as central themes to both fields the multiple timescales over which animals adapt (and fail to adapt) to their environments, and the need for integrative models to study these processes. At one extreme are the short-term regulatory responses that modulate the state of animals in relation to the environment, which are variously considered under the concepts of homeostasis, homeorhesis, enantiostasis, heterostasis and allostasis. In the longer term are developmental responses, including phenotypic plasticity and transgenerational effects mediated by non-genomic influences such as parental physiology, epigenetic effects and cultural learning. Over a longer timescale still are the cumulative genetic changes that take place in Darwinian evolution. We present examples showing how the adaptive responses of animals across these timescales have been represented in an integrative framework from NE, the geometric framework (GF) for nutrition, and close with an illustration of how GF can be applied to the central issue in CP, animal conservation. PMID:22566672

  1. Match and mismatch: conservation physiology, nutritional ecology and the timescales of biological adaptation.

    PubMed

    Raubenheimer, David; Simpson, Stephen J; Tait, Alice H

    2012-06-19

    Conservation physiology (CP) and nutritional ecology (NE) are both integrative sciences that share the fundamental aim of understanding the patterns, mechanisms and consequences of animal responses to changing environments. Here, we explore the high-level similarities and differences between CP and NE, identifying as central themes to both fields the multiple timescales over which animals adapt (and fail to adapt) to their environments, and the need for integrative models to study these processes. At one extreme are the short-term regulatory responses that modulate the state of animals in relation to the environment, which are variously considered under the concepts of homeostasis, homeorhesis, enantiostasis, heterostasis and allostasis. In the longer term are developmental responses, including phenotypic plasticity and transgenerational effects mediated by non-genomic influences such as parental physiology, epigenetic effects and cultural learning. Over a longer timescale still are the cumulative genetic changes that take place in Darwinian evolution. We present examples showing how the adaptive responses of animals across these timescales have been represented in an integrative framework from NE, the geometric framework (GF) for nutrition, and close with an illustration of how GF can be applied to the central issue in CP, animal conservation.

  2. Brief post-stressor treatment with pregabalin in an animal model for PTSD: short-term anxiolytic effects without long-term anxiogenic effect.

    PubMed

    Zohar, Joseph; Matar, Michael A; Ifergane, Gal; Kaplan, Zeev; Cohen, Hagit

    2008-09-01

    The short- and long-term behavioral effects of a brief course of pregabalin, an antiepileptic structural analogue of alpha-aminobyturic acid with analgesic and anxiolytic effects, were assessed in an animal model of post-traumatic stress disorder (PTSD). Two-hundred thirty-three adult male Sprague-Dawley rats were employed. Behavioral responses to traumatic stress exposure (predator urine scent) were assessed immediately after (1 h) and 30 days after treatment with saline or pregabalin (at doses of 30, 100 and 300 mg/kg) in terms of behavior in the elevated plus maze (EPM) and the acoustic startle response (ASR) paradigms. At day 31 the freezing response to a trauma cue (clean cat litter) was assessed. The same treatment regimen initiated at day 7 was assessed at day 30 and in response to the trauma cue on day 31 in a separate experiment. In the short term, doses of 100 mg/kg and 300 mg/kg of pregabalin effectively attenuated anxiety-like behaviors. In the longer-term, pregabalin did not attenuate the onset of PTSD-like behaviors or the prevalence rates of severe cue-responses, for either the immediate or the delayed treatment regimens. Pregabalin may present an alternative compound for acute anxiolytic treatment after exposure to trauma, but has no long-term protective/preventive effects.

  3. Effectiveness of opioids in the treatment of chronic non-cancer pain.

    PubMed

    Trescot, Andrea M; Glaser, Scott E; Hansen, Hans; Benyamin, Ramsin; Patel, Samir; Manchikanti, Laxmaiah

    2008-03-01

    For thousands of years, opioids have been used to treat pain, and they continue to be one of the most commonly prescribed medications for pain. It is estimated that 90% of patients presenting to pain centers and receiving treatment in such facilities are on opioids. Opioids can be considered broad-spectrum analgesics that act at multiple points along the pain pathway. Unfortunately, opioids also have the potential for great harm, with multiple side effects and potential complications, some of which are lethal. They are also uniquely addictive, which can lead to misuse and diversion. We reviewed the relevant English literature and did thorough manual searches of the bibliographies of known primary and review articles. We utilized pain relief as the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, improvement in work status, and evidence of addiction. Short-term use and improvement was defined as less than 6 months and long-term relief was defined as 6 months or longer. The 3 systematic reviews evaluating long-term effectiveness of opioids for chronic non-cancer pain provided unclear and weak evidence. The results of this review showed that many patients in the included studies were dissatisfied with adverse events or insufficient pain relief from opioids and withdrew from the studies. For patients able to continue on opioids, evidence was weak suggesting that their pain scores were lower than before therapy and that this relief could be maintained long-term (> 6 months). There was also weak evidence that long-term opioid therapy with morphine and transdermal fentanyl not only decreases pain but also improves functioning. Limited evidence was available for the most commonly used opioids, oxycodone and hydrocodone. Evidence for the ability to drive on chronic opioid therapy was moderate without major side effects or complications. It is concluded that, for long-term opioid therapy of 6 months or longer in managing chronic non-cancer pain, with improvement in function and reduction in pain, there is weak evidence for morphine and transdermal fentanyl. However, there is limited or lack of evidence for all other controlled substances, including the most commonly used drugs, oxycodone and hydrocodone.

  4. An idealised study for the long term evolution of crescentic bars

    NASA Astrophysics Data System (ADS)

    Chen, W. L.; Dodd, N.; Tiessen, M. C. H.; Calvete, D.

    2018-01-01

    An idealised study that identifies the mechanisms in the long term evolution of crescentic bar systems in nature is presented. Growth to finite amplitude (i.e., equilibration, sometimes referred to as saturation) and higher harmonic interaction are hypothesised to be the leading nonlinear effects in long-term evolution of these systems. These nonlinear effects are added to a linear stability model and used to predict crescentic bar development along a beach in Duck, North Carolina (USA) over a 2-month period. The equilibration prolongs the development of bed patterns, thus allowing the long term evolution. Higher harmonic interaction enables the amplitude to be transferred from longer to shorter lengthscales, which leads to the dominance of shorter lengthscales in latter post-storm stages, as observed at Duck. The comparison with observations indicates the importance of higher harmonic interaction in the development of nearshore crescentic bar systems in nature. Additionally, it is concluded that these nonlinear effects should be included in models simulating the development of different bed patterns, and that this points a way forward for long-term morphodynamical modelling in general.

  5. Far-red light is needed for efficient photochemistry and photosynthesis.

    PubMed

    Zhen, Shuyang; van Iersel, Marc W

    2017-02-01

    The efficiency of monochromatic light to drive photosynthesis drops rapidly at wavelengths longer than 685nm. The photosynthetic efficiency of these longer wavelengths can be improved by adding shorter wavelength light, a phenomenon known as the Emerson enhancement effect. The reverse effect, the enhancement of photosynthesis under shorter wavelength light by longer wavelengths, however, has not been well studied and is often thought to be insignificant. We quantified the effect of adding far-red light (peak at 735nm) to red/blue or warm-white light on the photosynthetic efficiency of lettuce (Lactuca sativa). Adding far-red light immediately increased quantum yield of photosystem II (Φ PSII ) of lettuce by an average of 6.5 and 3.6% under red/blue and warm-white light, respectively. Similar or greater increases in Φ PSII were observed after 20min of exposure to far-red light. This longer-term effect of far-red light on Φ PSII was accompanied by a reduction in non-photochemical quenching of fluorescence (NPQ), indicating that far-red light reduced the dissipation of absorbed light as heat. The increase in Φ PSII and complementary decrease in NPQ is presumably due to preferential excitation of photosystem I (PSI) by far-red light, which leads to faster re-oxidization of the plastoquinone pool. This facilitates reopening of PSII reaction centers, enabling them to use absorbed photons more efficiently. The increase in Φ PSII by far-red light was associated with an increase in net photosynthesis (P n ). The stimulatory effect of far-red light increased asymptotically with increasing amounts of far-red. Overall, our results show that far-red light can increase the photosynthetic efficiency of shorter wavelength light that over-excites PSII. Copyright © 2016 Elsevier GmbH. All rights reserved.

  6. Insulin treatment augments KCNQ1/KCNE1 currents but not KCNQ1 currents, which is associated with an increase in KCNE1 expression.

    PubMed

    Wu, Minghua; Obara, Yutaro; Ohshima, Shingo; Nagasawa, Yoshinobu; Ishii, Kuniaki

    2017-11-04

    Diabetes mellitus affects ion channel physiology. We have previously reported that acute application of insulin suppresses the KCNQ1/KCNE1 currents that play an important role in terminating ventricular action potential. In this study, we investigated the effect of long-term insulin treatment on KCNQ1/KCNE1 currents using the Xenopus oocyte expression system. Insulin treatment with a duration longer than 6 h had an opposite effect to acute insulin application, that is, it augmented the KCNQ1/KCNE1 currents. Inhibitors of PI3K, wortmannin and LY294002, and a MEK inhibitor, U0126, abolished the potentiating effect of long-term insulin treatment. The long-term treatment with insulin had no effect on KCNQ1 currents indicating an essential role of KCNE1 in the insulin effect, which is similar to the acute insulin effect. Cycloheximide, an inhibitor of protein synthesis, and brefeldin A, an inhibitor of protein transport from endoplasmic reticulum, suppressed the long-term insulin effect. Western blotting analysis combined with these pharmacological data suggest that long-term insulin treatment augments KCNQ1/KCNE1 currents by increasing KCNE1 protein expression. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Staff expectations and views of cognitive behaviour therapy (CBT) for adults with intellectual disabilities.

    PubMed

    Stenfert Kroese, Biza; Jahoda, Andrew; Pert, Carol; Trower, Peter; Dagnan, Dave; Selkirk, Mhairi

    2014-03-01

    The role of support workers and other professionals in the psychotherapeutic process has been commented upon but not as yet been systematically investigated. To explore their views and expectations of cognitive behaviour therapy (CBT) for adults with intellectual disabilities, eleven paid support workers and professionals were recruited and interviewed before the CBT sessions commenced for their service users and nine took part in the second interview that took place after nine sessions. Thematic Analysis of the interview transcripts indicates that staff members do not perceive CBT as a long-term solution for psychological problems have little knowledge of CBT and do not feel included in the process. Nevertheless, after nine sessions, most participants reported improved psychological well-being for their service users and expressed a wish for longer-term involvement of the therapist. The results suggest that for CBT to be effective in the longer term, the therapist is required to consider a wider systemic approach including staff training and supervision, staff and management consultancy and creating a delicate balance between confidentiality and sharing the psychological formulation with 'significant others' to ensure maintenance and generalisation of improved psychological well-being. © 2013 John Wiley & Sons Ltd.

  8. Feeding preterm infants after hospital discharge: growth and development at 18 months of age.

    PubMed

    Cooke, R J; Embleton, N D; Griffin, I J; Wells, J C; McCormick, K P

    2001-05-01

    We have shown that preterm infants fed a preterm formula grow better than those fed a standard term infant formula after hospital discharge. The purpose of this follow-up study was to determine whether improved early growth was associated with later growth and development. Preterm infants (< or =1750 g birth weight, < or =34 wk gestation) were randomized to be fed either a preterm infant formula (discharge to 6 mo corrected age), or a term formula (discharge to 6 mo), or the preterm (discharge to term) and the term formula (term to 6 mo). Anthropometry was performed at 12 wk and 6, 12, and 18 mo. Mental and psychomotor development were assessed using the Bayley Scales of Infant Development II at 18 mo. Differences in growth observed at 12 wk were maintained at 18 mo. At 18 mo, boys fed the preterm formula were 1.0 kg heavier, 2 cm longer, and had a 1.0 cm greater occipitofrontal circumference than boys fed the term formula. Boys fed the preterm formula were also 600 g heavier and 2 cm longer than girls fed the preterm formula. However, no differences were noted in MDI or PDI between boys fed the preterm formula and boys fed the term formula or between the boys fed preterm formula and girls fed the preterm formula. Overall, boys had significantly lower MDI than girls (mean difference, 6.0; p < 0.01), primarily reflecting lower scores in boys fed the term formula. Thus, early diet has long-term effects on growth but not development at 18 mo of age. Sex remains an important confounding variable when assessing growth and developmental outcome in these high-risk infants.

  9. Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients.

    PubMed

    Attenberger, Corinna; Amsler, Felix; Gross, Thomas

    2012-09-01

    No sufficiently validated disease-specific instrument is available to assess patient outcome after polytrauma. The aim of this investigation was to test the recently published Trauma Outcome Profile (TOP) in the longer-term outcome of multiply injured patients. Single centre validation study on the TOP in comparison with objective and subjective measures of patient, injury or treatment characteristics and longer-term outcome (e.g. medical outcomes study Short Form-36, SF-36; Nottingham Health Profile, NHP; working capacity), at least 2 years following trauma in 117 survivors of polytrauma (injury severity score, ISS>16), using comparative analysis and correlation testing of prospectively collected data. Patients' mean weighted self-rating with regard to the 10 single TOP dimensions of Health Related Quality of Life (HRQoL, 0-100) ranged from lowest values for mental functioning (52.6+33.5) to highest values for daily activities (79.0+27.5). The rate of persons who indicated an abnormal level of function or pain increased significantly from pre-injury status (2% and 5%, resp.) to 46% for both values at longer-term follow-up (p<0.001). Observed associations between single dimensions or TOP component summary scores with the corresponding values from general HRQol instruments, such as the SF-36, resulted in R (Pearson) up to 0.85. Survivors of polytrauma who presented with a reduced working capacity (RWC) at longer-term follow-up in all TOP dimensions included a significantly higher rate of patients conspicuous for a relevantly reduced outcome compared with those with a non reduced working capacity (NRWC) (posttraumatic stress disease, PTSD: p<0.05; all other dimensions: p<0.001). Patients with a RWC were characterised by an almost fivefold probability of reduced outcome with regard to the TOP dimensions 'social interaction' or 'satisfaction' (odds ratio, OR 12.4 (95% CI 5.1-30.1) and 12.5 (4.0-39.0), resp.). This first clinical and methodological evaluation in a well defined cohort of polytrauma patients found the TOP to be a reliable and well discriminating score covering both relevant general and trauma-specific aspects of longer-term outcome. Despite these promising primary results, until further validation, the TOP should be used together with already accepted HRQoL measures to allow adequate international comparison of data in the future. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature.

    PubMed

    Cook, Sharon A; Salmon, Peter; Hayes, Gemma; Byrne, Angela; Fisher, Peter L

    2018-03-01

    Why some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer-term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social, and psychological factors available at or within 3 months of diagnosis that are reliable predictors of emotional distress at least 12 months later. A systematic search of literature for prospective studies addressing our research question and predicting a range of distress outcomes was conducted. Thirty-nine papers (reporting 36 studies) were subjected to narrative synthesis of the evidence. There was no consistent evidence that demographic, clinical, or social factors reliably predicted longer-term distress. Of the psychological factors examined, only baseline distress (significant in 26 of 30 relevant papers; 24 of 28 studies) and neuroticism (significant in all 5 papers/studies that examined it) consistently predicted longer-term distress. The heterogeneity of included studies, particularly in populations studied and methodology, precluded meta-analytic techniques. This review supports current clinical guidance advising early assessment of distress as a marker of vulnerability to persistent problems. Additionally, neuroticism is also indicated as a useful marker of vulnerability. However, the review also highlights that more sophisticated research designs, capable of identifying the psychological processes that underlie the association between these marker variables and persistent distress, are needed before more effective early interventions can be developed. © 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

  11. Reassuringly calm? Self-reported patterns of responses to reassurance seeking in obsessive compulsive disorder.

    PubMed

    Salkovskis, Paul M; Kobori, Osamu

    2015-12-01

    The perception of threat and associated feelings of anxiety typically prompt people to seek safety; reassurance seeking is an interpersonal strategy almost universally used to reduce the immediate perception of risk. Excessive Reassurance Seeking (ERS) is considered to be particularly prominent and unequivocally counter-productive in people suffering from anxiety disorders in general and OCD in particular, producing short term relief but a longer term return and worsening of the original anxiety. We evaluated the extent and specificity of the effects of ERS in OCD and mechanisms involved in both anxiety relief and the hypothesized later return of anxiety.. Self rated effects of reassurance seeking were investigated in 153 individuals with OCD, 50 with panic disorder, and 52 healthy controls, evaluating reactions to the provision and non-provision of reassurance. Reassurance is associated with short term relief then longer term return of both discomfort and the urge to seek further reassurance in both anxious groups; healthy controls do not experience significant resurgence. Greater return of anxiety and urge to seek more reassurance were associated with higher levels of overall reassurance seeking.. The findings were based on retrospective self-report of naturally occurring episodes of ERS; prospective studies and induced behaviours are now needed. Not only is reassurance a quick fix for people experiencing OCD, but in the absence of treatment the only fix! The findings explain why reassurance seeking continues despite advice that it will worsen anxiety problems. Such advice is potentially harmful to patients and their loved ones.. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Near-Term Actions to Address Long-Term Climate Risk

    NASA Astrophysics Data System (ADS)

    Lempert, R. J.

    2014-12-01

    Addressing climate change requires effective long-term policy making, which occurs when reflecting on potential events decades or more in the future causes policy makers to choose near-term actions different than those they would otherwise pursue. Contrary to some expectations, policy makers do sometimes make such long-term decisions, but not as commonly and successfully as climate change may require. In recent years however, the new capabilities of analytic decision support tools, combined with improved understanding of cognitive and organizational behaviors, has significantly improved the methods available for organizations to manage longer-term climate risks. In particular, these tools allow decision makers to understand what near-term actions consistently contribute to achieving both short- and long-term societal goals, even in the face of deep uncertainty regarding the long-term future. This talk will describe applications of these approaches for infrastructure, water, and flood risk management planning, as well as studies of how near-term choices about policy architectures can affect long-term greenhouse gas emission reduction pathways.

  13. Job satisfaction and short-term sickness absence among Dutch workers.

    PubMed

    Notenbomer, Annette; Roelen, Corné A M; Groothoff, Johan W

    2006-06-01

    Sickness absence is a considerable economic and social problem. Short-term sickness absence is known to be associated with behavioural attitudes. The correlation between sickness absence and job satisfaction has been studied infrequently and with contradictory results. This study investigated the correlation between short-term sickness absence and both global and specific job satisfaction. We defined short-term sickness absence as spells of up to 42 days. A random sample of 898 Dutch workers from a variety of economic sectors and companies received a self-report questionnaire on their first day of sick leave. The questionnaire measured global and specific job satisfaction. In our regression analysis, we controlled for the confounding factors of age, gender, educational level, perceived workload, job autonomy and decision latitude. The duration of an absence spell was defined as the amount of calendar days between sick leave and return to work. Global job satisfaction did not correlate significantly with the duration of short-term sickness absence. While increasing physical job demands predicted longer absence, increasing job autonomy and educational level predicted shorter absence. Satisfaction with colleagues predicted longer duration absence. Global job satisfaction did not correlate with the duration of short-term absence spells, but specific satisfaction with colleagues was associated with longer sickness spells.

  14. Social Norms and Global Environmental Challenges: The Complex Interaction of Behaviors, Values, and Policy

    PubMed Central

    Ehrlich, Paul R.; Alston, Lee J.; Arrow, Kenneth; Barrett, Scott; Buchman, Timothy G.; Daily, Gretchen C.; Levin, Bruce; Levin, Simon; Oppenheimer, Michael; Ostrom, Elinor; Saari, Donald

    2014-01-01

    SUMMARY Government policies are needed when people’s behaviors fail to deliver the public good. Those policies will be most effective if they can stimulate long-term changes in beliefs and norms, creating and reinforcing the behaviors needed to solidify and extend the public good.It is often the short-term acceptability of potential policies, rather than their longer-term efficacy, that determines their scope and deployment. The policy process should consider both time scales. The academy, however, has provided insufficient insight on the coevolution of social norms and different policy instruments, thus compromising the capacity of decision makers to craft effective solutions to the society’s most intractable environmental problems. Life scientists could make fundamental contributions to this agenda through targeted research on the emergence of social norms. PMID:25143635

  15. Effect of macronutrient composition on short-term food intake and weight loss.

    PubMed

    Bellissimo, Nick; Akhavan, Tina

    2015-05-01

    The purpose of this review is to describe the role of macronutrient composition on the suppression of short-term food intake (FI) and weight loss. The effects of macronutrient composition on short-term FI will be reviewed first, followed by a brief examination of longer-term clinical trials that vary in effects of dietary macronutrient composition on weight loss. The objectives were: 1) to examine the effect of macronutrient composition on the suppression of short-term FI, 2) to determine whether some macronutrient sources suppress FI beyond their provision of energy, 3) to assess the combined effects of macronutrients on FI and glycemic response, and 4) to determine whether knowledge of the effect of macronutrients on short-term FI has led to greater success in spontaneous weight loss, adherence to energy-restricted diets, and better weight maintenance after weight loss. Although knowledge of macronutrient composition on short-term FI regulation has advanced our understanding of the role of diet composition on energy balance, it has yet to lead to greater success in long-term weight loss and weight maintenance. It is clear from this review that many approaches based on manipulating dietary macronutrient composition can help people lose weight as long as they follow the diets. However, only by evaluating the interaction between the physiologic systems that govern FI and body weight may the benefits of dietary macronutrient composition be fully realized. © 2015 American Society for Nutrition.

  16. Short-term plasticity in auditory cognition.

    PubMed

    Jääskeläinen, Iiro P; Ahveninen, Jyrki; Belliveau, John W; Raij, Tommi; Sams, Mikko

    2007-12-01

    Converging lines of evidence suggest that auditory system short-term plasticity can enable several perceptual and cognitive functions that have been previously considered as relatively distinct phenomena. Here we review recent findings suggesting that auditory stimulation, auditory selective attention and cross-modal effects of visual stimulation each cause transient excitatory and (surround) inhibitory modulations in the auditory cortex. These modulations might adaptively tune hierarchically organized sound feature maps of the auditory cortex (e.g. tonotopy), thus filtering relevant sounds during rapidly changing environmental and task demands. This could support auditory sensory memory, pre-attentive detection of sound novelty, enhanced perception during selective attention, influence of visual processing on auditory perception and longer-term plastic changes associated with perceptual learning.

  17. Rehabilitation in Guillian Barre syndrome.

    PubMed

    Khan, Fary

    2004-12-01

    Guillian Barre syndrome (GBS) is the most common form of neuromuscular paralysis. It mostly affects young people and can cause long-term residual disability. This article outlines the rehabilitation treatment for patients recovering from GBS. Recovery from GBS can be prolonged. Early rehabilitation intervention ensures medical stability, appropriate treatment and preventive measures to minimise long term complications. Specific problems include deep venous thrombosis prevention, complications of immobility, dysautonomia, de-afferent pain syndromes, muscle pain and fatigue. Longer-term issues include psychosocial adjustment, return to work and driving, and resumption of the role within the family and community. Effective communication between the GP and rehabilitation physicians is imperative for improved functional outcomes and successful social reintegration.

  18. Cognitive therapy and exposure therapy for hypochondriasis (health anxiety): A 3-year naturalistic follow-up.

    PubMed

    Weck, Florian; Nagel, Laura Carlotta; Höfling, Volkmar; Neng, Julia M B

    2017-10-01

    Cognitive-behavioral therapy (CBT) has been shown to be effective in treating hypochondriasis. However, there are doubts regarding the long-term effectiveness of CBT for hypochondriasis, in particular for follow-up periods longer than 1 year. The aim of the present study was to evaluate the long-term effectiveness of cognitive therapy (CT) and exposure therapy (ET) for the treatment of hypochondriasis. Seventy-five patients with a diagnosis of hypochondriasis who were previously treated with CT or ET were contacted 3 years after treatment. Fifty (67%) patients participated and were interviewed by an independent and blinded diagnostician using standardized interviews. We found further improvements after therapy in primary outcome measures (d = .37), general functioning (d = .38), and reduced doctor visits (d = .30) during the naturalistic follow-up period. At the 3-year follow-up, 72% of the patients no longer fulfilled the diagnosis of hypochondriasis. Based on the main outcome measure, we found response rates of 76% and remission rates of 68%. At follow-up, only 4% of patients were taking antidepressant medication. Additional psychological treatment was utilized by 18% of the patients during the follow-up period (only 8% because of health anxiety). We found no overall differences between CT and ET. Only a trend for a greater deterioration rate in CT (13%) in comparison to ET (0%) was found. Our results suggest that ⅔ of the patients with hypochondriasis were remitted in the long term. Thus, remission rates after CBT were twice as high as in untreated samples. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Satisfaction with support versus size of network: differential effects of social support on psychological distress in parents of pediatric cancer patients.

    PubMed

    Harper, Felicity W K; Peterson, Amy M; Albrecht, Terrance L; Taub, Jeffrey W; Phipps, Sean; Penner, Louis A

    2016-05-01

    This study examined the direct and buffering effects of social support on longer-term global psychological distress among parents coping with pediatric cancer. In both sets of analyses, we examined whether these effects depended on the dimension of social support provided (i.e., satisfaction with support versus size of support network). Participants were 102 parents of pediatric cancer patients. At study entry, parents reported their trait anxiety, depression, and two dimensions of their social support network (satisfaction with support and size of support network). Parents subsequently reported their psychological distress in 3- and 9-month follow-up assessments. Parents' satisfaction with support had a direct effect on longer-term psychological distress; satisfaction was negatively associated with distress at both follow-ups. In contrast, size of support network buffered (moderated) the impact of trait anxiety and depression on later distress. Parents with smaller support networks and higher levels of trait anxiety and depression at baseline had higher levels of psychological distress at both follow-ups; for parents with larger support networks, there was no relationship. Social support can attenuate psychological distress in parents coping with pediatric cancer; however, the nature of the effect depends on the dimension of support. Whereas interventions that focus on increasing satisfaction with social support may benefit all parents, at-risk parents will likely benefit from interventions that ensure they have an adequate number of support resources. Copyright © 2015 John Wiley & Sons, Ltd.

  20. Satisfaction with support versus size of network: Differential effects of social support on psychological distress in parents of pediatric cancer patients

    PubMed Central

    Harper, Felicity W. K.; Peterson, Amy M.; Albrecht, Terrance L.; Taub, Jeffrey W.; Phipps, Sean; Penner, Louis A.

    2016-01-01

    Objective This study examined the direct and the buffering effects of social support on longer-term global psychological distress among parents coping with pediatric cancer. In both sets of analyses we examined whether these effects depended on the dimension of social support provided (i.e., satisfaction with support versus size of support network). Method Participants were 102 parents of pediatric cancer patients. At study entry, parents reported their trait anxiety, depression, and two dimensions of their social support network (satisfaction with support and size of support network). Parents subsequently reported their psychological distress in 3- and 9-month follow-up assessments. Results Parents’ satisfaction with support had a direct effect on longer-term psychological distress; satisfaction was negatively associated with distress at both follow-ups. In contrast, size of support network buffered (moderated) the impact of trait anxiety and depression on later distress. Parents with smaller support networks and higher levels of trait anxiety and depression at baseline had higher levels of psychological distress at both follow-ups; for parents with larger support networks, there was no relationship. Conclusion Social support can attenuate psychological distress in parents coping with pediatric cancer; however, the nature of the effect depends on the dimension of support. Whereas, interventions that focus on increasing satisfaction with social support may benefit all parents, at-risk parents will likely benefit from interventions that ensure they have an adequate number of support resources. PMID:27092714

  1. Alcoholics Anonymous and Reduced Impulsivity: A Novel Mechanism of Change

    PubMed Central

    Blonigen, Daniel M.; Timko, Christine; Moos, Rudolf H.

    2012-01-01

    Reduced impulsivity is a novel, yet plausible, mechanism of change associated with the salutary effects of Alcoholics Anonymous (AA). Here, we review our work on links between AA attendance and reduced impulsivity using a 16-year prospective study of men and women with alcohol use disorders (AUD) who were initially untreated for their drinking problems. Across the study period, there were significant mean-level decreases in impulsivity, and longer AA duration was associated with reductions in impulsivity. In turn, decreases in impulsivity from baseline to Year 1 were associated with fewer legal problems and better drinking and psychosocial outcomes at Year 1, and better psychosocial functioning at Year 8. Decreases in impulsivity mediated associations between longer AA duration and improvements on several Year 1 outcomes, with the indirect effects conditional on participants’ age. Findings are discussed in terms of their potential implications for research on AA and, more broadly, interventions for individuals with AUD. PMID:23327499

  2. Head and Eye Movements Affect Object Processing in 4-Month-Old Infants More than an Artificial Orientation Cue

    ERIC Educational Resources Information Center

    Wahl, Sebastian; Michel, Christine; Pauen, Sabina; Hoehl, Stefanie

    2013-01-01

    This study investigates the effects of attention-guiding stimuli on 4-month-old infants' object processing. In the human head condition, infants saw a person turning her head and eye gaze towards or away from objects. When presented with the objects again, infants showed increased attention in terms of longer looking time measured by eye…

  3. Sustained impact of the "Healthy Habits, Healthy Girls – Brazil" school-based randomized controlled trial for adolescents living in low-income communities

    USDA-ARS?s Scientific Manuscript database

    Pediatric obesity is a major public health concern in low- and middle-income countries, such as Brazil. There is an urgent need for preventive programs for adolescents and, the assessment of their sustained impact. This paper reports the longer-term (6-month post intervention) effects of the "H3G-Br...

  4. "Short Courses Shouldn't Be Short-Lived!" Enhancing Longer-Term Impact of Short English as a Foreign Language INSET Initiatives in China

    ERIC Educational Resources Information Center

    Yan, Chunmei; He, Chuanjun

    2015-01-01

    Short in-service teacher development (INSET) programmes have been globally used as a form of teacher development, but their impact has been under question. This study sought to examine teacher participants' perceptions of short INSET programmes to come up with better solutions to enhancing their effect on teachers' professional learning. A…

  5. Study protocol: The Improving Care of Acute Lung Injury Patients (ICAP) study

    PubMed Central

    Needham, Dale M; Dennison, Cheryl R; Dowdy, David W; Mendez-Tellez, Pedro A; Ciesla, Nancy; Desai, Sanjay V; Sevransky, Jonathan; Shanholtz, Carl; Scharfstein, Daniel; Herridge, Margaret S; Pronovost, Peter J

    2006-01-01

    Introduction The short-term mortality benefit of lower tidal volume ventilation (LTVV) for patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) has been demonstrated in a large, multi-center randomized trial. However, the impact of LTVV and other critical care therapies on the longer-term outcomes of ALI/ARDS survivors remains uncertain. The Improving Care of ALI Patients (ICAP) study is a multi-site, prospective cohort study that aims to evaluate the longer-term outcomes of ALI/ARDS survivors with a particular focus on the effect of LTVV and other critical care therapies. Methods Consecutive mechanically ventilated ALI/ARDS patients from 11 intensive care units (ICUs) at four hospitals in the city of Baltimore, MD, USA, will be enrolled in a prospective cohort study. Exposures (patient-based, clinical management, and ICU organizational) will be comprehensively collected both at baseline and throughout patients' ICU stay. Outcomes, including mortality, organ impairment, functional status, and quality of life, will be assessed with the use of standardized surveys and testing at 3, 6, 12, and 24 months after ALI/ARDS diagnosis. A multi-faceted retention strategy will be used to minimize participant loss to follow-up. Results On the basis of the historical incidence of ALI/ARDS at the study sites, we expect to enroll 520 patients over two years. This projected sample size is more than double that of any published study of long-term outcomes in ALI/ARDS survivors, providing 86% power to detect a relative mortality hazard of 0.70 in patients receiving higher versus lower exposure to LTVV. The projected sample size also provides sufficient power to evaluate the association between a variety of other exposure and outcome variables, including quality of life. Conclusion The ICAP study is a novel, prospective cohort study that will build on previous critical care research to improve our understanding of the longer-term impact of ALI/ARDS, LTVV and other aspects of critical care management. Given the paucity of information about the impact of interventions on long-term outcomes for survivors of critical illness, this study can provide important information to inform clinical practice. PMID:16420652

  6. Effects of remedial grouting on the ground-water flow system at Red Rock Dam near Pella, Iowa

    USGS Publications Warehouse

    Linhart, S. Mike; Schaap, Bryan D.

    2001-01-01

    Hydrographs, statistical analysis of waterlevel data, and water-chemistry data suggest that underseepage on the northeast side of the dam has been reduced but not completely eliminated. Some areas appear to have been affected to a greater degree and for a longer period of time than other areas. Future monitoring of water levels, water chemistry, and stable isotopes can aid in the evaluation of the long-term effectiveness of remedial grouting.

  7. Demonstration Assessment of Light-Emitting Diode (LED) Roadway Lighting, I-35W Bridge, Minneapolis, Minnesota, Phase II Report

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

    Kinzey, B. R.; Davis, R. G.

    2014-09-30

    On the I-35W Bridge in Minneapolis, Minnesota, the GATEWAY program conducted a two-phase demonstration of LED roadway lighting on the main span, which is one of the country's oldest continuously operated exterior LED lighting installations. The Phase II report documents longer-term performance of the LED lighting system that was installed in 2008, and is the first report on the longer-term performance of LED lighting in the field.

  8. NASA earth science and applications division: The program and plans for FY 1988-1989-1990

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Described here are the Division's research goals, priorities and emphases for the next several years and an outline of longer term plans. Included are highlights of recent accomplishments, current activities in FY 1988, research emphases in FY 1989, and longer term future plans. Data and information systems, the Geodynamics Program, the Land Processes Program, the Oceanic Processes Program, the Atmospheric Dynamics and Radiation Program, the Atmospheric Chemistry Program, and space flight programs are among the topic covered.

  9. Short-term sleep deprivation reinstates memory retrieval in mice: the role of corticosterone secretion.

    PubMed

    Takatsu-Coleman, André L; Zanin, Karina A; Patti, Camilla L; Zager, Adriano; Lopes-Silva, Leonardo B; Longo, Beatriz M; Tufik, Sergio; Andersen, Monica L; Frussa-Filho, Roberto

    2013-10-01

    While the effects of sleep deprivation (SD) on the acquisition and consolidation phases of memory have been extensively characterized, its effects on memory retrieval remain overlooked. SD alone is a stressor, and stress-activated glucocorticoids promote bimodal effects on memory. Because we have recently demonstrated that 72h SD impairs memory retrieval in the plus-maze discriminative avoidance task (PM-DAT) in mice, this study investigated whether shorter SD periods would facilitate retrieval. In Experiment I, the temporal forgetting curve of the PM-DAT was determined and an interval between training/testing in which retrieval was no longer present was used in all subsequent experiments. In Experiments II and III, retrieval performance and corticosterone concentration, respectively, were quantified in mice that were sleep deprived for 12 or 24h before testing. In Experiments IV and V, the effects of the corticosterone synthesis inhibitor metyrapone were evaluated on 12h SD-induced retrieval reinstatement and corticosterone concentration enhancement, respectively. Experiment VI determined whether pre-test acute administration of exogenous corticosterone would mimic the facilitatory effects of 12h SD on retrieval. Thirty days after training, mice presented poor performance of the task; however, SD for 12h (but not for 24) before testing reinstated memory retrieval. This facilitatory effect was accompanied by increased corticosterone concentration, abolished by metyrapone, and mimicked by pre-test acute corticosterone administration. Collectively, short-term SD can facilitate memory retrieval by enhancing corticosterone secretion. This facilitatory effect is abolished by longer periods of SD. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Tree-ring-based estimates of long-term seasonal precipitation in the Souris River Region of Saskatchewan, North Dakota and Manitoba

    USGS Publications Warehouse

    Ryberg, Karen R.; Vecchia, Aldo V.; Akyüz, F. Adnan; Lin, Wei

    2016-01-01

    Historically unprecedented flooding occurred in the Souris River Basin of Saskatchewan, North Dakota and Manitoba in 2011, during a longer term period of wet conditions in the basin. In order to develop a model of future flows, there is a need to evaluate effects of past multidecadal climate variability and/or possible climate change on precipitation. In this study, tree-ring chronologies and historical precipitation data in a four-degree buffer around the Souris River Basin were analyzed to develop regression models that can be used for predicting long-term variations of precipitation. To focus on longer term variability, 12-year moving average precipitation was modeled in five subregions (determined through cluster analysis of measures of precipitation) of the study area over three seasons (November–February, March–June and July–October). The models used multiresolution decomposition (an additive decomposition based on powers of two using a discrete wavelet transform) of tree-ring chronologies from Canada and the US and seasonal 12-year moving average precipitation based on Adjusted and Homogenized Canadian Climate Data and US Historical Climatology Network data. Results show that precipitation varies on long-term (multidecadal) time scales of 16, 32 and 64 years. Past extended pluvial and drought events, which can vary greatly with season and subregion, were highlighted by the models. Results suggest that the recent wet period may be a part of natural variability on a very long time scale.

  11. Neuromodulation directed at the prefrontal cortex of subjects with obesity reduces snack food intake and hunger in a randomized trial.

    PubMed

    Heinitz, Sascha; Reinhardt, Martin; Piaggi, Paolo; Weise, Christopher M; Diaz, Enrique; Stinson, Emma J; Venti, Colleen; Votruba, Susanne B; Wassermann, Eric M; Alonso-Alonso, Miguel; Krakoff, Jonathan; Gluck, Marci E

    2017-12-01

    Background: Obesity is associated with reduced activation in the left dorsolateral prefrontal cortex (DLPFC), a region of the brain that plays a key role in the support of self-regulatory aspects of eating behavior and inhibitory control. Transcranial direct current stimulation (tDCS) is a noninvasive technique used to modulate brain activity. Objectives: We tested whether repeated anodal tDCS targeted at the left DLPFC (compared with sham tDCS) has an immediate effect on eating behavior during ad libitum food intake, resulting in weight change, and whether it might influence longer-term food intake-related appetite ratings in individuals with obesity. Design: In a randomized parallel-design study combining inpatient and outpatient assessments over 31 d, 23 individuals with obesity [12 men; mean ± SD body mass index (BMI; in kg/m 2 ): 39.3 ± 8.42] received 15 sessions of anodal (i.e., enhancing cortical activity) or sham tDCS aimed at the left DLPFC. Ad libitum food intake was assessed through the use of a vending machine paradigm and snack food taste tests (SFTTs). Appetite was evaluated with a visual analog scale (VAS). Body weight was measured. We examined the effect of short-term (i.e., 3 sessions) and long-term (i.e., 15 sessions) tDCS on these variables. Results: Relative to sham tDCS, short-term anodal tDCS did not influence ad libitum intake of food from the vending machines. Accordingly, no effect on short-term or 4-wk weight change was observed. In the anodal tDCS group, compared with the sham group, VAS ratings for hunger and the urge to eat declined significantly more ( P = 0.01 and P = 0.05, respectively), and total energy intake during an SFTT was relatively lower in satiated individuals ( P = 0.01), after long-term tDCS. Conclusions: Short-term anodal tDCS of the left DLPFC did not have an immediate effect on ad libitum food intake or thereby weight change, relative to sham tDCS. Hunger and snack food intake were reduced only after a longer period of anodal tDCS in individuals with obesity. This trial was registered at clinicaltrials.gov as NCT00739362. © 2017 American Society for Nutrition.

  12. Use of outsourced nurses in long-term acute care hospitals: outcomes and leadership preferences.

    PubMed

    Alvarez, M Raymond; Kerr, Bernard J; Burtner, Joan; Ledlow, Gerald; Fulton, Larry V

    2011-02-01

    When staffing effectiveness is not maintained over time, the likelihood of negative outcomes increases. This challenge is particularly problematic in long-term acute care hospitals (LTACHs) where use of outsourced temporary nurses is common when providing safe, sufficient care to medically complex patients who require longer hospital stays than normally would occur. To assess this issue, the authors discuss the outcomes of their survey of LTACH chief nursing officers that demonstrated LTACH quality indicators and overall patient satisfaction were within nationally accepted benchmarks even with higher levels of outsourced nurses used in this post-acute care setting.

  13. Pregnancy and alcohol use: evidence and recommendations for prenatal care.

    PubMed

    Bailey, Beth A; Sokol, Robert J

    2008-06-01

    Pregnancy alcohol consumption has been linked to poor birth outcomes and long-term developmental problems. Despite this, a significant number of women drink during pregnancy. Although most prenatal care providers are asking women about alcohol use, validated screening tools are infrequently employed. Research has demonstrated that currently available screening methods and intervention techniques are effective in identifying and reducing pregnancy drinking. Implementing universal screening and appropriate intervention for pregnancy alcohol use should be a priority for prenatal care providers, as these efforts could substantially improve pregnancy, birth, and longer term developmental outcomes for those affected.

  14. Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies.

    PubMed

    Wray, Faye; Clarke, David

    2017-10-06

    To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Systematic review and thematic synthesis. We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such approaches must be designed to help survivors to manage the unique psychosocial consequences of poststroke communication difficulties. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Long-Term Outcomes of Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder.

    PubMed

    Krebs, Georgina; de la Cruz, Lorena Fernández; Monzani, Benedetta; Bowyer, Laura; Anson, Martin; Cadman, Jacinda; Heyman, Isobel; Turner, Cynthia; Veale, David; Mataix-Cols, David

    2017-07-01

    Emerging evidence suggests that cognitive-behavioral therapy (CBT) is an efficacious treatment for adolescent body dysmorphic disorder (BDD) in the short term, but longer-term outcomes remain unknown. The current study aimed to follow up a group of adolescents who had originally participated in a randomized controlled trial of CBT for BDD to determine whether treatment gains were maintained. Twenty-six adolescents (mean age = 16.2, SD = 1.6) with a primary diagnosis of BDD received a course of developmentally tailored CBT and were followed up over 12 months. Participants were assessed at baseline, midtreatment, posttreatment, 2-, 6-, and 12-month follow-up. The primary outcome measure was the clinician-rated Yale-Brown Obsessive-Compulsive Scale Modified for BDD. Secondary outcomes included measures of insight, depression, quality of life, and global functioning. BDD symptoms decreased significantly from pre- to posttreatment and remained stable over the 12-month follow-up. At this time point, 50% of participants were classified as responders and 23% as remitters. Participants remained significantly improved on all secondary outcomes at 12-month follow-up. Neither baseline insight nor baseline depression predicted long-term outcomes. The positive effects of CBT appear to be durable up to 12-month follow-up. However, the majority of patients remained symptomatic and vulnerable to a range of risks at 12-month follow-up, indicating that longer-term monitoring is advisable in this population. Future research should focus on enhancing the efficacy of CBT in order to improve long-term outcomes. Copyright © 2017. Published by Elsevier Ltd.

  16. Child health in Syria: recognising the lasting effects of warfare on health.

    PubMed

    Devakumar, Delan; Birch, Marion; Rubenstein, Leonard S; Osrin, David; Sondorp, Egbert; Wells, Jonathan C K

    2015-01-01

    The war in Syria, now in its fourth year, is one of the bloodiest in recent times. The legacy of war includes damage to the health of children that can last for decades and affect future generations. In this article we discuss the effects of the war on Syria's children, highlighting the less documented longer-term effects. In addition to their present suffering, these children, and their own children, are likely to face further challenges as a result of the current conflict. This is essential to understand both for effective interventions and for ethical reasons.

  17. Positive interventions: An emotion regulation perspective.

    PubMed

    Quoidbach, Jordi; Mikolajczak, Moïra; Gross, James J

    2015-05-01

    The rapid growth of the literature on positive interventions to increase "happiness" has suggested the need for an overarching conceptual framework to integrate the many and apparently disparate findings. In this review, we used the process model of emotion regulation (Gross, 1998) to organize the existing literature on positive interventions and to advance theory by clarifying the mechanisms underlying their effectiveness. We have proposed that positive emotions can be increased both in the short- and longer-term through 5 families of emotion regulation strategies (i.e., situation selection, situation modification, attentional deployment, cognitive change, and response modulation), showing how these emotion regulation strategies can be applied before, during, and after positive emotional events. Regarding short-term increases in positive emotions, our review found that attentional deployment, cognitive change, and response modulation strategies have received the most empirical support, whereas more work is needed to establish the effectiveness of situation selection and situation modification strategies. Regarding longer-term increases in positive emotions, strategies such as situation selection during an event and attentional deployment before, during, and after an event have received strong empirical support and are at the center of many positive interventions. However, more work is needed to establish the specific benefits of the other strategies, especially situation modification. We argue that our emotion regulation framework clarifies existing interventions and points the way for new interventions that might be used to increase positive emotions in both nonclinical and clinical populations. (c) 2015 APA, all rights reserved).

  18. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants.

    PubMed

    Gridneva, Zoya; Kugananthan, Sambavi; Hepworth, Anna R; Tie, Wan J; Lai, Ching T; Ward, Leigh C; Hartmann, Peter E; Geddes, Donna T

    2016-12-28

    Human milk (HM) components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE), a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants ( n = 41, 2 and/or 5 mo). Stomach volumes (SV) were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV) was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (-0.07 [-0.10, -0.03], p < 0.001) GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001), and longer GE times (0.24 [0.03, 0.46], p = 0.033). Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023). Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002) and dose (0.02 [0.01, 0.03], p = 0.005), and lower casein:whey ratio (-65.89 [-107.13, -2.66], p = 0.003). FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.

  19. Focusing on Short-Term Achievement Gains Fails to Produce Long-Term Gains

    ERIC Educational Resources Information Center

    Grissmer, David W.; Ober, David R.; Beekman, John A.

    2014-01-01

    The short-term emphasis engendered by No Child Left Behind (NCLB) has focused research predominantly on unraveling the complexities and uncertainties in assessing short-term results, rather than developing methods and assessing results over the longer term. In this paper we focus on estimating long-term gains and address questions important to…

  20. Toxicopathological Effects of the Sunscreen UV Filter, Oxybenzone (Benzophenone-3), on Coral Planulae and Cultured Primary Cells and Its Environmental Contamination in Hawaii and the U.S. Virgin Islands.

    PubMed

    Downs, C A; Kramarsky-Winter, Esti; Segal, Roee; Fauth, John; Knutson, Sean; Bronstein, Omri; Ciner, Frederic R; Jeger, Rina; Lichtenfeld, Yona; Woodley, Cheryl M; Pennington, Paul; Cadenas, Kelli; Kushmaro, Ariel; Loya, Yossi

    2016-02-01

    Toxicity persistence to the nontarget amphipod Hyalella curvispina in runoff events following chlorpyrifos applications to soy experimental plots was compared in conventional and no-till management. Two application scenarios were compared: an early-season application with the soil almost bare and a late-season application after the foliage had attained complete soil cover. H. curvispina was exposed to chlorpyrifos using two different test systems: a short-term (48 h) runoff water exposure and a long-term (10 days) soil exposure. Both commonly used crop management practices for soybean production resulted in runoff toxicity following pesticide applications and represent a toxicity risk for adjacent inland waters. Toxicity persistence was longer after the earlier than the late season application, likely because of higher volatilization and photodecomposition losses from the soy canopy than from the soil. For the early-season application, toxicity persisted longer in the no-till plots than in the conventional tillage plots. Suspended matter was higher in the conventional treatment. Chlorpyrifos sorption to suspended matter likely contributed to the shorter persistence. For the late-season application, toxicity persisted longer in the conventional treatment. The causes remain conjectural. The soil organic carbon content was higher in the no-till treatment. Sorption to organic matter might have contributed to the shorter chlorpyrifos toxicity persistence in no-till management. Late applications are more frequent and prevail longer throughout the soy growing season. Overall, the no-till management practice seems preferably because shorter toxicity persistence in runoff represents a lower environmental risk for the adjacent inland waters.

  1. Conflict in Somalia: impact on child undernutrition

    PubMed Central

    Kinyoki, Damaris K; Moloney, Grainne M; Uthman, Olalekan A; Kandala, Ngianga-Bakwin; Odundo, Elijah O; Noor, Abdisalan M; Berkley, James A

    2017-01-01

    Introduction In Somalia, protracted conflict and drought have caused population displacement and livelihood destruction. There is also widespread childhood undernutrition. We aimed to determine the independent effects of conflict on wasting and stunting among children aged 6–59 months nationwide in Somalia. Methods Data were from household surveys during 2007–2010, including 73 778 children in 1066 clusters, the Armed Conflict Location and Event Data project database and remote sensing. We used Bayesian hierarchical spatial-temporal regression to examine the effects of conflict on wasting and stunting. Models included individual, household and environmental covariates and recent (<3 months) or longer term (3–12 months) conflict events. Results 15 355 (21%) and 22 739 (31%) observations were from wasted and stunted children, respectively. The conflict was associated with undernutrition independently of the individual, household and environmental factors, and its inclusion improved model performance. Recent conflict was associated with wasting (OR 1.37, 95% credible interval (CrI): (1.33, 1.42) and attributable fraction (AF) 7.6%)) and stunting (OR 1.21, 95% CrI (1.15, 1.28), AF 6.9%). Longer term conflict had greater effects on wasting (OR 1.76, 95% CrI (1.71, 1.81), AF 6.0%) and stunting (OR 1.88, 95% CrI = (1.83, 1.94), AF 7.4%). After controlling for conflict, the harmful effect of internal displacement and protective effects of rainfall and vegetation cover on undernutrition were enhanced. Conclusion Conflict and internal displacement have large effects on undernutrition in ways not fully captured by simply measuring individual, household and environmental factors or drought. PMID:28966793

  2. Neuropeptide Trefoil factor 3 improves learning and retention of novel object recognition memory in mice.

    PubMed

    Shi, Hai-Shui; Yin, Xi; Song, Li; Guo, Qing-Jun; Luo, Xiang-Heng

    2012-02-01

    Accumulating evidence has implicated neuropeptides in modulating recognition, learning and memory. However, to date, no study has investigated the effects of neuropeptide Trefoil factor 3 (TFF3) on the process of learning and memory. In the present study, we evaluated the acute effects of TFF3 administration (0.1 and 0.5mg/kg, i.p.) on the acquisition and retention of object recognition memory in mice. We found that TFF3 administration significantly enhanced both short-term and long-term memory during the retention test, conducted 90 min and 24h after training respectively. Remarkably, acute TFF3 administration transformed a learning event that would not normally result in long-term memory into an event retained for a long-term period and produced no effect on locomotor activity in mice. In conclusion, the present results provide an important role of TFF3 in improving object recognition memory and reserving it for a longer time, which suggests a potential therapeutic application for diseases with recognition and memory impairment. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Long-Term In Vitro Degradation of a High-Strength Brushite Cement in Water, PBS, and Serum Solution

    PubMed Central

    Ajaxon, Ingrid; Öhman, Caroline; Persson, Cecilia

    2015-01-01

    Bone loss and fractures may call for the use of bone substituting materials, such as calcium phosphate cements (CPCs). CPCs can be degradable, and, to determine their limitations in terms of applications, their mechanical as well as chemical properties need to be evaluated over longer periods of time, under physiological conditions. However, there is lack of data on how the in vitro degradation affects high-strength brushite CPCs over longer periods of time, that is, longer than it takes for a bone fracture to heal. This study aimed at evaluating the long-term in vitro degradation properties of a high-strength brushite CPC in three different solutions: water, phosphate buffered saline, and a serum solution. Microcomputed tomography was used to evaluate the degradation nondestructively, complemented with gravimetric analysis. The compressive strength, chemical composition, and microstructure were also evaluated. Major changes from 10 weeks onwards were seen, in terms of formation of a porous outer layer of octacalcium phosphate on the specimens with a concomitant change in phase composition, increased porosity, decrease in object volume, and mechanical properties. This study illustrates the importance of long-term evaluation of similar cement compositions to be able to predict the material's physical changes over a relevant time frame. PMID:26587540

  4. Male urethral strictures and their management

    PubMed Central

    Hampson, Lindsay A.; McAninch, Jack W.; Breyer, Benjamin N.

    2014-01-01

    Male urethral stricture disease is prevalent and has a substantial impact on quality of life and health-care costs. Management of urethral strictures is complex and depends on the characteristics of the stricture. Data show that there is no difference between urethral dilation and internal urethrotomy in terms of long-term outcomes; success rates range widely from 8–80%, with long-term success rates of 20–30%. For both of these procedures, the risk of recurrence is greater for men with longer strictures, penile urethral strictures, multiple strictures, presence of infection, or history of prior procedures. Analysis has shown that repeated use of urethrotomy is not clinically effective or cost-effective in these patients. Long-term success rates are higher for surgical reconstruction with urethroplasty, with most studies showing success rates of 85–90%. Many techniques have been utilized for urethroplasty, depending on the location, length, and character of the stricture. Successful management of urethral strictures requires detailed knowledge of anatomy, pathophysiology, proper patient selection, and reconstructive techniques. PMID:24346008

  5. Cost-Effectiveness of Percutaneous Closure of the Left Atrial Appendage in Atrial Fibrillation Based on Results from PROTECT AF vs. PREVAIL

    PubMed Central

    Freeman, James V.; Hutton, David W.; Barnes, Geoffrey D.; Zhu, Ruo P.; Owens, Douglas K.; Garber, Alan M.; Go, Alan S.; Hlatky, Mark A.; Heidenreich, Paul A.; Wang, Paul J.; Al-Ahmad, Amin; Turakhia, Mintu P.

    2016-01-01

    Background Randomized trials of left atrial appendage (LAA) closure with the Watchman device have shown varying results, and its cost-effectiveness compared to anticoagulation has not been evaluated using all available contemporary trial data. Methods and Results We used a Markov decision model to estimate lifetime quality-adjusted survival, costs, and cost-effectiveness of LAA closure with Watchman, compared directly with warfarin and indirectly with dabigatran, using data from the long-term (mean 3.8 year) follow-up of PROTECT AF and PREVAIL randomized trials. Using data from PROTECT AF, the incremental cost-effectiveness ratios (ICER) compared to warfarin and dabigatran were $20,486 and $23,422 per quality adjusted life year (QALY), respectively. Using data from PREVAIL, LAA closure was dominated by warfarin and dabigatran, meaning that it was less effective (8.44, 8.54, and 8.59 QALYs, respectively) and more costly. At a willingness-to-pay-threshold of $50,000 per QALY, LAA closure was cost-effective 90% and 9% of the time under PROTECT AF and PREVAIL assumptions, respectively. These results were sensitive to the rates of ischemic stroke and intracranial hemorrhage for LAA closure and medical anticoagulation. Conclusions Using data from the PROTECT AF trial, LAA closure with the Watchman device was cost-effective; using PREVAIL trial data, Watchman was more costly and less effective than warfarin and dabigatran. PROTECT AF enrolled more patients and has substantially longer follow-up time, allowing greater statistical certainty with the cost-effectiveness results. However, longer term trial results and post-marketing surveillance of major adverse events will be vital to determining the value of the Watchman in clinical practice. PMID:27307517

  6. Long-term MBR performance of polymeric membrane modified with Bismuth-BAL chelate (BisBAL).

    PubMed

    Turken, Turker; Kose-Mutlu, Borte; Okatan, Selin; Durmaz, Gamze; Guclu, Mehmet C; Guclu, Serkan; Ovez, Suleyman; Koyuncu, Ismail

    2018-02-15

    An ultrafiltration membrane prepared by polyethersulfone (PES) was modified with Bismuth-BAL chelate (BisBAL) and was used in submerged membrane bioreactor system. Moreover, a control membrane reactor was also tasked to evaluate the effect of BisBAL on the membrane performance. The flux profile, transmembrane pressure, the effect of chemical treatment, cake layer formation, anti-fouling properties against extracellular polymeric substances (EPS) and soluble microbial products (SMP) were studied. The UF modified membrane demonstrated a sustained permeability, low cleaning frequency, and longer filtration time. In terms of anti-EPS and SMP accumulation, the modified membrane showed a lower membrane resistance. It can be illustrated from scanning electron microscopy and confocal laser scanning microscope images that the modified membrane had presented better properties than bare PES membrane, as it was looser and thinner. Thus, the UF membrane proved to be more efficient in terms of permeability and lifetime.

  7. Soil Dissolved Organic Carbon Fluxes are Controlled by both Precipitation and Longer-Term Climate Effects on Boreal Forest Ecosystems

    NASA Astrophysics Data System (ADS)

    Hotchkiss, E. R.; Ziegler, S. E.; Edwards, K. A.; Bowering, K.

    2017-12-01

    Water acts as a control on the cycling of organic carbon (OC). Forest productivity responses to climate change are linked to water availability while water residence time is a major control on OC loss in aquatic ecosystems. However, controls on the export of terrestrial OC to the aquatic environment remains poorly understood. Transport of dissolved OC (DOC) through soils both vertically to deeper soil horizons and into aquatic systems is a key flux of terrestrial OC, but the climate drivers controlling OC mobilized from soils is poorly understood. We installed zero-tension lysimeters across similar balsam fir forest sites within three regions that span a MAT gradient of 5.2˚C and MAP of 1050-1500 mm. Using soil water collected over all seasons for four years we tested whether a warmer and wetter climate promotes greater DOC fluxes in ecosystems experiencing relatively high precipitation. Variability within and between years was compared to that observed across climates to test the sensitivity of this flux to shorter relative to longer-term climate effects on this flux. The warmest and wettest southern site exhibited the greatest annual DOC flux (25 to 28 g C m-2 y-1) in contrast to the most northern site (8 to 10 g C m -2 y-1). This flux represented 10% of litterfall C inputs across sites and surpassed the DOC export from associated forested headwater streams (1 to 16 g C m-2 y-1) suggesting terrestrial to aquatic interface processing. Historical climate and increased soil C inputs explain the greater DOC flux in the southern region. Even in years with comparable annual precipitation among regions the DOC flux differed by climate region. Furthermore, neither quantity nor form of precipitation could explain inter-annual differences in DOC flux within each region. Region specific relationships between precipitation and soil water flux instead suggest historical climate effects may impact soil water transport efficiency thereby controlling the regional variation in the DOC flux. As these forests are exposed to a warmer and wetter climate, DOC transport from organic soils will likely increase. Although precipitation changes will impact this C flux, longer-term climate effects impacting soil inputs, composition and structure of these forests will play an important role in controlling DOC transport in a warmer and wetter future.

  8. Time to Confront Willis's Lads with a Ballet Class? A Case Study of Educational Orthodoxy and White Working-Class Boys

    ERIC Educational Resources Information Center

    Ashley, Martin

    2009-01-01

    This is a retrospective study tracing the longer term effects on identity and aspiration of white working-class boys from an area of high social deprivation. The boys were members of an acclaimed boys' dance company and have been retrospectively interviewed as young men in their twenties. Documentary and film material dating from the time they…

  9. A Comparative and Developmental Study of the Effects of Desegregation in Selected Public Schools. Final Report.

    ERIC Educational Resources Information Center

    Haubrich, Vernon

    This study, conceived of as a follow-up of "Equality of Educational Opportunity," attempted to review longer term aspects of school achievement and to examine comparison data over a period of five to six years. The final sample of cities included three in the South, three in the North and one in the Middle Border region of the country. Over a…

  10. A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems

    PubMed Central

    Taylor, Tatiana L; Killaspy, Helen; Wright, Christine; Turton, Penny; White, Sarah; Kallert, Thomas W; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kališová, Lucie; Onchev, Georgi; Dimitrov, Hristo; Mezzina, Roberto; Wolf, Kinou; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitri; Gonidakis, Fragiskos; Caldas-de-Almeida, José; Cardoso, Graça; King, Michael B

    2009-01-01

    Background A proportion of people with mental health problems require longer term care in a psychiatric or social care institution. However, there are no internationally agreed quality standards for institutional care and no method to assess common care standards across countries. We aimed to identify the key components of institutional care for people with longer term mental health problems and the effectiveness of these components. Methods We undertook a systematic review of the literature using comprehensive search terms in 11 electronic databases and identified 12,182 titles. We viewed 550 abstracts, reviewed 223 papers and included 110 of these. A "critical interpretative synthesis" of the evidence was used to identify domains of institutional care that are key to service users' recovery. Results We identified eight domains of institutional care that were key to service users' recovery: living conditions; interventions for schizophrenia; physical health; restraint and seclusion; staff training and support; therapeutic relationship; autonomy and service user involvement; and clinical governance. Evidence was strongest for specific interventions for the treatment of schizophrenia (family psychoeducation, cognitive behavioural therapy (CBT) and vocational rehabilitation). Conclusion Institutions should, ideally, be community based, operate a flexible regime, maintain a low density of residents and maximise residents' privacy. For service users with a diagnosis of schizophrenia, specific interventions (CBT, family interventions involving psychoeducation, and supported employment) should be provided through integrated programmes. Restraint and seclusion should be avoided wherever possible and staff should have adequate training in de-escalation techniques. Regular staff supervision should be provided and this should support service user involvement in decision making and positive therapeutic relationships between staff and service users. There should be clear lines of clinical governance that ensure adherence to evidence-based guidelines and attention should be paid to service users' physical health through regular screening. PMID:19735562

  11. A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems.

    PubMed

    Taylor, Tatiana L; Killaspy, Helen; Wright, Christine; Turton, Penny; White, Sarah; Kallert, Thomas W; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kalisová, Lucie; Onchev, Georgi; Dimitrov, Hristo; Mezzina, Roberto; Wolf, Kinou; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitri; Gonidakis, Fragiskos; Caldas-de-Almeida, José; Cardoso, Graça; King, Michael B

    2009-09-07

    A proportion of people with mental health problems require longer term care in a psychiatric or social care institution. However, there are no internationally agreed quality standards for institutional care and no method to assess common care standards across countries. We aimed to identify the key components of institutional care for people with longer term mental health problems and the effectiveness of these components. We undertook a systematic review of the literature using comprehensive search terms in 11 electronic databases and identified 12,182 titles. We viewed 550 abstracts, reviewed 223 papers and included 110 of these. A "critical interpretative synthesis" of the evidence was used to identify domains of institutional care that are key to service users' recovery. We identified eight domains of institutional care that were key to service users' recovery: living conditions; interventions for schizophrenia; physical health; restraint and seclusion; staff training and support; therapeutic relationship; autonomy and service user involvement; and clinical governance. Evidence was strongest for specific interventions for the treatment of schizophrenia (family psychoeducation, cognitive behavioural therapy (CBT) and vocational rehabilitation). Institutions should, ideally, be community based, operate a flexible regime, maintain a low density of residents and maximise residents' privacy. For service users with a diagnosis of schizophrenia, specific interventions (CBT, family interventions involving psychoeducation, and supported employment) should be provided through integrated programmes. Restraint and seclusion should be avoided wherever possible and staff should have adequate training in de-escalation techniques. Regular staff supervision should be provided and this should support service user involvement in decision making and positive therapeutic relationships between staff and service users. There should be clear lines of clinical governance that ensure adherence to evidence-based guidelines and attention should be paid to service users' physical health through regular screening.

  12. Physiotherapy and lumbar facet joint injections as a combination treatment for chronic low back pain. A narrative review of lumbar facet joint injections, lumbar spinal mobilizations, soft tissue massage and lower back mobility exercises.

    PubMed

    Chambers, Hannah

    2013-06-01

    The aim of this study was to summarize the available evidence on lumbar facet joint injections and the physiotherapy treatments, land-based lower back mobility exercise, soft tissue massage and lumbar spinal mobilizations for chronic low back pain (CLBP). The plausibility of physiotherapy and lumbar facet joint injections as a combination treatment is discussed. Using a systematic process, an online electronic search was performed using key words utilizing all available databases and hand searching reference lists. Using a critical appraisal tool from the Critical Appraisal Skills Programme (CASP), the literature was screened to include primary research. The main aspects of the research were summarized. The evidence for lumbar facet joint injections suggests an overall short-term positive effect on CLBP. Land-based lower back mobility exercise and soft tissue massage appear to have a positive effect on CLBP in the short term and possibly in the longer term. There is insufficient evidence to draw conclusions for lumbar spinal mobilizations. The review indicates that lumbar facet joint injections create a short period when pain is reduced. Physiotherapy treatments including land-based lower back mobility exercise and soft tissue massage may be of benefit during this time to improve the longer-term outcomes of patients with CLBP. It is not possible to make generalizations or firm conclusions. The current review highlights the need for further research. A randomized controlled trial is recommended to assess the impact of physiotherapy in combination with lumbar facet joint injections on CLBP. Copyright © 2013 John Wiley & Sons, Ltd.

  13. Airmen with mild traumatic brain injury (mTBI) at increased risk for subsequent mishaps.

    PubMed

    Whitehead, Casserly R; Webb, Timothy S; Wells, Timothy S; Hunter, Kari L

    2014-02-01

    Little is known regarding long-term performance decrements associated with mild Traumatic Brain Injury (mTBI). The goal of this study was to determine if individuals with an mTBI may be at increased risk for subsequent mishaps. Cox proportional hazards modeling was utilized to calculate hazard ratios for 518,958 active duty U.S. Air Force service members (Airmen) while controlling for varying lengths of follow-up and potentially confounding variables. Two non-mTBI comparison groups were used; the second being a subset of the original, both without head injuries two years prior to study entrance. Hazard ratios indicate that the causes of increased risk associated with mTBI do not resolve quickly. Additionally, outpatient mTBI injuries do not differ from other outpatient bodily injuries in terms of subsequent injury risk. These findings suggest that increased risk for subsequent mishaps are likely due to differences shared among individuals with any type of injury, including risk-taking behaviors, occupations, and differential participation in sports activities. Therefore, individuals who sustain an mTBI or injury have a long-term risk of additional mishaps. Differences shared among those who seek medical care for injuries may include risk-taking behaviors (Cherpitel, 1999; Turner & McClure, 2004; Turner, McClure, & Pirozzo, 2004), occupations, and differential participation in sports activities, among others. Individuals with an mTBI should be educated that they are at risk for subsequent injury. Historical data supported no lingering effects of mTBI, but more recent data suggest longer lasting effects. This study further adds that one of the longer term sequelae of mTBI may be an increased risk for subsequent mishap. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

  14. [Cost-effectiveness of laparoscopic versus open cholecystectomy].

    PubMed

    Fajardo, Roosevelt; Valenzuela, José Ignacio; Olaya, Sandra Catalina; Quintero, Gustavo; Carrasquilla, Gabriel; Pinzón, Carlos Eduardo; López, Catalina; Ramírez, Juan Camilo

    2011-01-01

    Cholecystectomy has been the subject of several clinical and cost comparison studies. The results of open or laparoscopy cholecystectomy were compared in terms of cost and effectiveness from the perspective of health care institutions and from that of the patients. The cost-effectiveness study was undertaken at two university hospitals in Bogotá, Colombia. The approach was to select the type of cholecystectomy retrospectively and then assess the result prospectively. The cost analysis used the combined approach of micro-costs and daily average cost. Patient resource consumption was gathered from the time of surgery room entry to time of discharge. A sample of 376 patients with cholelithiasis/cystitis (May 2005-June 2006) was selected--156 underwent open cholecystectomy and 220 underwent laparoscopic cholecystectomy. The following data were tabulated: (1) frequency of complications and mortality, post-surgical hospital stay, (2) reincorporation to daily activities, (3) surgery duration, (4) direct medical costs, (5) costs to the patient, and (6) mean and incremental cost-effectiveness ratios. Frequency of complications was 13.5% for open cholecystectomy and 6.4% for laparoscopic cholecystectomy (p=0.02); hospital stay was longer in open cholecystectomy than in laparoscopic cholecystectomy (p=0.003) as well as the reincorporation to daily activities reported by the patients (p<0.001). The duration of open cholecystectomy was 22 min longer than laparoscopic cholecystectomy (p<0.001). The average cost of laparoscopic cholecystectomy was lower than open cholecystectomy and laparoscopic cholecystectomy was more cost-effective than open cholecystectomy (US$ 995 vs. US$ 1,048, respectively). The patient out-of-pocket expenses were greater in open cholecystectomy compared to laparoscopic cholecystectomy (p=0.015). Mortality was zero. The open laparoscopy procedure was associated with longer hospital stays, where as the cholecystectomy procedure required a longer surgical duration. The direct cost of the latter was lower for both for the health care institution and patients. The cost-effectiveness for both procedures was comparable.

  15. Review of magnetic and electric field effects near active faults and volcanoes in the U.S.A.

    USGS Publications Warehouse

    Johnston, M.J.S.

    1989-01-01

    Synchronized measurements of geomagnetic field have been recorded along 800 km of the San Andreas fault and in the Long Valley caldera since 1974, and during eruptions on Mount St. Helens since 1980. For shorter periods of time, continuous measurements of geoelectric field measurements have been made on Mount St. Helens and near the San Andreas fault where moderate seismicity and fault slip frequently occurs. Significant tectonic and volcanic events for which nearby magnetic and electric field data have been obtained include: (1) two moderate earthquakes (ML > 5.8) for which magnetometers were close enough to expect observable signals (about three source lengths), (2) one moderate earthquake (MS 7.3) for which magnetometers were installed as massive fluid outflow occurred during the post-seismic phase, (3) numerous fault creep events and moderate seismicity, (4) a major explosive volcanic eruption and numerous minor extrusive eruptions, and (5) an episode of aseismic uplift. For one of the two earthquakes with ML > 5.8, seismomagnetic effects of -1.3 and -0.3 nT were observed. For this event, magnetometers were optimally located near the epicenter and the observations obtained are consistent with simple seismomagnetic models of the event. Similar models for the other event indicate that the expected seismomagnetic effects are below the signal resolution of the nearest magnetometer. Precursive tectonomagnetic effects were recorded on two independent instruments at distances of 30 and 50 km from a ML 5.2 earthquake. Longer-term changes were recorded in one region in southern California where a moderate ML 5.9 earthquake has since occurred. Surface observations of fault creep events have no associated magnetic or electrical signature above the present measurement precision (0.25 nT and 0.01%, respectively) and are consistent with near-surface fault failure models of these events. Longer-term creep is sometimes associated with corresponding longer-term magnetic field perturbations. Correlated changes in gravity, magnetic field, areal strain, and uplift occurred during episodes of aseismic deformation in southern California primarily between 1979 and 1983. Because the relationships between these parameters agrees with those calculated from simple deformation and tectonomagnetic models, the preferred explanation appeals to short-term strain episodes independently detected in each data set. An unknown source of meteorologically generated noise in the strain, gravity, and uplift data and an unknown, but correlated, disturbance in the absolute magnetic data might also explain the data. No clear observations of seismoelectric or tectonoelectric effects have yet been reported. The eruption of Mount St. Helens generated large oscillatory fields and 9 ?? 2 nT offset on the only surviving magnetometer. A large-scale traveling magnetic disturbance passed through the San Andreas array from 1 to 2 h after the eruption. Subsequent extrusive eruptions generated small precursory magnetic changes in some cases. These data are consistent with a simple volcanomagnetic model, magneto-gas dynamic effects, and a blast excited traveling ionospheric disturbance. Traveling ionospheric disturbances (TIDs), also generated by earthquake-related atmospheric pressure waves, may explain many electromagnetic disturbances apparently associated with earthquakes. Local near-fault magnetic field transients rarely exceed a few nT at periods of a few minutes and longer. ?? 1989.

  16. Enduring consequences of terrorism: 7-month follow-up survey of reactions to the bombings in London on 7 July 2005.

    PubMed

    Rubin, G James; Brewin, Chris R; Greenberg, Neil; Hughes, Jamie Hacker; Simpson, John; Wessely, Simon

    2007-04-01

    Terrorist attacks can have psychological effects on the general public. To assess the medium-term effects of the July 2005 London bombings on the general population in London and to identify risk factors for persistent effects. We telephoned 1010 Londoners 11-13 days after the bombings to assess stress levels, perceived threat and travel intentions. Seven months later, 574 respondents were contacted again and asked similar questions, and questions concerning altered perceptions of self and the world. ;Substantial stress' (11%), perceived threat to self (43%) and reductions in travel because of the bombings (19%) persisted at a reduced level; other perceived threats remained unchanged. A more negative world view was common. Other than degree of exposure to the bombings, there were no consistent predictors of which people with short-term reactions would develop persistent reactions. A longer-term impact of terrorism on the perceptions and behaviour of Londoners was documented.

  17. Blonanserin: a review of its use in the management of schizophrenia.

    PubMed

    Deeks, Emma D; Keating, Gillian M

    2010-01-01

    Oral blonanserin (Lonasen) is an atypical antipsychotic agent indicated for use in patients with schizophrenia in Japan and Korea. It is effective in the treatment of patients with schizophrenia, providing short- and long-term efficacy against both the positive and negative symptoms of the disorder in several randomized and noncomparative trials. Notably, in two randomized, double-blind trials of 8 weeks' duration, blonanserin was noninferior to haloperidol or risperidone for primary endpoints, although it appeared to be better than haloperidol in improving negative symptoms. Blonanserin is generally well tolerated and appears to have an acceptable profile in terms of bodyweight gain. Potential tolerability benefits of the drug in short-term trials included fewer extrapyramidal symptoms than haloperidol and fewer reports of prolactin level increases or hyperprolactinaemia than risperidone. Nevertheless, extrapyramidal symptoms and hyperprolactinaemia were among the most common adverse reactions associated with blonanserin in noncomparative long-term studies. Further prospective and long-term comparative studies are required in order to definitively position blonanserin with respect to other antipsychotic agents. In the meantime, available clinical data suggest that blonanserin is an effective and generally well tolerated option for the short-term treatment of schizophrenia and for those requiring longer-term therapy.

  18. Bringing influenza vaccines into the 21st century

    PubMed Central

    Settembre, Ethan C; Dormitzer, Philip R; Rappuoli, Rino

    2014-01-01

    The recent H7N9 influenza outbreak in China highlights the need for influenza vaccine production systems that are robust and can quickly generate substantial quantities of vaccines that target new strains for pandemic and seasonal immunization. Although the influenza vaccine system, a public-private partnership, has been effective in providing vaccines, there are areas for improvement. Technological advances such as mammalian cell culture production and synthetic vaccine seeds provide a means to increase the speed and accuracy of targeting new influenza strains with mass-produced vaccines by dispensing with the need for egg isolation, adaptation, and reassortment of vaccine viruses. New influenza potency assays that no longer require the time-consuming step of generating sheep antisera could further speed vaccine release. Adjuvants that increase the breadth of the elicited immune response and allow dose sparing provide an additional means to increase the number of available vaccine doses. Together these technologies can improve the influenza vaccination system in the near term. In the longer term, disruptive technologies, such as RNA-based flu vaccines and ‘universal’ flu vaccines, offer a promise of a dramatically improved influenza vaccine system. PMID:24378716

  19. Bringing influenza vaccines into the 21st century.

    PubMed

    Settembre, Ethan C; Dormitzer, Philip R; Rappuoli, Rino

    2014-01-01

    The recent H7N9 influenza outbreak in China highlights the need for influenza vaccine production systems that are robust and can quickly generate substantial quantities of vaccines that target new strains for pandemic and seasonal immunization. Although the influenza vaccine system, a public-private partnership, has been effective in providing vaccines, there are areas for improvement. Technological advances such as mammalian cell culture production and synthetic vaccine seeds provide a means to increase the speed and accuracy of targeting new influenza strains with mass-produced vaccines by dispensing with the need for egg isolation, adaptation, and reassortment of vaccine viruses. New influenza potency assays that no longer require the time-consuming step of generating sheep antisera could further speed vaccine release. Adjuvants that increase the breadth of the elicited immune response and allow dose sparing provide an additional means to increase the number of available vaccine doses. Together these technologies can improve the influenza vaccination system in the near term. In the longer term, disruptive technologies, such as RNA-based flu vaccines and 'universal' flu vaccines, offer a promise of a dramatically improved influenza vaccine system.

  20. Outlining face processing skills of portrait artists: Perceptual experience with faces predicts performance.

    PubMed

    Devue, Christel; Barsics, Catherine

    2016-10-01

    Most humans seem to demonstrate astonishingly high levels of skill in face processing if one considers the sophisticated level of fine-tuned discrimination that face recognition requires. However, numerous studies now indicate that the ability to process faces is not as fundamental as once thought and that performance can range from despairingly poor to extraordinarily high across people. Here we studied people who are super specialists of faces, namely portrait artists, to examine how their specific visual experience with faces relates to a range of face processing skills (perceptual discrimination, short- and longer term recognition). Artists show better perceptual discrimination and, to some extent, recognition of newly learned faces than controls. They are also more accurate on other perceptual tasks (i.e., involving non-face stimuli or mental rotation). By contrast, artists do not display an advantage compared to controls on longer term face recognition (i.e., famous faces) nor on person recognition from other sensorial modalities (i.e., voices). Finally, the face inversion effect exists in artists and controls and is not modulated by artistic practice. Advantages in face processing for artists thus seem to closely mirror perceptual and visual short term memory skills involved in portraiture. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Spatial variation of ultrafine particles and black carbon in two cities: results from a short-term measurement campaign.

    PubMed

    Klompmaker, Jochem O; Montagne, Denise R; Meliefste, Kees; Hoek, Gerard; Brunekreef, Bert

    2015-03-01

    Recently, short-term monitoring campaigns have been carried out to investigate the spatial variation of air pollutants within cities. Typically, such campaigns are based on short-term measurements at relatively large numbers of locations. It is largely unknown how well these studies capture the spatial variation of long term average concentrations. The aim of this study was to evaluate the within-site temporal and between-site spatial variation of the concentration of ultrafine particles (UFPs) and black carbon (BC) in a short-term monitoring campaign. In Amsterdam and Rotterdam (the Netherlands) measurements of number counts of particles larger than 10nm as a surrogate for UFP and BC were performed at 80 sites per city. Each site was measured in three different seasons of 2013 (winter, spring, summer). Sites were selected from busy urban streets, urban background, regional background and near highways, waterways and green areas, to obtain sufficient spatial contrast. Continuous measurements were performed for 30 min per site between 9 and 16 h to avoid traffic spikes of the rush hour. Concentrations were simultaneously measured at a reference site to correct for temporal variation. We calculated within- and between-site variance components reflecting temporal and spatial variations. Variance ratios were compared with previous campaigns with longer sampling durations per sample (24h to 14 days). The within-site variance was 2.17 and 2.44 times higher than the between-site variance for UFP and BC, respectively. In two previous studies based upon longer sampling duration much smaller variance ratios were found (0.31 and 0.09 for UFP and BC). Correction for temporal variation from a reference site was less effective for the short-term monitoring campaign compared to the campaigns with longer duration. Concentrations of BC and UFP were on average 1.6 and 1.5 times higher at urban street compared to urban background sites. No significant differences between the other site types and urban background were found. The high within to between-site concentration variances may result in the loss of precision and low explained variance when average concentrations from short-term campaigns are used to develop land use regression models. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making

    PubMed Central

    Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

    2008-01-01

    Background In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Methods Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Results Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Conclusion Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health. PMID:19094194

  3. Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making.

    PubMed

    Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

    2008-12-18

    In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health.

  4. Effect of creep in titanium alloy Ti-6Al-4V at elevated temperature on aircraft design and flight test

    NASA Technical Reports Server (NTRS)

    Jenkins, J. M.

    1984-01-01

    Short-term compressive creep tests were conducted on three titanium alloy Ti-6Al-4V coupons at three different stress levels at a temperature of 714 K (825 F). The test data were compared to several creep laws developed from tensile creep tests of available literature. The short-term creep test data did not correlate well with any of the creep laws obtained from available literature. The creep laws themselves did not correlate well with each other. Short-term creep does not appear to be very predictable for titanium alloy Ti-6Al-4V. Aircraft events that result in extreme, but short-term temperature and stress excursions for this alloy should be approached cautiously. Extrapolations of test data and creep laws suggest a convergence toward predictability in the longer-term situation.

  5. Presynaptic learning and memory with a persistent firing neuron and a habituating synapse: a model of short term persistent habituation.

    PubMed

    Ramanathan, Kiruthika; Ning, Ning; Dhanasekar, Dhiviya; Li, Guoqi; Shi, Luping; Vadakkepat, Prahlad

    2012-08-01

    Our paper explores the interaction of persistent firing axonal and presynaptic processes in the generation of short term memory for habituation. We first propose a model of a sensory neuron whose axon is able to switch between passive conduction and persistent firing states, thereby triggering short term retention to the stimulus. Then we propose a model of a habituating synapse and explore all nine of the behavioral characteristics of short term habituation in a two neuron circuit. We couple the persistent firing neuron to the habituation synapse and investigate the behavior of short term retention of habituating response. Simulations show that, depending on the amount of synaptic resources, persistent firing either results in continued habituation or maintains the response, both leading to longer recovery times. The effectiveness of the model as an element in a bio-inspired memory system is discussed.

  6. The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain

    PubMed Central

    MacPherson, H; Vertosick, EA; Foster, NE; Lewith, G; Linde, K; Sherman, KJ; Witt, CM; Vickers, AJ

    2016-01-01

    There is uncertainty regarding how long the effects of acupuncture treatment persist after a course of treatment. We aimed to determine the trajectory of pain scores over time following acupuncture, using a large individual patient dataset from high quality randomized trials of acupuncture for chronic pain. The available individual patient dataset included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck and shoulder), osteoarthritis of the knee and headache/migraine. We used meta-analytic techniques to determine the trajectory of post-treatment pain scores. Data on longer-term follow-up were available for 20 trials, including 6376 patients. In trials comparing acupuncture to no acupuncture control (wait-list, usual care, etc), effect sizes diminished by a non-significant 0.011 SD per 3 months (95% CI: −0.014 to 0.037, p = 0.4) after treatment ended. The central estimate suggests that about 90% of the benefit of acupuncture relative to controls would be sustained at 12 months. For trials comparing acupuncture to sham, we observed a reduction in effect size of 0.025 SD per 3 months (95% CI: 0.000 to 0.050, p = 0.050), suggesting about a 50% diminution at 12 months. The effects of a course of acupuncture treatment for patients with chronic pain do not appear to decrease importantly over 12 months. Patients can generally be reassured that treatment effects persist. Studies of the cost-effectiveness of acupuncture should take our findings into account when considering the time horizon of acupuncture effects. Further research should measure longer term outcomes of acupuncture. PMID:27764035

  7. Mapping adaptation opportunities and activities in an interactive atlas.

    PubMed

    Morris, Daniel F; Krishnan, Nisha

    2012-01-01

    The need for transparency is taking more prominence in international climate negotiations as developed countries pledge large sums of money to foster adaptation efforts in developing countries. Tools that provide accurate and up-to-date spatial information that can be easily used and vetted by local practitioners may provide effective and affordable ways to improve transparency. The Global Adaptation Atlas is such a tool, combining vetted, publicly available climate impact data with timely maps of on the ground adaptation projects to highlight confluences of effects of climate change with actions taken to address those effects. Here, we describe the structure and general functions of the Global Adaptation Atlas and explain how it may be utilized to track short-term investments in adaptation. Over longer time scales, it may also help gauge the effectiveness of specific adaptation investments as well as reveal how different climate impacts affect long-term investment in differing regions.

  8. Quantum Theory of Wormholes

    NASA Astrophysics Data System (ADS)

    González-Díaz, Pedro F.

    We re-explore the effects of multiply-connected wormholes on ordinary matter at low energies. It is obtained that the path integral that describes these effects is given in terms of a Planckian probability distribution for the Coleman α-parameters, rather than a classical Gaussian distribution law. This implies that the path integral over all low-energy fields with the wormhole effective interactions can no longer vary continuously, and that the quantities α2 are interpretable as the momenta of a quantum field. Using the new result that, rather than being given in terms of the Coleman-Hawking probability, the Euclidean action must equal negative entropy, the model predicts a very small but still nonzero cosmological constant and quite reasonable values for the pion and neutrino masses. The divergence problems of Euclidean quantum gravity are also discussed in the light of the above results.

  9. Influence of short-term energy supplementation on estrus, ovarian activity, and blood biochemistry in Ossimi ewes synchronized with fluorogestone acetate in the subtropics.

    PubMed

    Senosy, W; Mahmoud, G B; Abdel-Raheem, Sh M

    2017-01-15

    The objective of this study was to evaluate if short-term high-energy diet treatments have any overstimulatory effects on ovarian function and metabolic status in Ossimi ewes synchronized with progesterone sponge. Thirteen ewes were divided into high-energy (HEG; n = 7) and normal-energy or control (NEG; n = 6) groups. Progesterone sponges were placed intravaginally for 14 days during the winter breeding season (December-February). Four days before the removal of the sponges, a high-energy diet (130% of maintenance) was fed to HEG, whereas NEG was offered maintenance diet throughout the experiment. Ovarian performance and progesterone, estradiol, and blood metabolites were assessed daily starting from the day of removal of the sponges. Estrus period was longer in HEG (P < 0.05) when compared with NEG. Ovulation took place considerably longer with larger ovulatory follicles in HEG (P < 0.05). A marked increase in the level of total protein, albumin, glucose, and blood urea during the first 2 days following the removal of progesterone sponge was noticed in HEG when compared with NEG ewes. Eighty-five percentage (85.7%; 6/7) and 66.6% (4/6) had ovulation for the HEG and NEG, respectively. Dietary energy had a nonsignificant effect on the number of the recruited follicles, whereas a significant effect was observed for the diameter of the ovulatory follicle and ovulation rate (HEG, 2.3 ± 0.1 vs. NEG, 1.2 ± 0.3). It is concluded that short-term energy supplementation improves estrus expression and ovarian activity in fluorgestone acetate (FGA)-synchronized Ossimi ewes. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Shoreline oiling effects and recovery of salt marsh macroinvertebrates from the Deepwater Horizon Oil Spill

    PubMed Central

    Fleeger, John W.; Bourgoin, Stefan M.; Mendelssohn, Irving A.; Lin, Qianxin; Hou, Aixin

    2017-01-01

    Salt marshes in northern Barataria Bay, Louisiana, USA were oiled, sometimes heavily, in the aftermath of the Deepwater Horizon oil spill. Previous studies indicate that fiddler crabs (in the genus Uca) and the salt marsh periwinkle (Littoraria irrorata) were negatively impacted in the short term by the spill. Here, we detail longer-term effects and recovery from moderate and heavy oiling over a 3-year span, beginning 30 months after the spill. Although neither fiddler crab burrow density nor diameter differed between oiled and reference sites when combined across all sampling events, these traits differed among some individual sampling periods consistent with a pattern of lingering oiling impacts. Periwinkle density, however, increased in all oiling categories and shell-length groups during our sampling period, and periwinkle densities were consistently highest at moderately oiled sites where Spartina alterniflora aboveground biomass was highest. Periwinkle shell length linearly increased from a mean of 16.5 to 19.2 mm over the study period at reference sites. In contrast, shell lengths at moderately oiled and heavily oiled sites increased through month 48 after the spill, but then decreased. This decrease was associated with a decline in the relative abundance of large adults (shell length 21–26 mm) at oiled sites which was likely caused by chronic hydrocarbon toxicity or oil-induced effects on habitat quality or food resources. Overall, the recovery of S. alterniflora facilitated the recovery of fiddler crabs and periwinkles. However, our long-term record not only indicates that variation in periwinkle mean shell length and length-frequency distributions are sensitive indicators of the health and recovery of the marsh, but agrees with synoptic studies of vegetation and infaunal communities that full recovery of heavily oiled sites will take longer than 66 months. PMID:28828273

  11. Shoreline oiling effects and recovery of salt marsh macroinvertebrates from the Deepwater Horizon Oil Spill.

    PubMed

    Deis, Donald R; Fleeger, John W; Bourgoin, Stefan M; Mendelssohn, Irving A; Lin, Qianxin; Hou, Aixin

    2017-01-01

    Salt marshes in northern Barataria Bay, Louisiana, USA were oiled, sometimes heavily, in the aftermath of the Deepwater Horizon oil spill. Previous studies indicate that fiddler crabs (in the genus Uca ) and the salt marsh periwinkle ( Littoraria irrorata) were negatively impacted in the short term by the spill. Here, we detail longer-term effects and recovery from moderate and heavy oiling over a 3-year span, beginning 30 months after the spill. Although neither fiddler crab burrow density nor diameter differed between oiled and reference sites when combined across all sampling events, these traits differed among some individual sampling periods consistent with a pattern of lingering oiling impacts. Periwinkle density, however, increased in all oiling categories and shell-length groups during our sampling period, and periwinkle densities were consistently highest at moderately oiled sites where Spartina alterniflora aboveground biomass was highest. Periwinkle shell length linearly increased from a mean of 16.5 to 19.2 mm over the study period at reference sites. In contrast, shell lengths at moderately oiled and heavily oiled sites increased through month 48 after the spill, but then decreased. This decrease was associated with a decline in the relative abundance of large adults (shell length 21-26 mm) at oiled sites which was likely caused by chronic hydrocarbon toxicity or oil-induced effects on habitat quality or food resources. Overall, the recovery of S. alterniflora facilitated the recovery of fiddler crabs and periwinkles. However, our long-term record not only indicates that variation in periwinkle mean shell length and length-frequency distributions are sensitive indicators of the health and recovery of the marsh, but agrees with synoptic studies of vegetation and infaunal communities that full recovery of heavily oiled sites will take longer than 66 months.

  12. Vitrification-based cryopreservation of shoot-tips of Pinus kesiya Royle ex. Gord.

    PubMed

    Kalita, V; Choudhury, H; Kumaria, S; Tandon, P

    2012-01-01

    The present investigation was aimed at developing a protocol for long-term preservation of germplasm of Pinus kesiya Royle ex. Gord. through vitrification. Some of the critical components affecting explant tolerance to cryopreservation, such as effects of preculture, vitrification solutions, exposure time to vitrification solutions, volume of vitrification solution and its toxicity, washing of vitrified tissues after thawing, were analysed. The results showed that shoot regrowth of P. kesiya shoot-tips was considerably affected when exposed to cryoprotectants for longer periods of time (longer than 10 min). Among different vitrification solutions studied, maximum survival (76 percent) of shoot-tips was achieved with mVSL (using 0.6 ml of the solution) in MS basal medium containing 4.0 mg l-1 N6-benzyladenine (BA).

  13. Monitoring long-term evolutionary changes following Wolbachia introduction into a novel host: the Wolbachia popcorn infection in Drosophila simulans.

    PubMed

    Carrington, Lauren B; Hoffmann, Ary A; Weeks, Andrew R

    2010-07-07

    Wolbachia may act as a biological control agent for pest management; in particular, the Wolbachia variant wMelPop (popcorn) shortens host longevity and may be useful for dengue suppression. However, long-term changes in the host and Wolbachia genomes can alter Wolbachia spread and/or host effects that suppress disease. Here, we investigate the phenotypic effects of wMelPop in a non-native host, Drosophila simulans, following artificial transinfection approximately 200 generations ago. Long-term rearing and maintenance of the bacteria were at 19 degrees C in the original I-102 genetic background that was transinfected with the popcorn strain. The bacteria were then introgressed into three massbred backgrounds, and tetracycline was used to create uninfected sublines. The effect of wMelPop on longevity in this species appears to have changed; longevity was no longer reduced at 25 degrees C in some nuclear backgrounds, reflecting different geographical origin, selection or drift, although the reduction was still evident for flies held at 30 degrees C. Wolbachia influenced productivity and viability, and development time in some host backgrounds. These findings suggest that long-term attenuation of Wolbachia effects may compromise the effectiveness of this bacterium in pest control. They also emphasize the importance of host nuclear background on Wolbachia phenotypic effects.

  14. Cognitive behavior therapy may sustain antidepressant effects of intravenous ketamine in treatment-resistant depression

    PubMed Central

    Wilkinson, Samuel T.; Wright, DaShaun; Fasula, Madonna K.; Fenton, Lisa; Griepp, Matthew; Ostroff, Robert B.; Sanacora, Gerard

    2017-01-01

    Introduction Ketamine has shown rapid though short-lived antidepressant effects. The possibility of concerning neurobiological changes following repeated exposure to the drug motivate the development of strategies that obviate or minimize the need for longer-term treatment with ketamine. In this open-label trial, we investigated whether cognitive behavioral therapy (CBT) can sustain or extend ketamine's antidepressant effects. Methods Patients who were pursuing ketamine infusion therapy for treatment-resistant depression (TRD) were invited to participate in the study. If enrolled, the subjects initiated a 12-session, 10-week course of CBT concurrently with a short 4-treatment, 2-week course of intravenous ketamine (0.5mg/kg infused over 40 mins) provided under a standardized clinical protocol. Results Sixteen participants initiated the protocol, with 8 (50%) attaining a response to the ketamine and 7 (43.8%) achieving remission during the first two weeks of protocol. Among ketamine responders, the relapse rate at the end of the CBT course (8 weeks following the last ketamine exposure) was 25% (2/8). On longer-term follow up, 5 of 8 subjects eventually relapsed, the median time-to-relapse being 12 weeks following ketamine exposure. Among ketamine remitters, 3 of 7 retained remission until at least 4 weeks following the last ketamine exposure, with 2 retaining remission through 8 weeks following ketamine exposure. Ketamine non-responders did not appear to benefit from CBT. Conclusions CBT may sustain the antidepressant effects of ketamine in TRD. Well-powered randomized controlled trials are warranted to further investigate this treatment combination as a way to sustain ketamine's antidepressant effects. PMID:28490030

  15. Amoxicillin for acute lower respiratory tract infection in primary care: subgroup analysis of potential high-risk groups

    PubMed Central

    Moore, Michael; Stuart, Beth; Coenen, Samuel; Butler, Chris C; Goossens, Herman; Verheij, Theo JM; Little, Paul

    2014-01-01

    Background Antibiotics are of limited overall clinical benefit for uncomplicated lower respiratory tract infection (LRTI) but there is uncertainty about their effectiveness for patients with features associated with higher levels of antibiotic prescribing. Aim To estimate the benefits and harms of antibiotics for acute LRTI among those producing coloured sputum, smokers, those with fever or prior comorbidities, and longer duration of prior illness. Design and setting Secondary analysis of a randomised controlled trial of antibiotic placebo for acute LRTI in primary care. Method Two thousand and sixty-one adults with acute LRTI, where pneumonia was not suspected clinically, were given amoxicillin or matching placebo. The duration of symptoms, rated moderately bad or worse (primary outcome), symptom severity on days 2–4 (0–6 scale), and the development of new or worsening symptoms were analysed in pre-specified subgroups of interest. Evidence of differential treatment effectiveness was assessed in prespecified subgroups by interaction terms. Results No subgroups were identified that were significantly more likely to benefit from antibiotics in terms of symptom duration or the development of new or worsening symptoms. Those with a history of significant comorbidities experienced a significantly greater reduction in symptom severity between days 2 and 4 (interaction term −0.28, P = 0.003; estimated effect of antibiotics among those with a past history −0.28 [95% confidence interval = −0.44 to −0.11], P = 0.001), equivalent to three people in 10 rating symptoms as a slight rather than a moderately bad problem. For subgroups not specified in advance antibiotics provided a modest reduction in symptom severity for non-smokers and for those with short prior illness duration (<7 days), and a modest reduction in symptom duration for those with short prior illness duration. Conclusion There is no clear evidence of clinically meaningful benefit from antibiotics in the studied high-risk groups of patients presenting in general practice with uncomplicated LRTIs where prescribing is highest. Any possible benefit must be balanced against the side-effects and longer-term effects on antibiotic resistance. PMID:24567620

  16. Individual payments as a longer-term incentive in online panels.

    PubMed

    Göritz, Anja S; Wolff, Hans-Georg; Goldstein, Daniel G

    2008-11-01

    Does it pay to pay online panel members? A three-wave longitudinal experiment was conducted with an online panel to examine whether per person payments, paid through an online intermediary, influence response and retention rates. In the payment condition, participants were promised payment for participation at each wave, whereas control participants were not offered any payment. The promise of a payment had a negative effect on response in Wave 1, but a positive effect on response in Wave 2. Payment had no significant effect on retention. Completing a given wave was an indicator for responding to a subsequent invitation.

  17. Fire effects in southwestern forests: Proceedings of the Second La Mesa Fire symposium

    USGS Publications Warehouse

    Allen, Craig D.

    1996-01-01

    In 1977, the La Mesa Fire burned across 15,444 acres of ponderosa pine forests on the adjoining lands of Bandelier National Monument, the Santa Fe National Forest, and Los Alamos National Laboratory. Following this event, several fire effects studies were initiated. The 16 papers herein document longer-term knowledge gained about the ecological effects of the fire and about Southwestern fire ecology in general. The presentations are also designed to give resource managers practical information for managing fire in local landscapes. Studies presented range from fire histories and avifauna to geomorphology and arthropods.

  18. Pharmacovigilance in hospice/palliative care: the net immediate and short-term effects of dexamethasone for anorexia.

    PubMed

    Hatano, Yutaka; Moroni, Matteo; Wilcock, Andrew; Quinn, Stephen; Csikós, Ágnes; Allan, Simon G; Agar, Meera; Clark, Katherine; Clayton, Josephine M; Currow, David C

    2016-09-01

    Loss of appetite is prevalent in palliative care and distressing for patients and families. Therapies include corticosteroids or progestogens. This study explores the net effect of dexamethasone on anorexia. Prospective data were collected when dexamethasone was started for anorexia as part of routine care. The National Cancer Institute's Common Toxicity Criteria for Adverse Events (NCICTCAE) Likert scales assessed severity of anorexia and immediate and short-term harms at 2 time points: baseline and 7 days. This study (41 sites, 8 countries) collected data (July 2013 to July 2014) from 114 patients (mean age 71 (SD 11), 96% with cancer). Median Australian-modified Karnofsky Performance Scale was 50% (range 20-70). Mean baseline NCICTCAE anorexia score was 2.7 (SD 0.6; median 3). 6 patients died by day 7. Of 108 evaluable patients, 74 (68.5%; 95% CI 59.0% to 76.7%) reported ≥1 reduction anorexia scores by day 7, of whom 30 were 0. Mean dexamethasone dose on day 7 was 4.1 mg/day (SD 3.4; median 4; range 0-46 mg). 24 patients reported ≥1 harms (32.4% CI 22.6% to 44.1%; insomnia n=10, depression n=7, euphoria n=7 and hyperglycaemia n=7). Of 24 patients with no benefit, 10 reported ≥1 harms. This study shows positive and negative effects of 7 days of dexamethasone as an appetite stimulant in patients with advanced life-limiting illnesses. Identifying clinicodemographic characteristics of people most at risk of harms with no benefit is a crucial next step. Longer term follow-up will help to understand longer term and cumulative harms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Long-term effectiveness of the SpeechEasy fluency-enhancement device.

    PubMed

    Gallop, Ronald F; Runyan, Charles M

    2012-12-01

    The SpeechEasy has been found to be an effective device for reduction of stuttering frequency for many people who stutter (PWS); published studies typically have compared stuttering reduction at initial fitting of the device to results achieved up to one year later. This study examines long-term effectiveness by examining whether effects of the SpeechEasy were maintained for longer periods, from 13 to 59 months. Results indicated no significant change for seven device users from post-fitting to the time of the study (t=-.074, p=.943); however, findings varied greatly on a case-by-case basis. Most notably, when stuttering frequency for eleven users and former users, prior to device fitting, was compared to current stuttering frequency while not wearing the device, the change over time was found to be statistically significant (t=2.851, p=.017), suggesting a carry-over effect of the device. There was no significant difference in stuttering frequency when users were wearing versus not wearing the device currently (t=1.949, p=0.92). Examinations of these results, as well as direction for future research, are described herein. The reader will be able to: (a) identify and briefly describe two types of altered auditory feedback which the SpeechEasy incorporates in order to help reduce stuttering; (b) describe the carry-over effect found in this study, suggest effectiveness associated with the device over a longer period of time than previously reported, as well as its implications, and (c) list factors that might be assessed in future research involving this device in order to more narrowly determine which prospective users are most likely to benefit from employing the SpeechEasy. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. PubMed Central

    2000-01-01

    • A cream containing 0.05% tretinoin (Retinova® is approved for treatment of sun-induced skin damage (“photoaging”). • Three trials comparing tretinoin with the excipient show that the effects of tretinoin cream are at best limited and slow to occur. Furthermore, they disappear on treatment cessation, necessitating long-term use. • The 0.05% tretinoin cream has poor local tolerability: most subjects develop irritation and fragile skin and require longer intervals between each application. Systemic adverse effects occur in some circumstances. • There are persistent doubts about whether it is safe to use tretinoin during pregnancy. PMID:10790815

  1. Transmitting signals over interstellar distances: three approaches compared in the context of the Drake equation

    NASA Astrophysics Data System (ADS)

    Arnold, Luc

    2013-07-01

    I compare three methods for transmitting signals over interstellar distances: radio transmitters, lasers and artificial transits. The quantitative comparison is based on physical quantities depending on energy cost and transmitting time L, the last parameter in the Drake equation. With our assumptions, radio transmitters are the most energy-effective, while macro-engineered planetary-sized objects producing artificial transits seem effective on the long term to transmit an attention-getting signal for a time that might be much longer than the lifetime of the civilization that produced the artefact.

  2. In patients with minimally symptomatic OSA can baseline characteristics and early patterns of CPAP usage predict those who are likely to be longer-term users of CPAP.

    PubMed

    Turnbull, Christopher D; Bratton, Daniel J; Craig, Sonya E; Kohler, Malcolm; Stradling, John R

    2016-02-01

    Long-term continuous positive airway pressure (CPAP) usage varies between individuals. It would be of value to be able to identify those who are likely to benefit from CPAP (and use it long term), versus those who would not, and might therefore benefit from additional help early on. First, we explored whether baseline characteristics predicted CPAP usage in minimally symptomatic obstructive sleep apnoea (OSA) patients, a group who would be expected to have low usage. Second, we explored if early CPAP usage was predictive of longer-term usage, as has been shown in more symptomatic OSA patients. The MOSAIC trial was a multi-centre randomised controlled trial where minimally symptomatic OSA patients were randomised to CPAP, or standard care, for 6 months. Here we have studied only those patients randomised to CPAP treatment. Baseline characteristics including symptoms, questionnaires [including the Epworth sleepiness score (ESS)] and sleep study parameters were recorded. CPAP usage was recorded at 2-4 weeks after initiation and after 6 months. The correlation and association between baseline characteristics and 6 months CPAP usage was assessed, as was the correlation between 2 and 4 weeks CPAP usage and 6 months CPAP usage. One hundred and ninety-five patients randomised to CPAP therapy had median [interquartile range (IQR)] CPAP usage of 2:49 (0:44, 5:13) h:min/night (h/n) at the 2-4 weeks visit, and 2:17 (0:08, 4:54) h/n at the 6 months follow-up visit. Only male gender was associated with increased long-term CPAP use (male usage 2:56 h/n, female 1:57 h/n; P=0.02). There was a moderate correlation between the usage of CPAP at 2-4 weeks and 6 months, with about 50% of the variability in long-term use being predicted by the short-term use. In patients with minimally symptomatic OSA, our study has shown that male gender (and not OSA severity or symptom burden) is associated with increased long-term use of CPAP at 6 months. Although, in general, early patterns of CPAP usage predicted longer term use, there are patients in whom this is not the case, and patients with low initial usage may need to extend their CPAP trial before a decision about longer-term use is made.

  3. Increasing the interval between neoadjuvant chemoradiotherapy and surgery in esophageal cancer: a meta-analysis of published studies.

    PubMed

    Lin, G; Han, S-Y; Xu, Y-P; Mao, W-M

    2016-11-01

    The aim of this meta-analysis was to clarify whether a longer interval between the end of neoadjuvant chemoradiotherapy (nCRT) and surgery is associated with better outcomes in esophageal cancer. nCRT followed by surgery is the most common approach for patients with resectable esophageal cancer. Operations are performed within 2-8 weeks after nCRT; however, the optimal interval between nCRT and surgery for esophageal cancer is unknown. We performed a systematic literature search in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Clinical Trials database for studies published between January 2000 and December 2014. Eligible studies were prospective or retrospective studies of esophageal cancer that assessed the effects of intervals longer or shorter than 7-8 weeks between the end of nCRT and surgery. The primary end-points were the overall survival (OS) and pathologic complete response (pCR). Secondary end-points were anastomotic leak, R0 resection, and postoperative mortality rate. A meta-analysis was performed to estimate odds ratios (ORs) using fixed-effect and random-effect models, with Review Manager 5.2. The five studies that met the eligibility requirements included 1,016 patients: 520 in the shorter interval group (≤7-8 weeks) and 496 in the longer interval group (>7-8 weeks). The results of our meta-analysis indicate that a longer interval between nCRT and surgery may be disadvantageous for 2-year OS (OR = 1.40, 95% confidence interval [CI]: 1.09-1.80, P = 0.010) and R0 resection rate (OR = 1.71, 95% CI: 1.14-2.22, P = 0.009). The pCR, anastomotic leak rate, and postoperative morbidity were similar in the two groups. A longer interval (more than the standard 7-8 weeks) from the end of preoperative nCRT to surgery did not increase the rate of pCR in esophageal cancer, and the different intervals had similar effects on anastomotic leak rate and postoperative mortality rates. However, the longer interval between nCRT and surgery may be disadvantageous for long-term OS. These results should be validated prospectively in a randomized trial. © 2015 International Society for Diseases of the Esophagus.

  4. Quality improvement in hospitals: how much does it reduce healthcare costs?

    PubMed

    Jones, S B

    1995-01-01

    The philosophy of W.E. Deming suggests that continuous quality improvement efforts, when properly applied, ultimately will lead to financial dividends and will help ensure business longevity. Reducing hospital charges can be exciting for the participants and can provide an impetus for expanding quality improvement efforts. Americans, however, tend to demand almost instant gratification and have limited patience for longer-term results. This factor, coupled with minimal knowledge of actual operational costs and inaccurate charge accounting systems, may lead hospital managers to misinterpret the potential net long-term effects of their quality improvement efforts. In the approaching environment of capitated reimbursement, such mistakes may have serious consequences.

  5. Raising awareness of assistive technology in older adults through a community-based, cooperative extension program.

    PubMed

    Sellers, Debra M; Markham, Melinda Stafford

    2012-01-01

    The Fashion an Easier Lifestyle with Assistive Technology (FELAT) curriculum was developed as a needs-based, community educational program provided through a state Cooperative Extension Service. The overall goal for participants was to raise awareness of assistive technology. Program evaluation included a postassessment and subsequent interview to determine short-term knowledge gain and longer term behavior change. The sample consisted of mainly older, married females. The FELAT program was effective at raising awareness and increasing knowledge of assistive technology, and for many participants, the program acted as a catalyst for planning to or taking action related to assistive technology.

  6. Quality of Life Changes Following Surgery for Hyperhidrosis.

    PubMed

    de Campos, José Ribas Milanez; da Fonseca, Hugo Veiga Sampaio; Wolosker, Nelson

    2016-11-01

    The best way to evaluate the impact of primary hyperhidrosis on quality of life (QL) is through specific questionnaires, avoiding generic models that do not appropriately evaluate individuals. QL improves significantly in the short term after sympathectomy. In the longer term, a sustained and stable improvement is seen, although there is a small decline in the numbers; after 5 and even at 10 years of follow-up it shows virtually the same numerical distribution. Compensatory hyperhidrosis is a major side effect and the main aggravating factor in postoperative QL, requiring attention to its management and prevention. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Independent versus system-affiliated hospitals: a comparative analysis of financial performance, cost, and productivity.

    PubMed Central

    Levitz, G S; Brooke, P P

    1985-01-01

    This article analyzes differences in the financial performance, cost, and productivity between system-affiliated and independent hospitals. Data for the study were obtained from the 1981 American Hospital Association (AHA) Annual Survey of Hospitals for the State of Iowa and included 94 nonstate or nonfederal short-term hospitals without long-term care units. An interpretation of the results indicated that system-affiliated hospitals are more profitable, have better access to capital markets, are more effective price setters, and experience higher costs per case which are related to longer lengths of stay and less productive use of plant and equipment in generating revenues. PMID:4019214

  8. Growth in HMO share of the Medicare market, 1989-1994.

    PubMed

    Welch, W P

    1996-01-01

    Between 1989 and 1994 the health maintenance organization (HMO) share of the Medicare market grew rapidly. It is still heavily concentrated geographically, however. The most influential factor in this growth is HMO penetration into an area's general health care market. Medicare payment rates and prior Medicare HMO penetration also have an impact, but their effects are much weaker. Thus, payment rate reform is likely to have only a modest impact on Medicare HMO growth in the short term. In the longer term, the HMO share of the Medicare market will continue to grow, because HMO penetration in the general health care market is growing rapidly.

  9. [The short-and long term effect of multidisciplinary obesity treatment on body mass index and mental health].

    PubMed

    Gunnarsson, Bjarni Kristinn; Hansdottir, Ingun; Bjornsdottir, Erla; Birgisdottir, Erl Bjorg; Arnadottir, Anna Thora; Magnusson, Bjorn

    2016-02-01

    The aim of this treatment study was to evaluate both short- and long-term effects of a multidisciplinary obesity treatment. Long-term outcomes of patients receiving gastric bypass surgery in addition to behavioral obesity treatment were compared with those who did not undergo surgery. The participants were 100 patients undergoing a four week inpatient obesity treatment at the Hospital in Neskaupsstaður (Fjórðungsjúkrahúsið í Neskaupstað (FSN). After treatment was completed, 28 of these patients underwent further treatment, receiving gastric bypass surgery. All patients were followed for two years after completing the four week treatment. Body mass index (BMI), quality of life and symptoms of depression and anxiety were measured for all participants before and after treatment, and again using mailed questionnaires in a cross-sectional data collection in the summer of 2012. Participants achieved statistically significant weight loss (median 1,85 BMI points), improved their quality of life and mental health after four week obesity treatment, and long term results remained significant. Three years after the conclusion of treatment, statistically significant weight loss was still present for patients that had not undergone gastric bypass surgery (median 2.13 BMI points), but improvements in mental health and quality of life were no longer present among subjects who did not undergo surgery. Patients who underwent gastric bypass surgery achieved greater weight loss (median 13.12 BMI points) and longer lasting improvements in mental health and quality of life. Results show that the multidisciplinary obesity treatment is effective in reducing obesity and improving mental health and quality of life in the short term. With follow-up treatment, the weight loss is maintained for up to three years after treatment for all participants. The bypass surgery group lost more weight and showed more permanent improvements in mental health and quality of life. These results underline the necessity of providing long-term treatment in maintaining improvements when treating obesity. 1Municipal Service Centre for Miðborg and Hlíðar 2University of Iceland, 3National University Hospital of Iceland, 4East Coast Regional Hospital in Iceland, 5The Health Care Institution of South Iceland. obesity, short- and long term treatment outcomes, weight loss, quality of life, mental health, interdisciplinary treatment. Correspondence: Bjarni Kristinn Gunnarsson bjarnikris@gmail.com.

  10. EAR Program Research Results : Updated through 2013

    DOT National Transportation Integrated Search

    2013-12-31

    The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...

  11. EAR Program Research Results: Updated through 2014

    DOT National Transportation Integrated Search

    2014-12-31

    The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...

  12. EAR Program Research Results: Updated through 2016

    DOT National Transportation Integrated Search

    2016-12-31

    The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...

  13. Glossary of Terms--Nuclear Weapon Phenomena and Effects

    DTIC Science & Technology

    1985-02-15

    w".: w~*~ combat ineffective. An individual whose injuries are of such nature that he is no longer capable of carrying out his assigned task...significantly harmful result [39]. That dose of ionizing radiation that is not expected to cause appreciable bodily injury to a person at any time during his...art and science of protecting human beings from injury by radia- tion, and promoting better health through beneficial applications of radiation [39

  14. Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births.

    PubMed

    Kroese, S J; de Hair, M J H; Limper, M; Lely, A T; van Laar, J M; Derksen, R H W M; Fritsch-Stork, R D E

    2017-01-01

    To investigate the effect of hydroxychloroquine (HCQ) in pregnant women with systemic lupus erythematosus (SLE). In SLE pregnancies of a single Dutch center (2000-2015), lupus activity and flares before and during pregnancy and postpartum were assessed using the SLE Disease Activity Index (SLEDAI)/SLEPDAI (SLEDAI adjusted for pregnancy). The association between HCQ use and pregnancy outcomes (early spontaneous abortion, fetal death, and preterm and term live birth) was analyzed using generalized estimating equations (GEE) accounting for the occurrence of multiple pregnancies per patient. Analyses were adjusted for antiphospholipid antibody (aPL) status. 110 pregnancies (63 mostly Caucasian patients) were included, of which, in 30, HCQ was used; overall occurrence of flares was low (non-HCQ group: 5 mild (6.4%) and 2 severe (2.6%); HCQ group: 2 mild (6.7%) and no severe flares). The HCQ group showed a trend towards lower dosage of prednisone (OR 0.2 (95% CI 0.0-1.4); p = 0.10). Pregnancy outcomes were comparable between groups. Among preterm live births, pregnancy duration was significantly longer in HCQ users (2.4 weeks (95% CI 1.0-3.8; p ≤ 0.001)). HCQ use was associated with longer pregnancy duration in the vulnerable preterm birth population, underscoring the beneficial effect of HCQ use during pregnancy.

  15. Time-Dependent Subcellular Distribution and Effects of Carbon Nanotubes in Lungs of Mice

    PubMed Central

    Købler, Carsten; Poulsen, Sarah S.; Saber, Anne T.; Jacobsen, Nicklas R.; Wallin, Håkan; Yauk, Carole L.; Halappanavar, Sabina; Vogel, Ulla; Qvortrup, Klaus; Mølhave, Kristian

    2015-01-01

    Background and Methods Pulmonary deposited carbon nanotubes (CNTs) are cleared very slowly from the lung, but there is limited information on how CNTs interact with the lung tissue over time. To address this, three different multiwalled CNTs were intratracheally instilled into female C57BL/6 mice: one short (850 nm) and tangled, and two longer (4 μm and 5.7 μm) and thicker. We assessed the cellular interaction with these CNTs using transmission electron microscopy (TEM) 1, 3 and 28 days after instillation. Results TEM analysis revealed that the three CNTs followed the same overall progression pattern over time. Initially, CNTs were taken up either by a diffusion mechanism or via endocytosis. Then CNTs were agglomerated in vesicles in macrophages. Lastly, at 28 days post-exposure, evidence suggesting CNT escape from vesicle enclosures were found. The longer and thicker CNTs more often perturbed and escaped vesicular enclosures in macrophages compared to the smaller CNTs. Bronchoalveolar lavage (BAL) showed that the CNT exposure induced both an eosinophil influx and also eosinophilic crystalline pneumonia. Conclusion Two very different types of multiwalled CNTs had very similar pattern of cellular interactions in lung tissue, with the longer and thicker CNTs resulting in more severe effects in terms of eosinophil influx and incidence of eosinophilic crystalline pneumonia (ECP). PMID:25615613

  16. Measuring single constructs by single items: Constructing an even shorter version of the “Short Five” personality inventory

    PubMed Central

    Konstabel, Kenn; Lönnqvist, Jan-Erik; Leikas, Sointu; García Velázquez, Regina; Qin, Hiaying; Verkasalo, Markku; Walkowitz, Gari

    2017-01-01

    The aim of this study was to construct a short, 30-item personality questionnaire that would be, in terms of content and meaning of the scores, as comparable as possible with longer, well-established inventories such as NEO PI-R and its clones. To do this, we shortened the formerly constructed 60-item “Short Five” (S5) by half so that each subscale would be represented by a single item. We compared all possibilities of selecting 30 items (preserving balanced keying within each domain of the five-factor model) in terms of correlations with well-established scales, self-peer correlations, and clarity of meaning, and selected an optimal combination for each domain. The resulting shortened questionnaire, XS5, was compared to the original S5 using data from student samples in 6 different countries (Estonia, Finland, UK, Germany, Spain, and China), and a representative Finnish sample. The correlations between XS5 domain scales and their longer counterparts from well-established scales ranged from 0.74 to 0.84; the difference from the equivalent correlations for full version of S5 or from meta-analytic short-term dependability coefficients of NEO PI-R was not large. In terms of prediction of external criteria (emotional experience and self-reported behaviours), there were no important differences between XS5, S5, and the longer well-established scales. Controlling for acquiescence did not improve the prediction of criteria, self-peer correlations, or correlations with longer scales, but it did improve internal reliability and, in some analyses, comparability of the principal component structure. XS5 can be recommended as an economic measure of the five-factor model of personality at the level of domain scales; it has reasonable psychometric properties, fair correlations with longer well-established scales, and it can predict emotional experience and self-reported behaviours no worse than S5. When subscales are essential, we would still recommend using the full version of S5. PMID:28800630

  17. Measuring single constructs by single items: Constructing an even shorter version of the "Short Five" personality inventory.

    PubMed

    Konstabel, Kenn; Lönnqvist, Jan-Erik; Leikas, Sointu; García Velázquez, Regina; Qin, Hiaying; Verkasalo, Markku; Walkowitz, Gari

    2017-01-01

    The aim of this study was to construct a short, 30-item personality questionnaire that would be, in terms of content and meaning of the scores, as comparable as possible with longer, well-established inventories such as NEO PI-R and its clones. To do this, we shortened the formerly constructed 60-item "Short Five" (S5) by half so that each subscale would be represented by a single item. We compared all possibilities of selecting 30 items (preserving balanced keying within each domain of the five-factor model) in terms of correlations with well-established scales, self-peer correlations, and clarity of meaning, and selected an optimal combination for each domain. The resulting shortened questionnaire, XS5, was compared to the original S5 using data from student samples in 6 different countries (Estonia, Finland, UK, Germany, Spain, and China), and a representative Finnish sample. The correlations between XS5 domain scales and their longer counterparts from well-established scales ranged from 0.74 to 0.84; the difference from the equivalent correlations for full version of S5 or from meta-analytic short-term dependability coefficients of NEO PI-R was not large. In terms of prediction of external criteria (emotional experience and self-reported behaviours), there were no important differences between XS5, S5, and the longer well-established scales. Controlling for acquiescence did not improve the prediction of criteria, self-peer correlations, or correlations with longer scales, but it did improve internal reliability and, in some analyses, comparability of the principal component structure. XS5 can be recommended as an economic measure of the five-factor model of personality at the level of domain scales; it has reasonable psychometric properties, fair correlations with longer well-established scales, and it can predict emotional experience and self-reported behaviours no worse than S5. When subscales are essential, we would still recommend using the full version of S5.

  18. Interventions to improve physical activity among socioeconomically disadvantaged groups: an umbrella review.

    PubMed

    Craike, Melinda; Wiesner, Glen; Hilland, Toni A; Bengoechea, Enrique Garcia

    2018-05-15

    People from socioeconomically disadvantaged population groups are less likely to be physically active and more likely to experience adverse health outcomes than those who are less disadvantaged. In this umbrella review we examined across all age groups, (1) the effectiveness of interventions to improve physical activity among socioeconomically disadvantaged groups, (2) the characteristics of effective interventions, and (3) directions for future research. PubMed/MEDLINE and Scopus were searched up to May 2017 to identify systematic reviews reporting physical activity interventions in socioeconomically disadvantaged populations or sub-groups. Two authors independently conducted study screening and selection, data extraction (one author, with data checked by two others) and assessment of methodological quality using the 'Assessment of Multiple Systematic Reviews' scale. Results were synthesized narratively. Seventeen reviews met our inclusion criteria, with only 5 (30%) reviews being assessed as high quality. Seven (41%) reviews focused on obesity prevention and an additional four focused on multiple behavioural outcomes. For pre school children, parent-focused, group-based interventions were effective in improving physical activity. For children, school-based interventions and policies were effective; few studies focused on adolescents and those that did were generally not effective; for adults, there was mixed evidence of effectiveness but characteristics such as group-based interventions and those that focused on physical activity only were associated with effectiveness. Few studies focused on older adults. Across all ages, interventions that were more intensive tended to be more effective. Most studies reported short-term, rather than longer-term, outcomes and common methodological limitations included high probability of selection bias, low response rates, and high attrition. Interventions can be successful at improving physical activity among children from socioeconomically disadvantaged groups, with evidence for other age groups weak or inconclusive. More high-quality studies in this population group are needed, which adopt strategies to increase recruitment rates and reduce attrition, report longer term outcomes, and provide adequate intervention details, to allow determination of the characteristics of effective interventions. We recommend that the benefits of physical activity be recognised more broadly than obesity prevention in future studies, as this may have implications for the design and appeal of interventions.

  19. Word-length effect in verbal short-term memory in individuals with Down's syndrome.

    PubMed

    Kanno, K; Ikeda, Y

    2002-11-01

    Many studies have indicated that individuals with Down's syndrome (DS) show a specific deficit in short-term memory for verbal information. The aim of the present study was to investigate the influence of the length of words on verbal short-term memory in individuals with DS. Twenty-eight children with DS and 10 control participants matched for memory span were tested on verbal serial recall and speech rate, which are thought to involve rehearsal and output speed. Although a significant word-length effect was observed in both groups for the recall of a larger number of items with a shorter spoken duration than for those with a longer spoken duration, the number of correct recalls in the group with DS was reduced compared to the control subjects. The results demonstrating poor short-term memory in children with DS were irrelevant to speech rate. In addition, the proportion of repetition-gained errors in serial recall was higher in children with DS than in control subjects. The present findings suggest that poor access to long-term lexical knowledge, rather than overt articulation speed, constrains verbal short-term memory functions in individuals with DS.

  20. Toward Augmented Radiologists: Changes in Radiology Education in the Era of Machine Learning and Artificial Intelligence.

    PubMed

    Tajmir, Shahein H; Alkasab, Tarik K

    2018-06-01

    Radiology practice will be altered by the coming of artificial intelligence, and the process of learning in radiology will be similarly affected. In the short term, radiologists will need to understand the first wave of artificially intelligent tools, how they can help them improve their practice, and be able to effectively supervise their use. Radiology training programs will need to develop curricula to help trainees acquire the knowledge to carry out this new supervisory duty of radiologists. In the longer term, artificially intelligent software assistants could have a transformative effect on the training of residents and fellows, and offer new opportunities to bring learning into the ongoing practice of attending radiologists. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  1. 'If they're helping me then how can I be independent?' The perceptions and experience of users of home-care re-ablement services.

    PubMed

    Wilde, Alison; Glendinning, Caroline

    2012-11-01

    Home-care re-ablement is a short-term, intensive service that helps people to (re-) establish their capacity and confidence in performing basic personal care and domestic tasks at home, thereby reducing needs for longer term help. Home-care re-ablement is an increasingly common feature of English adult social care services; there are similar service developments in Australia and New Zealand. This paper presents evidence from semi-structured interviews conducted in early 2010 with 34 service users and 10 carers from five established re-ablement services in England. The interviews formed part of a larger, mixed-methods study into the immediate and longer term impacts and cost-effectiveness of home-care re-ablement services. There was clear evidence that interviewees felt that they had benefitted from re-ablement services; most service users and their families valued the intervention. However, the interviews also identified potential barriers to optimal independence for some service users, particularly those with progressive conditions, sensory impairments, specific cultural needs, or who lived alone. The beneficial impacts of re-ablement could also be reduced if users failed to understand the aims of the service, or if the service failed to provide support with activities or outcomes that were particularly important to the service user or carer. Putting the lived experiences of people receiving re-ablement at the centre of analysis, this paper concludes that re-ablement services have the potential for enhanced effectiveness, particularly if there is more understanding of users' own priorities and concepts of independence. © 2012 Blackwell Publishing Ltd.

  2. Glioma surgery in eloquent areas: can we preserve cognition?

    PubMed

    Satoer, Djaina; Visch-Brink, Evy; Dirven, Clemens; Vincent, Arnaud

    2016-01-01

    Cognitive preservation is crucial in glioma surgery, as it is an important aspect of daily life functioning. Several studies claimed that surgery in eloquent areas is possible without causing severe cognitive damage. However, this conclusion was relatively ungrounded due to the lack of extensive neuropsychological testing in homogenous patient groups. In this study, we aimed to elucidate the short-term and long-term effects of glioma surgery on cognition by identifying all studies who conducted neuropsychological tests preoperatively and postoperatively in glioma patients. We systematically searched the electronical databases Embase, Medline OvidSP, Web of Science, PsychINFO OvidSP, PubMed, Cochrane, Google Scholar, Scirius and Proquest aimed at cognitive performance in glioma patients preoperatively and postoperatively. We included 17 studies with tests assessing the cognitive domains: language, memory, attention, executive functions and/or visuospatial abilities. Language was the domain most frequently examined. Immediately postoperatively, all studies except one, found deterioration in one or more cognitive domains. In the longer term (3-6/6-12 months postoperatively), the following tests showed both recovery and deterioration compared with the preoperative level: naming and verbal fluency (language), verbal word learning (memory) and Trailmaking B (executive functions). Cognitive recovery to the preoperative level after surgery is possible to a certain extent; however, the results are too arbitrary to draw definite conclusions and not all studies investigated all cognitive domains. More studies with longer postoperative follow-up with tests for cognitive change are necessary for a better understanding of the conclusive effects of glioma surgery on cognition.

  3. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants

    PubMed Central

    Gridneva, Zoya; Kugananthan, Sambavi; Hepworth, Anna R.; Tie, Wan J.; Lai, Ching T.; Ward, Leigh C.; Hartmann, Peter E.; Geddes, Donna T.

    2016-01-01

    Human milk (HM) components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE), a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo). Stomach volumes (SV) were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV) was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (−0.07 [−0.10, −0.03], p < 0.001) GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001), and longer GE times (0.24 [0.03, 0.46], p = 0.033). Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023). Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002) and dose (0.02 [0.01, 0.03], p = 0.005), and lower casein:whey ratio (−65.89 [−107.13, −2.66], p = 0.003). FV and HM composition influence GE and breastfeeding patterns in term breastfed infants. PMID:28036041

  4. A neuromorphic circuit mimicking biological short-term memory.

    PubMed

    Barzegarjalali, Saeid; Parker, Alice C

    2016-08-01

    Research shows that the way we remember things for a few seconds is a different mechanism from the way we remember things for a longer time. Short-term memory is based on persistently firing neurons, whereas storing information for a longer time is based on strengthening the synapses or even forming new neural connections. Information about location and appearance of an object is segregated and processed by separate neurons. Furthermore neurons can continue firing using different mechanisms. Here, we have designed a biomimetic neuromorphic circuit that mimics short-term memory by firing neurons, using biological mechanisms to remember location and shape of an object. Our neuromorphic circuit has a hybrid architecture. Neurons are designed with CMOS 45nm technology and synapses are designed with carbon nanotubes (CNT).

  5. Short and Long-Term Physiological Responses of Male and Female Rats to Two Dietary Levels of Pre-Gelatinized Maca (Lepidium Peruvianum Chacon)

    PubMed Central

    Meissner, H. O.; Kedzia, B.; Mrozikiewicz, P. M.; Mscisz, A.

    2006-01-01

    Objective: The aim of this study is to identify physiological responses of male and female rats to either a short- or long-term administration of two doses of Maca (Lepidium peruvianum) and observe relationships which may exist between groups of hormones and effects mediated by them. Design: The effect of pre-gelatinized (extruded) organic Maca powder (Maca-GO) was studied on Sprague-Dowley male and female rats (1:1 ratio) receiving two dietary levels of Maca-GO (0.75 g/kg and 7.5 g/kg body weight) and assessed against control during 28 and 90 day laboratory trials on 30 and 60 rats respectively. Blood morphology, biochemistry (hormones, lipids and minerals) and histology of internal organs were determined. Homogenates of skeletal muscles and bones of rats were also analyzed. Results: Maca-GO has low toxicity (LD=7.5 g/kg) and appears to be safe for short-term and extended use as dietary supplement or as a component of functional dietary and therapeutic preparations. There were different responses of male and female rats to different levels of Maca-GO administered during a short- and a longer-term periodl. When administered at higher dose for extended period of time (90 days), Maca-GO acted as a toner of hormonal processes in adult female rats at increased progesterone and a steady estradiol level, without affecting levels of blood FSH, LH and TSH. Conclusions: Obtained results justify further clinical research on use of Maca-GO in sportsmen, physically-active people of both sexes and peri-menopausal women to clarify mechanisms underlaying physiological mode of action of Maca-GO validaet in clinical study on humans. Substantial decrease in blood cortisol levels in a short- and longer-term trial and simultaneous tendency to lower blood ACTH, may indicate antidepressive effect of Maca-GO, which together with reduction in body weight, lowering triglycerides in blood plasma and increasing calcium and phosphorus deposition in bone and muscle tissues is worthy consideration in potential application to women at both, pre- and postmenopausal stage. PMID:23674962

  6. Short and long-term physiological responses of male and female rats to two dietary levels of pre-gelatinized maca (lepidium peruvianum chacon).

    PubMed

    Meissner, H O; Kedzia, B; Mrozikiewicz, P M; Mscisz, A

    2006-02-01

    The aim of this study is to identify physiological responses of male and female rats to either a short- or long-term administration of two doses of Maca (Lepidium peruvianum) and observe relationships which may exist between groups of hormones and effects mediated by them. The effect of pre-gelatinized (extruded) organic Maca powder (Maca-GO) was studied on Sprague-Dowley male and female rats (1:1 ratio) receiving two dietary levels of Maca-GO (0.75 g/kg and 7.5 g/kg body weight) and assessed against control during 28 and 90 day laboratory trials on 30 and 60 rats respectively. Blood morphology, biochemistry (hormones, lipids and minerals) and histology of internal organs were determined. Homogenates of skeletal muscles and bones of rats were also analyzed. Maca-GO has low toxicity (LD=7.5 g/kg) and appears to be safe for short-term and extended use as dietary supplement or as a component of functional dietary and therapeutic preparations. There were different responses of male and female rats to different levels of Maca-GO administered during a short- and a longer-term periodl. When administered at higher dose for extended period of time (90 days), Maca-GO acted as a toner of hormonal processes in adult female rats at increased progesterone and a steady estradiol level, without affecting levels of blood FSH, LH and TSH. Obtained results justify further clinical research on use of Maca-GO in sportsmen, physically-active people of both sexes and peri-menopausal women to clarify mechanisms underlaying physiological mode of action of Maca-GO validaet in clinical study on humans. Substantial decrease in blood cortisol levels in a short- and longer-term trial and simultaneous tendency to lower blood ACTH, may indicate antidepressive effect of Maca-GO, which together with reduction in body weight, lowering triglycerides in blood plasma and increasing calcium and phosphorus deposition in bone and muscle tissues is worthy consideration in potential application to women at both, pre- and postmenopausal stage.

  7. Longer-term effects of selective thinning on microarthropod communities in a late-successional coniferous forest

    USGS Publications Warehouse

    Peck, R.W.; Niwa, C.G.

    2005-01-01

    Microarthropod densities within late-successional coniferous forests thinned 16-41 yr before sampling were compared with adjacent unthinned stands to identify longer term effects of thinning on this community. Soil and forest floor layers were sampled separately on eight paired sites. Within the forest floor oribatid, mesostigmatid, and to a marginal extent, prostigmatid mites, were reduced in thinned stands compared with unthinned stands. No differences were found for Collembola in the forest floor or for any mite suborder within the soil. Family level examination of mesostigmatid and prostigmatid mites revealed significant differences between stand types for both horizons. At the species level, thinning influenced numerous oribatid mites and Collembola. For oribatid mites, significant or marginally significant differences were found for seven of 15 common species in the forest floor and five of 16 common species in soil. Collembola were affected less, with differences found for one of 11 common species in the forest floor and three of 13 common species in soil. Multivariate analysis of variance and ordination indicated that forest thinning had little influence on the composition of oribatid mite and collembolan communities within either the forest floor or soil. Differences in microclimate or in the accumulation of organic matter on the forest floor were likely most responsible for the observed patterns of abundance. Considering the role that microarthropods play in nutrient cycling, determining the functional response of a wide range of taxa to thinning may be important to effective ecosystem management.

  8. Ten month outcome of cognitive behavioural therapy v. interpersonal psychotherapy in patients with major depression: a randomised trial of acute and maintenance psychotherapy.

    PubMed

    Mulder, R; Boden, J; Carter, J; Luty, S; Joyce, P

    2017-10-01

    Cognitive behaviour therapy (CBT) and interpersonal psychotherapy (IPT) are the most studied psychotherapies for treatment of depression, but they are rarely directly compared particularly over the longer term. This study compares the outcomes of patients treated with CBT and IPT over 10 months and tests whether there are differential or general predictors of outcome. A single centre randomised controlled trial (RCT) of depressed outpatients treated with weekly CBT or IPT sessions for 16 weeks and then 24 weeks of maintenance CBT or IPT. The principle outcome was depression severity measured using the MADRS. Pre-specified predictors of response were in four domains: demographic depression, characteristics, comorbidity and personality. Data were analysed over 16 weeks and 40 weeks using general linear mixed effects regression models. CBT was significantly more effective than IPT in reducing depressive symptoms over the 10 month study largely because it appeared to work more quickly. There were no differential predictors of response to CBT v. IPT at 16 weeks or 40 weeks. Personality variables were most strongly associated with overall outcome at both 16 weeks and 40 weeks. The number of personality disorder symptoms and lower self-directness and reward dependence scores were associated with poorer outcome for both CBT and IPT at 40 weeks. CBT and IPT are effective treatments for major depression over the longer term. CBT may work more quickly. Personality variables are the most relevant predictors of outcome.

  9. The effect of corticosteroid versus platelet-rich plasma injection therapies for the management of lateral epicondylitis: A systematic review

    PubMed Central

    Ben-Nafa, Walid; Munro, Wendy

    2018-01-01

    Introduction: Lateral epicondylitis is a common musculoskeletal disorder of the upper limb. Corticosteroid injection has been widely used as a major mode of treatment. However, better understanding of the pathophysiology of the disease led to a major change in treating the disease, with new options including platelet-rich plasma (PRP) are currently used. Objectives/research aim: To systematically evaluate the effect of corticosteroid versus PRP injections for the treatment of LE. Hypothesis: PRP injections provide longer-term therapeutic effect and less rate of complications compared to corticosteroid injection. Level of evidence: Level 2 evidence (4 included studies are of level 1 evidence, 1 study of level 2 evidence). Design: Systematic Review (according to PRISMA guidelines). Methods: Eleven databases used to search for relevant primary studies comparing the effects of corticosteroid and PRP injections for the treatment of LE. Quality appraisal of studies performed using Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0, CASP Randomised Controlled Trial Checklist, and SIGN Methodology Checklist 2. Results: 732 papers were identified. Five randomised controlled trials (250 Patients) met the inclusion criteria. Clinical findings: Corticosteroid injections provided rapid symptomatic improvement with maximum effect at 6/8/8 weeks before symptoms recurrence, whereas PRP showed slower ongoing improvements up to 24/52/104 weeks(3 studies). Corticosteroid showed more rapid symptomatic improvement of symptoms compared to PRP up to the study end-point of 3 months(1 study). Comparable therapeutic effects of corticosteroid and PRP were observed at 6 weeks(1 study). Ultrasonographic Findings: (1) Doppler activity decreased more significantly in patients who received corticosteroid compared to PRP. (2) Reduced tendon thickness and more patients with cortical erosion noted in corticosteroid group whereas increased tendon thickness and less number of patients with common extensor tendon tears noted in PRP group. (3) Fewer patients reported Probe-induced tenderness and oedema in the common extensor tendon in both corticosteroid and PRP groups (2 studies). Conclusion: Corticosteroid injections provide rapid therapeutic effect in the short-term with recurrence of symptoms afterwards, compared to the relatively slower but longer-term effect of platelet-rich plasma. PMID:29561260

  10. Calciphylaxis: no longer rare; no longer calciphylaxis? A paradigm shift for wound, ostomy and continence nursing.

    PubMed

    Feeser, Dianne L

    2011-01-01

    This article challenges conventional wisdom that calciphylaxis is a rare condition. Rather, emerging evidence suggests that calciphylaxis is neither rare nor uncommon. In addition, the term calciphylaxis is questioned because misrepresents the underlying etiology of the condition. Multiple researchers and clinicians advocate abandoning the use of the term, but nursing literature has not yet followed suit. This article reviews the epidemiology, clinical manifestations, diagnosis, prevention, and treatment of this condition and associated wounds, and suggests areas for future research. The WOC nurse's role as an educator, leader, researcher, clinical expert, and patient advocate is summarized.

  11. Neighborhood Predictors of Cognitive Training Outcomes and Trajectories in ACTIVE

    PubMed Central

    Meyer, Oanh L.; Sisco, Shannon M.; Harvey, Danielle; Zahodne, Laura B.; Glymour, M. Maria; Manly, Jennifer J.; Marsiske, Michael

    2015-01-01

    We examined the influence of neighborhood socioeconomic position (SEP), racial/ethnic composition, and living in a major city on cognitive trajectories and intervention outcomes. Data came from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (N = 2,438). Mixed effects analyses examined associations between neighborhood variables and memory, reasoning, speed of processing, and everyday cognition, estimating differences in initial gains (potentially related to practice) and long-term rate of change over 10 years. The effect of reasoning training on initial gain was weaker for individuals in a major city. For everyday cognition, there was a stronger initial gain for memory-trained and control participants in areas with more racial/ethnic minorities, and for speed-trained and control individuals in higher SEP areas. The racial/ethnic minority effect was no longer significant after adjustment for multiple comparisons. Neighborhood factors may be more important in practice-related improvement than in long-term change. PMID:26667987

  12. The Effect of Exercise Training on Serum Lipids in the Elderly.

    PubMed

    Ades, Philip A.; Poehlman, Eric T.

    1996-10-01

    Numerous intervention trials in young subjects suggest that aerobic exercise training exerts favorable effects on specific lipid subfractions, in particular serum triglycerides and high density lipoprotein (HDL) cholesterol. Cross sectional studies in older individuals suggest that active individuals have more favorable lipid profiles than inactive individuals. However, it remains controversial as to whether leisure time activity or fitness levels per se are independent predictors of lipid measures in the elderly versus their intermediate effects on body composition and body fat distribution. That is, a greater deposition of abdominal fat in the least fit individuals is associated with adverse lipid profiles. Short-term (8-weeks) aerobic exercise in elders is not associated with any significant changes in lipid profiles, however, longer term programs, particularly if associated with improvements in body fat distribution and/or weight loss, have been demonstrated to yield significant improvements in lipid subfractions, in particular triglycerides and HDL cholesterol.

  13. Short-term vegetation response following mechanical control of saltcedar (Tamarix spp.) on the Virgin River, Nevada, USA

    USGS Publications Warehouse

    Ostoja, Steven M.; Brooks, Matthew L.; Dudley, Tom; Lee, Steven R.

    2014-01-01

    and species diversity were very low, suggesting that targets of restoring vegetation to pre-invasion conditions were not met. Longer evaluation periods are needed to adequately evaluate how short-term post-treatment patterns translate to long-term patterns of plant community dynamics.

  14. Statins in hypercholesterolaemia: A dose-specific meta-analysis of lipid changes in randomised, double blind trials

    PubMed Central

    Edwards, Jayne E; Moore, R Andrew

    2003-01-01

    Background Statins alter lipid concentrations. This systematic review determined the efficacy of particular statins, in terms of their ability to alter cholesterol. Review methods PubMed, the Cochrane Library, references lists of reports, and reviews were searched (September 2001) for randomised, double blind trials of statins for cholesterol in trials of 12 weeks or longer. Mean change in total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides was calculated using pooled data for particular statins, and for particular doses of a statin. Pre-planned sensitivity analyses were used to determine the effects of initial concentration of total cholesterol, study duration, the effects of major trials, and effects in placebo versus active controlled trials. Information was not collected on adverse events. Results Different statins at a range of doses reduced total cholesterol by 17–35% and LDL-cholesterol by 24–49% from baseline. Lower doses of statins generally produced less cholesterol lowering, though for most statins in trials of 12 weeks or longer there was at best only a weak relationship between dose and cholesterol reduction. Duration of treatment and baseline total cholesterol concentration did not alter the amount of the benefit attained. Conclusions Statins are effective medicines and confer benefit to patients in terms of primary and secondary prevention of coronary heart disease. Reductions in total cholesterol of 25% or more and LDL cholesterol of more than 30% were recorded for fixed doses of simvastatin 40 mg, atorvastatin 10 mg, and rosuvastatin 5 mg and 10 mg. PMID:14969594

  15. The spatial learning and memory performance in methamphetamine–sensitized and withdrawn rats

    PubMed Central

    Bigdeli, Imanollah; Asia, Masomeh Nikfarjam- Haft; Miladi-Gorji, Hossein; Fadaei, Atefeh

    2015-01-01

    Objective(s): There is controversial evidence about the effect of methamphetamine (METH) on spatial memory. We tested the time- dependent effects of METH on spatial short-term (working) and long-term (reference) memory in METH –sensitized and withdrawn rats in the Morris water maze. Materials and Methods: Rats were sensitized to METH (2 mg/kg, daily/5 days, SC). Rats were trained in water maze (4 trials/day/for 5 days). Probe test was performed 24 hr after training. Two days after probe test, working memory training (2 trials/day/for 5 days) was conducted. Acquisition–retention interval was 75 min. The treatment was continued per day 30 and 120 min before the test. Two groups of METH –sensitized rats were trained in reference memory after a longer period of withdrawal (30 days). Results: Sensitized rats exhibited significantly longer escape latencies on the training, spent significantly less time in the target zone (all, P<0.05), and their working memory impaired 30 min after injection. While, METH has no effect on the spatial learning process 120 min after injection, and rats spent significantly less time in the target zone (P<0.05), as well it has no effect on working memory. Also, impairment of reference memory persisted after prolonged abstinence. Conclusion: Our findings indicated that METH impaired spatial learning and memory 30 min after injection, but spared spatial learning, either acquisition or retention of spatial working, but partially impaired retention of spatial reference memory following 120 min after injection in sensitized rats, which persisted even after prolonged abstinence. PMID:25945235

  16. Economic effects of clean indoor air policies on bar and restaurant employment in Minneapolis and St Paul, Minnesota.

    PubMed

    Klein, Elizabeth G; Forster, Jean L; Erickson, Darin J; Lytle, Leslie A; Schillo, Barbara

    2010-01-01

    Clean indoor air (CIA) policies have been adopted by communities across the United States and internationally to protect employees in all workplaces from exposure to environmental tobacco smoke. Concerns have been raised that banning smoking in workplaces, particularly in bars and restaurants, will result in severe, negative economic effects. Although objective studies have consistently found no significant economic effects from CIA policies, the concerns persist that CIA policies will negatively affect hospitality businesses. Employment in bars and restaurants in Minneapolis and St Paul, Minnesota, was independently evaluated over a five-year period during which CIA policies were established in each city. An interrupted time series analysis was used to evaluate the short-, intermediate, and longer-term economic effects of the local CIA policies, accounting for the rest of the hospitality industry. The CIA policies were associated with an increase of three percent to four percent in employment for restaurants in Minneapolis and St Paul, after accounting for the rest of the hospitality industry. The CIA policies were inconsistent in their association with bar employment. A comprehensive CIA policy in Minneapolis was associated with an increase of five percent to six percent in bar employment, and St Paul had a one percent nonsignificant decrease in bar employment. The CIA policies continue to yield the best protection against workplace exposure to environmental tobacco smoke for bars and restaurant employees and were not associated with large employment changes for the short or longer term in two urban Midwestern cities in the United States.

  17. A meta-analysis of working memory impairments in survivors of moderate-to-severe traumatic brain injury.

    PubMed

    Dunning, Darren L; Westgate, Briony; Adlam, Anna-Lynne R

    2016-10-01

    To establish the magnitude of deficits in working memory (WM) and short-term memory (STM) in those with moderate-to-severe traumatic brain injury (TBI) relative to age-matched, healthy controls and to explore the moderating effects of time since injury and age at injury on these impairments. Twenty-one studies that compared the WM and/or STM abilities of individuals with at least a moderate TBI relative to healthy controls were included in a random effects meta-analysis. Measures used to examine memory performance were categorized by modality (visuospatial, verbal) and memory system (WM, STM). Individuals with TBI had significant deficits in verbal STM (Cohen's d = .41), visuospatial WM (Cohen's d = .69), and verbal WM (Cohen's d = .37) relative to controls. Greater decrements in verbal STM and verbal WM skills were associated with longer time postinjury. Larger deficits were observed in verbal WM abilities in individuals with older age at injury. Evidence for WM impairments following TBI is consistent with previous research. Larger verbal STM and verbal WM deficits were related to a longer time postinjury, suggesting that these aspects of memory do not "recover" over time and instead, individuals might show increased rates of cognitive decline. Age at injury was associated with the severity of verbal WM impairments, with larger deficits evident for injuries that occurred later in life. Further research needs to chart the long-term effects of TBI on WM and to compare the effects of injury on verbal relative to visuospatial memory. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Dispositional optimism as predictor of outcome in short- and long-term psychotherapy.

    PubMed

    Heinonen, Erkki; Heiskanen, Tiia; Lindfors, Olavi; Härkäpää, Kristiina; Knekt, Paul

    2017-09-01

    Dispositional optimism predicts various beneficial outcomes in somatic health and treatment, but has been little studied in psychotherapy. This study investigated whether an optimistic disposition differentially predicts patients' ability to benefit from short-term versus long-term psychotherapy. A total of 326 adult outpatients with mood and/or anxiety disorder were randomized into short-term (solution-focused or short-term psychodynamic) or long-term psychodynamic therapy and followed up for 3 years. Dispositional optimism was assessed by patients at baseline with the self-rated Life Orientation Test (LOT) questionnaire. Outcome was assessed at baseline and seven times during the follow-up, in terms of depressive (BDI, HDRS), anxiety (SCL-90-ANX, HARS), and general psychiatric symptoms (SCL-90-GSI), all seven follow-up points including patients' self-reports and three including interview-based measures. Lower dispositional optimism predicted faster symptom reduction in short-term than in long-term psychotherapy. Higher optimism predicted equally rapid and eventually greater benefits in long-term, as compared to short-term, psychotherapy. Weaker optimism appeared to predict sustenance of problems early in long-term therapy. Stronger optimism seems to best facilitate engaging in and benefiting from a long-term therapy process. Closer research might clarify the psychological processes responsible for these effects and help fine-tune both briefer and longer interventions to optimize treatment effectiveness for particular patients and their psychological qualities. Weaker dispositional optimism does not appear to inhibit brief therapy from effecting symptomatic recovery. Patients with weaker optimism do not seem to gain added benefits from long-term therapy, but instead may be susceptible to prolonged psychiatric symptoms in the early stages of long-term therapy. © 2016 The British Psychological Society.

  19. The effects of volume versus intensity of long-term voluntary exercise on physiology and behavior in C57/Bl6 mice.

    PubMed

    Robison, Lisa S; Popescu, Dominique L; Anderson, Maria E; Beigelman, Steven I; Fitzgerald, Shannon M; Kuzmina, Antonina E; Lituma, David A; Subzwari, Sarima; Michaelos, Michalis; Anderson, Brenda J; Van Nostrand, William E; Robinson, John K

    2018-06-04

    Cardiovascular exercise (CVE) is associated with healthy aging and reduced risk of disease in humans, with similar benefits seen in animals. Most rodent studies, however, have used shorter intervention periods of a few weeks to a few months, begging questions as to the effects of longer-term, or even life-long, exercise. Additionally, most animal studies have utilized a single exercise treatment group - usually unlimited running wheel access - resulting in large volumes of exercise that are not clinically relevant. It is therefore incumbent to determine the physiological and cognitive/behavioral effects of a range of exercise intensities and volumes over a long-term period that model a lifelong commitment to CVE. In the current study, C57/Bl6 mice remained sedentary or were allowed either 1, 3, or 12 h of access to a running wheel per day, 5 days/weeks, beginning at 3.5-4 months of age. Following an eight-month intervention period, animals underwent a battery of behavioral testing, then euthanized and blood and tissue were collected. Longer access to a running wheel resulted in greater volume and higher running speed, but more breaks in running. All exercise groups showed similarly reduced body weight, increased muscle mass, improved motor function on the rotarod, and reduced anxiety in the open field. While all exercise groups showed increased food intake, this was greatest in the 12 h group but did not differ between 1 h and 3 h mice. While exercise dose-dependently increased working memory performance in the y-maze, the 1 h and 12 h groups showed the largest changes in the mass of many organs, as well as alterations in several behaviors including social interaction, novel object recognition, and Barnes maze performance. These findings suggest that long-term exercise has widespread effects on physiology, behavior, and cognition, which vary by "dose" and measure, and that even relatively small amounts of daily exercise can provide benefits. Copyright © 2018. Published by Elsevier Inc.

  20. Long-Term Efficacy of Oxybutynin for Palmar and Plantar Hyperhidrosis in Children Younger than 14 Years.

    PubMed

    Wolosker, Nelson; Teivelis, Marcelo P; Krutman, Mariana; de Paula, Rafael P; Schvartsman, Claudio; Kauffman, Paulo; de Campos, José R M; Puech-Leão, Pedro

    2015-01-01

    Oxybutynin for treating hyperhidrosis in children has been evaluated only in short-term studies. We aimed to investigate the long-term effects of oxybutynin in treating children with palmar and plantar hyperhidrosis who had not undergone surgery and who were monitored for at least 6 months (median 19.6 mos). A cohort of 97 patients was evaluated retrospectively, with particular attention to 59 children (ages 4-14 yrs) who were treated for longer than 6 months. Their quality of life (QOL) was evaluated using a validated clinical questionnaire before and after 6 weeks of pharmacologic therapy. A self-assessment of hyperhidrosis was performed after 6 weeks and after the last consultation. By their final office visit, more than 91% of the children with hyperhidrosis treated with oxybutynin experienced moderate or great improvement in their level of sweating and 94.9% experienced improvement in QOL. More than 90% of children reported improvement of hyperhidrosis at other sites. Dry mouth was the most common side effect. Oxybutynin appears to be an effective treatment option for children with hyperhidrosis, and positive results are maintained over the long term (median 19.6 mos). © 2014 Wiley Periodicals, Inc.

  1. Life cycles of traumatized teeth: long-term observations from a cohort of dental trauma victims - series 2.

    PubMed

    Heithersay, G S

    2016-09-01

    In this the second of a series of life cycles of dental trauma victims, the short and particularly long-term responses of four survivors of either multiple luxation injuries or avulsions have been documented over periods varying up to 41 years. The development of ankylosis, either in the short or longer term post trauma, proved a common feature in the series and management strategies have been outlined. External invasive resorption was also identified as a complicating response for which the topical application of trichloracetic acid, intracanal dressing and root canal obturation proved effective in resorption management. Long-term observations indicate that some compromised teeth can be functionally and aesthetically retained for extended periods, but follow-up examinations are important so that treatment interventions can be implemented if adverse responses are diagnosed. © 2016 Australian Dental Association.

  2. Investigation of Fat Metabolism during Antiobesity Interventions by Magnetic Resonance Imaging and Spectroscopy.

    PubMed

    Pola, Arunima; Sadananthan, Suresh Anand; Gopalan, Venkatesh; Tan, Min-Li Sandra; Keong, Terry Yew; Zhou, Zhihong; Ishino, Seigo; Nakano, Yoshihide; Watanabe, Masanori; Horiguchi, Takashi; Nishimoto, Tomoyuki; Zhu, Bin; Velan, S Sendhil

    2014-01-01

    The focus of current treatments for obesity is to reduce the body weight or visceral fat, which requires longer duration to show effect. In this study, we investigated the short-term changes in fat metabolism in liver, abdomen, and skeletal muscle during antiobesity interventions including Sibutra mine treatment and diet restriction in obese rats using magnetic resonance imaging, magnetic resonance spectroscopy, and blood chemistry. Sibutramine is an antiobesity drug that results in weight loss by increasing satiety and energy expenditure. The Sibutramine-treated rats showed reduction of liver fat and intramyocellular lipids on day 3. The triglycerides (TG) decreased on day 1 and 3 compared to baseline (day 0). The early response/nonresponse in different fat depots will permit optimization of treatment for better clinical outcome rather than staying with a drug for longer periods.

  3. 5 CFR 412.401 - Continuing executive development.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Section 412.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE DEVELOPMENT Executive Development § 412.401 Continuing executive... participation in short-term and longer-term experiences, meet organizational needs for leadership, managerial...

  4. 5 CFR 412.401 - Continuing executive development.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... participation in short-term and longer-term experiences, meet organizational needs for leadership, managerial improvement, and organizational results; (2) Address enhancement of existing executive competencies and such other competencies as will strengthen the executive's performance; (3) Outline developmental...

  5. Is There a Delay in Diagnosis of Duchenne Muscular Dystrophy Among Preterm-Born Males?

    PubMed

    Soim, Aida; Smith, Michael G; Kwon, Jennifer M; Mann, Joshua R; Thomas, Shiny; Ciafaloni, Emma

    2018-07-01

    The objective of this study was to investigate whether males who were born preterm took longer to receive a Duchenne muscular dystrophy diagnosis than term males. Data for males with Duchenne muscular dystrophy identified through a population-based surveillance system were analyzed using a Kaplan-Meier estimator. The first signs and symptoms were noted at a median age of 2 years in both groups. Median age when first signs and symptoms prompted medical evaluation was 2.59 years among preterm and 4.01 years among term males. Median age at definitive diagnosis was 4.25 years and 4.92 years for preterm and term males, respectively. Neither difference was statistically significant. Preterm males tended to be seen for their initial medical evaluation earlier than term males, though they were not diagnosed significantly earlier. It may take clinicians longer after the initial evaluation of preterm males to arrive at a Duchenne muscular dystrophy diagnosis.

  6. The cost-effectiveness of exercise-based cardiac rehabilitation: a systematic review of the characteristics and methodological quality of published literature.

    PubMed

    Edwards, Katherine; Jones, Natasha; Newton, Julia; Foster, Charlie; Judge, Andrew; Jackson, Kate; Arden, Nigel K; Pinedo-Villanueva, Rafael

    2017-10-19

    This descriptive review aimed to assess the characteristics and methodological quality of economic evaluations of cardiac rehabilitation (CR) programs according to updated economic guidelines for healthcare interventions. Recommendations will be made to inform future research addressing the impact of a physical exercise component on cost-effectiveness. Electronic databases were searched for economic evaluations of exercise-based CR programs published in English between 2000 and 2014. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement was used to review the methodological quality of included economic evaluations. Fifteen economic evaluations met the review inclusion criteria. Assessed study characteristics exhibited wide variability, particularly in their economic perspective, time horizon, setting, comparators and included costs, with significant heterogeneity in exercise dose across interventions. Ten evaluations were based on randomised controlled trials (RCTs) spanning 6-24 months but often with weak or inconclusive results; two were modelling studies; and the final three utilised longer time horizons of 3.5-5 years from which findings suggest that long-term exercise-based CR results in lower costs, reduced hospitalisations and a longer cumulative patient lifetime. None of the 15 articles met all the CHEERS quality criteria, with the majority either fully or partially meeting a selection of the assessed variables. Evidence exists supporting the cost-effectiveness of exercise-based CR for cardiovascular disease patients. However, variability in CR program delivery and weak consistency between study perspective and design limits study comparability and therefore the accumulation of evidence in support of a particular exercise regime. The generalisability of study findings was limited due to the exclusion of patients with comorbidities as would typically be found in a real-world setting. The use of longer time-horizons would be more comparable with a chronic condition and enable economic assessments of the long-term effects of CR. As none of the articles met recent reporting standards for the economic assessment of healthcare interventions, it is recommended that future studies adhere to such guidelines.

  7. Whatever Became of the Learning City?

    ERIC Educational Resources Information Center

    Yarnit, Martin

    2015-01-01

    During the 1990s, the UK Learning City Network was a large and influential movement with government support, the most significant national body of its kind anywhere. Yet, less than a decade later, it was in decline and now no longer exists. But while few UK towns or cities any longer use the term "learning city", the notion lives on as…

  8. 2014 - 2015 Civil Affairs Issue Papers: The Future of Civil Affairs

    DTIC Science & Technology

    2015-02-18

    companies. Included is a request for a SME on zoonotic diseases to help with a strange virus effecting goat herds in Beledweyne, a call for advice from a...local veterinary officer orders the right medication to treat the goats , the water plant manager or- ders the right pumps to improve agricultural...Since most CIM RFI deal with longer term civil sector challenges such as agri- cultural, farming , and education questions, responses are not

  9. [Therapy of Childhood Asthma with Beclomethasone Dipropionate (author's transl)].

    PubMed

    Wahn, U; Lipinski, Ch

    1976-08-01

    In addition to the usual mangement of asthma the introduction of Beclomethasone-dipropionate aerosol can be considered as a progress in the long-term treatment of asthma, because in most cases oral and parenteral application of corticosteroids is no longer necessary. According to the results of many authors the wellknown side effects of steriod therapy have so far not been observed. We report our experiences with Beclomethasone in the treatment of 19 chronically asthmatic children.

  10. 76 FR 7881 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... and Bonds of Specified Maturities (in percent) 3-Year 5-Year 7-Year 10-Year 20-Year 30-Year 1.4 1.9 2...-Year 5-Year 7-Year 10-Year 20-Year 30-Year 0.0 0.4 0.8 1.3 2.1 2.3 Analyses of programs with terms... longer than 30 years may use the 30-year interest rate. [FR Doc. 2011-3044 Filed 2-10-11; 8:45 am...

  11. Preventing adolescent drug use: long-term results of a junior high program.

    PubMed Central

    Ellickson, P L; Bell, R M; McGuigan, K

    1993-01-01

    OBJECTIVES. Although several studies have reported short-term gains for drug-use prevention programs targeted at young adolescents, few have assessed the long-term effects of such programs. Such information is essential for judging how long prevention benefits last. This paper reports results over a 6-year period for a multisite randomized trial that achieved reductions in drug use during the junior high school years. METHODS. The 11-lesson curriculum, which was tested in 30 schools in eight highly diverse West Coast communities, focused on helping 7th and 8th grade students develop the motivation and skills to resist drugs. Schools were randomly assigned to treatment and control conditions. About 4000 students were assessed in grade 7 and six times thereafter through grade 12. Program effects were adjusted for pretest covariates and school effects. RESULTS. Once the lessons stopped, the program's effects on drug use stopped. Effects on cognitive risk factors persisted for a longer time (many through grade 10), but were not sufficient to produce corresponding reductions in use. CONCLUSIONS. It is unlikely that early prevention gains can be maintained without additional prevention efforts during high school. Future research is needed to develop and test such efforts. PMID:8498624

  12. Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis.

    PubMed

    Ding, Chao; Jiang, Da-ming; Tao, Kai-yu; Duan, Qun-jun; Li, Jie; Kong, Min-jian; Shen, Zhong-hua; Dong, Ai-qiang

    2014-06-01

    Mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (P<0.00001). According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.

  13. Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis

    PubMed Central

    Ding, Chao; Jiang, Da-ming; Tao, Kai-yu; Duan, Qun-jun; Li, Jie; Kong, Min-jian; Shen, Zhong-hua; Dong, Ai-qiang

    2014-01-01

    Objective: Mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. Methods: One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. Results: ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (P<0.00001). According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Conclusions: Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival. PMID:24903989

  14. Effectiveness of cognitive-behavioural therapy on glycaemic control and psychological outcomes in adults with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Uchendu, C; Blake, H

    2017-03-01

    Diabetes is a chronic progressive condition presenting physical, social and psychological challenges that increase the risk of comorbid mental health problems. Cognitive-behavioural therapy (CBT) is effective in treating a variety of psychological disorders, and may potentially improve glycaemic control and psychological outcomes in diabetes. This systematic review and meta-analysis aims to establish the effectiveness of CBT on glycaemic control and comorbid diabetes-related distress, depression, anxiety and quality of life in the short, medium and longer term among adults with diabetes. An electronic search was conducted in PubMed, Embase, MEDLINE, PsycINFO, CINAHL, Web of Knowledge, Cochrane Central Register of Controlled Trials and references in reviews. Twelve randomized controlled trials (RCTs) were identified that evaluated the effectiveness of CBT on at least one of: glycaemic control, diabetes-related distress, anxiety, depression or quality of life in adults with Type 1 or Type 2 diabetes. The Cochrane Risk of Bias Tool and Review Manager version 5.3 were used for risk of bias assessment and meta-analysis, respectively. CBT is effective in reducing short-term and medium-term glycaemic control, although no significant effect was found for long-term glycaemic control. CBT improved short- and medium-term anxiety and depression, and long-term depression. Mixed results were found for diabetes-related distress and quality of life. CBT is beneficial in improving depression for adults with diabetes. It may have benefits for improving glycaemic control and other aspects of psychological health, although the findings are inconclusive. © 2016 Diabetes UK.

  15. Pharmacological Treatment of Binge Eating Disorder: Update Review and Synthesis

    PubMed Central

    Reas, Deborah L.; Grilo, Carlos M.

    2015-01-01

    Introduction Binge-eating disorder (BED), a formal eating-disorder diagnosis in the DSM-5, is characterized by recurrent binge-eating, marked distress about binge-eating, and the absence of extreme weight compensatory behaviors. BED is more prevalent than other eating-disorders, with broader distribution across age, sex, and ethnic/racial groups, and is associated strongly with obesity and heightened risk for psychiatric/medical comorbidities. Areas Covered This article provides an overview of pharmacotherapy for BED with a focus on III randomized controlled trials (RCTs). The search with minimal methodological inclusion requirements yielded 22 RCTs investigating several different medication classes; most were pharmacotherapy-only trials with eight trials testing combination approaches with psychological-behavioral methods. Expert Opinion The evidence base regarding pharmacotherapy for BED remains limited, although this year the FDA approved the first medication (i.e., lisdexamfetamine dimesylate; LDX) specifically for moderate-to-severe BED. Data from RCTs suggests certain medications are superior to placebo for reducing binge-eating over the short-term; almost no data exist regarding longer-term effects of pharmacotherapy for BED. Except for topiramate, which significantly reduces both binge-eating and weight, tested medications yield minimal weight loss and LDX is not indicated for weight loss. Psychological-behavioral and combination approaches with certain medications yield superior outcomes to pharmacotherapy-only acutely and over longer-term follow-up. PMID:26044518

  16. Sex influence on face recognition memory moderated by presentation duration and reencoding.

    PubMed

    Weirich, Sebastian; Hoffmann, Ferdinand; Meissner, Lucia; Heinz, Andreas; Bengner, Thomas

    2011-11-01

    It has been suggested that women have a better face recognition memory than men. Here we analyzed whether this advantage depends on a better encoding or consolidation of information and if the advantage is visible during short-term memory (STM), only, or whether it also remains evident in long-term memory (LTM). We tested short- and long-term face recognition memory in 36 nonclinical participants (19 women). We varied the duration of item presentation (1, 5, and 10 s), the time of testing (immediately after the study phase, 1 hr, and 24 hr later), and the possibility to reencode items (none, immediately after the study phase, after 1 hr). Women showed better overall face recognition memory than men (ηp² = .15, p < .05). We found this advantage, however, only with a longer duration of item presentation (interaction effect Sex × ηp² = .16, p < .05). Women's advantage in face recognition was visible mainly if participants had the possibility to reencode faces during former test trials. Our results suggest women do not have a better face recognition memory than men per se, but may profit more than men from longer durations of presentation during encoding or the possibility for reencoding. Future research on sex differences in face recognition memory should explicate possible causes for the better encoding of face information in women.

  17. Achievement of target A1C levels with negligible hypoglycemia and low glucose variability in youth with short-term type 1 diabetes and residual β-cell function.

    PubMed

    Sherr, Jennifer; Tamborlane, William V; Xing, Dongyuan; Tsalikian, Eva; Mauras, Nelly; Buckingham, Bruce; White, Neil H; Arbelaez, Ana Maria; Beck, Roy W; Kollman, Craig; Ruedy, Katrina

    2012-04-01

    To determine exposure to hyper- and hypoglycemia using blinded continuous glucose monitoring (CGM) profiles in youth with type 1 diabetes (T1D) with residual β-cell function during the first year of insulin treatment. Blinded, 3-7 day CGM profiles were obtained in 16 short-term T1D patients (age 8-18 years, T1D duration 6-52 weeks) who had peak C-peptide levels ranging from 0.46 to 1.96 nmol/L during a mixed-meal tolerance test. Results in this short-term group were compared with those in 34 patients with well-controlled, longer-term T1D (duration ≥5 years), matched for age and A1C with the short-term T1D group, and with those in 26 age-matched nondiabetic individuals. Despite matching for A1C, and therefore similar mean sensor glucose levels in the two T1D groups, short-term T1D participants had a lower frequency of hypoglycemia (0.3 vs. 7.6%, P < 0.001), a trend toward less hyperglycemia (17 vs. 32%, P = 0.15), and a greater percentage in the target range (median 77 vs. 60%, P = 0.02). Indeed, the percentage of sensor glucose levels ≤70 mg/dL in the short-term T1D group (0.3%) did not differ from those in the nondiabetic group (1.7%, P = 0.73). The coefficient of variation of sensor glucose levels (an index of glucose variability) was lower in short-term vs. longer-term T1D participants (27 vs. 42%, respectively, P < 0.001). In youth with short-term T1D who retain residual β-cell function, there is negligible exposure to hypoglycemia and lower glucose variability than in youth with well-controlled T1D of longer duration.

  18. Evidence for effective interventions to reduce mental-health-related stigma and discrimination.

    PubMed

    Thornicroft, Graham; Mehta, Nisha; Clement, Sarah; Evans-Lacko, Sara; Doherty, Mary; Rose, Diana; Koschorke, Mirja; Shidhaye, Rahul; O'Reilly, Claire; Henderson, Claire

    2016-03-12

    Stigma and discrimination in relation to mental illnesses have been described as having worse consequences than the conditions themselves. Most medical literature in this area of research has been descriptive and has focused on attitudes towards people with mental illness rather than on interventions to reduce stigma. In this narrative Review, we summarise what is known globally from published systematic reviews and primary data on effective interventions intended to reduce mental-illness-related stigma or discrimination. The main findings emerging from this narrative overview are that: (1) at the population level there is a fairly consistent pattern of short-term benefits for positive attitude change, and some lesser evidence for knowledge improvement; (2) for people with mental illness, some group-level anti-stigma inventions show promise and merit further assessment; (3) for specific target groups, such as students, social-contact-based interventions usually achieve short-term (but less clearly long-term) attitudinal improvements, and less often produce knowledge gains; (4) this is a heterogeneous field of study with few strong study designs with large sample sizes; (5) research from low-income and middle-income countries is conspicuous by its relative absence; (6) caution needs to be exercised in not overgeneralising lessons from one target group to another; (7) there is a clear need for studies with longer-term follow-up to assess whether initial gains are sustained or attenuated, and whether booster doses of the intervention are needed to maintain progress; (8) few studies in any part of the world have focused on either the service user's perspective of stigma and discrimination or on the behaviour domain of behavioural change, either by people with or without mental illness in the complex processes of stigmatisation. We found that social contact is the most effective type of intervention to improve stigma-related knowledge and attitudes in the short term. However, the evidence for longer-term benefit of such social contact to reduce stigma is weak. In view of the magnitude of challenges that result from mental health stigma and discrimination, a concerted effort is needed to fund methodologically strong research that will provide robust evidence to support decisions on investment in interventions to reduce stigma. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Taking the fuel out of the fire: evidence for the use of anti-inflammatory agents in the treatment of bipolar disorders.

    PubMed

    Ayorech, Ziada; Tracy, Derek K; Baumeister, David; Giaroli, Giovanni

    2015-03-15

    Inflammation has emerged as a potentially important factor - and thus putative pharmacological target - in the pathology of bipolar disorders. However to date no systematic evaluations of the efficacy of add on anti-inflammatory treatment for the depressive and manic episodes have been carried out. Sixteen articles were ultimately identified - by computer searches of databases (including PsycINFO, MEDLINE, and EMBASE), supplemented by hand searches and personal communication - as meeting study inclusion criteria. Anti-manic effects were evaluated in two trials, one of adjunctive n-acetyl cysteine (NAC), one of omega-3 fatty acids (O3FA), and significant improvements only emerged for NAC. Celecoxib had a rapid but short-lived antidepressant effect. Despite limited effects of O3FA on symptoms, imaging data demonstrated alterations in neuronal functioning that might have longer-term therapeutic effects. Evidence was strongest for adjunctive NAC in bipolar depression though conclusions are limited by small sample sizes. Definitive conclusions are limited by the paucity of data, small study sizes, and the variability in methodology used. Current evidence for aspirin or celecoxib is insufficient though further investigation of the potential of celecoxib in early illness onset is warranted. Variable evidence exists for add-on O3FA though an indication of short-term treatment effects on membrane fluidity and neuronal activity suggest longer follow-up assessment is needed. The strongest evidence emerged for NAC in depression and future studies must address the role of illness duration and patients׳ baseline medications on outcomes. Careful consideration of lithium toxicity in the elderly and renal impaired is essential. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Monitoring long-term evolutionary changes following Wolbachia introduction into a novel host: the Wolbachia popcorn infection in Drosophila simulans

    PubMed Central

    Carrington, Lauren B.; Hoffmann, Ary A.; Weeks, Andrew R.

    2010-01-01

    Wolbachia may act as a biological control agent for pest management; in particular, the Wolbachia variant wMelPop (popcorn) shortens host longevity and may be useful for dengue suppression. However, long-term changes in the host and Wolbachia genomes can alter Wolbachia spread and/or host effects that suppress disease. Here, we investigate the phenotypic effects of wMelPop in a non-native host, Drosophila simulans, following artificial transinfection approximately 200 generations ago. Long-term rearing and maintenance of the bacteria were at 19°C in the original I-102 genetic background that was transinfected with the popcorn strain. The bacteria were then introgressed into three massbred backgrounds, and tetracycline was used to create uninfected sublines. The effect of wMelPop on longevity in this species appears to have changed; longevity was no longer reduced at 25°C in some nuclear backgrounds, reflecting different geographical origin, selection or drift, although the reduction was still evident for flies held at 30°C. Wolbachia influenced productivity and viability, and development time in some host backgrounds. These findings suggest that long-term attenuation of Wolbachia effects may compromise the effectiveness of this bacterium in pest control. They also emphasize the importance of host nuclear background on Wolbachia phenotypic effects. PMID:20219740

  1. Low-carbohydrate diet induces metabolic depression: a possible mechanism to conserve glycogen.

    PubMed

    Winwood-Smith, Hugh S; Franklin, Craig E; White, Craig R

    2017-10-01

    Long-term studies have found that low-carbohydrate diets are more effective for weight loss than calorie-restricted diets in the short term but equally or only marginally more effective in the long term. Low-carbohydrate diets have been linked to reduced glycogen stores and increased feelings of fatigue. We propose that reduced physical activity in response to lowered glycogen explains the diminishing weight loss advantage of low-carbohydrate compared with low-calorie diets over longer time periods. We explored this possibility by feeding adult Drosophila melanogaster a standard or a low-carbohydrate diet for 9 days and measured changes in metabolic rate, glycogen stores, activity, and body mass. We hypothesized that a low-carbohydrate diet would cause a reduction in glycogen stores, which recover over time, a reduction in physical activity, and an increase in resting metabolic rate. The low-carbohydrate diet reduced glycogen stores, which recovered over time. Activity was unaffected by diet, but metabolic rate was reduced, in the low-carbohydrate group. We conclude that metabolic depression could explain the decreased effectiveness of low-carbohydrate diets over time and recommend further investigation of long-term metabolic effects of dietary interventions and a greater focus on physiological plasticity within the study of human nutrition. Copyright © 2017 the American Physiological Society.

  2. In vitro influence of light radiation on hair steroid concentrations.

    PubMed

    Grass, Juliane; Miller, Robert; Carlitz, Esther H D; Patrovsky, Fabian; Gao, Wei; Kirschbaum, Clemens; Stalder, Tobias

    2016-11-01

    Hair cortisol concentrations (hairF) are considered to be relatively robust to various confounding influences. However, a potentially important covariate factor that has received little attention in this context is hair exposure to ultraviolet/sunlight radiation. We conducted a detailed experimental investigation to examine the effects of light exposure on hair cortisol. In study I, a hydrocortisone-containing solution was subjected to short-term artificial light irradiation for 1, 3, 5, 10, 15, or 30min to evaluate the stability of cortisol molecules due to radiant energy. In study II, hair samples (N=12) were subjected to single short-term artificial light irradiation for 0, 1, or 5h to examine light-induced effects in the hair matrix. In study III, hair samples (N=25) were subjected to long-term naturalistic sunlight radiation over a period of two months (during summer) with daily exposure times of 0, 1, 3, or 6h, respectively. Besides cortisol, studies II & III also examined concentrations of cortisone (hairE), dehydroepiandrosterone (hairDHEA) and progesterone (hairP) in hair, quantified using LC-MS/MS technology. Results across the three studies consistently revealed effects of light irradiation on hair steroid concentrations: Longer light exposure resulted in a decrease of dissolved hydrocortisone (study I) as well as of hairF and hairE (studies II and III). Conversely, hairDHEA and hairP increased with longer natural sunlight exposure times (study III), while this effect was not observed for short-term artificial light irradiation (study II). Combined, our findings imply sunlight exposure as a potential confound in hair steroid research. Given the experimental character of this investigation, the magnitude of this effect under real-life testing conditions is difficult to estimate. To support future investigation into this, we designed a 'sunlight-exposure' questionnaire to share with the research community. The assessment and statistical accounting for sunlight exposure-related effects in future hair steroid research (using this or a similar questionnaire) may help to reduce the potential influence of this unwanted error source and could thus lead to more valid and reliable results. In addition, our data strongly suggest that hair samples for steroid analyses need to be stored in a dark environment. Copyright © 2016. Published by Elsevier Ltd.

  3. Simulation of Halocarbon Production and Emissions and Effects on Ozone Depletion

    PubMed

    Holmes; Ellis

    1997-09-01

    / This paper describes an integrated model that simulates future halocarbon production/emissions and potential ozone depletion. Applications and historical production levels for various halocarbons are discussed first. A framework is then presented for modeling future halocarbon impacts incorporating differences in underlying demands, applications, regulatory mandates, and environmental characteristics. The model is used to simulate the potential impacts of several prominent issues relating to halocarbon production, regulation, and environmental interactions, notably: changes in agricultural methyl bromide use, increases in effectiveness of bromine for ozone depletion, modifications to the elimination schedule for HCFCs, short-term expansion of CFC demand in low use compliance countries, and delays in Russian Federation compliance. Individually, each issue does not unequivocally represent a significant likely increase in long-term atmospheric halogen loading and stratospheric ozone depletion. In combination, however, these impacts could increase peak halogen concentrations and long-term integral halogen loading, resulting in higher levels of stratospheric ozone depletion and longer exposure to increased levels of UV radiation.KEY WORDS: Halocarbons; Ozone depletion; Montreal Protocol; Integrated assessment

  4. Using enquiry in learning: from vision to reality in higher education.

    PubMed

    Horne, Maria; Woodhead, Kath; Morgan, Liz; Smithies, Lynda; Megson, Denise; Lyte, Geraldine

    2007-02-01

    This paper reports on the contribution of six nurse educators to embed enquiry-led learning in a pre-registration nursing programme. Their focus was to evaluate student and facilitator perspectives of a hybrid model of problem-based learning, a form of enquiry-based learning and to focus on facilitators' perceptions of its longer-term utility with large student groups. Problem-based learning is an established learning strategy in healthcare internationally; however, insufficient evidence of its effectiveness with large groups of pre-registration students exists. Fourth Generation Evaluation was used, applying the Nominal Group Technique and Focus Group interviews, for data collection. In total, four groups representing different branches of pre-registration students (n = 121) and 15 facilitators participated. Students identified seven strengths and six areas for development related to problem-based learning. Equally, analysis of facilitators' discussions revealed several themes related to strengths and challenges. The consensus was that using enquiry aided the development of independent learning and encouraged deeper exploration of nursing and allied subject material. However, problems and frustrations were identified in relation to large numbers of groups, group dynamics, room and library resources and personal development. The implications of these findings for longer-term utility with large student groups are discussed.

  5. Collaborative risk governance in informal urban areas: The case of Wallacedene temporary relocation area

    PubMed Central

    2017-01-01

    Community-based disaster risk management (CBDRM) is an emancipatory approach that aims to empower local communities in reducing their own risks. A community risk assessment (CRA) is an essential element of CBDRM, incorporating highly participatory processes of hazard identification and vulnerability analysis. By incorporating local knowledge and insights, together with those contributed by other external role players, the nature of local risks can be more accurately identified, giving consideration to their causal factors, the nature of their realised impacts or potential effects on a local community and the challenges posed in addressing them. Reflecting on the process and outcomes of a CRA conducted in an informal settlement in the Cape Town metropolitan area, this article describes how one such risk assessment contributed to building local agency through a process of collaborative engagement. Offered as an example of possible best practice, it illustrates both the immediate and potentially longer term benefits to be derived from such a collaborative process, suggesting that a community-based risk assessment may contribute significantly to building more resilient communities. It concludes with a consideration of the challenges of sustaining longer term risk reduction efforts.

  6. Effect of working conditions on non-work-related sickness absence.

    PubMed

    Sampere, M; Gimeno, D; Serra, C; Plana, M; Martínez, J M; Delclos, G L; Benavides, F G

    2012-01-01

    There is limited evidence of the role of working conditions as prognostic factors for non-work-related sickness absence (i.e. absence due to injuries or diseases of non-occupational origin). To analyse the association between working conditions and time to return to work (RTW) in workers with long-term (>15 days) non-work-related sickness absence. We followed up a total of 655 workers, who completed a baseline questionnaire including physical and psychosocial work factors, until their non-work-related long-term sickness absence ended. Time to RTW was determined based on the health insurance company register. Cox proportional hazard models were constructed to evaluate the associations between working conditions and time to RTW. A self-perceived high level of physical activity at work and work with back twisted or bent were related to longer duration of sickness absence. We did not find any strong evidence of associations between psychosocial work factors and time to RTW, although higher job insecurity and low reward showed marginal statistical significance. Hazardous physical working conditions are associated with longer duration of non-work-related sickness absence. Workplace ergonomic interventions could conceivably shorten the length of sickness absence that has not originated at work.

  7. Connectivity variations in time and space: role of events, structures and morphology in ephemeral channels

    NASA Astrophysics Data System (ADS)

    Hooke, Janet

    2017-04-01

    Flow and sediment processes in ephemeral channels are highly dynamic and spatially variable. The connectivity characteristics in a range of events are examined for several semi-arid catchments in Southeast Spain. Rainfall thresholds for runoff generation on slopes and for flow generation in channels have been identified at various scales. In many events, flow is not continuous down the channel system due partly to localised rainfall and to transmission losses but also to structural and morphological conditions. One extreme flow event with high sediment supply produced very high flow and sediment connectivity throughout the system. Results of spatial analysis of variation in hydraulics and sediment processes are presented and the effects are analysed. Amounts and locations of sediment storage were identified from repeat surveys. The overall contribution of such an event to morphological and sedimentological changes in the channel and longer-term landscape evolution is assessed. Land use and management are demonstrated to have a profound influence on the sediment delivery and connectivity functioning. The implications for land, channel and flood management in such an environment, together with the impacts of longer-term variations in flow regime due to land use and climate change, are considered.

  8. Custodial Parole Sanctions and Earnings after Release from Prison

    PubMed Central

    Harding, David J.; Siegel, Jonah A.; Morenoff, Jeffrey D.

    2018-01-01

    Although the labor market consequences of incarceration in prison have been central to the literature on mass incarceration, punishment, and inequality, other components of the growing criminal justice system have received less attention from sociologists. In particular, the rise of mass incarceration was accompanied by an even larger increase in community supervision. In this paper, we examine the labor market effects of one frequently experienced aspect of post-prison parole, short-term custody for parole violations. Although such sanctions are viewed as an alternative to returning parole violators to prison, they have the potential to affect labor market outcomes in ways similar to imprisonment, including both adverse and positive effects on earnings. We estimate that parolees lost approximately 37 percent of their earnings in quarters during which they were in short-term custody. Although their earnings tended to increase in the quarter immediately following short-term custody—consistent with the stated intentions of such sanctions—parolees experienced further earnings loss over the longer term after such sanctions. In the third quarter following a short-term custody sanction, earnings are lowered by about 13 percent. These associations are larger for those who were employed in the formal labor market before their initial incarceration. PMID:29706673

  9. Double-blind optimization of subcallosal cingulate deep brain stimulation for treatment-resistant depression: a pilot study.

    PubMed

    Ramasubbu, Rajamannar; Anderson, Susan; Haffenden, Angela; Chavda, Swati; Kiss, Zelma H T

    2013-09-01

    Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is reported to be a safe and effective new treatment for treatment-resistant depression (TRD). However, the optimal electrical stimulation parameters are unknown and generally selected by trial and error. This pilot study investigated the relationship between stimulus parameters and clinical effects in SCC-DBS treatment for TRD. Four patients with TRD underwent SCC-DBS surgery. In a double-blind stimulus optimization phase, frequency and pulse widths were randomly altered weekly, and corresponding changes in mood and depression were evaluated using a visual analogue scale (VAS) and the 17-item Hamilton Rating Scale for Depression (HAM-D-17). In the open-label postoptimization phase, depressive symptoms were evaluated biweekly for 6 months to determine long-term clinical outcomes. Longer pulse widths (270-450 μs) were associated with reductions in HAM-D-17 scores in 3 patients and maximal happy mood VAS responses in all 4 patients. Only 1 patient showed acute clinical or mood effects from changing the stimulation frequency. After 6 months of open-label therapy, 2 patients responded and 1 patient partially responded. Limitations include small sample size, weekly changes in stimulus parameters, and fixed-order and carry-forward effects. Longer pulse width stimulation may have a role in stimulus optimization for SCC-DBS in TRD. Longer pulse durations produce larger apparent current spread, suggesting that we do not yet know the optimal target or stimulus parameters for this therapy. Investigations using different stimulus parameters are required before embarking on large-scale randomized sham-controlled trials.

  10. Preferred viewing distance and screen angle of electronic paper displays.

    PubMed

    Shieh, Kong-King; Lee, Der-Song

    2007-09-01

    This study explored the viewing distance and screen angle for electronic paper (E-Paper) displays under various light sources, ambient illuminations, and character sizes. Data analysis showed that the mean viewing distance and screen angle were 495 mm and 123.7 degrees. The mean viewing distances for Kolin Chlorestic Liquid Crystal display was 500 mm, significantly longer than Sony electronic ink display, 491 mm. Screen angle for Kolin was 127.4 degrees, significantly greater than that of Sony, 120.0 degrees. Various light sources revealed no significant effect on viewing distances; nevertheless, they showed significant effect on screen angles. The screen angle for sunlight lamp (D65) was similar to that of fluorescent lamp (TL84), but greater than that of tungsten lamp (F). Ambient illumination and E-paper type had significant effects on viewing distance and screen angle. The higher the ambient illumination was, the longer the viewing distance and the lesser the screen angle. Character size had significant effect on viewing distances: the larger the character size, the longer the viewing distance. The results of this study indicated that the viewing distance for E-Paper was similar to that of visual display terminal (VDT) at around 500 mm, but greater than normal paper at about 360 mm. The mean screen angle was around 123.7 degrees, which in terms of viewing angle is 29.5 degrees below horizontal eye level. This result is similar to the general suggested viewing angle between 20 degrees and 50 degrees below the horizontal line of sight.

  11. Plantar hyperhidrosis: A review of current management.

    PubMed

    Singh, Sanjay; Kaur, Simranjit; Wilson, Paul

    2016-11-01

    To critically appraise current literature regarding the management of plantar hyperhidrosis in the form of a structured review. A literature search was conducted using various databases and search criteria. The literature reports the use of conservative, medical and surgical treatment modalities for the management of plantar hyperhidrosis. However, long-term follow-up data are rare and some treatment modalities currently available are not fully understood. There is a considerable dearth in the literature on the management of plantar hyperhidrosis. Further study in larger populations with longer follow-up times is critical to access the long-term effects of treatment. Nonetheless, iontophoresis, botulinum toxin injection and lumbar sympathectomy are promising treatment modalities for this disorder.

  12. CF6-6D engine performance deterioration

    NASA Technical Reports Server (NTRS)

    Wulf, R. H.; Kramer, W. H.; Pass, J. E.; Smith, J. J.

    1980-01-01

    Cruise cockpit recordings and test cell performance data in conjunction with hardware inspection data from airline overhaul shops were analyzed to define the extent and magnitude of performance deterioration of the General Electric CF6-6D model engine. These studies successfully isolated short-term deterioration from the longer term, and defined areas where a significant reduction in aircraft energy requirements for the 1980's can be realized. Unrestored losses which remain after engine refurbishment represent over 70% of the loss at engine shop visit. Sixty-three percent of the unrestored losses are cost-effective to restore which could reduce fuel consumed by CF6-6D engines in 1980 by 10.9 million gallons.

  13. Long-term-average, solar cycle, and seasonal response of magnetospheric energetic electrons to the solar wind speed

    NASA Astrophysics Data System (ADS)

    Vassiliadis, D.; Klimas, A. J.; Kanekal, S. G.; Baker, D. N.; Weigel, R. S.

    2002-11-01

    Among the interplanetary activity parameters the solar wind speed is the one best correlated with the energetic electron fluxes in the inner magnetosphere. We examine the radial and temporal characteristics of the 2-6 MeV electron response, approximating it in this paper with linear filters. The filter response is parameterized by the time delay (τ), measured from the time of solar wind impact, and the L shell (L). We examine solar cycle and seasonal effects using an 8-year-long database of Solar, Anomalous, and Magnetospheric Particle Explorer (SAMPEX)/ Proton Electron Telescope (PET) measurements at the radial range L = 1.1-10. The main peak P1 of the long-term-average response is at (τ, L) = (2, 5.3) and has a simultaneous response over a wide range of radial distances, ΔL = 5. The duration of the response after the peak is inversely proportional to the L shell. The central part of the inner magnetosphere (L = 3.7-5.75) has a much more prolonged response (>10 days) than other parts. Prior to the main response, P1, a brief response, P0, of typically lower amplitude appears at (τ, L) = (0, 3), probably as a quasi-adiabatic response to the compression of the magnetosphere by the solar wind pressure. Over the solar cycle the variation in solar wind input results in a systematic change of the position, amplitude, radial extent, and duration of the two peaks: during solar wind minimum the quasi-adiabatic peak disappears, and the radial size of the responding region decreases; both are responses to low-density, high-speed streams. During solar minimum, the duration is at least 3 days (30%) longer than average, probably due to the sustained solar wind input. Systematic variations appear also as a function of season due to several magnetic and fluid effects. During equinoxes the coupling is stronger, and the duration is longer (by at least 2 days) compared to solstices. Between the two equinoxes the fall response has a significantly higher amplitude and longer duration than the spring equinox response. This is at least partly due to the higher GSE By component during the observation time, which acts to increase the effective GSM Bz component according to the Russell-McPherron effect. The seasonal modulation of the response is consistent with the variation in the fluxes themselves [, 1999]. The modulation is discussed in terms of the equinoctial and axial hypotheses [, 1970; , 1973; , 2000].

  14. 18 CFR 806.31 - Term of approvals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... approval issued under this part shall be no longer than 15 years or the anticipated life of the project... AND APPROVAL OF PROJECTS Terms and Conditions of Approval § 806.31 Term of approvals. (a) Approvals... approval of a project shall expire three years from the date of such approval if the withdrawal, diversion...

  15. Improving adherence to physical activity.

    PubMed

    Bélisle, M; Roskies, E; Lévesque, J M

    1987-01-01

    Two studies tested the efficacy of Marlatt and Gordon's relapse-prevention approach in increasing attendance during an exercise program (short-term adherence) and continuation of exercise activities for 12 weeks following termination of the formal program (longer term adherence). Participants in both studies were registrants in 10-week exercise groups (jogging, aerobic dance, and pre-ski training) sponsored by the Université de Montréal Sports Centre. The intervention, designed to increase awareness of obstacles to exercise and to develop appropriate techniques for coping with them, was delivered by group leaders within the context of the regular program. Results of both studies indicate a small but consistent superiority of adherence in the experimental condition compared to the control condition. The low cost of this intervention, however, makes even small gains cost effective. Possible methods for strengthening the treatment effect are discussed.

  16. A comparison of the effectiveness of a game informed online learning activity and face to face teaching in increasing knowledge about managing aggression in health settings.

    PubMed

    McKenzie, Karen

    2013-12-01

    The present study compared the impact of face to face teaching with a short online game informed learning activity on health participants' knowledge about, and confidence in, managing aggressive situations. Both forms of teaching resulted in a significant increase in participants' knowledge and confidence. Face to face training led to significantly greater increases in knowledge but was equivalent in terms of confidence. Both forms of teaching were rated positively, but face to face teaching received significantly higher ratings than the online activity. The study suggests that short online game informed learning activities may offer an effective alternative for health professional training where face to face training is not possible. Further research is needed on the longer term impact of both types of training on practice.

  17. In patients with minimally symptomatic OSA can baseline characteristics and early patterns of CPAP usage predict those who are likely to be longer-term users of CPAP

    PubMed Central

    Bratton, Daniel J.; Craig, Sonya E.; Kohler, Malcolm; Stradling, John R.

    2016-01-01

    Background Long-term continuous positive airway pressure (CPAP) usage varies between individuals. It would be of value to be able to identify those who are likely to benefit from CPAP (and use it long term), versus those who would not, and might therefore benefit from additional help early on. First, we explored whether baseline characteristics predicted CPAP usage in minimally symptomatic obstructive sleep apnoea (OSA) patients, a group who would be expected to have low usage. Second, we explored if early CPAP usage was predictive of longer-term usage, as has been shown in more symptomatic OSA patients. Methods The MOSAIC trial was a multi-centre randomised controlled trial where minimally symptomatic OSA patients were randomised to CPAP, or standard care, for 6 months. Here we have studied only those patients randomised to CPAP treatment. Baseline characteristics including symptoms, questionnaires [including the Epworth sleepiness score (ESS)] and sleep study parameters were recorded. CPAP usage was recorded at 2–4 weeks after initiation and after 6 months. The correlation and association between baseline characteristics and 6 months CPAP usage was assessed, as was the correlation between 2 and 4 weeks CPAP usage and 6 months CPAP usage. Results One hundred and ninety-five patients randomised to CPAP therapy had median [interquartile range (IQR)] CPAP usage of 2:49 (0:44, 5:13) h:min/night (h/n) at the 2–4 weeks visit, and 2:17 (0:08, 4:54) h/n at the 6 months follow-up visit. Only male gender was associated with increased long-term CPAP use (male usage 2:56 h/n, female 1:57 h/n; P=0.02). There was a moderate correlation between the usage of CPAP at 2–4 weeks and 6 months, with about 50% of the variability in long-term use being predicted by the short-term use. Conclusions In patients with minimally symptomatic OSA, our study has shown that male gender (and not OSA severity or symptom burden) is associated with increased long-term use of CPAP at 6 months. Although, in general, early patterns of CPAP usage predicted longer term use, there are patients in whom this is not the case, and patients with low initial usage may need to extend their CPAP trial before a decision about longer-term use is made. PMID:26904268

  18. Adapting to the Weather: Lessons from U.S. History.

    PubMed

    Bleakley, Hoyt; Hong, Sok Chul

    2017-09-01

    An important unknown in understanding the impact of climate change is the scope of adaptation, which requires observations on historical time scales. We consider how weather across U.S. history (1860-2000) has affected various measures of productivity. Using cross-sectional and panel methods, we document significant responses of agricultural and individual productivity to weather. We find strong effects of hotter and wetter weather early in U.S. history, but these effects have been attenuated in recent decades. The results suggest that estimates from a given period may be of limited use in forecasting the longer-term impacts of climate change.

  19. Animals in biomedical space research

    NASA Technical Reports Server (NTRS)

    Phillips, R. W.

    1986-01-01

    Rat and squirrel monkeys experiments have been planned in concert with human experiments to help answer fundamental questions concerning the effect of weightlessness on mammalism function. For the most part, these experiments focus on identified changes noted in humans during space flight. Utilizing space laboratory facilities, manipulative experiments can be completed while animals are still in orbit. Other experiments are designed to study changes in gravity receptor structure and function and the effect of weightlessness on early vertibrate development. Following these preliminary animal experiments on Spacelab Shuttle flights, longer term programs of animal investigation will be conducted on Space Station.

  20. Decadal trends in marine reserves reveal differential rates of change in direct and indirect effects

    USGS Publications Warehouse

    Babcock, R.C.; Shears, N.T.; Alcala, A.C.; Barrett, N.S.; Edgar, G.J.; Lafferty, K.D.; McClanahan, T.R.; Russ, G.R.

    2010-01-01

    Decadal-scale observations of marine reserves suggest that indirect effects on taxa that occur through cascading trophic interactions take longer to develop than direct effects on target species. Combining and analyzing a unique set of long-term time series of ecologic data in and out of fisheries closures from disparate regions, we found that the time to initial detection of direct effects on target species (+ or -SE) was 5.13 + or - 1.9 years, whereas initial detection of indirect effects on other taxa, which were often trait mediated, took significantly longer (13.1 + or - 2.0 years). Most target species showed initial direct effects, but their trajectories over time were highly variable. Many target species continued to increase, some leveled off, and others decreased. Decreases were due to natural fluctuations, fishing impacts from outside reserves, or indirect effects from target species at higher trophic levels. The average duration of stable periods for direct effects was 6.2 + or - 1.2 years, even in studies of more than 15 years. For indirect effects, stable periods averaged 9.1 + or - 1.6 years, although this was not significantly different from direct effects. Populations of directly targeted species were more stable in reserves than in fished areas, suggesting increased ecologic resilience. This is an important benefit of marine reserves with respect to their function as a tool for conservation and restoration.

  1. Decadal trends in marine reserves reveal differential rates of change in direct and indirect effects.

    PubMed

    Babcock, R C; Shears, N T; Alcala, A C; Barrett, N S; Edgar, G J; Lafferty, K D; McClanahan, T R; Russ, G R

    2010-10-26

    Decadal-scale observations of marine reserves suggest that indirect effects on taxa that occur through cascading trophic interactions take longer to develop than direct effects on target species. Combining and analyzing a unique set of long-term time series of ecologic data in and out of fisheries closures from disparate regions, we found that the time to initial detection of direct effects on target species (±SE) was 5.13 ± 1.9 years, whereas initial detection of indirect effects on other taxa, which were often trait mediated, took significantly longer (13.1 ± 2.0 years). Most target species showed initial direct effects, but their trajectories over time were highly variable. Many target species continued to increase, some leveled off, and others decreased. Decreases were due to natural fluctuations, fishing impacts from outside reserves, or indirect effects from target species at higher trophic levels. The average duration of stable periods for direct effects was 6.2 ± 1.2 years, even in studies of more than 15 years. For indirect effects, stable periods averaged 9.1 ± 1.6 years, although this was not significantly different from direct effects. Populations of directly targeted species were more stable in reserves than in fished areas, suggesting increased ecologic resilience. This is an important benefit of marine reserves with respect to their function as a tool for conservation and restoration.

  2. Implicit short- and long-term memory direct our gaze in visual search.

    PubMed

    Kruijne, Wouter; Meeter, Martijn

    2016-04-01

    Visual attention is strongly affected by the past: both by recent experience and by long-term regularities in the environment that are encoded in and retrieved from memory. In visual search, intertrial repetition of targets causes speeded response times (short-term priming). Similarly, targets that are presented more often than others may facilitate search, even long after it is no longer present (long-term priming). In this study, we investigate whether such short-term priming and long-term priming depend on dissociable mechanisms. By recording eye movements while participants searched for one of two conjunction targets, we explored at what stages of visual search different forms of priming manifest. We found both long- and short- term priming effects. Long-term priming persisted long after the bias was present, and was again found even in participants who were unaware of a color bias. Short- and long-term priming affected the same stage of the task; both biased eye movements towards targets with the primed color, already starting with the first eye movement. Neither form of priming affected the response phase of a trial, but response repetition did. The results strongly suggest that both long- and short-term memory can implicitly modulate feedforward visual processing.

  3. Prevention Programs to Augment Family and Child Resilience Can Have Lasting Effects on Suicidal Risk.

    PubMed

    Brent, David

    2016-04-01

    In this commentary, the effects of four family-based preventive interventions designed to augment parent and child resilience, originally designed to prevent mental health and substance abuse, on suicide ideation and attempts are reviewed. Three of the preventive interventions showed a beneficial effect either on child suicide ideation or attempts, and one found a beneficial effect on parental suicidal ideation. The duration of effects in two of these studies was well longer than a decade. These studies suggest that interventions to augment family and child resiliency originally designed to prevent mental health and substance abuse disorders can also have beneficial, often long-term, effects on suicidal ideation and behavior. © 2016 The American Association of Suicidology.

  4. Cerebral white matter maturation patterns in preterm infants: an MRI T2 relaxation anisotropy and diffusion tensor imaging study

    PubMed Central

    Knight, Michael J.; Smith-Collins, Adam; Newell, Sarah; Denbow, Mark; Kauppinen, Risto A.

    2017-01-01

    Background and Purpose Preterm birth is associated with worse neurodevelopmental outcome, but brain maturation in preterm infants is poorly characterised with standard methods. We evaluated white matter (WM) of infant brains at term-equivalent age, as a function of gestational age at birth, using multi-modal MRI. Methods Infants born very pre-term (< 32 weeks gestation) and late pre-term (33-36 weeks gestation) were scanned at 3T at term-equivalent age using diffusion tensor imaging (DTI) and T2 relaxometry. MRI data were analysed using tract-based spatial statistics, and anisotropy of T2 relaxation was also determined. Principal component analysis and linear discriminant analysis were applied to seek the variables best distinguishing very pre-term and late pre-term groups. Results Across widespread regions of WM, T2 is longer in very pre-term infants than in late pre-term ones. These effects are more prevalent in regions of WM which myelinate earlier and faster. Similar effects are obtained from DTI, showing that fractional anisotropy (FA) is lower and radial diffusivity higher in the very pre-term group, with a bias towards earlier myelinating regions. Discriminant analysis shows high sensitivity and specificity of combined T2 relaxometry and DTI for the detection of a distinct WM development pathway in very preterm infants. T2 relaxation is anisotropic, depending on the angle between WM fibre and magnetic field, and this effect is modulated by FA. Conclusions Combined T2 relaxometry and DTI characterises specific patterns of retarded WM maturation, at term equivalent age, in infants born very pre-term relative to late pre-term. PMID:29205635

  5. 26 CFR 25.2512-5A - Valuation of annuities, unitrust interests, interests for life or term of years, and remainder or...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Estate and Gift Tax,” (Rev. 5-59). This publication is no longer available for purchase from the... (CONTINUED) ESTATE AND GIFT TAXES GIFT TAX; GIFTS MADE AFTER DECEMBER 31, 1954 Actuarial Tables Applicable... One and Two Lives” (12-70). These publications are no longer available for purchase from the...

  6. How does temperature affect forest "fungus breath"? Diurnal non-exponential temperature-respiration relationship, and possible longer-term acclimation in fungal sporocarps

    Treesearch

    Erik A. Lilleskov

    2017-01-01

    Fungal respiration contributes substantially to ecosystem respiration, yet its field temperature response is poorly characterized. I hypothesized that at diurnal time scales, temperature-respiration relationships would be better described by unimodal than exponential models, and at longer time scales both Q10 and mass-specific respiration at 10 °...

  7. Long-term followup of a phase I/II randomized, placebo-controlled trial of palifermin to prevent graft-versus-host disease (GVHD) after related donor allogeneic hematopoietic cell transplantation (HCT)

    PubMed Central

    Levine, John E.; Blazar, Bruce R.; DeFor, Todd; Ferrara, James L.M.; Weisdorf, Daniel J.

    2008-01-01

    We previously conducted a randomized, double-blind, placebo-controlled study conducted from 2000–2003 of palifermin, a recombinant human keratinocyte growth factor, dosed from 240 mcg/kg to 720 mcg/kg, in 100 allogeneic hematopoietic stem cell transplantation (HCT) recipients. Treatment with palifermin showed beneficial effects on mucositis, but no significant effect on engraftment, acute GVHD, or early survival. In addition to the effect of palifermin on mucosa, other pleotrophic effects, including more rapid immune reconstitution, have been seen in experimental transplant models. Therefore, we investigated whether with longer follow-up we could detect additional differences between the palifermin treated and placebo cohorts. We found no differences in CMV or invasive fungal infections, chronic GVHD, or long-term survival between cohorts. We conclude that the benefits of palifermin appear to primarily be limited to ameliorating mucotoxicity when given to allogeneic HCT recipients. PMID:18721764

  8. Empowering Workers to Rebuild America's Economy and Longer-Term Competitiveness: Green Skills Training for Workers. Hearing of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eleventh Congress, First Session on Examining Empowering Workers to Rebuild America's Economy and Longer-Term Competitiveness, Focusing on Green Skills Training for Workers (April 21, 2009). Senate Hearing 111-813

    ERIC Educational Resources Information Center

    US Senate, 2011

    2011-01-01

    Among the topics discussed in this hearing were: what constitutes green energy, how workers can best be provided the skills to thrive in green industries, and the future of America's energy and environmental policies. Statements were presented by: Honorable Patty Murray, a U.S. Senator from the State of Washington, opening statement; Honorable…

  9. Maintenance Cognitive Stimulation Therapy (CST) for dementia: A single-blind, multi-centre, randomized controlled trial of Maintenance CST vs. CST for dementia

    PubMed Central

    2010-01-01

    Background Psychological treatments for dementia are widely used in the UK and internationally, but only rarely have they been standardised, adequately evaluated or systematically implemented. There is increasing recognition that psychosocial interventions may have similar levels of effectiveness to medication, and both can be used in combination. Cognitive Stimulation Therapy (CST) is a 7-week cognitive-based approach for dementia that has been shown to be beneficial for cognition and quality of life and is cost-effective, but there is less conclusive evidence for the effects of CST over an extended period. Methods/Design This multi-centre, pragmatic randomised controlled trial (RCT) to assess the effectiveness and cost-effectiveness of Maintenance CST groups for dementia compares a intervention group who receive CST for 7 weeks followed by the Maintenance CST programme once a week for 24 weeks with the control group who receive CST for 7 weeks, followed by treatment as usual for 24 weeks. The primary outcome measures are quality of life of people with dementia assessed by the QoL-AD and cognition assessed by the ADAS-Cog. Secondary outcomes include the person with dementia's mood, behaviour, activities of daily living, ability to communicate and costs; as well as caregiver health-related quality of life. Using a 5% significance level, comparison of 230 participants will yield 80% power to detect a standardised difference of 0.39 on the ADAS-Cog between the groups. The trial includes a cost-effectiveness analysis from a public sector perspective. Discussion A pilot study of longer-term Maintenance CST, offering 16 weekly sessions of maintenance following the initial CST programme, previously found a significant improvement in cognitive function (MMSE) for those on the intervention group. The study identified the need for a large-scale, multi-centre RCT to define the potential longer-term benefits of continuing the therapy. This study aims to provide definitive evidence of the potential efficacy of maintenance CST and establish how far the long-term benefits can be compared with antidementia drugs such as cholinesterase inhibitors. Trial Registration ISRCTN26286067 PMID:20426866

  10. Maintenance Cognitive Stimulation Therapy (CST) for dementia: a single-blind, multi-centre, randomized controlled trial of Maintenance CST vs. CST for dementia.

    PubMed

    Aguirre, Elisa; Spector, Aimee; Hoe, Juanita; Russell, Ian T; Knapp, Martin; Woods, Robert T; Orrell, Martin

    2010-04-28

    Psychological treatments for dementia are widely used in the UK and internationally, but only rarely have they been standardised, adequately evaluated or systematically implemented. There is increasing recognition that psychosocial interventions may have similar levels of effectiveness to medication, and both can be used in combination. Cognitive Stimulation Therapy (CST) is a 7-week cognitive-based approach for dementia that has been shown to be beneficial for cognition and quality of life and is cost-effective, but there is less conclusive evidence for the effects of CST over an extended period. This multi-centre, pragmatic randomised controlled trial (RCT) to assess the effectiveness and cost-effectiveness of Maintenance CST groups for dementia compares a intervention group who receive CST for 7 weeks followed by the Maintenance CST programme once a week for 24 weeks with the control group who receive CST for 7 weeks, followed by treatment as usual for 24 weeks.The primary outcome measures are quality of life of people with dementia assessed by the QoL-AD and cognition assessed by the ADAS-Cog. Secondary outcomes include the person with dementia's mood, behaviour, activities of daily living, ability to communicate and costs; as well as caregiver health-related quality of life. Using a 5% significance level, comparison of 230 participants will yield 80% power to detect a standardised difference of 0.39 on the ADAS-Cog between the groups. The trial includes a cost-effectiveness analysis from a public sector perspective. A pilot study of longer-term Maintenance CST, offering 16 weekly sessions of maintenance following the initial CST programme, previously found a significant improvement in cognitive function (MMSE) for those on the intervention group. The study identified the need for a large-scale, multi-centre RCT to define the potential longer-term benefits of continuing the therapy. This study aims to provide definitive evidence of the potential efficacy of maintenance CST and establish how far the long-term benefits can be compared with antidementia drugs such as cholinesterase inhibitors.

  11. A new initiative on precision medicine.

    PubMed

    Collins, Francis S; Varmus, Harold

    2015-02-26

    President Obama has announced a research initiative that aims to accelerate progress toward a new era of precision medicine, with a near-term focus on cancers and a longer-term aim to generate knowledge applicable to the whole range of health and disease.

  12. The self-management of longer-term depression: learning from the patient, a qualitative study.

    PubMed

    Chambers, Eleni; Cook, Sarah; Thake, Anna; Foster, Alexis; Shaw, Sue; Hutten, Rebecca; Parry, Glenys; Ricketts, Tom

    2015-07-24

    Depression is a common mental health condition now viewed as chronic or long-term. More than 50 % of people will have at least one further episode of depression after their first, and therefore it requires long-term management. However, little is known about the effectiveness of self-management in depression, in particular from the patients' perspective. This study aimed to understand how people with longer-term depression manage the condition, how services can best support self-management and whether the principles and concepts of the recovery approach would be advantageous. Semi-structured in depth interviews were carried out with 21 participants, recruited from a range of sources using maximum variation sampling. Interpretative Phenomenological Analysis was used by a diverse team comprised of service users, practitioners and academics. Four super-ordinate themes were found: experience of depression, the self, the wider environment, self-management strategies. Within these, several prominent sub-themes emerged of importance to the participants. These included how aspects of themselves such as hope, confidence and motivation could be powerful agents; and how engaging in a wide range of chosen activities could contribute to their emotional, mental, physical, social, spiritual and creative wellbeing. Services in general were not perceived to be useful in specifically facilitating self-management. Increased choice and control were needed and a greater emphasis on an individualised holistic model. Improved information was needed about how to develop strategies and locate resources, especially during the first episode of depression. These concepts echoed those of the recovery approach, which could therefore be seen as valuable in aiding the self-management of depression.

  13. The temporal structure of intergenerational exchange: a within-family analysis of parent-child reciprocity.

    PubMed

    Leopold, Thomas; Raab, Marcel

    2013-08-01

    Previous studies of parent-child reciprocity have focused either on the long term (generalized exchange over the life course) or on the short term (concurrent exchange in later life). The purpose of this research was to investigate the linkage between both temporal patterns of reciprocity within an integrative conceptual framework. We assessed whether long-term and short-term reciprocity operated as interdependent mechanisms that initially selected and subsequently relieved intergenerational caregiving relationships. We used data from the Asset and Health Dynamics Among the Oldest Old study (AHEAD) provided by frail, single-living parents of at least two children (N=1010 respondents comprising 3768 parent-child dyads). Fixed-effects conditional logit models estimated between-sibling differences in assistance provided to parents, measured by instrumental help (i.e., assistance with IADLs) and hands-on care (i.e., assistance with ADLs). Key predictors were two measures of financial transfers given to children referring to longer and shorter recall periods. Receiving earlier and current financial transfers increased adult children's propensity to support their parents in later life. The effect of earlier transfers pertained to help rather than care whereas the reverse was true for the effect of current transfers. We found no evidence for a linkage between long-term and short-term reciprocity. Overall, the results indicate that adult children might balance long-term support accounts relative to their siblings, suggesting an intra-generational orientation on equity. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Cost-Effectiveness of Percutaneous Closure of the Left Atrial Appendage in Atrial Fibrillation Based on Results From PROTECT AF Versus PREVAIL.

    PubMed

    Freeman, James V; Hutton, David W; Barnes, Geoffrey D; Zhu, Ruo P; Owens, Douglas K; Garber, Alan M; Go, Alan S; Hlatky, Mark A; Heidenreich, Paul A; Wang, Paul J; Al-Ahmad, Amin; Turakhia, Mintu P

    2016-06-01

    Randomized trials of left atrial appendage (LAA) closure with the Watchman device have shown varying results, and its cost effectiveness compared with anticoagulation has not been evaluated using all available contemporary trial data. We used a Markov decision model to estimate lifetime quality-adjusted survival, costs, and cost effectiveness of LAA closure with Watchman, compared directly with warfarin and indirectly with dabigatran, using data from the long-term (mean 3.8 year) follow-up of Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation (PROTECT AF) and Prospective Randomized Evaluation of the Watchman LAA Closure Device in Patients With Atrial Fibrillation (PREVAIL) randomized trials. Using data from PROTECT AF, the incremental cost-effectiveness ratios compared with warfarin and dabigatran were $20 486 and $23 422 per quality-adjusted life year, respectively. Using data from PREVAIL, LAA closure was dominated by warfarin and dabigatran, meaning that it was less effective (8.44, 8.54, and 8.59 quality-adjusted life years, respectively) and more costly. At a willingness-to-pay threshold of $50 000 per quality-adjusted life year, LAA closure was cost effective 90% and 9% of the time under PROTECT AF and PREVAIL assumptions, respectively. These results were sensitive to the rates of ischemic stroke and intracranial hemorrhage for LAA closure and medical anticoagulation. Using data from the PROTECT AF trial, LAA closure with the Watchman device was cost effective; using PREVAIL trial data, Watchman was more costly and less effective than warfarin and dabigatran. PROTECT AF enrolled more patients and has substantially longer follow-up time, allowing greater statistical certainty with the cost-effectiveness results. However, longer-term trial results and postmarketing surveillance of major adverse events will be vital to determining the value of the Watchman in clinical practice. © 2016 American Heart Association, Inc.

  15. Effects of temperature on mortality in Chiang Mai city, Thailand: a time series study

    PubMed Central

    2012-01-01

    Background The association between temperature and mortality has been examined mainly in North America and Europe. However, less evidence is available in developing countries, especially in Thailand. In this study, we examined the relationship between temperature and mortality in Chiang Mai city, Thailand, during 1999–2008. Method A time series model was used to examine the effects of temperature on cause-specific mortality (non-external, cardiopulmonary, cardiovascular, and respiratory) and age-specific non-external mortality (<=64, 65–74, 75–84, and > =85 years), while controlling for relative humidity, air pollution, day of the week, season and long-term trend. We used a distributed lag non-linear model to examine the delayed effects of temperature on mortality up to 21 days. Results We found non-linear effects of temperature on all mortality types and age groups. Both hot and cold temperatures resulted in immediate increase in all mortality types and age groups. Generally, the hot effects on all mortality types and age groups were short-term, while the cold effects lasted longer. The relative risk of non-external mortality associated with cold temperature (19.35°C, 1st percentile of temperature) relative to 24.7°C (25th percentile of temperature) was 1.29 (95% confidence interval (CI): 1.16, 1.44) for lags 0–21. The relative risk of non-external mortality associated with high temperature (31.7°C, 99th percentile of temperature) relative to 28°C (75th percentile of temperature) was 1.11 (95% CI: 1.00, 1.24) for lags 0–21. Conclusion This study indicates that exposure to both hot and cold temperatures were related to increased mortality. Both cold and hot effects occurred immediately but cold effects lasted longer than hot effects. This study provides useful data for policy makers to better prepare local responses to manage the impact of hot and cold temperatures on population health. PMID:22613086

  16. Efficacy of Residence at Moderate Versus Low Altitude on Reducing Acute Mountain Sickness in Men Following Rapid Ascent to 4300 m

    DTIC Science & Technology

    2013-01-01

    et al., 1980); presumably, longer-term moderate-altitude res- idence should reduce AMS symptoms even more, since many physiologic and hematologic...Effect of six days of staging on physiologic adjustments and acute mountain sickness during ascent to 4300 m. High Alt Med Biol 10: 253–260. Beidleman...Brothers MD, Doan BK, Zupan MF, Wile AL, Wilber RL, and Byrnes WC. (2010). Hematological and physiological adap- tations following 46 weeks of moderate

  17. Advanced Fuels Campaign FY 2015 Accomplishments Report

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

    Braase, Lori Ann; Carmack, William Jonathan

    2015-10-29

    The mission of the Advanced Fuels Campaign (AFC) is to perform research, development, and demonstration (RD&D) activities for advanced fuel forms (including cladding) to enhance the performance and safety of the nation’s current and future reactors; enhance proliferation resistance of nuclear fuel; effectively utilize nuclear energy resources; and address the longer-term waste management challenges. This report is a compilation of technical accomplishment summaries for FY-15. Emphasis is on advanced accident-tolerant LWR fuel systems, advanced transmutation fuels technologies, and capability development.

  18. Dynamics of soil CO 2 efflux under varying atmospheric CO 2 concentrations reveal dominance of slow processes

    Treesearch

    Dohyoung Kim; Ram Oren; James S. Clark; Sari Palmroth; A. Christopher Oishi; Heather R. McCarthy; Chris A. Maier; Kurt Johnsen

    2017-01-01

    We evaluated the effect on soil CO2 efflux (FCO2) of sudden changes in photosynthetic rates by altering CO2 concentration in plots subjected to +200 ppmv for 15 years. Five-day intervals of exposure to elevated CO2 (eCO2) ranging 1.0–1.8 times ambient did not affect FCO2. FCO2 did not decrease until 4 months after termination of the long-term eCO2 treatment, longer...

  19. The Effect of Long Term Monocular Occlusion on Vernier Threshold: Elasticity in the Young Adult Visual System.

    DTIC Science & Technology

    1986-06-01

    Experiments-The Animal Model Plasticity in animals during a "critical period" has been well demonstrated by Hubel and Wiesel and many other authors. (23...the cortical cells are "utterly plastic". Hubel and Wiesel (1970) suggested an analagous critical period for man which could be signifi- cantly longer...in their ju- venile macaque monkeys, Hubel , Wiesel , and Levay (1977) noted a significant change in the ocular dominance columns in lay- er IV C of

  20. The impact of ocular hemodynamics and intracranial pressure on intraocular pressure during acute gravitational changes.

    PubMed

    Nelson, Emily S; Mulugeta, Lealem; Feola, Andrew; Raykin, Julia; Myers, Jerry G; Samuels, Brian C; Ethier, C Ross

    2017-08-01

    Exposure to microgravity causes a bulk fluid shift toward the head, with concomitant changes in blood volume/pressure, and intraocular pressure (IOP). These and other factors, such as intracranial pressure (ICP) changes, are suspected to be involved in the degradation of visual function and ocular anatomical changes exhibited by some astronauts. This is a significant health concern. Here, we describe a lumped-parameter numerical model to simulate volume/pressure alterations in the eye during gravitational changes. The model includes the effects of blood and aqueous humor dynamics, ICP, and IOP-dependent ocular compliance. It is formulated as a series of coupled differential equations and was validated against four existing data sets on parabolic flight, body inversion, and head-down tilt (HDT). The model accurately predicted acute IOP changes in parabolic flight and HDT, and was satisfactory for the more extreme case of inversion. The short-term response to the changing gravitational field was dominated by ocular blood pressures and compliance, while longer-term responses were more dependent on aqueous humor dynamics. ICP had a negligible effect on acute IOP changes. This relatively simple numerical model shows promising predictive capability. To extend the model to more chronic conditions, additional data on longer-term autoregulation of blood and aqueous humor dynamics are needed. NEW & NOTEWORTHY A significant percentage of astronauts present anatomical changes in the posterior eye tissues after spaceflight. Hypothesized increases in ocular blood volume and intracranial pressure (ICP) in space have been considered to be likely factors. In this work, we provide a novel numerical model of the eye that incorporates ocular hemodynamics, gravitational forces, and ICP changes. We find that changes in ocular hemodynamics govern the response of intraocular pressure during acute gravitational change. Copyright © 2017 the American Physiological Society.

  1. The Effectiveness of Suicide Prevention Education Programs for Nurses.

    PubMed

    Ferguson, Monika S; Reis, Julie A; Rabbetts, Lyn; Ashby, Heather-Jean; Bayes, Miriam; McCracken, Tara; Ross, Christine; Procter, Nicholas G

    2018-03-01

    Education to improve health professionals' responses to suicide is considered an important suicide prevention strategy. However, the effectiveness of this approach for nurses is unclear. To systematically review the peer-reviewed literature regarding the effectiveness of suicide prevention education programs for nurses. Nine academic databases (CINAHL, Cochrane Reviews & Trials, Embase, Informit Health Collection, Joanna Briggs Institute, Medline, PsycINFO, Scopus, and Web of Science) were searched in November 2016, utilizing search terms related to suicide, education, and nurses, with no limits placed on publication date or study design. The search yielded 5,456 identified articles, 11 of which met the inclusion criteria. Studies were primarily quantitative (RCTs n = 3; quasi-experimental n = 6; qualitative n = 2), and involved nurses (range = 16-561) working in a diversity of settings, particularly hospitals (n = 9). Studies revealed positive changes in nurses' competence, knowledge, and attitudes associated with training over the short term. The heterogeneity of education programs and methodological weaknesses of included studies limit the conclusions drawn. There is a moderate body of evidence to support the effectiveness of suicide prevention education programs for nurses. Future research should examine longer-term changes in clinical practice and strategies for continuing education, with more rigorous study designs.

  2. Long-term effects of drinking-water treatment residuals on dissolved phosphorus export from vegetated buffer strips.

    PubMed

    Habibiandehkordi, Reza; Quinton, John N; Surridge, Ben W J

    2015-04-01

    The export of dissolved phosphorus (P) in surface runoff from agricultural land can lead to water quality degradation. Surface application of aluminium (Al)-based water treatment residuals (Al-WTRs) to vegetated buffer strip (VBS) soils can enhance P removal from surface runoff during single runoff events. However, the longer-term effects on P removal in VBSs following application of products such as Al-WTR remain uncertain. We used field experimental plots to examine the long-term effects of applying a freshly generated Al-WTR to VBSs on dissolved P export during multiple runoff events, occurring between 1 day and 42 weeks after the application of Al-WTR. Vegetated buffer strip plots amended with Al-WTR significantly reduced soluble reactive P and total dissolved P concentrations in surface runoff compared to both unamended VBS plots and control plots. However, the effectiveness of Al-WTR decreased over time, by approximately 70% after 42 weeks compared to a day following Al-WTR application. Reduced performance did not appear to be due to drying of Al-WTR in the field. Instead, the development of preferential flow paths as well as burying of Al-WTR with freshly deposited sediments may explain these observations. Better understanding of the processes controlling long-term P removal by Al-WTR is required for effective management of VBSs.

  3. Interventions to reduce discrimination and stigma: the state of the art.

    PubMed

    Gronholm, Petra C; Henderson, Claire; Deb, Tanya; Thornicroft, Graham

    2017-03-01

    There is a rich literature on the nature of mental health-related stigma and the processes by which it severely affects the life chances of people with mental health problems. However, applying this knowledge to deliver and evaluate interventions to reduce discrimination and stigma in a lasting way is a complex and long-term challenge. We conducted a narrative synthesis of systematic reviews published since 2012, and supplemented this with papers published subsequently as examples of more recent work. There is evidence for small to moderate positive impacts of both mass media campaigns and interventions for target groups in terms of stigma-related knowledge, attitudes, and intended behaviour in terms of desire for contact. However, the limited evidence from longer follow-up times suggests that it is not clear whether short-term contact interventions have a lasting impact. The risk that short-term interventions may only have a short-term impact suggests a need to study longer term interventions and to use interim process and outcome data to improve interventions along the way. There is scope for more thorough application of intergroup contact theory whenever contact is used and of evidence-based teaching and assessment methods when skills training is used for target groups.

  4. Prospective study comparing laparoscopic and open adenomectomy: Surgical and functional results.

    PubMed

    Garcia-Segui, A; Angulo, J C

    Open adenomectomy (OA) is the surgery of choice for large volume benign prostatic hyperplasia, and laparoscopic adenomectomy (LA) represents a minimally invasive alternative. We present a long-term, prospective study comparing both techniques. The study consecutively included 199 patients with benign prostatic hyperplasia and prostate volumes>80g who were followed for more than 12 months. The patients underwent OA (n=97) or LA (n=102). We recorded and compared demographic and perioperative data, functional results and complications using a descriptive statistical analysis. The mean age was 69.2±7.7 years (range 42-87), and the mean prostate volume (measured by TRUS) was 112.1±32.7mL (range 78-260). There were no baseline differences among the groups in terms of age, ASA scale, prostate volume, PSA levels, Qmax, IPSS, QoL or treatments prior to the surgery. The surgical time (P<.0001) and catheter time (P<.0002) were longer in the LA group. Operative bleeding (P<.0001), transfusion rate (P=.0015) and mean stay (P<.0001) were significantly lower in the LA group. The LA group had a lower rate of complications (P=.04), but there were no significant differences between the groups in terms of major complications (Clavien score≥3) (P=.13) or in the rate of late complications (at one year) (P=.66). There were also no differences between the groups in the functional postoperative results: IPSS (P=.17), QoL (P=.3) and Qmax (P=.17). LA is a reasonable, safe and effective alternative that results in less bleeding, fewer transfusions, shorter hospital stays and lower morbidity than OA. LA has similar functional results to OA, at the expense of longer surgical times and longer catheter times. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Timescale differences between SC-PDSI and SPEI for drought monitoring in China

    NASA Astrophysics Data System (ADS)

    Zhao, Haiyan; Gao, Ge; An, Wei; Zou, Xukai; Li, Haitao; Hou, Meiting

    2017-12-01

    The Palmer Drought Severity Index (PDSI) has been widely used to monitor drought. Its characteristics are more suitable for measuring droughts of longer timescales, and this fact has not received much attention. The Standardized Precipitation Evapotranspiration Index (SPEI) can better reflect the climatic water balance, owing to its combination of precipitation and potential evapotranspiration. In this study, we selected monthly average air temperature and precipitation data from 589 meteorological stations of China's National Meteorological Information Center, to compare the effects of applying a self-calibrating PDSI (SC-PDSI) and SPEI to monitor drought events in the station regions, with a special focus on differences of event timescale. The results show the following. 1) Comparative analysis using SC-PDSI and SPEI for drought years and characters of three dry periods from 1961 to 2011 in the Beijing region showed that durations of SC-PDSI-based dry spells were longer than those of 3-month and 6-month SPEIs, but equal to those of 12-month or longer timescale SPEIs. 2) For monitoring evolution of the fall 2009 to spring 2010 Southwest China drought and spring 2000 Huang-Huai drought, 3-month SPEI could better monitor the initiation, aggravation, alleviation and relief of drought in the two regions, whereas the SC-PDSI was insensitive to drought recovery because of its long-term memory of previous climate conditions. 3) Analysis of the relationship between SC-PDSI for different regions and SPEI for different timescales showed that correlation of the two indexes changed with region, and SC-PDSI was maximally correlated with SPEI of 9-19 months in China. Therefore, SC-PDSI is only suitable for monitoring mid- and long-term droughts, owing to the strong lagged autocorrelation such as 0.4786 for 12-month lagged ones in Beijing, whereas SPEI is suitable for both short- and long-term drought-monitoring and should have greater application prospects in China.

  6. MK-801 and memantine act differently on short-term memory tested with different time-intervals in the Morris water maze test.

    PubMed

    Duda, Weronika; Wesierska, Malgorzata; Ostaszewski, Pawel; Vales, Karel; Nekovarova, Tereza; Stuchlik, Ales

    2016-09-15

    N-methyl-d-aspartate receptors (NMDARs) play a crucial role in spatial memory formation. In neuropharmacological studies their functioning strongly depends on testing conditions and the dosage of NMDAR antagonists. The aim of this study was to assess the immediate effects of NMDAR block by (+)MK-801 or memantine on short-term allothetic memory. Memory was tested in a working memory version of the Morris water maze test. In our version of the test, rats underwent one day of training with 8 trials, and then three experimental days when rats were injected intraperitoneally with low- 5 (MeL), high - 20 (MeH) mg/kg memantine, 0.1mg/kg MK-801 or 1ml/kg saline (SAL) 30min before testing, for three consecutive days. On each experimental day there was just one acquisition and one test trial, with an inter-trial interval of 5 or 15min. During training the hidden platform was relocated after each trial and during the experiment after each day. The follow-up effect was assessed on day 9. Intact rats improved their spatial memory across the one training day. With a 5min interval MeH rats had longer latency then all rats during retrieval. With a 15min interval the MeH rats presented worse working memory measured as retrieval minus acquisition trial for path than SAL and MeL and for latency than MeL rats. MK-801 rats had longer latency than SAL during retrieval. Thus, the high dose of memantine, contrary to low dose of MK-801 disrupts short-term memory independent on the time interval between acquisition and retrieval. This shows that short-term memory tested in a working memory version of water maze is sensitive to several parameters: i.e., NMDA receptor antagonist type, dosage and the time interval between learning and testing. Copyright © 2016. Published by Elsevier B.V.

  7. Gender and discipline in 5-12-month-old infants: a longitudinal study.

    PubMed

    Ahl, Richard Evan; Fausto-Sterling, Anne; García-Coll, Cynthia; Seifer, Ronald

    2013-04-01

    We examined the effects of infant age and gender on the behaviors of infants and mothers during discipline interactions using longitudinal, naturalistic, home-based, taped observations of 16 mother-infant dyads (eight males and eight females). These observations were conducted between the child ages of 5 and 12 months and used a devised Maternal Discipline Coding System to code for the occurrence of discipline events. During discipline interactions, mothers vocalized longer, used harsher tones, and used more explanations with older compared to younger infants. Male infants were more likely than female infants to cry or whine during discipline events. Mothers of male infants used longer vocalizations, more words, and more affectionate terms than mothers of female infants. Male infants were more difficult during discipline interactions than female infants, but it appeared that mothers of males responded to this difficulty by using milder discipline techniques. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Comprehension of Navigation Directions

    NASA Technical Reports Server (NTRS)

    Schneider, Vivian I.; Healy, Alice F.

    2000-01-01

    In an experiment simulating communication between air traffic controllers and pilots, subjects were given navigation instructions varying in length telling them to move in a space represented by grids on a computer screen. The subjects followed the instructions by clicking on the grids in the locations specified. Half of the subjects read the instructions, and half heard them. Half of the subjects in each modality condition repeated back the instructions before following them,and half did not. Performance was worse for the visual than for the auditory modality on the longer messages. Repetition of the instructions generally depressed performance, especially with the longer messages, which required more output than did the shorter messages, and especially with the visual modality, in which phonological recoding from the visual input to the spoken output was necessary. These results are explained in terms of the degrading effects of output interference on memory for instructions.

  9. Flavan-3-ols, theobromine, and the effects of cocoa and chocolate on cardiometabolic risk factors.

    PubMed

    Berends, Lindsey M; van der Velpen, Vera; Cassidy, Aedin

    2015-02-01

    Although there is growing interest surrounding the potential health benefits of cocoa and chocolate, the relative contribution of bioactive constituents for these effects remains unclear. This review summarizes the recent research on the cardiometabolic effects of cocoa and chocolate with a focus on two key constituents: flavan-3-ols and theobromine. Recent meta-analyses suggest beneficial cardiometabolic effects of chocolate following short-term intake, including improvements in flow-mediated dilatation, blood pressure, lipoprotein levels and biomarkers of insulin resistance. Flavan-3-ols may play a role, but it is currently unclear which specific compounds or metabolites are key. Theobromine has also been shown to improve lipoprotein levels in trials, although these findings need verification at habitual intake levels. Longer term dose-response randomized controlled trials are required to determine the sustainability of the short-term effects and the optimal dose. Quantifying levels of bioactives in intervention products and their metabolites in biological samples will facilitate the assessment of their relative impact and the underlying mechanisms of action. Promising data support the beneficial cardiometabolic effects of cocoa and chocolate intake, with significant interest in the flavan-3-ol and theobromine content. Validated biomarkers of intake together with more relevant mechanistic insights from experimental models using physiologically relevant concentrations and metabolites will continue to inform this research field.

  10. Aligning Assessment with Long-Term Learning. Special Issue: Learning-Oriented Assessment: Principles and Practice

    ERIC Educational Resources Information Center

    Boud, David; Falchikov, Nancy

    2006-01-01

    Assessment in higher education is commonly held to contribute to feedback to students on their learning and the certification of their achievement. This paper argues that this short-term focus must be balanced against a longer-term emphasis for learning-oriented assessment to foster future learning after graduation. The paper proposes that…

  11. The Long-Term Pavement Performance Program Roadmap: A Strategic Plan

    DOT National Transportation Integrated Search

    1995-09-01

    The goal of the ongoing, 20-year long-term pavement performance (LTPP) studies is to give State and Provincial transportation departments- the owners and customers of the LTPP program-the information and tools they need to build and maintain longer-l...

  12. POLLUTION CONTROL FOR UTILITY POWER GENERATION, 1990-2020

    EPA Science Inventory

    The paper discusses pollution control for utility power generation between the years 1990 and 2020, when the major anticipated environmental challenges facing the utility industry will be acid deposition control in the near term and global warming mitigation in the longer term. T...

  13. Precision Education Initiative: Moving toward Personalized Education

    ERIC Educational Resources Information Center

    Hart, Sara A.

    2016-01-01

    This article proposes the Precision Education Initiative, which is the tailoring of education to the specific characteristics of the individual student. Mirroring precision medicine, the author lays out both near-term and longer term goals that educational research, and importantly educational practice, should follow.

  14. Keep your mind off negative things: coping with long-term effects of acute myeloid leukemia (AML).

    PubMed

    Ghodraty-Jabloo, Vida; Alibhai, Shabbir M H; Breunis, Henriette; Puts, Martine T E

    2016-05-01

    Acute myeloid leukemia (AML) is characterized by sudden onset, intensive treatment, a poor prognosis, and significant relapse risk. Quality of life (QOL) and well-being among AML survivors have been extensively studied during the 6 months of active treatment. However, it is not clear what survivors experience after active treatment. The purpose of our study was to explore how AML survivors describe their longer-term physical and psychosocial well-being and how they cope with these challenges. We conducted a prospective qualitative study and interviewed 19 adult participants (11 had completed treatment, 8 were receiving maintenance chemotherapy). Data were collected using semi-structured interviews that were audio-recorded and transcribed verbatim. The grounded theory approach was used for data analysis. A marked improvement in physical health was reported; however, psychosocial well-being was compromised by enduring emotional distress. A range of emotion- and problem-focused coping strategies were reported. Keeping one's mind off negative things through engaging in formal work or informal activities and seeking control were the two most commonly used coping strategies. Seeking social support for reassurance was also common. Problem-focused strategies were frequently described by the ongoing treatment group to manage treatment side effects. Although physical symptoms improved after completion of treatment, psychosocial distress persisted over longer period of time. In addition, essential needs of AML survivors shifted across survivorship as psychological burden gradually displaced physical concerns. The integral role of coping mechanisms in the adaptation process suggests a need for effective and ongoing psychological interventions.

  15. Museums, zoos, and gardens: how formal-informal partnerships can impact urban students' performance in science.

    PubMed

    Weinstein, Meryle; Whitesell, Emilyn Ruble; Schwartz, Amy Ellen

    2014-12-01

    Informal science education institutions (ISEIs) are critical partners in public science education, as they support the science efforts of school systems by providing authentic opportunities for scientific inquiry. This study reports findings from an evaluation of urban advantage (UA), a collaboration between the New York City Department of Education and eight ISEIs designed to improve science education in New York City (NYC) middle schools. Now in its 10th year, the program harnesses the resources and expertise of NYC's ISEIs to (a) enhance the science content knowledge of middle school science teachers, (b) develop teachers' skills at using inquiry-based approaches in their classrooms, and (c) improve the science achievement of middle school students. We examine whether the UA program has led to increased student achievement on the eighth-grade New York State standardized science exam for students in participating schools; in supplemental analyses, we examine the effects on longer term (ninth-grade) outcomes. We use a difference-in-differences framework with school fixed effects to estimate the impact of attending a UA school in eighth grade on science achievement. Our key outcome is performance on New York State's eighth-grade intermediate-level science assessment; longer term outcomes include enrollment at specialized science, technology, engineering, and math high schools as well as taking and passing the high school (Regents) science exams. We find that attending a UA school increases student performance on the eighth-grade science exam by approximately 0.05 SD, and there is some evidence of small effects on Regents taking and passing rates. © The Author(s) 2014.

  16. Relevant factors for the optimal duration of extended endocrine therapy in early breast cancer.

    PubMed

    Blok, Erik J; Kroep, Judith R; Meershoek-Klein Kranenbarg, Elma; Duijm-de Carpentier, Marjolijn; Putter, Hein; Liefers, Gerrit-Jan; Nortier, Johan W R; Rutgers, Emiel J Th; Seynaeve, Caroline M; van de Velde, Cornelis J H

    2018-04-01

    For postmenopausal patients with hormone receptor-positive early breast cancer, the optimal subgroup and duration of extended endocrine therapy is not clear yet. The aim of this study using the IDEAL patient cohort was to identify a subgroup for which longer (5 years) extended therapy is beneficial over shorter (2.5 years) extended endocrine therapy. In the IDEAL trial, 1824 patients who completed 5 years of adjuvant endocrine therapy (either 5 years of tamoxifen (12%), 5 years of an AI (29%), or a sequential strategy of both (59%)) were randomized between either 2.5 or 5 years of extended letrozole. For each prior therapy subgroup, the value of longer therapy was assessed for both node-negative and node-positive patients using Kaplan Meier and Cox regression survival analyses. In node-positive patients, there was a significant benefit of 5 years (over 2.5 years) of extended therapy (disease-free survival (DFS) HR 0.67, p = 0.03, 95% CI 0.47-0.96). This effect was only observed in patients who were treated initially with a sequential scheme (DFS HR 0.60, p = 0.03, 95% CI 0.38-0.95). In all other subgroups, there was no significant benefit of longer extended therapy. Similar results were found in patients who were randomized for their initial adjuvant therapy in the TEAM trial (DFS HR 0.37, p = 0.07, 95% CI 0.13-1.06), although this additional analysis was underpowered for definite conclusions. This study suggests that node-positive patients could benefit from longer extended endocrine therapy, although this effect appears isolated to patients treated with sequential endocrine therapy during the first 5 years and needs validation and long-term follow-up.

  17. Effects of a cycle training course on children's cycling skills and levels of cycling to school.

    PubMed

    Ducheyne, Fabian; De Bourdeaudhuij, Ilse; Lenoir, Matthieu; Cardon, Greet

    2014-06-01

    The primary aim of the present study was to evaluate the short- and longer-term effects of a cycle training on children's cycling skills. A second aim of the study was to examine the effects of a cycle training, with and without parental involvement, on levels of cycling to school and on parental attitudes towards cycling. Three participating schools were randomly assigned to the "intervention" (25 children), the "intervention plus parent" (34 children) or "control" condition (35 children). A cycle training (four sessions of 45 min) took place only in the intervention schools. Parents in the "intervention plus parent" condition were asked to assist their child in completing weekly homework tasks. Children's cycling skills were assessed, using a practical cycling test. All participating children also received a short parental questionnaire on cycling behavior and parental attitudes towards cycling. Assessments took place at baseline, within 1 week after the last session and at 5-months follow-up. Repeated measure analyses were conducted to evaluate the effects of the cycle training. Children's total cycling skill score increased significantly more from pre to post and from pre to 5-months follow-up in the intervention group than in the control group. On walking with the bicycle (F=1.6), cycling in a straight line (F=2.6), cycling a slalom (F=1.9), cycling over obstacles (F=2.1), cycling on a sloping surface (F=1.7) and dismounting the bicycle (F=2.0), the cycle training had no effect. For all other cycling skills, significant improvements were observed on short- and longer-term. No significant intervention effects were found on children's cycling to school levels (F=1.9) and parental attitudes towards cycling. The cycle training course was effective in improving children's cycling skills and the improvements were maintained 5 months later. However, the cycle training course was not effective in increasing children's cycling to school levels. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Adverse effects of outdoor pollution in the elderly

    PubMed Central

    Baldacci, Sandra; Maio, Sara; Cerrai, Sonia; Sarno, Giuseppe; Viegi, Giovanni

    2015-01-01

    With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure to ambient air pollution. Few studies have assessed long-term mortality in the elderly. It is still unclear what are the pollutants most damaging to the health of the elderly. It seems that elderly subjects are more vulnerable to particulate matter (PM) than to other pollutants, with particular effect on daily cardio-respiratory mortality and acute hospital admissions. Not many studies have targeted elderly people specifically, as well as specific respiratory morbidity. Most data have shown higher risks in the elderly compared to the rest of the population. Future epidemiological cohort studies need to keep investigating the health effects of air pollutants (mainly cardiopulmonary diseases) on the elderly. PMID:25694816

  19. Adverse effects of outdoor pollution in the elderly.

    PubMed

    Simoni, Marzia; Baldacci, Sandra; Maio, Sara; Cerrai, Sonia; Sarno, Giuseppe; Viegi, Giovanni

    2015-01-01

    With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure to ambient air pollution. Few studies have assessed long-term mortality in the elderly. It is still unclear what are the pollutants most damaging to the health of the elderly. It seems that elderly subjects are more vulnerable to particulate matter (PM) than to other pollutants, with particular effect on daily cardio-respiratory mortality and acute hospital admissions. Not many studies have targeted elderly people specifically, as well as specific respiratory morbidity. Most data have shown higher risks in the elderly compared to the rest of the population. Future epidemiological cohort studies need to keep investigating the health effects of air pollutants (mainly cardiopulmonary diseases) on the elderly.

  20. Cost-Effectiveness of Tolvaptan in Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Erickson, Kevin F.; Chertow, Glenn M.; Goldhaber-Fiebert, Jeremy D.

    2014-01-01

    Background: In the Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and its Outcomes (TEMPO) trial, tolvaptan significantly reduced expansion of kidney volume and loss of kidney function. Objective: To determine how benefits observed in the TEMPO trial might relate to longer-term health outcomes such as progression to end-stage renal disease (ESRD) and mortality in addition to its cost-effectiveness. Design: A decision-analytic model. Data Sources: Published literature. Target Population: Persons with early Autosomal Dominant Polycystic Kidney Disease (ADPKD). Time Horizon: Lifetime. Perspective: Societal. Interventions: We compared a strategy where patients receive tolvaptan therapy until death, development of ESRD, or liver complications to one where they do not receive tolvaptan. Outcome Measures: Median age at ESRD onset, life expectancy, discounted quality-adjusted life years (QALYs) and lifetime costs (in 2010 USD), and incremental cost-effectiveness ratios. Results of Base Case Analysis: Tolvaptan prolonged the median age at ESRD onset by 6.5 years and increased life expectancy by 2.6 years. At a drug cost of $5,760 per month, tolvaptan cost $744,100 per QALY gained compared to standard care. Results of Sensitivity Analysis: For patients with ADPKD progressing more slowly, tolvaptan’s cost per QALY gained was even higher. Limitations: Although the TEMPO trial followed patients for 3 years, our main analysis assumed that the clinical benefits of tolvaptan persisted over patients’ lifetimes. Conclusions and Relevance: Assuming that tolvaptan’s benefits persist longer term, the drug may slow progression to ESRD and reduce mortality. However, barring an approximately 95% reduction in the price of tolvaptan, its cost-effectiveness does not compare favorably with many other commonly accepted medical interventions. PMID:24042366

  1. Assessment of beach and dune erosion and accretion using LiDAR: Impact of the stormy 2013-14 winter and longer term trends on the Sefton Coast, UK

    NASA Astrophysics Data System (ADS)

    Pye, Kenneth; Blott, Simon J.

    2016-08-01

    An important question for coastal management concerns the importance of individual storms and clusters of storms on longer term beach sediment budgets, beach and dune erosion, and coastal flood risk. Between October 2013 and March 2014 a series of deep Atlantic low pressure systems crossed the Northeast Atlantic, and strong winds, high waves and high water levels affected many coastal areas in the UK and other parts of western Europe. Net dune recession of up to 12.1 m occurred around Formby Point. On 5 December 2013 the highest water level ever recorded at Liverpool (6.22 m ODN) coincided with waves of Hs of 4.55 m and Tp of 9.3 s in Liverpool Bay. Wave trimming of the dune toe occurred along the entire length of the Sefton coast, but significant dune erosion occurred only where the upper beach (between the mean high water spring tide level and the dune toe) was < 25 m wide. Sediment budget calculations based on LiDAR surveys in October 2013 and May 2014 indicated a net loss of 127 × 103 m3 of sediment from the beach (above 0 m ODN) and a loss of 268 × 103 m3 from the frontal dune system, mostly at Formby Point. However, some parts of the beach to the south of Formby Point gained sediment, indicating net north to south transport over the winter. When considered in a longer term context, the 2013-14 winter represents only a small perturbation on the longer-term coast trend of erosion at Formby Point and progradation to the north and south. Analysis of LiDAR data over a longer time period 1999-2014 indicated upper beach and dune sediment loss of 780 × 103 m3 from the north-central part of Formby Point, with net gains of 806 × 103 m3 and 2116 × 103 m3 in areas to the north and south, respectively. This indicates a net onshore transport of 2142 × 103 m3 from Liverpool Bay towards the coast between Birkdale and Altcar, with a further net total of 210 × 103 m3 transported towards the shore between Altcar and Crosby. In view of the demonstrated value of airborne LiDAR surveys for the quantification of storm impacts and longer term coastal changes, it is recommended that such surveys should be undertaken before and after each winter storm period, covering the area between mean low water spring tide level and a line 200 m landward of the dune toe, of as a part of the regional coastal monitoring programme.

  2. The intergenerational effects of war on the health of children.

    PubMed

    Devakumar, Delan; Birch, Marion; Osrin, David; Sondorp, Egbert; Wells, Jonathan C K

    2014-04-02

    The short- and medium-term effects of conflict on population health are reasonably well documented. Less considered are its consequences across generations and potential harms to the health of children yet to be born. Looking first at the nature and effects of exposures during conflict, and then at the potential routes through which harm may propagate within families, we consider the intergenerational effects of four features of conflict: violence, challenges to mental health, infection and malnutrition. Conflict-driven harms are transmitted through a complex permissive environment that includes biological, cultural and economic factors, and feedback loops between sources of harm and weaknesses in individual and societal resilience to them. We discuss the multiplicative effects of ongoing conflict when hostilities are prolonged. We summarize many instances in which the effects of war can propagate across generations. We hope that the evidence laid out in the article will stimulate research and--more importantly--contribute to the discussion of the costs of war; particularly in the longer-term in post-conflict situations in which interventions need to be sustained and adapted over many years.

  3. The intergenerational effects of war on the health of children

    PubMed Central

    2014-01-01

    Background The short- and medium-term effects of conflict on population health are reasonably well documented. Less considered are its consequences across generations and potential harms to the health of children yet to be born. Discussion Looking first at the nature and effects of exposures during conflict, and then at the potential routes through which harm may propagate within families, we consider the intergenerational effects of four features of conflict: violence, challenges to mental health, infection and malnutrition. Conflict-driven harms are transmitted through a complex permissive environment that includes biological, cultural and economic factors, and feedback loops between sources of harm and weaknesses in individual and societal resilience to them. We discuss the multiplicative effects of ongoing conflict when hostilities are prolonged. Summary We summarize many instances in which the effects of war can propagate across generations. We hope that the evidence laid out in the article will stimulate research and – more importantly – contribute to the discussion of the costs of war; particularly in the longer-term in post-conflict situations in which interventions need to be sustained and adapted over many years. PMID:24694212

  4. Anxiety, inhibition, efficiency, and effectiveness. An investigation using antisaccade task.

    PubMed

    Derakshan, Nazanin; Ansari, Tahereh L; Hansard, Miles; Shoker, Leor; Eysenck, Michael W

    2009-01-01

    Effects of anxiety on the antisaccade task were assessed. Performance effectiveness on this task (indexed by error rate) reflects a conflict between volitional and reflexive responses resolved by inhibitory processes (Hutton, S. B., & Ettinger, U. (2006). The antisaccade task as a research tool in psychopathology: A critical review. Psychophysiology, 43, 302-313). However, latency of the first correct saccade reflects processing efficiency (relationship between performance effectiveness and use of resources). In two experiments, high-anxious participants had longer correct antisaccade latencies than low-anxious participants and this effect was greater with threatening cues than positive or neutral ones. The high- and low-anxious groups did not differ in terms of error rate in the antisaccade task. No group differences were found in terms of latency or error rate in the prosaccade task. These results indicate that anxiety affects performance efficiency but not performance effectiveness. The findings are interpreted within the context of attentional control theory (Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion, 7 (2), 336-353).

  5. Investigating the Female Subaltern, Colonial Discourse and False Consciousness: A Spivakian Marxist-Postcolonialist Reading of Chinua Achebe's "Things Fall Apart" and "No Longer at Ease"

    ERIC Educational Resources Information Center

    Mostafaee, Jalal

    2016-01-01

    The present research study attempts to investigate Chinua Achebe's "Things Fall Apart" and "No Longer at Ease" in terms of Gayatri Spivak Marxist-Post colonialist conceptions of subaltern, colonial discourse and false consciousness. In Postmodernist fiction, there is anxiety that historical concerns such as the scale of…

  6. Combating the Urban Heat Island Effect: Results from a Long-Term Monitoring Study on Urban Green, White, and Black Roofs in New York City

    NASA Astrophysics Data System (ADS)

    Gaffin, S. R.; Kong, A. Y.; Hartung, E.; Hsu, B.; Roditi, A.; Rosenzweig, C.

    2011-12-01

    Urban heat island mitigation strategies include increasing urban vegetation and increasing the albedo of impervious surfaces. Vegetated "green" roofs can provide benefits to stormwater management, water quality, energy cost efficiency, and biodiversity in cities, but the body of research on green roofs in the US is not large and cities in the US have been slow to adopt green roofs. On the other hand, "high-albedo" white roofs have been applied more widely through projects such as New York City Cool Roofs. There are several major issues (e.g., albedo decline, product differences, and long-term temperature controls) about green and white roof performance versus typical black roofs with respect to urban heat island mitigation that have yet to be fully addressed. Here, we present data from an on-going, long-term study in New York City in which pilot, urban albedo enhancement and vegetation effects have been monitored at the building-scale since 2007. Although the urban heat island effect can be detected throughout the year, our objective for this paper was to compare green roof vegetation with those of the high-albedo roofs for their ability to reduce the electricity demand for cooling in the summer. Using energy balance methodology across our sites (three), we found that green and white roof membrane temperature peaks are on average 60°F (33°C) and 30° F (17°C), respectively, cooler than black roof temperature peaks, and that these alternative surfaces significantly reduce thermal stress to roof membranes. Interestingly, we found that industrial white membranes [thermoplastic polyolefin (TPO) and ethylene propylene diene monomer (EPDM)] stay cleaner longer, thereby, maintaining the high-albedo benefits longer than the painted roofs, which tend to lose their albedo properties rapidly. Results thus far suggest that more long-term research comparing the albedo and cooling benefits of green and white roofs to black roofs is necessary to understand temporal changes to roof performance.

  7. On the Formation and Seasonal Properties of Topical Cirrus Clouds over Amazon Basin (2.89ºS, 59.97ºW): Observations from Lidar, Radiosonde and Satellite instruments.

    NASA Astrophysics Data System (ADS)

    Blagev, D. P.; Mendoza, D. L.; Rea, S.; Sorensen, J.

    2014-12-01

    Adverse health effects have been associated with urban pollutant exposure arising from close proximity to highly-emitting sources and atmospheric mixing. The relative air pollution exposure dose and time effects on various diseases remains unknown. This study compares the increased risk of health complications when patients are exposed to short term high-levels of air pollution vs. longer term exposure to lower levels of air pollution. We used the electronic medical record of an integrated hospital system based in Utah, Intermountain Healthcare, to identify a cohort of patients with Chronic Obstructive Pulmonary Disease (COPD) who were seen between 2009-2014. We determined patient demographics as well as comorbidity data and healthcare utilization. To determine the approximate air pollution dose and time exposure, we used the Hestia highly-resolved emissions inventory for Salt Lake County, Utah in conjunction with emissions based on the National Emissions Inventory (NEI). Hourly emissions of CO2 and criteria air pollutants were gridded at a 0.002o x 0.002o resolution for the study years. The resulting emissions were transported using the CALPUFF and AERMOD dispersion models to estimate air pollutant concentrations at an hourly 0.002o x 0.002oresolution. Additionally, pollutant concentrations were estimated at each patient's home and work address to estimate exposure. Multivariate analysis adjusting for patient demographics, comorbidities and severity of COPD was performed to determine association between air pollution exposure and the risk of hospitalization or emergency department (ED) visit for COPD exacerbation and an equivalency estimate for air pollution exposure was developed. We noted associations with air pollution levels for each pollutant and hospitalizations and ED visits for COPD and other patient comorbidities. We also present an equivalency estimate for dose of air pollution exposure and health outcomes. This analysis compares the increased risk of health complications when patients are exposed to short term high-levels of air pollution vs. longer term exposure to lower levels of air pollution. These findings highlight pollutant emissions and exposures spatial and temporal heterogeneity and associated health effects.

  8. Interaction between Chronic Obstructive Pulmonary Disease (COPD) and other important health conditions and measurable air pollution

    NASA Astrophysics Data System (ADS)

    Blagev, D. P.; Mendoza, D. L.; Rea, S.; Sorensen, J.

    2015-12-01

    Adverse health effects have been associated with urban pollutant exposure arising from close proximity to highly-emitting sources and atmospheric mixing. The relative air pollution exposure dose and time effects on various diseases remains unknown. This study compares the increased risk of health complications when patients are exposed to short term high-levels of air pollution vs. longer term exposure to lower levels of air pollution. We used the electronic medical record of an integrated hospital system based in Utah, Intermountain Healthcare, to identify a cohort of patients with Chronic Obstructive Pulmonary Disease (COPD) who were seen between 2009-2014. We determined patient demographics as well as comorbidity data and healthcare utilization. To determine the approximate air pollution dose and time exposure, we used the Hestia highly-resolved emissions inventory for Salt Lake County, Utah in conjunction with emissions based on the National Emissions Inventory (NEI). Hourly emissions of CO2 and criteria air pollutants were gridded at a 0.002o x 0.002o resolution for the study years. The resulting emissions were transported using the CALPUFF and AERMOD dispersion models to estimate air pollutant concentrations at an hourly 0.002o x 0.002oresolution. Additionally, pollutant concentrations were estimated at each patient's home and work address to estimate exposure. Multivariate analysis adjusting for patient demographics, comorbidities and severity of COPD was performed to determine association between air pollution exposure and the risk of hospitalization or emergency department (ED) visit for COPD exacerbation and an equivalency estimate for air pollution exposure was developed. We noted associations with air pollution levels for each pollutant and hospitalizations and ED visits for COPD and other patient comorbidities. We also present an equivalency estimate for dose of air pollution exposure and health outcomes. This analysis compares the increased risk of health complications when patients are exposed to short term high-levels of air pollution vs. longer term exposure to lower levels of air pollution. These findings highlight pollutant emissions and exposures spatial and temporal heterogeneity and associated health effects.

  9. Selenium Enrichment of Horticultural Crops.

    PubMed

    Puccinelli, Martina; Malorgio, Fernando; Pezzarossa, Beatrice

    2017-06-04

    The ability of some crops to accumulate selenium (Se) is crucial for human nutrition and health. Selenium has been identified as a cofactor of the enzyme glutathione peroxidase, which is a catalyzer in the reduction of peroxides that can damage cells and tissues, and can act as an antioxidant. Plants are the first link in the food chain, which ends with humans. Increasing the Se quantity in plant products, including leafy and fruity vegetables, and fruit crops, without exceeding the toxic threshold, is thus a good way to increase animal and human Se intake, with positive effects on long-term health. In many Se-enriched plants, most Se is in its major organic form. Given that this form is more available to humans and more efficient in increasing the selenium content than inorganic forms, the consumption of Se-enriched plants appears to be beneficial. An antioxidant effect of Se has been detected in Se-enriched vegetables and fruit crops due to an improved antioxidative status and to a reduced biosynthesis of ethylene, which is the hormone with a primary role in plant senescence and fruit ripening. This thus highlights the possible positive effect of Se in preserving a longer shelf-life and longer-lasting quality.

  10. Determinants of longer job tenure among home care aides: what makes some stay on the job while others leave?

    PubMed

    Butler, Sandra S; Brennan-Ing, Mark; Wardamasky, Sara; Ashley, Alison

    2014-03-01

    An inadequate supply of direct care workers and a high turnover rate in the workforce has resulted in a "care gap" in our long-term care system. As people are increasingly choosing community-based care, retention of home care workers is particularly important. The mixed-method study described herein explored determinants of longer job tenure for home care aides (n = 261). Study participants were followed for 18 months, completing two mail surveys and one telephone interview each. Predictors of longer job tenure included older age, living rurally, lower physical function, higher wages, a greater sense of autonomy on the job, and less frequent feelings of personal accomplishment. Thematic analysis of telephone interviews revealed long-term stayers to be less concerned about low wages and inconsistent hours than those who left their jobs within a year; both groups of workers reported high levels of job satisfaction. Policy implications of study findings are discussed.

  11. The effect of preterm birth on vestibular evoked myogenic potentials in children.

    PubMed

    Eshaghi, Zahra; Jafari, Zahra; Shaibanizadeh, Abdolreza; Jalaie, Shohreh; Ghaseminejad, Azizeh

    2014-01-01

    Preterm birth is a significant global health problem with serious short- and long-term consequences. This study examined the long term effects of preterm birth on vestibular evoked myogenic potentials (VEMPs) among preschool-aged children. Thirty-one children with preterm and 20 children with term birth histories aged 5.5 to 6.5 years were studied. Each child underwent VEMPs testing using a 500 Hz tone-burst stimulus with a 95 dB nHL (normal hearing level) intensity level. The mean peak latencies of the p13 and n23 waves in the very preterm group were significantly longer than for the full-term group (p≤ 0.041). There was a significant difference between very and mildly preterm children in the latency of peak p13 (p= 0.003). No significant differences existed between groups for p13-n23 amplitude and the interaural amplitude difference ratio. The tested ear and gender did not affect the results of the test. Prolonged VEMPs in very preterm children may reflect neurodevelopmental impairment and incomplete maturity of the vestibulospinal tract (sacculocollic reflex pathway), especially myelination. VEMPs is a non-invasive technique for investigating the vestibular function in young children, and considered to be an appropriate tool for evaluating vestibular impairments at the low brainstem level. It can be used in follow-ups of the long-term effects of preterm birth on the vestibular system.

  12. The impact of logging on biodiversity and carbon sequestration in tropical forests

    NASA Astrophysics Data System (ADS)

    Cazzolla Gatti, R.

    2012-04-01

    Tropical deforestation is one of the most relevant environmental issues at planetary scale. Forest clearcutting has dramatic effect on local biodiversity, on the terrestrial carbon sink and atmospheric GHGs balance. In terms of protection of tropical forests selective logging is, instead, often regarded as a minor or even positive management practice for the ecosystem and it is supported by international certifications. However, few studies are available on changes in the structure, biodiversity and ecosystem services due to the selective logging of African forests. This paper presents the results of a survey on tropical forests of West and Central Africa, with a comparison of long-term dynamics, structure, biodiversity and ecosystem services (such as the carbon sequestration) of different types of forests, from virgin primary to selectively logged and secondary forest. Our study suggests that there is a persistent effect of selective logging on biodiversity and carbon stock losses in the long term (up to 30 years since logging) and after repeated logging. These effects, in terms of species richness and biomass, are greater than the expected losses from commercial harvesting, implying that selective logging in West and Central Africa is impairing long term (at least until 30 years) ecosystem structure and services. A longer selective logging cycle (>30 years) should be considered by logging companies although there is not yet enough information to consider this practice sustainable.

  13. Racial Disparities in Access to Care Under Conditions of Universal Coverage.

    PubMed

    Siddiqi, Arjumand A; Wang, Susan; Quinn, Kelly; Nguyen, Quynh C; Christy, Antony Dennis

    2016-02-01

    Racial disparities in access to regular health care have been reported in the U.S., but little is known about the extent of disparities in societies with universal coverage. To investigate the extent of racial disparities in access to care under conditions of universal coverage by observing the association between race and regular access to a doctor in Canada. Racial disparities in access to a regular doctor were calculated using the largest available source of nationally representative data in Canada--the Canadian Community Health Survey. Surveys from 2000-2010 were analyzed in 2014. Multinomial regression analyses predicted odds of having a regular doctor for each racial group compared to whites. Analyses were stratified by immigrant status--Canadian-born versus shorter-term immigrant versus longer-term immigrants--and controlled for sociodemographics and self-rated health. Racial disparities in Canada, a country with universal coverage, were far more muted than those previously reported in the U.S. Only among longer-term Latin American immigrants (OR=1.90, 95% CI=1.45, 2.08) and Canadian-born Aboriginals (OR=1.34, 95% CI=1.22, 1.47) were significant disparities noted. Among shorter-term immigrants, all Asians were more likely than whites, and among longer-term immigrants, South Asians were more like than whites, to have a regular doctor. Universal coverage may have a major impact on reducing racial disparities in access to health care, although among some subgroups, other factors may also play a role above and beyond health insurance. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Trade-offs between global warming and day length on the start of the carbon uptake period in seasonally cold ecosystems

    NASA Astrophysics Data System (ADS)

    Wohlfahrt, Georg; Cremonese, Edoardo; Hammerle, Albin; Hörtnagl, Lukas; Galvagno, Marta; Gianelle, Damiano; Marcolla, Barbara; Cella, Umberto Morra

    2013-12-01

    is well established that warming leads to longer growing seasons in seasonally cold ecosystems. Whether this goes along with an increase in the net ecosystem carbon dioxide (CO2) uptake is much more controversial. We studied the effects of warming on the start of the carbon uptake period (CUP) of three mountain grasslands situated along an elevational gradient in the Alps. To this end, we used a simple empirical model of the net ecosystem CO2 exchange, calibrated, and forced with multiyear empirical data from each site. We show that reductions in the quantity and duration of daylight associated with earlier snowmelts were responsible for diminishing returns, in terms of carbon gain, from longer growing seasons caused by reductions in daytime photosynthetic uptake and increases in nighttime losses of CO2. This effect was less pronounced at high, compared to low, elevations, where the start of the CUP occurred closer to the summer solstice when changes in day length and incident radiation are minimal.

  15. Comparative study of treatment continuation using second-generation antipsychotics in patients with schizophrenia or schizoaffective disorder

    PubMed Central

    Azekawa, Takaharu; Ohashi, Shizuko; Itami, Akira

    2011-01-01

    Background Effectiveness of a drug is a key concept dependent on efficacy, safety, and tolerability. Time to discontinuation of treatment is also representative of effectiveness. We investigated differences in treatment discontinuation among newly started second-generation antipsychotics in the clinical setting. Methods Using a retrospective cohort study design, we screened all outpatients (n = 7936) who visited the Shioiri Mental Clinic between July 1, 2008 and June 30, 2010. We identified a cohort of patients (n = 703) diagnosed with schizophrenia or schizoaffective disorder and calculated the time to discontinuation of each second-generation antipsychotic. Results Of the 703 patients, 149 were newly treated with aripiprazole, 67 with blonanserin, 95 with olanzapine, 36 with quetiapine, 74 with perospirone, and 120 with risperidone. The time to discontinuation for all causes was significantly longer for aripiprazole than for blonanserin, olanzapine, and risperidone. In addition, aripiprazole tended to be continued for longer than quetiapine and perospirone, but these differences were not significant. Conclusion Aripiprazole may be considered the best available option for long-term treatment of patients with schizophrenia or schizoaffective disorder. PMID:22128254

  16. Comparative study of treatment continuation using second-generation antipsychotics in patients with schizophrenia or schizoaffective disorder.

    PubMed

    Azekawa, Takaharu; Ohashi, Shizuko; Itami, Akira

    2011-01-01

    Effectiveness of a drug is a key concept dependent on efficacy, safety, and tolerability. Time to discontinuation of treatment is also representative of effectiveness. We investigated differences in treatment discontinuation among newly started second-generation antipsychotics in the clinical setting. Using a retrospective cohort study design, we screened all outpatients (n = 7936) who visited the Shioiri Mental Clinic between July 1, 2008 and June 30, 2010. We identified a cohort of patients (n = 703) diagnosed with schizophrenia or schizoaffective disorder and calculated the time to discontinuation of each second-generation antipsychotic. Of the 703 patients, 149 were newly treated with aripiprazole, 67 with blonanserin, 95 with olanzapine, 36 with quetiapine, 74 with perospirone, and 120 with risperidone. The time to discontinuation for all causes was significantly longer for aripiprazole than for blonanserin, olanzapine, and risperidone. In addition, aripiprazole tended to be continued for longer than quetiapine and perospirone, but these differences were not significant. Aripiprazole may be considered the best available option for long-term treatment of patients with schizophrenia or schizoaffective disorder.

  17. Performance of convolutional codes on fading channels typical of planetary entry missions

    NASA Technical Reports Server (NTRS)

    Modestino, J. W.; Mui, S. Y.; Reale, T. J.

    1974-01-01

    The performance of convolutional codes in fading channels typical of the planetary entry channel is examined in detail. The signal fading is due primarily to turbulent atmospheric scattering of the RF signal transmitted from an entry probe through a planetary atmosphere. Short constraint length convolutional codes are considered in conjunction with binary phase-shift keyed modulation and Viterbi maximum likelihood decoding, and for longer constraint length codes sequential decoding utilizing both the Fano and Zigangirov-Jelinek (ZJ) algorithms are considered. Careful consideration is given to the modeling of the channel in terms of a few meaningful parameters which can be correlated closely with theoretical propagation studies. For short constraint length codes the bit error probability performance was investigated as a function of E sub b/N sub o parameterized by the fading channel parameters. For longer constraint length codes the effect was examined of the fading channel parameters on the computational requirements of both the Fano and ZJ algorithms. The effects of simple block interleaving in combatting the memory of the channel is explored, using the analytic approach or digital computer simulation.

  18. Tradeoffs between global warming and day length on the start of the carbon uptake period in seasonally cold ecosystems.

    PubMed

    Wohlfahrt, Georg; Cremonese, Edoardo; Hammerle, Albin; Hörtnagl, Lukas; Galvagno, Marta; Gianelle, Damiano; Marcolla, Barbara; di Cella, Umberto Morra

    2013-12-16

    It is well established that warming leads to longer growing seasons in seasonally cold ecosystems. Whether this goes along with an increase in the net ecosystem carbon dioxide (CO 2 ) uptake is much more controversial. We studied the effects of warming on the start of the carbon uptake period (CUP) of three mountain grasslands situated along an elevational gradient in the Alps. To this end we used a simple empirical model of the net ecosystem CO 2 exchange, calibrated and forced with multi-year empirical data from each site. We show that reductions in the quantity and duration of daylight associated with earlier snowmelts were responsible for diminishing returns, in terms of carbon gain, from longer growing seasons caused by reductions in daytime photosynthetic uptake and increases in nighttime losses of CO 2 . This effect was less pronounced at high, compared to low, elevations, where the start of the CUP occurred closer to the summer solstice when changes in day length and incident radiation are minimal.

  19. Alcohol, appetite and energy balance: is alcohol intake a risk factor for obesity?

    PubMed

    Yeomans, Martin R

    2010-04-26

    The increased recognition that the worldwide increase in incidence of obesity is due to a positive energy balance has lead to a focus on lifestyle choices that may contribute to excess energy intake, including the widespread belief that alcohol intake is a significant risk factor for development of obesity. This brief review examines this issue by contrasting short-term laboratory-based studies of the effects of alcohol on appetite and energy balance and longer-term epidemiological data exploring the relationship between alcohol intake and body weight. Current research clearly shows that energy consumed as alcohol is additive to that from other dietary sources, leading to short-term passive over-consumption of energy when alcohol is consumed. Indeed, alcohol consumed before or with meals tends to increase food intake, probably through enhancing the short-term rewarding effects of food. However, while these data might suggest that alcohol is a risk factor for obesity, epidemiological data suggests that moderate alcohol intake may protect against obesity, particularly in women. In contrast, higher intakes of alcohol in the absence of alcohol dependence may increase the risk of obesity, as may binge-drinking, however these effects may be secondary to personality and habitual beverage preferences. Copyright 2010 Elsevier Inc. All rights reserved.

  20. The influence of time horizon on results of cost-effectiveness analyses.

    PubMed

    Kim, David D; Wilkinson, Colby L; Pope, Elle F; Chambers, James D; Cohen, Joshua T; Neumann, Peter J

    2017-12-01

    Debates persist on the appropriate time horizon from a payer's perspective and how the time horizon in cost-effectiveness analysis (CEA) influences the value assessment. We systematically reviewed the Tufts Medical Center CEA Registry and identified US-based studies that used a payer perspective from 2005-2014. We classified the identified CEAs as short-term (time horizon ≤ 5 years) and long-term (> 5 years), and examined associations between study characteristics and the specified time horizon. We also developed case studies with selected interventions to further explore the relationship between time horizon and projected costs, benefits, and incremental cost-effectiveness ratios (ICER). Among 782 identified studies that met our inclusion criteria, 552 studies (71%) utilized a long-term time horizon while 198 studies (25%) used a short-term horizon. Among studies that employed multiple time horizons, the extension of the time horizon yielded more favorable ICERs in 19 cases and less favorable ICERs in 4 cases. Case studies showed the use of a longer time horizon also yielded more favorable ICERs. The assumed time horizon in CEAs can substantially influence the value assessment of medical interventions. To capture all consequences, we encourage the use of time horizons that extend sufficiently into the future.

  1. On-farm animal welfare assessment in beef bulls: consistency over time of single measures and aggregated Welfare Quality(®) scores.

    PubMed

    Kirchner, M K; Schulze Westerath, H; Knierim, U; Tessitore, E; Cozzi, G; Winckler, C

    2014-03-01

    Consistency over time of (on-farm) animal welfare assessment systems forms part of reliability, meaning that results of the assessment should be representative of the longer-term welfare state of the farm as long as the housing and management conditions have not changed considerably. This is especially important if assessments are to be used for certification purposes. It was the aim of the present study to investigate consistency over time of the Welfare Quality(®) (WQ(®)) assessment system for fattening cattle at single measure level, aggregated criterion and principle scores, and overall classification across short-term (1 month) and longer-term periods (6 months). We hypothesized that consistency over time of aggregated criterion and principle scores is higher than that of single measures. Consistency was also expected to be lower with longer intervals between assessments. Data were obtained using the WQ(®) protocol for fattening cattle during three visits (months 0, 1 and 7) on 63 beef farms in Austria, Germany and Italy. Only data from farms where no major changes in housing and management had taken place were considered for analysis. At the single measure level, Spearman rank correlations between visits were >0.7 and variance was lower within farms than between farms for six and two of 19 measures after 1 month and 6 months, respectively. After aggregation of single measures into criterion and principle scores, five and two of 10 criteria and three and one of four principles were found reliable after 1 and 6 months, respectively. At the WQ(®) principle level, this was the case for three and one of four principles. Seventy-nine per cent and 75% of the farms were allocated to the same overall welfare category after 1 month and 6 months. Possible reasons for a lack of consistency are seasonal effects or short-term fluctuations that occur under normal farm conditions, low prevalence of clinical measures and probably insufficient sample size, whereas poor inter-observer agreement leading to inflation of correlation can be ruled out. At the criterion and principle level, aggregation of information into scores appears to partly smoothen undirected variation at the single measure level without losing sensitivity in terms of welfare evaluation. Reliable on-farm animal welfare assessments should therefore be based on repeated assessments. Further long-term studies are recommended to better understand the factors influencing consistency over time.

  2. Space medicine considerations: Skeletal and calcium homeostasis

    NASA Technical Reports Server (NTRS)

    Schneider, Victor B.

    1989-01-01

    Based on the information obtained from space missions, particularly Skylab and the longer Salyut missions, it is clear that bone and mineral metabolism is substantially altered during space flight. Calcium balance becomes increasingly more negative throughout the flight, and the bone mineral content of the os calcis declines. The major health hazards associated with skeletal changes include the signs and symptoms of hypercalcemia with rapid bone turnover, the risk of kidney stones because of hypercalciuria, the lengthy recovery of lost bone mass after flight, the possibility of irreversible bone loss (particularly the trabecular bone), the possible effects of metastated calcification in the soft tissues, and the possible increase in fracture potential. For these reasons, major efforts need to be directed toward elucidating the fundamental mechanisms by which bone is lost in space and developing more effective countermeasures to prevent both short-term and long-term complications.

  3. Performance of V-4Cr-4Ti material exposed to DIII-D tokamak environment

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

    Tsai, H.; Chung, H.M.; Smith, D.L.

    1997-04-01

    Test specimens made with the 832665 heat of V-4Cr-4Ti alloy were exposed in the DIII-D tokamak environment to support the installation of components made of a V-4Cr-4Ti alloy in the radiative divertor of the DIII-D. Some of the tests were conducted with the Divertor Materials Evaluation System (DiMES) to study the short-term effects of postvent bakeout, when concentrations of gaseous impurities in the DIII-D chamber are the highest. Other specimens were mounted next to the chamber wall behind the divertor baffle plate, to study the effects of longer-term exposures. By design, none of the specimens directly interacted with the plasma.more » Preliminary results from testing the exposed specimens indicate only minor degradation of mechanical properties. Additional testing and microstructural characterization are in progress.« less

  4. Political devolution and the health services in Great Britain.

    PubMed

    Woods, Kevin J

    2004-01-01

    This article reviews the effects of political devolution on health care in the countries of Great Britain at the end of the first term of the new political institutions created in 1999. In the light of the powers transferred, an assessment is made of the nature and extent of policy autonomy exercised by the devolved administrations. The author considers the question of whether political devolution is leading to local variations in health care provision that threaten established concepts of equity in a U.K. National Health Service. Policy areas discussed include the personal care of older people, mental health, governance, competition, the role of the private sector, and the health care workforce. Also discussed are the dynamics of intergovernmental relations in the longer term, including the effects of the developing European Union. The article concludes by assessing the extent to which the individual countries within Great Britain are likely to develop health care systems with distinctive identities.

  5. Long-Term Lunar Radiation Degradation Effects on Materials

    NASA Technical Reports Server (NTRS)

    Rojdev, Kristina; ORourke, Mary Jane; Koontz, Steve; Alred, John; Hill, Charles; Devivar, Rodrigo; Morera-Felix, Shakira; Atwell, William; Nutt, Steve; Sabbann, Leslie

    2010-01-01

    The National Aeronautics and Space Administration (NASA) is focused on developing technologies for extending human presence beyond low Earth orbit. These technologies are to advance the state-of-the-art and provide for longer duration missions outside the protection of Earth's magnetosphere. One technology of great interest for large structures is advanced composite materials, due to their weight and cost savings, enhanced radiation protection for the crew, and potential for performance improvements when compared with existing metals. However, these materials have not been characterized for the interplanetary space environment, and particularly the effects of high energy radiation, which is known to cause damage to polymeric materials. Therefore, a study focusing on a lunar habitation element was undertaken to investigate the integrity of potential structural composite materials after exposure to a long-term lunar radiation environment. An overview of the study results are presented, along with a discussion of recommended future work.

  6. Effects of long-term hypergravity treatment on the development of inflorescence stems of arabidopsis

    NASA Astrophysics Data System (ADS)

    Karahara, Ichirou; Tamaoki, Daisuke; Kamisaka, Seiichiro; Yamaguchi, Takashi; Shinohara, Hironori; Kume, Atsushi; Inoue, Hiroshi

    Hypergravity experiments with plants have been mostly performed using a commercial centrifuge in the dark. In order to see longer-term effect of hypergravity on the development of plant shoots, however, it is necessary to carry out the experiments in the light. In the present study, we have set up a centrifuge equipped with lighting system, which supports long-term plant growth under hypergravity condition, in order to see long-term effects of hypergravity on the development of vascular tissues of inflorescence stems. Arabidopsis plants (Arabidopsis thaliana (L.) Heynh., Col-0), which were grown under 1 G conditions for 20-23 days and having the first visible flower bud, i.e., at Arabidopsis growth stage number 5 (according to Boys et al., 2001), were selected as the plant material. These plants were exposed to hypergravity stimulus at 10 G in a direction from the shoot to root for 10 days in the continuous light. Effects of hypergravity on growth of inflorescence stems, lignin content, and morphometrical parameters of the stem tissues were examined. As a result, the length of the inflorescence stem was decreased. Cross sectional area as well as cell number, and lignin content in the stem were increased under hypergravity. The length of basal internodes of the stem was decreased under hypergravity. In conclusion, the inflorescence stem was suggested to be strengthened through changes in its morphological characteristics as well as lignin deposition under long-term hypergravity conditions.

  7. Chronic effects of an invasive species on an animal community.

    PubMed

    Doody, J Sean; Rhind, David; Green, Brian; Castellano, Christina; McHenry, Colin; Clulow, Simon

    2017-08-01

    Invasive species can trigger trophic cascades in animal communities, but published cases involving their removal of top predators are extremely rare. An exception is the invasive cane toad (Rhinella marina) in Australia, which has caused severe population declines in monitor lizards, triggering trophic cascades that facilitated dramatic and sometimes unexpected increases in several prey of the predators, including smaller lizards, snakes, turtles, crocodiles, and birds. Persistence of isolated populations of these predators with a decades-long sympatry with toads suggests the possibility of recovery, but alternative explanations are possible. Confirming predator recovery requires longer-term study of populations with both baseline and immediate post-invasion densities. Previously, we quantified short-term impacts of invasive cane toads on animal communities over seven years at two sites in tropical Australia. Herein, we test the hypothesis that predators have begun to recover by repeating the study 12 yr after the initial toad invasion. The three predatory lizards that experienced 71-97% declines in the short-term study showed no sign of recovery, and indeed a worse fate: two of the three species were no longer detectable in 630 km of river surveys, suggesting local extirpation. Two mesopredators that had increased markedly in the short term due to these predator losses showed diverse responses in the medium term; a small lizard species increased by ~500%, while populations of a snake species showed little change. Our results indicate a system still in ecological turmoil, having not yet reached a "new equilibrium" more than a decade after the initial invasion; predator losses due to this toxic invasive species, and thus downstream effects, were not transient. Given that cane toads have proven too prolific to eradicate or control, we suggest that recovery of impacted predators must occur unassisted by evolutionary means: dispersal into extinction sites from surviving populations with alleles for toxin resistance or toad avoidance. Evolution and subsequent dispersal may be the only solution for a number of species or communities affected by invasive species for which control is either prohibitively expensive, or not possible. © 2017 by the Ecological Society of America.

  8. Environmental Modifications and 2-Year Measured and Self-reported Stair-Use: A Worksite Randomized Trial

    PubMed Central

    Linde, Jennifer A.; Cousins, Julie M.; Jeffery, Robert W.

    2014-01-01

    Environmental modifications have been shown to increase short-term stair use, longer-term success is unclear. This study assessed the 2-year effectiveness of an environmental intervention promoting worksite stair use. We assessed stair use at work by means of self-reports and infrared beam counters (which send a safe and invisible beam of infrared light from one side of a stairwell to a reflector on the other side; when an individual uses the stairs, the infrared beam is disrupted and an instance of stair use is recorded) at six worksites (three intervention, three control) in a group randomized, controlled worksite weight-gain prevention trial in Minneapolis/St. Paul, MN. Intervention modifications were signs encouraging stair use, music, and art posters in stairwells. We collected data before environmental modifications (2006–2007) and at the end of the 2-year intervention (2008–2009). The intervention had a significant positive effect on stair use measured both objectively and via self-report, with greatest increases reported among those participants who used the stairs least at baseline. Following 2-years of continuously-maintained stairwell modifications, increases in both objectively-measured and self-reported stair use were significantly larger at intervention than control worksites. Study findings suggest that the positive impact of environmental modifications on stair use persist over a longer time period than has been previously demonstrated. Results also indicate that infrequent stair users may be most amenable to the behavior changes encouraged by these environmental enhancements. PMID:23979097

  9. Poor Long-Term Outcomes of Adult Liver Transplantation Involving Elderly Living Donors.

    PubMed

    Tokodai, K; Kawagishi, N; Miyagi, S; Nakanishi, C; Hara, Y; Fujio, A; Kashiwadate, T; Maida, K; Goto, H; Kamei, T; Ohuchi, N

    2016-05-01

    Donor hepatectomy requires particular care to ensure the safety of the donor and the success of the liver transplantation. The aim of this study was to evaluate the effect of donor age on the postoperative outcomes of liver transplant donors and the long-term graft survival rates. We retrospectively reviewed 56 consecutive adult patients who underwent living donor liver transplantation at our institution between April 2001 and August 2010. Donors and recipients were divided into 2 groups, based on the age of the donor: the elderly donor group (donor age ≥50 years) and the younger donor group (donor age <50 years). Perioperative variables, postoperative complication rates, and long-term graft survival rates were compared between the 2 groups. The average ages in the elderly donor group and younger donor group were 58 years and 32 years, respectively. Baseline data excluding the age of the donor did not differ between the groups, nor did the overall complication rates of the donors. Hospital stays were longer in the elderly donor group than in the younger donor group (25 vs 18 days, P < .05). The 1-, 3-, and 5-year graft survival rates were 80%, 60%, and 50% in the elderly donor group, and 89%, 87%, and 82% in the younger donor group, respectively (P = .0002). Donor hepatectomy can be performed safely in elderly patients. However, compared with younger donors, their hospital stays were longer and the graft survival rates were shorter. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Ocean acidification and rising temperatures may increase biofilm primary productivity but decrease grazer consumption

    PubMed Central

    Russell, Bayden D.; Connell, Sean D.; Findlay, Helen S.; Tait, Karen; Widdicombe, Stephen; Mieszkowska, Nova

    2013-01-01

    Climate change may cause ecosystems to become trophically restructured as a result of primary producers and consumers responding differently to increasing CO2 and temperature. This study used an integrative approach using a controlled microcosm experiment to investigate the combined effects of CO2 and temperature on key components of the intertidal system in the UK, biofilms and their consumers (Littorina littorea). In addition, to identify whether pre-exposure to experimental conditions can alter experimental outcomes we explicitly tested for differential effects on L. littorea pre-exposed to experimental conditions for two weeks and five months. In contrast to predictions based on metabolic theory, the combination of elevated temperature and CO2 over a five-week period caused a decrease in the amount of primary productivity consumed by grazers, while the abundance of biofilms increased. However, long-term pre-exposure to experimental conditions (five months) altered this effect, with grazing rates in these animals being greater than in animals exposed only for two weeks. We suggest that the structure of future ecosystems may not be predictable using short-term laboratory experiments alone owing to potentially confounding effects of exposure time and effects of being held in an artificial environment over prolonged time periods. A combination of laboratory (physiology responses) and large, long-term experiments (ecosystem responses) may therefore be necessary to adequately predict the complex and interactive effects of climate change as organisms may acclimate to conditions over the longer term. PMID:23980241

  11. Ocean acidification and rising temperatures may increase biofilm primary productivity but decrease grazer consumption.

    PubMed

    Russell, Bayden D; Connell, Sean D; Findlay, Helen S; Tait, Karen; Widdicombe, Stephen; Mieszkowska, Nova

    2013-01-01

    Climate change may cause ecosystems to become trophically restructured as a result of primary producers and consumers responding differently to increasing CO2 and temperature. This study used an integrative approach using a controlled microcosm experiment to investigate the combined effects of CO2 and temperature on key components of the intertidal system in the UK, biofilms and their consumers (Littorina littorea). In addition, to identify whether pre-exposure to experimental conditions can alter experimental outcomes we explicitly tested for differential effects on L. littorea pre-exposed to experimental conditions for two weeks and five months. In contrast to predictions based on metabolic theory, the combination of elevated temperature and CO2 over a five-week period caused a decrease in the amount of primary productivity consumed by grazers, while the abundance of biofilms increased. However, long-term pre-exposure to experimental conditions (five months) altered this effect, with grazing rates in these animals being greater than in animals exposed only for two weeks. We suggest that the structure of future ecosystems may not be predictable using short-term laboratory experiments alone owing to potentially confounding effects of exposure time and effects of being held in an artificial environment over prolonged time periods. A combination of laboratory (physiology responses) and large, long-term experiments (ecosystem responses) may therefore be necessary to adequately predict the complex and interactive effects of climate change as organisms may acclimate to conditions over the longer term.

  12. Biological effects of long term fine limestone tailings discharge in a fjord ecosystem.

    PubMed

    Brooks, Lucy; Melsom, Fredrik; Glette, Tormod

    2015-07-15

    Benthic infaunal data collected from 1993 to 2010 were analysed to examine the effect of long term discharge of fine limestone tailings on macrofaunal species assemblages in a fjord. Relative distance from the outfall and proportion of fine tailings in the sediment were correlated with benthic community structure. Diversity decreased with increasing proportion of fine tailings. Biological Traits Analysis (BTA) was used to explore the temporal and spatial effects of the tailings gradient on macrofaunal functional attributes. BTA revealed that all stations along a pressure gradient of fine limestone tailings were dominated by free-living species. As the proportion of fine tailings in the sediment increased, there was an increase in fauna that were smaller, highly mobile, living on or nearer the surface sediment, with shorter lifespans. There was a decrease in permanent tube dwellers, those fauna with low or no mobility, that live deeper in the sediment and have longer lifespans (>5 yrs). Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Ozone-induced impairment of mucociliary transport and its prevention with N-acetylcysteine

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

    Allegra, L.; Moavero, N.E.; Rampoldi, C.

    1991-09-30

    The effects of an oxidizing gaseous pollutant on tracheal mucous velocity have been studied in conscious sheep. Acute (2 hours) exposure to 1.0 ppm of ozone showed an effect on tracheal mucous velocity that resulted in a significant decrease 40 minutes and 2 hours after exposure (35% and 40% of the baseline, respectively). Repeated exposure for longer periods (4 days, 5 hours/day) to 1.0 ppm of ozone also significantly decreased tracheal mucous velocity during the first and the second day (-47% and -70% of the baseline, respectively), but during the following days of exposure adaptation took place (tracheal mucous velocitymore » ranging from -42% to -55% of baseline). The tracheal mucous velocity still significantly decreased 5 days after the last exposure. N-Acetylcysteine, known both for its mucolytic and antioxidizing properties, has been demonstrated to prevent significantly all of the immediate effects of either short-term or long-term ozone exposures on mucociliary functions.« less

  14. The Effects of Gender Differences in Patients with Depression on Their Emotional Working Memory and Emotional Experience

    PubMed Central

    Li, Mi; Lu, Shengfu; Wang, Gang; Zhong, Ning

    2015-01-01

    A large amount of research has been conducted on the effects of sex hormones on gender differences in patients with depression, yet research on cognitive differences between male and female patients with depression is insufficient. This study uses emotion pictures to investigate the differences of the emotional working memory ability and emotional experience in male and female patients with depression. Despite identifying that the working memory of patients with depression is impaired, our study found no significant gender differences in emotional working memory. Moreover, the research results revealed that memory effects of mood congruence are produced in both men and women, which may explain why the depression state can be maintained. Furthermore, female patients have more emotional experiences than male patients, which is particularly significant in terms of negative emotional experiences. This result provides cognitive evidence to explain why women suffer from longer terms of depression, are more susceptible to relapse, and can more easily suffer from major depressive disorder in the future. PMID:26578820

  15. Long-Term Effects Produced by Small Doses of Radioactive Substances in Chronical Experiment); OTDALENNYE POSLEDSTVIYA PORAZHENIYA MALYMI DOZAMI RADIOAKTIVNYKH VESHCHESTV V KHRONICHESKOM EKSPERIMENTE

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

    Burykina, L.N.; Zakutinskii, D.I.; Kraevskii, N.A.

    Data on the long-term effects produced by radioactive substances administered to dogs, rabbits, and rats in various ways, both in single and repeated doses, are reported. The animals were studied for three years or longer. Three successive phases were found in the chronic irradiation disease caused by the introduction of radioactive substances: the stimulation phase characterized by an instability and variability of clinical symptoms (blood picture, cardio- vascular system, and the physiological system); the phase of apparent compensation when all the symptoms are restored to normal, although changes are recorded in the reactivity of various systems of the organism whenmore » functional loads are applied; and the phase when symptoms, typical of the chronic stage of radiation disease, develop. The blastomogenous effects of radioactive substances was given special attention. Pre-tumor changes in the bone was also studied. (J.S.R.)« less

  16. 12 CFR 370.5 - Participation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

  17. 12 CFR 370.5 - Participation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

  18. 12 CFR 370.5 - Participation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

  19. 12 CFR 370.5 - Participation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... constitutes its agreement to be: (1) Bound by the terms and conditions of the program, including without limitation, assessments and the terms of the Master Agreement as set forth on the FDIC's Web site; (2... noninterest-bearing transaction accounts will no longer be guaranteed in full under the Transaction Account...

  20. Value of Underground Storage in Today's Natural Gas Industry, The

    EIA Publications

    1995-01-01

    This report explores the significant and changing role of storage in the industry by examining the value of natural gas storage; short-term relationships between prices, storage levels, and weather; and some longer term impacts of the Federal Energy Regulatory Commission's (FERC) Order 636.

  1. Experience-Dependent Effects of Cocaine Self-Administration/Conditioning on Prefrontal and Accumbens Dopamine Responses

    PubMed Central

    Ikegami, Aiko; Olsen, Christopher M.; D’Souza, Manoranjan S.; Duvauchelle, Christine L.

    2008-01-01

    Experiments were performed to examine the effects of cocaine self-administration and conditioning experience on operant behavior, locomotor activity, and nucleus accumbens (NAcc) and prefrontal cortex (PFC) dopamine (DA) responses. Sensory cues were paired with alternating cocaine and nonreinforcement during 12 (limited training) or 40 (long-term training) daily operant sessions. After limited training, NAcc DA responses to cocaine were significantly enhanced in the presence of cocaine-associated cues compared with nonreward cues and significantly depressed after cocaine-paired cues accompanied a nonreinforced lever response. PFC DA levels were generally nonresponsive to cues after the same training duration. However, after long-term training, cocaine-associated cues increased the magnitude of cocaine-stimulated PFC DA levels significantly over levels observed with nonreinforcement cues. Conversely, conditioned cues no longer influenced NAcc DA levels after long-term training. In addition, cocaine-stimulated locomotor activity was enhanced by cocaine-paired cues after long-term, but not after limited, training. Findings demonstrate that cue-induced cocaine expectation exerts a significant impact on dopaminergic and behavioral systems, progressing from mesolimbic to mesocortical regions and from latent to patent behaviors as cocaine and associative experiences escalate. PMID:17469929

  2. Psychodynamic group psychotherapy: impact of group length and therapist professional characteristics on development of therapeutic alliance.

    PubMed

    Lorentzen, Steinar; Bakali, Jan Vegard; Hersoug, Anne Grete; Hagtvet, Knut A; Ruud, Torleif; Høglend, Per

    2012-09-01

    Little research has been done on therapeutic alliance in group psychotherapy, especially the impact of treatment duration and therapist professional characteristics. Therapeutic alliance was rated by patients on the Working Alliance Inventory-Short Form at three time points (sessions 3, 10 and 17) in a randomized controlled trial of short-term and long-term psychodynamic group psychotherapy. As predictors we selected therapist clinical experience and length of didactic training, which have demonstrated ambiguous results in previous research. Linear latent variable growth curve models (structural equation modeling) were developed for the three Working Alliance Inventory-Short Form subscales bond, task and goal. We found a significant variance in individual growth curves (intercepts and slopes) but no differential development due to group length. Longer therapist formal training had a negative impact on early values of subscale task in both treatments. There was an interaction between length of the therapists' clinical experience and group length on early bond, task and goal: therapists with longer clinical experience were rated lower on initial bond in the long-term group but less so in the short-term group. Longer clinical experience influenced initial task and goal positively in the short-term group but was unimportant for task or significantly negative for goal in the long-term group. There was no mean development of alliance, and group length did not differentially impact the alliance during 6 months. Early ratings of the three Working Alliance Inventory-Short Form subscales partly reflected different preparations of patients in the two group formats, partly therapist characteristics, but more research is needed to see how these aspects impact alliance development and outcome. Therapists should pay attention to all three aspects of the alliance, when they prepare patients for group therapy. In psychodynamic groups, length of therapy does not differentiate the overall level or the development of member-leader alliance. Within psychodynamic groups, each individual appear to have their unique perception of the member-leader alliance. Therapists with longer formal psychotherapy training may be less successful in establishing early agreement with patients on the tasks of psychodynamic group psychotherapy. Patients perceive a somewhat lower degree of early emotional bonding with the more clinically experienced therapists in long-term psychodynamics groups. Therapists with more clinical experience may contribute to a stronger degree of initial agreement with patients on the tasks and goals of short-term group psychotherapy. Copyright © 2011 John Wiley & Sons, Ltd.

  3. An Evaluation of Talent 4 . . . : A Programme to Identify Talent and Skills for Prisoners, Disadvantaged, Unemployed, and Vulnerable Groups.

    PubMed

    McGuire-Snieckus, Rebecca; Caulfield, Laura

    2017-11-01

    Previous research suggests that the relationship between employment and recidivism is complex, with more support needed to facilitate employability motivation for sustained change. An arts-based programme designed to facilitate vocational self-determinism among prisoners with evidence of impact across three prisons in the United Kingdom was replicated and delivered to 234 prisoners and long-term unemployed participants from six European countries, to explore whether the findings from the previous evaluation would be replicated on a much larger scale. The research presented in this article found that supporting prisoners and the long-term unemployed to articulate employability goals had a positive effect on personal growth as well as understanding of individual strengths and weaknesses with respect to work, employment, problem solving, and thinking styles. Future research might explore the longer term impact on employment and recidivism.

  4. Long-term and large-scale perspectives on the relationship between biodiversity and ecosystem functioning

    USGS Publications Warehouse

    Symstad, A.J.; Chapin, F. S.; Wall, D.H.; Gross, K.L.; Huenneke, L.F.; Mittelbach, G.G.; Peters, Debra P.C.; Tilman, D.

    2003-01-01

    In a growing body of literature from a variety of ecosystems is strong evidence that various components of biodiversity have significant impacts on ecosystem functioning. However, much of this evidence comes from short-term, small-scale experiments in which communities are synthesized from relatively small species pools and conditions are highly controlled. Extrapolation of the results of such experiments to longer time scales and larger spatial scales—those of whole ecosystems—is difficult because the experiments do not incorporate natural processes such as recruitment limitation and colonization of new species. We show how long-term study of planned and accidental changes in species richness and composition suggests that the effects of biodiversity on ecosystem functioning will vary over time and space. More important, we also highlight areas of uncertainty that need to be addressed through coordinated cross-scale and cross-site research.

  5. Creep behavior of bone cement: a method for time extrapolation using time-temperature equivalence.

    PubMed

    Morgan, R L; Farrar, D F; Rose, J; Forster, H; Morgan, I

    2003-04-01

    The clinical lifetime of poly(methyl methacrylate) (PMMA) bone cement is considerably longer than the time over which it is convenient to perform creep testing. Consequently, it is desirable to be able to predict the long term creep behavior of bone cement from the results of short term testing. A simple method is described for prediction of long term creep using the principle of time-temperature equivalence in polymers. The use of the method is illustrated using a commercial acrylic bone cement. A creep strain of approximately 0.6% is predicted after 400 days under a constant flexural stress of 2 MPa. The temperature range and stress levels over which it is appropriate to perform testing are described. Finally, the effects of physical aging on the accuracy of the method are discussed and creep data from aged cement are reported.

  6. Long term fluctuations of groundwater mine pollution in a sulfide mining district with dry Mediterranean climate: Implications for water resources management and remediation.

    PubMed

    Caraballo, Manuel A; Macías, Francisco; Nieto, José Miguel; Ayora, Carlos

    2016-01-01

    Water resources management and restoration strategies, and subsequently ecological and human life quality, are highly influenced by the presence of short and long term cycles affecting the intensity of a targeted pollution. On this respect, a typical acid mine drainage (AMD) groundwater from a sulfide mining district with dry Mediterranean climate (Iberian Pyrite Belt, SW Spain) was studied to unravel the effect of long term weather changes in water flow rate and metal pollutants concentration. Three well differentiated polluting stages were observed and the specific geochemical, mineralogical and hydrological processes involved (pyrite and enclosing rocks dissolution, evaporitic salts precipitation-redisolution and pluviometric long term fluctuations) were discussed. Evidencing the importance of including longer background monitoring stage in AMD management and restoration strategies, the present study strongly advise a minimum 5-years period of AMD continuous monitoring previous to the design of any AMD remediation system in regions with dry Mediterranean climate. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Visual implant elastomer and anchor tag retention in largemouth bass

    USGS Publications Warehouse

    Hartman, K.J.; Janney, E.C.

    2006-01-01

    We double-marked largemouth bass Micropterus salmoides with Floy FD-68B anchor tags and visible implant elastomer (VIE) marks before stocking to compare retention of the two marks for age-0 (178 mm total length [TL]) and age-1 (273 mm TL) largemouth bass. In a short-term (31-d) evaluation, retention rate of anchor tags was over 94% for each age-class and retention of VIE marks was 98% in both age-classes. In a longer-term comparison of fish stocked into the Ohio River, retention was substantially higher for VIE marks (92.9%) than for anchor tags (42.9%) after 403 d (ages combined). Although anchor tags had high retention in two sizes of largemouth bass during the short-term experiment, they should not be used in situations where accurate identification of marked fish is required for periods longer than 123 d. ?? Copyright by the American Fisheries Society 2006.

  8. Comparative effects of short- and long-term feeding of safflower oil and perilla oil on lipid metabolism in rats.

    PubMed

    Ihara, M; Umekawa, H; Takahashi, T; Furuichi, Y

    1998-10-01

    Diets high in linoleic acid (20% safflower oil contained 77.3% linoleic acid, SO-diet) and alpha-linolenic acid (20% perilla oil contained 58.4% alpha-linolenic acid, PO-diet) were fed to rats for 3, 7, 20, and 50 days, and effects of the diets on lipid metabolism were compared. Levels of serum total cholesterol and phospholipids in the rats fed the PO-diet were markedly lower than those fed the SO-diet after the seventh day. In serum and hepatic phosphatidylcholine and phosphatidylethanolamine, the proportion of n-3 fatty acids showed a greater increase in the PO group than in the SO group in the respective feeding-term. At the third and seventh days after the commencement of feeding the experimental diets, expressions of hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase mRNA were significantly higher in the SO group than those in the PO group, although the difference was not observed in the longer term. There were no significant differences in the LDL receptor mRNA levels between the two groups through the experimental term, except 3-days feeding. These results indicate that alpha-linolenic acid has a more potent serum cholesterol-lowering ability than linoleic acid both in short and long feeding-terms.

  9. The Historical Context of the 2017 Hurricane Season's Ocean Warmth

    NASA Astrophysics Data System (ADS)

    Jacobs, P.; Akella, S.; Trenberth, K. E.; Lijing, C.; Abraham, J. P.

    2017-12-01

    Public discussion of the unusually active 2017 North Atlantic Hurricane Season quickly focused on the role of sea surface temperatures (SSTs) in the North Atlantic. Some meteorologists characterized them as near-normal, while climate-focused voices tended to characterize them as warmer than average, placing them in the context of anthropogenic warming. Much of this divergence in views can be explained by the relatively recent, relatively warm baseline (1981-2010) used for daily SST information, such as provided by OISSTv2. Longer term records of SSTs, such as HadISST, HadSST, and ERSST only attempt to provide monthly averages, while tropical cyclones have lifetimes on the timescale of days. Further, hurricanes create a cold wake which can impact storm movement and intensity, as well as subsequent storms, but is gradually wiped out by the sun. This process is further complicated by the role of ocean heat content (OHC), an increase in which can mitigate the impact of upwelled water. Here we examine the statistical characteristics of daily SSTs and OHC during the satellite record, including their temporal autocorrelation, and use this information in conjunction with longer term monthly records to bound what we can and cannot confidently say about the longer term historical context of the storms Harvey, Irma, and Maria.

  10. Professionals' views of fetal-monitoring support the development of devices to provide objective longer-term assessment of fetal wellbeing.

    PubMed

    Brown, Rebecca; Johnstone, Edward D; Heazell, Alexander E P

    2016-01-01

    Continuous longer-term fetal monitoring has been proposed to address limitations of current technologies in the detection of fetal compromise. We aimed to assess professionals' views regarding current fetal-monitoring techniques and proposed longer-term continuous fetal monitoring. A questionnaire was designed and validated to assess obstetricians' and midwives' use of current fetal-monitoring techniques and their views towards continuous monitoring. 125 of 173 received responses (72% obstetricians, 28% midwives) were analysed. Professionals had the strongest views about supporting evidence for the most commonly employed fetal-monitoring techniques (maternal awareness of fetal movements, ultrasound assessment of fetal growth and umbilical artery Doppler). 45.1% of professionals agreed that a continuous monitoring device would be beneficial (versus 28.7% who disagreed); this perceived benefit was not influenced by professionals' views regarding current techniques or professional background. Professionals have limited experience of continuous fetal monitoring, but most respondents believed that it would increase maternal anxiety (64.3%) and would have concerns with its use in clinical practice (81.7%). Continuous fetal monitoring would be acceptable to the majority of professionals. However, development of these technologies must be accompanied by extended examination of professionals' and women's views to determine barriers to its introduction.

  11. Continuous Timescale Long-Short Term Memory Neural Network for Human Intent Understanding

    PubMed Central

    Yu, Zhibin; Moirangthem, Dennis S.; Lee, Minho

    2017-01-01

    Understanding of human intention by observing a series of human actions has been a challenging task. In order to do so, we need to analyze longer sequences of human actions related with intentions and extract the context from the dynamic features. The multiple timescales recurrent neural network (MTRNN) model, which is believed to be a kind of solution, is a useful tool for recording and regenerating a continuous signal for dynamic tasks. However, the conventional MTRNN suffers from the vanishing gradient problem which renders it impossible to be used for longer sequence understanding. To address this problem, we propose a new model named Continuous Timescale Long-Short Term Memory (CTLSTM) in which we inherit the multiple timescales concept into the Long-Short Term Memory (LSTM) recurrent neural network (RNN) that addresses the vanishing gradient problem. We design an additional recurrent connection in the LSTM cell outputs to produce a time-delay in order to capture the slow context. Our experiments show that the proposed model exhibits better context modeling ability and captures the dynamic features on multiple large dataset classification tasks. The results illustrate that the multiple timescales concept enhances the ability of our model to handle longer sequences related with human intentions and hence proving to be more suitable for complex tasks, such as intention recognition. PMID:28878646

  12. Consequences of Beauty: Effects of Rater Sex and Sexual Orientation on the Visual Exploration and Evaluation of Attractiveness in Real World Scenes

    PubMed Central

    Mitrovic, Aleksandra; Tinio, Pablo P. L.; Leder, Helmut

    2016-01-01

    One of the key behavioral effects of attractiveness is increased visual attention to attractive people. This effect is often explained in terms of evolutionary adaptations, such as attractiveness being an indicator of good health. Other factors could influence this effect. In the present study, we explored the modulating role of sexual orientation on the effects of attractiveness on exploratory visual behavior. Heterosexual and homosexual men and women viewed natural-looking scenes that depicted either two women or two men who varied systematically in levels of attractiveness (based on a pre-study). Participants’ eye movements and attractiveness ratings toward the faces of the depicted people were recorded. The results showed that although attractiveness had the largest influence on participants’ behaviors, participants’ sexual orientations strongly modulated the effects. With the exception of homosexual women, all participant groups looked longer and more often at attractive faces that corresponded with their sexual orientations. Interestingly, heterosexual and homosexual men and homosexual women looked longer and more often at the less attractive face of their non-preferred sex than the less attractive face of their preferred sex, evidence that less attractive faces of the preferred sex might have an aversive character. These findings provide evidence for the important role that sexual orientation plays in guiding visual exploratory behavior and evaluations of the attractiveness of others. PMID:27047365

  13. Consequences of Beauty: Effects of Rater Sex and Sexual Orientation on the Visual Exploration and Evaluation of Attractiveness in Real World Scenes.

    PubMed

    Mitrovic, Aleksandra; Tinio, Pablo P L; Leder, Helmut

    2016-01-01

    One of the key behavioral effects of attractiveness is increased visual attention to attractive people. This effect is often explained in terms of evolutionary adaptations, such as attractiveness being an indicator of good health. Other factors could influence this effect. In the present study, we explored the modulating role of sexual orientation on the effects of attractiveness on exploratory visual behavior. Heterosexual and homosexual men and women viewed natural-looking scenes that depicted either two women or two men who varied systematically in levels of attractiveness (based on a pre-study). Participants' eye movements and attractiveness ratings toward the faces of the depicted people were recorded. The results showed that although attractiveness had the largest influence on participants' behaviors, participants' sexual orientations strongly modulated the effects. With the exception of homosexual women, all participant groups looked longer and more often at attractive faces that corresponded with their sexual orientations. Interestingly, heterosexual and homosexual men and homosexual women looked longer and more often at the less attractive face of their non-preferred sex than the less attractive face of their preferred sex, evidence that less attractive faces of the preferred sex might have an aversive character. These findings provide evidence for the important role that sexual orientation plays in guiding visual exploratory behavior and evaluations of the attractiveness of others.

  14. Minimum Wage Effects in the Longer Run

    ERIC Educational Resources Information Center

    Neumark, David; Nizalova, Olena

    2007-01-01

    Exposure to minimum wages at young ages could lead to adverse longer-run effects via decreased labor market experience and tenure, and diminished education and training, while beneficial longer-run effects could arise if minimum wages increase skill acquisition. Evidence suggests that as individuals reach their late 20s, they earn less the longer…

  15. Physiological condition of juvenile wading birds in relation to multiple landscape stressors in the Florida Everglades: effects of hydrology, prey availability, and mercury bioaccumulation

    USGS Publications Warehouse

    Herring, Garth; Eagles-Smith, Collin A.; Gawlik, Dale E.; Beerens, James M.; Ackerman, Joshua T.

    2014-01-01

    The physiological condition of juvenile birds can be influenced by multiple ecological stressors, and few studies have concurrently considered the effects of environmental contaminants in combination with ecological attributes that can influence foraging conditions and prey availability. Using three temporally distinct indices of physiological condition, we compared the physiological response of nestling great egrets (Ardea alba) and white ibises (Eudocimus albus) to changing prey availability, hydrology (water depth, recession rate), and mercury exposure in the Florida Everglades. We found that the physiological response of chicks varied between species and among environmental variables. Chick body condition (short-term index) and fecal corticosterone levels (medium-term) were influenced by wetland water depth, prey availability, region, and age, but not by mercury contamination. However, mercury exposure did influence heat shock protein 70 (HSP70) in egret chicks, indicating a longer-term physiological response to contamination. Our results indicate that the physiological condition of egret and ibis chicks were influenced by several environmental stressors, and the time frame of the effect may depend on the specialized foraging behavior of the adults provisioning the chicks.

  16. Physiological condition of juvenile wading birds in relation to multiple landscape stressors in the Florida Everglades: effects of hydrology, prey availability, and mercury bioaccumulation.

    PubMed

    Herring, Garth; Eagles-Smith, Collin A; Gawlik, Dale E; Beerens, James M; Ackerman, Joshua T

    2014-01-01

    The physiological condition of juvenile birds can be influenced by multiple ecological stressors, and few studies have concurrently considered the effects of environmental contaminants in combination with ecological attributes that can influence foraging conditions and prey availability. Using three temporally distinct indices of physiological condition, we compared the physiological response of nestling great egrets (Ardea alba) and white ibises (Eudocimus albus) to changing prey availability, hydrology (water depth, recession rate), and mercury exposure in the Florida Everglades. We found that the physiological response of chicks varied between species and among environmental variables. Chick body condition (short-term index) and fecal corticosterone levels (medium-term) were influenced by wetland water depth, prey availability, region, and age, but not by mercury contamination. However, mercury exposure did influence heat shock protein 70 (HSP70) in egret chicks, indicating a longer-term physiological response to contamination. Our results indicate that the physiological condition of egret and ibis chicks were influenced by several environmental stressors, and the time frame of the effect may depend on the specialized foraging behavior of the adults provisioning the chicks.

  17. Physiological Condition of Juvenile Wading Birds in Relation to Multiple Landscape Stressors in the Florida Everglades: Effects of Hydrology, Prey Availability, and Mercury Bioaccumulation

    PubMed Central

    Herring, Garth; Eagles-Smith, Collin A.; Gawlik, Dale E.; Beerens, James M.; Ackerman, Joshua T.

    2014-01-01

    The physiological condition of juvenile birds can be influenced by multiple ecological stressors, and few studies have concurrently considered the effects of environmental contaminants in combination with ecological attributes that can influence foraging conditions and prey availability. Using three temporally distinct indices of physiological condition, we compared the physiological response of nestling great egrets (Ardea alba) and white ibises (Eudocimus albus) to changing prey availability, hydrology (water depth, recession rate), and mercury exposure in the Florida Everglades. We found that the physiological response of chicks varied between species and among environmental variables. Chick body condition (short-term index) and fecal corticosterone levels (medium-term) were influenced by wetland water depth, prey availability, region, and age, but not by mercury contamination. However, mercury exposure did influence heat shock protein 70 (HSP70) in egret chicks, indicating a longer-term physiological response to contamination. Our results indicate that the physiological condition of egret and ibis chicks were influenced by several environmental stressors, and the time frame of the effect may depend on the specialized foraging behavior of the adults provisioning the chicks. PMID:25184221

  18. Hypothalamus and amygdala response to acupuncture stimuli in Carpal Tunnel Syndrome.

    PubMed

    Napadow, V; Kettner, N; Liu, J; Li, M; Kwong, K K; Vangel, M; Makris, N; Audette, J; Hui, K K S

    2007-08-01

    Brain processing of acupuncture stimuli in chronic neuropathic pain patients may underlie its beneficial effects. We used fMRI to evaluate verum and sham acupuncture stimulation at acupoint LI-4 in Carpal Tunnel Syndrome (CTS) patients and healthy controls (HC). CTS patients were retested after 5 weeks of acupuncture therapy. Thus, we investigated both the short-term brain response to acupuncture stimulation, as well as the influence of longer-term acupuncture therapy effects on this short-term response. CTS patients responded to verum acupuncture with greater activation in the hypothalamus and deactivation in the amygdala as compared to HC, controlling for the non-specific effects of sham acupuncture. A similar difference was found between CTS patients at baseline and after acupuncture therapy. For baseline CTS patients responding to verum acupuncture, functional connectivity was found between the hypothalamus and amygdala--the less deactivation in the amygdala, the greater the activation in the hypothalamus, and vice versa. Furthermore, hypothalamic response correlated positively with the degree of maladaptive cortical plasticity in CTS patients (inter-digit separation distance). This is the first evidence suggesting that chronic pain patients respond to acupuncture differently than HC, through a coordinated limbic network including the hypothalamus and amygdala.

  19. Beverage consumption and adult weight management: A review.

    PubMed

    Dennis, Elizabeth A; Flack, Kyle D; Davy, Brenda M

    2009-12-01

    Total energy consumption among United States adults has increased in recent decades, and energy-containing beverages are a significant contributor to this increase. Because beverages are less satiating than solid foods, consumption of energy-containing beverages may increase energy intake and lead to weight gain; trends in food and beverage consumption coinciding with increases in overweight and obesity support this possibility. The purpose of this review is to present what is known about the effect of beverage consumption on short-term (i.e., meal) energy intake, as well as longer-term effects on body weight. Specific beverages addressed include water, other energy-free beverages (diet soft drinks, coffee and tea), and energy-containing beverages (soft drinks, juices and juice drinks, milk and soy beverages, alcohol). Existing evidence, albeit limited, suggests that encouraging water consumption, and substituting water and other energy-free beverages (diet soft drinks, coffee and tea) for energy-containing beverages may facilitate weight management. Energy-containing beverages acutely increase energy intake, however long-term effects on body weight are uncertain. While there may be health benefits for some beverage categories, additional energy provided by beverages should be compensated for by reduced consumption of other foods in the diet.

  20. Beverage Consumption and Adult Weight Management: A Review

    PubMed Central

    Dennis, Elizabeth A.; Flack, Kyle D.; Davy, Brenda M.

    2010-01-01

    Total energy consumption among United States adults has increased in recent decades, and energy-containing beverages are a significant contributor to this increase. Because beverages are less satiating than solid foods, consumption of energy-containing beverages may increase energy intake and lead to weight gain; trends in food and beverage consumption coinciding with increases in overweight and obesity support this possibility. The purpose of this review is to present what is known about the effect of beverage consumption on short-term (i.e., meal) energy intake, as well as longer-term effects on body weight. Specific beverages addressed include water, other energy-free beverages (diet soft drinks, coffee and tea), and energy-containing beverages (soft drinks, juices and juice drinks, milk and soy beverages, alcohol). Existing evidence, albeit limited, suggests that encouraging water consumption, and substituting water and other energy-free beverages (diet soft drinks, coffee and tea) for energy-containing beverages may facilitate weight management. Energy-containing beverages acutely increase energy intake, however long-term effects on body weight are uncertain. While there may be health benefits for some beverage categories, additional energy provided by beverages should be compensated for by reduced consumption of other foods in the diet. PMID:19778754

  1. Articulatory Control in Childhood Apraxia of Speech in a Novel Word-Learning Task.

    PubMed

    Case, Julie; Grigos, Maria I

    2016-12-01

    Articulatory control and speech production accuracy were examined in children with childhood apraxia of speech (CAS) and typically developing (TD) controls within a novel word-learning task to better understand the influence of planning and programming deficits in the production of unfamiliar words. Participants included 16 children between the ages of 5 and 6 years (8 CAS, 8 TD). Short- and long-term changes in lip and jaw movement, consonant and vowel accuracy, and token-to-token consistency were measured for 2 novel words that differed in articulatory complexity. Children with CAS displayed short- and long-term changes in consonant accuracy and consistency. Lip and jaw movements did not change over time. Jaw movement duration was longer in children with CAS than in TD controls. Movement stability differed between low- and high-complexity words in both groups. Children with CAS displayed a learning effect for consonant accuracy and consistency. Lack of change in movement stability may indicate that children with CAS require additional practice to demonstrate changes in speech motor control, even within production of novel word targets with greater consonant and vowel accuracy and consistency. The longer movement duration observed in children with CAS is believed to give children additional time to plan and program movements within a novel skill.

  2. The effect of metal microstructure on the initial attachment of Escherichia coli to 1010 carbon steel.

    PubMed

    Javed, M A; Stoddart, P R; McArthur, S L; Wade, S A

    2013-09-01

    Metallurgical features have been shown to play an important role in the attachment of microorganisms to metal surfaces. In the present study, the influence of the microstructure of as-received (AR) and heat-treated (HT) 1010 carbon steel on the initial attachment of bacteria was investigated. Heat treatment was carried out with the aim of increasing the grain size of the carbon steel coupons. Mirror-polished carbon steel coupons were immersed in a minimal medium inoculated with Escherichia coli (ATCC 25922) to investigate the early (15, 30 and 60 min) and relatively longer-term (4 h) stages of bacterial attachment. The results showed preferential colonisation of bacteria on the grain boundaries of the steel coupons. The bacterial attachment to AR steel coupons was relatively uniform compared to the HT steel coupons where an increased number of localised aggregates of bacteria were found. Quantitative analysis showed that the ratio of the total number of isolated (i.e., single) bacteria to the number of bacteria in aggregates was significantly higher on the AR coupons than the HT coupons. Longer-term immersion studies showed production of extracellular polymeric substances by the bacteria and corrosion at the grain boundaries on both types of steel coupon tested.

  3. Evening salivary cortisol and alpha-amylase at 14months and neurodevelopment at 4years: Sex differences.

    PubMed

    Andiarena, Ainara; Balluerka, Nekane; Murcia, Mario; Ibarluzea, Jesús; Glover, Vivette; Vegas, Oscar

    2017-08-01

    Stress system activity in early life can have long-term effects on neurodevelopment. The main aim of this study was to assess the association of child evening salivary cortisol and alpha-amylase basal levels at 14months of age with longer-term neuropsychological development at 4years in a low-risk population-based birth cohort derived from the INMA (Environment and Childhood) project in Spain. We included 186 parent-children pairs with information on both stress system activity and neurodevelopment. Both stress markers at 14months of age showed an association with neuropsychological development at 4years. Salivary cortisol showed a sex-specific pattern of association. In girls, cortisol levels at 14months were negatively associated with cognitive development [long-term declarative memory (β=-17.8, p=0.028; 95% CI=-33.2 to -2.5); executive function (β=-9.8, p=0.08; 95% CI=-21 to 1)] and gross motor development (β=-13; p=0.022; 95% CI=-24 to -2), whereas in boys cortisol levels were negatively associated with socioemotional development [autistic-like behaviours: Incidence Rate Ratio (IRR)=1.6, p=0.039; 95% CI=1.01 to 2.41]. Salivary alpha-amylase was positively associated with socioemotional development in boys only [social competence (β=2.11, p=0.013; 95% CI=0.47 to 3.72), autistic-like behaviours (IRR=0.93, p=0.042; 95% CI=0.87 to 0.99) and hyperactivity symptoms (IRR=0.81, p=0.021; 95% CI=0.69 to 0.97)]. These results suggest that stress system activity in early life is associated with longer-term neurodevelopment and that sex is an important factor in this relationship. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

    PubMed

    Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, José Miguel; Cardoso, Graça; King, Michael

    2012-01-01

    The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. 1750/2495 (70%) users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning). A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care. Interventions that improve quality of care in these settings may promote service users' autonomy.

  5. Risk factors of workplace violence at hospitals in Japan.

    PubMed

    Fujita, Shigeru; Ito, Shinya; Seto, Kanako; Kitazawa, Takefumi; Matsumoto, Kunichika; Hasegawa, Tomonori

    2012-02-01

    Patients and their relatives exposed to mental stress caused by hospitalization or illness might use violence against healthcare staff and interfere with quality healthcare. The aim of this study was to investigate incidences of workplace violence and the attributes of healthcare staff who are at high risk. A questionnaire-based, anonymous, and self-administered cross-sectional survey. Healthcare staff (n = 11,095) of 19 hospitals in Japan. Incidence rates and adjusted odd ratios of workplace violence were calculated to examine the effect of attributes of healthcare staff to workplace violence by using logistic regression analysis. The response rate for survey completion was 79.1% (8711/11,095). Among the respondents, 36.4% experienced workplace violence by patients or their relatives in the past year; 15.9% experienced physical aggression, 29.8% experienced verbal abuse, and 9.9% experienced sexual harassment. Adjusted odds ratios of physical aggression were significantly high in psychiatric wards, critical care centers/intensive care units (ICU)/cardiac care units (CCU), long-term care wards, for nurses, nursing aides/care workers, and for longer working hours. Adjusted odds ratios of verbal abuse were significantly high in psychiatric wards, long-term care wards, outpatient departments, dialysis departments, and for longer years of work experience, and for longer working hours. Adjusted odds ratios of sexual harassment were significantly high in dialysis departments, for nurses, nursing aides/care workers, technicians, therapists and females. The general ward and direct interaction with patients were common risk factors for each type of workplace violence. The mechanisms and the countermeasures for each type of workplace violence at those high-risk areas should be investigated. Copyright © 2011 Society of Hospital Medicine.

  6. Improvement in Parenteral Nutrition-Associated Cholestasis With the Use of Omegaven in an Infant With Short Bowel Syndrome.

    PubMed

    Strang, Brian J; Reddix, Bruce A; Wolk, Robert A

    2016-10-01

    Parenteral nutrition-associated cholestasis (PNAC) and liver disease have been associated with soybean oil-based intravenous fat emulsions (IVFEs). The benefit of fish oil-based IVFEs in the reversal of parenteral nutrition (PN)-associated liver damage includes allowing for longer PN duration without immediate need for bowel or liver transplantation. The present case involves an infant born with short bowel syndrome (SBS) requiring long-term PN with development of PNAC and subsequent administration of a fish oil-based IVFE. An infant born with SBS was initiated on PN and enteral feeds. After failed enteral progression, bowel lengthening by serial transverse enteroplasty (STEP) resulted in postoperative ileus with delayed enteral feeding for 4 weeks. The administration of long-term PN led to development of PNAC, resulting in initiation of a fish oil-based IVFE. After 4 months, the cholestasis had resolved. Despite the STEP, at 16 months, the child required bowel tapering due to inability to advance enteral feeding. Fish oil-based IVFE was effectively used to reverse PNAC in a child with SBS. Despite early STEP, the patient was not able to tolerate enteral feedings and required bowel tapering. This case illustrates that early surgical intervention did not allow for improved feed tolerance. This resulted in a significant period without enteral nutrition, leading to development of cholestasis. The use of fish oil-based IVFE may permit a longer duration of PN administration without the development of cholestasis or liver disease, allowing for longer time for bowel adaptation prior to the need for surgical intervention. © 2016 American Society for Parenteral and Enteral Nutrition.

  7. 24 CFR 578.51 - Rental assistance.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... months of rent; medium-term, for 3 to 24 months of rent; or long-term, for longer than 24 months of rent... been a victim of domestic violence, dating violence, sexual assault, or stalking, and who reasonably believe they are imminently threatened by harm from further domestic violence, dating violence, sexual...

  8. 24 CFR 578.51 - Rental assistance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... months of rent; medium-term, for 3 to 24 months of rent; or long-term, for longer than 24 months of rent... been a victim of domestic violence, dating violence, sexual assault, or stalking, and who reasonably believe they are imminently threatened by harm from further domestic violence, dating violence, sexual...

  9. Long-term maintenance of luteinizing hormone-responsive testosterone formation by primary rat Leydig cells in vitro.

    PubMed

    Wang, Yiyan; Huang, Shengsong; Wang, Zhao; Chen, Fenfen; Chen, Panpan; Zhao, Xingxing; Lin, Han; Ge, Renshan; Zirkin, Barry; Chen, Haolin

    2018-04-24

    The inability of cultured primary Leydig cells to maintain luteinizing hormone (LH)-responsive testosterone formation in vitro for more than 3-5 days has presented a major challenge in testing trophic effects of regulatory factors or environmental toxicants. Our primary objective was to establish culture conditions sufficient to maintain LH-responsive testosterone formation by Leydig cells for at least a month. When isolated rat adult Leydig cells were cultured in DMEM/F12 and M199 culture medium containing insulin (10μg/ml), PDGFAA (10 ng/ml), lipoprotein (0.25 mg/ml), horse serum (1%) and a submaximal concentration of LH (0.2 ng/ml), the cells retained the ability to produce testosterone in vitro for at least 4 weeks. By using the longer-term culture conditions of this system, we were able to detect suppressive effects on testosterone production by low levels of the toxicant MEHP (mono-(2-ethylhexyl) phthalate), an active metabolite of the plasticizer DEHP, that were not detected by short-term culture. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Impacts of a fuel oil spill on seagrass meadows in a subtropical port, Gladstone, Australia--the value of long-term marine habitat monitoring in high risk areas.

    PubMed

    Taylor, Helen A; Rasheed, Michael A

    2011-01-01

    We used an established seagrass monitoring programme to examine the short and longer-term impacts of an oil spill event on intertidal seagrass meadows. Results for potentially impacted seagrass areas were compared with existing monitoring data and with control seagrass meadows located outside of the oil spill area. Seagrass meadows were not significantly affected by the oil spill. Declines in seagrass biomass and area 1month post-spill were consistent between control and impact meadows. Eight months post-spill, seagrass density and area increased to be within historical ranges. The declines in seagrass meadows were likely attributable to natural seasonal variation and a combination of climatic and anthropogenic impacts. The lack of impact from the oil spill was due to several mitigating factors rather than a lack of toxic effects to seagrasses. The study demonstrates the value of long-term monitoring of critical habitats in high risk areas to effectively assess impacts. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  11. Drug treatment for obesity in the post-sibutramine era.

    PubMed

    Cheung, Bernard M Y

    2011-08-01

    Obesity is a major health problem worldwide. It is associated with cardiovascular diseases, diabetes mellitus and decreased longevity. In managing obesity, diet and exercise are essential; pharmacological therapy may be added for obese patients or overweight patients with cardiovascular risk factors. Sibutramine is a serotonergic and adrenergic drug that reduces food intake and increases thermogenesis. It reduces bodyweight by about 4.2 kg after 12 months, and improves blood glucose and lipids; however, it can increase heart rate and blood pressure. In the SCOUT (Sibutramine Cardiovascular OUTcomes) study, sibutramine increased serious cardiovascular events, such as stroke or myocardial infarction, compared with placebo, and was consequently withdrawn from the market. The lesson learnt from this is the importance of patient selection, limiting the duration of treatment and stopping treatment in non-responders. Currently, phentermine and amfepramone (diethylpropion) are approved for short-term treatment of obesity (up to 3 months) and orlistat is approved for longer-term treatment; however, the gastrointestinal adverse effects of orlistat may be intolerable for some patients. There is now a clear need to find anti-obesity drugs that are effective and safe in the long term.

  12. Timing of introduction of complementary food: short- and long-term health consequences.

    PubMed

    Przyrembel, Hildegard

    2012-01-01

    Complementary food is needed when breast milk (or infant formula) alone is no longer sufficient for both nutritional and developmental reasons. The timing of its introduction, therefore, is an individual decision, although 6 months of exclusive breastfeeding can be recommended for most healthy term infants. The new foods are intended to 'complement' ongoing breastfeeding with those dietary items whose intake has become marginal or insufficient. Both breastfeeding and complementary feeding can have direct or later consequences on health. The evaluation of consequences of both early and late introduction of complementary food can neither disregard the effect of breastfeeding compared to formula feeding nor the composition or quality of the complementary food. Possible short-term health effects concern growth velocity and infections, and possible long-term effects may relate to atopic diseases, type 1 and 2 diabetes, obesity and neuromuscular development. On the basis of the currently available evidence, it is impossible to exactly determine the age when risks related to the start of complementary feeding are lowest or highest for most of these effects, with the possible exception of infections and early growth velocity. The present knowledge on undesirable health effects, however, is mainly based on observational studies, and although some mechanisms have been proposed, further prospective studies have to clarify these unsolved issues. Even less evidence on the consequences of the timing of complementary food introduction is available for formula-fed infants. Copyright © 2012 S. Karger AG, Basel.

  13. Long-term neurodevelopmental benefits of breastfeeding.

    PubMed

    Bar, Sari; Milanaik, Ruth; Adesman, Andrew

    2016-08-01

    The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of an infant#$#apos;s life, with continuation of breastfeeding for at least a year or as mutually desired by mother and child. A robust body of research literature documenting the short-term medical, developmental, and emotional benefits of breastfeeding for infants and toddlers supports this position. This article reviews the neurodevelopmental benefits of breastfeeding as it relates to preschool and school-age children, with particular emphasis on cognitive development, attention-deficit/hyperactivity disorder, and autism spectrum disorder. The majority of research studies examining breastfeeding and long-term neurodevelopmental outcomes suggest that children who breastfeed for longer than 6 months have better cognitive outcomes, lower risk of developing attention-deficit/hyperactivity disorder, and lower risk of being diagnosed with autism spectrum disorder. Pediatricians play a critical role in educating and counseling families about infant nutrition and feeding. Along with the many positive short-term medical effects that breastfeeding confers, physicians should be aware of the growing body of research suggesting that there are also significant long-term neurodevelopmental benefits of breastfeeding.

  14. A review of the consequences of fluid and electrolyte shifts in weightlessness

    NASA Technical Reports Server (NTRS)

    Leach, C. S.

    1979-01-01

    This review describes the renal-endocrine mechanisms related to the early losses of fluid-electrolytes from the body during weightlessness as well as their contribution to longer term adaptation of fluid-electrolyte balance. The hypotheses presented were generated by a systematic analysis of body fluid and renal dynamics observed under conditions of actual and simulated spaceflight. These have increased our understanding of the effects of acute headward fluid shifts on renal excretion, the factors promoting excess sodium excretion and the regulation of extracellular fluid composition.

  15. A review of the consequences of fluid and electrolyte shifts in weightlessness

    NASA Technical Reports Server (NTRS)

    Leach, C. S.

    1978-01-01

    This review describes the renal-endocrine mechanisms related to the early losses of fluid-electrolytes from the body during weightlessness as well as their contribution to longer term adaptation of fluid-electrolyte balance. The hypotheses presented were generated by a systematic analysis of body fluid and renal dynamics observed under conditions of actual and simulated spaceflight. These have increased our understanding of the effects of acute headward fluid shifts on renal excretion, the factors promoting excess sodium excretion and the regulation of extracellular fluid composition.

  16. The effectiveness and cost-effectiveness of minimal access surgery amongst people with gastro-oesophageal reflux disease - a UK collaborative study. The REFLUX trial.

    PubMed

    Grant, A; Wileman, S; Ramsay, C; Bojke, L; Epstein, D; Sculpher, M; Macran, S; Kilonzo, M; Vale, L; Francis, J; Mowat, A; Krukowski, Z; Heading, R; Thursz, M; Russell, I; Campbell, M

    2008-09-01

    To evaluate the clinical effectiveness, cost-effectiveness and safety of a policy of relatively early laparoscopic surgery compared with continued medical management amongst people with gastro-oesophageal reflux disease (GORD) judged suitable for both policies. Relative clinical effectiveness was assessed by a randomised trial (with parallel non-randomised preference groups) comparing a laparoscopic surgery-based policy with a continued medical management policy. The economic evaluation compared the cost-effectiveness of the two management policies in order to identify the most efficient provision of future care and describe the resource impact that various policies for fundoplication would have on the NHS. A total of 21 hospitals throughout the UK with a local partnership between surgeon(s) and gastroenterologist(s) who shared the secondary care of patients with GORD. The 810 participants, who were identified retrospectively or prospectively via their participating clinicians, had both documented evidence of GORD (endoscopy and/or manometry/24-hour pH monitoring) and symptoms for longer than 12 months. In addition, the recruiting clinician(s) was clinically uncertain about which management policy was best. Of the 810 eligible patients who consented to participate, 357 were recruited to the randomised arm of the trial (178 allocated to surgical management, 179 allocated to continued, but optimised, medical management) and 453 recruited to the parallel non-randomised preference arm (261 chose surgical management, 192 chose to continue with best medical management). The type of fundoplication was left to the discretion of the surgeon. Participants completed a baseline REFLUX questionnaire, developed specifically for this study, containing a disease-specific outcome measure, the Short Form with 36 Items (SF-36), the EuroQol-5 Dimensions (EQ-5D) and the Beliefs about Medicines and Surgery questionnaires (BMQ/BSQ). Postal questionnaires were completed at participant-specific time intervals after joining the trial (equivalent to approximately 3 and 12 months after surgery). Intraoperative data were recorded by the surgeons and all other in-hospital data were collected by the research nurse. At the end of the study period, participants completed a discrete choice experiment questionnaire. The randomised groups were well balanced at entry. Participants had been taking GORD medication for a median of 32 months; the mean age of participants was 46 years and 66% were men. Of 178 randomised to surgery, 111 (62%) actually had fundoplication. There was a mixture of clinical and personal reasons why some patients did not have surgery, sometimes related to long waiting times. A total or partial wrap procedure was performed depending on surgeon preference. Complications were uncommon and there were no deaths associated with surgery. By the equivalent of 12 months after surgery, 38% in the randomised surgical group (14% amongst those who had surgery) were taking reflux medication compared with 90% in the randomised medical group. There were substantial differences (one-third to one-half standard deviation) favouring the randomised surgical group across the health status measures, the size depending on assumptions about the proportion that actually had fundoplication. These differences were the same or somewhat smaller than differences observed at 3 months. The lower the REFLUX score, the worse the symptoms at trial entry and the larger the benefit observed after surgery. The preference surgical group had the lowest REFLUX scores at baseline. These scores improved substantially after surgery, and by 12 months they were better than those in the preference medical group. The BMQ/BSQ and discrete choice experiment did distinguish the preference groups from each other and from the randomised groups. The latter indicated that the risk of serious complications was the most important single attribute of a treatment option. A within-trial cost-effectiveness analysis suggested that the surgery policy was more costly (mean 2049 pounds) but also more effective [+0.088 quality-adjusted life-years (QALYs)]. The estimated incremental cost per QALY was 19,000-23,000 pounds, with a probability between 46% (when 62% received surgery) and 19% (when all received surgery) of cost-effectiveness at a threshold of 20,000 pounds per QALY. Modelling plausible longer-term scenarios (such as lifetime benefit after surgery) indicated a greater likelihood (74%) of cost-effectiveness at a threshold of 20,000 pounds, but applying a range of alternative scenarios indicated wide uncertainty. The expected value of perfect information was greatest for longer-term quality of life and proportions of surgical patients requiring medication. Amongst patients requiring long-term medication to control symptoms of GORD, surgical management significantly increases general and reflux-specific health-related quality of life measures, at least up to 12 months after surgery. Complications of surgery were rare. A surgical policy is, however, more costly than continued medical management. At a threshold of 20,000 pounds per QALY it may well be cost-effective, especially when putative longer-term benefits are taken into account, but this is uncertain. The more troublesome the symptoms, the greater the potential benefit from surgery. Uncertainty about cost-effectiveness would be greatly reduced by more reliable information about relative longer-term costs and benefits of surgical and medical policies. This could be through extended follow-up of the REFLUX trial cohorts or of other cohorts of fundoplication patients. Current Controlled Trials ISRCTN15517081.

  17. Comparing two books and establishing probably efficacious treatment for low sexual desire.

    PubMed

    Balzer, Alexandra M; Mintz, Laurie B

    2015-04-01

    Using a sample of 45 women, this study compared the effectiveness of a previously studied (Mintz, Balzer, Zhao, & Bush, 2012) bibliotherapy intervention (Mintz, 2009), a similar self-help book (Hall, 2004), and a wait-list control (WLC) group. To examine intervention effectiveness, between and within group standardized effect sizes (interpreted with Cohen's, 1988 benchmarks .20 = small, .50 = medium, .80+ = large) and their confidence limits are used. In comparison to the WLC group, both interventions yielded large between-group posttest effect sizes on a measure of sexual desire. Additionally, large between-group posttest effect sizes were found for sexual satisfaction and lubrication among those reading the Mintz book. When examining within-group pretest to posttest effect sizes, medium to large effects were found for desire, lubrication, and orgasm for both books and for satisfaction and arousal for those reading the Mintz book. When directly comparing the books, all between-group posttest effect sizes were likely obtained by chance. It is concluded that both books are equally effective in terms of the outcome of desire, but whether or not there is differential efficacy in terms of other domains of sexual functioning is equivocal. Tentative evidence is provided for the longer term effectiveness of both books in enhancing desire. Arguing for applying criteria for empirically supported treatments to self-help, results are purported to establish the Mintz book as probably efficacious and to comprise a first step in this designation for the Hall book. (c) 2015 APA, all rights reserved).

  18. Three-Year Follow-Up of Insomnia and Hypnotics after Controlled Internet Treatment for Insomnia.

    PubMed

    Blom, Kerstin; Jernelöv, Susanna; Rück, Christian; Lindefors, Nils; Kaldo, Viktor

    2016-06-01

    To investigate the long-term effects of therapist-guided Internet-based insomnia treatment on insomnia severity and sleep medication use, compared with active control. This study was an 8 week randomized controlled trial with follow-up posttreatment and at 6, 12, and 36 months, set at the Internet Psychiatry Clinic, Stockholm, Sweden. Participants were 148 media-recruited nondepressed adults with insomnia. Interventions were Guided Internet-based cognitive behavioral therapy for insomnia (ICBT-i) or active control treatment (ICBT-ctrl). Primary outcome was insomnia severity, measured with the Insomnia Severity Index. Secondary outcomes were sleep medication use and use of other treatments. The large pretreatment to posttreatment improvements in insomnia severity of the ICBT-i group were maintained during follow-up. ICBT-ctrl exhibited significantly less improvement posttreatment (between-Cohen d = 0.85), but after 12 and 36 months, there was no longer a significant difference. The within-group effect sizes from pretreatment to the 36-months follow-up were 1.6 (ICBT-i) and 1.7 (ICBT-ctrl), and 74% of the interviewed participants no longer had insomnia diagnosis after 36 mo. ICBT-ctrl used significantly more sleep medication (P = 0.017) and underwent significantly more other insomnia treatments (P < 0.001) during the follow-up period. The large improvements in the ICBT-i group were maintained after 36 months, corroborating that CBT for insomnia has long-term effects. After 36 months, the groups did not differ in insomnia severity, but ICBT-ctrl had used more sleep medication and undergone more other additional insomnia treatments during the follow-up period. The trial was registered, together with a parallel trial, at Clinicaltrials.gov as "Internet-CBT for Insomnia" registration ID: NCT01256099. © 2016 Associated Professional Sleep Societies, LLC.

  19. Army Logistician. Volume 41, Issue 4, July-August 2009

    DTIC Science & Technology

    2009-08-01

    misuse the terms associated with targeting to fit sustainment, we run the risk of misusing the original term when it is used in the context of lethal...but as the term became a “catch- all” for Army operations, the original concept lost its intended purpose. We no longer use the term because of its...the detriment of its original purpose in Army plan- ning and operations. Rather than change terminology, the sustainment community needs to focus on

  20. A prospective study of the severity of early respiratory distress in late preterms compared to term infants.

    PubMed

    Kitsommart, Ratchada; Phatihattakorn, Chayawat; Pornladnun, Pornpat; Paes, Bosco

    2016-01-01

    To compare the severity of early respiratory distress in late preterm (LPT) versus term infants. A prospective cohort study was conducted in a tertiary care neonatal unit in Thailand. Levels of respiratory support, duration of intubation, and short term morbidities were compared between LPT and term infants. Two-hundred nineteen LPT and 564 term infants were included over a period of 2 years (2009-2011). 106 (48.4%) LPTs versus 58 (10.3%) term infants received non-invasive ventilation or intubation [p < 0.001; OR (95% CI) 8.2 (5.6, 12.0)]. The intubation rate was 24.7% in LPTs versus 7.3% in term infants [p < 0.001; OR (95% CI) 4.18 (2.7, 6.5)]. The duration of intubation was longer in LPT infants (median 5.0 versus 2.0 days. p = 0.03). There was a non-significant trend towards a higher mortality rate in the LPT group [p = 0.14; OR (95% CI) 3.9 (0.7, 23.5)]. This is one of three published prospective studies on the topic. The study design lends more robust credence to the results previously identified only in retrospective and systematic reviews. LPT infants are more likely to require positive-pressure ventilation support and incur a longer duration of intubation. A trend towards greater mortality is prevalent compared to term infants.

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