Long-term hand tele-rehabilitation on the PlayStation 3: benefits and challenges.

PubMed

Burdea, Grigore C; Jain, Abhishek; Rabin, Bryan; Pellosie, Richard; Golomb, Meredith

2011-01-01

Rehabilitation interventions for the hand have shown benefits for children with Hemiplegia due to cerebral palsy or traumatic brain injury. Longer interventions are facilitated if training is provided in the patient's home, due to easier access to care and reduced impact on school or work activities. Providing remote rehabilitation over lengthy periods of time has however its own challenges. This paper presents two pediatric patients with hemiplegia, who practiced virtual hand rehabilitation games using a modified PlayStation 3 and 5DT sensing gloves. Despite severe initial hand spasticity, and occasional technology shortcomings, the subjects practiced for about 14 months, and 6 months, respectively. Game performance data for the second patient is presented. Follow-up evaluations 14 months from the removal of the PlayStation 3 from the home of the child with cerebral palsy showed that the patient had good retention in terms of grasp strength, hand function and bone health. Challenges of long-term home tele-rehabilitation are also discussed.

LONG-TERM EVOLUTION OF THE MAIN-ON STATES IN HERCULES X-1

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

Šimon, Vojtech, E-mail: simon@asu.cas.cz

2015-07-15

Rossi X-ray Timing Explorer All-sky Monitor (RXTE ASM) observations and American Association of Variable Star Observers (AAVSO) optical data were used for a time-series analysis of the long-term activity of Her X-1. The problem of measuring the long-term evolution of the X-ray intensity in the light curve which consists only of separated intense spikes was addressed. For this purpose, the fluence of each Main-On state was determined. The fluences vary generally (not only in the transitions into/from anomalous low states (ALSs)) by tens of percent on timescales of at least several epochs of the cycle length of the superorbital cyclemore » (but without any stable cycle) while irradiation of the donor producing the optical modulation remains considerably more stable. ALS1 and ALS2 are extensions of the tail in the statistical distribution of these fluences. In this interpretation, the variations of the fluences are caused by the changes of the structure of the inner disk region, which produces variable obscuration of the beams (emitting in the ASM band) at the neutron star. A small change of obscuration of these beams by the inner disk region suffices to change the fluences largely. However, the irradiation of the donor is changed significantly less because this inner disk region (which emits beyond the ASM band and acts as the occulting region of the beams) also irradiates the donor.« less

PS1-09: Comparing the Greatest Challenges of Long-Term Rectal Cancer Survivors with Anastomosis Versus Ostomy

PubMed Central

McMullen, Carmit; Altschuler, Andrea; Bulkley, Joanna; Grant, Marcia; Hornbrook, Mark; Krouse, Robert

2012-01-01

Background Patients surgically treated for rectal cancer receive either an intestinal ostomy (externalization of the bowel to the abdominal wall) or, more frequently, an anastomosis (reconnection) of the rectum. While the challenges of intestinal ostomies have been previously described by this research team, much less is known about the long-term challenges of living with an anastomosis. Understanding the challenges of long-term rectal cancer survivors with both types of surgeries is important for informing and improving current practice. Methods We mailed our survey to 1000 long-term (at least 5 years post-diagnosis) rectal cancer survivors in KP Northern California and KP Northwest during 2010–2011. Our overall response rate was 57.7% (577/1000). The survey contained an open-ended question that asked respondents to write about the greatest challenge they experienced after their cancer surgery. Seventy-three percent of respondents provided a response to this “greatest challenge” question. Responses were analyzed qualitatively to compare the challenges reported by patients with anastomosis vs. ostomy. Results Challenges related to managing bowel function and output were found in both groups. Ostomy patients reported challenges to managing ostomy equipment that were unique to their condition—ostomy appliance failures, skin breakdown around the ostomy, and finding suitable places to empty, clean, and reconnect their appliance. Other notable differences in the greatest challenges among ostomy and anastomosis patients included: patients with an ostomy reported a range of psychosocial challenges relating to depression, shame, stigma, and post-operative psychological trauma about having an ostomy and such psychosocial impacts were notably absent among anastomosis patients; patients with ostomies reported regret about having an ostomy, but patients with anastomosis did not report regret about the surgery they received; and, anastomosis patients mentioned more

Long-term Monitoring Program Optimization for Chlorinated Volatile Organic Compound Plume, Naval Air Station Brunswick, Maine

NASA Astrophysics Data System (ADS)

Calderone, G. M.

2006-12-01

A long-term monitoring program was initiated in 1995 at 6 sites at NAS Brunswick, including 3 National Priorities List (Superfund) sites. Primary contaminants of concern include chlorinated volatile organic compounds, including tetrachloroethane, trichloroethene, and vinyl chloride, in addition to metals. More than 80 submersible pumping systems were installed to facilitate sample collection utilizing the low-flow sampling technique. Long-term monitoring of the groundwater is conducted to assess the effectiveness of remedial measures, and monitor changes in contaminant concentrations in the Eastern Plume Operable Unit. Long-term monitoring program activities include quarterly groundwater sampling and analysis at more than 90 wells across 6 sites; surface water, sediment, seep, and leachate sampling and analysis at 3 sites; landfill gas monitoring; well maintenance; engineering inspections of landfill covers and other sites or evidence of stressed vegetation; water level gauging; and treatment plant sampling and analysis. Significant cost savings were achieved by optimizing the sampling network and reducing sampling frequency from quarterly to semi- annual or annual sampling. As part of an ongoing optimization effort, a geostatistical assessment of the Eastern Plume was conducted at the Naval Air Station, Brunswick, Maine. The geostatistical assessment used 40 monitoring points and analytical data collected over 3 years. For this geostatistical assessment, EA developed and utilized a database of analytical results generated during 3 years of long-term monitoring which was linked to a Geographic Information System to enhance data visualization capacity. The Geographic Information System included themes for groundwater volatile organic compound concentration, groundwater flow directions, shallow and deep wells, and immediate access to point-specific analytical results. This statistical analysis has been used by the site decision-maker and its conclusions supported a

The greatest challenges reported by long-term colorectal cancer survivors with stomas.

PubMed

McMullen, Carmit K; Hornbrook, Mark C; Grant, Marcia; Baldwin, Carol M; Wendel, Christopher S; Mohler, M Jane; Altschuler, Andrea; Ramirez, Michelle; Krouse, Robert S

2008-04-01

This paper presents a qualitative analysis of the greatest challenges reported by long-term colorectal cancer survivors with ostomies. Surveys that included an open-ended question about challenges of living with an ostomy were administered at three Kaiser Permanente regions: Northern California, Northwest, and Hawaii. The study was coordinated at the Southern Arizona Veterans Affairs Health Care System in Tucson. The City of Hope Quality of Life Model for Ostomy Patients provided a framework for the study's design, measures, data collection, and data analysis. The study's findings may be generalized broadly to community settings across the United States. Results replicate those of previous research among veterans, California members of the United Ostomy Association, Koreans with ostomies, and colorectal cancer survivors with ostomies residing in the United Kingdom. The greatest challenges reported by 178 colorectal cancer survivors with ostomies confirmed the Institute of Medicine's findings that survivorship is a distinct, chronic phase of cancer care and that cancer's effects are broad and pervasive. The challenges reported by study participants should inform the design, testing and integration of targeted education, early interventions, and ongoing support services for colorectal cancer patients with ostomies.

ISS Regenerative Life Support: Challenges and Success in the Quest for Long-Term Habitability in Space

NASA Technical Reports Server (NTRS)

Bazley, Jesse A.

2011-01-01

This presentation will discuss the International Space Station s (ISS) Regenerative Environmental Control and Life Support System (ECLSS) operations with discussion of the on-orbit lessons learned, specifically regarding the challenges that have been faced as the system has expanded with a growing ISS crew. Over the 10 year history of the ISS, there have been numerous challenges, failures, and triumphs in the quest to keep the crew alive and comfortable. Successful operation of the ECLSS not only requires maintenance of the hardware, but also management of the station resources in case of hardware failure or missed re-supply. This involves effective communication between the primary International Partners (NASA and Roskosmos) and the secondary partners (JAXA and ESA) in order to keep a reserve of the contingency consumables and allow for re-supply of failed hardware. The ISS ECLSS utilizes consumables storage for contingency usage as well as longer-term regenerative systems, which allow for conservation of the expensive resources brought up by re-supply vehicles. This long-term hardware, and the interactions with software, was a challenge for Systems Engineers when they were designed and require multiple operational workarounds in order to function continuously. On a day-to-day basis, the ECLSS provides big challenges to the on console controllers. Main challenges involve the utilization of the resources that have been brought up by the visiting vehicles prior to undocking, balance of contributions between the International Partners for both systems and resources, and maintaining balance between the many interdependent systems, which includes providing the resources they need when they need it. The current biggest challenge for ECLSS is the Regenerative ECLSS system, which continuously recycles urine and condensate water into drinking water and oxygen. These systems were brought to full functionality on STS-126 (ULF-2) mission. Through system failures and recovery

Personal Reflection: Reflections on SoTL by a Casual Lecturer--Personal Benefits, Long-Term Challenges

ERIC Educational Resources Information Center

Dobbins, Kerry

2011-01-01

I have just completed my second year as a casual lecturer and have enjoyed engaging in the scholarship of teaching and learning (SoTL). However, my casual status has brought a number of challenges to ensuring my SoTL work has both long term and institutional impact. As the trend for casualisation in higher education continues across the world, I…

China’s Rapidly Aging Population Creates Policy Challenges In Shaping A Viable Long-Term Care System

PubMed Central

Feng, Zhanlian; Liu, Chang; Guan, Xinping; Mor, Vincent

2013-01-01

In China, formal long-term care services for the large aging population have increased to meet escalating demands as demographic shifts and socioeconomic changes have eroded traditional elder care. We analyze China’s evolving long-term care landscape and trace major government policies and private-sector initiatives shaping it. Although home and community-based services remain spotty, institutional care is booming with little regulatory oversight. Chinese policy makers face mounting challenges overseeing the rapidly growing residential care sector, given the tension arising from policy inducements to further institutional growth, a weak regulatory framework, and the lack of enforcement capacity. We recommend addressing the following pressing policy issues: building a balanced system of services and avoiding an “institutional bias” that promotes rapid growth of elder care institutions over home or community-based care; strengthening regulatory oversight and quality assurance with information systems; and prioritizing education and training initiatives to grow a professionalized long-term care workforce. PMID:23213161

Reforming Long-Term Care Funding in Alberta.

PubMed

Crump, R Trafford; Repin, Nadya; Sutherland, Jason M

2015-01-01

Like many provinces across Canada, Alberta is facing growing demand for long-term care. Issues with the mixed funding model used to pay long-term care providers had Alberta Health Services concerned that it was not efficiently meeting the demand for long-term care. Consequently, in 2010, Alberta Health Services introduced the patient/care-based funding (PCBF) model. PCBF is similar to activity-based funding in that it directly ties the complexity and care needs of long-term care residents to the payment received by long-term care providers. This review describes PCBF and discusses some of its strengths and weaknesses. In doing so, this review is intended to inform other provinces faced with similar long-term care challenges and contemplating their own funding reforms.

[Long-term care in Europe. Challenges and strategies in nursing staff management].

PubMed

Kuhlmann, E; Larsen, C

2013-08-01

Across Europe, long-term care (LTC) is one of the most challenging areas of social policy. Despite a growing awareness of the problems and improved data, current institutional reforms are an ineffective response to demographic change. This article aims to provide an overview of the challenges of future nursing and care staff in LTC in Europe, and to discuss the German case in a wider European context. We focus on the nursing workforce and on the link between current and prospective analyses on the demand and offer of LTC services and LTC professionals/nursing staff. We draw on a secondary analysis of the literature and public statistics, especially OECD data. The European comparison shows a high variation in the future demand for LTC. In Germany, a number of problematic trends create a negative scenario: the growing demand for LTC meets with a decrease in nursing staff on the supply side. We conclude by suggesting intervention strategies that may reduce this negative scenario.

Data-centric Science: New challenges for long-term archives and data publishers

NASA Astrophysics Data System (ADS)

Stockhause, Martina; Lautenschlager, Michael

2016-04-01

In the recent years the publication of data has become more and more common. Data and metadata for a single project are often disseminated by multiple data centers in federated data infrastructures. In the same time data is shared earlier to enable collaboration within research projects. The research data environment has become more heterogeneous and the data more dynamic. Only few data or metadata repositories are long-term archives (LTAs) with WDS/DSA certificates, complying to Force 11's 'Joint Declaration of Data Citation Principles'. Therefore for long-term usage of these data and information, a small number of LTAs have the task to preserve these pieces of information. They replicate, connect, quality assure, harmonize, archive, and curate these different types of data from multiple data centers with different operation procedures and data standards. Consortia or federations of certified LTAs are needed to meet the challenges of big data storage and citations. Data publishers play a central role in storing, preserving, and disseminating scientific information. Portals of these federations of LTAs or data registration agencies like DataCite might even become the portals of the future for scientific knowledge discovery. The example CMIP6 is used to illustrate this future perspective of the role of LTAs/data publishers.

Social Justice: A Long-Term Challenge for Counseling Psychology

ERIC Educational Resources Information Center

Ivey, Allen E.; Collins, Noah M.

2003-01-01

Counseling psychology has a long history of interest and commitment to social justice and multicultural issues. This article discusses some of that history and, in addition, speaks to specifics of implementing a liberation psychology frame of reference into clinical practice along with the issues of implementation and challenges faced by those of…

Long and Short Term Variability of the Main Physical Parameters in the Coastal Area of the SE Baltic Proper

NASA Astrophysics Data System (ADS)

Mingelaite, Toma; Rukseniene, Viktorija; Dailidiene, Inga

2015-04-01

Keywords: SE Baltic Sea, coastal upwelling, IR Remote Sensing The memory of the ocean and seas of atmospheric forcing events contributes to the long-term climate change. Intensifying climate change processes in the North Atlantic region including Baltic Sea has drawn widespread interest, as a changing water temperature has ecological, economic and social impact in coastal areas of the Europe seas. In this work we analyse long and short term variability of the main physical parameters in the coastal area of the South Eastern Baltic Sea Proper. The analysis of long term variability is based on monitoring data measured in the South Eastern Baltic Sea for the last 50 years. The main focus of the long term variability is changes of hydro meteorological parameters relevant to the observed changes in the climate.The water salinity variations in the Baltic Sea near the Lithuanian coast and in the Curonian Lagoon, a shallow and enclosed sub-basin of the Baltic Sea, were analysed along with the time series of some related hydroclimatic factors. The short term water temperature and salinity variations were analysed with a strong focus on coastal upwelling events. Combining both remote sensing and in situ monitoring data physical parameters such as vertical salinity variations during upwelling events was analysed. The coastal upwelling in the SE Baltic Sea coast, depending on its scale and intensity, may lead to an intrusion of colder and saltier marine waters to the Curonian Lagoon resulting in hydrodynamic changes and pronounced temperature drop extending for 30-40 km further down the Lagoon. The study results show that increasing trends of water level, air and water temperature, and decreasing ice cover duration are related to the changes in meso-scale atmospheric circulation, and more specifically, to the changes in regional and local wind regime climate. That is in a good agreement with the increasing trends in local higher intensity of westerly winds, and with the winter

An overview of potential labor-saving and quality-improving innovations in long-term care for older people.

PubMed

Thoma-Lürken, Theresa; Bleijlevens, Michel H C; Lexis, Monique A S; Hamers, Jan P H; de Witte, Luc P

2015-06-01

Increasing demands in long-term care for older people and a decrease in workforce availability can be expected in the future. These developments challenge the sustainability and quality of long-term care for older people. To address these challenges, long-term care organizations are forced to innovate. The aim of this study is to provide an overview of potential labor-saving and quality-improving innovations long-term care organizations are working on and to assess the self-reported extent of effectiveness. This is a descriptive cross-sectional study. In total, 32 long-term care organizations in the region of Limburg in The Netherlands were invited to participate in the study. The inventory was performed by means of semistructured interviews with chief executive officers, managers, and staff members of the long-term care organizations. Based on the interview data, all innovations were described in a standardized form and subsequently checked by the participants. All innovations were clustered into product, process, organizational, and marketing innovations. In total, 26 long-term care organizations delivering home and/or institutional long-term care for older people participated in the study. Overall, 228 innovations were identified; some innovations were described in a similar way by different organizations. The majority of innovations were product innovations (n = 96), followed by organizational innovations (n = 75), and process innovations (n = 42). In addition to the main types, 15 other innovations incorporating characteristics of different types of innovations were detected. Little evidence about the effectiveness of the innovations was reported by the organizations. This study shows that a large number and a broad variety of innovations have been implemented or are currently being developed in long-term care organizations for older people. However, according to the organizations, there is relatively little (scientific) evidence confirming the effectiveness

Long-term Bat Monitoring on Islands, Offshore Structures, and Coastal Sites in the Gulf of Maine, mid-Atlantic, and Great Lakes—Final Report

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

Peterson, Trevor; Pelletier, Steve; Giovanni, Matt

This report summarizes results of a long-term regional acoustic survey of bat activity at remote islands, offshore structures, and coastal sites in the Gulf of Maine, Great Lakes, and mid-Atlantic coast.

Long-Term Antiretroviral Treatment Adherence in HIV-Infected Adolescents and Adults in Uganda: A Qualitative Study

PubMed Central

Inzaule, Seth C.; Hamers, Raph L.; Kityo, Cissy; Rinke de Wit, Tobias F.; Roura, Maria

2016-01-01

Background Long-term success of HIV antiretroviral therapy requires near-perfect adherence, maintained throughout one’s lifetime. However, perceptions towards ART and patterns of adherence may change during the life course. We assessed challenges to long-term adherence in adolescents and adults in three regional HIV treatment centers in Uganda. Methods We conducted 24 in-depth interviews and 2 focus group discussions with a total of 33 health-care providers and expert clients (HIV patients on long-term ART who assist with adherence support of fellow patients). Interview topics included experiences with patients on long-term treatment with either declining adherence or persistent poor adherence. Transcribed texts were coded and analyzed based on the social-ecological framework highlighting differences and commonalities between adolescents and adults. Results The overarching themes in adolescents were unstructured treatment holidays, delays in disclosure of HIV status by caretakers, stigma, which was mainly experienced in boarding schools, and diminishing or lack of clinical support. In particular, there was minimal support for early and gradual disclosure for caretakers to the infected children, diminishing clinical support for young adults during transition to adult-based care and declining peer-to-peer support group activities. The predominating theme in adults was challenges with treatment access among temporary economic migrants. Common themes to adults and adolescents were challenges with disclosure in intimate relationships, treatment related factors including side effects, supply of single tablets in place of fixed-dose combined drugs, supply of drug brands with unfavorable taste and missed opportunities for counseling due to shortage of staff. Conclusion Adherence counseling and support should be adapted differently for adolescents and adults and to the emerging life course challenges in long-term treated patients. Programs should also address constraints

Long-Term Monitoring Research Needs: A DOE Perspective

NASA Astrophysics Data System (ADS)

Moore, B.; Davis, C. B.

2002-05-01

The U.S. Department of Energy's Office of Environmental Management is responsible for dealing with the nation's legacy of Cold War radioactive and hazardous waste and contamination. Major efforts are underway to deal with this legacy; these are expected to last up to decades and cost up to billions of dollars at some sites. At all sites, however, active remediation must eventually cease; if hazards then remain, the site must enter into a long-term stewardship mode. In this talk we discuss aspects of long-term monitoring pertinent to DOE sites, focusing on challenges to be faced, specific goals or targets to be met, and research needs to be addressed in order to enable DOE to meet its long-term stewardship obligations. DOE LTM research needs fall into three major categories: doing what we can do now much more efficiently; doing things we cannot do now; and proving the validity of our monitoring programs. Given the enormity of the DOE obligations, it will be highly desirable to develop much more efficient monitoring paradigms. Doing so will demand developing autonomous, remote monitoring networks of in situ sensors capable of replacing (or at least supplementing to a large extent) conventional groundwater and soil gas sampling and analysis programs. The challenges involved range from basic science (e.g., inventing in situ sensors for TCE that do not demand routine maintenance) to engineering (attaining superior reliability in data reporting in remote networks) to ergonomics (developing decent ways of selecting and presenting the "right" information from the monitoring network) to regulatory affairs (presenting convincing evidence that the more efficient systems actually provide superior monitoring). We explore these challenges in some detail, focusing on the "long" in long-term monitoring as it applies to DOE sites. Monitoring system performance validation and, ultimately, regulator and stakeholder acceptance of site closure and long-term stewardship plans depend

Long-term ecological research in a human-dominated world

Treesearch

G. Philip Robertson; Scott L. Collins; David R. Foster; Nicholas Brokaw; Hugh W. Ducklow; Ted L. Gragson; Corinna Gries; Stephen K. Hamilton; A. David McGuire; John C. Moore; Emily H. Stanley; Robert B. Waide; Mark W. Williams

2012-01-01

The US Long Term Ecological Research (LTER) Network enters its fourth decade with a distinguished record of achievement in ecological science. The value of long-term observations and experiments has never been more important for testing ecological theory and for addressing today’s most difficult environmental challenges. The network’s potential for tackling emergent...

Space shuttle main engine: Interactive design challenges

NASA Technical Reports Server (NTRS)

Mccarty, J. P.; Wood, B. K.

1985-01-01

The operating requirements established by NASA for the SSME were considerably more demanding than those for earlier rocket engines used in the military launch vehicles or Apollo program. The SSME, in order to achieve the high performance, low weight, long life, reusable objectives, embodied technical demands far in excess of its predecessor rocket engines. The requirements dictated the use of high combustion pressure and the staged combustion cycle which maximizes performance through total use of all propellants in the main combustion process. This approach presented a myriad of technical challenges for maximization of performance within attainable state of the art capabilities for operating pressures, operating temperatures and rotating machinery efficiencies. Controlling uniformity of the high pressure turbomachinery turbine temperature environment was a key challenge for thrust level and life capability demanding innovative engineering. New approaches in the design of the components were necessary to accommodate the multiple use, minimum maintenance objectives. Included were the use of line replaceable units to facilitate field maintenance automatic checkout and internal inspection capabilities.

Strategies and challenges of antimicrobial stewardship in long-term care facilities.

PubMed

Dyar, O J; Pagani, L; Pulcini, C

2015-01-01

As people are living longer the demand for long-term care facilities (LTCFs) continues to rise. For many reasons, antimicrobials are used intensively in LTCFs, with up to a half of this use considered inappropriate or unnecessary. Over-use of antimicrobials can have direct adverse consequences for LTCF residents and promotes the development and spread of resistant bacteria. It is therefore critical that LTCFs are able to engage in antimicrobial stewardship programmes, which have the potential to minimize the antibiotic selective pressure, while improving the quality of care received by LTCF residents. To date, no antimicrobial stewardship guidelines specific to LTCF settings have been published. Here we outline the scale of antimicrobial use in LTCFs and the underlying drivers for antibiotic over-use. We further describe the particular challenges of antimicrobial stewardship in LTCFs, and review the interventional studies that have aimed to improve antibiotic use in these settings. Practical recommendations are then drawn from this research to help guide the development and implementation of antimicrobial stewardship programmes. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

The Long-Term Conditions Questionnaire: conceptual framework and item development.

PubMed

Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A'Court, Christine; Fitzpatrick, Ray

2016-01-01

To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey.

The Long-Term Conditions Questionnaire: conceptual framework and item development

PubMed Central

Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A’Court, Christine; Fitzpatrick, Ray

2016-01-01

Purpose To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Materials and methods Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Results Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. Conclusion The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey. PMID:27621678

Long-term cropping systems study

USDA-ARS?s Scientific Manuscript database

This long-term study has been conducted on the Agronomy Farm at ARDC since the early 1970’s. In the beginning, the objectives were mainly related to crop production as affected by different cropping systems. The cropping systems included in the study are Continuous Corn, Soybean, and Sorghum; 2-year...

Advancing an ethical framework for long-term care.

PubMed

Carter, Mary Whelan

2002-02-01

This article represents an effort to formulate an ethical framework for long-term care with the explicit purpose of providing a catalyst to promote further discourse and expand consideration of what an ethic of long-term care might entail. Grounding the discussion, an introduction to traditional ethical philosophy is presented, focusing mainly on the fundamentals of deontological and teleological ethical theories. Attention then shifts to a review of the more frequently cited principles found in the long-term care ethics literature, followed by a critique of the current reliance upon principlism to resolve ethical dilemmas in long-term care. In response to this criticism, an agent-driven ethical framework stressing dignity and respect for personhood, drawn from the philosophy of Immanuel Kant, is advanced.

[Long-term physical activity after a myocardial infarction : a permanent challenge].

PubMed

Tessitore, Elena; Sigaud, Philippe; Meyer, Philippe; Mach, François

2017-05-24

Cardiac rehabilitation is a well-defined multidisciplinary program with the objective to reduce mortality and morbidity, while also improving the exercise capacity and quality of life of the patient following a myocardial infarction. Despite the fact that a cardiovascular rehabilitation program is now recommended by international guidelines for all patients who have suffered from an acute coronary syndrome, only half of all patients actually participate to such a program in Switzerland. Even worse, especially when taking into consideration the population in Geneva, less than 5 % of patients follow a long-term cardiac maintenance program (phase III). Since 2015, our project has been to encourage patients who have completed a phase II cardiac rehabilitation program, to resume regular physical activity in the long term.

Management of long-term conditions in a prison setting.

PubMed

Perry, J

This article, the fourth in a five-part series, explores the management of long-term conditions in the prison population, as well as patient-centred approaches to care and the challenges this may present. It discusses the effective management of chronic diseases and the importance of evidence-based practice in improving offender health care. The need for an understanding of the sociological and psychological perspectives of living with a long-term condition is explained.

Prevalence of Long-Term Opioid Use in Long-Stay Nursing Home Residents.

PubMed

Hunnicutt, Jacob N; Chrysanthopoulou, Stavroula A; Ulbricht, Christine M; Hume, Anne L; Tjia, Jennifer; Lapane, Kate L

2018-01-01

Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs). Cross-sectional. U.S. NHs (N = 13,522). Long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow-up (N = 315,949). We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short-term: ≤30 days, medium-term: >30-89 days, long-term: ≥90 days), adjuvants (e.g., anticonvulsants), and other pain medications (e.g., corticosteroids). MDS assessments in the follow-up period were used to measure nonpharmacological pain management use. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for age, gender, race and ethnicity, cognitive and physical impairment, and long-term opioid use. Of all long-stay residents, 32.4% were prescribed any opioid, and 15.5% were prescribed opioids long-term. Opioid users (versus nonusers) were more commonly prescribed pain adjuvants (32.9% vs 14.9%), other pain medications (25.5% vs 11.0%), and nonpharmacological pain management (24.5% vs 9.3%). Long-term opioid use was higher in women (aPR = 1.21, 95% CI = 1.18-1.23) and lower in racial and ethnic minorities (non-Hispanic blacks vs whites: APR = 0.93, 95% CI = 0.90-0.94) and those with severe cognitive impairment (vs no or mild impairment, aPR = 0.82, 95% CI = 0.79-0.83). One in seven NH residents was prescribed opioids long-term. Recent guidelines on opioid prescribing for pain recommend reducing long-term opioid use, but this is challenging in NHs because residents may not benefit from nonpharmacological and nonopioid interventions. Studies to address concerns about opioid safety and effectiveness (e.g., on pain and functional status) in NHs are needed. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics

Long-Term Recency in Anterograde Amnesia

PubMed Central

Talmi, Deborah; Caplan, Jeremy B.; Richards, Brian; Moscovitch, Morris

2015-01-01

Amnesia is usually described as an impairment of a long-term memory (LTM) despite an intact short-term memory (STM). The intact recency effect in amnesia had supported this view. Although dual-store models of memory have been challenged by single-store models based on interference theory, this had relatively little influence on our understanding and treatment of amnesia, perhaps because the debate has centred on experiments in the neurologically intact population. Here we tested a key prediction of single-store models for free recall in amnesia: that people with amnesia will exhibit a memory advantage for the most recent items even when all items are stored in and retrieved from LTM, an effect called long-term recency. People with amnesia and matched controls studied, and then free-recalled, word lists with a distractor task following each word, including the last (continual distractor task, CDFR). This condition was compared to an Immediate Free Recall (IFR, no distractors) and a Delayed Free Recall (DFR, end-of-list distractor only) condition. People with amnesia demonstrated the full long-term recency pattern: the recency effect was attenuated in DFR and returned in CDFR. The advantage of recency over midlist items in CDFR was comparable to that of controls, confirming a key prediction of single-store models. Memory deficits appeared only after the first word recalled in each list, suggesting the impairment in amnesia may emerge only as the participant’s recall sequence develops, perhaps due to increased susceptibility to output interference. Our findings suggest that interference mechanisms are preserved in amnesia despite the overall impairment to LTM, and challenge strict dual-store models of memory and their dominance in explaining amnesia. We discuss the implication of our findings for rehabilitation. PMID:26046770

Long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia): survey methods, data management, and long-term population trends.

PubMed

Ojanen, Sami P; Nieminen, Marko; Meyke, Evgeniy; Pöyry, Juha; Hanski, Ilkka

2013-10-01

Long-term observational studies conducted at large (regional) spatial scales contribute to better understanding of landscape effects on population and evolutionary dynamics, including the conditions that affect long-term viability of species, but large-scale studies are expensive and logistically challenging to keep running for a long time. Here, we describe the long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia) that has been conducted since 1991 in a large network of 4000 habitat patches (dry meadows) within a study area of 50 by 70 km in the Åland Islands in Finland. We explain how the landscape structure has been described, including definition, delimitation, and mapping of the habitat patches; methods of field survey, including the logistics, cost, and reliability of the survey; and data management using the EarthCape biodiversity platform. We describe the long-term metapopulation dynamics of the Glanville fritillary based on the survey. There has been no long-term change in the overall size of the metapopulation, but the level of spatial synchrony and hence the amplitude of fluctuations in year-to-year metapopulation dynamics have increased over the years, possibly due to increasing frequency of exceptional weather conditions. We discuss the added value of large-scale and long-term population studies, but also emphasize the need to integrate more targeted experimental studies in the context of long-term observational studies. For instance, in the case of the Glanville fritillary project, the long-term study has produced an opportunity to sample individuals for experiments from local populations with a known demographic history. These studies have demonstrated striking differences in dispersal rate and other life-history traits of individuals from newly established local populations (the offspring of colonizers) versus individuals from old, established local populations. The long-term observational study has stimulated the

Long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia): survey methods, data management, and long-term population trends

PubMed Central

Ojanen, Sami P; Nieminen, Marko; Meyke, Evgeniy; Pöyry, Juha; Hanski, Ilkka

2013-01-01

Long-term observational studies conducted at large (regional) spatial scales contribute to better understanding of landscape effects on population and evolutionary dynamics, including the conditions that affect long-term viability of species, but large-scale studies are expensive and logistically challenging to keep running for a long time. Here, we describe the long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia) that has been conducted since 1991 in a large network of 4000 habitat patches (dry meadows) within a study area of 50 by 70 km in the Åland Islands in Finland. We explain how the landscape structure has been described, including definition, delimitation, and mapping of the habitat patches; methods of field survey, including the logistics, cost, and reliability of the survey; and data management using the EarthCape biodiversity platform. We describe the long-term metapopulation dynamics of the Glanville fritillary based on the survey. There has been no long-term change in the overall size of the metapopulation, but the level of spatial synchrony and hence the amplitude of fluctuations in year-to-year metapopulation dynamics have increased over the years, possibly due to increasing frequency of exceptional weather conditions. We discuss the added value of large-scale and long-term population studies, but also emphasize the need to integrate more targeted experimental studies in the context of long-term observational studies. For instance, in the case of the Glanville fritillary project, the long-term study has produced an opportunity to sample individuals for experiments from local populations with a known demographic history. These studies have demonstrated striking differences in dispersal rate and other life-history traits of individuals from newly established local populations (the offspring of colonizers) versus individuals from old, established local populations. The long-term observational study has stimulated the

Soilaluminum, iron, and phosphorus dynamics in response to long-term experimental nitrogen and sulfur additions at the Bear Brook Watershed in Maine, USA

Treesearch

Jessica Sherman; Ivan J. Fernandez; Stephen A. Norton; Tsutomu Ohno; Lindsey E. Rustad

2006-01-01

Atmospheric deposition of nitrogen (N) and sulfur (S) containing compounds affects soil chemistry in forested ecosystems through (1) acidification and the depletion of base cations, (2) metal mobilization, particularly aluminum (Al), and iron (Fe), (3) phosphorus (P) mobilization, and (4) N accumulation. The Bear BrookWatershed in Maine (BBWM) is a long-term paired...

[Challenge and treatment strategy for ocular surface damage in patients with long term use of antiglaucoma drugs].

PubMed

He, Xiang-Ge

2011-02-01

Long term use of topical anti-glaucoma drugs has been shown to induce chronic conjunctivitis, superficial punctate keratitis (SPK) and dry eye symptom. Under these conditions, a loss of goblet cells in conjunctiva, epithelial squamous metaplasia and apoptosis were morphologically revealed. Benzalkonium Chloride (BKC), a most frequently used preservative in eye drops, has been found to be an important factor causing ocular surface damage. Furthermore, a big challenge for ophthalmologists is that toxic damage of medication to ocular surface tissues is mild, poor specificity, and delayed manifestation in patients, especially when coexisting with other ocular surface diseases. Impairment of ocular surface tissues greatly impacts the life quality of patients and subsequently influences compliance with glaucoma therapy. This paper emphasizes to take measures to prevent ocular surface tissue damage resulted from chronic use of topical anti-glaucoma drugs and further discusses the treatment strategy. Effective and long-lasting action drugs should always be selected for glaucomatous patients in order to decrease the frequency of topical instillation or at a more expensive medication, a fixed combination formula can be considered for glaucoma therapy. An early surgery or laser treatment is also proposed for the patients who require an IOP reduction with an existing ocular surface impairment. Future investigation and development of new medications with long-term efficacy and appropriate BKC are suggested and preservative-free or drugs with new preservative materials recommended.

Addressing challenges in cross-site synthesis of long-term ecological data

USDA-ARS?s Scientific Manuscript database

Long-term ecological datasets are becoming increasingly abundant on the internet, and are available both on websites hosted by the originating sites and/or in online repositories. While sites and networks are increasingly conforming to adopted metadata standards (which themselves continue to evolve ...

Long-term psychosocial consequences of surgical congenital malformations.

PubMed

Diseth, Trond H; Emblem, Ragnhild

2017-10-01

Surgical congenital malformations often represent years of treatment, large number of hospital stays, treatment procedures, and long-term functional sequels affecting patients' psychosocial functioning. Both functional defects and psychosocial difficulties that occur commonly in childhood may pass through adolescence on to adulthood. This overview presents reports published over the past 3 decades to elucidate the long-term psychosocial consequences of surgical congenital malformations. Literature searches conducted on PubMed database revealed that less than 1% of all the records of surgical congenital malformations described long-term psychosocial consequences, but with diverse findings. This inconsistency may be due to methodological differences or deficiencies; especially in study design, patient sampling, and methods. Most of the studies revealed that the functional deficits may have great impact on patients' mental health, psychosocial functioning, and QoL; both short- and long-term negative consequences. Factors other than functional problems, e.g., repeated anesthesia, multiple hospitalization, traumatic treatment procedures, and parental dysfunctioning, may also predict long-term mental health and psychosocial functioning. Through multidisciplinary approach, pediatric surgeons should also be aware of deficits in emotional and psychosocial functioning. To achieve overall optimal psychosocial functioning, the challenge is to find a compromise between physically optimal treatment procedures and procedures that are not psychologically detrimental. Copyright © 2017. Published by Elsevier Inc.

The Jornada Basin long term ecological research program

USDA-ARS?s Scientific Manuscript database

Chihuahuan Desert landscapes exemplify the ecological conditions, vulnerability, and management challenges in arid and semi-arid regions around the world. The goal of the Jornada Basin Long Term Ecological Research program (JRN LTER) established in 1982 is to understand and quantify the key factors ...

From 2D to 3D modelling in long term tectonics: Modelling challenges and HPC solutions (Invited)

NASA Astrophysics Data System (ADS)

Le Pourhiet, L.; May, D.

2013-12-01

Over the last decades, 3D thermo-mechanical codes have been made available to the long term tectonics community either as open source (Underworld, Gale) or more limited access (Fantom, Elvis3D, Douar, LaMem etc ...). However, to date, few published results using these methods have included the coupling between crustal and lithospheric dynamics at large strain. The fact that these computations are computational expensive is not the primary reason for the relatively slow development of 3D modeling in the long term tectonics community, as compare to the rapid development observed within the mantle dynamic community, or in the short-term tectonics field. Long term tectonics problems have specific issues not found in either of these two field, including; large strain (not an issue for short-term), the inclusion of free surface and the occurence of large viscosity contrasts. The first issue is typically eliminated using a combined marker-ALE method instead of fully lagrangian method, however, the marker-ALE approach can pose some algorithmic challenges in a massively parallel environment. The two last issues are more problematic because they affect the convergence of the linear/non-linear solver and the memory cost. Two options have been tested so far, using low order element and solving with a sparse direct solver, or using higher order stable elements together with a multi-grid solver. The first options, is simpler to code and to use but reaches its limit at around 80^3 low order elements. The second option requires more operations but allows using iterative solver on extremely large computers. In this presentation, I will describe the design philosophy and highlight results obtained using a code from the second-class method. The presentation will be oriented from an end-user point of view, using an application from 3D continental break up to illustrate key concepts. The description will proceed point by point from implementing physics into the code, to dealing with

Japanese public long-term care insured: preferences for future long-term care facilities, including relocation, waiting times, and individualized care.

PubMed

Sawamura, Kanae; Sano, Hiroshi; Nakanishi, Miharu

2015-04-01

Expenditures on long-term care insurance (LTCI) in Japan have been increasing with the aging of the population, which has led to an increase in premiums. To optimize resource allocation, we aim to clarify the priorities of the functions of long-term care facilities from the viewpoint of future beneficiaries. The present study was conducted using a cross-sectional study design. We conducted a mail-in survey targeting 2400 adults aged 50-65 in 8 cities in Japan, and 371 persons responded. Conjoint analysis was applied to measure participants' preferences for long-term care facility services. Participants read 1 of 2 vignettes of an 80-year-old person with either dementia or a fracture, and were asked to envision it as a possible future scenario for themselves. Participants then completed 8 or 9 tasks to select suitable long-term care facilities for the person described. The questionnaire also contained common questions on participants' personal profiles: age, gender, family situation, education, approximate yearly family income, experience as a family caregiver, dwelling status, present health status, and possibility of requiring long-term care services in the future. The results focused mainly on (1) possibilities of individual choice for daily schedules/meals; (2) availability of regular care staff; (3) room; (4) main daily interactions; (5) necessity of relocation associated with medical deterioration; 6) Waiting time; 7) distance from present residence; and (8) monthly fees. Necessity of relocation associated with medical deterioration was consistently given the greatest importance. Participants with experience as a family caregiver showed significantly greater preference for individualized care and communication. The option of avoiding relocation was highly valued by participants compared with private rooms and individualized care. The present situation of high demand for intensive care homes for the elderly, provoked by anxiety about future residence, will not

Long-term management of patients with multiple sclerosis.

PubMed

Weightman, Cherie

2006-07-01

This article explores the challenges of long-term case management for patients who have multiple sclerosis (MS). Currently there is scant research into district nursing input into long-term management of patients who have MS. Until now the role of the community nurses has been confined to palliation or terminal care, focusing on the more physical manifestations of MS. The contemporary role of district nurse is going to evolve to include proactive approaches. Governmental initiatives demand proactive services, and place emphasis on self-care for patients with MS. Themes that emerge from this article relate to the pre-existing skills--such as managing patients with complex needs and the advanced assessment skills--that will be required to achieve this. What is clear is that community nurses already possess many of the prerequisite skills needed for long-term management, and they should not be daunted by this prospect.

Science and society: the role of long-term studies in environmental stewardship

Treesearch

Charles T. Driscoll; Kathleen F. Lambert; F. Stuart Chapin; David J. Nowak; Thomas A. Spies; Frederick J. Swanson; David B. Kittredge; Clarisse M. Hart

2012-01-01

Long-term research should play a crucial role in addressing grand challenges in environmental stewardship. We examine the efforts of five Long Term Ecological Research Network sites to enhance policy, management, and conservation decisions for forest ecosystems. In these case studies, we explore the approaches used to inform policy on atmospheric deposition, public...

Short-Term Plasticity and Long-Term Potentiation in Magnetic Tunnel Junctions: Towards Volatile Synapses

NASA Astrophysics Data System (ADS)

Sengupta, Abhronil; Roy, Kaushik

2016-02-01

Synaptic memory is considered to be the main element responsible for learning and cognition in humans. Although traditionally nonvolatile long-term plasticity changes are implemented in nanoelectronic synapses for neuromorphic applications, recent studies in neuroscience reveal that biological synapses undergo metastable volatile strengthening followed by a long-term strengthening provided that the frequency of the input stimulus is sufficiently high. Such "memory strengthening" and "memory decay" functionalities can potentially lead to adaptive neuromorphic architectures. In this paper, we demonstrate the close resemblance of the magnetization dynamics of a magnetic tunnel junction (MTJ) to short-term plasticity and long-term potentiation observed in biological synapses. We illustrate that, in addition to the magnitude and duration of the input stimulus, the frequency of the stimulus plays a critical role in determining long-term potentiation of the MTJ. Such MTJ synaptic memory arrays can be utilized to create compact, ultrafast, and low-power intelligent neural systems.

Joint trajectories of cognitive functioning and challenging behavior for persons living with dementia in long-term care.

PubMed

Robitaille, Annie; Garcia, Linda; McIntosh, Cameron

2015-09-01

The current study examines the longitudinal relationship between dementia-related challenging behaviors (e.g., vocal disruption, physical aggression, repetitive behaviors, and restlessness) and cognitive functioning in the long-term care (LTC) context. A multivariate latent growth curve model within the structural equation modeling (SEM) framework was applied to data collected from 16,804 older adults upon admission to LTC and every 3 months for a period of 2.5 years. Increases in challenging behaviors were characterized by a significant positive linear and negative quadratic trend (i.e., a subtle leveling off at later assessment times), whereas increases in cognitive impairment were characterized by a positive linear trend. On average, individuals who were more cognitively impaired upon entry into LTC and who exhibited a steeper increase in cognitive impairment also exhibited more challenging behaviors at entry into LTC and a steeper increase in challenging behaviors, respectively. At the within-person level, individuals demonstrating an increase in cognitive impairment at a specific occasion were also more likely to demonstrate an increase in challenging behaviors at that same occasion; however, the magnitude of these effects was very small, suggesting limited practical implications. This study provides novel empirical evidence about the coevolution of cognitive impairment and challenging behaviors, going beyond prior research that has been either cross-sectional in nature, examined longitudinal change in only 1 variable, or simply looked at linear trends without attempting to explore the possibility of nonlinear change. Most importantly, this longitudinal examination of persons with dementia living in LTC has implications for how challenging behaviors can be better managed and for how new strategies can be implemented to prevent challenging behaviors. (c) 2015 APA, all rights reserved).

Approach to the E-ELT dome and main structure challenges

NASA Astrophysics Data System (ADS)

Bilbao, Armando; Murga, Gaizka; Gómez, Celia; Llarena, Javier

2014-07-01

The E-ELT as a whole could be classified as an extremely challenging project. More precisely, it should be defined as an array of many different sub-challenges, which comprise technical, logistical and managerial matters. This paper reviews some of these critical challenges, in particular those related to the Dome and the Main Structure, suggesting ways to face them in the most pragmatic way possible. Technical challenges for the Dome and the Main Structure are mainly related to the need to upscale current design standards to an order of magnitude larger design. Trying a direct design escalation is not feasible; it would not work. A design effort is needed to cross hybridize current design standards with technologies coming from other different applications. Innovative design is therefore not a wish but a must. And innovative design comes along with design risk. Design risk needs to be tackled from two angles: on the one hand through thorough design validation analysis and on the other hand through extensive pre-assembly and testing. And, once again, full scale integrated pre-assembly and testing of extremely large subsystems is not always possible. Therefore, defining a comprehensive test plan for critical components, critical subsystems and critical subassemblies becomes essential. Logistical challenges are linked to the erection site. Cerro Armazones is a remote site and this needs to be considered when evaluating transport and erection requirements. But it is not only the remoteness of the site that needs to be considered. The size of both Dome and Main Structure require large construction cranes and a well defined erection plan taking into account pre-assembly strategies, limited plan area utilization, erection sequence, erection stability during intermediate stages and, very specifically, efficient coordination between the Dome and the Main Structure erection processes. Managerial issues pose another set of challenges in this project. Both the size of the

Long-term outcomes of gastrografin in small bowel obstruction

PubMed Central

Baghdadi, Yaser M.K.; Choudhry, Asad J.; Goussous, Naeem; Khasawneh, Mohammad A.; Polites, Stephanie F.; Zielinski, Martin D.

2016-01-01

Background The gastrografin (GG) challenge is a diagnostic and therapeutic tool used to treat patients with small bowel obstruction (SBO); however, long-term data on SBO recurrence after the GG challenge remain limited. We hypothesized that patients treated with GG would have the same long-term recurrence as those treated before the implementation of the GG challenge protocol. Methods Patients ≥18 years who were treated for SBO between July 2009 and December 2012 were identified. We excluded patients with contraindications to the GG challenge (i.e., signs of strangulation), patients having SBO within 6-wk of previous abdominal or pelvic surgery and patients with malignant SBO. All patients had been followed a minimum of 1 y or until death. Kaplan–Meier method and Cox regression models were used to describe the time-dependent outcomes. Results A total of 202 patients were identified of whom 114 (56%) received the challenge. Mean patients age was 66 y (range, 19–99 y) with 110 being female (54%). A total of 184 patients (91%) were followed minimum of 1 year or death (18 patients lost to follow-up). Median follow-up of living patients was 3 y (range, 1–5 y). During follow-up, 50 patients (25%) experienced SBO recurrences, and 24 (12%) had exploration for SBO recurrence. The 3-year cumulative rate of SBO recurrence in patients who received the GG was 30% (95% confidence interval [CI], 21%–42%) compared to 27% (95% CI, 18%–38%) for those who did not (P = 0.4). The 3-year cumulative rate of exploration for SBO recurrence in patients who received the GG was 15% (95% CI, 8%–26%) compared to 12 % (95% CI, 6%–22%) for those who did not (P = 0.6). Conclusions The GG challenge is a clinically useful tool in treating SBO patients with comparable long-term recurrence rates compared to traditional management of SBO. PMID:27083946

Long-term outcomes of gastrografin in small bowel obstruction.

PubMed

Baghdadi, Yaser M K; Choudhry, Asad J; Goussous, Naeem; Khasawneh, Mohammad A; Polites, Stephanie F; Zielinski, Martin D

2016-05-01

The gastrografin (GG) challenge is a diagnostic and therapeutic tool used to treat patients with small bowel obstruction (SBO); however, long-term data on SBO recurrence after the GG challenge remain limited. We hypothesized that patients treated with GG would have the same long-term recurrence as those treated before the implementation of the GG challenge protocol. Patients ≥18 years who were treated for SBO between July 2009 and December 2012 were identified. We excluded patients with contraindications to the GG challenge (i.e., signs of strangulation), patients having SBO within 6-wk of previous abdominal or pelvic surgery and patients with malignant SBO. All patients had been followed a minimum of 1 y or until death. Kaplan-Meier method and Cox regression models were used to describe the time-dependent outcomes. A total of 202 patients were identified of whom 114 (56%) received the challenge. Mean patients age was 66 y (range, 19-99 y) with 110 being female (54%). A total of 184 patients (91%) were followed minimum of 1 year or death (18 patients lost to follow-up). Median follow-up of living patients was 3 y (range, 1-5 y). During follow-up, 50 patients (25%) experienced SBO recurrences, and 24 (12%) had exploration for SBO recurrence. The 3-year cumulative rate of SBO recurrence in patients who received the GG was 30% (95% confidence interval [CI], 21%-42%) compared to 27% (95% CI, 18%-38%) for those who did not (P = 0.4). The 3-year cumulative rate of exploration for SBO recurrence in patients who received the GG was 15% (95% CI, 8%-26%) compared to 12 % (95% CI, 6%-22%) for those who did not (P = 0.6). The GG challenge is a clinically useful tool in treating SBO patients with comparable long-term recurrence rates compared to traditional management of SBO. Copyright © 2016 Elsevier Inc. All rights reserved.

The Long Term Agroecosystem Research Network - Shared research strategy

USDA-ARS?s Scientific Manuscript database

Agriculture faces tremendous challenges in meeting multiple societal goals, including a safe and plentiful food supply; climate change adaptation and mitigation; supplying sources of bioenergy; improving water, air, and soil quality; and maintaining biodiversity. The Long Term Agroecosystem Research...

The Precise Orbit and the Challenge of Long Term Stability

NASA Technical Reports Server (NTRS)

Lemoine, Frank G.; Cerri, Luca; Otten, Michiel; Bertiger, William; Zelensky, Nikita; Willis, Pascal

2012-01-01

the future remains a source of error. Other sources of omission error include the geocenter for which no consensus model is as of yet applied. Although progress has been made in nonconservative force modeling through the use of detailed satellite-specific models, radiation pressure modeling, and atmospheric density modeling remain a potential source of orbit error. The longer term influence of variations in the solar and terrestrial radiation fields over annual and solar cycles remains principally untested. Also the long term variation in optical and thermal properties of the space vehicle surfaces would contribute to biases in the orbital frame if ignored. We review the status of altimetric precision orbit determination as exemplified by the recent computations undertaken by the different analysis centers for ERS, Envisat, TOPEX/Poseidon, Jason, Cryosat2 and HY2A, and we provide a perspective on the challenges for future missions such as the Jason-3, SENTINEL-3 and SWOT.

From Cell to Module: Fabrication and Long-term Stability of Dye-sensitized Solar Cells

NASA Astrophysics Data System (ADS)

Nursam, N. M.; Hidayat, J.; Muliani, L.; Anggraeni, P. N.; Retnaningsih, L.; Idayanti, N.

2017-07-01

Dye-sensitized solar cell (DSSC), which has been firstly developed by Graetzel et al back in 1991, has attracted a considerable interest since its discovery. However, two of the main challenges that the DSSC technology will have to overcome towards commercialization involve device scale-up and long-term stability. In our group, the fabrication technology of DSSC has been developed from laboratory to module scale over the past few years, nevertheless, the long-term stability has still became a major concern. In this contribution, the long-term DSSC performance in relation to their scale-up from cell to module is investigated. The photoelectrode of the DSSCs were fabricated using nanocrystalline titanium dioxide materials that were subsequently sensitized using ruthenium-based dye. Additionally, TiCl4 pre- and post-treatment were carried out to enhance the overall device efficiency. When fabricated as cells, the DSSC prototypes showed relatively stable performance during repeated tests over three months. In order to increase the output power of the solar cells, the DSSCs were then connected in a Z-type series connection to obtain sub-module panels. The DSSC sub-modules exhibit poor stability, particularly as indicated by the significant decrease in the short circuit current (ISC ). Herein, the effect of photoelectrode and sealant materials as well as module design are investigated, highlighting their profound influence upon the DSSC efficiency and long-term stability.

Outcome of long-term mechanical ventilation support in children.

PubMed

Hsia, Shao-Hsuan; Lin, Jainn-Jim; Huang, I-Anne; Wu, Chang-Teng

2012-10-01

Improved technology and care in recent years have significantly improved the prognosis and quality of life for patients on long-term mechanical ventilation. This study examined the status of children on long-term mechanical ventilation (MV) support in Taiwan. The medical records of patients between January 1998 and December 2006 were retrospectively reviewed, and the clinical factors were systematically reviewed. One hundred and thirty-nine (139) patients aged 3 months to 18 years, with 53 (38.1%) girls and 86 (61.9%) boys, were enrolled. The common underlying disorders included neurologic/neuromuscular diseases (n=100, 71.9%) and airway/lung dysfunction (n=19, 13.7%). After instituting MV, the children returned to the medical center mainly for infection (n=157, 47.7%) and elective surgery or procedures (n=46, 13.9%). After long-term follow-up, 37 (26.6%) died, 81 (58.3%) were transferred to respiratory care wards in local hospitals, and 21 (15.1%) received home care support. There are now more children on long-term MV support in Taiwan and most are in respiratory care wards in local hospitals. The shift in underlying diagnoses from pulmonary disease to neurogenic respiratory insufficiency affects hospitalization. The main cause of respiratory insufficiency is neurologic insult. Copyright © 2012. Published by Elsevier B.V.

Islet Transplantation in Type 1 Diabetes: Ongoing Challenges, Refined Procedures, and Long-Term Outcome

PubMed Central

Shapiro, A.M. James

2012-01-01

Remarkable progress has been made in islet transplantation over a span of 40 years. Once just an experimental curiosity in mice, this therapy has moved forward, and can now provide robust therapy for highly selected patients with type 1 diabetes (T1D), refractory to stabilization by other means. This progress could not have occurred without extensive dynamic international collaboration. Currently, 1,085 patients have undergone islet transplantation at 40 international sites since the Edmonton Protocol was reported in 2000 (752 allografts, 333 autografts), according to the Collaborative Islet Transplant Registry. The long-term results of islet transplantation in selected centers now match registry data of pancreas-alone transplantation, with 6 sites reporting five-year insulin independence rates ≥50%. Islet transplantation has been criticized for the use of multiple donor pancreas organs, but progress has also occurred in single-donor success, with 10 sites reporting increased single-donor engraftment. The next wave of innovative clinical trial interventions will address instant blood-mediated inflammatory reaction (IBMIR), apoptosis, and inflammation, and will translate into further marked improvements in single-donor success. Effective control of auto- and alloimmunity is the key to long-term islet function, and high-resolution cellular and antibody-based assays will add considerable precision to this process. Advances in immunosuppression, with new antibody-based targeting of costimulatory blockade and other T-B cellular signaling, will have further profound impact on the safety record of immunotherapy. Clinical trials will move forward shortly to test out new human stem cell derived islets, and in parallel trials will move forward, testing pig islets for compatibility in patients. Induction of immunological tolerance to self-islet antigens and to allografts is a difficult challenge, but potentially within our grasp. PMID:23804275

Long-term protective effects of methamphetamine preconditioning against single-day methamphetamine toxic challenges.

PubMed

Hodges, A B; Ladenheim, B; McCoy, M T; Beauvais, G; Cai, N; Krasnova, I N; Cadet, J L

2011-03-01

Methamphetamine (METH) use is associated with neurotoxic effects which include decreased levels of dopamine (DA), serotonin (5-HT) and their metabolites in the brain. We have shown that escalating METH dosing can protect against METH induced neurotoxicity in rats sacrificed within 24 hours after a toxic METH challenge. The purpose of the current study was to investigate if the protective effects of METH persisted for a long period of time. We also tested if a second challenge with a toxic dose of METH would cause further damage to monoaminergic terminals. Saline-pretreated rats showed significant METH-induced decreases in striatal DA and 5-HT levels in rats sacrificed 2 weeks after the challenge. Rats that received two METH challenges showed no further decreases in striatal DA or 5-HT levels in comparison to the single METH challenge. In contrast, METH-pretreated rats showed significant protection against METH-induced striatal DA and 5-HT depletion. In addition, the METH challenge causes substantial decreases in cortical 5-HT levels which were not further potentiated by a second drug challenge. METH preconditioning provided almost complete protection against METH -induced 5-HT depletion. These results are consistent with the idea that METH pretreatment renders the brain refractory to METH-induced degeneration of brain monoaminergic systems.

Long-term storage of Phytophthora cultures in water

Treesearch

Wendy Sutton; Paul Reeser; Everett Hansen

2009-01-01

Long-term storage of cultures of Phytophthora species is a challenge for any lab managing a working collection of isolates. Storage in liquid nitrogen is generally considered to be optimal for archival storage, and successful recovery of most species is regularly achieved after many years. Nitrogen storage has its drawbacks, however, especially for...

Effects of Acute Exercise on Long-Term Memory

ERIC Educational Resources Information Center

Labban, Jeffrey D.; Etnier, Jennifer L.

2011-01-01

In this study, we tested the effect of acute exercise on long-term memory, specifically the timing of exercise relative to the memory challenge. We assessed memory via paragraph recall, in which participants listened to two paragraphs (exposure) and recounted them following a 35-min delay. Participants (n = 48) were randomly assigned to one of…

Long-term outcomes of coronary artery bypass grafting versus stent-PCI for unprotected left main disease: a meta-analysis.

PubMed

De Rosa, Salvatore; Polimeni, Alberto; Sabatino, Jolanda; Indolfi, Ciro

2017-09-06

Coronary artery bypass graft (CABG) surgery has traditionally represented the standard of care for left main coronary artery (LMCA) disease. However, percutaneous coronary intervention with stent implantation (PCI) has more recently emerged as a valuable alternative. The long-time awaited results of the largest randomized trials on the long-term impact of PCI versus CABG in LMCA disease, the newly published NOBLE and EXCEL studies, revealed contrasting results. Thus, aim of the present meta-analysis was to review the most robust evidence from randomized comparisons of CABG versus PCI for revascularization of LMCA. Randomized studies comparing long-term clinical outcomes of CABG or Stent-PCI for the treatment of LMCA disease were searched for in PubMed, the Chochrane Library and Scopus electronic databases. A total of 5 randomized studies were selected, including 4499 patients. No significant difference between CABG and PCI was found in the primary analysis on the composite endpoint of death, stroke and myocardial infarction (OR = 1·06 95% CI 0·80-1·40; p = 0·70). Similarly, no differences were observed between CABG and PCI for all-cause death (OR = 1·03 95% CI 0·81-1·32; p = 0·81). Although not statistically significant, a lower rate of stroke was registered in the PCI arm (OR = 0·86; p = 0·67), while a lower rate of myocardial infarction was found in the CABG arm (OR = 1·43; p = 0·17). On the contrary, a significantly higher rate of repeat revascularization was registered in the PCI arm (OR = 1·76 95% CI 1·45-2·13; p < 0·001). The present meta-analysis, the most comprehensive and updated to date, including 5 randomized studies and 4499 patients, demonstrates no difference between Stent-PCI and CABG for the treatment of LMCA disease in the composite endpoint of death, stroke and myocardial infarction. Hence, a large part of patients with unprotected left main coronary artery disease can be managed equally well by means of both

Long-term experiences of Norwegian live kidney donors: qualitative in-depth interviews.

PubMed

Meyer, Käthe B; Bjørk, Ida Torunn; Wahl, Astrid Klopstad; Lennerling, Annette; Andersen, Marit Helen

2017-02-16

Live kidney donation is generally viewed as a welcome treatment option for severe kidney disease. However, there is a disparity in the body of research on donor experiences and postdonation outcome, and lack of knowledge on long-term consequences described by the donors. This study was conducted to provide insight into donors' subjective meanings and interpretation of their experiences ∼10 years after donation. Qualitative explorative in-depth interviews. The sampling strategy employed maximum variation. Setting Oslo University Hospital is the national centre for organ transplantation and donation in Norway, and there are 26 local nephrology centres. 16 donors representing all parts of Norway who donated a kidney in 2001-2004 participated in the study. The interviews were analysed using an interpretative approach. The analysis resulted in 4 main themes; the recipient outcome justified long-term experiences, family dynamics-tension still under the surface, ambivalence-healthy versus the need for regular follow-up, and life must go on. These themes reflect the complexity of live kidney donation, which fluctuated from positive experiences such as pride and feeling privileged to adverse experiences such as altered family relationships or reduced health. Live kidney donors seemed to possess resilient qualities that enabled them to address the long-term consequences of donation. The challenge is to provide more uniform information about long-term consequences. In future research, resilient qualities could be a topic to explore in live donation. 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/.

Epimural bacterial community structure in the rumen of Holstein cows with different responses to a long-term subacute ruminal acidosis diet challenge.

PubMed

Wetzels, S U; Mann, E; Pourazad, P; Qumar, M; Pinior, B; Metzler-Zebeli, B U; Wagner, M; Schmitz-Esser, S; Zebeli, Q

2017-03-01

Subacute ruminal acidosis (SARA) is a prevalent metabolic disorder in cattle, characterized by intermittent drops in ruminal pH. This study investigated the effect of a gradual adaptation and continuously induced long-term SARA challenge diet on the epimural bacterial community structure in the rumen of cows. Eight rumen-cannulated nonlactating Holstein cows were transitioned over 1 wk from a forage-based baseline feeding diet (grass silage-hay mix) to a SARA challenge diet, which they were fed for 4 wk. The SARA challenge diet consisted of 60% concentrates (dry matter basis) and 40% grass silage-hay mix. Rumen papillae biopsies were taken at the baseline, on the last day of the 1-wk adaptation, and on the last day of the 4-wk SARA challenge period; ruminal pH was measured using wireless sensors. We isolated DNA from papillae samples for 16S rRNA gene amplicon sequencing using Illumina MiSeq. Sequencing results of most abundant key phylotypes were confirmed by quantitative PCR. Although they were fed similar amounts of concentrate, cows responded differently in terms of ruminal pH during the SARA feeding challenge. Cows were therefore classified as responders (n = 4) and nonresponders (n = 4): only responders met the SARA criterion of a ruminal pH drop below 5.8 for longer than 330 min/d. Data showed that Proteobacteria, Firmicutes, and Bacteroidetes were the most abundant phyla, and at genus level, Campylobacter and Kingella showed highest relative abundance, at 15.5 and 7.8%, respectively. Diversity analyses revealed a significant increase of diversity after the 1-wk adaptation but a decrease of diversity and species richness after the 4-wk SARA feeding challenge, although without distinction between responders and nonresponders. At the level of the operational taxonomic unit, we detected diet-specific shifts in epimural community structure, but in the overall epimural bacterial community structure, we found no differences between responders and nonresponders

Emerging trends in the finance and delivery of long-term care: public and private opportunities and challenges.

PubMed

Cohen, M A

1998-02-01

A number of key trends are emerging in long-term care related to financing, new models of service delivery, and shifts in consumer expectations and preferences. Taken together, changes occurring in these areas point to a rapidly transforming long-term care landscape. Financing responsibility is shifting away from the federal government to states, individuals, and their families; providers are integrating and managing acute and long-term care services and adding new services to the continuum of care; and consumers are thinking more seriously about how to plan and pay for their future care needs, as well as how to independently navigate the long-term care system.

Long-term stability of sodium caseinate-stabilized nanoemulsions.

PubMed

Yerramilli, Manispuritha; Ghosh, Supratim

2017-01-01

Oil-in-water (5 wt%) nanoemulsions were prepared with different concentration (2.5-10 wt%) of sodium caseinate as a sole emulsifier and their long-term storage stability was investigated for 6 months. Previous studies associated with sodium caseinate looked only into nanoemulsion formation; hence the challenges with long-term stability were not addressed. All nanoemulsions displayed an average droplet size <200 nm, which remained unchanged over 6 months. However, all of them displayed rapid creaming due to unabsorbed protein induced depletion flocculation, whose extent increased with protein concentration, although the cream layer formed was weak and re-dispersible upon gentle mixing. Microstructural analysis of the cream layer showed compaction of flocculated nanodroplet network with time leaving the aqueous phase out. Calculation of depletion interaction energy showed an increase in inter-droplet attraction with protein concentration and decrease with a reduction in droplet size, making the nanoemulsions more resistant to flocculation than conventional emulsions. This work aids in understanding the dependence of protein concentration on long-term stability of sodium caseinate-stabilized nanoemulsions.

Resident challenges with daily life in Chinese long-term care facilities: A qualitative pilot study.

PubMed

Song, Yuting; Scales, Kezia; Anderson, Ruth A; Wu, Bei; Corazzini, Kirsten N

As traditional family-based care in China declines, the demand for residential care increases. Knowledge of residents' experiences with long-term care (LTC) facilities is essential to improving quality of care. This pilot study aimed to describe residents' experiences in LTC facilities, particularly as it related to physical function. Semi-structured open-ended interviews were conducted in two facilities with residents stratified by three functional levels (n = 5). Directed content analysis was guided by the Adaptive Leadership Framework. A two-cycle coding approach was used with a first-cycle descriptive coding and second-cycle dramaturgical coding. Interviews provided examples of challenges faced by residents in meeting their daily care needs. Five themes emerged: staff care, care from family members, physical environment, other residents in the facility, and personal strategies. Findings demonstrate the significance of organizational context for care quality and reveal foci for future research. Copyright © 2017 Elsevier Inc. All rights reserved.

Population pharmacokinetic model of THC integrates oral, intravenous, and pulmonary dosing and characterizes short- and long-term pharmacokinetics.

PubMed

Heuberger, Jules A A C; Guan, Zheng; Oyetayo, Olubukayo-Opeyemi; Klumpers, Linda; Morrison, Paul D; Beumer, Tim L; van Gerven, Joop M A; Cohen, Adam F; Freijer, Jan

2015-02-01

Δ(9)-Tetrahydrocannobinol (THC), the main psychoactive compound of Cannabis, is known to have a long terminal half-life. However, this characteristic is often ignored in pharmacokinetic (PK) studies of THC, which may affect the accuracy of predictions in different pharmacologic areas. For therapeutic use for example, it is important to accurately describe the terminal phase of THC to describe accumulation of the drug. In early clinical research, the THC challenge test can be optimized through more accurate predictions of the dosing sequence and the wash-out between occasions in a crossover setting, which is mainly determined by the terminal half-life of the compound. The purpose of this study is to better quantify the long-term pharmacokinetics of THC. A population-based PK model for THC was developed describing the profile up to 48 h after an oral, intravenous, and pulmonary dose of THC in humans. In contrast to earlier models, the current model integrates all three major administration routes and covers the long terminal phase of THC. Results show that THC has a fast initial and intermediate half-life, while the apparent terminal half-life is long (21.5 h), with a clearance of 38.8 L/h. Because the current model characterizes the long-term pharmacokinetics, it can be used to assess the accumulation of THC in a multiple-dose setting and to forecast concentration profiles of the drug under many different dosing regimens or administration routes. Additionally, this model could provide helpful insights into the THC challenge test used for the development of (novel) compounds targeting the cannabinoid system for different therapeutic applications and could improve decision making in future clinical trials.

Factors affecting early and long-term outcomes after completion pneumonectomy.

PubMed

Chataigner, Olivier; Fadel, Elie; Yildizeli, Bedrettin; Achir, Abdallah; Mussot, Sacha; Fabre, Dominique; Mercier, Olaf; Dartevelle, Philippe G

2008-05-01

To identify factors that affect operative mortality and morbidity and long-term survival after completion pneumonectomy. We retrospectively reviewed the charts of consecutive patients who underwent completion pneumonectomy at our cardiothoracic surgery department from January 1996 to December 2005. We identified 69 patients, who accounted for 17.8% of all pneumonectomies during the study period; 22 had benign disease and 47 malignant disease (second primary lung cancer, n=19; local recurrence, n=17; or metastasis, n=11). There were 50 males and 19 females with a mean age of 60 years (range, 29-80 years). Postoperative mortality was 12% and postoperative morbidity 41%. Factors associated with postoperative mortality included obesity (p=0.005), coronary artery disease (p=0.03), removal of the right lung (p=0.02), advanced age (p=0.02), and renal failure (p<0.0001). Preoperative renal failure was the only significant risk factor for mortality by multivariate analysis (p=0.036). Bronchopleural fistula developed in seven patients (10%), with risk factors being removal of the right lung (p=0.04) and mechanical stump closure (p=0.03). Overall survival was 65% after 3 years and 46% after 5 years. Long-term survival was not affected by the reason for completion pneumonectomy. Although long-term survival was acceptable, postoperative mortality and morbidity rates remained high, confirming the reputation of completion pneumonectomy as a challenging procedure. Significant comorbidities and removal of the right lung were the main risk factors for postoperative mortality. Improved patient selection and better management of preoperative renal failure may improve the postoperative outcomes of this procedure, which offers a chance for prolonged survival.

Long-Term Pavement Performance Bind Online [Product Brief

DOT National Transportation Integrated Search

2017-02-23

This Product Brief introduces the reader to the Long-Term Pavement Performance Bind (LTPPBind) Online Web-based tool for selecting asphalt binder performance grades (PGs).(1) It explains what the tool is, who can benefit from its use, what its main f...

[Long-term psychiatric hospitalizations].

PubMed

Plancke, L; Amariei, A

2017-02-01

Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

Promoting independence for children on long-term ventilation.

PubMed

Lawrence, Sue

2011-12-01

It is the responsibility of children's nurses to enable children and young people who are on long-term ventilation (LTV) to live independent and varied lives. This article considers the common challenges faced by such children and reflects on personal experience in planning and undertaking a respite week for a young person on LTV with Duchenne's muscular dystrophy without his parents.

Predicting isoproturon long-term mineralization from short-term experiment: Can this be a suitable approach?

PubMed

Wang, Fang; Dörfler, Ulrike; Jiang, Xin; Schroll, Reiner

2016-02-01

A worldwide used pesticide - isoproturon (IPU) - was selected to test whether short-term experiments can be used to predict long-term mineralization of IPU in soil. IPU-mineralization was measured for 39 and 265 days in four different agricultural soils with a low mineralization dynamic. Additionally, in one soil IPU dissipation, formation and dissipation of metabolites, formation of non-extractable residues (NER) and (14)C-microbial biomass from (14)C-IPU were monitored for 39 and 265 days. The data from short-term and long-term experiments were used for model fitting. The long-term dynamics of IPU mineralization were considerably overestimated by the short-term experiments in two soils with neutral pH, while in two other soils with low pH and lower mineralization, the long-term mineralization of IPU could be sufficiently predicted. Additional investigations in one of the soils with neutral pH showed that dissipation of IPU and metabolites could be correctly predicted by the short-term experiment. However, the formation of NER and (14)C-microbial biomass were remarkably overestimated by the short-term experiment. Further, it could be shown that the released NER and (14)C-microbial biomass were the main contributors of (14)CO2 formation at later incubation stages. Taken together, our results indicate that in soils with neutral pH short-term experiments were inadequate to predict the long-term mineralization of IPU. Copyright © 2015 Elsevier Ltd. All rights reserved.

Long-term potentiation and long-term depression: a clinical perspective

PubMed Central

Bliss, Timothy V.P.; Cooke, Sam F

2011-01-01

Long-term potentiation and long-term depression are enduring changes in synaptic strength, induced by specific patterns of synaptic activity, that have received much attention as cellular models of information storage in the central nervous system. Work in a number of brain regions, from the spinal cord to the cerebral cortex, and in many animal species, ranging from invertebrates to humans, has demonstrated a reliable capacity for chemical synapses to undergo lasting changes in efficacy in response to a variety of induction protocols. In addition to their physiological relevance, long-term potentiation and depression may have important clinical applications. A growing insight into the molecular mechanisms underlying these processes, and technological advances in non-invasive manipulation of brain activity, now puts us at the threshold of harnessing long-term potentiation and depression and other forms of synaptic, cellular and circuit plasticity to manipulate synaptic strength in the human nervous system. Drugs may be used to erase or treat pathological synaptic states and non-invasive stimulation devices may be used to artificially induce synaptic plasticity to ameliorate conditions arising from disrupted synaptic drive. These approaches hold promise for the treatment of a variety of neurological conditions, including neuropathic pain, epilepsy, depression, amblyopia, tinnitus and stroke. PMID:21779718

Highly Survivable Avionics Systems for Long-Term Deep Space Exploration

NASA Technical Reports Server (NTRS)

Alkalai, L.; Chau, S.; Tai, A. T.

2001-01-01

The design of highly survivable avionics systems for long-term (> 10 years) exploration of space is an essential technology for all current and future missions in the Outer Planets roadmap. Long-term exposure to extreme environmental conditions such as high radiation and low-temperatures make survivability in space a major challenge. Moreover, current and future missions are increasingly using commercial technology such as deep sub-micron (0.25 microns) fabrication processes with specialized circuit designs, commercial interfaces, processors, memory, and other commercial off the shelf components that were not designed for long-term survivability in space. Therefore, the design of highly reliable, and available systems for the exploration of Europa, Pluto and other destinations in deep-space require a comprehensive and fresh approach to this problem. This paper summarizes work in progress in three different areas: a framework for the design of highly reliable and highly available space avionics systems, distributed reliable computing architecture, and Guarded Software Upgrading (GSU) techniques for software upgrading during long-term missions. Additional information is contained in the original extended abstract.

Application of long-term simulation programs for analysis of system islanding

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

Sancha, J.L.; Llorens, M.L.; Moreno, J.M.

1997-02-01

This paper describes the main results and conclusions from the application of two different long-term stability programs to the analysis of a system islanding scenario for a study case developed by Red Electrica de Espana (REE), based on the Spanish system. Two main goals were to evaluate the performance of both the influence of some important control and protection elements (tie-line loss-of-synchronism relays, underfrequency load-shedding, load-frequency control, and power plant dynamics). Conclusions about modeling and computational requirements for system islanding (frequency) scenarios and use of long-term stability programs are presented.

Towards accurate localization: long- and short-term correlation filters for tracking

NASA Astrophysics Data System (ADS)

Li, Minglangjun; Tian, Chunna

2018-04-01

Visual tracking is a challenging problem, especially using a single model. In this paper, we propose a discriminative correlation filter (DCF) based tracking approach that exploits both the long-term and short-term information of the target, named LSTDCF, to improve the tracking performance. In addition to a long-term filter learned through the whole sequence, a short-term filter is trained using only features extracted from most recent frames. The long-term filter tends to capture more semantics of the target as more frames are used for training. However, since the target may undergo large appearance changes, features extracted around the target in non-recent frames prevent the long-term filter from locating the target in the current frame accurately. In contrast, the short-term filter learns more spatial details of the target from recent frames but gets over-fitting easily. Thus the short-term filter is less robust to handle cluttered background and prone to drift. We take the advantage of both filters and fuse their response maps to make the final estimation. We evaluate our approach on a widely-used benchmark with 100 image sequences and achieve state-of-the-art results.

Continuing education for staff in long-term care facilities: corporate philosophies and approaches.

PubMed

Ross, M M; Carswell, A; Dalziel, W B; Aminzadeh, F

2001-01-01

The purpose of this study was to determine corporate philosophies of continuing education and approaches to meeting the learning needs of staff who strive to provide for the increasingly challenging care requirements of seniors who reside in long-term care facilities. In-depth interviews lasting approximately 1 hour were conducted with key informants at the administrative level from nine long-term care facilities. Content analysis revealed a commitment to continuing education for staff. While recognizing the importance of organizational responsibility for continuing education, administrators placed emphasis on the individual responsibility of staff. Learning needs were identified as affective, managerial, and physical in nature. Challenges to providing continuing education programs were derived from a general lack of fiscal and human resources. A variety of measures was suggested as important to supporting the continuing learning of staff. Implications of this study point to the need for long-term care facilities to incorporate into their strategic plans measures of ensuring continuing education as a basis for the ongoing competence and development of staff. In addition, there is a need for collaboration between long-term care facilities and other institutions of a long-term care, acute care, and educational nature in the development of strategies to operationalize a philosophy of continuing learning as a basis for the provision of optimal care to residents.

Life-cycle management: a long-term challenge.

PubMed

Newman, Chris

2003-04-01

With some electronics components being withdrawn after only two years, life-cycle management is becoming a key strategic issue for users and manufacturers of electromedical equipment. This article describes some approaches to tackling the challenge.

An European framework for the long term preservation of EO data

NASA Astrophysics Data System (ADS)

Forcada, E.; Albani, M.; Beruti, V.

2009-04-01

The need for accessing historical Earth Observation (EO) data series strongly increased in the last ten years, mainly for long term science and environmental monitoring applications. This trend is likely to increase even more in the future in particular for the growing interest on global change monitoring that requires data time-series spanning 20 years and more, and for the need to support the United Nations Framework Convention on Climate Change (UNFCCC). Content of EO data archives is extending from a few years to decades and their scientific value is continuously increasing hence is well recognized the need to preserve them without time limitation and to keep the archived EO data well accessible and exploitable as they constitute a humankind asset. The large amount of new Earth Observation missions upcoming in the next years will moreover lead to a major increase of EO data volumes. This fact, together with the increased demands from the scientific user community, marks a challenge for Earth Observation satellite operators, Space Agencies and EO data providers regarding coherent data preservation and optimum availability and accessibility of the different data products. Traditionally in Europe, there has been poor cooperation in this field with no common approach for long term preservation and access to EO space data even if cooperation and sharing are key aspects to be pursued for the benefit of the user community. Single organizations have difficulties to afford data preservation in the long term that calls for the need of optimising costs and efforts, identifying commonalities. In 2006, the European Space Agency (ESA) initiated a coordination action to share among all the European (and Canadian) stakeholders a common approach to the long term preservation of Earth Observation data. During 2007, the Agency started consultations with its Member States presenting an EO Long Term Data Preservation (LTDP) strategy targeting the preservation of all European

Child maltreatment: pathway to chronic and long-term conditions?

PubMed

Taylor, Julie; Bradbury-Jones, Caroline; Lazenbatt, Anne; Soliman, Francesca

2016-09-01

The manifesto Start Well, Live Better by the UK Faculty of Public Health (Start Well, Live Better-A Manifesto for the Public's Health. London: UK Faculty of Public Health, 2014) sets out 12 compelling priorities for the protection of people's health. The focus of this document is preventative, calling for a comprehensive strategy to target a wide-ranging set of challenges to public health; however, it fails to mention child maltreatment and its negative impact on long-term health outcomes. In this article, we explore the long-term negative consequences of child maltreatment and how these can be conceptually aligned with four different characteristics of long-term health conditions. We suggest that situating child maltreatment within a long-term conditions framework could have significant advantages and implications for practice, policy and research, by strengthening a commitment across disciplines to apply evidence-based principles linked with policy and evaluation and recognizing the chronic effects of maltreatment to concentrate public, professional and government awareness of the extent and impact of the issue. We argue that a public health approach is the most effective way of focusing preventative efforts on the long-term sequelae of child maltreatment and to foster cooperation in promoting children's rights to grow and develop in a safe and caring environment free from violence and abuse. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Long-term recovery trajectory after stroke: an ongoing negotiation between body, participation and self.

PubMed

Arntzen, Cathrine; Borg, Tove; Hamran, Torunn

2015-01-01

Research has mainly focused on the first year of recovery trajectory after stroke, but there is limited knowledge about how stroke survivors manage their long-term everyday lives. This study seeks to fill this gap by exploring the long-term (1-13 years) negotiations of stroke survivors when they experience progress, wellbeing and faith in the future. Repeated in-depth interviews were conducted with nine people living with moderate impairment after stroke and their closest relatives. Concepts from phenomenology and critical psychology constituted the frame of reference of the study. The long-term stroke recovery trajectory can be understood as a process of struggling to overcome tensions between three phenomena under ongoing change: the lived body, participation in everyday life and sense of self. During the recovery process, stroke survivors experience progress, well-being and faith in the future when moving towards renewed relationships, characterised by (1) a modified habitual body, (2) repositioned participation in specific everyday life contexts and (3) a transformed sense of self. This study stresses the importance of developing new forms of professional support during the long-term recovery trajectory, to stimulate and increase interaction and coherence in the relationship between the stroke survivor's bodily perception, participation in everyday life and sense of self. The study deepening how the long-term recovery trajectory after stroke is about ongoing embodied, practical and socially situated negotiations. The study demonstrates that the recovery trajectory is a long term process of learning where the stroke survivor, as an embodied agent, gradually modifies new bodily habits, re-position participation and transforming of the self. Health personnel are usually available in the acute and early rehabilitation period. The three phenomenons under ongoing change; "body", "participation" and "self" are at this point just about being moved toward a renewed and

Catastrophic Incident Recovery: Long-Term Recovery from an Anthrax Event Symposium

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

Lesperance, Ann M.

On March 19, 2008, policy makers, emergency managers, and medical and Public Health officials convened in Seattle, Washington, for a workshop on Catastrophic Incident Recovery: Long-Term Recovery from an Anthrax Event. The day-long symposium was aimed at generating a dialogue about restoration and recovery through a discussion of the associated challenges that impact entire communities, including people, infrastructure, and critical systems.

'The challenge to take charge of life with long-term illness': nurses' experiences of supporting patients' learning with the didactic model.

PubMed

Andersson, Susanne; Svanström, Rune; Ek, Kristina; Rosén, Helena; Berglund, Mia

2015-12-01

The aim of this implementation study is to describe nurses' experiences of supporting patient learning using the model called 'The challenge to take charge of life with long-term illness'. Supporting patient learning for those suffering from a long-term illness is a complex art in nursing. Genuine learning occurs at a deep and existential level. If the patient's resistance to illness can be challenged and reflected upon, the patient may take charge of his/her life. The project lasted for 2 years and was initiated by a former patient on an assisted haemodialysis ward and involved 14 registered nurses. The project began with a session to review patients' learning and the didactic model. Monthly reflective meetings and group supervisions were held that focused on the nurses' experiences of supporting patient learning. Notes were written during these reflective meetings and group sessions. Data collected from interviews, notes and written stories were subjected to phenomenological analysis. Three aspects of nurses' experiences of the learning support approach were assessed: To have the courage to listen sincerely, a movement from providing information to supporting learning, and to let the patient indicate the direction. The approach resulted in an increased focus on genuine dialogue and the courage to encourage patients to take charge of their health process. The changes in nurses' approach to learning support reveal that they shift from providing information on the disease, illness and treatment to strengthening and supporting the patient in making decisions and taking responsibility. For nurses, the change entails accepting the patient's goals and regarding their own role as supportive rather than controlling. The didactic model and involved supervision contributed to the change in the nurses' approach. The didactic model might be useful in caring for persons with long-term illness, making the care more person-centred and enhancing the patient's self-care ability. �

The carina angle-new geometrical parameter associated with periprocedural side branch compromise and the long-term results in coronary bifurcation lesions with main vessel stenting only.

PubMed

Gil, Robert J; Vassilev, Dobrin; Formuszewicz, Radoslaw; Rusicka-Piekarz, Teresa; Doganov, Alexander

2009-12-01

The two main problems unresolved in coronary bifurcation stenting are periprocedural side branch compromise and higher restenosis at long term. The purpose of this study is to reveal the link between periprocedural side branch compromise and long-term results after main vessel stenting only in coronary bifurcations. Eighty-four patients formed the study population. The inclusion criteria were good-quality angiograms, with maximal between-branch angle opening, no overlap, permitting accurate angiographic analysis. Carina angle (alpha)-the distal angle between main vessel (MV) before bifurcation and side branch (SB)-was measured pre- and poststenting. Clinical follow-up 9-12 months was obtained with coronary angiography if needed. The patient population was high-risk with 33% diabetics and 84% two- and three-vessel disease. Ninety-five stents were implanted in 92 lesions, with three T-stenting cases. Drug-eluting stents were implanted in 54%. Kissing-balloon (KBI) or sequential inflation was performed in 35%. SB functional closure occurred in 17.4%, with independent predictors alpha < 40 degrees and diameter ratio MB/SB >1.22. After 12+/-4 months there were five myocardial infarctions (6%) and 13 (15%) target lesion revascularization procedures. Independent predictors of major cardiovascular events were carina angle <40 degrees , MB lesion length >8 mm, negative change of between-branch angle, DES usage, and KBI. Smaller carina angle with straightening of MV-main branch from stent implantation in coronary bifurcations predicted higher SB compromise, restenosis, and MACE rates during follow-up of 1 year.

Recommendations for sexual expression management in long-term care: a qualitative needs assessment

PubMed Central

Syme, Maggie L.; Lichtenberg, Peter; Moye, Jennifer

2017-01-01

Aims To conduct a qualitative needs assessment of Directors of Nursing regarding challenges and recommendations for addressing sexual expression and consent. Background Sexual expression management among long-term care residents is a complex issue for nursing home staff. Little guidance is available for those wanting to follow a person-centred approach. Policies and procedures are needed, and must be usable across long-term care settings. Design Qualitative design for in-depth exploration. Methods Semi-structured interviews were conducted with 20 Directors of Nursing in the spring and summer of 2013, representing a range of regions, facility sizes and resident populations. Interview questions prompted them to identify recommendations that address challenges to improving sexual expression management in long-term care settings. Results Comparative thematic analysis resulted in several codes, which were grouped into eight overall categories. Recommendation categories that addressed key challenges included: address the issue, make environmental changes, identify staff expertise, provide education and training, assess sexuality initially and recurrently, establish policies/procedures for sexual expression management, develop assessment tools for sexual expression and consent, and clarify legal issues. The recommendation to develop national guidelines was observed across categories. Discussion Directors of Nursing report several challenges to sexual expression management in their facilities, and perceive their current methods to be ad hoc. A proactive approach to policy and procedure development is needed. PMID:27188413

Long-term care survey reveals challenges. Facilities grapple with five broad issues, including changes in leadership and AIDS.

PubMed

Westhoff, L J; Schaefer, J C

1993-05-01

The Catholic Health Association's 1992 survey of Catholic long-term care (LTC) facilities identified five broad issues LTC facilities face in the 1990s: leadership, system affiliation, community programs, resident issues, and care of persons with AIDS. The transition to lay leadership presents new challenges to the relationship between LTC facilities and their sponsors. Despite the dominance of religious sponsors, an increasing number of laypersons are serving as healthcare administrators both in long-term and acute care. Thirty percent of respondents reported being affiliated with a multi-institutional system. This percentage has changed little in the past few years, although the number of facilities that are system members continues to increase at the fastest rate of any type of LTC facility. Only 27 percent of survey respondents said they provide educational or informational programs for persons in their communities. Thirty-nine percent of system-affiliated LTC facilities reported offering such programs. One encouraging finding shows that 80 percent of facilities have written policies for living wills, 64 percent for designated proxy, and 86 percent for durable power of attorney for healthcare. LTC providers are struggling to determine their role in caring for persons with HIV and AIDS. Only 3.6 percent of respondents care for residents with AIDS. A major problem LTC administrators face is a fear of potential infection of staff or residents.

Short-Term Gains, Long-Term Pains: How Cues about State Aid Learning in Dynamic Environments

ERIC Educational Resources Information Center

Gureckis, Todd M.; Love, Bradley C.

2009-01-01

Successful investors seeking returns, animals foraging for food, and pilots controlling aircraft all must take into account how their current decisions will impact their future standing. One challenge facing decision makers is that options that appear attractive in the short-term may not turn out best in the long run. In this paper, we explore…

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.

Long-term efficacy of reverse pull headgear therapy.

PubMed

Wells, Andrew P; Sarver, David M; Proffit, William R

2006-11-01

To add to the data for long-term reverse pull headgear (RPHG) outcomes and further explore possible variables that could be predictors of long-term failure. Cephalometric radiographs of 41 Class III malocclusion children treated with RPHG (face mask) were evaluated before and immediately after treatment; at 5 years posttreatment; and, for 18 patients, at 10 years posttreatment. Patients were assigned to success or failure groups according to positive or negative overjet at the longest available recall. Seventy-five percent of the patients maintained positive overjet, whereas 25% outgrew the correction. In a stepwise discriminant analysis, a large mandible and vertical positioning of the maxilla and mandible so that mandibular growth would be projected more horizontally were the major indicators of unfavorable later mandibular growth. Patients who experienced downward-backward rotation of the mandible during RPHG treatment were more likely to be categorized in the failure group. The age at which treatment began had no effect on long-term success and failure for patients younger than 10 years, but the percentage of successful treatment decreased after that age. When RPHG treatment is used for all but the most obviously prognathic children to correct anterior cross-bite in the early mixed dentition, positive overjet is maintained long-term in 70%-75% of cases, whereas 25%-30% of cases relapse into reverse overjet mainly because of increased horizontally directed and often late mandibular growth. Up to age 10, the time at which RPHG treatment began does not appear to be a major factor in long-term success in maintaining positive overjet.

Long-term consequences of anorexia nervosa.

PubMed

Meczekalski, Blazej; Podfigurna-Stopa, Agnieszka; Katulski, Krzysztof

2013-07-01

Anorexia nervosa (AN) is a psychiatric disorder that occurs mainly in female adolescents and young women. The obsessive fear of weight gain, critically limited food intake and neuroendocrine aberrations characteristic of AN have both short- and long-term consequences for the reproductive, cardiovascular, gastrointestinal and skeletal systems. Neuroendocrine changes include impairment of gonadotropin releasing-hormone (GnRH) pulsatile secretion and changes in neuropeptide activity at the hypothalamic level, which cause profound hypoestrogenism. AN is related to a decrease in bone mass density, which can lead to osteopenia and osteoporosis and a significant increase in fracture risk in later life. Rates of birth complications and low birth weight may be higher in women with previous AN. The condition is associated with fertility problems, unplanned pregnancies and generally negative attitudes to pregnancy. During pregnancy, women with the condition have higher rates of hyperemesis gravidarum, anaemia and obstetric complications, as well as impaired weight gain and compromised intrauterine foetal growth. It is reported that 80% of AN patients are affected by a cardiac complications such as sinus bradycardia, a prolonged QT interval on electrocardiography, arrythmias, myocardial mass modification and hypotension. A decrease in bone mineral density (BMD) is one of the most important medical consequences of AN. Reduced BMD may subsequently lead to a three- to seven-fold increased risk of spontaneous fractures. Untreated AN is associated with a significant increase in the risk of death. Better detection and sophisticated therapy should prevent the long-term consequences of this disorder. The aims of treatment are not only recovery but also prophylaxis and relief of the long-term effects of this disorder. Further investigations of the long-term disease risk are needed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Long-term lumen depreciation behavior and failure modes of multi-die array LEDs

NASA Astrophysics Data System (ADS)

Jayawardena, Asiri; Marcus, Daniel; Prugue, Ximena; Narendran, Nadarajah

2013-09-01

One of the main advantages of multi-die array light-emitting diodes (LEDs) is their high flux density. However, a challenge for using such a product in lighting fixture applications is the heat density and the need for thermal management to keep the junction temperatures of all the dies low for long-term reliable performance. Ten multi-die LED array samples for each product from four different manufacturers were subjected to lumen maintenance testing (as described in IES-LM-80-08), and their resulting lumen depreciation and failure modes were studied. The products were tested at the maximum case (or pin) temperature reported by the respective manufacturer by appropriately powering the LEDs. In addition, three samples for each product from two different manufacturers were subjected to rapid thermal cycling, and the resulting lumen depreciation and failure modes were studied. The results showed that the exponential lumen decay model using long-term lumen maintenance data as recommended in IES TM-21 does not fit for all package types. The failure of a string of dies and single die failure in a string were observed in some of the packages.

Long-term predictions using natural analogues

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

Ewing, R.C.

1995-09-01

One of the unique and scientifically most challenging aspects of nuclear waste isolation is the extrapolation of short-term laboratory data (hours to years) to the long time periods (10{sup 3}-10{sup 5} years) required by regulatory agencies for performance assessment. The direct validation of these extrapolations is not possible, but methods must be developed to demonstrate compliance with government regulations and to satisfy the lay public that there is a demonstrable and reasonable basis for accepting the long-term extrapolations. Natural systems (e.g., {open_quotes}natural analogues{close_quotes}) provide perhaps the only means of partial {open_quotes}validation,{close_quotes} as well as data that may be used directlymore » in the models that are used in the extrapolation. Natural systems provide data on very large spatial (nm to km) and temporal (10{sup 3}-10{sup 8} years) scales and in highly complex terranes in which unknown synergisms may affect radionuclide migration. This paper reviews the application (and most importantly, the limitations) of data from natural analogue systems to the {open_quotes}validation{close_quotes} of performance assessments.« less

Time-series modeling of long-term weight self-monitoring data.

PubMed

Helander, Elina; Pavel, Misha; Jimison, Holly; Korhonen, Ilkka

2015-08-01

Long-term self-monitoring of weight is beneficial for weight maintenance, especially after weight loss. Connected weight scales accumulate time series information over long term and hence enable time series analysis of the data. The analysis can reveal individual patterns, provide more sensitive detection of significant weight trends, and enable more accurate and timely prediction of weight outcomes. However, long term self-weighing data has several challenges which complicate the analysis. Especially, irregular sampling, missing data, and existence of periodic (e.g. diurnal and weekly) patterns are common. In this study, we apply time series modeling approach on daily weight time series from two individuals and describe information that can be extracted from this kind of data. We study the properties of weight time series data, missing data and its link to individuals behavior, periodic patterns and weight series segmentation. Being able to understand behavior through weight data and give relevant feedback is desired to lead to positive intervention on health behaviors.

Predictors of the highest long-term care expenditures in Japan.

PubMed

Olivares-Tirado, Pedro; Tamiya, Nanako; Kashiwagi, Masayo; Kashiwagi, Kimikazu

2011-05-17

In Japan, as the number of elderly covered by the Long-term Care Insurance (LTCI) system has increased, demand for long-term care services has increased substantially and consequently growing expenditures are threatening the sustainability of the system. Understanding the predictive factors associated with long-term care expenditures among the elderly would be useful in developing future strategies to ensure the sustainability of the system. We report a set of predictors of the highest long-term care expenditures in a cohort of elderly persons who received consecutive long-term care services during a year in a Japanese city. Data were obtained from databases of the LTC insurer of City A in Japan. Binary logistic regression was used to examine the predictors of the highest long-term care expenditures. We used a simplified model that focused on the effects of disability status and type of services used, while controlling for several relevant factors. Goodness of fit, a multicollinearity test, and logistic regression diagnostics were carried out for the final model. The study cohort consisted of 862 current users of LTCI system in city A. After controlling for gender and income, age, increased utilization rate of benefits, decline in functional status, higher care needs level and institutional care were found to be associated with the highest LTCI expenditures. An increased utilization rate of benefits (OR = 24.2) was a strong main effect predictors of the high LTC expenditures. However, a significant interaction between institutional care and high care need level was found, providing evidence of the combined effect of the two covariates. Beyond to confirm that disability status of elderly persons is the main factor driving the demand of LTC services and consequently the expenditures, we showed that changes in utilization rate of benefits -a specific insurance factor- and the use of institutional care conditional on the high care level, were strongest predictors of

Long-term impact of precision agriculture on a farmer’s field

USDA-ARS?s Scientific Manuscript database

Targeting management practices and inputs with precision agriculture has high potential to meet some of the grand challenges of sustainability in the coming century. Although potential is high, few studies have documented long-term effects of precision agriculture on crop production and environmenta...

Main challenges in demulsifier research and application

NASA Astrophysics Data System (ADS)

Zhang, Fusheng; Liu, Guoliang; Ma, Junhan; Ouyang, Jian; Yi, Xiaoling; Su, Huimin

2017-01-01

Main challenges in demulsifier research, such as demulsification of ASP flooding produced liquid, demulsification of heavy oil produced liquid, low temperature demulsification and fast demulsification, are summarized. Some importance technology routes to solve the challenges are proposed according to demulsification mechanisms and emulsion characteristics. The proposed routes include increasing aromaticity, molecular weight and branch degree of demulsifiers, and introducing double-function groups to demulsifiers for W/O and O/W emulsions, or groups with alkyl matching with alkyl carbon number of the crude oil into demulsifier molecule. The demulsification mechanisms of the above-mentioned research routes are described in detail.

Challenges Experienced by School Managers in the Nkangala District, Mpumalanga, Regarding the Provision of Long Term Leadership

ERIC Educational Resources Information Center

van Niekerk, E. J.

2012-01-01

The long term leadership task of creating favourable circumstances for followers to excel are discussed in this article using narratives supplied by education managers in schools of the Nkangala District in Mpumalanga Province. Thereby deficiencies in the long term leadership proficiency of these managers are identified with a view to be able to…

The development of Korea's new long-term care service infrastructure and its results: focusing on the market-friendly policy used for expansion of the numbers of service providers and personal care workers.

PubMed

Chon, Yongho

2013-01-01

One of the main reasons for reforming long-term care systems is a deficient existing service infrastructure for the elderly. This article provides an overview of why and how the Korean government expanded long-term care infrastructure through the introduction of a new compulsory insurance system, with a particular focus on the market-friendly policies used to expand the infrastructure. Then, the positive results of the expansion of the long-term care infrastructure and the challenges that have emerged are examined. Finally, it is argued that the Korean government should actively implement a range of practical policies and interventions within the new system.

Alpine Soils as long-term Bioindicators

NASA Astrophysics Data System (ADS)

Nestroy, O.

2009-04-01

Alpine soils as long-term bioindicators The introductory words concern the definitions and peculiarities of alpine soils and their position in the Austrian Soil Classification 2000 in comparison with the World Reference Base for Soil Resources 2006. The important parameters for genesis and threats for these soils in steep and high positions are discussed. It must be emphasized that the main threats are the very different kinds of erosion e.g. by water, wind and snow, and also by skiing (end of season) as well as and mountain-biking (mainly summer-sport). Due the very slow regeneration and - in this connection - due to the very slow changes of the soil entities, these soils give an utmost importance as a long-time bioindicator. With regard to the climate change one can assume an increase in the content of organic matter on site, but also an increase of erosion and mass movement on the other site, e. g. in kind of "plaiken" (soil slide) as result of an increasing intensity of rainfall. It lies partly in our hands to diminish the number and the intensity of the threats, we can influence the soil development, but the result to reach a new ecological equilibrium is very long - in case of alpine soil more than two generations.

Long term attenuation statistics at 11.6 GHz in the three Italian Main Stations

NASA Astrophysics Data System (ADS)

Carassa, Francesco; Mauri, Mario; Paraboni, Aldo

1987-04-01

Results are presented from the 5-year attenuation-measurement campaign conducted with the SIRIO satellite at 11.6 and 17.8, which used near-continuous measurements at the lower frequency from the Italian ground stations at Fucino, Lario, and Spino d'Adda, and fewer measurements at the higher frequency from Fucino and Lario. The long-term statistics thus obtained have been applied in the design of the Italian domestic satellite system Italsat, which is to begin operating in 1989. Attention is presently given to annual worst month, time-of-day dependence, rain rate attenuation correlation, and frequency scaling statistics.

On long-term ozone trends at Hohenpeissenberg

NASA Technical Reports Server (NTRS)

Claude, H.; Vandersee, W.; Wege, K.

1994-01-01

More than 2000 ozone soundings and a large number of Dobson observations have been performed since 1967 in a unique procedure. The achieved very homogeneous data sets were used to evaluate significant long-term trends both in the troposphere and the stratosphere. The trend amounts to about plus 2 percent per year in the troposphere and to about minus 0.5 percent per year in the stratosphere. Extremely low ozone records obtained during winter 1991/92 are discussed in the light of the long term series. The winter mean of the ozone column is the lowest one of the series. The ozone deficit occurred mainly in the lower stratosphere. One cause may be the Pinatubo cloud. Even compared with the extreme winter mean following the El Chichon eruption the ozone content was lower. Additionally ozone was reduced by dynamical effects due to unusual weather situations.

ISS Regenerative Life Support: Challenges and Success in the Quest for Long-Term Habitability in Space

NASA Technical Reports Server (NTRS)

Bazley, Jesse

2015-01-01

The International Space Station's (ISS) Regenerative Environmental Control and Life Support System (ECLSS) was launched in 2008 to continuously recycle urine and crew sweat into drinking water and oxygen using brand new technologies. This functionality was highly important to the ability of the ISS to transition to the long-term goal of 6-crew operations as well as being critical tests for long-term space habitability. Through the initial activation and long-term operations of these systems, important lessons were learned about the importance of system redundancy and operational workarounds that allow Systems Engineers to maintain functionality with limited on-orbit spares. This presentation will share some of these lessons learned including how to balance water through the different systems, store and use water for use in system failures and creating procedures to operate the systems in ways that they were not initially designed to do.

Long-term stellar variability

NASA Astrophysics Data System (ADS)

Pagano, Isabella

2010-02-01

Stars with significant subsurface convection zones develop magnetic loop structures that, arising from the surface upward to the external atmospheres, cause flux variability detectable throughout the whole electromagnetic spectrum. In fact, diagnostics of magnetic activity are in radio wavelengths, where gyrosincrotron radiation arises from the quiescent and flaring corona; in the optical region, where important signatures are the Balmer lines, the Ca ii IRT and H&K lines; in the UV and X ray domains, the latter mainly due to coronal thermal plasma. The zoo of different magnetic features observed for the Sun - spots, faculae, flares, CMEs - are characterized by different temporal evolution and energetics, both in quantity and quality. As a consequence, the time scale of variability, the amount of involved energy and the quality of the involved photons are used as fingerprints in interpreting the observed stellar variability in the framework of the solar-stellar analogy. Here I review main results from long-term multiwavelength observations of cool star atmospheres, with emphasis to similarities and differences with the solar case.

Long term thermoelectric module testing system.

PubMed

D'Angelo, Jonathan; Hogan, Timothy

2009-10-01

Thermoelectric generators can be used for converting waste heat into electric power. Significant interest in developing new materials in recent years has led to the discovery of several promising thermoelectrics, however, there can be considerable challenges in developing the materials into working devices. Testing and feedback is needed at each step to gain valuable information for identification of difficulties, quality of the materials and modules, repeatability in fabrication, and longevity of the devices. This paper describes a long-term module testing system for monitoring the output power of a module over extended testing times. To evaluate the system, we have tested commercially available thermoelectric modules over a one month time period.

Long-term prognosis of patients with acute myocardial infarction due to unprotected left main coronary artery disease: a single-centre experience over 14 years.

PubMed

Xu, Li; Sun, Hao; Wang, Le-Feng; Yang, Xin-Chun; Li, Kui-Bao; Zhang, Da-Peng; Wang, Hong-Shi; Li, Wei-Ming

2016-07-01

Acute myocardial infarction (AMI) due to unprotected left main coronary artery (ULMCA) disease is clinically catastrophic although it has a low incidence. Studies on the long-term prognosis of these patients are rare. From January 1999 to September 2013, 55 patients whose infarct-related artery was the ULMCA were enrolled. Clinical, angiographic and interventional data was collected. Short-term and long-term clinical follow-up results as well as prognostic determinants during hospitalisation and follow-up were analysed. Cardiogenic shock (CS) occurred in 30 (54.5%) patients. During hospitalisation, 22 (40.0%) patients died. Multivariate logistic regression analysis showed that CS (odds ratio [OR] 5.86; p = 0.03), collateral circulation of Grade 2 or 3 (OR 0.14; p = 0.02) and final flow of thrombolysis in myocardial infarction (TIMI) Grade 3 (OR 0.05; p = 0.03) correlated with death during hospitalisation. 33 patients survived to discharge; another seven patients died during the follow-up period of 44.6 ± 31.3 (median 60, range 0.67-117.00) months. The overall mortality rate was 52.7% (n = 29). Kaplan-Meier analysis showed that the total cumulative survival rate was 30.7%. Cox multivariate regression analysis showed that CS during hospitalisation was the only predictor of overall mortality (hazard ratio 4.07, 95% confidence interval 1.40-11.83; p = 0.01). AMI caused by ULMCA lesions is complicated by high incidence of CS and mortality. CS, poor collateral blood flow and failure to restore final flow of TIMI Grade 3 correlated with death during hospitalisation. CS is the only predictor of long-term overall mortality. Copyright: © Singapore Medical Association.

Safety and Efficacy of Rivastigmine in Adolescents with Down Syndrome: Long-Term Follow-Up

PubMed Central

Spiridigliozzi, Gail A.; Crissman, Blythe G.; McKillop, Jane Anne; Yamamoto, Haru; Kishnani, Priya S.

2010-01-01

Abstract Following the completion of a 20-week, open-label study of the safety and efficacy of liquid rivastigmine for adolescents with Down syndrome, 5 of the 10 adolescents in the clinical trial continued long-term rivastigmine therapy and 5 did not. After an average period of 38 months, all 10 subjects returned for a follow-up assessment to determine the safety and efficacy of long-term rivastigmine use. Rivastigmine was well tolerated and overall health appeared to be unaffected by long-term rivastigmine use. Performance change on cognitive and language measures administered at the termination of the open-label clinical trial was compared between the two groups. No between-group difference in median performance change across the long-term period was found, suggesting that the long-term use of rivastigmine does not improve cognitive and language performance. However, two subjects demonstrated remarkable improvement in adaptive function over the long-term period. Both subjects had received long-term rivastigmine therapy. The discussion addresses the challenge of assessing cognitive change in clinical trials using adolescents with Down syndrome as subjects and the use of group versus individual data to evaluate the relevance of medication effects. PMID:21186971

ECHO-AGE: an innovative model of geriatric care for long-term care residents with dementia and behavioral issues.

PubMed

Catic, Angela G; Mattison, Melissa L P; Bakaev, Innokentiy; Morgan, Marisa; Monti, Sara M; Lipsitz, Lewis

2014-12-01

To design, implement, and assess the pilot phase of an innovative, remote case-based video-consultation program called ECHO-AGE that links experts in the management of behavior disorders in patients with dementia to nursing home care providers. Pilot study involving surveying of participating long-term care sites regarding utility of recommendations and resident outcomes. Eleven long-term care sites in Massachusetts and Maine. An interprofessional specialty team at a tertiary care center and staff from 11 long-term care sites. Long-term care sites presented challenging cases regarding residents with dementia and/or delirium related behavioral issues to specialists via video-conferencing. Baseline resident characteristics and follow-up data regarding compliance with ECHO-AGE recommendations, resident improvement, hospitalization, and mortality were collected from the long-term care sites. Forty-seven residents, with a mean age of 82 years, were presented during the ECHO-AGE pilot period. Eighty-three percent of residents had a history of dementia and 44% were taking antipsychotic medications. The most common reasons for presentation were agitation, intrusiveness, and paranoia. Behavioral plans were recommended in 72.3% of patients. Suggestions for medication adjustments were also frequent. ECHO-AGE recommendations were completely or partially followed in 88.6% of residents. When recommendations were followed, sites were much more likely to report clinical improvement (74% vs 20%, P < .03). Hospitalization was also less common among residents for whom recommendations were followed. The results suggest that a case-based video-consultation program can be successful in improving the care of elders with dementia and/or delirium related behavioral issues by linking specialists with long-term care providers. Published by Elsevier Inc.

Plastic mulching in agriculture. Trading short-term agronomic benefits for long-term soil degradation?

PubMed

Steinmetz, Zacharias; Wollmann, Claudia; Schaefer, Miriam; Buchmann, Christian; David, Jan; Tröger, Josephine; Muñoz, Katherine; Frör, Oliver; Schaumann, Gabriele Ellen

2016-04-15

Plastic mulching has become a globally applied agricultural practice for its instant economic benefits such as higher yields, earlier harvests, improved fruit quality and increased water-use efficiency. However, knowledge of the sustainability of plastic mulching remains vague in terms of both an environmental and agronomic perspective. This review critically discusses the current understanding of the environmental impact of plastic mulch use by linking knowledge of agricultural benefits and research on the life cycle of plastic mulches with direct and indirect implications for long-term soil quality and ecosystem services. Adverse effects may arise from plastic additives, enhanced pesticide runoff and plastic residues likely to fragment into microplastics but remaining chemically intact and accumulating in soil where they can successively sorb agrochemicals. The quantification of microplastics in soil remains challenging due to the lack of appropriate analytical techniques. The cost and effort of recovering and recycling used mulching films may offset the aforementioned benefits in the long term. However, comparative and long-term agronomic assessments have not yet been conducted. Furthermore, plastic mulches have the potential to alter soil quality by shifting the edaphic biocoenosis (e.g. towards mycotoxigenic fungi), accelerate C/N metabolism eventually depleting soil organic matter stocks, increase soil water repellency and favour the release of greenhouse gases. A substantial process understanding of the interactions between the soil microclimate, water supply and biological activity under plastic mulches is still lacking but required to estimate potential risks for long-term soil quality. Currently, farmers mostly base their decision to apply plastic mulches rather on expected short-term benefits than on the consideration of long-term consequences. Future interdisciplinary research should therefore gain a deeper understanding of the incentives for farmers

Enhancing the quality of supportive supervisory behavior in long-term care facilities.

PubMed

McGillis Hall, Linda; McGilton, Katherine S; Krejci, Janet; Pringle, Dorothy; Johnston, Erin; Fairley, Laura; Brown, Maryanne

2005-04-01

The practices of managers and registered nurses (RNs) in long-term care facilities are frequently ineffective in assisting the licensed practical nurses (LPNs) and healthcare aides (HCAs) whom they supervise. Little research exists that examines the area of supportive relationships between nursing staff and supervisors in these settings. The purpose of this study was to gather data that could improve management practices in long-term care residential facilities and enhance the quality of the supervisory relationships between supervisors (nurse managers and RNs) and care providers (HCAs and LPNs) in these settings. The study also identified factors that influence the supervisors' ability to establish supportive relationships with care providers. The challenges and barriers to nurse managers and leaders related to enacting supportive behaviors are discussed as well as their implications for long-term care settings.

Long-term urethral catheterisation.

PubMed

Turner, Bruce; Dickens, Nicola

This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

Long-term solar-terrestrial observations

NASA Technical Reports Server (NTRS)

1988-01-01

The results of an 18-month study of the requirements for long-term monitoring and archiving of solar-terrestrial data is presented. The value of long-term solar-terrestrial observations is discussed together with parameters, associated measurements, and observational problem areas in each of the solar-terrestrial links (the sun, the interplanetary medium, the magnetosphere, and the thermosphere-ionosphere). Some recommendations are offered for coordinated planning for long-term solar-terrestrial observations.

Patient, resident, or person: Recognition and the continuity of self in long-term care for older people.

PubMed

Pirhonen, Jari; Pietilä, Ilkka

2015-12-01

Becoming a resident in a long-term care facility challenges older people's continuity of self in two major ways. Firstly, as they leave behind their previous home, neighborhood, and often their social surroundings, older people have to change their life-long lifestyles, causing fears of the loss of one's self. Secondly, modern-day care facilities have some features of 'total' institutions that produce patient-like role expectations and thus challenge older people's selves. Our ethnographic study in a geriatric hospital and a sheltered home in Finland aims to find out what features of daily life either support or challenge older people's continuity of self. A philosophical reading of the concept of recognition is used to explore how various daily practices and interactions support recognizing people as persons in long-term care. Categories of institution-centered and person-centered features are described to illustrate multiple ways in which people are recognized and misrecognized. The discussion highlights some ways in which long-term care providers could use the results of the study. Copyright © 2015 Elsevier Inc. All rights reserved.

Managing Records for the Long Term - 12363

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

Montgomery, John V.; Gueretta, Jeanie

The U.S. Department of Energy (DOE) is responsible for managing vast amounts of information documenting historical and current operations. This information is critical to the operations of the DOE Office of Legacy Management. Managing legacy records and information is challenging in terms of accessibility and changing technology. The Office of Legacy Management is meeting these challenges by making records and information management an organizational priority. The Office of Legacy Management mission is to manage DOE post-closure responsibilities at former Cold War weapons sites to ensure the future protection of human health and the environment. These responsibilities include environmental stewardship andmore » long-term preservation and management of operational and environmental cleanup records associated with each site. A primary organizational goal for the Office of Legacy Management is to 'Preserve, Protect, and Share Records and Information'. Managing records for long-term preservation is an important responsibility. Adequate and dedicated resources and management support are required to perform this responsibility successfully. Records tell the story of an organization and may be required to defend an organization in court, provide historical information, identify lessons learned, or provide valuable information for researchers. Loss of records or the inability to retrieve records because of poor records management processes can have serious consequences and even lead to an organisation's downfall. Organizations must invest time and resources to establish a good records management program because of its significance to the organization as a whole. The Office of Legacy Management will continue to research and apply innovative ways of doing business to ensure that the organization stays at the forefront of effective records and information management. DOE is committed to preserving records that document our nation's Cold War legacy, and the Office of Legacy

Long-term care: long-term care insurance--2005. End of Year Issue Brief.

PubMed

Tanner, Rachel; Bercaw, Lawren

2005-12-31

As the "Baby Boom" generation approaches retirement, state and federal lawmakers are struggling to ensure that the nation's long-term care system will provide adequate services for the growing number of senior citizens. A 2003 Administration on Aging report predicted that the elderly population will double by 2030. Accordingly, policymakers must prepare for the impending squeeze on public health and Medicaid resources. Many consumers are exploring private long-term care insurance options as a means of preparing for the cost of eldercare. Yet, a lack of market uniformity has rendered the long-term care insurance industry somewhat difficult for consumers to decipher. In addition, senior care insurance is often costly, particularly for those over age 50.

Short Term Gains, Long Term Pains: How Cues About State Aid Learning in Dynamic Environments

PubMed Central

Gureckis, Todd M.; Love, Bradley C.

2009-01-01

Successful investors seeking returns, animals foraging for food, and pilots controlling aircraft all must take into account how their current decisions will impact their future standing. One challenge facing decision makers is that options that appear attractive in the short-term may not turn out best in the long run. In this paper, we explore human learning in a dynamic decision-making task which places short- and long-term rewards in conflict. Our goal in these studies was to evaluate how people’s mental representation of a task affects their ability to discover an optimal decision strategy. We find that perceptual cues that readily align with the underlying state of the task environment help people overcome the impulsive appeal of short-term rewards. Our experimental manipulations, predictions, and analyses are motivated by current work in reinforcement learning which details how learners value delayed outcomes in sequential tasks and the importance that “state” identification plays in effective learning. PMID:19427635

The psychological contract: enhancing productivity and its implications for long-term care.

PubMed

Flannery, Raymond B

2002-01-01

When hired, a new employee is usually given a job description and an explanation of benefits. In addition, the employee will also have a psychological contract with the organization. This contract, often unstated, reflects the main source of the employee's motivation to work hard. This is true of all groups of employees, including long-term care staff. Common examples of psychological contracts for long-term care administrative staff include autonomy, social acceptance, and being in the forefront of cutting-edge research. An awareness of these psychological contracts can result in better "fits" between employee aspirations and relevant long-term care organization tasks so that productivity is enhanced. This article outlines the steps necessary to create these good fits in ways that benefit both the organization and its employees. These recommendations are of particular relevance to administrators and supervisors in long-term carefacilities.

Memory Reactivation Enables Long-Term Prevention of Interference.

PubMed

Herszage, Jasmine; Censor, Nitzan

2017-05-22

The ability of the human brain to successively learn or perform two competing tasks constitutes a major challenge in daily function. Indeed, exposing the brain to two different competing memories within a short temporal offset can induce interference, resulting in deteriorated performance in at least one of the learned memories [1-4]. Although previous studies have investigated online interference and its effects on performance [5-13], whether the human brain can enable long-term prevention of future interference is unknown. To address this question, we utilized the memory reactivation-reconsolidation framework [2, 12] stemming from studies at the synaptic level [14-17], according to which reactivation of a memory enables its update. In a set of experiments, using the motor sequence learning task [18] we report that a unique pairing of reactivating the original memory (right hand) in synchrony with novel memory trials (left hand) prevented future interference between the two memories. Strikingly, these effects were long-term and observed a month following reactivation. Further experiments showed that preventing future interference was not due to practice per se, but rather specifically depended on a limited time window induced by reactivation of the original memory. These results suggest a mechanism according to which memory reactivation enables long-term prevention of interference, possibly by creating an updated memory trace integrating original and novel memories during the reconsolidation time window. The opportunity to induce a long-term preventive effect on memories may enable the utilization of strategies optimizing normal human learning, as well as recovery following neurological insults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nodal variations and long-term changes in the main tides on the coasts of China

NASA Astrophysics Data System (ADS)

Feng, Xiangbo; Tsimplis, Michael N.; Woodworth, Philip L.

2015-02-01

The long-term changes in the main tidal constituents (O1, K1, M2, N2, and S2) along the coasts of China and in adjacent seas are investigated based on 17 tide-gauge records covering the period 1954-2012. The observed 18.61 year nodal modulations of the diurnal constituents O1 and K1 are in agreement with the equilibrium tidal theory, except in the South China Sea. The observed modulations of the M2 and N2 amplitudes are smaller than theoretically predicted at the northern stations and larger at the southern stations. The discrepancies between the theoretically predicted nodal variations and the observations are discussed. The 8.85 year perigean cycle is identifiable in the N2 parameters at most stations, except those in the South China Sea. The radiational component of S2 contributes on average 16% of the observed S2 except in the Gulf of Tonkin, on the south coast, where it accounts for up to 65%. We confirmed the existence of nodal modulation in S2, which is stronger on the north coast. The semidiurnal tidal parameters show significant secular trends in the Bohai and Yellow Seas, on the north coast, and in the Taiwan Strait. The largest increase is found for M2 for which the amplitude increases by 4-7 mm/yr in the Yellow Sea. The potential causes for the linear trends in tidal constants are discussed. This article was corrected on 13 MAR 2015. See the end of the full text for details.

Working memory, long-term memory, and medial temporal lobe function

PubMed Central

Jeneson, Annette; Squire, Larry R.

2012-01-01

Early studies of memory-impaired patients with medial temporal lobe (MTL) damage led to the view that the hippocampus and related MTL structures are involved in the formation of long-term memory and that immediate memory and working memory are independent of these structures. This traditional idea has recently been revisited. Impaired performance in patients with MTL lesions on tasks with short retention intervals, or no retention interval, and neuroimaging findings with similar tasks have been interpreted to mean that the MTL is sometimes needed for working memory and possibly even for visual perception itself. We present a reappraisal of this interpretation. Our main conclusion is that, if the material to be learned exceeds working memory capacity, if the material is difficult to rehearse, or if attention is diverted, performance depends on long-term memory even when the retention interval is brief. This fundamental notion is better captured by the terms subspan memory and supraspan memory than by the terms short-term memory and long-term memory. We propose methods for determining when performance on short-delay tasks must depend on long-term (supraspan) memory and suggest that MTL lesions impair performance only when immediate memory and working memory are insufficient to support performance. In neuroimaging studies, MTL activity during encoding is influenced by the memory load and correlates positively with long-term retention of the material that was presented. The most parsimonious and consistent interpretation of all the data is that subspan memoranda are supported by immediate memory and working memory and are independent of the MTL. PMID:22180053

Predictors of the highest long-term care expenditures in Japan

PubMed Central

2011-01-01

Background In Japan, as the number of elderly covered by the Long-term Care Insurance (LTCI) system has increased, demand for long-term care services has increased substantially and consequently growing expenditures are threatening the sustainability of the system. Understanding the predictive factors associated with long-term care expenditures among the elderly would be useful in developing future strategies to ensure the sustainability of the system. We report a set of predictors of the highest long-term care expenditures in a cohort of elderly persons who received consecutive long-term care services during a year in a Japanese city. Methods Data were obtained from databases of the LTC insurer of City A in Japan. Binary logistic regression was used to examine the predictors of the highest long-term care expenditures. We used a simplified model that focused on the effects of disability status and type of services used, while controlling for several relevant factors. Goodness of fit, a multicollinearity test, and logistic regression diagnostics were carried out for the final model. Results The study cohort consisted of 862 current users of LTCI system in city A. After controlling for gender and income, age, increased utilization rate of benefits, decline in functional status, higher care needs level and institutional care were found to be associated with the highest LTCI expenditures. An increased utilization rate of benefits (OR = 24.2) was a strong main effect predictors of the high LTC expenditures. However, a significant interaction between institutional care and high care need level was found, providing evidence of the combined effect of the two covariates. Conclusions Beyond to confirm that disability status of elderly persons is the main factor driving the demand of LTC services and consequently the expenditures, we showed that changes in utilization rate of benefits -a specific insurance factor- and the use of institutional care conditional on the high care

Long-term associative learning predicts verbal short-term memory performance.

PubMed

Jones, Gary; Macken, Bill

2018-02-01

Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term memory system separate from long-term knowledge. Using natural language corpora, we show experimentally and computationally that performance on three widely used measures of short-term memory (digit span, nonword repetition, and sentence recall) can be predicted from simple associative learning operating on the linguistic environment to which a typical child may have been exposed. The findings support the broad view that short-term verbal memory performance reflects the application of long-term language knowledge to the experimental setting.

Asthma Medicines: Long-Term Control

MedlinePlus

... Size Email Print Share Asthma Medicines: Long-term Control Page Content Article Body Corticosteroids Synthetic versions of ... form, they are used exclusively for long-term control; they are not very effective for acute symptoms. ...

Ultra-low power wireless sensing for long-term structural health monitoring

NASA Astrophysics Data System (ADS)

Bilbao, Argenis; Hoover, Davis; Rice, Jennifer; Chapman, Jamie

2011-04-01

Researchers have made significant progress in recent years towards realizing long-term structural health monitoring (SHM) utilizing wireless smart sensor networks (WSSNs). These efforts have focused on improving the performance and robustness of such networks to achieve high quality data acquisition and in-network processing. One of the primary challenges still facing the use of smart sensors for long-term monitoring deployments is their limited power resources. Periodically accessing the sensor nodes to change batteries is not feasible or economical in many deployment cases. While energy harvesting techniques show promise for prolonging unattended network life, low-power design and operation are still critically important. This research presents a new, fully integrated ultra-low power wireless smart sensor node and a flexible base station, both designed for long-term SHM applications. The power consumption of the sensor nodes and base station has been minimized through careful hardware selection and the implementation of power-aware network software, without sacrificing flexibility and functionality.

Long-term exercise adherence after public health training in at-risk adults.

PubMed

Saida, Trine Gro Riktrup Hansen; Juul Sørensen, Tina; Langberg, Henning

2017-07-01

Sustainment of healthy exercise behavior is essential in preventing cardiovascular disease and diabetes. Few studies have explored long-term exercise adherence after an exercise referral scheme. The objective of this study was to examine 12-month exercise adherence after an exercise intervention program. This was a pragmatic follow-up study in at-risk people performed between June 2012 and January 2014. The main outcome measure was self-reported single-item exercise adherence. Secondary outcomes were change in exercise level, quality of life rated on a visual analog scale and self-rated health. Predictors of long-term exercise adherence were assessed by logistic regression, estimating crude odds-ratios (OR) and 95% confidence intervals (95% CIs) and adjusting for age, gender, education, smoking, moderate and vigorous exercise. In total, 214 adults (mean age 58.8±11.97 years, 71% women) participated in the study and received a 12-week training intervention: 62% had hypertension, 64% dyslipidemia and 15% impaired glucose tolerance. Attrition rate was 84% (n=179). During the 12-month follow-up, 48% (n=85) reported long-term exercise adherence. The main predictors of long-term exercise adherence were participation in sport activities at baseline (adjusted odds-ratio [aOR] 4.22, 95% CI 1.72-10.40), self-rated health (aOR 2.60, 1.00-6.75) and quality of life (aOR 2.39, 1.03-5.54). Long-term non-adherence was associated with low education (<10 years; aOR 3.27, 1.14-9.43) and age<50 years (aOR 3.53, 1.32-9.43). In this pragmatic study, long-term exercise adherence was associated with participation in sport activities and self-rated health at baseline. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Public strategies for improving eHealth integration and long-term sustainability in public health care systems: Findings from an Italian case study.

PubMed

De Rosis, Sabina; Nuti, Sabina

2018-01-01

eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long-term sustainability. In a public health care system, the public actor is among the main "buyers" eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a "buyer") improve long-term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win-win strategies should be followed. Investments should take into account the need to long-term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the "platform approach" emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. © 2017 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

Space Missions: Long Term Preservation of IDL-based Software using GDL

NASA Astrophysics Data System (ADS)

Coulais, A.; Schellens, M.; Arabas, S.; Lenoir, M.; Noreskal, L.; Erard, S.

2012-09-01

GNU Data Language (GDL) is a free software clone of IDL, an interactive language widely used in Astronomy and space missions since decades. Proprietary status, license restrictions, price, sustainability and continuity of support for particular platforms are recurrent concerns in the Astronomy community, especially concerning space missions, which require long-term support. In this paper, we describe the key features of GDL and the main achievements from recent development work. We illustrate the maturity of GDL by presenting two examples of application: reading spectral cubes in PDS format and use of the HEALPix library. These examples support the main argument of the paper: that GDL has reached a level of maturity and usability ensuring long term preservation of analysis capabilities for numerous ground experiments and spaces missions based on IDL.

Problems in the long-term storage of data obtained from scientific space experiments

NASA Technical Reports Server (NTRS)

Zlotin, G. N.; Khovanskiy, Y. D.

1975-01-01

It is shown that long-term data storage systems can be achieved when the system which organizes and conducts the scientific space experiments is equipped with a specialized subsystem: the information filing system. Its main functions are described along with the necessity of stage-by-stage development and compatibility with the data processing systems. The requirements for long-term data storage media are discussed.

Breast Cancer Survivorship: A Comprehensive Review of Long-Term Medical Issues and Lifestyle Recommendations

PubMed Central

Bodai, Balazs I; Tuso, Phillip

2015-01-01

Long-term survival rates after a diagnosis of breast cancer are steadily rising. This is good news, but clinicians must also recognize that this brings new challenges to the medical community. As breast cancer becomes a chronic condition rather than a life-threatening illness owing to advances in early diagnosis and more effective treatments, health care practitioners must recognize and manage the long-term sequelae of the constellation of therapeutic modalities. Survivors of breast cancer represent a unique and extremely complex group of patients; not only do they have the challenge of dealing with multiple long-term side effects of treatment protocols, but many are also forced to address the preexisting comorbidities of their therapies, which often include multiple other issues. Therapies have additional and/or additive side effects that may interfere with treatments directed toward the new primary diagnosis of breast cancer. Our mandate is to establish a smooth transition from patient with breast cancer to survivor of breast cancer while providing ongoing and future guidance. Certainly, the information and resources to accomplish this transition are readily available; however, they are scattered throughout the literature and therefore are not easily accessible or available to the primary care physician. It is imperative that the information available regarding survivorship issues be accessible in an organized and useful format. This article is a modest attempt to provide a comprehensive review of the long-term medical issues relevant to survivorship after the diagnosis and treatment of breast cancer. A predicted shortage of oncologists by 2020 is well-recognized. Therefore, the bulk of long-term care will become dependent on the primary care physician. This shift of care means that these physicians will need to be well educated in the long-term medical issues related to breast cancer treatment. PMID:25902343

Effects of Long-Term Representations on Free Recall of Unrelated Words

ERIC Educational Resources Information Center

Katkov, Mikhail; Romani, Sandro; Tsodyks, Misha

2015-01-01

Human memory stores vast amounts of information. Yet recalling this information is often challenging when specific cues are lacking. Here we consider an associative model of retrieval where each recalled item triggers the recall of the next item based on the similarity between their long-term neuronal representations. The model predicts that…

Getting a Bigger Bang for Your Buck: A Collaborative Approach to Enhancing Dementia Education Planning in Long-Term Care Homes

PubMed Central

McAiney, Carrie A.; Hillier, Loretta M.; Ringland, Margaret; Cooper, Nancy

2009-01-01

A collaborative of Ontario-based long-term care associations, researchers, clinicians and educators representing various education initiatives related to dementia care and challenging behaviours used existing research evidence on adult learning principles, knowledge transfer and performance improvement to develop an evidence-based approach to support practice change and improvement in long-term care. The collaborative was led by the two provincial long-term care associations with no external funds to support its activities. This effort illustrates how people with common challenges, visions and goals can work together to share their intellectual and physical resources to address pervasive problems. PMID:21037817

'Nobody knows what's around the corner': the challenges of caring for people with long-term conditions in care homes.

PubMed

Martin, Susan; Martin, Joy

2018-06-02

People living with long-term conditions are increasingly being cared for in care homes. Prognostication in this population is particularly challenging, and outcomes are often uncertain. This case history highlights some of the difficulties encountered when clinicians give a time-bound prognosis. It also illustrates how education programmes with high facilitation and ongoing support for care home staff can sustain practice development and enable staff to become highly skilled in working with uncertainty. Practice development programmes such as those based on the Six Steps to Success Programme for care homes give care home staff a framework within which to regularly review a resident's clinical status and the confidence to have the ongoing conversations that empower residents to contribute to decision making and focus on their own goals for care.

Reforming long-term care financing through insurance

PubMed Central

Meiners, Mark R.

1988-01-01

Until recently, insurance for long-term care was not viewed as feasible. This perception has changed dramatically in the past few years. Several models of long-term care insurance have begun to be tested. Although the application of insurance principles to long-term care is still new, the emergence of private market interest in developing long-term care insurance has been a catalyst to renewed public-policy support for reforming the way we pay for long-term care. States, in particular, have become interested in developing public-private partnerships to support the emergence of long-term care insurance that could help relieve the mounting pressure on Medicaid budgets. PMID:10312962

Clinical review: Long-term noninvasive ventilation

PubMed Central

Robert, Dominique; Argaud, Laurent

2007-01-01

Noninvasive positive ventilation has undergone a remarkable evolution over the past decades and is assuming an important role in the management of both acute and chronic respiratory failure. Long-term ventilatory support should be considered a standard of care to treat selected patients following an intensive care unit (ICU) stay. In this setting, appropriate use of noninvasive ventilation can be expected to improve patient outcomes, reduce ICU admission, enhance patient comfort, and increase the efficiency of health care resource utilization. Current literature indicates that noninvasive ventilation improves and stabilizes the clinical course of many patients with chronic ventilatory failure. Noninvasive ventilation also permits long-term mechanical ventilation to be an acceptable option for patients who otherwise would not have been treated if tracheostomy were the only alternative. Nevertheless, these results appear to be better in patients with neuromuscular/-parietal disorders than in chronic obstructive pulmonary disease. This clinical review will address the use of noninvasive ventilation (not including continuous positive airway pressure) mainly in diseases responsible for chronic hypoventilation (that is, restrictive disorders, including neuromuscular disease and lung disease) and incidentally in others such as obstructive sleep apnea or problems of central drive. PMID:17419882

Does restructuring theory and clinical courses better prepare nursing students to manage residents with challenging behaviors in long-term care settings?

PubMed

O'Connell, Beverly; Guse, Lorna; Greenslade, Loreley

2018-01-30

Bachelor of Nursing students (BN) placed in long-term care encounter residents who exhibit challenging behaviors. Students are often inadequately prepared to manage these behaviors, and this is a source of distress for students. This study explored whether enhancing and restructuring theoretical and clinical courses resulted in student nurses feeling better prepared to manage residents' challenging behaviors and improve their levels of distress. This study was conducted in two phases with 116 BN students (first phase) and 99 students (second phase) where the course on older adults was restructured. The findings of this study indicated that students who felt less prepared experienced greater distress by residents' behaviors than those who felt better prepared. Scheduling a theoretical course on the care of older adults prior to the clinical course placement, as well as offering an online learning module focused on responsive behaviors, significantly increased students' feelings of preparedness to manage residents' complex behaviors.

Management training in long-term care.

PubMed

Evashwick, Connie

2002-01-01

The education of health care administrators faces its most dramatic change since the inception of the field. Recent discussions at the national level call for major overhaul of curricula and teaching modalities, including moving education to position students for evidence-based practice. This paper presents recommendations for incorporating training about chronic and long-term care into health care management curricula. It asserts that all health care management students should have a basic knowledge of the fundamental policy, operating, and financing principles of long-term care. The majority of people using the health care delivery system today, and increasingly in the future, suffer from chronic conditions. Long-term care services, although less expansive in structure, far outnumber acute care services and health plans. They will grow in the future to meet the portending demand. To maximize job opportunities and to optimize performance in any job, health care administrators need to know about the long-term care delivery system. This paper delineates critical topics pertaining to long-term care, organized according to 11 fundamental management areas in which the field is developing core competencies. The contents were derived from a year-long process of asking stakeholders in the various facets of long-term care what topics they thought were essential for administrators to know. The topics delineated in this document represent the consensus about essential knowledge that all health care administrators should have about long-term care, whether specializing in long-term care or following a more general management career. The education of health care administrators faces its most dramatic change since the inception ofthe field. Recent discussions at the national level call for major overhaul of curricula and teaching modalities, including moving education to position students to perform according to evidence-based practice. It is thus timely to consider content, as

Long-term social recognition memory is mediated by oxytocin-dependent synaptic plasticity in the medial amygdala.

PubMed

Gur, Rotem; Tendler, Alex; Wagner, Shlomo

2014-09-01

Recognition of specific individuals is fundamental to mammalian social behavior and is mediated in most mammals by the main and accessory olfactory systems. Both these systems innervate the medial amygdala (MeA), where activity of the neuropeptide oxytocin is thought to mediate social recognition memory (SRM). The specific contribution of the MeA to SRM formation and the specific actions of oxytocin in the MeA are unknown. We used the social discrimination test to evaluate short-term and long-term SRM in adult Sprague-Dawley male rats (n = 38). The role of protein synthesis in the MeA was investigated by local application of the protein synthesis blocker anisomycin (n = 11). Synaptic plasticity was assessed in vivo by recording the MeA evoked field potential responses to stimulation of the main (n = 21) and accessory (n = 56) olfactory bulbs before and after theta burst stimulation. Intracerebroventricular administration of saline, oxytocin, or oxytocin receptor antagonist was used to measure the effect of oxytocin on synaptic plasticity. Anisomycin application to the MeA prevented the formation of long-term SRM. In addition, the responses of MeA neurons underwent long-term depression (LTD) after theta burst stimulation of the accessory olfactory bulb, but not the main accessory bulb, in an oxytocin-dependent manner. No LTD was found in socially isolated rats, which are known to lack long-term SRM. Finally, accessory olfactory bulb stimulation before SRM acquisition blocked long-term SRM, supporting the involvement of LTD in the MeA in formation of long-term SRM. Our results indicate that long-term SRM in rats involves protein synthesis and oxytocin-dependent LTD in the MeA. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Structural Degradation of the Welded Joint of the Gas Main after a Long-Term Operation in Sub-Acid Soil

NASA Astrophysics Data System (ADS)

Maruschak, P. O.; Bishchak, R. T.; Maruschak, O. V.; Panin, S. V.

2018-01-01

The authors investigated the main regularities in the structural and mechanical degradation of steel and a welded joint of the “Soyuz” gas main in operation. It is established that the defect accumulation kinetics in welds are determined both by technological disruptions in their manufacture and by hydrogenation of the weld during a long operating time. A weakening of the mechanical properties of the weld after a prolonged operation is shown, which in some cases led to the appearance of cracks and fracture of the gas main.

Placenta previa and long-term morbidity of the term offspring.

PubMed

Walfisch, Asnat; Beharier, Ofer; Shoham-Vardi, Ilana; Sergienko, Ruslan; Landau, Daniella; Sheiner, Eyal

2016-08-01

The long-term impact of placenta previa on term infants is unknown. We aimed to investigate whether abnormal placentation increases the risk for long-term morbidity of the term offspring. A population-based cohort study compared the incidence of long-term hospitalizations up to the age of 18 due to cardiovascular, endocrine, neurological, hematological, respiratory and urinary morbidity of children born at term in pregnancies diagnosed with placenta previa and those without. Deliveries occurred between the years 1991-2013 in a tertiary medical center. Multiple pregnancies, and fetal congenital malformations were excluded. Kaplan-Meier survival curves were used to compare cumulative morbidity incidence over time. A multivariable generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders and for maternal clusters. During the study period 233,123 term deliveries met the inclusion criteria; 0.2% (n=502) of the children were born to mothers with placenta previa. During the follow-up period, children born to mothers with placenta previa did not have an increased risk for long-term cardiovascular, endocrine, hematological, neurological, respiratory, and urinary morbidity. Term offsprings of mothers diagnosed with placenta previa do not appear to be at an increased risk for long-term morbidity up to the age of 18. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Forced migration in childhood: are there long-term health effects?

PubMed

Saarela, Jan M; Elo, Irma T

2016-12-01

Studies on the health of migrants have increased considerably in number in recent years, but little is still known about the long-term health effects associated with forced migration, and particularly for people who were forced to migrate as children. Data shortcomings together with the methodological challenges of studying migrant populations limit the ability to disentangle the roles of various factors that influence migrant health outcomes. Finland provides an unusual opportunity to study long-term health consequences associated with forced migration. During World War II, twelve per cent of the Finnish population was forced to leave the region nowadays referred to as Ceded Karelia. After the war, these Karelians could not return home because the area was relinquished to the Soviet Union. Using high quality, linked register-based data for the period 1988-2012, we investigate whether this forced migration had long-term health consequences for those who were forced to migrate as children. Comparison groups are non-displaced persons born on the adjacent side of the new border, and people born elsewhere in Finland. Health at ages 43-65 years is measured by receipt of sickness benefit, which is an indicator of short-term illness, and receipt of disability pension, which reflects long-term illness or permanent disability. All-cause and cause-specific mortality is analysed at ages 43-84 years. We find no support for the hypothesis that the traumatic event of being forced to migrate during childhood has long-term negative health consequences. The forced child migrants have lower odds for receipt of sickness benefit, and women also have lower odds for receipt of disability pension. The mortality results are largely driven by patterns specific for eastern-born populations of Finland. A likely reason behind the absence of negative health consequences is that these migrants seem to have integrated well into post-war Finnish society.

Consider long-term care as service alternative.

PubMed

Loria, L S

1987-04-01

The increasing demand for elderly care services, pressures on inpatient average length of stay and payment levels, and potential financial rewards from providing additional services, makes long-term care look attractive to hospitals. Long-term care, however, is not for every hospital. Before deciding to establish long-term care services, management should examine how the service fits within the hospital's strategic plan. The action plan below provides guidance in evaluating a decision to use hospital facilities for long-term care. Examine how long-term care services fit within the hospital's strategic plan. Study area demographics and competitors to assess the need and supply of long-term care services. Survey the medical staff, consumers and payers to determine attitudes, perceptions and interests regarding long-term care services. Develop a facility plan that identifies areas of excess capacity that can be most easily converted into long-term care with minimal effects on hospital operations. Prepare a financial feasibility analysis of the contribution margin and return on investment attributable to long-term care services. Include an impact analysis on hospital operations. Establish a management task force to develop a detailed implementation plan including assigned individual responsibilities and related timetable. Develop an effective marketing plan designed to generate increased patient market share.

Long-term data archiving

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

Moore, David Steven

2009-01-01

Long term data archiving has much value for chemists, not only to retain access to research and product development records, but also to enable new developments and new discoveries. There are some recent regulatory requirements (e.g., FDA 21 CFR Part 11), but good science and good business both benefit regardless. A particular example of the benefits of and need for long term data archiving is the management of data from spectroscopic laboratory instruments. The sheer amount of spectroscopic data is increasing at a scary rate, and the pressures to archive come from the expense to create the data (or recreatemore » it if it is lost) as well as its high information content. The goal of long-term data archiving is to save and organize instrument data files as well as any needed meta data (such as sample ID, LIMS information, operator, date, time, instrument conditions, sample type, excitation details, environmental parameters, etc.). This editorial explores the issues involved in long-term data archiving using the example of Raman spectral databases. There are at present several such databases, including common data format libraries and proprietary libraries. However, such databases and libraries should ultimately satisfy stringent criteria for long term data archiving, including readability for long times into the future, robustness to changes in computer hardware and operating systems, and use of public domain data formats. The latter criterion implies the data format should be platform independent and the tools to create the data format should be easily and publicly obtainable or developable. Several examples of attempts at spectral libraries exist, such as the ASTM ANDI format, and the JCAMP-DX format. On the other hand, proprietary library spectra can be exchanged and manipulated using proprietary tools. As the above examples have deficiencies according to the three long term data archiving criteria, Extensible Markup Language (XML; a product of the World Wide

Long-Term Control Medications for Lung Diseases

MedlinePlus

... Asthma Medications Long-Term Control Medications Long-Term Control Medications Make an Appointment Ask a Question Refer Patient Long-term control medications are taken daily to control and prevent ...

Long-term Studies of Marine Halogen Release

NASA Astrophysics Data System (ADS)

Tschritter, J.; Holla, R.; Frieß, U.; Platt, U.

2009-04-01

Institute of Enviromental Physics, Heidelberg, Germany. Long term measurements of atmospheric trace gases using multi-axis DOAS instruments are pursued at the new SOLAS observatory on the island of Sao Vicente, (Cape Verde). This research is part of the SOPRAN (Surface Ocean Processes in the ANthropocene) project (Fördernummer:03F0462F). Reactive halogen species (RHS) such as bromine- and iodine- containing species play major roles in the chemistry of ozone in both the troposphere and lower stratosphere and thus possibly influence the ozone budget on a global scale. In addition iodine-species emitted from the ocean surface have been shown to be responsible for the production of new atmospheric particles in the marine boundary layer. This may have an effect on cloud formation and radiation transfer on local and global scales. Long term measurements of RHS abundances will help to identify their key regions and processes for formation. A new long term Multi-MAX-DOAS instrument has been installed at the SOLAS observatory on the island of Sao Vicente, (Cape Verde). The main focus of these unique measurements is the investigation of reactive halogen chemistry in the subtropical marine boundary layer based on measurements of BrO, IO, and possibly OIO. Because of its wide spectral range also the use for O4-retrievals to gain aerosol profiles is possible. IO has been detected with mixing ratios up to 1.3 ppt. For BrO an upper limit of 2 ppt could be determined.

Haloperidol for long-term aggression in psychosis.

PubMed

Khushu, Abha; Powney, Melanie J

2016-11-27

Psychotic disorders can lead some people to become agitated. Characterised by restlessness, excitability and irritability, this can result in verbal and physically aggressive behaviour - and both can be prolonged. Aggression within the psychiatric setting imposes a significant challenge to clinicians and risk to service users; it is a frequent cause for admission to inpatient facilities. If people continue to be aggressive it can lengthen hospitalisation. Haloperidol is used to treat people with long-term aggression. To examine whether haloperidol alone, administered orally, intramuscularly or intravenously, is an effective treatment for long-term/persistent aggression in psychosis. We searched the Cochrane Schizophrenia Group Trials Register (July 2011 and April 2015). We included randomised controlled trials (RCT) or double blind trials (implying randomisation) with useable data comparing haloperidol with another drug or placebo for people with psychosis and long-term/persistent aggression. One review author (AK) extracted data. For dichotomous data, one review author (AK) calculated risk ratios (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a fixed-effect model. One review author (AK) assessed risk of bias for included studies and created a 'Summary of findings' table using GRADE. We have no good-quality evidence of the absolute effectiveness of haloperidol for people with long-term aggression. One study randomising 110 chronically aggressive people to three different antipsychotic drugs met the inclusion criteria. When haloperidol was compared with olanzapine or clozapine, skewed data (n=83) at high risk of bias suggested some advantage in terms of scale scores of unclear clinical meaning for olanzapine/clozapine for 'total aggression'. Data were available for only one other outcome, leaving the study early. When compared with other antipsychotic drugs, people allocated to haloperidol were no more likely to leave the study

US-23 aggregate test road long-term performance evaluation : final report.

DOT National Transportation Integrated Search

2017-03-24

The US-23 Aggregate Test Road was constructed in 1992 with the main purpose to determine the influence of coarse : aggregate of varying frost susceptibility on long-term concrete durability. The pavement structure for the entire Test Road consists : ...

Long-term deconditioning of gas-filled surge arresters

NASA Astrophysics Data System (ADS)

Stanković, Koviljka; Brajović, Dragan; Alimpijević, Mališa; Lončar, Boris

2016-07-01

pressure that is as high as possible (with pd = const), and that the electrode active surface should have a marked microscopic topography. In addition to this, an essential conclusion for GFSA manufacturers is that long-term system deconditioning is caused by impurities and adsorbed gases that appear at electrode during the state of rest. Out of these two causes, the influence of impurities is probably the dominant one, which is proved by considerably reduced long-term deconditioning in the case of noble metal electrodes, not susceptible to corrosion. This has also been confirmed by a less distinct effect of long-term deconditioning in the case of sandblasted electrodes that have a stronger tendency towards gas adsorption and a weaker tendency towards corrosion. However, it has been shown that adding of the third electrode (that is concentric to the main electrode system) on a free floating potential along with usage of sandblasted electrodes and with smaller interelectrode distance significantly reduces the effects of the long-term deconditioning.

Taking stock of infections and antibiotic resistance in the elderly and long-term care facilities: A survey of existing and upcoming challenges.

PubMed

Augustine, S; Bonomo, R A

2011-09-01

Treating elderly patients with infections represents one of the greatest challenges to health-care providers. Older adults are the largest growing sector of the population and suffer excessively from infectious diseases such as pneumonia, urinary tract infections (UTIs), and skin and soft-tissue infections. Often because of disabilities, the elderly require treatment of infectious diseases in long-term care facilities (LTCFs). As a result of antibiotic use, LTCFs have become "reservoirs of resistance" and multi-drug resistant (MDR) pathogens are frequently recovered. Clinicians also need to be aware of the impairment of immune function and other emerging chronic infections (HIV, HCV) that are now present in the elderly. Despite vigilance regarding this issue, delays in diagnosis and initiation of therapy are common. This article reviews the changing landscape of infections in the elderly and the challenge these syndromes present in the context of an increasing older population that requires dedicated resources.

Biogeography and organic matter removal shape long-term effects of timber harvesting on forest soil microbial communities

Treesearch

Roland C Wilhelm; Erick Cardenas; Kendra R Maas; Hilary Leung; Larisa McNeil; Shannon Berch; William Chapman; Graeme Hope; J M Kranabetter; Stephane Dubé; Matt Busse; Robert Fleming; Paul Hazlett; Kara L Webster; David Morris; D Andrew Scott; William W Mohn

2017-01-01

The growing demand for renewable, carbon-neutral materials and energy is leading to intensified forest land-use. The long-term ecological challenges associated with maintaining soil fertility in managed forests are not yet known, in part due to the complexity of soil microbial communities and the heterogeneity of forest soils. This study determined the long-term...

Identification of a Functional Connectome for Long-Term Fear Memory in Mice

PubMed Central

Wheeler, Anne L.; Teixeira, Cátia M.; Wang, Afra H.; Xiong, Xuejian; Kovacevic, Natasa; Lerch, Jason P.; McIntosh, Anthony R.; Parkinson, John; Frankland, Paul W.

2013-01-01

Long-term memories are thought to depend upon the coordinated activation of a broad network of cortical and subcortical brain regions. However, the distributed nature of this representation has made it challenging to define the neural elements of the memory trace, and lesion and electrophysiological approaches provide only a narrow window into what is appreciated a much more global network. Here we used a global mapping approach to identify networks of brain regions activated following recall of long-term fear memories in mice. Analysis of Fos expression across 84 brain regions allowed us to identify regions that were co-active following memory recall. These analyses revealed that the functional organization of long-term fear memories depends on memory age and is altered in mutant mice that exhibit premature forgetting. Most importantly, these analyses indicate that long-term memory recall engages a network that has a distinct thalamic-hippocampal-cortical signature. This network is concurrently integrated and segregated and therefore has small-world properties, and contains hub-like regions in the prefrontal cortex and thalamus that may play privileged roles in memory expression. PMID:23300432

Different Methods for Long-term Systematic Assessment of Challenging Behaviors in People with Severe Intellectual Disability

PubMed Central

Delgado, Candida; Gonzalez-Gordon, Rodrigo G.; Aragón, Estívaliz; Navarro, Jose I.

2017-01-01

The aim of this study was to compare the advantages and disadvantages of different behavioral assessment procedures with the purpose of design a long-term assessment procedure that brings together the benefits observed. The study involved four adults with severe and profound intellectual disabilities and severe behavioral problems. A behavioral assessment has been carried out with Scatter Plot, Antecedent-Behavior-Consequence record sheets and, finally, The Observer XT. We conducted a comprehensive assessment of challenging behavior of each participant, by reviewing bio-psychosocial records, interviewing family and direct caregiver staff, as well as direct observation. A large inter-subject behavior variability and instability of intra-subject behavior were found, raising questions about the election of the period to evaluate. The first evaluation level highlighted information about stability of behavior, the second level stand out the context in which it occurs and the third level detailed the different topographies of each behavioral category. The results suggest the desirability of a continuous assessment by combining these three levels for adjusting to the specific characteristics of behavior. We suggest the need of designing a single behavioral assessment procedure that includes the benefits observed in each of the instruments used. PMID:28154543

Different Methods for Long-term Systematic Assessment of Challenging Behaviors in People with Severe Intellectual Disability.

PubMed

Delgado, Candida; Gonzalez-Gordon, Rodrigo G; Aragón, Estívaliz; Navarro, Jose I

2017-01-01

The aim of this study was to compare the advantages and disadvantages of different behavioral assessment procedures with the purpose of design a long-term assessment procedure that brings together the benefits observed. The study involved four adults with severe and profound intellectual disabilities and severe behavioral problems. A behavioral assessment has been carried out with Scatter Plot, Antecedent-Behavior-Consequence record sheets and, finally, The Observer XT. We conducted a comprehensive assessment of challenging behavior of each participant, by reviewing bio-psychosocial records, interviewing family and direct caregiver staff, as well as direct observation. A large inter-subject behavior variability and instability of intra-subject behavior were found, raising questions about the election of the period to evaluate. The first evaluation level highlighted information about stability of behavior, the second level stand out the context in which it occurs and the third level detailed the different topographies of each behavioral category. The results suggest the desirability of a continuous assessment by combining these three levels for adjusting to the specific characteristics of behavior. We suggest the need of designing a single behavioral assessment procedure that includes the benefits observed in each of the instruments used.

Long-term Blood Pressure Measurement in Freely Moving Mice Using Telemetry.

PubMed

Alam, Mohammad Afaque; Parks, Cory; Mancarella, Salvatore

2016-05-17

During the development of new vasoactive agents, arterial blood pressure monitoring is crucial for evaluating the efficacy of the new proposed drugs. Indeed, research focusing on the discovery of new potential therapeutic targets using genetically altered mice requires a reliable, long-term assessment of the systemic arterial pressure variation. Currently, the gold standard for obtaining long-term measurements of blood pressure in ambulatory mice uses implantable radio-transmitters, which require artery cannulation. This technique eliminates the need for tethering, restraining, or anesthetizing the animals which introduce stress and artifacts during data sampling. However, arterial blood pressure monitoring in mice via catheterization can be rather challenging due to the small size of the arteries. Here we present a step-by-step guide to illustrate the crucial key passages for a successful subcutaneous implantation of radio-transmitters and carotid artery cannulation in mice. We also include examples of long-term blood pressure activity taken from freely moving mice after a period of post-surgery recovery. Following this procedure will allow reliable direct blood pressure recordings from multiple animals simultaneously.

Establishing Long-Term Efficacy in Chronic Disease: Use of Recursive Partitioning and Propensity Score Adjustment to Estimate Outcome in MS

PubMed Central

Goodin, Douglas S.; Jones, Jason; Li, David; Traboulsee, Anthony; Reder, Anthony T.; Beckmann, Karola; Konieczny, Andreas; Knappertz, Volker

2011-01-01

Context Establishing the long-term benefit of therapy in chronic diseases has been challenging. Long-term studies require non-randomized designs and, thus, are often confounded by biases. For example, although disease-modifying therapy in MS has a convincing benefit on several short-term outcome-measures in randomized trials, its impact on long-term function remains uncertain. Objective Data from the 16-year Long-Term Follow-up study of interferon-beta-1b is used to assess the relationship between drug-exposure and long-term disability in MS patients. Design/Setting To mitigate the bias of outcome-dependent exposure variation in non-randomized long-term studies, drug-exposure was measured as the medication-possession-ratio, adjusted up or down according to multiple different weighting-schemes based on MS severity and MS duration at treatment initiation. A recursive-partitioning algorithm assessed whether exposure (using any weighing scheme) affected long-term outcome. The optimal cut-point that was used to define “high” or “low” exposure-groups was chosen by the algorithm. Subsequent to verification of an exposure-impact that included all predictor variables, the two groups were compared using a weighted propensity-stratified analysis in order to mitigate any treatment-selection bias that may have been present. Finally, multiple sensitivity-analyses were undertaken using different definitions of long-term outcome and different assumptions about the data. Main Outcome Measure Long-Term Disability. Results In these analyses, the same weighting-scheme was consistently selected by the recursive-partitioning algorithm. This scheme reduced (down-weighted) the effectiveness of drug exposure as either disease duration or disability at treatment-onset increased. Applying this scheme and using propensity-stratification to further mitigate bias, high-exposure had a consistently better clinical outcome compared to low-exposure (Cox proportional hazard ratio = 0.30�

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration.

PubMed

Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of

Long-term Agroecosystem Research in the Northern Great Plains.

NASA Astrophysics Data System (ADS)

Schmer, M.; Sanderson, M.; Liebig, M. A.; Wienhold, B.; Awada, T.; Papiernik, S.; Osborne, S.; Kemp, W.; Okalebo, J. A.; Riedall, W.

2015-12-01

The Northern Great Plains is the bread basket of the United States, accounting for a substantial portion of U.S. agricultural production. This region faces critical challenges regarding balancing food needs, resource conservation (e.g Ogallala aquifer), environmental concerns, and rural economy development. Developing transformative, multifunctional systems will require equally imaginative and efficient tools to help farmers manage complex agroecosystems in a rapidly changing climate. The Northern Plains long-term agroecosystem research (LTAR) site at Mandan, ND and the Platte River High Plains LTAR (ARS/University of Nebraska-Lincoln) at Lincoln, NE in collaboration with USDA-ARS research units in Brookings, SD and Fargo, ND are collaborating to address the grand challenge of providing and sustaining multiple service provisions from Northern Great Plains agroecosystems. We propose to attain these goals through sustainable intensification based on the adoption of conservation agriculture principles including reduced soil disturbance, livestock integration, and greater complexity and diversity in the cropping system. Here, we summarize new concepts these locations have pioneered in dynamic cropping systems, resource use efficiency, and agricultural management technologies. As part of the LTAR network, we will conduct long-term cross-site research to design and assess new agricultural practices and systems aimed at improving our understanding of decision making processes and outcomes across an array of agricultural systems.

Transcription Factors in Long-Term Memory and Synaptic Plasticity

PubMed Central

Alberini, Cristina M.

2013-01-01

Transcription is a molecular requisite for long-term synaptic plasticity and long-term memory formation. Thus, in the last several years, one main interest of molecular neuroscience has been the identification of families of transcription factors that are involved in both of these processes. Transcription is a highly regulated process that involves the combined interaction and function of chromatin and many other proteins, some of which are essential for the basal process of transcription, while others control the selective activation or repression of specific genes. These regulated interactions ultimately allow a sophisticated response to multiple environmental conditions, as well as control of spatial and temporal differences in gene expression. Evidence based on correlative changes in expression, genetic mutations, and targeted molecular inhibition of gene expression have shed light on the function of transcription in both synaptic plasticity and memory formation. This review provides a brief overview of experimental work showing that several families of transcription factors, including CREB, C/EBP, Egr, AP-1, and Rel have essential functions in both processes. The results of this work suggest that patterns of transcription regulation represent the molecular signatures of long-term synaptic changes and memory formation. PMID:19126756

Demand for Long-Term Care Insurance in China.

PubMed

Wang, Qun; Zhou, Yi; Ding, Xinrui; Ying, Xiaohua

2017-12-22

The aim of this study was to estimate willingness to pay (WTP) for long-term care insurance (LTCI) and to explore the determinants of demand for LTCI in China. We collected data from a household survey conducted in Qinghai and Zhejiang on a sample of 1842 households. We relied on contingent valuation methods to elicit the demand for LTCI and random effects logistic regression to analyze the factors associated with the demand for LTCI. Complementarily, we used document analysis to compare the LTCI designed in this study and the current LTCI policies in the pilot cities. More than 90% of the respondents expressed their willingness to buy LTCI. The median WTP for LTCI was estimated at 370.14 RMB/year, accounting for 2.29% of average annual per capita disposable income. Price, age, education status, and income were significantly associated with demand for LTCI. Most pilot cities were found to mainly rely on Urban Employees Basic Medical Insurance funds as the financing source for LTCI. Considering that financing is one of the greatest challenges in the development of China's LTCI, we suggest that policy makers consider individual contribution as an important and possible option as a source of financing for LTCI.

The case of value-based healthcare for people living with complex long-term conditions.

PubMed

Elf, Marie; Flink, Maria; Nilsson, Marie; Tistad, Malin; von Koch, Lena; Ytterberg, Charlotte

2017-01-11

There is a trend towards value-based health service, striving to cut costs while generating value for the patient. The overall objective comprises higher-quality health services and improved patient safety and cost efficiency. The approach could align with patient-centred care, as it entails a focus on the patient's experience of her or his entire cycle of care, including the use of well-defined outcome measurements. Challenges arise when the approach is applied to health services for people living with long-term complex conditions that require support from various healthcare services. The aim of this work is to critically discuss the value-based approach and its implications for patients with long-term complex conditions. Two cases from clinical practice and research form the foundation for our reasoning, illustrating several challenges regarding value-based health services for people living with long-term complex conditions. Achieving value-based health services that provide the health outcomes that matter to patients and providing greater patient-centredness will place increased demands on the healthcare system. Patients and their informal caregivers must be included in the development and establishment of outcome measures. The outcome measures must be standardized to allow evaluation of specific conditions at an aggregated level, but they must also be sensitive enough to capture each patient's individual needs and goals. Healthcare systems that strive to establish value-based services must collaborate beyond the organizational boundaries to create clear patient trajectories in order to avoid fragmentation. The shift towards value-based health services has the potential to align healthcare-service delivery with patient-centred care if serious efforts to take the patient's perspective into account are made. This is especially challenging in fragmented healthcare systems and for patients with long-term- and multi-setting-care needs.

Data collection and storage in long-term ecological and evolutionary studies: The Mongoose 2000 system.

PubMed

Marshall, Harry H; Griffiths, David J; Mwanguhya, Francis; Businge, Robert; Griffiths, Amber G F; Kyabulima, Solomon; Mwesige, Kenneth; Sanderson, Jennifer L; Thompson, Faye J; Vitikainen, Emma I K; Cant, Michael A

2018-01-01

Studying ecological and evolutionary processes in the natural world often requires research projects to follow multiple individuals in the wild over many years. These projects have provided significant advances but may also be hampered by needing to accurately and efficiently collect and store multiple streams of the data from multiple individuals concurrently. The increase in the availability and sophistication of portable computers (smartphones and tablets) and the applications that run on them has the potential to address many of these data collection and storage issues. In this paper we describe the challenges faced by one such long-term, individual-based research project: the Banded Mongoose Research Project in Uganda. We describe a system we have developed called Mongoose 2000 that utilises the potential of apps and portable computers to meet these challenges. We discuss the benefits and limitations of employing such a system in a long-term research project. The app and source code for the Mongoose 2000 system are freely available and we detail how it might be used to aid data collection and storage in other long-term individual-based projects.

Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities.

PubMed

O'Riley, Alisa; Nadorff, Michael R; Conwell, Yeates; Edelstein, Barry

2013-06-01

Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents' responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting.

The Long-Term Budget Outlook

DTIC Science & Technology

2005-12-01

Revenues Under CBO’s Long-Term Budget Scenarios 56A-8. Real Gross Domestic Product Under CBO’s Long-Term Budget Scenarios 57A-9. Total Surplus or...scenarios suggest that total federal spending for Medicare and Medicaid in 2050 could range anywhere from 7 percent of gross domestic product (GDP)—a...see the Congressional Budget Office’s glossary of budgetary and economic terms, available at www.cbo.gov. 2. The future path of productivity growth

Predicting long-term outcome of Internet-delivered cognitive behavior therapy for social anxiety disorder using fMRI and support vector machine learning.

PubMed

Månsson, K N T; Frick, A; Boraxbekk, C-J; Marquand, A F; Williams, S C R; Carlbring, P; Andersson, G; Furmark, T

2015-03-17

Cognitive behavior therapy (CBT) is an effective treatment for social anxiety disorder (SAD), but many patients do not respond sufficiently and a substantial proportion relapse after treatment has ended. Predicting an individual's long-term clinical response therefore remains an important challenge. This study aimed at assessing neural predictors of long-term treatment outcome in participants with SAD 1 year after completion of Internet-delivered CBT (iCBT). Twenty-six participants diagnosed with SAD underwent iCBT including attention bias modification for a total of 13 weeks. Support vector machines (SVMs), a supervised pattern recognition method allowing predictions at the individual level, were trained to separate long-term treatment responders from nonresponders based on blood oxygen level-dependent (BOLD) responses to self-referential criticism. The Clinical Global Impression-Improvement scale was the main instrument to determine treatment response at the 1-year follow-up. Results showed that the proportion of long-term responders was 52% (12/23). From multivariate BOLD responses in the dorsal anterior cingulate cortex (dACC) together with the amygdala, we were able to predict long-term response rate of iCBT with an accuracy of 92% (confidence interval 95% 73.2-97.6). This activation pattern was, however, not predictive of improvement in the continuous Liebowitz Social Anxiety Scale-Self-report version. Follow-up psychophysiological interaction analyses revealed that lower dACC-amygdala coupling was associated with better long-term treatment response. Thus, BOLD response patterns in the fear-expressing dACC-amygdala regions were highly predictive of long-term treatment outcome of iCBT, and the initial coupling between these regions differentiated long-term responders from nonresponders. The SVM-neuroimaging approach could be of particular clinical value as it allows for accurate prediction of treatment outcome at the level of the individual.

Long-term outcomes after severe shock.

PubMed

Pratt, Cristina M; Hirshberg, Eliotte L; Jones, Jason P; Kuttler, Kathryn G; Lanspa, Michael J; Wilson, Emily L; Hopkins, Ramona O; Brown, Samuel M

2015-02-01

Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Seventy-six patients who were alive 90 days after severe shock (received ≥1 μg/kg per minute of norepinephrine equivalent) were eligible for the study. We measured 3-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised, and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. The mean long-term survival was 5.1 years; 82% (62 of 76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of 5 years after hospital admission. The patients' Physical Functioning scores were below U.S. population norms (P < 0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety, and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full-time. Early survivors of severe shock had a high 3-year survival rate. Patients' long-term physical and psychological outcomes were similar to those reported for cohorts of less severely ill intensive care unit survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term outcomes. Even extremely

Short-term Action Intentions Overrule Long-Term Semantic Knowledge

ERIC Educational Resources Information Center

van Elk, M.; van Schie, H.T.; Bekkering, H.

2009-01-01

In the present study, we investigated whether the preparation of an unusual action with an object (e.g. bringing a cup towards the eye) could selectively overrule long-term semantic representations. In the first experiment it was found that unusual action intentions activated short-term semantic goal representations, rather than long-term…

Long-term functioning following whiplash injury: the role of social support and personality traits.

PubMed

Nijs, Jo; Inghelbrecht, Els; Daenen, Liesbeth; Hachimi-Idrissi, Said; Hens, Luc; Willems, Bert; Roussel, Nathalie; Cras, Patrick; Bernheim, Jan

2011-07-01

Transition from acute whiplash injury to either recovery or chronicity and the development of chronic whiplash-associated disorders (WAD) remains a challenging issue for researchers and clinicians. The roles of social support and personality traits in long-term functioning following whiplash have not been studied concomitantly. The present study aimed to examine whether social support and personality traits are related to long-term functioning following whiplash. One hundred forty-three subjects, who had experienced a whiplash injury in a traffic accident 10-26 months before the study took place, participated. The initial diagnoses were a 'sprain of the neck' (ICD-9 code 847.0); only the outcome of grades I-III acute WAD was studied. Long-term functioning was considered within the biopsychosocial model: it was expressed in terms of disability, functional status, quality of life and psychological well-being. Participants filled out a set of questionnaires to measure the long-term functioning parameters (i.e. the Neck Disability Index, Medical Outcome Study Short-Form General Health Survey, Anamnestic Comparative Self-Assessment measure of overall well-being and the Symptom Checklist-90) and potential determinants of long-term functioning (the Dutch Personality Questionnaire and the Social Support List). The results suggest that social support (especially the discrepancies dimension of social support) and personality traits (i.e. inadequacy, self-satisfaction and resentment) are related to long-term functioning following whiplash injury (Spearman rho varied between 0.32 and 0.57; p < 0.01). Within the discrepancy dimension, everyday emotional support, emotional support during problems, appreciative support and informative support were identified as important correlates of long-term functioning. Future prospective studies are required to confirm the role of social support and personality traits in relation to long-term functioning following whiplash. For such

Compensation for PKMζ in long-term potentiation and spatial long-term memory in mutant mice.

PubMed

Tsokas, Panayiotis; Hsieh, Changchi; Yao, Yudong; Lesburguères, Edith; Wallace, Emma Jane Claire; Tcherepanov, Andrew; Jothianandan, Desingarao; Hartley, Benjamin Rush; Pan, Ling; Rivard, Bruno; Farese, Robert V; Sajan, Mini P; Bergold, Peter John; Hernández, Alejandro Iván; Cottrell, James E; Shouval, Harel Z; Fenton, André Antonio; Sacktor, Todd Charlton

2016-05-17

PKMζ is a persistently active PKC isoform proposed to maintain late-LTP and long-term memory. But late-LTP and memory are maintained without PKMζ in PKMζ-null mice. Two hypotheses can account for these findings. First, PKMζ is unimportant for LTP or memory. Second, PKMζ is essential for late-LTP and long-term memory in wild-type mice, and PKMζ-null mice recruit compensatory mechanisms. We find that whereas PKMζ persistently increases in LTP maintenance in wild-type mice, PKCι/λ, a gene-product closely related to PKMζ, persistently increases in LTP maintenance in PKMζ-null mice. Using a pharmacogenetic approach, we find PKMζ-antisense in hippocampus blocks late-LTP and spatial long-term memory in wild-type mice, but not in PKMζ-null mice without the target mRNA. Conversely, a PKCι/λ-antagonist disrupts late-LTP and spatial memory in PKMζ-null mice but not in wild-type mice. Thus, whereas PKMζ is essential for wild-type LTP and long-term memory, persistent PKCι/λ activation compensates for PKMζ loss in PKMζ-null mice.

Long-term consequences of pain in human neonates.

PubMed

Grunau, Ruth E; Holsti, Liisa; Peters, Jeroen W B

2006-08-01

The low tactile threshold in preterm infants when they are in the neonatal intensive care unit (NICU), while their physiological systems are unstable and immature, potentially renders them more vulnerable to the effects of repeated invasive procedures. There is a small but growing literature on pain and tactile responsivity following procedural pain in the NICU, or early surgery. Long-term effects of repeated pain in the neonatal period on neurodevelopment await further research. However, there are multiple sources of stress in the NICU, which contribute to inducing high overall 'allostatic load', therefore determining specific effects of neonatal pain in human infants is challenging.

Using Workflow Diagrams to Address Hand Hygiene in Pediatric Long-Term Care Facilities1

PubMed Central

Carter, Eileen J.; Cohen, Bevin; Murray, Meghan T.; Saiman, Lisa; Larson, Elaine L.

2015-01-01

Hand hygiene (HH) in pediatric long-term care settings has been found to be sub-optimal. Multidisciplinary teams at three pediatric long-term care facilities developed step-by-step workflow diagrams of commonly performed tasks highlighting HH opportunities. Diagrams were validated through observation of tasks and concurrent diagram assessment. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene. The development of workflow diagrams is an opportunity to identify and address the complexity of HH in pediatric long-term care facilities. PMID:25773517

Estimating long-term multivariate progression from short-term data.

PubMed

Donohue, Michael C; Jacqmin-Gadda, Hélène; Le Goff, Mélanie; Thomas, Ronald G; Raman, Rema; Gamst, Anthony C; Beckett, Laurel A; Jack, Clifford R; Weiner, Michael W; Dartigues, Jean-François; Aisen, Paul S

2014-10-01

Diseases that progress slowly are often studied by observing cohorts at different stages of disease for short periods of time. The Alzheimer's Disease Neuroimaging Initiative (ADNI) follows elders with various degrees of cognitive impairment, from normal to impaired. The study includes a rich panel of novel cognitive tests, biomarkers, and brain images collected every 6 months for as long as 6 years. The relative timing of the observations with respect to disease pathology is unknown. We propose a general semiparametric model and iterative estimation procedure to estimate simultaneously the pathological timing and long-term growth curves. The resulting estimates of long-term progression are fine-tuned using cognitive trajectories derived from the long-term "Personnes Agées Quid" study. We demonstrate with simulations that the method can recover long-term disease trends from short-term observations. The method also estimates temporal ordering of individuals with respect to disease pathology, providing subject-specific prognostic estimates of the time until onset of symptoms. When the method is applied to ADNI data, the estimated growth curves are in general agreement with prevailing theories of the Alzheimer's disease cascade. Other data sets with common outcome measures can be combined using the proposed algorithm. Software to fit the model and reproduce results with the statistical software R is available as the grace package. ADNI data can be downloaded from the Laboratory of NeuroImaging. Copyright © 2014 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program

NASA Astrophysics Data System (ADS)

Gosz, J.

2001-12-01

The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage

Geocoronal hydrogen studies using Fabry Perot interferometers, part 2: Long-term observations

NASA Astrophysics Data System (ADS)

Nossal, S. M.; Mierkiewicz, E. J.; Roesler, F. L.; Reynolds, R. J.; Haffner, L. M.

2006-09-01

Long-term data sets are required to investigate sources of natural variability in the upper atmosphere. Understanding the influence of sources of natural variability such as the solar cycle is needed to characterize the thermosphere + exosphere, to understand coupling processes between atmospheric regions, and to isolate signatures of natural variability from those due to human-caused change. Multi-year comparisons of thermospheric + exospheric Balmer α emissions require cross-calibrated and well-understood instrumentation, a stable calibration source, reproducible observing conditions, separation of the terrestrial from the Galactic emission line, and consistent data analysis accounting for differences in viewing geometry. We discuss how we address these criteria in the acquisition and analysis of a mid-latitude geocoronal Balmer α column emission data set now spanning two solar cycles and taken mainly from Wisconsin and Kitt Peak, Arizona. We also discuss results and outstanding challenges for increasing the accuracy and use of these observations.

Long-Term Opioid Therapy Reconsidered

PubMed Central

Von Korff, Michael; Kolodny, Andrew; Deyo, Richard A.; Chou, Roger

2012-01-01

In the past 20 years, primary care physicians have greatly increased prescribing of long-term opioid therapy. However, the rise in opioid prescribing has outpaced the evidence regarding this practice. Increased opioid availability has been accompanied by an epidemic of opioid abuse and overdose. The rate of opioid addiction among patients receiving long-term opioid therapy remains unclear, but research suggests that opioid misuse is not rare. Recent studies report increased risks for serious adverse events, including fractures, cardiovascular events, and bowel obstruction, although further research on medical risks is needed. New data indicate that opioid-related risks may increase with dose. From a societal perspective, higher-dose regimens account for the majority of opioids dispensed, so cautious dosing may reduce both diversion potential and patient risks for adverse effects. Limiting long-term opioid therapy to patients for whom it provides decisive benefits could also reduce risks. Given the warning signs and knowledge gaps, greater caution and selectivity are needed in prescribing long-term opioid therapy. Until stronger evidence becomes available, clinicians should err on the side of caution when considering this treatment. PMID:21893626

An overview of morbidity, mortality and long-term outcome of late preterm birth.

PubMed

Dong, Ying; Yu, Jia-Lin

2011-08-01

Preterm birth rate continues to rise around the world mainly at the expense of late preterm newborns, recently defined as births between the gestational age of 34 weeks and 36-6/7 weeks. Late preterm infants are considered to have significantly more short-term and longterm adverse outcomes than term infants. Articles concerning morbidity, mortality and long-term outcomes of late preterm infants were retrieved from PubMed/MEDLINE published during the period of 2000-2010. Late preterm infants are the fastest growing subgroup of neonates, comprising the majority of all preterm births. Compared with term infants, they have significantly higher risk of morbidity, mortality and adverse long-term outcomes well beyond infancy into adulthood. However, epidemiology and etiology of late preterm births, the magnitude of their morbidity, the long-term life quality, and public health impact have not been well studied. The growing number of late preterm neonates substantiates the importance to better understand and medically approach this special preterm subgroup. A long-term evaluation, monitoring and follow-up of late preterm infants are needed to optimize neonatal care and improve human health status.

Very long-term sequelae of craniopharyngioma.

PubMed

Wijnen, Mark; van den Heuvel-Eibrink, Marry M; Janssen, Joseph A M J L; Catsman-Berrevoets, Coriene E; Michiels, Erna M C; van Veelen-Vincent, Marie-Lise C; Dallenga, Alof H G; van den Berge, J Herbert; van Rij, Carolien M; van der Lely, Aart-Jan; Neggers, Sebastian J C M M

2017-06-01

Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Cross-sectional study based on retrospective data. We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5-23 years). Initial craniopharyngioma treatment approaches included gross total resection ( n  = 25), subtotal resection without radiotherapy ( n  = 44), subtotal resection with radiotherapy ( n  = 25), cyst aspiration without radiotherapy ( n  = 8), and 90 Yttrium brachytherapy ( n  = 21). Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood- and adult-onset craniopharyngioma. Long-term health conditions were comparable after

Long-term individual recovery for the IRAS mission

NASA Technical Reports Server (NTRS)

Lau, C. O.; Wolff, D. M.

1984-01-01

IRAS (Infrared Astronomical Satellite) was launched on January 25, 1983 with the primary purpose of performing an infrared survey of the entire celestial sphere. Holes were left in the main survey when some areas received less than the minimum 2-layer coverage. A second survey filled in many of these holes; however, many still required long-term individual recovery. The result was a smooth survey with 96 percent of the sky covered to the desired depth of 2 or more layers.

Long-term care in international perspective.

PubMed

Doty, P

1988-12-01

The findings of a study of long-term care policies in 18 countries are reported in this article. Initial data were collected by a questionnaire survey under the auspices of the International Social Security Association. These data were supplemented by published documents and government statistics obtained while researching long-term care for the International Social Security Association and, subsequently, for the Organization for Economic Cooperation and Development. The principal focus is a cross-national comparison of institutionalization rates for the elderly. Differences in use rates for medically oriented facilities are less than those for nonmedical residential long-term care facilities. Only a small amount of variation is related to demographic differences, such as older or more female elderly populations in those countries with higher institutionalization rates. Included also is a description of the modes of financing long-term care.

Compensation for PKMζ in long-term potentiation and spatial long-term memory in mutant mice

PubMed Central

Tsokas, Panayiotis; Hsieh, Changchi; Yao, Yudong; Lesburguères, Edith; Wallace, Emma Jane Claire; Tcherepanov, Andrew; Jothianandan, Desingarao; Hartley, Benjamin Rush; Pan, Ling; Rivard, Bruno; Farese, Robert V; Sajan, Mini P; Bergold, Peter John; Hernández, Alejandro Iván; Cottrell, James E; Shouval, Harel Z; Fenton, André Antonio; Sacktor, Todd Charlton

2016-01-01

PKMζ is a persistently active PKC isoform proposed to maintain late-LTP and long-term memory. But late-LTP and memory are maintained without PKMζ in PKMζ-null mice. Two hypotheses can account for these findings. First, PKMζ is unimportant for LTP or memory. Second, PKMζ is essential for late-LTP and long-term memory in wild-type mice, and PKMζ-null mice recruit compensatory mechanisms. We find that whereas PKMζ persistently increases in LTP maintenance in wild-type mice, PKCι/λ, a gene-product closely related to PKMζ, persistently increases in LTP maintenance in PKMζ-null mice. Using a pharmacogenetic approach, we find PKMζ-antisense in hippocampus blocks late-LTP and spatial long-term memory in wild-type mice, but not in PKMζ-null mice without the target mRNA. Conversely, a PKCι/λ-antagonist disrupts late-LTP and spatial memory in PKMζ-null mice but not in wild-type mice. Thus, whereas PKMζ is essential for wild-type LTP and long-term memory, persistent PKCι/λ activation compensates for PKMζ loss in PKMζ-null mice. DOI: http://dx.doi.org/10.7554/eLife.14846.001 PMID:27187150

Competitive short-term and long-term memory processes in spatial habituation.

PubMed

Sanderson, David J; Bannerman, David M

2011-04-01

Exposure to a spatial location leads to habituation of exploration such that, in a novelty preference test, rodents subsequently prefer exploring a novel location to the familiar location. According to Wagner's (1981) theory of memory, short-term and long-term habituation are caused by separate and sometimes opponent processes. In the present study, this dual-process account of memory was tested. Mice received a series of exposure training trials to a location before receiving a novelty preference test. The novelty preference was greater when tested after a short, rather than a long, interval. In contrast, the novelty preference was weaker when exposure training trials were separated by a short, rather than a long interval. Furthermore, it was found that long-term habituation was determined by the independent effects of the amount of exposure training and the number of exposure training trials when factors such as the intertrial interval and the cumulative intertrial interval were controlled. A final experiment demonstrated that a long-term reduction of exploration could be caused by a negative priming effect due to associations formed during exploration. These results provide evidence against a single-process account of habituation and suggest that spatial habituation is determined by both short-term, recency-based memory and long-term, incrementally strengthened memory.

Long-term Kinetics of Uranyl Desorption from Sediments Under Advective Conditions

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

Shang, Jianying; Liu, Chongxuan; Wang, Zheming

2014-02-15

Long-term (> 4 months) column experiments were performed to investigate the kinetics of uranyl (U(VI)) desorption in sediments collected from the Integrated Field Research Challenge (IFRC) site at the US Department of Energy (DOE) Hanford 300 Area. The experimental results were used to evaluate alternative multi-rate surface complexation reaction (SCR) approaches to describe the short- and long-term kinetics of U(VI) desorption under flow conditions. The SCR stoichiometry, equilibrium constants, and multi-rate parameters were independently characterized in batch and stirred flow-cell reactors. Multi-rate SCR models that were either additively constructed using the SCRs for individual size fractions (e.g., Shang et al.,more » 2011), or composite in nature could effectively describe short-term U(VI) desorption under flow conditions. The long-term desorption results, however, revealed that using a labile U concentration measured by carbonate extraction under-estimated desorbable U(VI) and the long-term rate of U(VI) desorption. An alternative modeling approach using total U as the desorbable U(VI) concentration was proposed to overcome this difficulty. This study also found that the gravel size fraction (2-8 mm), which is typically treated as non-reactive in modeling U(VI) reactive transport because of low external surface area, can have an important effect on the U(VI) desorption in the sediment. This study demonstrates an approach to effectively extrapolate U(VI) desorption kinetics for field-scale application, and identifies important parameters and uncertainties affecting model predictions.« less

Data collection and storage in long-term ecological and evolutionary studies: The Mongoose 2000 system

PubMed Central

Griffiths, David J.; Mwanguhya, Francis; Businge, Robert; Griffiths, Amber G. F.; Kyabulima, Solomon; Mwesige, Kenneth; Sanderson, Jennifer L.; Thompson, Faye J.; Vitikainen, Emma I. K.; Cant, Michael A.

2018-01-01

Studying ecological and evolutionary processes in the natural world often requires research projects to follow multiple individuals in the wild over many years. These projects have provided significant advances but may also be hampered by needing to accurately and efficiently collect and store multiple streams of the data from multiple individuals concurrently. The increase in the availability and sophistication of portable computers (smartphones and tablets) and the applications that run on them has the potential to address many of these data collection and storage issues. In this paper we describe the challenges faced by one such long-term, individual-based research project: the Banded Mongoose Research Project in Uganda. We describe a system we have developed called Mongoose 2000 that utilises the potential of apps and portable computers to meet these challenges. We discuss the benefits and limitations of employing such a system in a long-term research project. The app and source code for the Mongoose 2000 system are freely available and we detail how it might be used to aid data collection and storage in other long-term individual-based projects. PMID:29315317

Short-term versus long-term rainfall time series in the assessment of potable water savings by using rainwater in houses.

PubMed

Ghisi, Enedir; Cardoso, Karla Albino; Rupp, Ricardo Forgiarini

2012-06-15

The main objective of this article is to assess the possibility of using short-term instead of long-term rainfall time series to evaluate the potential for potable water savings by using rainwater in houses. The analysis was performed considering rainfall data from 1960 to 1995 for the city of Santa Bárbara do Oeste, located in the state of São Paulo, southeastern Brazil. The influence of the rainfall time series, roof area, potable water demand and percentage rainwater demand on the potential for potable water savings was evaluated. The potential for potable water savings was estimated using computer simulations considering a set of long-term rainfall time series and different sets of short-term rainfall time series. The ideal rainwater tank capacity was also assessed for some cases. It was observed that the higher the percentage rainwater demand and the shorter the rainfall time series, the larger the difference between the potential for potable water savings and the greater the variation in the ideal rainwater tank size. The sets of short-term rainfall time series considered adequate for different scenarios ranged from 1 to 13 years depending on the roof area, percentage rainwater demand and potable water demand. The main finding of the research is that sets of short-term rainfall time series can be used to assess the potential for potable water savings by using rainwater, as the results obtained are similar to those obtained from the long-term rainfall time series. Copyright © 2012 Elsevier Ltd. All rights reserved.

Meteorological fluctuations define long-term crop yield patterns in conventional and organic production systems

USDA-ARS?s Scientific Manuscript database

Periodic variability in meteorological patterns presents significant challenges to crop production consistency and yield stability. Meteorological influences on corn and soybean grain yields were analyzed over an 18-year period at a long-term experiment in Beltsville, Maryland, U.S.A., comparing c...

'We just do the dirty work': dealing with incontinence, courtesy stigma and the low occupational status of carework in long-term aged care facilities.

PubMed

Ostaszkiewicz, Joan; O'Connell, Beverly; Dunning, Trisha

2016-09-01

To systematically examine, describe and explain how continence care was determined, delivered and communicated in Australian long aged care facilities. Incontinence is a highly stigmatising condition that affects a disproportionally large number of people living in long-term aged care facilities. Its day-to-day management is mainly undertaken by careworkers. We conducted a Grounded theory study to explore how continence care was determined, delivered and communicated in long-term aged care facilities. This paper presents one finding, i.e. how careworkers in long-term aged care facilities deal with the stigma, devaluation and the aesthetically unpleasant aspects of their work. Grounded theory. Eighty-eight hours of field observations in two long-term aged care facilities in Australia. In addition, in-depth interviews with 18 nurses and careworkers who had experience of providing, supervising or assessment of continence care in any long-term aged care facility in Australia. Occupational exposure to incontinence contributes to the low occupational status of carework in long-term aged care facilities, and continence care is a symbolic marker for inequalities within the facility, the nursing profession and society at large. Careworkers' affective and behavioural responses are characterised by: (1) accommodating the context; (2) dissociating oneself; (3) distancing oneself and (4) attempting to elevate one's role status. The theory extends current understandings about the links between incontinence, continence care, courtesy stigma, emotional labour and the low occupational status of carework in long-term aged care facilities. This study provides insights into the ways in which tacit beliefs and values about incontinence, cleanliness and contamination may affect the social organisation and delivery of care in long-term aged care facilities. Nurse leaders should challenge the stigma and devaluation of carework and careworkers, and reframe carework as 'dignity work'. �

Long-term Effect of Biomineralized Insulin Nanoparticles on Type 2 Diabetes Treatment

PubMed Central

Xiao, Yun; Wang, Xiaoyu; Wang, Ben; Liu, Xueyao; Xu, Xurong; Tang, Ruikang

2017-01-01

Intracellular insulin may exhibit a long-term effect in regulating protein synthesis, DNA synthesis, and gene transcription. However, the intracellular delivery of insulin is a great challenge. Here, we describe how a simple biomineralization modification of insulin can transport it into intact cells on a large scale, leading to a long-term therapeutic effect on diabetes mellitus. Using insulin-resistant HepG2 cell and diabetic KKAy mice as models, in vitro and in vivo assessments have demonstrated that biomineralized insulin nanoparticles can trigger glucose metabolism, and this improvement extends after the treatment. The potential exists to improve the current treatment of type 2 diabetes mellitus through biomineralized modifications of insulin. This study provides a new paradigm of biomimetic nanotechnology for biomedical applications. PMID:29158827

Business Students' Choice of Short-Term or Long-Term Study Abroad Opportunities

ERIC Educational Resources Information Center

Fitzsimmons, Stacey R.; Flanagan, David J.; Wang, Xiaodan

2013-01-01

Recent years have seen a proliferation of short-term study abroad opportunities. Although they are both supplementing and replacing semester-long study abroad programs, research has focused primarily on semester (long-term) programs. We draw on the theory of planned behavior (TPB) to explore factors that predict why students choose long-term and…

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration

PubMed Central

Sullivan, Jennifer L.; Adjognon, Omonyêlé L.; Engle, Ryann L.; Shin, Marlena H.; Afable, Melissa K.; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

2018-01-01

Background: From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. Purpose: The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Methodology: Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. Results: The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. Discussion: This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e

Long Periodic Terms in the Solar System

NASA Technical Reports Server (NTRS)

Bretagnon, P.

1982-01-01

The long period variations of the first eight planets in the solar system are studied. First, the Lagrangian solution is calculated and then the long period terms with fourth order eccentricities and inclinations are introduced into the perturbation function. A second approximation was made taking into account the short period terms' contribution, namely the perturbations of first order with respect to the masses. Special attention was paid to the determination of the integration constants. The relative importance of the different contributions is shown. It is useless, for example, to introduce the long period terms of fifth order if no account has been taken of the short period terms. Meanwhile, the terms that have been neglected would not introduce large changes in the integration constants. Even so, the calculation should be repeated with higher order short period terms and fifth order long periods.

Long-Term Hearing Results After Ossiculoplasty.

PubMed

Cox, Matthew D; Trinidade, Aaron; Russell, James Shep; Dornhoffer, John L

2017-04-01

To determine if the OOPS index is predictive of long-term hearing results after ossiculoplasty. Case series with retrospective chart review. Tertiary care otology practice. Adult and pediatric patients (3-88 years of age). Ossiculoplasty with cartilage tympanoplasty, with or without mastoidectomy. Primary outcome measures included short-term hearing results (pure-tone average air-bone gap [PTA-ABG] measured between 60 days and 1 year after surgery), long-term hearing results (PTA-ABG measured ≥5 years after surgery), and the rate of successful ABG closure to ≤20 dB. Secondary measures included the need for revision surgery, delayed tympanic membrane graft failure, worsening conductive hearing loss (after an initially satisfactory hearing result), and recurrence of cholesteatoma. There was no significant difference between adults and children for short-term hearing results (average post-op PTA-ABG was 18.9 dB vs. 19.8 dB, respectively; p = 0.544), long-term hearing results (average final PTA-ABG was 19.3 dB vs. 19.4 dB, respectively; p = 0.922), or rate of ABG closure to less than 20 dB (63.1% vs. 58.0%, p = 0.282). Spearman's rank-order correlation (ρ) identified a strong positive correlation between OOPS index score and average post-operative PTA-ABG (ρ = 0.983; p < 0.001; 2-tailed), as well as average long-term PTA-ABG (ρ = 0.950, p < 0.001; 2-tailed). The OOPS index makes it possible to accurately prognosticate hearing outcomes in adult and pediatric patients undergoing ossiculoplasty in both the short term and the long term.

Short-term memory and long-term memory are still different.

PubMed

Norris, Dennis

2017-09-01

A commonly expressed view is that short-term memory (STM) is nothing more than activated long-term memory. If true, this would overturn a central tenet of cognitive psychology-the idea that there are functionally and neurobiologically distinct short- and long-term stores. Here I present an updated case for a separation between short- and long-term stores, focusing on the computational demands placed on any STM system. STM must support memory for previously unencountered information, the storage of multiple tokens of the same type, and variable binding. None of these can be achieved simply by activating long-term memory. For example, even a simple sequence of digits such as "1, 3, 1" where there are 2 tokens of the digit "1" cannot be stored in the correct order simply by activating the representations of the digits "1" and "3" in LTM. I also review recent neuroimaging data that has been presented as evidence that STM is activated LTM and show that these data are exactly what one would expect to see based on a conventional 2-store view. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Short-Term Memory and Long-Term Memory are Still Different

PubMed Central

2017-01-01

A commonly expressed view is that short-term memory (STM) is nothing more than activated long-term memory. If true, this would overturn a central tenet of cognitive psychology—the idea that there are functionally and neurobiologically distinct short- and long-term stores. Here I present an updated case for a separation between short- and long-term stores, focusing on the computational demands placed on any STM system. STM must support memory for previously unencountered information, the storage of multiple tokens of the same type, and variable binding. None of these can be achieved simply by activating long-term memory. For example, even a simple sequence of digits such as “1, 3, 1” where there are 2 tokens of the digit “1” cannot be stored in the correct order simply by activating the representations of the digits “1” and “3” in LTM. I also review recent neuroimaging data that has been presented as evidence that STM is activated LTM and show that these data are exactly what one would expect to see based on a conventional 2-store view. PMID:28530428

Numerical simulation of gender differences in a long-term microgravity exposure

NASA Astrophysics Data System (ADS)

Perez-Poch, Antoni

The objective of this work is to analyse and simulate gender differences when individuals are exposed to long-term microgravity. Risk probability of a health impairment which may put in jeopardy a long-term mission is also evaluated. Computer simulations are becoming a promising research line of work, as physiological models become more and more sophisticated and reliable. Technological advances in state-of-the-art hardware technology and software allow nowadays for better and more accurate simulations of complex phenomena, such as the response of the human cardiovascular system to long-term exposure to microgravity. Experimental data for long-term missions are difficult to achieve and reproduce, therefore the predictions of computer simulations are of a major importance in this field. Our approach is based on a previous model developed and implemented in our laboratory (NELME: Numerical Evaluation of Long-term Microgravity Effects). The software simulates the behaviour of the cardiovascular system and different human organs, has a modular architecture, and allows to introduce perturbations such as physical exercise or countermeasures. The implementation is based on a complex electricallike model of this control system, using inexpensive software development frameworks, and has been tested and validated with the available experimental data. Gender differences have been implemented for this specific work, as an adjustment of a number of parameters that are included in the model. Women versus men physiological differences have been therefore taken into account, based upon estimations from the physiology bibliography. A number of simulations have been carried out for long-term exposure to microgravity. Gravity varying from Earth-based to zero, and time exposure are the two main variables involved in the construction of results, including responses to patterns of physical aerobical exercise, and also thermal stress simulating an extra-vehicular activity. Results show

Long-term object tracking combined offline with online learning

NASA Astrophysics Data System (ADS)

Hu, Mengjie; Wei, Zhenzhong; Zhang, Guangjun

2016-04-01

We propose a simple yet effective method for long-term object tracking. Different from the traditional visual tracking method, which mainly depends on frame-to-frame correspondence, we combine high-level semantic information with low-level correspondences. Our framework is formulated in a confidence selection framework, which allows our system to recover from drift and partly deal with occlusion. To summarize, our algorithm can be roughly decomposed into an initialization stage and a tracking stage. In the initialization stage, an offline detector is trained to get the object appearance information at the category level, which is used for detecting the potential target and initializing the tracking stage. The tracking stage consists of three modules: the online tracking module, detection module, and decision module. A pretrained detector is used for maintaining drift of the online tracker, while the online tracker is used for filtering out false positive detections. A confidence selection mechanism is proposed to optimize the object location based on the online tracker and detection. If the target is lost, the pretrained detector is utilized to reinitialize the whole algorithm when the target is relocated. During experiments, we evaluate our method on several challenging video sequences, and it demonstrates huge improvement compared with detection and online tracking only.

Challenges faced in long term ventricular assist device support.

PubMed

Ikegami, Hirohisa; Kurlansky, Paul; Takeda, Koji; Naka, Yoshifumi

2016-08-01

The development of ventricular assist device (VAD) has been one of the revolutionary advancements in end-stage heart failure management. Although the device has developed and improved significantly over the last few decades, we still face multiple challenges. This review will discuss quality of life, survival, and clinically encountered complications in patients with VAD support. The literature was extensively reviewed for studies describing the above topic area. We describe the impact of major challenges faced in VAD support and discuss their future and expectations. Expert commentary: The technological advancement of VADs has contributed to major improvement of overall survival, enhancement of quality of life and decrease of incidence of complications. It is expected that technologies will continue to evolve. At the same time, the indications for and timing of device implantation, and selection of device type are continuously important in clinical practice setting.

Long-Term Memory Performance in Adult ADHD.

PubMed

Skodzik, Timo; Holling, Heinz; Pedersen, Anya

2017-02-01

Memory problems are a frequently reported symptom in adult ADHD, and it is well-documented that adults with ADHD perform poorly on long-term memory tests. However, the cause of this effect is still controversial. The present meta-analysis examined underlying mechanisms that may lead to long-term memory impairments in adult ADHD. We performed separate meta-analyses of measures of memory acquisition and long-term memory using both verbal and visual memory tests. In addition, the influence of potential moderator variables was examined. Adults with ADHD performed significantly worse than controls on verbal but not on visual long-term memory and memory acquisition subtests. The long-term memory deficit was strongly statistically related to the memory acquisition deficit. In contrast, no retrieval problems were observable. Our results suggest that memory deficits in adult ADHD reflect a learning deficit induced at the stage of encoding. Implications for clinical and research settings are presented.

[Predictors of long-term remission after transsphenoidal surgery in Cushing's disease].

PubMed

Abellán Galiana, Pablo; Fajardo Montañana, Carmen; Riesgo Suárez, Pedro Antonio; Gómez Vela, José; Escrivá, Carlos Meseguer; Lillo, Vicente Rovira

2013-10-01

There is no consensus on the remission criteria for Cushing's disease or on the definition of disease recurrence after transsphenoidal surgery, and comparison of the different published series is therefore difficult. A long-term recurrence rate of Cushing's disease ranging from 2%-25% has been reported. Predictors of long-term remission reported include: 1) adenoma-related factors (aggressiveness, size, preoperative identification in MRI), 2) surgery-related factors, mainly neurosurgeon experience, 3) clinical factors, of which dependence on and duration of glucocorticoid treatment are most important, and 4) biochemical factors. Among the latter, low postoperative cortisol levels, less than 2 mcg/dL predict for disease remission. However, even when undetectable plasma cortisol levels are present, long-term recurrence may still occur and lifetime follow-up is required. We report the preliminary results of the first 20 patients with Cushing's disease operated on at our hospital using nadir cortisol levels less than 2 mcg/dl as remission criterion. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

Spaced Retrieval Practice Increases College Students' Short- and Long-Term Retention of Mathematics Knowledge

ERIC Educational Resources Information Center

Hopkins, Robin F.; Lyle, Keith B.; Hieb, Jeff L.; Ralston, Patricia A. S.

2016-01-01

A major challenge college students face is retaining the knowledge they acquire in their classes, especially in cumulative disciplines such as engineering, where ultimate success depends on long-term retention of foundational content. Cognitive psychologists have recently recommended various techniques educators might use to increase retention.…

New challenges and opportunities in the eddy-covariance methodology for long-term monitoring networks

NASA Astrophysics Data System (ADS)

Papale, Dario; Fratini, Gerardo

2013-04-01

Eddy-covariance is the most direct and most commonly applied methodology for measuring exchange fluxes of mass and energy between ecosystems and the atmosphere. In recent years, the number of environmental monitoring stations deploying eddy-covariance systems increased dramatically at the global level, exceeding 500 sites worldwide and covering most climatic and ecological regions. Several long-term environmental research infrastructures such as ICOS, NEON and AmeriFlux selected the eddy-covariance as a method to monitor GHG fluxes and are currently collaboratively working towards defining common measurements standards, data processing approaches, QA/QC procedures and uncertainty estimation strategies, to the aim of increasing defensibility of resulting fluxes and intra and inter-comparability of flux databases. In the meanwhile, the eddy-covariance research community keeps identifying technical and methodological flaws that, in some cases, can introduce - and can have introduced to date - significant biases in measured fluxes or increase their uncertainty. Among those, we identify three issues of presumably greater concern, namely: (1) strong underestimation of water vapour fluxes in closed-path systems, and its dependency on relative humidity; (2) flux biases induced by erroneous measurement of absolute gas concentrations; (3) and systematic errors due to underestimation of vertical wind variance in non-orthogonal anemometers. If not properly addressed, these issues can reduce the quality and reliability of the method, especially as a standard methodology in long-term monitoring networks. In this work, we review the status of the art regarding such problems, and propose new evidences based on field experiments as well as numerical simulations. Our analyses confirm the potential relevance of these issues but also hint at possible coping approaches, to minimize problems during setup design, data collection and post-field flux correction. Corrections are under

Virtual Models of Long-Term Care

ERIC Educational Resources Information Center

Phenice, Lillian A.; Griffore, Robert J.

2012-01-01

Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

Detection of low-level environmental chemical allergy by a long-term sensitization method.

PubMed

Fukuyama, Tomoki; Ueda, Hideo; Hayashi, Koichi; Tajima, Yukari; Shuto, Yasufumi; Saito, Toru R; Harada, Takanori; Kosaka, Tadashi

2008-07-30

Multiple chemical sensitivity (MCS) is characterized by various signs, including neurological disorders and allergy. Exposure may occur through a major event, such as a chemical spill, or from long-term contact with chemicals at low levels. We are interested in the allergenicity of MCS and the detection of low-level chemical-related hypersensitivity. We used long-term sensitization followed by low-dose challenge to evaluate sensitization by well-known Th2 type sensitizers (trimellitic anhydride (TMA) and toluene diisocyanate (TDI)) and a Th1 type sensitizer (2,4-dinitrochlorobenzene (DNCB)). After topically sensitizing BALB/c mice (9 times in 3 weeks) and challenging them with TMA, TDI or DNCB, we assayed their auricular lymph nodes (LNs) for number of lymphocytes, surface antigen expression of B cells, and local cytokine production, and measured antigen-specific serum IgE levels. TMA and TDI induced marked increases in levels of antigen-specific serum IgE and of Th2 cytokines (IL-4, IL-5, IL-10, and IL-13) produced by ex vivo restimulated lymph node cells. DNCB induced a marked increase in Th1 cytokine (IL-2, IFN-gamma, and TNF-alpha) levels, but antigen-specific serum IgE levels were not elevated. All chemicals induced significant increases in number of lymphocytes and surface antigen expression of B cells. Our mouse model enabled the identification and characterization of chemical-related allergic reactions at low levels. This long-term sensitization method would be useful for detecting environmental chemical-related hypersensitivity.

Cascabel prescribed fire long-term watershed study: an opportunity to monitor climate change

Treesearch

Gerald Gottfried; Daniel Neary; Peter Ffolliott; Karen Koestner

2012-01-01

Experimental watershed studies can provide answers to new challenges facing land managers and society including the impacts of fires and climate change on upstream and regional hydrology. The Cascabel Watersheds long-term prescribed fire study provides a unique opportunity to monitor climate change because of its location in an oak savanna situated between deserts or...

Investigation of in-vivo skin autofluorescence lifetimes under long-term cw optical excitation

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

Lihachev, A; Ferulova, I; Vasiljeva, K

2014-08-31

The main results obtained during the last five years in the field of laser-excited in-vivo human skin photobleaching effects are presented. The main achievements and results obtained, as well as methods and experimental devices are briefly described. In addition, the impact of long-term 405-nm cw low-power laser excitation on the skin autofluorescence lifetime is experimentally investigated. (laser biophotonics)

eLearning, knowledge brokering, and nursing: strengthening collaborative practice in long-term care.

PubMed

Halabisky, Brenda; Humbert, Jennie; Stodel, Emma J; MacDonald, Colla J; Chambers, Larry W; Doucette, Suzanne; Dalziel, William B; Conklin, James

2010-01-01

Interprofessional collaboration is vital to the delivery of quality care in long-term care settings; however, caregivers in long-term care face barriers to participating in training programs to improve collaborative practices. Consequently, eLearning can be used to create an environment that combines convenient, individual learning with collaborative experiential learning. Findings of this study revealed that learners enjoyed the flexibility of the Working Together learning resource. They acquired new knowledge and skills that they were able to use in their practice setting to achieve higher levels of collaborative practice. Nurses were identified as team leaders because of their pivotal role in the long-term care home and collaboration with all patient care providers. Nurses are ideal as knowledge brokers for the collaborative practice team. Quantitative findings showed no change in learner's attitudes regarding collaborative practice; however, interviews provided examples of positive changes experienced. Face-to-face collaboration was found to be a challenge, and changes to organizations, systems, and technology need to be made to facilitate this process. The Working Together learning resource is an important first step toward strengthening collaboration in long-term care, and the pilot implementation provides insights that further our understanding of both interprofessional collaboration and effective eLearning.

Long-Term Research in Ecology and Evolution (LTREE): 2015 survey data.

PubMed

Bradford, Mark A; Leiserowitz, Anthony; Feinberg, Geoffrey; Rosenthal, Seth A; Lau, Jennifer A

2017-11-01

of incentives for conducting long-term research. Qualitative questions were used to assess community views on the most important topics and questions for long-term research to address, and primary incentives and challenges to realizing this work. Finally, demographic data were collected to determine if views were conditional on such things as years of experience and field of expertise. The final questionnaire and all responses are provided for unrestricted use. © 2017 by the Ecological Society of America.

Long-term results of small-diameter proximal splenorenal venous shunt: A retrospective study

PubMed Central

Chen, Hao; Yang, Wei-Ping; Yan, Ji-Qi; Li, Qin-Yu; Ma, Di; Li, Hong-Wei

2011-01-01

AIM: To investigate recurrent variceal hemorrhage and long-term survival rates of patients treated with partial proximal splenorenal venous shunt. METHODS: Patients with variceal hemorrhage who were treated with small-diameter proximal splenorenal venous shunt in Ruijin Hospital between 1996 and 2009 were included in this study. Shunt diameter was determined before operation using Duplex Doppler ultrasonography. Peri-operative and long-term results in term of rehemorrhage, encephalopathy and mortality were followed up. RESULTS: Ninety-eight patients with Child A and B variceal hemorrhage received small-diameter proximal splenorenal venous shunt with a diameter of 7-10 mm. After operation, the patients’ mean free portal pressure (P < 0.01) and the flow rate of main portal vein (P < 0.01) decreased significantly compared with that before operation. The rates of rebleeding and mortality were 6.12% (6 cases) and 2.04% (2 cases), respectively. Ninety-one patients were followed up for 7 mo-14 years (median, 48.57 mo). Long-term rates of rehemorrhage and encephalopathy were 4.40% (4 cases) and 3.30% (3 cases), respectively. Thirteen patients (14.29%) died mainly due to progressive hepatic dysfunction. Five- and ten-year survival rates were 82.12% and 71.24%, respectively. CONCLUSION: Small-diameter proximal splenorenal venous shunt affords protection against variceal rehemorrhage with a low occurrence of encephalopathy in patients with normal liver function. PMID:21876638

Who owns the long term? Perspectives from global business leaders.

PubMed

Lévy, Maurice; Eskew, Mike; Bernotat, Wulf H; Barner, Marianne

2007-01-01

Day-to-day management is challenging enough for CEOs. How do they manage for the long term as well? We posed that question to four top executives of global companies. According to Maurice Levy, chairman and CEO of Publicis Groupe, building the future is really about building the present and keeping close to the front line--those who deal with your customers and markets. He also attributes his company's success in large part to knowing when to take action: In a market where clients' needs steer your long-term future, timing is everything. UPS Chairman and CEO Mike Eskew emphasizes staying true to your vision and values over the long run, despite meeting obstacles along the way. It took more than 20 years, and many lessons learned, to produce consistent profits in what is today the company's fastest-growing and most profitable business: international small packages. Wulf H. Bernotat, CEO of E.ON, examines the challenges facing business leaders and politicians as they try to balance energy needs against potential environmental damage. He calls for educating people about consumption and waste, and he maintains that a diverse and reliable mix of energy sources is the only way to ensure a secure supply while protecting our environment. Finally, Marianne Barner, the director of corporate communications and ombudsman for children's issues at IKEA, discusses how the company is taking steps to improve the environment and be otherwise socially responsible. For example, it's partnering with NGOs to address child labor issues and, on its own, is working to help mitigate climate change. IKEA's goals include using renewable sources for 100% of its energy needs and cutting its overall energy consumption by 25%.

Implicit attitudes towards smoking predict long-term relapse in abstinent smokers.

PubMed

Spruyt, Adriaan; Lemaigre, Valentine; Salhi, Bihiyga; Van Gucht, Dinska; Tibboel, Helen; Van Bockstaele, Bram; De Houwer, Jan; Van Meerbeeck, Jan; Nackaerts, Kristiaan

2015-07-01

It has previously been argued that implicit attitudes toward substance-related cues drive addictive behavior. Nevertheless, it remains an open question whether behavioral markers of implicit attitude activation can be used to predict long-term relapse. The main objective of this study was to examine the relationship between implicit attitudes toward smoking-related cues and long-term relapse in abstaining smokers. Implicit attitudes toward smoking-related cues were assessed by means of the Implicit Association Test (IAT) and the evaluative priming task (EPT). Both measures were completed by a group of smokers who volunteered to quit smoking (patient group) and a group of nonsmokers (control group). Participants in the patient group completed these measures twice: once prior to smoking cessation and once after smoking cessation. Relapse was assessed by means of short telephone survey, 6 months after completion of the second test session. EPT scores obtained prior to smoking cessation were related to long-term relapse and correlated with self-reported nicotine dependence as well as daily cigarette consumption. In contrast, none of the behavioral outcome measures were found to correlate with the IAT scores. These findings corroborate the idea that implicit attitudes toward substance-related cues are critically involved in long-term relapse. A potential explanation for the divergent findings obtained with the IAT and EPT is provided.

Complex network structure influences processing in long-term and short-term memory.

PubMed

Vitevitch, Michael S; Chan, Kit Ying; Roodenrys, Steven

2012-07-01

Complex networks describe how entities in systems interact; the structure of such networks is argued to influence processing. One measure of network structure, clustering coefficient, C, measures the extent to which neighbors of a node are also neighbors of each other. Previous psycholinguistic experiments found that the C of phonological word-forms influenced retrieval from the mental lexicon (that portion of long-term memory dedicated to language) during the on-line recognition and production of spoken words. In the present study we examined how network structure influences other retrieval processes in long- and short-term memory. In a false-memory task-examining long-term memory-participants falsely recognized more words with low- than high-C. In a recognition memory task-examining veridical memories in long-term memory-participants correctly recognized more words with low- than high-C. However, participants in a serial recall task-examining redintegration in short-term memory-recalled lists comprised of high-C words more accurately than lists comprised of low-C words. These results demonstrate that network structure influences cognitive processes associated with several forms of memory including lexical, long-term, and short-term.

Long-Term Energy Deficit in Mice Causes Long-Lasting Hypothalamic Alterations after Recovery.

PubMed

Méquinion, Mathieu; Le Thuc, Ophélia; Zgheib, Sara; Alexandre, David; Chartrel, Nicolas; Rovère, Carole; Hardouin, Pierre; Viltart, Odile; Chauveau, Christophe

2017-01-01

Although the short-term effects of fasting or energy deficit on hypothalamic neuropeptide circuitries are now better understood, the effects of long-term energy deficit and refeeding remain to be elucidated. We showed that after a long-term energy deficit, mice exhibited persistent hypoleptinemia following the refeeding period despite restoration of fat mass, ovarian activity, and feeding behavior. We aimed to examine the hypothalamic adaptations after 10 weeks of energy deficit and after 10 further weeks of nutritional recovery. To do so, we assessed the mRNA levels of the leptin receptor and the main orexigenic and anorexigenic peptides, and their receptors regulated by leptin. Markers of hypothalamic inflammation were assessed as leptin can also participate in this phenomenon. Long-term time-restricted feeding and separation induced significant increase in mRNA levels of hypothalamic orexigenic peptides, while both Y1 and Y5 receptor mRNAs were downregulated. No changes occurred in the mRNA levels of orexin (OX), melanin-concentrating hormone, pro-opiomelanocortin, 26RFa (26-amino acid RF-amide peptide), and their receptors despite an increase in the expression of melanocortin receptors (MC3-R and MC4-R) and OXR1 (OX receptor 1). The refeeding period induced an overexpression of leptin receptor mRNA in the hypothalamus. The other assessed mRNA levels were normalized except for Y2, Y5, MC3-R, and MC4-R, which remained upregulated. No convincing changes were observed in neuroinflammatory markers, even if interleukin-1β mRNA levels were increased in parallel with those of Iba1 (ionized calcium-binding adaptor molecule 1), a marker of microglial activation. Normalization of leptin-regulated functions and hypothalamic gene expressions in refed mice with low plasma leptin levels could be sustained by recalibration of hypothalamic sensitivity to leptin. © 2016 S. Karger AG, Basel.

Searching for signposts: Adaptive planning thresholds in long-term water supply projections for the Western U.S.

NASA Astrophysics Data System (ADS)

Robinson, B.; Herman, J. D.

2017-12-01

Long-term water supply planning is challenged by highly uncertain streamflow projections across climate models and emissions scenarios. Recent studies have devised infrastructure and policy responses that can withstand or adapt to an ensemble of scenarios, particularly those outside the envelope of historical variability. An important aspect of this process is whether the proposed thresholds for adaptation (i.e., observations that trigger a response) truly represent a trend toward future change. Here we propose an approach to connect observations of annual mean streamflow with long-term projections by filtering GCM-based streamflow ensembles. Visualizations are developed to investigate whether observed changes in mean annual streamflow can be linked to projected changes in end-of-century mean and variance relative to the full ensemble. A key focus is identifying thresholds that point to significant long-term changes in the distribution of streamflow (+/- 20% or greater) as early as possible. The analysis is performed on 87 sites in the Western United States, using streamflow ensembles through 2100 from a recent study by the U.S. Bureau of Reclamation. Results focus on three primary questions: (1) how many years of observed data are needed to identify the most extreme scenarios, and by what year can they be identified? (2) are these features different between sites? and (3) using this analysis, do observed flows to date at each site point to significant long-term changes? This study addresses the challenge of severe uncertainty in long-term streamflow projections by identifying key thresholds that can be observed to support water supply planning.

The long-term health of vegetarians and vegans.

PubMed

Appleby, Paul N; Key, Timothy J

2016-08-01

Vegetarians, who do not eat any meat, poultry or fish, constitute a significant minority of the world's population. Lacto-ovo-vegetarians consume dairy products and/or eggs, whereas vegans do not eat any foods derived wholly or partly from animals. Concerns over the health, environmental and economic consequences of a diet rich in meat and other animal products have focussed attention on those who exclude some or all of these foods from their diet. There has been extensive research into the nutritional adequacy of vegetarian diets, but less is known about the long-term health of vegetarians and vegans. We summarise the main findings from large cross-sectional and prospective cohort studies in western countries with a high proportion of vegetarian participants. Vegetarians have a lower prevalence of overweight and obesity and a lower risk of IHD compared with non-vegetarians from a similar background, whereas the data are equivocal for stroke. For cancer, there is some evidence that the risk for all cancer sites combined is slightly lower in vegetarians than in non-vegetarians, but findings for individual cancer sites are inconclusive. Vegetarians have also been found to have lower risks for diabetes, diverticular disease and eye cataract. Overall mortality is similar for vegetarians and comparable non-vegetarians, but vegetarian groups compare favourably with the general population. The long-term health of vegetarians appears to be generally good, and for some diseases and medical conditions it may be better than that of comparable omnivores. Much more research is needed, particularly on the long-term health of vegans.

Reinstatement of long-term memory following erasure of its behavioral and synaptic expression in Aplysia

PubMed Central

Chen, Shanping; Cai, Diancai; Pearce, Kaycey; Sun, Philip Y-W; Roberts, Adam C; Glanzman, David L

2014-01-01

Long-term memory (LTM) is believed to be stored in the brain as changes in synaptic connections. Here, we show that LTM storage and synaptic change can be dissociated. Cocultures of Aplysia sensory and motor neurons were trained with spaced pulses of serotonin, which induces long-term facilitation. Serotonin (5HT) triggered growth of new presynaptic varicosities, a synaptic mechanism of long-term sensitization. Following 5HT training, two antimnemonic treatments—reconsolidation blockade and inhibition of PKM—caused the number of presynaptic varicosities to revert to the original, pretraining value. Surprisingly, the final synaptic structure was not achieved by targeted retraction of the 5HT-induced varicosities but, rather, by an apparently arbitrary retraction of both 5HT-induced and original synapses. In addition, we find evidence that the LTM for sensitization persists covertly after its apparent elimination by the same antimnemonic treatments that erase learning-related synaptic growth. These results challenge the idea that stable synapses store long-term memories. DOI: http://dx.doi.org/10.7554/eLife.03896.001 PMID:25402831

Barriers to ethical nursing practice for older adults in long-term care facilities.

PubMed

Choe, Kwisoon; Kang, Hyunwook; Lee, Aekyung

2018-03-01

To explore barriers to ethical nursing practice for older adults in long-term care facilities from the perspectives of nurses in South Korea. The number of older adults admitted to long-term care facilities is increasing rapidly in South Korea. To provide this population with quality care, a solid moral foundation should be emphasised to ensure the provision of ethical nursing practices. Barriers to implementing an ethical nursing practice for older adults in long-term care facilities have not been fully explored in previous literature. A qualitative, descriptive design was used to explore barriers to ethical nursing practice as perceived by registered nurses in long-term care facilities in South Korea. Individual interviews were conducted with 17 registered nurses recruited using purposive (snowball) sampling who care for older adults in long-term care facilities in South Korea. Data were analysed using qualitative content analysis. Five main themes emerged from the data analysis concerning barriers to the ethical nursing practice of long-term care facilities: emotional distress, treatments restricting freedom of physical activities, difficulty coping with emergencies, difficulty communicating with the older adult patients and friction between nurses and nursing assistants. This study has identified methods that could be used to improve ethical nursing practices for older adults in long-term care facilities. Because it is difficult to improve the quality of care through education and staffing alone, other factors may also require attention. Support programmes and educational opportunities are needed for nurses who experience emotional distress and lack of competency to strengthen their resilience towards some of the negative aspects of care and being a nurse that were identified in this study. © 2017 John Wiley & Sons Ltd.

Long-term outcomes of acute kidney injury.

PubMed

Coca, Steven G

2010-05-01

The goal of this review is to summarize the recent plethora of data that relate to long-term outcomes after acute kidney injury (AKI). Surviving patients with AKI are still at high risk for long-term adverse outcomes, even if serum creatinine returns to normal. After adjusting for potential confounders, many recent studies have demonstrated that AKI is independently associated with chronic kidney disease, end-stage renal disease, and premature death. Unfortunately, definitive evidence from randomized controlled trials demonstrating that prevention or treatment of AKI prevents long-term adverse outcomes is not yet available. AKI is clearly a prognostic marker for poor long-term outcomes, but more studies will be needed to determine whether AKI is truly causal and whether or not the risk is modifiable.

Home health, long-term care, and other compliance activities.

PubMed

Anderson, T D; Sadoff, J W

1999-04-01

The Federal government continues to crack down on fraud and abuse in the healthcare industry with such initiatives and tools as Operation Restore Trust and intermediate tax sanctions. Home health and long-term care organizations are the latest entities under study by the Office of Inspector General, and the result of these studies likely will be more antifraud and abuse measures being taken against these entities. All healthcare organizations should pay particular attention to their tax risk exposure. Healthcare organizations that put effective compliance programs in place should be able to reduce the overall risk of challenges to their financial practices.

New Long-Term Care Policies in Latin America: The National System of Care in Uruguay.

PubMed

Matus-Lopez, Mauricio; Pedraza, Camilo Cid

2016-07-01

Uruguay is the Latin American country with the largest share of elderly population and it has the greatest pressure for formal long-term care services in the region. For this reason, last year the government approved a law creating a National System of Care. This article describes and analyzes the long-term care policy in the recently created National System of Care of Uruguay. The Director of the National System of Care was asked to complete a questionnaire with a description and management of long-term care programs. This information was completed with official information and peer-reviewed articles of long-term care in Uruguay. The National System of Care includes long-term care services. The main services are carried out through a cash-for-care system for home-based services, but in the future the benefits will expand to day centers and residential and nursing homes. The system follows international trends in terms of universality, services, and regulations dealing with care. However, the current and future financing is low, and this condition could undermine its development capacity. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Accelerated Long-Term Forgetting Is Not Epilepsy Specific: Evidence from Childhood Traumatic Brain Injury.

PubMed

Lah, Suncica; Black, Carly; Gascoigne, Michael B; Gott, Chloe; Epps, Adrienne; Parry, Louise

2017-09-01

Accelerated long-term forgetting (ALF) is characterized by adequate recall after short, but not long delays. ALF is not detected by standardized neuropsychological memory tests. Currently, the prevailing conceptualization of ALF is of a temporal lobe seizure-related phenomenon. Nevertheless, Mayes and colleagues (2003) proposed that ALF may occur when any of the components of the brain network involved in long-term memory formation, or their interaction, is disrupted. This disruption does not have to be caused by temporal lobe seizures for ALF to occur. Here, we investigate this possibility in a group of school-age children who have sustained traumatic brain injury (TBI) (n = 28), as TBI typically disrupts the brain network that is important for long-term memory formation and recall. Healthy control children (n = 62) also participated. Contrary to the dominant conceptualization of ALF being a seizure-related phenomenon, children with TBI showed ALF. Sustaining a severe TBI and diffuse subcortical damage was related to ALF. Individually, 8 of the 13 children with severe TBI presented with ALF. ALF would remain undetected on standardized testing in six of these eight children. One child had the opposite pattern of dissociation, an impaired score on standardized testing, but an average long-term memory score. This is the first study, to our knowledge, to show ALF in patients with TBI, which has remained undiagnosed and untreated in this patient population. Our study also challenges the dominant hypothesis of ALF being a temporal lobe seizure-related phenomenon, and raises a possibility that short-term and long-term memory systems may be independent.

Controlling for unmeasured confounding and spatial misalignment in long-term air pollution and health studies.

PubMed

Lee, Duncan; Sarran, Christophe

2015-11-01

The health impact of long-term exposure to air pollution is now routinely estimated using spatial ecological studies, owing to the recent widespread availability of spatial referenced pollution and disease data. However, this areal unit study design presents a number of statistical challenges, which if ignored have the potential to bias the estimated pollution-health relationship. One such challenge is how to control for the spatial autocorrelation present in the data after accounting for the known covariates, which is caused by unmeasured confounding. A second challenge is how to adjust the functional form of the model to account for the spatial misalignment between the pollution and disease data, which causes within-area variation in the pollution data. These challenges have largely been ignored in existing long-term spatial air pollution and health studies, so here we propose a novel Bayesian hierarchical model that addresses both challenges and provide software to allow others to apply our model to their own data. The effectiveness of the proposed model is compared by simulation against a number of state-of-the-art alternatives proposed in the literature and is then used to estimate the impact of nitrogen dioxide and particulate matter concentrations on respiratory hospital admissions in a new epidemiological study in England in 2010 at the local authority level. © 2015 The Authors. Environmetrics published by John Wiley & Sons Ltd.

Long-Term Dynamics of Autonomous Fractional Differential Equations

NASA Astrophysics Data System (ADS)

Liu, Tao; Xu, Wei; Xu, Yong; Han, Qun

This paper aims to investigate long-term dynamic behaviors of autonomous fractional differential equations with effective numerical method. The long-term dynamic behaviors predict where systems are heading after long-term evolution. We make some modification and transplant cell mapping methods to autonomous fractional differential equations. The mapping time duration of cell mapping is enlarged to deal with the long memory effect. Three illustrative examples, i.e. fractional Lotka-Volterra equation, fractional van der Pol oscillator and fractional Duffing equation, are studied with our revised generalized cell mapping method. We obtain long-term dynamics, such as attractors, basins of attraction, and saddles. Compared with some existing stability and numerical results, the validity of our method is verified. Furthermore, we find that the fractional order has its effect on the long-term dynamics of autonomous fractional differential equations.

The Womanly World of Long Term Care: The Plight of the Long Term Care Worker. Gray Paper.

ERIC Educational Resources Information Center

Older Women's League, Washington, DC.

Long-term care workers (those who are paid to provide custodial care for long-term patients in nursing homes or at home) must care for a growing number of increasingly disabled or dependent persons. They are working for agencies and institutions under growing pressure to increase productivity. They face new training and competency requirements,…

Parents' experiences of living with a child with a long-term condition: a rapid structured review of the literature.

PubMed

Smith, Joanna; Cheater, Francine; Bekker, Hilary

2015-08-01

Living with a child with a long-term condition can result in challenges above usual parenting because of illness-specific demands. A critical evaluation of research exploring parents' experiences of living with a child with a long-term condition is timely because international health policy advocates that patients with long-term conditions become active collaborators in care decisions. A rapid structured review was undertaken (January 1999-December 2009) in accordance with the United Kingdom Centre for Reviews and Dissemination guidance. Three data bases (MEDLINE, CINAHL, PSYCINFO) were searched and also hand searching of the Journal of Advanced Nursing and Child: Care, Health and Development. Primary research studies written in English language describing parents' experiences of living with a child with a long-term condition were included. Thematic analysis underpinned data synthesis. Quality appraisal involved assessing each study against predetermined criteria. Thirty-four studies met the inclusion criteria. The impact of living with a child with a long-term condition related to dealing with immediate concerns following the child's diagnosis and responding to the challenges of integrating the child's needs into family life. Parents' perceived they are not always supported in their quest for information and forming effective relationships with health-care professionals can be stressful. Although having ultimate responsibility for their child's health can be overwhelming, parents developed considerable expertise in managing their child's condition. Parents' accounts suggest they not always supported in their role as manager for their child's long-term condition and their expertise, and contribution to care is not always valued. © 2013 John Wiley & Sons Ltd.

The Electrification of Energy: Long-Term Trends and Opportunities

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

Tsao, Jeffrey Y.; Fouquet, Roger; Schubert, E. Fred

Here, we present and analyze three powerful long-term historical trends in energy, particularly electrical energy, as well as the opportunities and challenges associated with these trends. The first trend is from a world containing a diversity of energy currencies to one whose predominant currency is electricity, driven by electricity’s transportability, exchangeability, and steadily decreasing cost. The second trend is from electricity generated from a diversity of sources to electricity generated predominantly by free-fuel sources, driven by their steadily decreasing cost and long-term abundance. These trends necessitate a just-emerging third trend: from a grid in which electricity is transported uni-directionally, tradedmore » at near-static prices, and consumed under direct human control; to a grid in which electricity is transported bi-directionally, traded at dynamic prices, and consumed under human-tailored agential control. Early acceptance and appreciation of these trends will accelerate their remaking of humanity’s energy landscape into one in which energy is much more affordable, abundant and efficiently deployed than it is today; with major economic, geo-political, and environmental benefits to human society.« less

Long-term studies of dopamine agonists.

PubMed

Hubble, Jean P

2002-02-26

Dopamine agonists have long been used as adjunctive therapy for the treatment of Parkinson's disease (PD). In more recent years these drugs have also been proved safe and effective as initial therapy in lieu of levodopa in the treatment of PD. Long-term levodopa therapy is associated with motor complications, including fluctuating response patterns and dyskinesia. By initially introducing a dopamine agonist as symptomatic drug therapy, it may be possible to postpone the use of levodopa and delay or prevent the development of motor complications. Recently, four clinical trials have explored this hypothesis by comparing the long-term response and side effects of levodopa with dopamine agonist therapy. The drugs studied have included ropinirole, pramipexole, cabergoline, and pergolide. In each of these projects, the occurrence of motor complications, such as wearing off and dyskinesia, was significantly less in the subjects assigned to initiation of therapy with a dopamine agonist. The addition of levodopa could be postponed by many months or even several years. Therefore, these long-term studies of dopamine agonists support the initiation of a dopamine agonist instead of levodopa in an effort to postpone levodopa-related motor complications. This therapeutic approach may be particularly appropriate in PD patients with a long treatment horizon on the basis of age and general good health. The extension phase of the long-term study comparing pramipexole with levodopa is ongoing, and follow-up information may help to establish the value of this treatment strategy.

New Zealand: long-term care in a decade of change.

PubMed

Ashton, T

2000-01-01

Long-term care in New Zealand incorporates a mix of public and private funding and provision. After a decade of structural change, the purchasing of almost all publicly funded health and social care is now the responsibility of one central agency. Services for older persons are poorly integrated, and there are problems of access to and quality of some services. Efforts are being made to address these problems. The challenge now is to ensure that this groundwork is not lost amid the turmoil of yet another round of restructuring by an enthusiastic, newly elected government.

Responding to chemical, biological, or nuclear terrorism: the indirect and long-term health effects may present the greatest challenge.

PubMed

Hyams, Kenneth C; Murphy, Frances M; Wessely, Simon

2002-04-01

The possibility of terrorists employing chemical, biological, or nuclear/ radiological (CBN) materials has been a concern since 1995 when sarin gas was dispersed in a Tokyo subway. Contingency planning almost exclusively involved detection. containment, and emergency health care for mass casualties. However, it is clear that even small-scale CBN incidents--like the recent spread of anthrax spores through the mail--can cause widespread confusion, fear, and psychological stress that have lasting effects on the health of affected communities and on a nation's sense of well-being. More emphasis therefore needs to be placed on indirect effects and on the medical, social, economic, and legal consequences that follow months to years afterward. To respond effectively to CBN attacks, a comprehensive strategy needs to be developed that includes not only emergency response, but also long-term health care, risk communication, research, and economic assistance. Organizing an effective response challenges government institutions because the issues involved--eligibility for health care, the effects of low-level exposure to toxic agents. stress-related illnesses, unlicensed therapeutics. financial compensation--are complex and controversial.

Building long-term constituencies for space exploration: The challenge of raising public awareness and engagement in the United States and in Europe

NASA Astrophysics Data System (ADS)

Ehrenfreund, P.; Peter, N.; Billings, L.

2010-08-01

Space exploration is a multifaceted endeavor and will be a "grand challenge" of the 21st century. It has already become an element of the political agenda of a growing number of countries worldwide. However, the public is largely unaware of space exploration activities and in particular does not perceive any personal benefit. In order to achieve highly ambitious space exploration goals to explore robotically and with humans the inner solar system, space agencies must improve and expand their efforts to inform and raise the awareness of the public about what they are doing, and why. Therefore adopting new techniques aiming at informing and engaging the public using participatory ways, new communication techniques to reach, in particular, the younger generation will be a prerequisite for a sustainable long-term exploration program: as they will enable it and carry most of the associated financial burden. This paper presents an environmental analysis of space exploration in the United States and Europe and investigates the current branding stature of the National Aeronautics and Space Administration (NASA) and the European Space Agency (ESA). We discuss how improved market research and new branding methods can increase public space awareness and improve the image of NASA and ESA. We propose a new participatory approach to engage the public as major stakeholder (along governments, the industrial space sector and the science community) that may provide sufficient resources for and sustainability of a long-term space exploration program.

Long-term training modifies the modular structure and organization of walking balance control

PubMed Central

Allen, Jessica L.

2015-01-01

How does long-term training affect the neural control of movements? Here we tested the hypothesis that long-term training leading to skilled motor performance alters muscle coordination during challenging, as well as nominal everyday motor behaviors. Using motor module (a.k.a., muscle synergy) analyses, we identified differences in muscle coordination patterns between professionally trained ballet dancers (experts) and untrained novices that accompanied differences in walking balance proficiency assessed using a challenging beam-walking test. During beam walking, we found that experts recruited more motor modules than novices, suggesting an increase in motor repertoire size. Motor modules in experts had less muscle coactivity and were more consistent than in novices, reflecting greater efficiency in muscle output. Moreover, the pool of motor modules shared between beam and overground walking was larger in experts compared with novices, suggesting greater generalization of motor module function across multiple behaviors. These differences in motor output between experts and novices could not be explained by differences in kinematics, suggesting that they likely reflect differences in the neural control of movement following years of training rather than biomechanical constraints imposed by the activity or musculoskeletal structure and function. Our results suggest that to learn challenging new behaviors, we may take advantage of existing motor modules used for related behaviors and sculpt them to meet the demands of a new behavior. PMID:26467521

Long-term training modifies the modular structure and organization of walking balance control.

PubMed

Sawers, Andrew; Allen, Jessica L; Ting, Lena H

2015-12-01

How does long-term training affect the neural control of movements? Here we tested the hypothesis that long-term training leading to skilled motor performance alters muscle coordination during challenging, as well as nominal everyday motor behaviors. Using motor module (a.k.a., muscle synergy) analyses, we identified differences in muscle coordination patterns between professionally trained ballet dancers (experts) and untrained novices that accompanied differences in walking balance proficiency assessed using a challenging beam-walking test. During beam walking, we found that experts recruited more motor modules than novices, suggesting an increase in motor repertoire size. Motor modules in experts had less muscle coactivity and were more consistent than in novices, reflecting greater efficiency in muscle output. Moreover, the pool of motor modules shared between beam and overground walking was larger in experts compared with novices, suggesting greater generalization of motor module function across multiple behaviors. These differences in motor output between experts and novices could not be explained by differences in kinematics, suggesting that they likely reflect differences in the neural control of movement following years of training rather than biomechanical constraints imposed by the activity or musculoskeletal structure and function. Our results suggest that to learn challenging new behaviors, we may take advantage of existing motor modules used for related behaviors and sculpt them to meet the demands of a new behavior. Copyright © 2015 the American Physiological Society.

Long Term TOA - M Data and Information

Atmospheric Science Data Center

2017-09-06

... A Long-Term TOA and Constrained Surface Radiation Budget Project A Long-Term TOA and Constrained Surface Readiation ... Budget Experiment (ERBE) and Clouds and the Earth's Radiant Energy System (CERES), that span nearly 30 years to date.   The ...

Long-term biological investigations in space.

PubMed

Lotz, R G; Fuchs, H; Bertsche, U

1975-01-01

Missions in space within the next two decades will be of longer duration than those carried out up to the present time, and the effects of such long-term flights on biological organisms are unknown. Results of biological experiments that have been performed to date cannot be extrapolated to results in future flights because of the unknown influence of adaptation over a long period of time. Prior experiments with Axolotl, fishes, and vertebrates by our research team (in part with sounding rockets) showed that these specimens did not appear to be suitable for long-term missions on which minimization of expense, technique, and energy is required. Subsequent investigations have shown the suitability of the leech (Hirudo medicinalis), which consumes blood of mammals up to ten times its own weight (1 g) and can live more than 2 years without further food supply. Emphasis in the experiments with Hirudo medicinalis is placed on metabolic rhythm and motility. Resorption and diffusion in tissue, development, and growth under long-term effects of cosmic proton radiation and zero-gravity are other focal points. The constancy of cellular life in the mature animals is a point in favor of these specimens. We have also taken into account the synergistic effects of the space environment on the problems just mentioned. The life-support system constructed for the leech has been tested successfully in four sounding rocket flights and, on that basis, has been prepared for a long-term mission. Long-term investigations out of the terrestrial biosphere will provide us with information concerning the degree of adaptation of certain physiological and biochemical functions and as to what extent biological readjustment or repair processes can occur under the specific stress conditions of space flight.

Embolization of renal angiomyolipomas: short-term and long-term outcomes, complications, and tumor shrinkage.

PubMed

Lee, Shen-Yang; Hsu, Hsiang-Hao; Chen, Yung-Chang; Huang, Chen-Chih; Wong, Yon-Cheong; Wang, Li-Jen; Chuang, Cheng-Keng; Yang, Chih-Wei

2009-11-01

This study retrospectively evaluated outcomes, complications, and tumor shrinkage in renal angiomyolipomas after transcatheter arterial embolization (TAE). All renal angiomyolipoma patients who underwent TAE between August 2000 and December 2008 and had short-term (long-term (>6 months) follow-up images were evaluated. Complications and tumor relapse after TAE were reviewed. The sizes of embolized tumors were measured to calculate size reductions and reduction rates after TAE. Differences in tumor size, size reduction, and reduction rate between different time points (pre-TAE, short-term follow-up, and long-term follow-up) and groups (completely and incompletely embolized) were determined. Eleven renal angiomyolipoma patients who had undergone TAE were included. Seven (63.6%) patients had postembolization syndrome and one had abscess formation following TAE. Two patients had a tumor relapse (18.2%). The mean tumor size was 8.57+/-2.66 cm on pre-TAE images. The mean size reduction was 3.1 cm (33.3%) and 3.8 cm (43.0%) at short-term and long-term follow-up. Tumor sizes differed significantly between pre-TAE and short-term (p=0.004) or long-term images (p=0.022) but not between short-term and long-term images (p=0.059). Results stratified by the completeness of embolization indicate that only the short-term size reduction rate differed significantly (p=0.025), while the long-term reduction rate and short- and long-term follow-up tumor size and size reduction were comparable between the two groups. In conclusion, selective TAE is effective for tumor shrinkage in most renal angiomyolipomas, with acceptable complication and relapse rates. Tumor shrinkage occurring within 6 months after TAE may reflect the long-term effect of TAE.

Genetically Encoded Calcium Indicators For Studying Long-Term Calcium Dynamics During Apoptosis

PubMed Central

Garcia, M. Iveth; Chen, Jessica J.; Boehning, Darren

2017-01-01

Intracellular calcium release is essential for regulating almost all cellular functions. Specific spatio-temporal patterns of cytosolic calcium elevations are critical determinants of cell fate in response to pro-apoptotic cellular stressors. As the apoptotic program can take hours or days, measurement of long-term calcium dynamics are essential for understanding the mechanistic role of calcium in apoptotic cell death. Due to the technical limitations of using calcium-sensitive dyes to measure cytosolic calcium little is known about long-term calcium dynamics in living cells after treatment with apoptosis-inducing drugs. Genetically encoded calcium indicators could potentially overcome some of the limitations of calcium-sensitive dyes. Here, we compared the performance of the genetically encoded calcium indicators GCaMP6s and GCaMP6f with the ratiometric dye Fura-2. GCaMP6s performed as well or better than Fura-2 in detecting agonist-induced calcium transients. We then examined the utility of GCaMP6s for continuously measuring apoptotic calcium release over the course of ten hours after treatment with staurosporine. We found that GCaMP6s was suitable for measuring apoptotic calcium release over long time courses and revealed significant heterogeneity in calcium release dynamics in individual cells challenged with staurosporine. Our results suggest GCaMP6s is an excellent indicator for monitoring long-term changes cytosolic calcium during apoptosis. PMID:28073595

Long-term prehypertension treatment with losartan effectively prevents brain damage and stroke in stroke-prone spontaneously hypertensive rats.

PubMed

He, De-Hua; Zhang, Liang-Min; Lin, Li-Ming; Ning, Ruo-Bing; Wang, Hua-Jun; Xu, Chang-Sheng; Lin, Jin-Xiu

2014-02-01

Prehypertension has been associated with adverse cerebrovascular events and brain damage. The aims of this study were to investigate ⅰ) whether short‑ and long-term treatments with losartan or amlodipine for prehypertension were able to prevent blood pressure (BP)-linked brain damage, and ⅱ) whether there is a difference in the effectiveness of treatment with losartan and amlodipine in protecting BP-linked brain damage. In the present study, prehypertensive treatment with losartan and amlodipine (6 and 16 weeks treatment with each drug) was performed on 4-week‑old stroke-prone spontaneously hypertensive rats (SHRSP). The results showed that long-term (16 weeks) treatment with losartan is the most effective in lowering systolic blood pressure in the long term (up to 40 weeks follow-up). Additionally, compared with the amlodipine treatment groups, the short‑ and long-term losartan treatments protected SHRSP from stroke and improved their brains structurally and functionally more effectively, with the long-term treatment having more benefits. Mechanistically, the short‑ and long-term treatments with losartan reduced the activity of the local renin-angiotensin-aldosterone system (RAAS) in a time-dependent manner and more effectively than their respective counterpart amlodipine treatment group mainly by decreasing AT1R levels and increasing AT2R levels in the cerebral cortex. By contrast, the amlodipine treatment groups inhibited brain cell apoptosis more effectively as compared with the losartan treatment groups mainly through the suppression of local oxidative stress. Taken together, the results suggest that long-term losartan treatment for prehypertension effectively protects SHRSP from stroke-induced brain damage, and this protection is associated with reduced local RAAS activity than with brain cell apoptosis. Thus, the AT1R receptor blocker losartan is a good candidate drug that may be used in the clinic for long-term treatment on prehypertensive

Automated Long - Term Scheduling for the SOFIA Airborne Observatory

NASA Technical Reports Server (NTRS)

Civeit, Thomas

2013-01-01

The NASA Stratospheric Observatory for Infrared Astronomy (SOFIA) is a joint US/German project to develop and operate a gyro-stabilized 2.5-meter telescope in a Boeing 747SP. SOFIA's first science observations were made in December 2010. During 2011, SOFIA accomplished 30 flights in the "Early Science" program as well as a deployment to Germany. The new observing period, known as Cycle 1, is scheduled to begin in 2012. It includes 46 science flights grouped in four multi-week observing campaigns spread through a 13-month span. Automation of the flight scheduling process offers a major challenge to the SOFIA mission operations. First because it is needed to mitigate its relatively high cost per unit observing time compared to space-borne missions. Second because automated scheduling techniques available for ground-based and space-based telescopes are inappropriate for an airborne observatory. Although serious attempts have been made in the past to solve part of the problem, until recently mission operations staff was still manually scheduling flights. We present in this paper a new automated solution for generating SOFIA long-term schedules that will be used in operations from the Cycle 1 observing period. We describe the constraints that should be satisfied to solve the SOFIA scheduling problem in the context of real operations. We establish key formulas required to efficiently calculate the aircraft course over ground when evaluating flight schedules. We describe the foundations of the SOFIA long-term scheduler, the constraint representation, and the random search based algorithm that generates observation and instrument schedules. Finally, we report on how the new long-term scheduler has been used in operations to date.

Pelvic ring injuries: Surgical management and long-term outcomes

PubMed Central

Halawi, Mohamad J.

2016-01-01

Pelvic ring injuries present a therapeutic challenge to the orthopedic surgeon. Management is based on the patient's physiological status, fracture classification, and associated injuries. Surgical stabilization is indicated in unstable injury patterns and those that fail nonsurgical management. The optimal timing for definitive fixation is not clearly defined, but early stabilization is recommended. Surgical techniques include external fixation, open reduction and internal fixation, and minimally invasive percutaneous osteosynthesis. Special considerations are required for concomitant acetabular fractures, sacral fractures, and those occurring in skeletally immature patients. Long-term outcomes are limited by lack of pelvis-specific outcome measures and burden of associated injuries. PMID:26908968

The emerging phenotype of long-term survivors with infantile Pompe disease

PubMed Central

Prater, Sean N.; Banugaria, Suhrad G.; DeArmey, Stephanie M.; Botha, Eleanor G.; Stege, Erin M.; Case, Laura E.; Jones, Harrison N.; Phornphutkul, Chanika; Wang, Raymond Y.; Young, Sarah P.; Kishnani, Priya S.

2013-01-01

Purpose Enzyme replacement therapy with alglucosidase alfa for infantile Pompe disease has improved survival creating new management challenges. We describe an emerging phenotype in a retrospective review of long-term survivors. Methods Inclusion criteria included ventilator-free status and age ≤6 months at treatment initiation, and survival to age ≥5 years. Clinical outcome measures included invasive ventilator-free survival and parameters for cardiac, pulmonary, musculoskeletal, gross motor and ambulatory status; growth; speech, hearing, and swallowing; and gastrointestinal and nutritional status. Results Eleven of 17 patients met study criteria. All were cross-reactive immunologic material-positive, alive, and invasive ventilator-free at most recent assessment, with a median age of 8.0 years (range: 5.4 to 12.0 years). All had marked improvements in cardiac parameters. Commonly present were gross motor weakness, motor speech deficits, sensorineural and/or conductive hearing loss, osteopenia, gastroesophageal reflux disease, and dysphagia with aspiration risk. Seven of 11 patients were independently ambulatory and four required the use of assistive ambulatory devices. All long-term survivors had low or undetectable anti-alglucosidase alfa antibody titers. Conclusions Long-term survivors exhibited sustained improvements in cardiac parameters and gross motor function. Residual muscle weakness, hearing loss, risk for arrhythmias, hypernasal speech, dysphagia with risk for aspiration, and osteopenia were commonly observed findings. PMID:22538254

From Sky to Archive: Long Term Management of Sky Survey Data

NASA Astrophysics Data System (ADS)

Darch, Peter T.; Sands, Ashley E.; Borgman, Christine; Golshan, Milena S.; Traweek, Sharon

2017-01-01

Sky survey data may remain scientifically valuable long beyond the end of a survey’s operational period, both for continuing inquiry and for calibrating and testing instruments for subsequent generations of surveys. Astronomy infrastructure has many stakeholders, including those concerned with data management. Research libraries are increasingly partnering with scholars to sustain access to data.The Sloan Digital Sky Survey (SDSS) was among the first major scientific projects to partner with libraries in this way, embarking on a data transfer process with two university libraries. We report on a qualitative case study of this process.Ideally, long-term sustainability of sky survey data would be a key part of planning and construction, but rarely does this occur. Teams are under pressure to deliver a project on time and on budget that produces high-quality data during its operational period, leaving few resources available to plan long-term data management. The difficulty of planning is further compounded by the complexity of predicting circumstances and needs of the astronomy community in future decades. SDSS team members regarded libraries, long-lived institutions concerned with access to scholarship, as a potential solution to long-term data sustainability.As the SDSS data transfer was the first of this scale attempted - 160 TB of data - astronomers and library staff were faced with scoping the range of activities involved. They spent two years planning this five-year process. While successful overall as demonstration projects, the libraries encountered many obstacles. We found all parties experienced difficulty in articulating their notions of “scientific data,” “archiving,” “serving,” and “providing access” to the datasets. Activities and interpretations of the data transfer process varied by institutional motivations for participation and by available infrastructure. We conclude several, rather than a single, “library solutions” for long-term

Evaluation of Long-term Soil Moisture Proxies in the U.S. Great Plains

NASA Astrophysics Data System (ADS)

Yuan, S.; Quiring, S. M.

2016-12-01

Soil moisture plays an important role in land-atmosphere interactions through both surface energy and water balances. However, despite its importance, there are few long-term records of observed soil moisture for investigating long-term spatial and temporal variations of soil moisture. Hence, it is necessary to find suitable approximations of soil moisture observations. 5 drought indices will be compared with simulated and observed soil moisture over the U.S. Great Plains during two time periods (1980 - 2012 and 2003 - 2012). Standardized Precipitation Index (SPI), Standardized Precipitation-Evapotranspiration Index (SPEI), Palmer Z Index (zindex) and Crop Moisture Index (CMI) will be calculated by PRISM data. The soil moisture simulations will be derived from NLDAS. In situ soil moisture will be obtained from North American Soil Moisture Database. The evaluation will focus on three main aspects: trends, variations and persistence. The results will support further research investigating long-term variations in soil moisture-climate interactions.

Beyond Quarterly Earnings: Preparing the Business Community for Long-term Climate Risks

NASA Astrophysics Data System (ADS)

Carlson, C.; Goldman, G. T.

2014-12-01

The business community stands to be highly impacted by climate change. In both short and long-term timescales, climate change presents material and financial risks to companies in diverse economic sectors. How the private sector accounts for long-term risks while making short-term decisions about operations is a complex challenge. Companies are accountable to shareholders and must report performance to them on a quarterly basis. At the same time, company investors are exposed to long-term climate-related risks and face losses if companies fail to prepare for climate impacts. The US Securities and Exchange Commission (SEC) obligates publicly traded companies to discuss risks that might materially affect their business and since 2010, the agency recommends that companies consider and discuss any significant risks to their business from climate change. Some companies have complied with this guidance and comprehensively analyze potential climate change impacts, yet others fail to consider climate change at all. Such omissions leave companies without plans for addressing future risks and expose investors and the public to potential catastrophic events from climate change impacts. Climate risk projections can inform companies about the vulnerability of their facilities, supply chains, transportation pathways, and other assets. Such projections can help put climate-related risks in terms of material costs for companies and their investors. Focusing on the vulnerability of coastal facilities, we will use climate change impact projections to demonstrate the economic impacts of climate change faced by the private sector. These risks are then compared to company disclosures to the SEC to assess the degree to which companies have considered their vulnerability to climate change. Finally, we will discuss ways that companies can better assess and manage long-term climate risks.

Partnership insurance: an innovation to meet long-term care financing needs in an era of federal minimalism.

PubMed

Meiners, Mark R; McKay, Hunter L; Mahoney, Kevin J

2002-01-01

In the case of long-term care financing, federal minimalism is not new news. Long-term care has long played a weak "third fiddle" to national health reform concerns about the uninsured and catastrophic expenditures on prescription drugs. The states have been left to struggle with the issue of long-term financing as part of their responsibilities in funding and administering the means-tested Medicaid program. Recently, the environment has become even more challenging. Much of what is on the national agenda for health and welfare reform has been delegated to the states. This "devolution" of responsibilities has created many competing priorities for both the attention and resources of states. This context of evolving federal minimalism calls for creative solutions that balance competing points of view. In this article, we provide some background and insights from one such effort: a collaboration between state governments and private insurers to put into operation an insurance-based approach to long-term care financing that uses Medicaid as an incentive to encourage potential purchasers.

Palila Restoration: Lessons from Long-term Research

USGS Publications Warehouse

,

2006-01-01

specialists, palila lay few eggs, raise few young each year, and take a relatively long time to complete the nesting cycle. Low rates of reproduction result in low rates of population growth and low potential for recovery from disturbances. Long-term studies of palila offer important insights into the conservation biology of all Hawaiian forest bird species, particularly feeding specialists like the palila. Palila face many challenges common to both generalist and specialist Hawaiian honeycreeper species. Habitat loss and degradation, as well as introduced avian diseases, have reduced their numbers and limited their distribution to a very small portion of their historic range. Introduced mammals prey on palila, while alien insects reduce caterpillars that are particularly important in the diet of nestlings. Securing legal protection and funding for palila restoration has been challenging. Understanding how the palila has avoided extinction can help managers plan its recovery, and better design recovery plans for species with different feeding strategies in other habitats.

42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

Code of Federal Regulations, 2010 CFR

2010-10-01

... December 29, 2007, was co-located with an entity that is a provider-based, off-campus location of a... hospital or the satellite facility from any individual hospital not co-located with the long-term care... from any individual hospital not co-located with the long-term care hospital or with the satellite of a...

Hippocampal Focal Knockout of CBP Affects Specific Histone Modifications, Long-Term Potentiation, and Long-Term Memory

PubMed Central

Barrett, Ruth M; Malvaez, Melissa; Kramar, Eniko; Matheos, Dina P; Arrizon, Abraham; Cabrera, Sara M; Lynch, Gary; Greene, Robert W; Wood, Marcelo A

2011-01-01

To identify the role of the histone acetyltransferase (HAT) CREB-binding protein (CBP) in neurons of the CA1 region of the hippocampus during memory formation, we examine the effects of a focal homozygous knockout of CBP on histone modifications, gene expression, synaptic plasticity, and long-term memory. We show that CBP is critical for the in vivo acetylation of lysines on histones H2B, H3, and H4. CBP's homolog p300 was unable to compensate for the loss of CBP. Neurons lacking CBP maintained phosphorylation of the transcription factor CREB, yet failed to activate CREB:CBP-mediated gene expression. Loss of CBP in dorsal CA1 of the hippocampus resulted in selective impairments to long-term potentiation and long-term memory for contextual fear and object recognition. Together, these results suggest a necessary role for specific chromatin modifications, selectively mediated by CBP in the consolidation of memories. PMID:21508930

Long-term three-dimensional perfusion culture of human adult bone marrow mononuclear cells in bioreactors.

PubMed

Schmelzer, Eva; Finoli, Anthony; Nettleship, Ian; Gerlach, Jörg C

2015-04-01

The construction and long-term maintenance of three-dimensional in vitro bone marrow models is of great interest but still quite challenging. Here we describe the use of a multi-compartment hollow-fiber membrane based three-dimensional perfusion bioreactor for long-term culture of whole human bone marrow mononuclear cells. We also investigated bioreactors with incorporated open-porous foamed hydroxyapatite scaffolds, mimicking the in vivo bone matrix. Cells in bioreactors with and without scaffolds were cultured to 6 weeks and compared to Petri dish controls. Cells were analyzed for gene expression, surface markers by flow cytometry, metabolic activity, hematopoietic potential, viability, and attachment by immunocytochemistry. Cells in bioreactors were metabolic active during long-term culture. The percentages of hematopoietic stem cell and mature endothelial cell fractions were maintained in bioreactors. The expression of most of the analyzed genes stabilized and increased after long-term culture of 6 weeks. Compared to Petri dish culture controls, bioreactor perfusion culture improved in both the short and long-term, the colony formation unit capacity of hematopoietic progenitors. Cells attached to the ample surface area provided by hydroxyapatite scaffolds. The implementation of a hydroxyapatite scaffold did not influence colony formation capacity, percentages of cell type specific fractions, gene expression, cell viability or metabolic turnover when compared to control cells cultured in bioreactors without scaffolds. In conclusion, three-dimensional perfusion bioreactor culture enables long-term maintenance of primary human bone marrow cells, with hydroxyapatite scaffolds providing an in vivo-like scaffold for three-dimensional culture. © 2015 Wiley Periodicals, Inc.

Short-term and long-term treatment outcomes with Class III activator

PubMed Central

Ryu, Hyo-kyung; Chong, Hyun-Jeong; An, Ki-Yong

2015-01-01

Objective The purpose of this retrospective study was to investigate short-term and long-term skeletodental outcomes of Class III activator treatment. Methods A Class III activator treatment group (AG) comprised of 22 patients (9 boys, 13 girls) was compared with a Class III control group (CG) comprised of 17 patients (6 boys, 11 girls). The total treatment period was divided into three stages; the initial stage (T1), the post-activator treatment or post-mandibular growth peak stage (T2), and the long-term follow-up stage (T3). Cephalometric changes were evaluated statistically via the Mann-Whitney U-test and the Friedman test. Results The AG exhibited significant increases in the SNA angle, ANB angle, Wits appraisal, A point-N perpendicular, Convexity of A point, and proclination of the maxillary incisors, from T1 to T2. In the long-term follow-up (T1-T3), the AG exhibited significantly greater increases in the ANB angle, Wits appraisal, and Convexity of A point than the CG. Conclusions Favorable skeletal outcomes induced during the Class III activator treatment period were generally maintained until the long-term follow-up period of the post-mandibular growth peak stage. PMID:26445717

Challenges Faced by Maine School Districts in Providing High Quality Public Education. Research Brief

ERIC Educational Resources Information Center

Silvernail, David L.; Linet, Sarah R.

2014-01-01

The goal of this study was to: (1) identify challenges faced by Maine school districts in providing high quality public education; (2) describe the magnitude of the challenges; and (3) identify areas where school districts were experiencing some success in meeting these challenges. The School Districts Challenge Survey was distributed online to…

Long-term monitoring FBG-based cable load sensor

NASA Astrophysics Data System (ADS)

Zhang, Zhichun; Zhou, Zhi; Wang, Chuan; Ou, Jinping

2006-03-01

Stay cables are the main load-bearing components of stayed-cable bridges. The cables stress status is an important factor to the stayed-cable bridge structure safety evaluation. So it's very important not only to the bridge construction, but also to the long-term safety evaluation for the bridge structure in-service. The accurate measurement for cable load depends on an effective sensor, especially to meet the long time durability and measurement demand. FBG, for its great advantage of corrosion resistance, absolute measurement, high accuracy, electro-magnetic resistance, quasi-distribution sensing, absolute measurement and so on, is the most promising sensor, which can cater for the cable force monitoring. In this paper, a load sensor has been developed, which is made up of a bushing elastic supporting body, 4 FBGs uniformly-spaced attached outside of the bushing supporting body, and a temperature compensation FBG for other four FBGs, moreover a cover for protection of FBGs. Firstly, the sensor measuring principle is analyzed, and relationship equation of FBG wavelength shifts and extrinsic load has also been gotten. And then the sensor calibration experiments of a steel cable stretching test with the FBG load sensor and a reference electric pressure sensor is finished, and the results shows excellent linearity of extrinsic load and FBG wavelength shifts, and good repeatability, which indicates that such kind of FBG-based load sensor is suitable for load measurement, especially for long-term, real time monitoring of stay-cables.

[Psychosocial issues of long-term cancer survivors].

PubMed

Weis, J; Faller, H

2012-04-01

Although cancer incidence rates are increasing, recent statistical studies suggest that cancer patients are showing higher cure rates as well as improved overall survival rates for most cancer locations. These advances are explained by improved strategies in early diagnoses as well as improved cancer therapies. Therefore, the number of long-term cancer survivors has also increased, but only few studies, especially within the last years, have focused on psychosocial issues of this subgroup. Some studies show that overall quality of life of long-term cancer survivors is quite high and comparable to that of the normal population. Nevertheless, a substantial percentage of former patients shows reduced quality of life and suffers from various sequelae of cancer and its treatment. This review focuses on the most common psychosocial issue of long-term survivors such as reduced psychological wellbeing, neuropsychological deficits and cancer-related fatigue syndrome. Finally, recommendations for problem-oriented interventions as well as improvement of psychosocial care of long-term survivors are given.

A security/safety survey of long term care facilities.

PubMed

Acorn, Jonathan R

2010-01-01

What are the major security/safety problems of long term care facilities? What steps are being taken by some facilities to mitigate such problems? Answers to these questions can be found in a survey of IAHSS members involved in long term care security conducted for the IAHSS Long Term Care Security Task Force. The survey, the author points out, focuses primarily on long term care facilities operated by hospitals and health systems. However, he believes, it does accurately reflect the security problems most long term facilities face, and presents valuable information on security systems and practices which should be also considered by independent and chain operated facilities.

Plate convergence and long-term crustal deformation in central Japan

NASA Astrophysics Data System (ADS)

Heki, Kosuke; Miyazaki, Shin'ichi

Surveys by continuous Global Positioning System in and around Japan revealed that the Amurian Plate collides with the North American Plate in central Japan by ∼2 cm/yr. Long-term crustal deformation seems to be influenced mainly by this collision although subduction of oceanic plates governs short-term elastic deformation over the arc. Here we study the long-term deformation field by carefully removing the short-term signals inferred from a-priori plate convergence vectors and coupling strengths predicted by a thermal model. The obtained field shows that the change in velocities occurs along the longitude 135° ∼ 137°, and there exist a relatively rigid block and zones accommodating strains. Characteristic compressional deformation is found northwest of Izu due possibly to the collision of the Izu-Bonin arc with Honshu. Plate convergence rate along the Nankai-Suruga Trough is considerably smaller in eastern parts, due partly to the transition from the Amurian to the North American Plate of the landward side, and partly to the motion of the Izu Microplate relative to the Philippine Sea Plate. This accounts for longer recurrence intervals of interplate earthquakes in the Suruga Trough where the Tokai earthquake is anticipated to occur.

Long-Term Care Financing: Lessons From France

PubMed Central

Doty, Pamela; Nadash, Pamela; Racco, Nathalie

2015-01-01

Context An aging population leads to a growing demand for long-term services and supports (LTSS). In 2002, France introduced universal, income-adjusted, public long-term care coverage for adults 60 and older, whereas the United States funds means-tested benefits only. Both countries have private long-term care insurance (LTCI) markets: American policies create alternatives to out-of-pocket spending and protect purchasers from relying on Medicaid. Sales, however, have stagnated, and the market's viability is uncertain. In France, private LTCI supplements public coverage, and sales are growing, although its potential to alleviate the long-term care financing problem is unclear. We explore whether France's very different approach to structuring public and private financing for long-term care could inform the United States’ long-term care financing reform efforts. Methods We consulted insurance experts and conducted a detailed review of public reports, academic studies, and other documents to understand the public and private LTCI systems in France, their advantages and disadvantages, and the factors affecting their development. Findings France provides universal public coverage for paid assistance with functional dependency for people 60 and older. Benefits are steeply income adjusted and amounts are low. Nevertheless, expenditures have exceeded projections, burdening local governments. Private supplemental insurance covers 11% of French, mostly middle-income adults (versus 3% of Americans 18 and older). Whether policyholders will maintain employer-sponsored coverage after retirement is not known. The government's interest in pursuing an explicit public/private partnership has waned under President François Hollande, a centrist socialist, in contrast to the previous center-right leader, President Nicolas Sarkozy, thereby reducing the prospects of a coordinated public/private strategy. Conclusions American private insurers are showing increasing interest in long-term

Long-term care financing: options for the future.

PubMed

Mulvey, Janemarie; Li, Annelise

2002-01-01

The aging of the baby boomers will have an enormous impact on the future of long-term care costs. This article projects the magnitude of that impact, discusses sources of financing, and considers the cost and feasibility of three options for financing future long-term care services. The authors investigate the alternatives of increasing personal savings, raising payroll taxes and expanding employer-sponsored private long-term care insurance coverage, respectively.

Long-Term Memory and Learning

ERIC Educational Resources Information Center

Crossland, John

2011-01-01

The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

Long term contracts, expansion, innovation and stability: North Dakota's lignite mines thrive

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

Buchsbaum, L.

2009-08-15

North Dakota's lignite coal industry is mainly located in three countries in the central part of the state. Its large surface lignite mines are tied through long-term (20-40 years) contracts to power plants. The article talks about operations at three of the most productive mines - the Freedom mine, Falkirk mine and Center Mine. 4 figs.

Role of calcitonin gene-related peptide in cardioprotection of short-term and long-term exercise preconditioning.

PubMed

Sun, Xiao-Juan; Pan, Shan-Shan

2014-07-01

To examine the role of calcitonin gene-related peptide (CGRP) in cardioprotection of short-term and long-term exercise preconditioning (EP). Male Sprague-Dawley rats were, respectively, subjected to continuous intermittent treadmill training 3 days or 3 weeks as short-term or long-term EP protocols. The myocardial injury induced by isoproterenol (ISO) was performed 24 hours after short-term and long-term EP. The myocardial injury was evaluated in terms of the serum cardiac troponin levels and the hematoxylin-basic fuchsin-picric acid staining. Additionally, serum CGRP levels, CGRP expression in the dorsal root ganglion (DRG), and heart were analyzed as possible mechanisms to explain short-term and long-term EP-induced cardioprotection. Both short-term and long-term EP markedly attenuated the isoproterenol-induced myocardial ischemia with lower serum cardiac troponin levels. Short-term EP does not alter serum CGRP levels and CGRP expression in the DRG and heart. Long-term EP significantly increases serum CGRP levels and CGRP expression in the DRG and heart. The results indicate that short-term EP does not increase the synthesis and release of CGRP. Therefore, the cardioprotective effect of short-term EP does not involve CGRP adaptation. Furthermore, long-term EP increases CGRP synthesis in the DRG and promotes CGRP release in the blood and heart. Hence, CGRP may play an important role in the cardioprotective effect of long-term EP.

Investigating the long-term course of schizophrenia by sequence analysis.

PubMed

An der Heiden, Wolfram; Häfner, Heinz

2015-08-30

In the present study we set out to explore the long-term clinical course of schizophrenia in a holistic manner by adopting sequence analysis. Our aim was to identify course types of illness by means of cluster analysis. The study was based on course and outcome data for 107 patients followed up over 134 months after first admission in the ABC Schizophrenia Study. Focusing on the main syndromes (positive, negative, depressive and unspecific symptoms) and their combinations we looked for similarities in individual illness courses using the 'optimal matching' method. A cluster analysis performed on the resulting similarity matrix yielded two main groups (a 'improving' and a 'chronic' group), which comprised a total of six different types of illness course. The course types differed in both quantitative (frequency of syndromes and syndrome combinations) and qualitative terms (clinical presentation, sequence of syndromes). Cluster membership was only rarely, but clearly associated with sociodemographic characteristics, treatment data and other illness variables. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Oral Finasteride Presents With Sexual-Unrelated Withdrawal in Long-Term Treated Androgenic Alopecia in Men.

PubMed

Perez-Mora, Nicolas; Velasco, Carlos; Bermüdez, Fernando

2015-01-01

Side effects associated with oral finasteride (FT) (1 mg/d) and topical 5% minoxidil (M5) have been previously described. The authors have evaluated long-term adverse effects and causes of long-term therapy withdrawal in patients with androgenic alopecia (AGA) treated with M5+FT vs M5 without FT. A total of 130 AGA patients with a minimum 2-year follow-up volunteered to complete a questionnaire on side effects. Patients' responses were classified as "never," "rarely," "sometimes," "often," and "all the time." An adverse effect was considered in the presence of an "often" or "all the time" response. A total of 100 patients received combined M5+FT and were compared with 30 patients receiving single-therapy M5 according to the physician's clinical criteria. Erectile dysfunction (3%), diminished libido (4%), and reduced ejaculation (7%) were present in patients taking M5+FT but were absent in patients taking M5. Only 1 of 100 patients taking M5+FT quit long-term therapy due to sexual adverse effects (diminished libido). The main causes for therapy withdrawal in the FT group were lack of positive results in 11% and in the M5 group side effects in 4% (P < .02). Increased body hair was different between groups: with 6.6% in the M5 group and 4% in the M5+FT group (P < .03). FT demonstrates sexual-unrelated reasons as the main cause of therapy withdrawal in long-term treated AGA patients.

Long-term care policy and financing as a public or private matter in the United States.

PubMed

Yee, D L

2001-01-01

Effective approaches to assure adequate resources, infrastructure, and broad societal support to address chronic care needs are volatile and potentially unpopular issues that can result in many losers (those getting far less than they want) and few winners (those who gain access to scarce societal resources for care). In the United States, debates on long-term care involve a complex set of issues and services that link health, social services (welfare), and economic policies that often pit public and private sector interests and values against one another. Yet long-term care policies fill a necessary function in society to clarify roles, expectations, and functions of public, non-profit, for profit, individual, and family sectors of a society. By assessing and developing policy proposals that include all long-term care system dimensions, a society can arrive at systematic, fair, and rational decisions. Limiting decisions to system financing aspects alone is likely to result in unforeseen or unintended effects in a long-term care system that stopgap "fixes" cannot resolve. Three underlying policy challenges are presented: the need for policymakers to consider whether the public sector is the first or last source of payment for long-term care; whether government is seen primarily as a risk or cost manager; and the extent to which choice is afforded to elders and family caregivers with regard to the types, settings, and amount of long-term care desired to complement family care.

Quantifying long-term evolution of intra-urban spatial interactions

PubMed Central

Sun, Lijun; Jin, Jian Gang; Axhausen, Kay W.; Lee, Der-Horng; Cebrian, Manuel

2015-01-01

Understanding the long-term impact that changes in a city's transportation infrastructure have on its spatial interactions remains a challenge. The difficulty arises from the fact that the real impact may not be revealed in static or aggregated mobility measures, as these are remarkably robust to perturbations. More generally, the lack of longitudinal, cross-sectional data demonstrating the evolution of spatial interactions at a meaningful urban scale also hinders us from evaluating the sensitivity of movement indicators, limiting our capacity to understand the evolution of urban mobility in depth. Using very large mobility records distributed over 3 years, we quantify the impact of the completion of a metro line extension: the Circle Line (CCL) in Singapore. We find that the commonly used movement indicators are almost identical before and after the project was completed. However, in comparing the temporal community structure across years, we do observe significant differences in the spatial reorganization of the affected geographical areas. The completion of CCL enables travellers to re-identify their desired destinations collectively with lower transport cost, making the community structure more consistent. These changes in locality are dynamic and characterized over short timescales, offering us a different approach to identify and analyse the long-term impact of new infrastructures on cities and their evolution dynamics. PMID:25551142

Planning long-term vegetation studies at landscape scales

USGS Publications Warehouse

Stohlgren, Thomas J.

1995-01-01

Long-term ecological research is receiving more attention now than ever before. Two recent books, Long-term Studies in Ecology: Approaches and Alternatives, edited by Gene Likens (1989), and Long-term Ecological Research: An International Perspective, edited by Paul Risser (1991), prompt the question, “Why are these books so thin?” Except for data from paleoecological, retrospective studies (see below), there are exceptionally few long-term data sets in terrestrial ecology (Strayer et al. 1986; Tilman 1989; this volume). In a sample of 749 papers published in Ecology, Tilman (1989) found that only 1.7% of the studies lasted at least five field seasons. Only one chapter in each of the review books dealt specifically with expanding both the temporal and the spatial scales of ecological research (Berkowitz et al. 1989; Magnuson et al. 1991). Judging by the growing number of landscape-scale long-term studies, however, such as the Long-Term Ecological Research (LTER) Program (Callahan 1991), the U.S. Environmental Protection Agency’s Environmental Monitoring and Assessment Program (EMAP; Palmer et al. 1991), the U.S. Army’s Land Condition-Trend Analysis (LCTA) Program (Diersing et al. 1992), and various agencies’ global change research programs (CEES 1993), there is a growing interest to expand ecological research both temporally and spatially.

Zeitgeists and development trends in long-term care facility design.

PubMed

Wang, Chia-Hui; Kuo, Nai-Wen

2006-06-01

Through literature analysis, in-depth interviews, and the application of the Delphi survey, this study explored long-term care resident priorities with regard to long-term care facility design in terms of both physical and psychological needs. This study further clarified changing trends in long-term care concepts; illustrated the impact that such changes are having on long-term care facility design; and summarized zeitgeists related to the architectural design of long-term care facilities. Results of our Delphi survey indicated the following top five priorities in long-term care facility design: (1) creating a home-like feeling; (2) adhering to Universal Design concepts; (3) providing well-defined private sleeping areas; (4) providing adequate social space; and (5) decentralizing residents' rooms into clusters. The three major zeitgeists related to long-term care facility design include: (1) modern long-term care facilities should abandon their traditional "hospital" image and gradually reposition facilities into homelike settings; (2) institution-based care for the elderly should be de-institutionalized under the concept of aging-in-place; and (3) living clusters, rather than traditional hospital-like wards, should be designed into long-term care facilities.

Modelling the effects of trade-offs between long and short-term objectives in fisheries management.

PubMed

Mardle, Simon; Pascoe, Sean

2002-05-01

Fisheries management is typically a complex problem, from both an environmental and political perspective. The main source of conflict occurs between the need for stock conservation and the need for fishing community well-being, which is typically measured by employment and income levels. For most fisheries, overexploitation of the stock requires a reduction in the level of fishing activity. While this may lead to long-term benefits (both conservation and economic), it also leads to a short-term reduction in employment and regional incomes. In regions which are heavily dependent on fisheries, short-term consequences of conservation efforts may be considerable. The relatively high degree of scientific uncertainty with respect to the status of the stocks and the relatively short lengths of political terms of office, generally give rise to the short-run view taking the highest priority when defining policy objectives. In this paper, a multi-objective model of the North Sea is developed that incorporates both long-term and short-term objectives. Optimal fleet sizes are estimated taking into consideration different preferences between the defined short-term and long-term objectives. The subsequent results from the model give the short-term and long-term equilibrium status of the fishery incorporating the effects of the short-term objectives. As would be expected, an optimal fleet from a short-term perspective is considerably larger than an optimal fleet from a long-run perspective. Conversely, stock sizes and sustainable yields are considerably lower in the long-term if a short-term perspective is used in setting management policies. The model results highlight what is essentially a principal-agent problem, with the objectives of the policy makers not necessarily reflecting the objectives of society as a whole.

Disability in long-term care residents explained by prevalent geriatric syndromes, not long-term care home characteristics: a cross-sectional study.

PubMed

Lane, Natasha E; Wodchis, Walter P; Boyd, Cynthia M; Stukel, Thérèse A

2017-02-10

Self-care disability is dependence on others to conduct activities of daily living, such as bathing, eating and dressing. Among long-term care residents, self-care disability lowers quality of life and increases health care costs. Understanding the correlates of self-care disability in this population is critical to guide clinical care and ongoing research in Geriatrics. This study examines which resident geriatric syndromes and chronic conditions are associated with residents' self-care disability and whether these relationships vary across strata of age, sex and cognitive status. It also describes the proportion of variance in residents' self-care disability that is explained by residents' geriatric syndromes versus long-term care home characteristics. We conducted a cross-sectional study using a health administrative cohort of 77,165 long-term care home residents residing in 614 Ontario long-term care homes. Eligible residents had their self-care disability assessed using the RAI-MDS 2.0 activities of daily living long-form score (range: 0-28) within 90 days of April 1st, 2011. Hierarchical multivariable regression models with random effects for long-term care homes were used to estimate the association between self-care disability and resident geriatric syndromes, chronic conditions and long-term care home characteristics. Differences in findings across strata of sex, age and cognitive status (cognitively intact versus cognitively impaired) were examined. Geriatric syndromes were much more strongly associated with self-care disability than chronic conditions in multivariable models. The direction and size of some of these effects were different for cognitively impaired versus cognitively intact residents. Residents' geriatric syndromes explained 50% of the variation in their self-care disability scores, while characteristics of long-term care homes explained an additional 2% of variation. Differences in long-term care residents' self-care disability are

Impacts of Wildfires on Long-term Land Surface Phenology

NASA Astrophysics Data System (ADS)

Wang, J.; Zhang, X.

2016-12-01

Land surface phenology (LSP) detected from satellite data characterizes seasonal dynamics of vegetation communities within a moderate or coarse resolution pixel. Its long-term variation has been widely used to indicate the biological responses to climate changes. However, few studies have focused on the influence of land disturbance on LSP variations. The wildfire is one of the most important drivers of land disturbances across the world, which shows an increasing trend during past decades. To explore the wildfire impacts on LSP, we analyzed post-fire and pre-fire LSP in two forest fire events that are Hayman Fire occurred in 2002 and Mason Fire occurred in 2005 in Colorado. Specifically, we first generated a two band enhanced vegetation index (EVI2) from MODIS daily surface reflectance product (MOD09GQ) at a spatial resolution of 250 m from 2001-2014. The time series of daily EVI2 was then used to detect the start of growing season (SOS) by applying the LSP detection algorithm based on a hybrid piecewise logistic model (HPLM-LSPD). The SOS was further separated for four levels of burn severity obtained from Monitoring Trends in Burn Severity (MTBS) maps for each fire event. The long-term SOS in the burn scars was finally deviated from surrounding areas based on land cover types. Results show that forests were mainly converted to shrubs in both fire events with some grasslands in Hayman. On average, SOS in Hayman burn scar area was advanced 11 days relative to surrounding region while it was delayed 9 days in Mason fire. The deviation also varied with the burn severity spatially. Moreover, the long-term SOS trend in the local area from 2001-2014 was significantly different with and without considerations of the fire influences. This study demonstrates that the long-term LSP SOS trend is significantly influenced by land disturbances in a local and regional scales.

[Long-term follow-up of patients with suprasellar germinomas].

PubMed

Bauditz, Juergen; Lochs, Herbert; Ventz, Manfred

2007-10-15

Suprasellar germinomas are rare intracranial neoplasms, which mainly occur in children and adolescents and manifest with endocrine symptoms and/or compression syndromes. The clinical, hormonal and morphological findings as well as treatment and complications were investigated in seven patients (six male, one female) with germinomas. Mean age at diagnosis was 19.7 years (range 15-32 years). First disease-related symptoms were diabetes insipidus (three patients), loss of libido (two patients), pseudopubertas praecox (one patient), and dwarfism (one patient). However, decisive symptoms leading to final diagnosis were visual disturbances (five patients), pubertas tarda (one patient), and hypogonadism (one patient). All patients were treated by transcranial radiation with a dose of 40-54 Gy. One patient received additional chemotherapy with cisplatin, etoposide, and ifosfamide (PEI). Patients were followed up for 14.6 years (range 7-27 years). Intracranial and pulmonary relapses were observed in two patients. Panhypopituitarism and diabetes insipidus were seen in all patients after treatment. Two patients suffered from loss of vision, two further patients from unilateral amaurosis. One patient developed epilepsy and persistent cognitive impairment. Long-term follow-up shows that two patients died from recurrent disease and decompensated liver cirrhosis, respectively. The other patients are long-term survivors. Full social integration with employment was possible in one case. Suprasellar germinomas cause endocrine symptoms during early tumor stages, however, diagnosis is generally established when ocular symptoms related to tumor compression are already present. Long-term survival is characterized by panhypopituitarism, diabetes insipidus and, partly, ocular or cerebral defects.

Soil Organic Matter Dynamics in the Rothamsted Long-term Experiments

NASA Astrophysics Data System (ADS)

MacDonald, A.; Poulton, P.

2009-04-01

Soil science research at Rothamsted dates from 1843 when John Bennet Lawes and Joseph Henry Gilbert started the first of a series of what became long-term field experiments. The main object of these experiments was to examine the effect of inorganic and organic fertilisers and manures on crop yield and soil fertility. These "Classical Field Experiments" included studies on winter wheat (Broadbalk 1843), spring barley (Hoos Barley 1852) and permanent grassland (Park Grass 1856). Additional experiments were established in the 20th century to examine the value of ley-arable cropping, including the Highfield and Fosters Ley-arable experiments (1948) and the Woburn Ley-arable experiment (1938). More recently, the effects of incorporating organic manures and cereal straw have been examined. Early results quickly showed the benefits of inorganic N and P fertilisers on crop production, but the effects of contrasting land uses and management practices on soil properties emerged more slowly. Measurements of soil organic carbon (C) and nitrogen (N) in soils taken at intervals from the long-term experiments indicate that the rate of soil organic matter (SOM) accumulation is controlled largely by the balance between the rate of organic matter inputs and its oxidation rate, and that these are strongly influenced by land use and management, soil texture (especially clay content) and climate. A recent examination of soil organic C data from two long-term grassland experiments in the UK (including Park Grass) indicates that any changes observed in soil organic C under long-term grasslands over the past 40 years are more likely to be due to changes in land use and management rather than climate change. Data from the Rothamsted Long-term experiments have been used to develop and test biogeochemical models of C and N dynamics. In particular, the Roth-C model has successfully simulated soil C dynamics in the long-term experiments at Rothamsted and elsewhere. This model uses several

Caught in suffering bodies: a qualitative study of immigrant women on long-term sick leave in Norway.

PubMed

Nortvedt, Line; Hansen, Helle Ploug; Kumar, Bernadette N; Lohne, Vibeke

2015-11-01

This article explores the issues faced by immigrant women on long-term sick leave due to chronic pain, focusing on their personal perspectives on their daily lives, their bodies and their pain. An increasing number of immigrants in Norway present a challenge to the public health service, above all in relation to the health needs of immigrant women, many of whom risk having to take long-term sick leave due to chronic pain. This study has a qualitative design, with participant observation and in-depth interviews. Participant observations were carried out from a sample of fourteen immigrant women in an outpatient clinic at a rehabilitation hospital. In addition, qualitative interviews were conducted after the rehabilitation period. A hermeneutic approach was used to understand the meaning of the narrated text. The analysis revealed one main theme, 'Bodies marked by onerous experiences', as well as two subthemes: 'It is in my body' and 'Invisible pain'. The immigrant women struggled with invisible, chronic pain, which they blamed on physically tiring workdays and stressful life situations. Furthermore, they felt that their experiences of discriminative attitudes at the workplace worsened their suffering. The chronic pain made the immigrant women suffer, because they experienced it as a threatening, incomprehensible and unreal force, without meaning or the ability to be controlled. Their own psychological distress exacerbated their pain. Immigrant women on long-term sick leave are likely to need special approaches that are closely adapted to their different backgrounds and their unique personal experiences. We recommend culturally appropriate family counselling and collaboration with employers at the women's workplaces. © 2015 John Wiley & Sons Ltd.

Contribution of cannabis and MDMA ("ecstasy") to cognitive changes in long-term polydrug users.

PubMed

Dafters, Richard Ian; Hoshi, Rosa; Talbot, Annie Claire

2004-05-01

Establishing whether cognitive changes follow long-term use of MDMA ("ecstasy") in humans has been difficult because of possible confounds with other drug use, particularly cannabis. Convincing evidence may be only obtained using experimental designs that account for such confounds. In the present study, cognitive/behavioural measures were used to investigate whether long-term MDMA use or long-term cannabis use is responsible for the changes sometimes observed in recreational MDMA users. Tests of attention and memory were administered to subjects who used both MDMA and cannabis, cannabis only, or neither drug. The main finding was that cannabis users, whether or not they also used MDMA, showed significantly impaired memory function on word free-recall and on immediate and delayed story recall compared to non-users. The findings highlight the importance of controlling for other drug use (particularly cannabis) when investigating persistent effects of MDMA in humans.

Long-term course of orthostatic tremor in serial posturographic measurement.

PubMed

Feil, K; Böttcher, N; Guri, F; Krafczyk, S; Schöberl, F; Zwergal, A; Strupp, M

2015-08-01

Primary orthostatic tremor (OT) is a rare neurological disease of unknown pathophysiology characterized by a high-frequency tremor mainly of the legs when standing. The aim of this study was to examine its long-term course by subjective estimation and objective recording by serial posturography and to obtain further standardized epidemiological and clinical data on patients with OT. A clinical cohort of 37 patients with the diagnosis of primary OT was screened for this longitudinal follow-up study. Eighteen patients consented to participate. During study visit all patients underwent a standardized neurological examination and completed subjective scales and scores. Posturographic recordings at follow-up were compared to prior clinical posturographic measurements in 15 cases. In our cohort the mean duration of symptoms was 14.1 ± 6.8 years. Subjectively, 78% of patients reported progression of the disease. Posturographic data (5.4 ± 4.0 years) revealed a significant increase of the total sway path (standing on firm ground with eyes open) from 2.4 ± 1.3 to 3.4 ± 1.4 m/min (p = 0.022) and of the total root mean square values from 9.8 ± 4.3 to 12.4 ± 4.8 mm (p = 0.028). None of these observations are explained by aging of the patients. Mean frequency of the tremor did not change over time (14.7 ± 1.9 Hz vs. 14.9 ± 2.0 Hz at follow-up). Clinically, most patients had signs of cerebellar dysfunction and a substantial portion also showed proprioceptive deficits in the long-term course. This long-term follow-up study indicates, that primary OT is a progressive disorder. Furthermore, the clinical observation of cerebellar dysfunction in most OT patients in the long-term course might indicate an important role of the cerebellum in its pathophysiology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Long-Term Monitoring of Global Climate Forcings and Feedbacks

NASA Technical Reports Server (NTRS)

Hansen, J. (Editor); Rossow, W. (Editor); Fung, I. (Editor)

1993-01-01

A workshop on Long-Term Monitoring of Global Climate Forcings and Feedbacks was held February 3-4, 1992, at NASA's Goddard Institute for Space Studies to discuss the measurements required to interpret long-term global temperature changes, to critique the proposed contributions of a series of small satellites (Climsat), and to identify needed complementary monitoring. The workshop concluded that long-term (several decades) of continuous monitoring of the major climate forcings and feedbacks is essential for understanding long-term climate change.

Is Ecosystem-Atmosphere Observation in Long-Term Networks actually Science?

NASA Astrophysics Data System (ADS)

Schmid, H. P. E.

2015-12-01

Science uses observations to build knowledge by testable explanations and predictions. The "scientific method" requires controlled systematic observation to examine questions, hypotheses and predictions. Thus, enquiry along the scientific method responds to questions of the type "what if …?" In contrast, long-term observation programs follow a different strategy: we commonly take great care to minimize our influence on the environment of our measurements, with the aim to maximize their external validity. We observe what we think are key variables for ecosystem-atmosphere exchange and ask questions such as "what happens next?" or "how did this happen?" This apparent deviation from the scientific method begs the question whether any explanations we come up with for the phenomena we observe are actually contributing to testable knowledge, or whether their value remains purely anecdotal. Here, we present examples to argue that, under certain conditions, data from long-term observations and observation networks can have equivalent or even higher scientific validity than controlled experiments. Internal validity is particularly enhanced if observations are combined with modeling. Long-term observations of ecosystem-atmosphere fluxes identify trends and temporal scales of variability. Observation networks reveal spatial patterns and variations, and long-term observation networks combine both aspects. A necessary condition for such observations to gain validity beyond the anecdotal is the requirement that the data are comparable: a comparison of two measured values, separated in time or space, must inform us objectively whether (e.g.) one value is larger than the other. In turn, a necessary condition for the comparability of data is the compatibility of the sensors and procedures used to generate them. Compatibility ensures that we compare "apples to apples": that measurements conducted in identical conditions give the same values (within suitable uncertainty intervals

Antibiotic prescribing in long-term care facilities: a qualitative, multidisciplinary investigation

PubMed Central

Fleming, Aoife; Bradley, Colin; Cullinan, Shane; Byrne, Stephen

2014-01-01

Objectives To explore healthcare professionals’ views of antibiotic prescribing in long-term care facilities (LTCFs). To use the findings to recommend intervention strategies for antimicrobial stewardship in LTCFs. Design Qualitative semistructured interviews were conducted. The data were analysed by thematic content analysis. After the interviews, the emerging findings were mapped to the theoretical domains framework (TDF), and the behaviour change wheel and behaviour change technique (BCT) taxonomy were used to recommend future intervention strategies. Participants Interviews were conducted with 37 healthcare professionals who work in LTCFs (10 general practitioners, 4 consultants, 14 nurses, 9 pharmacists) between December 2012 and March 2013. Setting Interviews were conducted in the greater Cork region. Results The main domains from the TDF which emerged were: ‘Knowledge’, ‘Environmental context and resources’, ‘Social influences’, ‘Beliefs about consequences’, ‘Memory, attention and decision making’, with the findings identifying a need for ‘Behavioural regulation’. Many participants believed that antibiotic prescribing was satisfactory at their LTCF, despite the lack of surveillance activities. Conclusions This study, using the TDF and BCT taxonomy, has found that antibiotic prescribing in LTCFs is influenced by many social and contextual factors. The challenges of the setting and patient population, the belief about consequences to the patient, and the lack of implementation of guidelines and knowledge regarding antibiotic prescribing patterns are significant challenges to address. On the basis of the study findings and the application of the TDF and BCT taxonomy, we suggest some practical intervention functions for antimicrobial stewardship in LTCFs. PMID:25377014

Long Term Care Aide/Homemaker. Resource Handbook.

ERIC Educational Resources Information Center

Illerbrun, Marley

This handbook provides basic information for preparing individuals to work as long-term care aides and homemakers. It is written both for college students in long-term care aide/homemaker programs and for individuals already employed in these occupations. Health care agencies giving orientation training for new employees and inservice training for…

Developmental Dyslexia and Explicit Long-Term Memory

ERIC Educational Resources Information Center

Menghini, Deny; Carlesimo, Giovanni Augusto; Marotta, Luigi; Finzi, Alessandra; Vicari, Stefano

2010-01-01

The reduced verbal long-term memory capacities often reported in dyslexics are generally interpreted as a consequence of their deficit in phonological coding. The present study was aimed at evaluating whether the learning deficit exhibited by dyslexics was restricted only to the verbal component of the long-term memory abilities or also involved…

Long-term potential and actual evapotranspiration of two different forests on the Atlantic Coastal Plain

Treesearch

Devendra Amatya; S. Tian; Z. Dai; Ge Sun

2016-01-01

A reliable estimate of potential evapotranspiration (PET) for a forest ecosystem is critical in ecohydrologic modeling related with water supply, vegetation dynamics, and climate change and yet is a challenging task due to its complexity. Based on long-term on-site measured hydro-climatic data and predictions from earlier validated hydrologic modeling studies...

78 FR 36449 - State Long-Term Care Ombudsman Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... 0985-AA08 State Long-Term Care Ombudsman Program AGENCY: Administration on Aging, Administration for... Act, the State Long-Term Care Ombudsman program. This proposed rule replaces AoA's 1994 Notice of... highlighted the difficulty of determining State compliance in carrying out the Long-Term Care Ombudsman...

Importance of Data Management in a Long-Term Biological Monitoring Program

NASA Astrophysics Data System (ADS)

Christensen, Sigurd W.; Brandt, Craig C.; McCracken, Mary K.

2011-06-01

The long-term Biological Monitoring and Abatement Program (BMAP) has always needed to collect and retain high-quality data on which to base its assessments of ecological status of streams and their recovery after remediation. Its formal quality assurance, data processing, and data management components all contribute to meeting this need. The Quality Assurance Program comprehensively addresses requirements from various institutions, funders, and regulators, and includes a data management component. Centralized data management began a few years into the program when an existing relational database was adapted and extended to handle biological data. The database's main data tables and several key reference tables are described. One of the most important related activities supporting long-term analyses was the establishing of standards for sampling site names, taxonomic identification, flagging, and other components. The implemented relational database supports the transmittal of data to the Oak Ridge Environmental Information System (OREIS) as the permanent repository. We also discuss some limitations to our implementation. Some types of program data were not easily accommodated in the central systems, and many possible data-sharing and integration options are not easily accessible to investigators. From our experience we offer data management advice to other biologically oriented long-term environmental sampling and analysis programs.

Surgeon's guide to anticoagulant and antiplatelet medications part two: antiplatelet agents and perioperative management of long-term anticoagulation

PubMed Central

Yeung, Louise Y Y; Sarani, Babak; Weinberg, Jordan A; McBeth, Paul B; May, Addison K

2016-01-01

An increasing number of potent antiplatelet and anticoagulant medications are being used for the long-term management of cardiac, cerebrovascular, and peripheral vascular conditions. Management of these medications in the perioperative and peri-injury settings can be challenging for surgeons, mandating an understanding of these agents and the risks and benefits of various management strategies. In this two part review, agents commonly encountered by surgeons in the perioperative and peri-injury settings are discussed and management strategies for patients on long-term antiplatelet and anticoagulant therapy reviewed. In part one, we review warfarin and the new direct oral anticoagulants. In part two, we review antiplatelet agents and assessment of platelet function and the perioperative management of long-term anticoagulation and antiplatelet therapy. PMID:29767644

Long-term memory, sleep, and the spacing effect.

PubMed

Bell, Matthew C; Kawadri, Nader; Simone, Patricia M; Wiseheart, Melody

2014-01-01

Many studies have shown that memory is enhanced when study sessions are spaced apart rather than massed. This spacing effect has been shown to have a lasting benefit to long-term memory when the study phase session follows the encoding session by 24 hours. Using a spacing paradigm we examined the impact of sleep and spacing gaps on long-term declarative memory for Swahili-English word pairs by including four spacing delay gaps (massed, 12 hours same-day, 12 hours overnight, and 24 hours). Results showed that a 12-hour spacing gap that includes sleep promotes long-term memory retention similar to the 24-hour gap. The findings support the importance of sleep to the long-term benefit of the spacing effect.

A double-blind randomized placebo-controlled withdrawal trial comparing memantine and antipsychotics for the long-term treatment of function and neuropsychiatric symptoms in people with Alzheimer's disease (MAIN-AD).

PubMed

Ballard, Clive; Thomas, Alan; Gerry, Stephen; Yu, Ly-Mee; Aarsland, Dag; Merritt, Claire; Corbett, Anne; Davison, Christopher; Sharma, Narenda; Khan, Zunera; Creese, Byron; Loughlin, Paul; Bannister, Carol; Burns, Alistair; Win, Soe Nyunt; Walker, Zuzana

2015-04-01

Neuropsychiatric symptoms in Alzheimer disease (AD) cause significant distress and present a complex clinical challenge for treatment. Pharmacological treatment options are limited to antipsychotics, which carry extensive safety issues. There is emerging evidence to support the potential benefits of memantine, currently licensed for moderate to severe AD, in the prophylaxis of neuropsychiatric symptoms. The MAIN-AD study is a double-blind randomized placebo-controlled withdrawal trial comparing memantine with antipsychotics for the treatment of neuropsychiatric symptoms over 24 weeks. A total of 199 people with probable AD living in care homes already receiving an antipsychotic were randomized to receive either memantine or to continue an antipsychotic. The primary outcomes were function (Bristol Activities of Daily Living Scale [BADLS]) and agitation (Cohen-Mansfield Agitation Inventory [CMAI]). Secondary outcomes were Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), and mortality. There was no significant difference between groups on the BADLS or CMAI. At 24 weeks, there was a nonsignificant adjusted difference in favor of memantine on the BADLS of 0.23 (95% CI -1.80-2.27; P = .82) and in favor of antipsychotic on the CMAI of 0.09 (95% CI -0.35-8.53; P = .07). Although there were no significant differences in total NPI, there were 5.01 (95% CI -1.68-11.70; P = .05) and 3.63 (95% CI -1.40-8.67; P = .16) point advantages favoring antipsychotics at weeks 12 and 24, respectively. In addition, in an exploratory analysis, individuals allocated to antipsychotics were significantly less likely to experience relapse of neuropsychiatric symptoms at all time points. The group receiving memantine had a nonsignificant 1.3-point advantage on the MMSE at 24 weeks. This study indicates no benefits for memantine in the long-term treatment and prophylaxis of clinically significant neuropsychiatric symptoms. The results did indicate some benefits for

Long-term course of opioid addiction.

PubMed

Hser, Yih-Ing; Evans, Elizabeth; Grella, Christine; Ling, Walter; Anglin, Douglas

2015-01-01

Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.

Genetically encoded calcium indicators for studying long-term calcium dynamics during apoptosis.

PubMed

Garcia, M Iveth; Chen, Jessica J; Boehning, Darren

2017-01-01

Intracellular calcium release is essential for regulating almost all cellular functions. Specific spatio-temporal patterns of cytosolic calcium elevations are critical determinants of cell fate in response to pro-apoptotic cellular stressors. As the apoptotic program can take hours or days, measurement of long-term calcium dynamics are essential for understanding the mechanistic role of calcium in apoptotic cell death. Due to the technical limitations of using calcium-sensitive dyes to measure cytosolic calcium little is known about long-term calcium dynamics in living cells after treatment with apoptosis-inducing drugs. Genetically encoded calcium indicators could potentially overcome some of the limitations of calcium-sensitive dyes. Here, we compared the performance of the genetically encoded calcium indicators GCaMP6s and GCaMP6f with the ratiometric dye Fura-2. GCaMP6s performed as well or better than Fura-2 in detecting agonist-induced calcium transients. We then examined the utility of GCaMP6s for continuously measuring apoptotic calcium release over the course of ten hours after treatment with staurosporine. We found that GCaMP6s was suitable for measuring apoptotic calcium release over long time courses and revealed significant heterogeneity in calcium release dynamics in individual cells challenged with staurosporine. Our results suggest GCaMP6s is an excellent indicator for monitoring long-term changes cytosolic calcium during apoptosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Beyond the short term : transportation asset management for long-term sustainability, accountability and performance

DOT National Transportation Integrated Search

2010-01-01

Transportation Asset Management (TAM) has long been recognized as a sound, long-term approach to managing infrastructure. It provides decision makers with a rational, long-term systematic process for making difficult and complex decisions about how t...

Rural long-term care work, gender, and restructuring.

PubMed

Leach, Belinda; Joseph, Gillian

2011-06-01

Restructuring--the introduction of changes that alter the way health care is delivered for maximum efficiency and least cost--layered with rurality and with rural gender ideologies and practices, results in rural long-term care settings that have particular consequences for the women working in them, and for the residents and communities that they serve. This research investigated how rurality affects the implementation of patient classification in Ontario long-term care homes. Methods involved interviews and focus groups with front-line long-term care workers, administrators, and key participants. The findings revealed that rural long-term care delivery takes place when a restructured work environment intersects with gender ideologies and practices that take on particular characteristics when developed and sustained in a rural context. These factors shape the labor market and working conditions for rural women. We argue that this produces a uniquely rural experience for long-term care workers and conclude that those implementing classification systems must consider contextual factors as well as practical and financial exigencies.

[Long-term memory, neurogenesis and novelty signal].

PubMed

Sokolova, E N; Nezlina, N I

2003-01-01

In accordance with the advanced hypothesis the long-term memory is a collection of "gnostic units" selectively tuned to experienced events. The long-term memory is continuously supplemented by new neurons differentiated from stem cells during neurogenesis (particularly, in adults). The transformation of neuronal progenitors into event-selective gnostic units is accomplished with participation of hippocampal "novelty neurons" emphasizing information inputs to be stored in the long-term memory. The formation of the gnostic units is preceded by informational processes occurring in the ventral ("what?") and dorsal ("where?") systems. The formation of a new gnostic unit selectively tuned to a particular event is a result of combination of feature-detector excitation and novelty signal generated by hippocampal novelty neurons.

Space ventures and society long-term perspectives

NASA Technical Reports Server (NTRS)

Brown, W. M.

1985-01-01

A futuristic evaluation of mankind's potential long term future in space is presented. Progress in space will not be inhibited by shortages of the Earth's physical resources, since long term economic growth will be focused on ways to constrain industrial productivity by changing social values, management styles, or government competence. Future technological progress is likely to accelerate with an emphasis on international cooperation, making possible such large joint projects as lunar colonies or space stations on Mars. The long term future in space looks exceedingly bright even in relatively pessimistic scenarios. The principal driving forces will be technological progress, commercial and public-oriented satellites, space industrialization, space travel, and eventually space colonization.

Legislation on Long-Term Care Insurance. Report No. 11.

ERIC Educational Resources Information Center

Wisconsin State Legislative Council, Madison.

This report presents Wisconsin state legislation on long-term care insurance. Part I summarizes key provisions of six 1987 assembly bills concerned with long-term care insurance. Part II describes activities of the Wisconsin State Legislative Council's Special Committee on Long-Term Health Care Insurance. Part III provides background information…

Long-term outcome of urethroplasty after failed urethrotomy versus primary repair.

PubMed

Barbagli, G; Palminteri, E; Lazzeri, M; Guazzoni, G; Turini, D

2001-06-01

A urethral stricture recurring after repeat urethrotomy challenges even a skilled urologist. To address the question of whether to repeat urethrotomy or perform open reconstructive surgery, we retrospectively review a series of 93 patients comparing those who underwent primary repair versus those who had undergone urethrotomy and underwent secondary treatment. From 1975 to 1998, 93 males between age 13 and 78 years (mean 39) underwent surgical treatment for bulbar urethral stricture. In 46 (49%) of the patients urethroplasty was performed as primary repair, and in 47 (51%) after previously failed urethrotomy. The strictures were localized in the bulbous urethra without involvement of penile or membranous tracts. The etiology was ischemic in 37 patients, traumatic in 23, unknown in 17 and inflammatory in 16. To simplify evaluation of the results, the clinical outcome was considered either a success or a failure at the time any postoperative procedure was needed, including dilation. In our 93 patients primary urethroplasty had a final success rate of 85%, and after failed urethrotomy 87%. Previously failed urethrotomy did not influence the long-term outcome of urethroplasty. The long-term results of different urethroplasty techniques had a final success rate ranging from 77% to 96%. We conclude that failed urethrotomy does not condition the long-term result of surgical repair. With extended followup, the success rate of urethroplasty decreases with time but it is in fact still higher than that of urethrotomy.

Neuroradiological findings of trisomy 13 in a rare long-term survivor.

PubMed

Goff, Ryan D; Soares, Bruno P

2017-01-01

Patau syndrome remains a difficult diagnosis for parents and a challenging conversation for clinicians due to the overall poor prognosis. Previous population-based reports have documented the sobering life expectancies of these patients, with few surviving to 1 year of age. Despite the high mortality rate in infants born with trisomy 13, there are several reports of survival into late childhood and early adulthood. While clinical outcomes have been well documented, there has been a paucity of literature describing postnatal imaging findings in long-term survivors. We present a case report of a 2-year-old girl with trisomy 13 who underwent brain magnetic resonance imaging examination at our institution to evaluate for possible structural abnormalities contributing to central sleep apnea. We describe the clinical and postnatal neuroimaging findings of this rare patient with trisomy 13. Understanding the spectrum of neuroradiological findings in long-term survivors with trisomy 13, in combination with other organ system abnormalities, could add important clinical information and help better predict patient outcomes and expectations among parents.

Measuring Worker Turnover in Long-Term Care: Lessons from the Better Jobs Better Care Demonstration

ERIC Educational Resources Information Center

Piercy, Kathleen Walsh, Ed.; Barry, Theresa; Kemper, Peter; Brannon, S. Diane

2008-01-01

Purpose: Turnover among direct-care workers (DCWs) continues to be a challenge in long-term care. Both policy makers and provider organizations recognize this issue as a major concern and are designing efforts to reduce turnover among these workers. However, there is currently no standardized method of measuring turnover to define the scope of the…

Transplantology: Challenges for Today.

PubMed

Boratyńska, Maria; Patrzałek, Dariusz

2016-12-01

Clinical transplantology in Poland had its 50th anniversary this year. With the early and long results comparable to the best achieved in the world leading centers, we face old and completely new challenges for this medical speciality. Main and growing challenge is insufficient number of available organs. With less than 15 donors/mln population/year Poland stay in the lower row of European countries in this measurement of transplant activity. Donation system is not efficient enough and we lose a big number of potential donors still. Living donation (with the exception for the fragments of the liver) remains low despite of different initiatives made so far on the national and local levels. Donation after cardiac death is possible from the point of Polish juridical regulations, but since last 3 years had not showed real impact on country donation rates (only three procedures done). Methods of tissue typing remain slow and cause relatively long times of cold ischemia for kidney programs. Second main challenge is chronic rejection causing loss of organs in the long-term follow-up and no efficient treatment employed. The emerging possibility of tolerance induction despite of plenty of new protocols proposition in the publications does not show up a clinical everyday practice in work. The same is with xenotransplantation promises; even we were informed recently that till 2030 such genetically modified porcine organs will be available. The next challenge is production of organs and tissues from own recipients cells installed on the different scaffolds or 3D printed. Other challenge is the personnel working in this field. We observe like in the other European countries lack of new candidates for work in this field together with serious problems of nursing staff, being a catastrophic perspective in country medical service in general, not only in transplant centers. The last but not least challenge is financial side of transplant programs.

Long-term variations of the upper atmosphere parameters on Rome ionosonde observations and their interpretation

NASA Astrophysics Data System (ADS)

Perrone, Loredana; Mikhailov, Andrey; Cesaroni, Claudio; Alfonsi, Lucilla; Santis, Angelo De; Pezzopane, Michael; Scotto, Carlo

2017-09-01

A recently proposed self-consistent approach to the analysis of thermospheric and ionospheric long-term trends has been applied to Rome ionosonde summer noontime observations for the (1957-2015) period. This approach includes: (i) a method to extract ionospheric parameter long-term variations; (ii) a method to retrieve from observed foF1 neutral composition (O, O2, N2), exospheric temperature, Tex and the total solar EUV flux with λ < 1050 Å; and (iii) a combined analysis of the ionospheric and thermospheric parameter long-term variations using the theory of ionospheric F-layer formation. Atomic oxygen, [O] and [O]/[N2] ratio control foF1 and foF2 while neutral temperature, Tex controls hmF2 long-term variations. Noontime foF2 and foF1 long-term variations demonstrate a negative linear trend estimated over the (1962-2010) period which is mainly due to atomic oxygen decrease after ˜1990. A linear trend in (δhmF2)11y estimated over the (1962-2010) period is very small and insignificant reflecting the absence of any significant trend in neutral temperature. The retrieved neutral gas density, ρ atomic oxygen, [O] and exospheric temperature, Tex long-term variations are controlled by solar and geomagnetic activity, i.e. they have a natural origin. The residual trends estimated over the period of ˜5 solar cycles (1957-2015) are very small (<0.5% per decade) and statistically insignificant.

Valuing a long-term care facility.

PubMed

Mellen, C M

1992-10-01

The business valuation industry generally uses at least one of three basic approaches to value a long-term care facility: the cost approach, sales comparison approach, or income approach. The approach that is chosen and the resulting weight that is applied to it depend largely on the circumstances involved. Because a long-term care facility is a business enterprise, more weight usually is given to the income approach which factors into the estimate of value both the tangible and intangible assets of the facility.

Evaluating Indicator-Based Methods of "Measuring Long-Term Impacts of a Science Center on Its Community"

ERIC Educational Resources Information Center

Jensen, Eric Allen

2016-01-01

This article addresses some of the challenges faced when attempting to evaluate the long-term impact of informal science learning interventions. To contribute to the methodological development of informal science learning research, we critically examine (Falk and Needham (2011) "Journal of Research in Science Teaching," 48: 1-12.) study…

Desire, longing and vanity: emotions behind successful return to work for women on long-term sick leave.

PubMed

Ahrberg, Y; Landstad, B J; Bergroth, A; Ekholm, J

2010-01-01

The purpose of this study is to identify situations and phenomena that have simplified returning to work for women on long-term sick leave. Seven women who were exposed to a relatively large number of risk factors that normally are associated with difficulties in returning to work. In-depth interviews with qualitative content analysis. The analysis indicated four main categories of factors: The Individual, Interactions, Surrounding Resources, and Situations. In each of the main categories structural factors exist and it appears that these have been of significant importance to the women in their return to work. These are presented as Key Factors and they are: clarification of--and the need for--support in the personal process of change; desire, longing, and vanity; respectful interactions between the individual and people in her surroundings; the structure and content of the rehabilitation clinic; the importance of the perceived reality; and the individual's sense of control during the work related rehabilitation process. The results mostly revealed phenomena that have been indicated and described in earlier research studies. However, emotions such as desire, longing and vanity as motivation and driving forces behind a return to work have not been earlier described.

Long-term forest ecosystem research: a programmatic view

Treesearch

Wayne Swank; James Vose

2010-01-01

Long-term research provides the building blocks of knowledge needed to address natural resource and environmental issues. "Long-term" has frequently been considered to span decades with a time frame that usually encompasses at least one generation of scientists and frequently two or more generations. In the rich history of forest science, the origin of long-...

Short- and Long-Term Consequences of Adolescent Work.

ERIC Educational Resources Information Center

Mihalic, Sharon Wofford; Elliott, Delbert

1997-01-01

Examines the short- and long-term consequences of working during adolescence. Responses from 1,725 adolescents reveal that the negative short-term effects are in the domains of school, family and friend bonding, beliefs, and substance use. The long-term beneficial effect is that the duration of early work helps employability in adulthood. (GR)

The interaction of short-term and long-term memory in phonetic category formation

NASA Astrophysics Data System (ADS)

Harnsberger, James D.

2002-05-01

This study examined the role that short-term memory capacity plays in the relationship between novel stimuli (e.g., non-native speech sounds, native nonsense words) and phonetic categories in long-term memory. Thirty native speakers of American English were administered five tests: categorial AXB discrimination using nasal consonants from Malayalam; categorial identification, also using Malayalam nasals, which measured the influence of phonetic categories in long-term memory; digit span; nonword span, a short-term memory measure mediated by phonetic categories in long-term memory; and paired-associate word learning (word-word and word-nonword pairs). The results showed that almost all measures were significantly correlated with one another. The strongest predictor for the discrimination and word-nonword learning results was nonword (r=+0.62) and digit span (r=+0.51), respectively. When the identification test results were partialed out, only nonword span significantly correlated with discrimination. The results show a strong influence of short-term memory capacity on the encoding of phonetic detail within phonetic categories and suggest that long-term memory representations regulate the capacity of short-term memory to preserve information for subsequent encoding. The results of this study will also be discussed with regards to resolving the tension between episodic and abstract models of phonetic category structure.

A Short-Term Biological Indicator for Long-Term Kidney Damage after Radionuclide Therapy in Mice

PubMed Central

Pellegrini, Giovanni; Siwowska, Klaudia; Haller, Stephanie; Antoine, Daniel J.; Schibli, Roger; Kipar, Anja; Müller, Cristina

2017-01-01

Folate receptor (FR)-targeted radionuclide therapy using folate radioconjugates is of interest due to the expression of the FR in a variety of tumor types. The high renal accumulation of radiofolates presents, however, a risk of radionephropathy. A potential option to address this challenge would be to use radioprotectants, such as amifostine. Methods for early detection of kidney damage that—in this case—cannot be predicted based on dose estimations, would facilitate the development of novel therapies. The aim of this study was, therefore, to assess potentially changing levels of plasma and urine biomarkers and to determine DNA damage at an early stage after radiofolate application. The identification of an early indicator for renal damage in mice would be useful since histological changes become apparent only several months after treatment. Mice were injected with different quantities of 177Lu-folate (10 MBq, 20 MBq and 30 MBq), resulting in mean absorbed kidney doses of ~23 Gy, ~46 Gy and ~69 Gy, respectively, followed by euthanasia two weeks (>85% of the mean renal radiation dose absorbed) or three months later. Whereas all investigated biomarkers remained unchanged, the number of γ-H2AX-positive nuclei in the renal cortex showed an evident dose-dependent increase as compared to control values two weeks after treatment. Comparison with the extent of kidney injury determined by histological changes five to eight months after administration of the same 177Lu-folate activities suggested that the quantitative assessment of double-strand breaks can be used as a biological indicator for long-term radiation effects in the kidneys. This method may, thus, enable faster assessment of radiopharmaceuticals and protective measures by preventing logistically challenging long-term investigations to detect kidney damage. PMID:28635637

Medical directors of long-term care facilities

PubMed Central

Frank, C.; Seguin, R.; Haber, Shelly; Godwin, Marshall; Stewart, G.I.

2006-01-01

OBJECTIVE The long-term care (LTC) sector in Canada is expanding, but little attention has been given to medical human resources in this area. Our objective was to seek LTC medical directors’ opinions about medical services in LTC and about strategies for recruitment and retention. DESIGN Mailed survey. SETTING Long-term care facilities and nursing homes. PARTICIPANTS Seven hundred five medical directors of LTC facilities across Canada were identified from the Canadian Healthcare Association database. MAIN OUTCOME MEASURES Responses to open- and closed-ended questions and to Likert-type scales. RESULTS The response rate was 55%. The average age of medical directors was 54 years. Most had started work in LTC because of a vacant position, as opposed to self-perceived skills or training. Most (75.3%) reported satisfaction with their role as medical directors, but 82.7% believed that there was a significant shortage of physicians working in LTC, and 42% had seriously considered leaving their positions. Major sources of satisfaction identified were clinical, especially working with older patients and improving care. Important sources of dissatisfaction were remuneration for LTC work, on-call coverage, and excessive paperwork. Directors suggested increases to fee schedules as the main recruitment and retention strategy, and many believed that increasing exposure to LTC during residency would increase recruitment. Development of larger on-call groups for coverage and alternative methods of remuneration were not cited as important factors. Most did not believe that working in a teaching nursing home would increase their satisfaction. Directors did not think the use of nurse practitioners would alleviate concerns about shortages of physicians. CONCLUSION Medical directors of LTC facilities are aging, and many are considering leaving their work in LTC. Without an increase in the number of physicians willing to work in LTC institutions, the current shortage of LTC

Bridge condition assessment based on long-term strain monitoring

NASA Astrophysics Data System (ADS)

Sun, LiMin; Sun, Shouwang

2011-04-01

In consideration of the important role that bridges play as transportation infrastructures, their safety, durability and serviceability have always been deeply concerned. Structural Health Monitoring Systems (SHMS) have been installed to many long-span bridges to provide bridge engineers with the information needed in making rational decisions for maintenance. However, SHMS also confronted bridge engineers with the challenge of efficient use of monitoring data. Thus, methodologies which are robust to random disturbance and sensitive to damage become a subject on which many researches in structural condition assessment concentrate. In this study, an innovative probabilistic approach for condition assessment of bridge structures was proposed on the basis of long-term strain monitoring on steel girder of a cable-stayed bridge. First, the methodology of damage detection in the vicinity of monitoring point using strain-based indices was investigated. Then, the composition of strain response of bridge under operational loads was analyzed. Thirdly, the influence of temperature and wind on strains was eliminated and thus strain fluctuation under vehicle loads is obtained. Finally, damage evolution assessment was carried out based on the statistical characteristics of rain-flow cycles derived from the strain fluctuation under vehicle loads. The research conducted indicates that the methodology proposed is qualified for structural condition assessment so far as the following respects are concerned: (a) capability of revealing structural deterioration; (b) immunity to the influence of environmental variation; (c) adaptability to the random characteristic exhibited by long-term monitoring data. Further examination of the applicability of the proposed methodology in aging bridge may provide a more convincing validation.

Women's experiences of long term sickness absence: implications for rehabilitation practice and theory.

PubMed

Ockander, Marlene K; Timpka, Toomas

2003-01-01

In most European countries, spells of long-term absence contribute the largest number of days that are reimbursed as a result of sickness absence. This group is growing and it is constituted mainly of women. The present study seeks further knowledge about what happens then and there, i.e. how women on long-term sickness absence handle and explain, for themselves and others, this interruption in their daily life. Semi-structured interviews were performed with 82 middle-aged women with personal experience of long-term sickness absence. The women's accounts of sickness absence contained interpretations of what had happened to them, how things were at present, and what they thought the future would bring. Three different accounts could be distinguished: crisis, breakpoint, and migration. The perception of their own situation and especially what they thought about their future was associated with their feeling of power to take the initiative, and their well-being. From this study the authors have found implications for central topics of importance: time elapse, sense of coherence, reorientation/adaptation, vital goals, and gender.

Abstracts 1987. New Horizons in Long Term Care: A Report on the Long Term Care Research and Demonstration Projects.

ERIC Educational Resources Information Center

Illinois State Dept. of Public Aid, Springfield.

This booklet provides a description of 14 projects which were awarded funds during fiscal year 1987 for collaborative research in long-term care to find new ways to treat long-term care patients in Illinois nursing homes. It includes the organization or institution receiving the award, an abstract of the research proposal, and the name of the…

Altered visual perception in long-term ecstasy (MDMA) users.

PubMed

White, Claire; Brown, John; Edwards, Mark

2013-09-01

The present study investigated the long-term consequences of ecstasy use on visual processes thought to reflect serotonergic functions in the occipital lobe. Evidence indicates that the main psychoactive ingredient in ecstasy (methylendioxymethamphetamine) causes long-term changes to the serotonin system in human users. Previous research has found that amphetamine-abstinent ecstasy users have disrupted visual processing in the occipital lobe which relies on serotonin, with researchers concluding that ecstasy broadens orientation tuning bandwidths. However, other processes may have accounted for these results. The aim of the present research was to determine if amphetamine-abstinent ecstasy users have changes in occipital lobe functioning, as revealed by two studies: a masking study that directly measured the width of orientation tuning bandwidths and a contour integration task that measured the strength of long-range connections in the visual cortex of drug users compared to controls. Participants were compared on the width of orientation tuning bandwidths (26 controls, 12 ecstasy users, 10 ecstasy + amphetamine users) and the strength of long-range connections (38 controls, 15 ecstasy user, 12 ecstasy + amphetamine users) in the occipital lobe. Amphetamine-abstinent ecstasy users had significantly broader orientation tuning bandwidths than controls and significantly lower contour detection thresholds (CDTs), indicating worse performance on the task, than both controls and ecstasy + amphetamine users. These results extend on previous research, which is consistent with the proposal that ecstasy may damage the serotonin system, resulting in behavioral changes on tests of visual perception processes which are thought to reflect serotonergic functions in the occipital lobe.

[Participation as Target of Social Medicine and Nursing Care: - Legal Definition of Long-Term Care Dependency - Strategies to Prevent Long-Term Care Dependency].

PubMed

Nüchtern, Elisabeth; Gansweid, Barbara; Gerber, Hans; von Mittelstaedt, Gert

2017-01-01

Objective: By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Methods: Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Results: Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Conclusion: Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their

A new image for long-term care.

PubMed

Wager, Richard; Creelman, William

2004-04-01

To counter widely held negative images of long-term care, managers in the industry should implement quality-improvement initiatives that include six key strategies: Manage the expectations of residents and their families. Address customers' concerns early. Build long-term customer satisfaction. Allocate resources to achieve exceptional outcomes in key areas. Respond to adverse events with compassion. Reinforce the facility's credibility.

Effects of additional oxazepam in long-term users of oxazepam.

PubMed

Voshaar, Richard C Oude; Verkes, Robbert-Jan; van Luijtelaar, Gilles L J M; Edelbroek, Peter M; Zitman, Frans G

2005-02-01

Although additional dosages of benzodiazepines in long-term users of benzodiazepines are common, it is unknown whether these additional dosages resort any effect. The effects of an additional 20-mg dosage oxazepam were assessed in a double-blind, balanced-order, crossover randomized study comparing 16 long-term users of oxazepam (patients) with 18 benzodiazepine-naive controls (controls). The effects of 10 and 30 mg oxazepam were assessed at pretest and 2.5 hours after drug administration on: (a) saccadic eye movements as proxy for the sedative effect, (b) acoustic startle response (ASR) as proxy for the anxiolytic effects, (c) memory, (d) reaction time tasks, and (e) subjective measurements. Dose-related effects were found in patients on the peak velocity of saccadic eye movement and on response probability, respectively peak amplitude of the ASR. Comparison with controls, however, suggests that in patients the sedative effects might be mixed up with suppression of sedative withdrawal symptoms, whereas patients were as sensitive as benzodiazepine-naive controls for the effects of an additional dosage on the ASR. Neither 10 nor 30 mg oxazepam challenge affected the reaction time tasks in patients, whereas controls show a dose-related impairment. The memory impairing effects, however, did not differ significantly between patients and controls. In contrast to controls, patients could not discriminate between a 10- and 30-mg dosage as assessed by visual analogue scales and the STAI-DY-1, which might indicate a placebo effect in the 10-mg challenge in patients. We conclude that additional dosages of oxazepam still exert pronounced effects after daily use for more than 10 years.

The future of long-term USDA Forest Service research sites in the Northeast

Treesearch

Michael T. Rains

2006-01-01

The mission of the Northeastern Research Station is "Improving Lives and Protecting Our Earth Through Research." Our nine experimental sites are the keystone of this mission. Our experimental sites are located in major forest types from West Virginia to Maine, and in Baltimore, Maryland, where we have a long-term ecological research site representing urban...

Long-term characteristics of nuclear emulsion

NASA Astrophysics Data System (ADS)

Naganawa, N.; Kuwabara, K.

2010-02-01

Long-term characteristics of the nuclear emulsion so called ``OPERA film'' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

Very-long-term and short-term chromatic adaptation: are their influences cumulative?

PubMed

Belmore, Suzanne C; Shevell, Steven K

2011-02-09

Very-long-term (VLT) chromatic adaptation results from exposure to an altered chromatic environment for days or weeks. Color shifts from VLT adaptation are observed hours or days after leaving the altered environment. Short-term chromatic adaptation, on the other hand, results from exposure for a few minutes or less, with color shifts measured within seconds or a few minutes after the adapting light is extinguished; recovery to the pre-adapted state is complete in less than an hour. Here, both types of adaptation were combined. All adaptation was to reddish-appearing long-wavelength light. Shifts in unique yellow were measured following adaptation. Previous studies demonstrate shifts in unique yellow due to VLT chromatic adaptation, but shifts from short-term chromatic adaptation to comparable adapting light can be far greater than from VLT adaptation. The question considered here is whether the color shifts from VLT adaptation are cumulative with large shifts from short-term adaptation or, alternatively, does simultaneous short-term adaptation eliminate color shifts caused by VLT adaptation. The results show the color shifts from VLT and short-term adaptation together are cumulative, which indicates that both short-term and very-long-term chromatic adaptation affect color perception during natural viewing. Copyright © 2010 Elsevier Ltd. All rights reserved.

The affordable care act and long-term care: comprehensive reform or just tinkering around the edges?

PubMed

Miller, Edward Alan

2012-01-01

The Patient Protection and Affordable Care Act (ACA) includes several provisions that aim to improve prevailing deficiencies in the nation's long-term care system. But just how effective is the ACA likely to be in addressing these challenges? Will it result in meaningful or marginal reform? This special issue of Journal of Aging & Social Policy seeks to answer these questions. The most prominent long-term care provision is the now-suspended Community Living Assistance Services and Supports Act. Others include incentives and options for expanding home- and community-based care, a number of research and demonstration projects in the areas of chronic care coordination and the dually eligible, and nursing home quality reforms. There are also elements that seek to improve workforce recruitment and retention, in addition to benefit improvements and spending reductions under Medicare. This article reviews the basic problems plaguing the long-term care sector and the provisions within the ACA meant to address them. It also includes a brief overview of issue content.

Marketing in the long-term care continuum.

PubMed

Laurence, J Nathan; Kash, Bita A

2010-04-01

Today, long-term care facilities are composed of independent, assisted living, and skilled nursing facilities along with many variations of those themes in between. The clientele for these various types of facilities differ because of the level of care the facility provides as well as the amenities long-term care consumers are looking for. However, there many similarities and common approaches to how reaching the target audience through effective marketing activities. Knowing who the target audience is, how to reach them, and how to communicate with them will serve any facility well in this competitive market. Developing marketing strategies for long-term care settings is as important as understanding what elements of care can be marketed individually as a niche market. Determining the market base for a facility is equally crucial since the target populations differ among the three types of facilities. By reviewing current marketing articles and applying marketing practices, we have crafted some general principles for which each facility type can learn from. Finally, we will discuss the types of marketing and how they related to the spectrum of long-term care facilities.

Impact of crop rotation and soil amendments on long-term no-tilled soybean yields

USDA-ARS?s Scientific Manuscript database

Continuous cropping systems without cover crops are perceived as unsustainable for long-term yield and soil health. To test this, cropping sequence and cover crop effects on soybean (Glycine max L.) yields were assessed. Main effects were 10 cropping sequences of soybean, corn (Zea mays L.), and co...

Long-Term Neurotoxic Effects of Early Life Exposure to Tetrachloroethylene-contaminated Drinking Water

PubMed Central

Aschengrau, Ann; Janulewicz, Patricia A.; White, Roberta F.; Vieira, Veronica M.; Gallagher, Lisa G.; Getz, Kelly D.; Webster, Thomas F.; Ozonoff, David M.

2016-01-01

Background Tetrachloroethene (PCE) is a common environmental and occupational contaminant and an acknowledged neurotoxicant. From 1968 through 1983 widespread contamination of public drinking water supplies with PCE occurred in the Cape Cod region of Massachusetts. The source of the contamination was a vinyl liner applied to the inner surface of water distribution pipes. Objectives A retrospective cohort study (“the Cape Cod Health Study”) was undertaken to examine possible health consequences of early life exposure to PCE-contaminated drinking water. This review describes the study methods and findings regarding the impact of prenatal and childhood exposure on neurological outcomes during early adulthood, including vision, neuropsychological functioning, brain structure, risky behaviors, and mental illness. The review also describes the strengths and challenges of conducting population-based epidemiological research in this unique setting. Methods Subjects were identified by cross-matching birth certificate and water system data. Information on health outcomes and confounding variables was collected from self-administered surveys (N= 1,689), neuropsychological tests (N=63), vision exam (N=63), and magnetic resonance imaging (N=42). Early life exposure to PCE was estimated using a leaching and transport model. The data analysis compared the occurrence of each health outcome among subjects with prenatal and early childhood PCE exposure to unexposed subjects while considering the impact of confounding variables. Results The study found evidence that early life exposure to PCE-contaminated drinking water has long-term neurotoxic effects. The strongest associations were seen with illicit drug use, bipolar disorder, and post-traumatic stress disorder. Key strengths of the study were availability of historical data on affected water systems, a relatively high exposure prevalence and wide range of exposure levels, and little confounding. Challenges arose mainly from

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.

Long term stability following genioplasty: a cephalometric study.

PubMed

Kumar, B Lakshman; Raju, G Kranthi Praveen; Kumar, N Dilip; Reddy, G Vivek; Naik, B Ravindra; Achary, C Ravindranath

2015-04-01

A receding chin associated with an orthognathic mandible is a common situation and surgical changes in chin position are often required to improve the overall harmony of the face. Genioplasty is one such procedure. Stability of hard and soft tissue changes following genioplasty on a long term basis needs to be assessed. Studies on the stability of hard and soft tissue changes following genioplasty on a short term basis have revealed it as a procedure with good stability. This study is done to assess the stability of hard and soft tissue changes following genioplasty on a long term basis. Pre-surgical, postsurgical and long term post-surgical cephalograms of 15 cases treated by vertical reduction augmentation genioplasty were obtained. Paired t-test was used to compare the changes between pre-surgical, postsurgical and long term postsurgical cephalograms. Findings of this study demonstrated that genioplasty is a stable procedure. After long term follow-up period, there was a relapse of 1.5 mm at the pogonion accounting for 24% of the surgical advancement. This is attributed to the remodeling that occurs at the surgical site, but not the instability due to the surgical procedure. With the present study, it can be concluded that vertical reduction and advancement genioplasty can be considered as an adjunctive procedure that produces predictable results and the bony and soft tissue stability were generally very good.

Long-term memory, neurogenesis, and signal novelty.

PubMed

Sokolov, E N; Nezlina, N I

2004-10-01

According to our suggested hypothesis, long-term memory is a collection of "gnostic units," selectively tuned to past events. The formation of long-term memory occurs with the involvement of constantly appearing new neurons which differentiate from stem cells during the process of neurogenesis, in particular in adults. Conversion of precursor neurons into "gnostic units" selective in relation to ongoing events, supplemented by the involvement of hippocampal "novelty neurons," which increase the flow of information needing to be fixed in long-term memory. "Gnostic units" form before the informational processes occurring in the ventral ("what?") and dorsal ("where?") systems. Formation of new "gnostic units" selectively tuned to a particular event results from the combination of excitation of the detector for stimulus characteristics and the novelty signal generated by "novelty neurons" in the hippocampus.

Long-term care financing: lessons from France.

PubMed

Doty, Pamela; Nadash, Pamela; Racco, Nathalie

2015-06-01

POLICY POINTS: France's model of third-party coverage for long-term services and supports (LTSS) combines a steeply income-adjusted universal public program for people 60 or older with voluntary supplemental private insurance. French and US policies differ: the former pay cash; premiums are lower; and take-up rates are higher, in part because employer sponsorship, with and without subsidization, is more common-but also because coverage targets higher levels of need and pays a smaller proportion of costs. Such inexpensive, bare-bones private coverage, especially if marketed as a supplement to a limited public benefit, would be more affordable to those Americans currently most at risk of "spending down" to Medicaid. An aging population leads to a growing demand for long-term services and supports (LTSS). In 2002, France introduced universal, income-adjusted, public long-term care coverage for adults 60 and older, whereas the United States funds means-tested benefits only. Both countries have private long-term care insurance (LTCI) markets: American policies create alternatives to out-of-pocket spending and protect purchasers from relying on Medicaid. Sales, however, have stagnated, and the market's viability is uncertain. In France, private LTCI supplements public coverage, and sales are growing, although its potential to alleviate the long-term care financing problem is unclear. We explore whether France's very different approach to structuring public and private financing for long-term care could inform the United States' long-term care financing reform efforts. We consulted insurance experts and conducted a detailed review of public reports, academic studies, and other documents to understand the public and private LTCI systems in France, their advantages and disadvantages, and the factors affecting their development. France provides universal public coverage for paid assistance with functional dependency for people 60 and older. Benefits are steeply income

Importance of Data Management in a Long-term Biological Monitoring Program

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

Christensen, Sigurd W; Brandt, Craig C; McCracken, Kitty

2011-01-01

The long-term Biological Monitoring and Abatement Program (BMAP) has always needed to collect and retain high-quality data on which to base its assessments of ecological status of streams and their recovery after remediation. Its formal quality assurance, data processing, and data management components all contribute to this need. The Quality Assurance Program comprehensively addresses requirements from various institutions, funders, and regulators, and includes a data management component. Centralized data management began a few years into the program. An existing relational database was adapted and extended to handle biological data. Data modeling enabled the program's database to process, store, and retrievemore » its data. The data base's main data tables and several key reference tables are described. One of the most important related activities supporting long-term analyses was the establishing of standards for sampling site names, taxonomic identification, flagging, and other components. There are limitations. Some types of program data were not easily accommodated in the central systems, and many possible data-sharing and integration options are not easily accessible to investigators. The implemented relational database supports the transmittal of data to the Oak Ridge Environmental Information System (OREIS) as the permanent repository. From our experience we offer data management advice to other biologically oriented long-term environmental sampling and analysis programs.« less

What Legislators Need to Know about Long-Term Care Insurance.

ERIC Educational Resources Information Center

Landes, David

This booklet discusses the potential importance to states of long-term care insurance, describes general policy characteristics, and summarizes state actions to both regulate and promote long-term care insurance. It is intended as a resource for legislators and others involved in long-term care financing and public policy formulation. Long-term…

Private long-term care insurance and state tax incentives.

PubMed

Stevenson, David G; Frank, Richard G; Tau, Jocelyn

2009-01-01

To increase the role of private insurance in financing long-term care, tax incentives for long-term care insurance have been implemented at both the federal and state levels. To date, there has been surprisingly little study of these initiatives. Using a panel of national data, we find that market take-up for long-term care insurance increased over the last decade, but state tax incentives were responsible for only a small portion of this growth. Ultimately, the modest ability of state tax incentives to lower premiums implies that they should be viewed as a small piece of the long-term care financing puzzle.

Innovative Strategy For Long Term Monitoring Of Metal And Radionuclide Plumes

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

Eddy-Dilek, Carol; Millings, Margaret R.; Looney, Brian B.

2014-01-08

Many government and private industry sites that were once contaminated with radioactive and chemical wastes cannot be cleaned up enough to permit unrestricted human access. The sites will require long term management, in some cases indefinitely, leaving site owners with the challenge of protecting human health and environmental quality at these "legacy" sites. Long-term monitoring of groundwater contamination is one of the largest projected costs in the life cycle of environmental management at the Savannah River Site, the larger DOE complex, and many large federal and private sites. There is a need to optimize the performance and manage the costmore » of long term surveillance and monitoring at their sites. Currently, SRNL is initiating a pilot field test using alternative protocols for long term monitoring of metals and radionuclides. A key component of the approach is that monitoring efforts are focused on measurement of low cost metrics related to hydrologic and chemical conditions that control contaminant migration. The strategy combines careful monitoring of hydrologic boundary conditions with measurement of master variables such as chemical surrogates along with a smaller number of standard well analyses. In plumes contaminated with metals, master variables control the chemistry of the groundwater system, and include redox variables (ORP, DO, chemicals), pH, specific conductivity, biological community (breakdown/decay products), and temperature. Significant changes in these variables will result in conditions whereby the plume may not be stable and therefore can be used to predict possible plume migration. Conversely, concentration measurements for all types of contaminants in groundwater are a lagging indicator plume movement - major changes contaminant concentrations indicate that contamination has migrated. An approach based on measurement of master variables and explicit monitoring of hydrologic boundary conditions combined with traditional metrics

VALIDATION OF A METHOD FOR ESTIMATING LONG-TERM EXPOSURES BASED ON SHORT-TERM MEASUREMENTS

EPA Science Inventory

A method for estimating long-term exposures from short-term measurements is validated using data from a recent EPA study of exposure to fine particles. The method was developed a decade ago but long-term exposure data to validate it did not exist until recently. In this paper, ...

Long-Term Memory for Affiliates in Ravens

PubMed Central

Boeckle, Markus; Bugnyar, Thomas

2012-01-01

Summary Complex social life requires individuals to recognize and remember group members [1] and, within those, to distinguish affiliates from nonaffiliates. Whereas long-term individual recognition has been demonstrated in some nonhuman animals [2–5], memory for the relationship valence to former group members has received little attention. Here we show that adult, pair-housed ravens not only respond differently to the playback of calls from previous group members and unfamiliar conspecifics but also discriminate between familiar birds according to the relationship valence they had to those subjects up to three years ago as subadult nonbreeders. The birds' distinction between familiar and unfamiliar individuals is reflected mainly in the number of calls, whereas their differentiation according to relationship valence is reflected in call modulation only. As compared to their response to affiliates, ravens responded to nonaffiliates by increasing chaotic parts of the vocalization and lowering formant spacing, potentially exaggerating the perceived impression of body size. Our findings indicate that ravens remember relationship qualities to former group members even after long periods of separation, confirming that their sophisticated social knowledge as nonbreeders is maintained into the territorial breeding stage. PMID:22521788

Impact of Procedure-Related Complications on Long-term Islet Transplantation Outcome.

PubMed

Caiazzo, Robert; Vantyghem, Marie-Christine; Raverdi, Violeta; Bonner, Caroline; Gmyr, Valery; Defrance, Frederique; Leroy, Clara; Sergent, Geraldine; Hubert, Thomas; Ernst, Oliver; Noel, Christian; Kerr-Conte, Julie; Pattou, François

2015-05-01

Pancreatic islet transplantation offers a promising biotherapy for the treatment of type 1 diabetes, but this procedure has met significant challenges over the years. One such challenge is to address why primary graft function still remains inconsistent after islet transplantation. Several variables have been shown to affect graft function, but the impact of procedure-related complications on primary and long-term graft functions has not yet been explored. Twenty-six patients with established type 1 diabetes were included in this study. Each patient had two to three intraportal islet infusions to obtain 10,000 islet equivalent (IEQ)/kg in body weight, equaling a total of 68 islet infusions. Islet transplantation consisted of three sequential fresh islet infusions within 3 months. Islet infusions were performed surgically or under ultrasound guidance, depending on patient morphology, availability of the radiology suite, and patient medical history. Prospective assessment of adverse events was recorded and graded using "Common Terminology Criteria for adverse events in Trials of Adult Pancreatic Islet Transplantation." There were no deaths or patients dropouts. Early complications occurred in nine of 68 procedures. β score 1 month after the last graft and optimal graft function (β score ≥7) rate were significantly lower in cases of procedure-related complications (P = 0.02, P = 0.03). Procedure-related complications negatively impacted graft function (P = 0.009) and was an independent predictive factor of long-term graft survival (P = 0.033) in multivariate analysis. Complications occurring during radiologic or surgical intraportal islet transplantation significantly impair primary graft function and graft survival regardless of their severity.

Assessing state efforts to meet baby boomers' long-term care needs: a case study in compensatory federalism.

PubMed

Pandey, Sanjay K

2002-01-01

The role of the state government and the character of federal-state relations in social policy have evolved considerably. Frank Thompson uses the phrase compensatory federalism to describe increased activity by state governments to make up for a diminished federal role. For compensatory federalism to work, it is essential for states to take leadership roles in key policy areas. Few studies examine whether states have risen to the challenge of compensatory federalism in social policy. This paper examines an emerging issue of great significance in social policy-challenges involved in meeting future long-term care needs for the baby boomer generation. The paper provides an in-depth case study of attempts by Maryland to meet the challenges of financing long-term care needs for the baby boomer generation. The detailed description of the agenda-setting and problem-structuring process in Maryland is followed by an analysis that uses three different frameworks to assess the policy development processes. These models are rooted in a bureaucratic politics perspective, an agenda-setting perspective and an interest group politics perspective. The paper concludes with a discussion of the limitations and possibilities of state leadership in the social policy sphere.

Short-term and long-term attentional biases to frequently encountered target features.

PubMed

Sha, Li Z; Remington, Roger W; Jiang, Yuhong V

2017-07-01

It has long been known that frequently occurring targets are attended better than infrequent ones in visual search. But does this frequency-based attentional prioritization reflect momentary or durable changes in attention? Here we observed both short-term and long-term attentional biases for visual features as a function of different types of statistical associations between the targets, distractors, and features. Participants searched for a target, a line oriented horizontally or vertically among diagonal distractors, and reported its length. In one set of experiments we manipulated the target's color probability: Targets were more often in Color 1 than in Color 2. The distractors were in other colors. Participants found Color 1 targets more quickly than Color 2 targets, but this preference disappeared immediately when the target's color became random in the subsequent testing phase. In the other set of experiments, we manipulated the diagnostic values of the two colors: Color 1 was more often a target than a distractor; Color 2 was more often a distractor than a target. Participants found Color 1 targets more quickly than Color 2 targets. Importantly, and in contrast to the first set of experiments, the featural preference was sustained in the testing phase. These results suggest that short-term and long-term attentional biases are products of different statistical information. Finding a target momentarily activates its features, inducing short-term repetition priming. Long-term changes in attention, on the other hand, may rely on learning diagnostic features of the targets.

Long-term care financing through Federal tax incentives.

PubMed

Moran, D W; Weingart, J M

1988-12-01

Congress and the Administration are currently exploring various methods of promoting access to long-term care. In this article, an inventory of recent legislative proposals for using the Federal tax code to expand access to long-term care services is provided. Proposals are arrayed along a functional typology that includes tax mechanisms to encourage accumulation of funds, promote purchase of long-term care insurance, or induce the diversion of funds accumulated for another purpose (such as individual retirement accounts). The proposals are evaluated against the public policy objective of encouraging risk pooling to minimize social cost.

Long-term care financing through Federal tax incentives

PubMed Central

Moran, Donald W.; Weingart, Janet M.

1988-01-01

Congress and the Administration are currently exploring various methods of promoting access to long-term care. In this article, an inventory of recent legislative proposals for using the Federal tax code to expand access to long-term care services is provided. Proposals are arrayed along a functional typology that includes tax mechanisms to encourage accumulation of funds, promote purchase of long-term care insurance, or induce the diversion of funds accumulated for another purpose (such as individual retirement accounts). The proposals are evaluated against the public policy objective of encouraging risk pooling to minimize social cost. PMID:10312964

Sustainability and Long Term-Tenure: Lion Trophy Hunting in Tanzania

PubMed Central

Brink, Henry; Skinner, Kirsten; Leader-Williams, Nigel

2016-01-01

It is argued that trophy hunting of large, charismatic mammal species can have considerable conservation benefits but only if undertaken sustainably. Social-ecological theory suggests such sustainability only results from developing governance systems that balance financial and biological requirements. Here we use lion (Panthera leo) trophy hunting data from Tanzania to investigate how resource ownership patterns influence hunting revenue and offtake levels. Tanzania contains up to half of the global population of free-ranging lions and is also the main location for lion trophy hunting in Africa. However, there are concerns that current hunting levels are unsustainable. The lion hunting industry in Tanzania is run by the private sector, although the government leases each hunting block to companies, enforces hunting regulation, and allocates them a species-specific annual quota per block. The length of these leases varies and theories surrounding property rights and tenure suggest hunting levels would be less sustainable in blocks experiencing a high turnover of short-term leases. We explored this issue using lion data collected from 1996 to 2008 in the Selous Game Reserve (SGR), the most important trophy hunting destination in Tanzania. We found that blocks in SGR with the highest lion hunting offtake were also those that experienced the steepest declines in trophy offtake. In addition, we found this high hunting offtake and the resultant offtake decline tended to be in blocks under short-term tenure. In contrast, lion hunting levels in blocks under long-term tenure matched more closely the recommended sustainable offtake of 0.92 lions per 1000 km2. However, annual financial returns were higher from blocks under short-term tenure, providing $133 per km2 of government revenue as compared to $62 per km2 from long-term tenure blocks. Our results provide evidence for the importance of property rights in conservation, and support calls for an overhaul of the system in

Sustainability and Long Term-Tenure: Lion Trophy Hunting in Tanzania.

PubMed

Brink, Henry; Smith, Robert J; Skinner, Kirsten; Leader-Williams, Nigel

2016-01-01

It is argued that trophy hunting of large, charismatic mammal species can have considerable conservation benefits but only if undertaken sustainably. Social-ecological theory suggests such sustainability only results from developing governance systems that balance financial and biological requirements. Here we use lion (Panthera leo) trophy hunting data from Tanzania to investigate how resource ownership patterns influence hunting revenue and offtake levels. Tanzania contains up to half of the global population of free-ranging lions and is also the main location for lion trophy hunting in Africa. However, there are concerns that current hunting levels are unsustainable. The lion hunting industry in Tanzania is run by the private sector, although the government leases each hunting block to companies, enforces hunting regulation, and allocates them a species-specific annual quota per block. The length of these leases varies and theories surrounding property rights and tenure suggest hunting levels would be less sustainable in blocks experiencing a high turnover of short-term leases. We explored this issue using lion data collected from 1996 to 2008 in the Selous Game Reserve (SGR), the most important trophy hunting destination in Tanzania. We found that blocks in SGR with the highest lion hunting offtake were also those that experienced the steepest declines in trophy offtake. In addition, we found this high hunting offtake and the resultant offtake decline tended to be in blocks under short-term tenure. In contrast, lion hunting levels in blocks under long-term tenure matched more closely the recommended sustainable offtake of 0.92 lions per 1000 km2. However, annual financial returns were higher from blocks under short-term tenure, providing $133 per km2 of government revenue as compared to $62 per km2 from long-term tenure blocks. Our results provide evidence for the importance of property rights in conservation, and support calls for an overhaul of the system in

Long-Term Breastfeeding in African American Mothers.

PubMed

Gross, Tyra Toston; Davis, Marsha; Anderson, Alex K; Hall, Jori; Hilyard, Karen

2017-02-01

According to the Centers for Disease Control and Prevention, 39.1% of African American infants are breastfed at 6 months. However, few studies have explored the breastfeeding experiences of African American women who successfully breastfeed to 6 months or longer durations. Research aim: The goal of this qualitative study was to explore the long-term breastfeeding experiences of low-income African American women using the positive deviance approach. African American women with breastfeeding experience were recruited through Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counselors. Eligibility criteria included being age 18 or older, currently participating in WIC, and having breastfed one child for at least 6 months in the past 2 years. Semistructured, in-depth interviews were conducted with 11 participants. Interviews were audio-recorded and professionally transcribed. Transcripts were then analyzed for emerging themes using thematic analysis in NVivo software. Participants had on average three children each, with an average length of breastfeeding of 10.5 months per child. Four main themes developed: (a) deciding to breastfeed, (b) initiating breastfeeding, (c) breastfeeding long-term, and (d) expanding breastfeeding support. Participants offered culturally tailored suggestions to improve breastfeeding support for other African American women: prenatal discussions of breastfeeding with health care providers, African American lactation support personnel and breastfeeding support groups, and African American breastfeeding promotion in print and digital media. Women who participated in this study breastfed for longer durations than the national average for African Americans. Findings can inform practice and research efforts to improve breastfeeding rates in this population using lessons learned from successful women.

Long-term exposure to spaceflight conditions affects bacterial response to antibiotics.

PubMed

Juergensmeyer, M A; Juergensmeyer, E A; Guikema, J A

1999-01-01

Bacteria exposed to the spaceflight environment have been shown to have an increased growth rate and an increased resistance to antibiotics. The mechanism of resistance has not yet been identified, as the resistance is quickly lost upon return to Earth. To more fully characterize the spaceflight-induced resistance to antibiotics, 4 species of bacteria were exposed to microgravity for 4 months on the Space Station MIR. Upon return to Earth, these cultures were challenged with a suite of 12 antibiotics of varying modes of action. In contrast to reports from short-term space flights, we find that long-term exposure to microgravity causes bacteria to become more susceptible to most, but not all, antibiotics. Each species responds differently to the suite of antibiotics, frequently becoming less resistant, but occasionally more resistant to the antibiotic. A pattern enabling prediction of response is not yet discernible. While contradicting the results from short-term pure culture research, this experiment confirms results from astronaut and cosmonaut skin flora samples.

The relationship between interannual and long-term cloud feedbacks

DOE PAGES

Zhou, Chen; Zelinka, Mark D.; Dessler, Andrew E.; ...

2015-12-11

The analyses of Coupled Model Intercomparison Project phase 5 simulations suggest that climate models with more positive cloud feedback in response to interannual climate fluctuations also have more positive cloud feedback in response to long-term global warming. Ensemble mean vertical profiles of cloud change in response to interannual and long-term surface warming are similar, and the ensemble mean cloud feedback is positive on both timescales. However, the average long-term cloud feedback is smaller than the interannual cloud feedback, likely due to differences in surface warming pattern on the two timescales. Low cloud cover (LCC) change in response to interannual andmore » long-term global surface warming is found to be well correlated across models and explains over half of the covariance between interannual and long-term cloud feedback. In conclusion, the intermodel correlation of LCC across timescales likely results from model-specific sensitivities of LCC to sea surface warming.« less

Group long-term care insurance: decision-making factors and implications for financing long-term care.

PubMed

Stum, Marlene S

2008-01-01

This study proposes and tests a systemic family decision-making framework to understand group long-term care insurance (LTCI) enrollment decisions. A random sample of public employees who were offered group LTCI as a workplace benefit were examined. Findings reveal very good predictive efficacy for the overall conceptual framework with a pseudo R2 value of .687, and reinforced the contributions of factors within the family system. Enrollees were more likely to have discussed the decision with others, used information sources, and had prior experience when compared to non-enrollees. Perceived health status, financial knowledge, attitudes regarding the role of private insurance, risk taking, and coverage features were additional factors related to enrollment decisions. The findings help to inform policymakers about the potential of LTCI as one strategy for financing long-term care.

Informed Consent to Research in Long-Term Care Settings

PubMed Central

Jablonski, Rita A.; Bourbonniere, Meg; Kolanowski, Ann

2010-01-01

Informed consent to nursing home research is a two-tiered process that begins with obtaining the consent of a long-term care community at the institutional level and progresses to the engagement of individuals in the consent process. Drawing on a review of the literature and the authors’ research experiences and institutional review board service, this paper describes the practical implications of nurse investigators’ obligation to ensure informed consent among participants in long-term care research. Recommendations focus on applying a community consent model to long-term care research, promoting an evidence-based approach to the protection of residents with decisional impairment, and increasing investigators’ attention to ethical issues involving long-term care staff. PMID:20078005

Cabotegravir long acting injection protects macaques against intravenous challenge with SIVmac251.

PubMed

Andrews, Chasity D; Bernard, Leslie St; Poon, Amanda Yee; Mohri, Hiroshi; Gettie, Natanya; Spreen, William R; Gettie, Agegnehu; Russell-Lodrigue, Kasi; Blanchard, James; Hong, Zhi; Ho, David D; Markowitz, Martin

2017-02-20

We evaluated the effectiveness of cabotegravir (CAB; GSK1265744 or GSK744) long acting as preexposure prophylaxis (PrEP) against intravenous simian immunodeficiency virus (SIV) challenge in a model that mimics blood transfusions based on the per-act probability of infection. CAB long acting is an integrase strand transfer inhibitor formulated as a 200 mg/ml injectable nanoparticle suspension that is an effective PrEP agent against rectal and vaginal simian/human immunodeficiency virus transmission in macaques. Three groups of rhesus macaques (n = 8 per group) were injected intramuscularly with CAB long acting and challenged intravenously with 17 animal infectious dose 50% SIVmac251 on week 2. Group 1 was injected with 50 mg/kg on week 0 and 4 to evaluate the protective efficacy of the CAB long-acting dose used in macaque studies mimicking sexual transmission. Group 2 was injected with 50 mg/kg on week 0 to evaluate the necessity of the second injection of CAB long acting for protection against intravenous challenge. Group 3 was injected with 25 mg/kg on week 0 and 50 mg/kg on week 4 to correlate CAB plasma concentrations at the time of challenge with protection. Five additional macaques remained untreated as controls. CAB long acting was highly protective with 21 of the 24 CAB long-acting-treated macaques remaining aviremic, resulting in 88% protection. The plasma CAB concentration at the time of virus challenge appeared to be more important for protection than sustaining therapeutic plasma concentrations with the second CAB long acting injection. These results support the clinical investigation of CAB long acting as PrEP in people who inject drugs.

Epigenetics as a mechanism linking developmental exposures to long-term toxicity.

PubMed

Barouki, R; Melén, E; Herceg, Z; Beckers, J; Chen, J; Karagas, M; Puga, A; Xia, Y; Chadwick, L; Yan, W; Audouze, K; Slama, R; Heindel, J; Grandjean, P; Kawamoto, T; Nohara, K

2018-05-01

A variety of experimental and epidemiological studies lend support to the Developmental Origin of Health and Disease (DOHaD) concept. Yet, the actual mechanisms accounting for mid- and long-term effects of early-life exposures remain unclear. Epigenetic alterations such as changes in DNA methylation, histone modifications and the expression of certain RNAs have been suggested as possible mediators of long-term health effects of environmental stressors. This report captures discussions and conclusions debated during the last Prenatal Programming and Toxicity meeting held in Japan. Its first aim is to propose a number of criteria that are critical to support the primary contribution of epigenetics in DOHaD and intergenerational transmission of environmental stressors effects. The main criteria are the full characterization of the stressors, the actual window of exposure, the target tissue and function, the specificity of the epigenetic changes and the biological plausibility of the linkage between those changes and health outcomes. The second aim is to discuss long-term effects of a number of stressors such as smoking, air pollution and endocrine disruptors in order to identify the arguments supporting the involvement of an epigenetic mechanism. Based on the developed criteria, missing evidence and suggestions for future research will be identified. The third aim is to critically analyze the evidence supporting the involvement of epigenetic mechanisms in intergenerational and transgenerational effects of environmental exposure and to particularly discuss the role of placenta and sperm. While the article is not a systematic review and is not meant to be exhaustive, it critically assesses the contribution of epigenetics in the long-term effects of environmental exposures as well as provides insight for future research. Copyright © 2018 Elsevier Ltd. All rights reserved.

Long-term reconstructions of total solar irradiance

NASA Astrophysics Data System (ADS)

Krivova, Natalie; Solanki, Sami K.; Dasi Espuig, Maria

2012-07-01

Solar irradiance is the main external driver of the Earth's climate, although its relative contribution compared to other internal and anthropogenic factors is not yet well determined. Variations of total solar irradiance have being measured for over three decades and are relatively well understood. Reconstructions of the irradiance into the past remain, however, rather uncertain. In particular, the magnitude of the secular change is highly debated. The reason is the lack of direct and well-sampled proxies of solar magnetic activity on time scales longer than a few decades. Reconstructions on time scales of centuries rely on sunspot observations available since 1610. Reconstructions on millennial time scales use concentrations of the cosmogenic isotopes in terrestrial archives. We will review long-term reconstructions of the solar irradiance using the SATIRE set of models, compare them with other recent models and discuss the remaining uncertainties.

Adverse event reporting in Czech long-term care facilities.

PubMed

Hěib, Zdenřk; Vychytil, Pavel; Marx, David

2013-04-01

To describe adverse event reporting processes in long-term care facilities in the Czech Republic. Prospective cohort study involving a written questionnaire followed by in-person structured interviews with selected respondents. Long-term care facilities located in the Czech Republic. Staff of 111 long-term care facilities (87% of long-term care facilities in the Czech Republic). None. Sixty-three percent of long-term health-care facilities in the Czech Republic have adverse event-reporting processes already established, but these were frequently very immature programs sometimes consisting only of paper recording of incidents. Compared to questionnaire responses, in-person interview responses only partially tended to confirm the results of the written survey. Twenty-one facilities (33%) had at most 1 unconfirmed response, 31 facilities (49%) had 2 or 3 unconfirmed responses and the remaining 11 facilities (17%) had 4 or more unconfirmed responses. In-person interviews suggest that use of a written questionnaire to assess the adverse event-reporting process may have limited validity. Staff of the facilities we studied expressed an understanding of the importance of adverse event reporting and prevention, but interviews also suggested a lack of knowledge necessary for establishing a good institutional reporting system in long-term care.

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.

The Use of Interactive Computer Services to Enhance the Quality of Life for Long-Term Care Residents.

ERIC Educational Resources Information Center

McConatha, Douglas; And Others

1994-01-01

Examined and documented effects of interactive computer-based education and training on rehabilitation of long-term care residents (n=14). This approach was found to provide mental stimulation and challenge, as well as improving practical skills which directly impact upon competencies and feelings of autonomy of participants. (Author/NB)

Long-Term Abstinence Following Holotropic Breathwork as Adjunctive Treatment of Substance Use Disorders and Related Psychiatric Comorbidity

ERIC Educational Resources Information Center

Brewerton, Timothy D.; Eyerman, James E.; Cappetta, Pamela; Mithoefer, Michael C.

2012-01-01

Addictions remain challenging conditions despite various promising traditional approaches. Although complete, long-term abstinence may be ideal, its attainment remains elusive. Many recovering addicts and clinicians stress the importance of spiritual issues in recovery, and 12-step programs such as AA are well-known approaches that embrace this…

Watershed Nitrogen and Mercury Geochemical Fluxes Integrate Landscape Factors in Long-term Research Watersheds at Acadia National Park, Maine, USA

Treesearch

J. S. Kahl; S. J. Nelson; I. Fernandez; T. Haines; S. Norton; G. B. Wiersma; G. Jacobson; A. Amirbahman; K. Johnson; M. Schauffler; L. Rustad; K. Tonnessen; R. Lent; M. Bank; J. Elvir; J. Eckhoff; H. Caron; P. Ruck; J. Parker; J. Campbell; D. Manski; R. Breen; K. Sheehan; A. Grygo

2007-01-01

This paper is an overview of this special issue devoted to watershed research in Acadia National Park (Acadia NP). The papers address components of an integrated research program on two upland watersheds at Acadia NP, USA (44° 20′ N latitude; 68° 15′ E longitude). These watersheds were instrumented in 1998 to provide a long-term foundation for regional ecological and...

Long-term follow-up of women and men after unsuccessful IVF.

PubMed

Filetto, Juliana N; Makuch, Maria Y

2005-10-01

The experience of 92 couples, who had unsuccessfully undergone one or more IVF cycles at a university clinic, was evaluated 3-8 years following their last failed attempt. One member of each couple completed a telephone questionnaire regarding life events during their last IVF cycle performed at the clinic and at the time of the interview. Some couples had continued further treatment and some had not. Multivariate correspondence analysis was used to analyse the data. Regarding the long-term experience of couples who had undergone further treatment, for men the main experiences were psychological problems and having adopted a child. For women, the main experiences were related to problems of self-image, psychological problems, loss of hope, and having adopted a child. These women also presented a strong association with problems in their marital relationship and with adoption. For the group that did not undergo further treatment, the women showed a strong association with considering adoption, and a less intense association with psychological problems and loss of hope. The men presented psychological problems and having adopted a child as associated variables. Comparison between men and women showed that recognizing the impossibility of conceiving a child and giving up treatment were strongly associated. Men and women who had not continued with further treatment were more affected in the long term than those who had undergone further treatment after IVF failure.

Long Term Stability Following Genioplasty: A Cephalometric Study

PubMed Central

Kumar, B Lakshman; Raju, G Kranthi Praveen; Kumar, N Dilip; Reddy, G Vivek; Naik, B Ravindra; Achary, C Ravindranath

2015-01-01

Background: A receding chin associated with an orthognathic mandible is a common situation and surgical changes in chin position are often required to improve the overall harmony of the face. Genioplasty is one such procedure. Stability of hard and soft tissue changes following genioplasty on a long term basis needs to be assessed. Studies on the stability of hard and soft tissue changes following genioplasty on a short term basis have revealed it as a procedure with good stability. This study is done to assess the stability of hard and soft tissue changes following genioplasty on a long term basis. Materials and Methods: Pre-surgical, postsurgical and long term post-surgical cephalograms of 15 cases treated by vertical reduction augmentation genioplasty were obtained. Paired t-test was used to compare the changes between pre-surgical, postsurgical and long term postsurgical cephalograms. Results: Findings of this study demonstrated that genioplasty is a stable procedure. After long term follow-up period, there was a relapse of 1.5 mm at the pogonion accounting for 24% of the surgical advancement. This is attributed to the remodeling that occurs at the surgical site, but not the instability due to the surgical procedure. Conclusion: With the present study, it can be concluded that vertical reduction and advancement genioplasty can be considered as an adjunctive procedure that produces predictable results and the bony and soft tissue stability were generally very good. PMID:25954070

Long-term EEG in children.

PubMed

Montavont, A; Kaminska, A; Soufflet, C; Taussig, D

2015-03-01

Long-term video-EEG corresponds to a recording ranging from 1 to 24 h or even longer. It is indicated in the following situations: diagnosis of epileptic syndromes or unclassified epilepsy, pre-surgical evaluation for drug-resistant epilepsy, follow-up of epilepsy or in cases of paroxysmal symptoms whose etiology remains uncertain. There are some specificities related to paediatric care: a dedicated pediatric unit; continuous monitoring covering at least a full 24-hour period, especially in the context of pre-surgical evaluation; the requirement of presence by the parents, technician or nurse; and stronger attachment of electrodes (cup electrodes), the number of which is adapted to the age of the child. The chosen duration of the monitoring also depends on the frequency of seizures or paroxysmal events. The polygraphy must be adapted to the type and topography of movements. It is essential to have at least an electrocardiography (ECG) channel, respiratory sensor and electromyography (EMG) on both deltoids. There is no age limit for performing long-term video-EEG even in newborns and infants; nevertheless because of scalp fragility, strict surveillance of the baby's skin condition is required. In the specific context of pre-surgical evaluation, long-term video-EEG must record all types of seizures observed in the child. This monitoring is essential in order to develop hypotheses regarding the seizure onset zone, based on electroclinical correlations, which should be adapted to the child's age and the psychomotor development. Copyright © 2015. Published by Elsevier SAS.

Long-term agroecosystem research in the central Mississippi river basin: introduction, establishment, and overview.

PubMed

Sadler, E John; Lerch, Robert N; Kitchen, Newell R; Anderson, Stephen H; Baffaut, Claire; Sudduth, Kenneth A; Prato, Anthony A; Kremer, Robert J; Vories, Earl D; Myers, D Brent; Broz, Robert; Miles, Randall J; Young, Fred J

2015-01-01

Many challenges currently facing agriculture require long-term data on landscape-scale hydrologic responses to weather, such as from the Goodwater Creek Experimental Watershed (GCEW), located in northeastern Missouri, USA. This watershed is prone to surface runoff despite shallow slopes, as a result of a significant smectitic clay layer 30 to 50 cm deep that restricts downward flow of water and gives rise to a periodic perched water table. This paper is the first in a series that documents the database developed from GCEW. The objectives of this paper are to (i) establish the context of long-term data and the federal infrastructure that provides it, (ii) describe the GCEW/ Central Mississippi River Basin (CMRB) establishment and the geophysical and anthropogenic context, (iii) summarize in brief the collected research results published using data from within GCEW, (iv) describe the series of papers this work introduces, and (v) identify knowledge gaps and research needs. The rationale for the collection derives from converging trends in data from long-term research, integration of multiple disciplines, and increasing public awareness of increasingly larger problems. The outcome of those trends includes being selected as the CMRB site in the USDA-ARS Long-Term Agro-Ecosystem Research (LTAR) network. Research needs include quantifying watershed scale fluxes of N, P, K, sediment, and energy, accounting for fluxes involving forest, livestock, and anthropogenic sources, scaling from near-term point-scale results to increasingly long and broad scales, and considering whole-system interactions. This special section informs the scientific community about this database and provides support for its future use in research to solve natural resource problems important to US agricultural, environmental, and science policy. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Long-term fuel retention in JET ITER-like wall

NASA Astrophysics Data System (ADS)

Heinola, K.; Widdowson, A.; Likonen, J.; Alves, E.; Baron-Wiechec, A.; Barradas, N.; Brezinsek, S.; Catarino, N.; Coad, P.; Koivuranta, S.; Krat, S.; Matthews, G. F.; Mayer, M.; Petersson, P.; Contributors, JET

2016-02-01

Post-mortem studies with ion beam analysis, thermal desorption, and secondary ion mass spectrometry have been applied for investigating the long-term fuel retention in the JET ITER-like wall components. The retention takes place via implantation and co-deposition, and the highest retention values were found to correlate with the thickness of the deposited impurity layers. From the total amount of retained D fuel over half was detected in the divertor region. The majority of the retained D is on the top surface of the inner divertor, whereas the least retention was measured in the main chamber on the mid-plane of the inner wall limiter. The recessed areas of the inner wall showed significant contribution to the main chamber total retention. Thermal desorption spectroscopy analysis revealed the energetic T from DD reactions being implanted in the divertor. The total T inventory was assessed to be \\gt 0.3 {{mg}}.

Assessing the market for long-term care services.

PubMed

Rice, J A; Taylor, S

1984-02-01

Traditionally, long-term care services have been used by a diverse marketplace. The chronically ill, developmentally disabled, mentally ill and aging population has looked to long-term care support services as a means of physical and emotional support. Much of the time these services were housed together for the sake of efficiency. The enormous burden these services are creating on the economy, and the growing aging population, have forced the recognition that long-term care service delivery systems must change. Alternate programming for long-term care services that reach out into the community and into individual homes is becoming an attractive approach to meeting the growing demands of the marketplace. Home health, specialized housing and creative funding mechanisms such as HMOs, are examples of initiatives undertaken by healthcare organizations that view diversification as a vehicle for survival. Market research techniques that have been used in other industries are being adapted to the healthcare industry to ensure the proper mix of services that are demanded by older, more knowledgeable consumers. The programs of the future will be market driven, with the ability of the individual to pay for such services playing a significant role. The healthcare provider of today is in a position to serve the community in new ways. By becoming an integral link in the long-term care system and by developing new programs, the organization can serve as a catalyst for change. It is up to the governing bodies and managers of these facilities to become visionaries and to accept responsibility for assessing the market for long-term care services and to guide their organization into the future.

Forensic entomology and main challenges in Brazil.

PubMed

Gomes, Leonardo; Von Zuben, Cláudio J

2006-01-01

Apart from an early case report from China (13th century), the first observations on insects and other arthropods as forensic indicators were documented in Germany and France during mass exhumations in the 1880s by Reinhard, who is considered a co-founder of the discipline. After the French publication of Mégnin's popular book on the applied aspects of forensic entomology, the concept quickly spread to Canada and United States. At that time, researchers recognized that the lack of systematic observations of insects of forensic importance jeopardized their use as indicators of postmortem interval. General advances in insect taxonomy and ecology helped to fill this gap over the following decades. After World Wars, few forensic entomology cases were reported in the scientific literature. From 1960s to the 1980s, Leclercq and Nuorteva were primarily responsible for maintaining the method in Central Europe, reporting isolated cases. Since then, basic research in the USA, Russia and Canada opened the way to the routine use of Entomology in forensic investigations. Identifications of insects associated with human cadavers are relatively few in the literature of the Neotropical region and have received little attention in Brazil. This article brings an overview of historic developments in this field, the recent studies and the main problems and challenges in South America and mainly in Brazil.

Carbon sequestration in croplands is mainly driven by management leading to increased net primary production - evidence from long-term field experiments in Northern Europe

NASA Astrophysics Data System (ADS)

Kätterer, Thomas; Bolinder, Martin Anders; Börjesson, Gunnar; Kirchmann, Holger; Poeplau, Christopher

2014-05-01

Sustainable intensification of agriculture in regions with high production potential is a prerequisite for providing services for an increasing human population, not only food, animal feed, fiber and biofuel but also to promote biodiversity and the beauty of landscapes. We investigated the effect of different management practices on soil fertility and carbon sequestration in long-term experiments, mainly from Northern Europe. In addition, a meta-analysis on the effect of catch crops was conducted. Improved management of croplands was found to be a win-win strategy resulting in both increased soil fertility and carbon sequestration. We quantified the effect of different management practices such as N fertilization, organic amendments, catch crops and ley-arable rotations versus continuous annual cropping systems on soil carbon stocks. Increasing net primary productivity (NPP) was found to be the main driver for higher soil carbon storage. Mineral N fertilization increased soil carbon stocks by 1-2 kg C ha-1 for each kg of N applied to cropland. Ley-arable rotations, being a combination of annual and perennial crops, are expected to have C stocks intermediate between those of continuous grass- and croplands. A summary of data from 15 long-term sites showed that on average 0.5 Mg ha-1 yr-1 (range 0.3 to 1.1; median 0.4 Mg ha-1 yr-1) more carbon was retained in soils in ley-arable compared to exclusively annual systems, depending on species composition, management, soil depth and the duration of the studies. The annual C accumulation rate for catch crops determined in the meta-analysis was well within that range (0.32±0.08 Mg C ha-1 yr-1). Retention factors calculated for straw, manure, sawdust, peat, sewage sludge and composted household waste varied widely in a decadal time scale. Retention of root and rhizodeposit carbon was higher than for above-ground crop residues. We conclude that NPP is the major driver for C sequestration and emphasize that increased soil

The SCIDIP-ES project - towards an international collaboration strategy for long term preservation of earth science data

NASA Astrophysics Data System (ADS)

Riddick, Andrew; Glaves, Helen; Marelli, Fulvio; Albani, Mirko; Tona, Calogera; Marketakis, Yannis; Tzitzikas, Yannis; Guarino, Raffaele; Giaretta, David; Di Giammatteo, Ugo

2013-04-01

The capability for long term preservation of earth science data is a key requirement to support on-going research and collaboration within and between many earth science disciplines. A number of critically important current research directions (e.g. understanding climate change, and ensuring sustainability of natural resources) rely on the preservation of data often collected over several decades in a form in which it can be accessed and used easily. Another key driver for strategic long term data preservation is that key research challenges (such as those described above) frequently require cross disciplinary research utilising raw and interpreted data from a number of earth science disciplines. Effective data preservation strategies can support this requirement for interoperability and collaboration, and thereby stimulate scientific innovation. The SCIDIP-ES project (EC FP7 grant agreement no. 283401) seeks to address these and other data preservation challenges by developing a Europe wide infrastructure for long term data preservation comprising appropriate software tools and infrastructure services to enable and promote long term preservation of earth science data. Because we define preservation in terms of continued usability of the digitally encoded information, the generic infrastructure services will allow a wide variety of data to be made usable by researchers from many different domains. This approach promotes international collaboration between researchers and will enable the cost for long-term usability across disciplines to be shared supporting the creation of strong business cases for the long term support of that data. This paper will describe our progress to date, including the results of community engagement and user consultation exercises designed to specify and scope the required tools and services. Our user engagement methodology, ensuring that we are capturing the views of a representative sample of institutional users, will be described. Key

Long-term abstinent alcoholics have normal memory.

PubMed

Reed, R J; Grant, I; Rourke, S B

1992-08-01

It is generally believed that many non-Korsakoff alcoholics have subtle defects in memory. To determine whether such defects vary as a function of length of abstinence (LOA), we performed extensive memory testing with: (1) recently detoxified (n = 31; LOA-29 days); (2) intermediate-term abstinent (n = 28; LOA = 1.9 years); (3) long-term abstinent (n = 32; LOA-7.0 years) alcoholics; and (4) nonalcoholic controls (n = 37). All subjects were matched on age and education. Alcoholics were matched on years of alcoholic drinking. Memory measures were divided into the following domains: verbal learning, verbal recall, visual learning, visual recall, and paired associate learning. A series of MANOVAs were conducted that revealed a significant relationship between visual learning and length of abstinence, and a significant interaction between age and length of abstinence on visual recall. Long-term abstinent subjects were not significantly different from controls on any test. We conclude that memory disturbance demonstrable among recently detoxified alcoholics in the early weeks of their abstinence is not evident in demographically matched long-term abstinent alcoholics with similar drinking histories.

Long-term archiving and data access: modelling and standardization

NASA Technical Reports Server (NTRS)

Hoc, Claude; Levoir, Thierry; Nonon-Latapie, Michel

1996-01-01

This paper reports on the multiple difficulties inherent in the long-term archiving of digital data, and in particular on the different possible causes of definitive data loss. It defines the basic principles which must be respected when creating long-term archives. Such principles concern both the archival systems and the data. The archival systems should have two primary qualities: independence of architecture with respect to technological evolution, and generic-ness, i.e., the capability of ensuring identical service for heterogeneous data. These characteristics are implicit in the Reference Model for Archival Services, currently being designed within an ISO-CCSDS framework. A system prototype has been developed at the French Space Agency (CNES) in conformance with these principles, and its main characteristics will be discussed in this paper. Moreover, the data archived should be capable of abstract representation regardless of the technology used, and should, to the extent that it is possible, be organized, structured and described with the help of existing standards. The immediate advantage of standardization is illustrated by several concrete examples. Both the positive facets and the limitations of this approach are analyzed. The advantages of developing an object-oriented data model within this contxt are then examined.

Short- and long-term immunogenicity and protection induced by non-replicating smallpox vaccine candidates in mice and comparison with the traditional 1st generation vaccine.

PubMed

Ferrier-Rembert, Audrey; Drillien, Robert; Tournier, Jean-Nicolas; Garin, Daniel; Crance, Jean-Marc

2008-03-25

This study assessed three non-replicating smallpox vaccine candidates (modified vaccinia Ankara (MVA), NYVAC and HR) for their immunogenicity and ability to protect mice against an intranasal cowpox virus challenge and compared them with the traditional replicating vaccine. A single immunisation with the non-replicating vaccines induced a complete protection from death at short-term, but was not fully protective when mice were challenged 150 days post-vaccination with protection correlated with the specific neutralizing antibodies and CD4(+) T-cells responses. Prime-boost vaccination enabled effective long-term protection from death for mice vaccinated with MVA, but protection from disease and CD4(+) T-cell level were lower than the ones induced by the traditional vaccine over the long-term period. Further investigations are necessary with MVA to determine the optimal conditions of immunisation to induce at long-term immunogenicity and protection observed with the 1st generation smallpox vaccine.

Long-term salvage therapy with cyclosporin A in refractory idiopathic thrombocytopenic purpura.

PubMed

Emilia, Giovanni; Morselli, Monica; Luppi, Mario; Longo, Giuseppe; Marasca, Roberto; Gandini, Giovanna; Ferrara, Leonardo; D'Apollo, Nicola; Potenza, Leonardo; Bertesi, Marcello; Torelli, Giuseppe

2002-02-15

Treatment of severe, chronic idiopathic thrombocytopenic purpura (ITP) refractory to most usual therapies is a difficult challenge. Little information exists on the clinical use of cyclosporin A (CyA) in the treatment of ITP. This report describes long-term treatment with CyA (median, 40 months) and follow-up (median, 36.8 months) in 12 adult patients with resistant ITP. CyA used in relatively low doses (2.5-3 mg/kg of body weight per day) led to a clinical improvement in 10 patients (83.3%). Five had a complete response (41.1%), 4 a complete response to maintenance therapy (33.3%), and one a partial response (8.3%). Two patients had no response. Most patients with a response (60%) had a long-term remission (mean, 28.6 months) after discontinuation of CyA. One patient had a relapse of ITP 4 years after CyA therapy was stopped. Side effects were moderate and transient, even in patients dependent on continued CyA treatment. CyA seems to represent reasonable salvage treatment in severe, potentially life-threatening, refractory ITP.

HIV is Now a Manageable Long-Term Condition, But What Makes it Unique? A Qualitative Study Exploring Views About Distinguishing Features from Multi-Professional HIV Specialists in North West England.

PubMed

Jelliman, Pauline; Porcellato, Lorna

HIV is evolving from a life-threatening infection to a long-term, manageable condition because of medical advances, radical changes in health and social care policy, and the impact of an aging population. However, HIV remains complex, presenting unique characteristics distinguishing it from other long-term conditions (LTCs). Our aim in this qualitative descriptive study was to identify and explore these features in the context of LTCs. A focus group (FG) method was used to gather the views and experiences of multi-professional HIV specialists who worked in North West England. Twenty-four staff participated in FGs (n = 3), which were audio recorded, manually transcribed, and thematically analyzed. We found four main themes: (a) stigma, (b) challenges faced by HIV specialists, (c) lack HIV-related knowledge, and (d) unique features, termed "stand alone." We concluded that these distinguishing features hindered full recognition and acceptance of HIV as an LTC. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Bringing Person- and Family-Centred Care Alive in Home, Community and Long-Term Care Organizations.

PubMed

Bender, Danielle; Holyoke, Paul

2016-01-01

It is now more important than ever for person- and family-centred care (PFCC) to be at the forefront of program and service design and delivery; yet, to date, very little guidance is available to assist home, community and long-term care (LTC) organizations to operationalize this concept and overcome inherent challenges. This article provides a list of practical strategies for healthcare leaders to promote and support a culture shift towards PFCC in their organizations and identifies and addresses five common concerns. The unique opportunities and challenges for practicing PFCC in home, community and LTC settings are also discussed.

Enhancing long-term memory with stimulation tunes visual attention in one trial.

PubMed

Reinhart, Robert M G; Woodman, Geoffrey F

2015-01-13

Scientists have long proposed that memory representations control the mechanisms of attention that focus processing on the task-relevant objects in our visual field. Modern theories specifically propose that we rely on working memory to store the object representations that provide top-down control over attentional selection. Here, we show that the tuning of perceptual attention can be sharply accelerated after 20 min of noninvasive brain stimulation over medial-frontal cortex. Contrary to prevailing theories of attention, these improvements did not appear to be caused by changes in the nature of the working memory representations of the search targets. Instead, improvements in attentional tuning were accompanied by changes in an electrophysiological signal hypothesized to index long-term memory. We found that this pattern of effects was reliably observed when we stimulated medial-frontal cortex, but when we stimulated posterior parietal cortex, we found that stimulation directly affected the perceptual processing of the search array elements, not the memory representations providing top-down control. Our findings appear to challenge dominant theories of attention by demonstrating that changes in the storage of target representations in long-term memory may underlie rapid changes in the efficiency with which humans can find targets in arrays of objects.

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…

Measuring short-term and long-term physiological stress effects by cortisol reactivity in saliva and hair.

PubMed

van Holland, Berry J; Frings-Dresen, Monique H W; Sluiter, Judith K

2012-11-01

The aims of this study were to investigate (1) the concurrent relationship between short-term and long-term stress reactivity measured by cortisol excretion and (2) the relationship of these physiological stress effects with self-reported stress and need for recovery after work (NFR). Participants were production workers in the meat-processing industry. Short-term cortisol excretion was calculated by summing 18 saliva samples, sampled over a 3-day period. Samples were delivered by 37 participants. Twenty-nine of them also supplied one hair sample of at least 3 cm in length for an analysis of long-term (3 months) cortisol excretion. All of them filled in a short questionnaire on self-reported stress and NFR. Self-reported stress was assessed by a three-item stress screener; NFR was assessed by an 11-item scale. Short-term and long-term cortisol excretion are significantly, but moderately, associated (r = 0.41, P = 0.03). Short-term and long-term cortisol excretion correlated weakly to self-reported stress and NFR (correlations varied from -0.04 to 0.21). Short-term and long-term physiological stress excretion levels are moderately associated. Physiological stress effects assessed from saliva and hair cannot be used interchangeably with self-reported stress because they only correlate weakly. To better predict long-term cortisol excretion in workers, the predictive value of short-term cortisol excretion must be evaluated in a prognostic longitudinal study in a working population.

Implantable fiber-optic interface for parallel multisite long-term optical dynamic brain interrogation in freely moving mice

PubMed Central

Doronina-Amitonova, L. V.; Fedotov, I. V.; Ivashkina, O. I.; Zots, M. A.; Fedotov, A. B.; Anokhin, K. V.; Zheltikov, A. M.

2013-01-01

Seeing the big picture of functional responses within large neural networks in a freely functioning brain is crucial for understanding the cellular mechanisms behind the higher nervous activity, including the most complex brain functions, such as cognition and memory. As a breakthrough toward meeting this challenge, implantable fiber-optic interfaces integrating advanced optogenetic technologies and cutting-edge fiber-optic solutions have been demonstrated, enabling a long-term optogenetic manipulation of neural circuits in freely moving mice. Here, we show that a specifically designed implantable fiber-optic interface provides a powerful tool for parallel long-term optical interrogation of distinctly separate, functionally different sites in the brain of freely moving mice. This interface allows the same groups of neurons lying deeply in the brain of a freely behaving mouse to be reproducibly accessed and optically interrogated over many weeks, providing a long-term dynamic detection of genome activity in response to a broad variety of pharmacological and physiological stimuli. PMID:24253232

Implantable fiber-optic interface for parallel multisite long-term optical dynamic brain interrogation in freely moving mice

NASA Astrophysics Data System (ADS)

Doronina-Amitonova, L. V.; Fedotov, I. V.; Ivashkina, O. I.; Zots, M. A.; Fedotov, A. B.; Anokhin, K. V.; Zheltikov, A. M.

2013-11-01

Seeing the big picture of functional responses within large neural networks in a freely functioning brain is crucial for understanding the cellular mechanisms behind the higher nervous activity, including the most complex brain functions, such as cognition and memory. As a breakthrough toward meeting this challenge, implantable fiber-optic interfaces integrating advanced optogenetic technologies and cutting-edge fiber-optic solutions have been demonstrated, enabling a long-term optogenetic manipulation of neural circuits in freely moving mice. Here, we show that a specifically designed implantable fiber-optic interface provides a powerful tool for parallel long-term optical interrogation of distinctly separate, functionally different sites in the brain of freely moving mice. This interface allows the same groups of neurons lying deeply in the brain of a freely behaving mouse to be reproducibly accessed and optically interrogated over many weeks, providing a long-term dynamic detection of genome activity in response to a broad variety of pharmacological and physiological stimuli.

Long-Term Economic and Labor Forecast Trends for Washington. 1996.

ERIC Educational Resources Information Center

Lefberg, Irv; And Others

This publication provides actual historical and long-term forecast data on labor force, total wage and salary employment, industry employment, and personal income for the state of Washington. The data are based upon the Washington Office of Financial Management long-term population forecast. Chapter 1 presents long-term forecasts of Washington…

Long-term academic stress enhances early processing of facial expressions.

PubMed

Zhang, Liang; Qin, Shaozheng; Yao, Zhuxi; Zhang, Kan; Wu, Jianhui

2016-11-01

Exposure to long-term stress can lead to a variety of emotional and behavioral problems. Although widely investigated, the neural basis of how long-term stress impacts emotional processing in humans remains largely elusive. Using event-related brain potentials (ERPs), we investigated the effects of long-term stress on the neural dynamics of emotionally facial expression processing. Thirty-nine male college students undergoing preparation for a major examination and twenty-one matched controls performed a gender discrimination task for faces displaying angry, happy, and neutral expressions. The results of the Perceived Stress Scale showed that participants in the stress group perceived higher levels of long-term stress relative to the control group. ERP analyses revealed differential effects of long-term stress on two early stages of facial expression processing: 1) long-term stress generally augmented posterior P1 amplitudes to facial stimuli irrespective of expression valence, suggesting that stress can increase sensitization to visual inputs in general, and 2) long-term stress selectively augmented fronto-central P2 amplitudes for angry but not for neutral or positive facial expressions, suggesting that stress may lead to increased attentional prioritization to processing negative emotional stimuli. Together, our findings suggest that long-term stress has profound impacts on the early stages of facial expression processing, with an increase at the very early stage of general information inputs and a subsequent attentional bias toward processing emotionally negative stimuli. Copyright © 2016 Elsevier B.V. All rights reserved.

Economic efficiency of short-term versus long-term water rights buyouts

USDA-ARS?s Scientific Manuscript database

Because of the decline of the Ogallala Aquifer, water districts, regional water managers, and state water officers are becoming increasingly interested in conservation policies. This study evaluates both short-term and long-term water rights buyout policies. This research develops dynamic production...

Issues in the Development of Long Term Care Gerontology Centers: The Centers Concept. Selected Topics in Long Term Care. Volume 6.

ERIC Educational Resources Information Center

Mortenson, Lee E.; Berdes, Celia M.

This document, one in a series developed to provide technical assistance to 22 Long-Term Care Gerontology Centers, describes the current administrative and structural phenomenon of these centers. Precedents useful in assessing both the current climate and actual prospects for development of long term care centers are cited. The first section…

Long term sleep disturbance due to traffic noise

NASA Astrophysics Data System (ADS)

Vallet, M.; Gagneux, J.-M.; Blanchet, V.; Favre, B.; Labiale, G.

1983-09-01

This contribution to the evaluation of the effects of traffic noise on sleep disturbance is focused on the responses of people living near a main road. Experiments were carried out in the homes of subjects who had habitually been exposed to noise for periods of more than four years. The chronic changes in overall sleep patterns and the temporary sleep responses to particular noise events caused by traffic are demonstrated. Young people show mainly stage 3 and 4 deficits whilst older people show REM sleep deficits. The cardiac response to noise during sleep was also examined. These results highlight that both long term average and peak levels are important in assessing sleep disturbance. The threshold levels, measured inside the bedroom and above which sleep quality starts to become impaired, are 37 Leq(A) and 45 dB (A) Lp max , respectively. For the type of traffic studied these two levels are coherent and it is therefore possible that a single noise index, Leq(A), is sufficient to scale sleep disturbance.

Long-term data from silvicultural studies: interpreting and assessing old records for economic insights

Treesearch

Paul E. Sendak; Robert M. Frank; William B. Leak

2006-01-01

Long-term silvicultural studies on the Penobscot Experimental Forest in Maine and Bartlett Experimental Forest in New Hampshire offer opportunities for the patient financial analyst. The economist working with carefully collected growth and yield data can increase the value of these studies to other researchers and ultimately to forest managers. Issues related to data...

Sleep Quality, Short-Term and Long-Term CPAP Adherence

PubMed Central

Somiah, Manya; Taxin, Zachary; Keating, Joseph; Mooney, Anne M.; Norman, Robert G.; Rapoport, David M.; Ayappa, Indu

2012-01-01

Study Objectives: Adherence to CPAP therapy is low in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). The purpose of the present study was to evaluate the utility of measures of sleep architecture and sleep continuity on the CPAP titration study as predictors of both short- and long-term CPAP adherence. Methods: 93 patients with OSAHS (RDI 42.8 ± 34.3/h) underwent in-laboratory diagnostic polysomnography, CPAP titration, and follow-up polysomnography (NPSG) on CPAP. Adherence to CPAP was objectively monitored. Short-term (ST) CPAP adherence was averaged over 14 days immediately following the titration study. Long-term (LT) CPAP adherence was obtained in 56/93 patients after approximately 2 months of CPAP use. Patients were grouped into CPAP adherence groups for ST (< 2 h, 2-4 h, and > 4 h) and LT adherence (< 4 h, > 4 h). Sleep architecture, sleep disordered breathing (SDB) indices, and daytime outcome variables from the diagnostic and titration NPSGs were compared between CPAP adherence groups. Results: There was a significant relationship between ST and LT CPAP adherence (r = 0.81, p < 0.001). Neither ST nor LT adherence were related to demographic variables, baseline severity of untreated SDB, sleep architecture, or measures of daytime impairment. Good CPAP adherence groups had significantly lower %N2 and greater %REM on the titration NPSG. A model combining change in sleep efficiency and change in sleep continuity between the diagnostic and titration NPSGs predicted 17% of the variance in LT adherence (p = 0.006). Conclusions: These findings demonstrate that characteristics of sleep architecture, even on the titration NPSG, may predict some of the variance in CPAP adherence. Better sleep quality on the titration night was related to better CPAP adherence, suggesting that interventions to improve sleep on/prior to the CPAP titration study might be used as a therapeutic intervention to improve CPAP adherence. Citation: Somiah M; Taxin Z; Keating

Chronic dietary chlorpyrifos causes long-term spatial memory impairment and thigmotaxic behavior.

PubMed

López-Granero, Caridad; Ruiz-Muñoz, Ana M; Nieto-Escámez, Francisco A; Colomina, María T; Aschner, Michael; Sánchez-Santed, Fernando

2016-03-01

Little is known about the long-term effects of chronic exposure to low-level organophosphate (OP) pesticides, and the role of neurotransmitter systems, other than the cholinergic system, in mediating OP neurotoxicity. In this study, rats were administered 5mg/kg/day of chlorpyrifos (CPF) for 6 months commencing at 3-months-of-age. The animals were examined 7 months later (at 16-months-of-age) for spatial learning and memory in the Morris water maze (MWM) and locomotor activity. In addition, we assessed the chronic effects of CPF on glutamatergic and gamma-aminobutyric acid (GABAergic) function using pharmacological challenges with dizocilpine (MK801) and diazepam. Impaired performance related to altered search patterns, including thigmotaxis and long-term spatial memory was noted in the MWM in animals exposed to CPF, pointing to dietary CPF-induced behavioral disturbances, such as anxiety. Twenty-four hours after the 31st session of repeated acquisition task, 0.1mg/kg MK801, an N-methyl-d-aspartate (NMDA) antagonist was intraperitoneally (i.p.) injected for 4 consecutive days. Decreased latencies in the MWM in the control group were noted after two sessions with MK801 treatment. Once the MWM assessment was completed, animals were administered 0.1 or 0.2mg/kg of MK801 and 1 or 3mg/kg of diazepam i.p., and tested for locomotor activity. Both groups, the CPF dietary and control, displayed analogous performance in motor activity. In conclusion, our data point to a connection between the long-term spatial memory, thigmotaxic response and CPF long after the exposure ended. Copyright © 2015 Elsevier Inc. All rights reserved.

Long-term memory and volatility clustering in high-frequency price changes

NASA Astrophysics Data System (ADS)

oh, Gabjin; Kim, Seunghwan; Eom, Cheoljun

2008-02-01

We studied the long-term memory in diverse stock market indices and foreign exchange rates using Detrended Fluctuation Analysis (DFA). For all high-frequency market data studied, no significant long-term memory property was detected in the return series, while a strong long-term memory property was found in the volatility time series. The possible causes of the long-term memory property were investigated using the return data filtered by the AR(1) model, reflecting the short-term memory property, the GARCH(1,1) model, reflecting the volatility clustering property, and the FIGARCH model, reflecting the long-term memory property of the volatility time series. The memory effect in the AR(1) filtered return and volatility time series remained unchanged, while the long-term memory property diminished significantly in the volatility series of the GARCH(1,1) filtered data. Notably, there is no long-term memory property, when we eliminate the long-term memory property of volatility by the FIGARCH model. For all data used, although the Hurst exponents of the volatility time series changed considerably over time, those of the time series with the volatility clustering effect removed diminish significantly. Our results imply that the long-term memory property of the volatility time series can be attributed to the volatility clustering observed in the financial time series.

Long-term complications in Hodgkin's lymphoma survivors.

PubMed

Kilickap, Saadettin; Barista, Ibrahim; Ulger, Sukran; Celik, Ismail; Selek, Ugur; Güllü, Ibrahim; Yildiz, Ferah; Kars, Ayse; Ozisik, Yavuz; Tekuzman, Gülten

2012-01-01

Background. Although patients with Hodgkin's lymphoma (HL) achieve prolonged survival, long-term complications are a major cause of morbidity and mortality among long-term survivors of HL. Methods. We retrospectively evaluated long-term complications in 336 HL survivors treated between January 1990 and January 2006 at the Department of Medical Oncology of the Hacettepe University Institute of Oncology who were >16 years old at presentation. All patients were regularly followed up every 3 months for the first 2 years after complete response, biannually for 3 years, and annually after 5 years. Results. Median follow-up was 8.5 years. The mean age (±SD) of the patients at the time of diagnosis was 35.7 ± 13.1 years. The male to female ratio was 61%/39%. During follow-up, 29 second malignancies (8.6%) were diagnosed in 28 patients with HL; 22 were solid tumors and 7 were hematological malignancies. Forty-seven (14.0%) of all patients with HL were found to have thyroid abnormalities. During follow-up, 54 (16.1%) patients developed cardiovascular complications. Overall, 29 (8.6%) patients developed late pulmonary toxicities. The cumulative number of chronic viral infections was 13 (3.9%). Conclusions. Long-term survivors of HL need to be properly followed up not only for disease control but also for evaluation of possible late morbidities to minimize the consequences.

Dynamical model of long-term synaptic plasticity

PubMed Central

Abarbanel, Henry D. I.; Huerta, R.; Rabinovich, M. I.

2002-01-01

Long-term synaptic plasticity leading to enhancement in synaptic efficacy (long-term potentiation, LTP) or decrease in synaptic efficacy (long-term depression, LTD) is widely regarded as underlying learning and memory in nervous systems. LTP and LTD at excitatory neuronal synapses are observed to be induced by precise timing of pre- and postsynaptic events. Modification of synaptic transmission in long-term plasticity is a complex process involving many pathways; for example, it is also known that both forms of synaptic plasticity can be induced by various time courses of Ca2+ introduction into the postsynaptic cell. We present a phenomenological description of a two-component process for synaptic plasticity. Our dynamical model reproduces the spike time-dependent plasticity of excitatory synapses as a function of relative timing between pre- and postsynaptic events, as observed in recent experiments. The model accounts for LTP and LTD when the postsynaptic cell is voltage clamped and depolarized (LTP) or hyperpolarized (LTD) and no postsynaptic action potentials are evoked. We are also able to connect our model with the Bienenstock, Cooper, and Munro rule. We give model predictions for changes in synaptic strength when periodic spike trains of varying frequency and Poisson distributed spike trains with varying average frequency are presented pre- and postsynaptically. When the frequency of spike presentation exceeds ≈30–40 Hz, only LTP is induced. PMID:12114531

Initiating Long-Term Soil Productivity Research in Missouri

Treesearch

Felix Ponder

1997-01-01

Management practices necessary for sustaining long-term soil productivity (LTSP) afforest lands are being defined from a network of coordinated, long-term experiments established in vartous ecosystems across the United States and British Columbia according to the same basic study plan. The study was established in the Ozark Region of southeastem Missouri in Shannon...

[Let us not underestimate the importance of good long-term programming and competent administration of health care].

PubMed

Holcík, J

2009-01-01

The origin of Social Medicine is in the theories on the health services in the 18th and 19th centuries. The first step was establishing so-called State Medicine. Socio-medical thinking, the beginnings of which were determined by the process of the industrial revolution and the increasing social differences, led at the beginning of 20th century to the first attempts to establish Social Medicine as a separate medical discipline. In the history of Social Medicine in the Czech Republic the important personalities were mainly professors Frantisek Procházka, Frantisek Hamza, Hynek Pelc, and Adolf Zácek. The main motivation of qualitative changes of Social Medicine in Czechoslovakia after 1989 were great political, economic and social changes, documents of the World Health Organization and the European health policy. Present health care reform brings new opportunities, challenges, and problems. As a tool of its implementation a long-term programming based on human values should be used in a larger scale. The adequate professional skills in health care administration are indispensable. Article presents concise information on the work of the Society of Social Medicine and Health Care Administration of the Czech Medical Society of J. E. Purkynje.

Long-term maintenance needs planning.

DOT National Transportation Integrated Search

2005-09-01

This research contributes to Kentucky's knowledge base of long-term maintenance needs in two parts. Part I presents an estimate of the average revenue needed to maintain four categories of highway in the first fifteen years after each is built or res...

Physicians' Knowledge of and Attitudes Toward Use of Opioids in Long-Term Care Facilities.

PubMed

Griffioen, Charlotte; Willems, Eva G; Kouwenhoven, Sanne M; Caljouw, Monique A A; Achterberg, Wilco P

2017-06-01

Insufficient pain management in vulnerable older persons living in long-term care facilities is common, and opiophobia might contribute to this. As opiophobia and its related factors have not been investigated in long-term care, this study evaluates the degree of knowledge of opioids among elderly-care physicians (ECPs) and ECP trainees, as well as their attitudes and other factors possibly influencing the clinical use of opioids in these facilities. A questionnaire was designed and distributed among ECPs and ECP trainees by email, regional symposia, and all three university training faculties for elderly-care medicine in the Netherlands. Respondents were 324 ECPs and 111 ECP trainees. Fear of addiction did not influence the prescription of opioids. Main barriers to the clinical use of opioids were patients' reluctance to take opioids (83.3%); unknown degree of pain (79.2%); and pain of unknown origin (51.4%). ECPs' average knowledge scores were sufficient: those who felt that their knowledge of opioids was poor scored lower than those who felt that their knowledge was good. Factors identified in this study may help provide better pain management for vulnerable older persons living in a long-term care facility. Also, more patient information on the pros and cons of opioid use is needed, as well as appropriate tools for better clinical assessment of pain in a long-term care population. © 2016 World Institute of Pain.

Long-term use of short- and long-acting nitrates in stable angina pectoris.

PubMed

Kosmicki, Marek Antoni

2009-05-01

Long-acting nitrates are effective antianginal drugs during initial treatment. However, their therapeutic value is compromised by the rapid development of tolerance during sustained therapy, which means that their clinical efficacy is decreased during long-term use. Sublingual nitroglycerin (NTG), a short-acting nitrate, is suitable for the immediate relief of angina. In patients with stable angina treated with oral long-acting nitrates, NTG maintains its full anti-ischemic effect both after initial oral ingestion and after intermittent long-term oral administration. However, NTG attenuates this effect during continuous treatment, when tolerance to oral nitrates occurs, and this is called cross-tolerance. In stable angina long-acting nitrates are considered third-line therapy because a nitrate-free interval is required to avoid the development of tolerance. Nitrates vary in their potential to induce the development of tolerance. During long-lasting nitrate therapy, except pentaerythritol tetranitrate (PETN), one can observe the development of reactive oxygen species (ROS) inside the muscular cell of a vessel wall, and these bind with nitric oxide (NO). This leads to decreased NO activity, thus, nitrate tolerance. PETN has no tendency to form ROS, and therefore during long-term PETN therapy, there is probably no tolerance or cross-tolerance, as during treatment with other nitrates.

What are the differences between long-term, short-term, and working memory?

PubMed

Cowan, Nelson

2008-01-01

In the recent literature there has been considerable confusion about the three types of memory: long-term, short-term, and working memory. This chapter strives to reduce that confusion and makes up-to-date assessments of these types of memory. Long- and short-term memory could differ in two fundamental ways, with only short-term memory demonstrating (1) temporal decay and (2) chunk capacity limits. Both properties of short-term memory are still controversial but the current literature is rather encouraging regarding the existence of both decay and capacity limits. Working memory has been conceived and defined in three different, slightly discrepant ways: as short-term memory applied to cognitive tasks, as a multi-component system that holds and manipulates information in short-term memory, and as the use of attention to manage short-term memory. Regardless of the definition, there are some measures of memory in the short term that seem routine and do not correlate well with cognitive aptitudes and other measures (those usually identified with the term "working memory") that seem more attention demanding and do correlate well with these aptitudes. The evidence is evaluated and placed within a theoretical framework depicted in Fig. 1.

Stirling engine - Approach for long-term durability assessment

NASA Technical Reports Server (NTRS)

Tong, Michael T.; Bartolotta, Paul A.; Halford, Gary R.; Freed, Alan D.

1992-01-01

The approach employed by NASA Lewis for the long-term durability assessment of the Stirling engine hot-section components is summarized. The approach consists of: preliminary structural assessment; development of a viscoplastic constitutive model to accurately determine material behavior under high-temperature thermomechanical loads; an experimental program to characterize material constants for the viscoplastic constitutive model; finite-element thermal analysis and structural analysis using a viscoplastic constitutive model to obtain stress/strain/temperature at the critical location of the hot-section components for life assessment; and development of a life prediction model applicable for long-term durability assessment at high temperatures. The approach should aid in the provision of long-term structural durability and reliability of Stirling engines.

Finance issue brief: long-term care insurance: year end report-2003.

PubMed

Tanner, Rachel C

2003-12-31

A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policymakers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

Local technicians in long-term research projects: evaluation of 25 years experience in an active tropical research station.

PubMed

Hurtado, Johanna; Clark, David B

2011-12-01

Most field ecology is conceived and financed by scientists from urban areas but is actually carried out in rural areas. Field staff can either be imported from urban areas or recruited from local residents. We evaluated the advantages and disadvantages of involving rural residents as local technicians over a 25- year period at active field research site in Costa Rica. We defined "local technicians" as local residents with no university education who acquired significant experience in field data collection, data management and/or laboratory work. We analyzed the experiences of incorporating these technicians into field research in developing countries from the points of view of scientist and of the local technicians themselves. Primary data were written responses from to a standardized survey of 19 senior scientists and Ph.D. students,and results from standardized personal interviews with 22 local technicians. Researchers highlighted the advantages of highly-skilled technicians with minimal staff turnover, as well as the technicians' knowledge of local ecological conditions. Local technicians considered the primary advantages of their jobs to be opportunities for continuing education training in science as well as cultural enrichment through interactions with people of different cultures. The main challenges identified by researchers were the lack of long-term funding for projects and extended training required for local technicians. Local technicians can be of great benefit to research projects by providing high-quality data collection at reasonable costs with low staff turnover. Over the last 25 years the research model at the field station we studied has evolved to the point that most long-term projects now depend heavily on local technicians. This model of involving local technicians in long-term research has multiple benefits for the researchers, the technicians and the local community, and could be adapted to a variety of settings in rural areas of developing

Intergovernmental relations and Long Term Care reforms: lessons from the Italian case.

PubMed

Gabriele, Stefania; Tediosi, Fabrizio

2014-05-01

The article aims at analysing the reasons why Italy failed to reform Long Term Care (LTC) policies, focusing on an aspect which has been overlooked: the interplay between LTC policies and the intergovernmental multilevel relationships. In the Italian LTC system, the main central intervention has been the regularisation of migrant care work, while the automatic growth of the cash benefits has accompanied the care needs evolution. Therefore the only institutional change has been a "gradual transformation". The causes of the failure to reform LTC have been mainly related to a strong fragmentation of the policy field, the existence of a universalistic cash benefit, the fiscal constraint. We argue that a further obstacle to reform LTC policies has been the weak and uncertain legislative framework of federalism. The uncertainty on the allocation and distribution of resources and the delay to apply the equalisation mechanism based on needs engendered a lame federalism that contributed to hindering welfare innovations and to increasing the institutional fragmentation. The analysis is partly consistent with previous literature, although it places less emphasis on the role of the constituencies and the scarcity of resources in influencing decisions, focusing more on the implications of the failure to fully realise the federalist reform. This focus shows that to implement institutional change in the welfare system, it is important to take into account the features of the federal governance, the intergovernmental relations, and to address the challenges that are connected to them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Patient empowerment in long-term conditions: development and preliminary testing of a new measure

PubMed Central

2013-01-01

Background Patient empowerment is viewed by policy makers and health care practitioners as a mechanism to help patients with long-term conditions better manage their health and achieve better outcomes. However, assessing the role of empowerment is dependent on effective measures of empowerment. Although many measures of empowerment exist, no measure has been developed specifically for patients with long-term conditions in the primary care setting. This study presents preliminary data on the development and validation of such a measure. Methods We conducted two empirical studies. Study one was an interview study to understand empowerment from the perspective of patients living with long-term conditions. Qualitative analysis identified dimensions of empowerment, and the qualitative data were used to generate items relating to these dimensions. Study two was a cross-sectional postal study involving patients with different types of long-term conditions recruited from general practices. The survey was conducted to test and validate our new measure of empowerment. Factor analysis and regression were performed to test scale structure, internal consistency and construct validity. Results Sixteen predominately elderly patients with different types of long-term conditions described empowerment in terms of 5 dimensions (identity, knowledge and understanding, personal control, personal decision-making, and enabling other patients). One hundred and ninety seven survey responses were received from mainly older white females, with relatively low levels of formal education, with the majority retired from paid work. Almost half of the sample reported cardiovascular, joint or diabetes long-term conditions. Factor analysis identified a three factor solution (positive attitude and sense of control, knowledge and confidence in decision making and enabling others), although the structure lacked clarity. A total empowerment score across all items showed acceptable levels of internal

Long-term dataset on aquatic responses to concurrent climate change and recovery from acidification

NASA Astrophysics Data System (ADS)

Leach, Taylor H.; Winslow, Luke A.; Acker, Frank W.; Bloomfield, Jay A.; Boylen, Charles W.; Bukaveckas, Paul A.; Charles, Donald F.; Daniels, Robert A.; Driscoll, Charles T.; Eichler, Lawrence W.; Farrell, Jeremy L.; Funk, Clara S.; Goodrich, Christine A.; Michelena, Toby M.; Nierzwicki-Bauer, Sandra A.; Roy, Karen M.; Shaw, William H.; Sutherland, James W.; Swinton, Mark W.; Winkler, David A.; Rose, Kevin C.

2018-04-01

Concurrent regional and global environmental changes are affecting freshwater ecosystems. Decadal-scale data on lake ecosystems that can describe processes affected by these changes are important as multiple stressors often interact to alter the trajectory of key ecological phenomena in complex ways. Due to the practical challenges associated with long-term data collections, the majority of existing long-term data sets focus on only a small number of lakes or few response variables. Here we present physical, chemical, and biological data from 28 lakes in the Adirondack Mountains of northern New York State. These data span the period from 1994-2012 and harmonize multiple open and as-yet unpublished data sources. The dataset creation is reproducible and transparent; R code and all original files used to create the dataset are provided in an appendix. This dataset will be useful for examining ecological change in lakes undergoing multiple stressors.

Factors Affecting Long-Term Abstinence from Substances Use

ERIC Educational Resources Information Center

Elsheikh, Salah Elgaily

2008-01-01

Objective: The purpose of this study is to explore the attitudes of abstainers from drug use that relate to the factors leading to long-term abstinence. Materials and Methods: Cross-sectional study was carried out in Al-Amal Hospital to examine, which attitudes of abstainers related to long-term abstinence. A random survey was conducted on 62…

Reconciling long-term cultural diversity and short-term collective social behavior.

PubMed

Valori, Luca; Picciolo, Francesco; Allansdottir, Agnes; Garlaschelli, Diego

2012-01-24

An outstanding open problem is whether collective social phenomena occurring over short timescales can systematically reduce cultural heterogeneity in the long run, and whether offline and online human interactions contribute differently to the process. Theoretical models suggest that short-term collective behavior and long-term cultural diversity are mutually excluding, since they require very different levels of social influence. The latter jointly depends on two factors: the topology of the underlying social network and the overlap between individuals in multidimensional cultural space. However, while the empirical properties of social networks are intensively studied, little is known about the large-scale organization of real societies in cultural space, so that random input specifications are necessarily used in models. Here we use a large dataset to perform a high-dimensional analysis of the scientific beliefs of thousands of Europeans. We find that interopinion correlations determine a nontrivial ultrametric hierarchy of individuals in cultural space. When empirical data are used as inputs in models, ultrametricity has strong and counterintuitive effects. On short timescales, it facilitates a symmetry-breaking phase transition triggering coordinated social behavior. On long timescales, it suppresses cultural convergence by restricting it within disjoint groups. Moreover, ultrametricity implies that these results are surprisingly robust to modifications of the dynamical rules considered. Thus the empirical distribution of individuals in cultural space appears to systematically optimize the coexistence of short-term collective behavior and long-term cultural diversity, which can be realized simultaneously for the same moderate level of mutual influence in a diverse range of online and offline settings.

Long-term effects of interference on short-term memory performance in the rat.

PubMed

Missaire, Mégane; Fraize, Nicolas; Joseph, Mickaël Antoine; Hamieh, Al Mahdy; Parmentier, Régis; Marighetto, Aline; Salin, Paul Antoine; Malleret, Gaël

2017-01-01

A distinction has always been made between long-term and short-term memory (also now called working memory, WM). The obvious difference between these two kinds of memory concerns the duration of information storage: information is supposedly transiently stored in WM while it is considered durably consolidated into long-term memory. It is well acknowledged that the content of WM is erased and reset after a short time, to prevent irrelevant information from proactively interfering with newly stored information. In the present study, we used typical WM radial maze tasks to question the brief lifespan of spatial WM content in rodents. Groups of rats were submitted to one of two different WM tasks in a radial maze: a WM task involving the repetitive presentation of a same pair of arms expected to induce a high level of proactive interference (PI) (HIWM task), or a task using a different pair in each trial expected to induce a low level of PI (LIWM task). Performance was effectively lower in the HIWM group than in LIWM in the final trial of each training session, indicative of a "within-session/short-term" PI effect. However, we also observed a different "between-session/long-term" PI effect between the two groups: while performance of LIWM trained rats remained stable over days, the performance of HIWM rats dropped after 10 days of training, and this impairment was visible from the very first trial of the day, hence not attributable to within-session PI. We also showed that a 24 hour-gap across training sessions known to allow consolidation processes to unfold, was a necessary and sufficient condition for the long-term PI effect to occur. These findings suggest that in the HIWM task, WM content was not entirely reset between training sessions and that, in specific conditions, WM content can outlast its purpose by being stored more permanently, generating a long-term deleterious effect of PI. The alternative explanation is that WM content could be transferred and stored

Opening the Door: The Experience of Chronic Critical Illness in a Long-Term Acute Care Hospital.

PubMed

Lamas, Daniela J; Owens, Robert L; Nace, R Nicholas; Massaro, Anthony F; Pertsch, Nathan J; Gass, Jonathon; Bernacki, Rachelle E; Block, Susan D

2017-04-01

Chronically critically ill patients have recurrent infections, organ dysfunction, and at least half die within 1 year. They are frequently cared for in long-term acute care hospitals, yet little is known about their experience in this setting. Our objective was to explore the understanding and expectations and goals of these patients and surrogates. We conducted semi-structured interviews with chronically critically ill long-term acute care hospital patients or surrogates. Conversations were recorded, transcribed, and analyzed. One long-term acute care hospital. Chronically critically ill patients, defined by tracheotomy for prolonged mechanical ventilation, or surrogates. Semi-structured conversation about quality of life, expectations, and planning for setbacks. A total of 50 subjects (30 patients and 20 surrogates) were enrolled. Thematic analyses demonstrated: 1) poor quality of life for patients; 2) surrogate stress and anxiety; 3) optimistic health expectations; 4) poor planning for medical setbacks; and 5) disruptive care transitions. Nearly 80% of patient and their surrogate decision makers identified going home as a goal; 38% were at home at 1 year. Our study describes the experience of chronically critically ill patients and surrogates in an long-term acute care hospital and the feasibility of patient-focused research in this setting. Our findings indicate overly optimistic expectations about return home and unmet palliative care needs, suggesting the need for integration of palliative care within the long-term acute care hospital. Further research is also needed to more fully understand the challenges of this growing population of ICU survivors.

Enhancing Long-Term Retention of New Vocabulary Using Visual Images.

ERIC Educational Resources Information Center

Igelsrud, Karen

A practicum used a new learning tool to enhance long-term retention of new vocabulary. Sixteen seventh-graders in Language Arts, who had a long-term retention mean score of approximately 40% of newly learned vocabulary, increased their long-term retention of new vocabulary by 25% (a new mean of 65% of new vocabulary). Additional objectives…

Long-term Neurotoxic Effects of Early-life Exposure to Tetrachloroethylene-contaminated Drinking Water.

PubMed

Aschengrau, Ann; Janulewicz, Patricia A; White, Roberta F; Vieira, Veronica M; Gallagher, Lisa G; Getz, Kelly D; Webster, Thomas F; Ozonoff, David M

2016-01-01

Tetrachloroethene (PCE) is a common environmental and occupational contaminant and an acknowledged neurotoxicant. From 1968 through 1983, widespread contamination of public drinking water supplies with PCE occurred in the Cape Cod region of Massachusetts. The source of the contamination was a vinyl liner applied to the inner surface of water distribution pipes. A retrospective cohort study (the Cape Cod Health Study) was undertaken to examine possible health consequences of early-life exposure to PCE-contaminated drinking water. This review describes the study methods and findings regarding the effects of prenatal and childhood exposure on neurologic outcomes during early adulthood, including vision, neuropsychological functioning, brain structure, risky behaviors, and mental illness. The review also describes the strengths and challenges of conducting population-based epidemiologic research in this unique setting. Participants were identified by cross-matching birth certificates and water system data. Information on health outcomes and confounding variables was collected from self-administered surveys (n = 1689), neuropsychological tests (n = 63), vision examinations (n = 63), and magnetic resonance imaging (n = 42). Early-life exposure to PCE was estimated using a leaching and transport model. The data analysis compared the occurrence of each health outcome among individuals with prenatal and early childhood PCE exposure to unexposed individuals while considering the effect of confounding variables. The study found evidence that early-life exposure to PCE-contaminated drinking water has long-term neurotoxic effects. The strongest associations were seen with illicit drug use, bipolar disorder, and post-traumatic stress disorder. Key strengths of the study were availability of historical data on affected water systems, a relatively high exposure prevalence and wide range of exposure levels, and little confounding. Challenges arose mainly from the historical

Salivary α-amylase and cortisol after exercise in menopause: influence of long-term HRT.

PubMed

Patacchioli, F R; Ghiciuc, C M; Bernardi, M; Dima-Cozma, L C; Fattorini, L; Squeo, M R; Galoppi, P; Brunelli, R; Ferrante, F; Pasquali, V; Perrone, G

2015-01-01

This observational prospective study analyzed the effect of an incremental cardiopulmonary exercise test (CPET) on the secretion of salivary biomarkers of the adrenergic nervous system and hypothalamus-pituitary-adrenal (HPA) axis activity by measuring salivary α-amylase and cortisol diurnal trajectories in the setting of long-term hormone replacement therapy (HRT). Fifteen healthy sedentary postmenopausal women who were current HRT users and 15 women who had never used HRT were consecutively recruited. α-Amylase and cortisol were measured in salivary samples collected on the CPET day and on a rest day. Cardiovascular and respiratory fitness parameters were recorded during the CPET challenge. The participants had very homogeneous somatic characteristics, and they were all in generally good health. The postmenopausal never-HRT users presented an abnormal diurnal pattern of α-amylase at baseline and a flattened response to CPET. In contrast, women on HRT had a physiological α-amylase diurnal pattern and increased salivary α-amylase production during the CPET-induced challenge. The CPET challenge physiologically activated the HPA axis activity, as shown by the increase in the concentration of salivary cortisol during the effort test. HPA axis activity was not affected by long-term HRT. Postmenopausal women using HRT exhibited a cardiorespiratory functional capacity that was significantly (p < 0.05) higher than that of non-users. Our findings show that healthy postmenopausal women present an asymmetry between adrenergic nervous system and HPA axis activities under both basal and stress conditions. HRT was able to modify the abnormal adrenergic nervous system activity, most likely by reducing the sympathetic hyperactivity that characterizes menopause.

Cytomegalovirus shapes long-term immune reconstitution after allogeneic stem cell transplantation

PubMed Central

Itzykson, Raphael; Robin, Marie; Moins-Teisserenc, Helene; Delord, Marc; Busson, Marc; Xhaard, Aliénor; de Fontebrune, Flore Sicre; de Latour, Régis Peffault; Toubert, Antoine; Socié, Gérard

2015-01-01

Immune reconstitution after allogeneic stem cell transplantation is a dynamic and complex process depending on the recipient and donor characteristics, on the modalities of transplantation, and on the occurrence of graft-versus-host disease. Multivariate methods widely used for gene expression profiling can simultaneously analyze the patterns of a great number of biological variables on a heterogeneous set of patients. Here we use these methods on flow cytometry assessment of up to 25 lymphocyte populations to analyze the global pattern of long-term immune reconstitution after transplantation. Immune patterns were most distinct from healthy controls at six months, and had not yet fully recovered as long as two years after transplant. The two principal determinants of variability were linked to the balance of B and CD8+ T cells and of natural killer and B cells, respectively. Recipient’s cytomegalovirus serostatus, cytomegalovirus replication, and chronic graft-versus-host disease were the main factors shaping the immune pattern one year after transplant. We identified a complex signature of under- and over-representation of immune populations dictated by recipient’s cytomegalovirus seropositivity. Finally, we identified dimensions of variance in immune patterns as significant predictors of long-term non-relapse mortality, independently of chronic graft-versus-host disease. PMID:25261095

Long-term nitrogen regulation of forest carbon sequestration

NASA Astrophysics Data System (ADS)

Yang, Y.; Luo, Y.

2009-12-01

It is well established that nitrogen (N) limits plant production but unclear how N regulates long-term terrestrial carbon (C) sequestration in response to rising atmospheric C dioxide (CO2)(Luo et al., 2004). Most experimental evidence on C-N interactions is primarily derived from short-term CO2 manipulative studies (e.g. Oren et al., 2001; Reich et al., 2006a), which abruptly increase C inputs into ecosystems and N demand from soil while atmospheric CO2 concentration in the real world is gradually increasing over time (Luo & Reynolds, 1999). It is essential to examine long-term N regulations of C sequestration in natural ecosystems. Here we present results of a synthesis of more than 100 studies on long-term C-N interactions during secondary succession. C significantly accumulates in plant, litter and forest floor in most studies, and in mineral soil in one-third studies during stand development. Substantial increases in C stock are tightly coupled with N accretion. The C: N ratio in plant increases with stand age in most cases, but remains relatively constant in litter, forest floor and mineral soil. Our results suggest that natural ecosystems could have the intrinsic capacity to maintain long-term C sequestration through external N accrual, high N use efficiency, and efficient internal N cycling.

Finance issue brief: long-term care insurance: year end report-2002.

PubMed

Tanner, Rachel

2002-12-31

A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policy makers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

The long term agroecosystem research network - shared research strategy

Treesearch

Jean L. Steiner; Timothy Strickland; Peter J.A. Kleinman; Kris Havstad; Thomas B. Moorman; M.Susan Moran; Phil Hellman; Ray B. Bryant; David Huggins; Greg McCarty

2016-01-01

While current weather patterns and rapidly accelerated changes in technology often focus attention on short-term trends in agriculture, the fundamental demands on modern agriculture to meet society food, feed, fuel and fiber production while providing the foundation for a healthy environment requires long-term perspective. The Long- Term Agroecoystem Research Network...

Long-term effects of islet transplantation.

PubMed

Holmes-Walker, D Jane; Kay, Thomas W H

2016-10-01

Islet transplantation has made great progress in recent years. This is a remarkable technical feat but raises the question of what the long-term benefits and risks are for type I diabetes recipients. Graft survival continues to improve, and recent multicenter studies show that islet transplantation is particularly effective to prevent hypoglycemic events even in those who do not become insulin-independent and to achieve excellent glycemic control. Concerns include histocompatability leucocyte antigen (HLA) sensitization and other risks including from immunosuppression that islet transplantation shares with other forms of allotransplantation. Reversal of hypoglycemia unawareness and protection from severe hypoglycemia events are two of the main benefits of islet transplantation and they persist for the duration of graft function. Islet transplantation compares favorably with other therapies for those with hypoglycemia unawareness, although new technologies have not been tested head-to-head with transplantation. HLA sensitization increases with time after transplantation especially if immunosuppression is ceased and is a risk for those who may require future transplantation as well as being associated with loss of graft function.

Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program.

PubMed

Tappen, Ruth M; Wolf, David G; Rahemi, Zahra; Engstrom, Gabriella; Rojido, Carolina; Shutes, Jill M; Ouslander, Joseph G

Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period. Themes related to barriers and facilitators were identified. Six major barriers to implementation were identified: the magnitude and complexity of the change (35%), instability of facility leadership (27%), competing demands (40%), stakeholder resistance (49%), scarce resources (86%), and technical problems (31%). Six facilitating strategies were also reported: organization-wide involvement (68%), leadership support (41%), use of administrative authority (14%), adequate training (66%), persistence and oversight on the part of the champion (73%), and unfolding positive results (14%). Successful introduction of a complex change such as the INTERACT® quality improvement program in a long-term care facility requires attention to the facilitators and barriers identified in this report from those at the frontline.

Setting the stage for long-term reproductive health.

PubMed

Payne, Craig A; Vander Ley, Brian; Poock, Scott E

2013-11-01

This article discusses some of the aspects of heifer development that contribute to long-term health and productivity, such as disease prevention and control. Nutrition is also an important component of long-term health, and body condition score is discussed as a way to determine whether the nutrient demands of heifers are being met. Copyright © 2013 Elsevier Inc. All rights reserved.

Long-term forecasting and comparison of mortality in the Evaluation of the Xience Everolimus Eluting Stent vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial: prospective validation of the SYNTAX Score II.

PubMed

Campos, Carlos M; van Klaveren, David; Farooq, Vasim; Simonton, Charles A; Kappetein, Arie-Pieter; Sabik, Joseph F; Steyerberg, Ewout W; Stone, Gregg W; Serruys, Patrick W

2015-05-21

To prospectively validate the SYNTAX Score II and forecast the outcomes of the randomized Evaluation of the Xience Everolimus-Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) Trial. Evaluation of the Xience Everolimus Eluting Stent vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization is a prospective, randomized multicenter trial designed to establish the efficacy and safety of percutaneous coronary intervention (PCI) with the everolimus-eluting stent compared with coronary artery bypass graft (CABG) surgery in subjects with unprotected left-main coronary artery (ULMCA) disease and low-intermediate anatomical SYNTAX scores (<33). After completion of patient recruitment in EXCEL, the SYNTAX Score II was prospectively applied to predict 4-year mortality in the CABG and PCI arms. The 95% prediction intervals (PIs) for mortality were computed using simulation with bootstrap resampling (10 000 times). For the entire study cohort, the 4-year predicted mortalities were 8.5 and 10.5% in the PCI and CABG arms, respectively [odds ratios (OR) 0.79; 95% PI 0.43-1.50). In subjects with low (≤22) anatomical SYNTAX scores, the predicted OR was 0.69 (95% PI 0.34-1.45); in intermediate anatomical SYNTAX scores (23-32), the predicted OR was 0.93 (95% PI 0.53-1.62). Based on 4-year mortality predictions in EXCEL, clinical characteristics shifted long-term mortality predictions either in favour of PCI (older age, male gender and COPD) or CABG (younger age, lower creatinine clearance, female gender, reduced left ventricular ejection fraction). The SYNTAX Score II indicates at least an equipoise for long-term mortality between CABG and PCI in subjects with ULMCA disease up to an intermediate anatomical complexity. Both anatomical and clinical characteristics had a clear impact on long-term mortality predictions and decision making between CABG and PCI. Published on behalf of the European Society

Sexuality and physical intimacy in long-term care.

PubMed

Lichtenberg, Peter A

2014-01-01

Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long-term care settings. Because older adults in medical rehabilitation and long-term care beds present with significant frailties, and often significant neurocognitive disorders, it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literature on sexuality and aging, examines some of the clinical practices and guidelines regarding sexual expression in long-term care, and presents two case examples. A semistructured interview and decision tree is presented to assist therapists in making careful and informed decisions and thereby balancing the needs for protection with the needs for autonomy.

The Long-Term Use of a Low-Phenylalanine Diet in Late-Treated Phenylketonuria: A Single Case Report

ERIC Educational Resources Information Center

Hewitt, Philippa; Cottle, Mandy; Coleman, Carol

2006-01-01

Background: When phenylketonuria (PKU) is not diagnosed and long-term treatment commenced within the first few weeks of life, permanent brain damage will occur. There is some evidence to show that late diagnosed or untreated people with PKU who have severe challenging behaviours may benefit from a low phenylalanine diet [Harper & Reid (1987)…

Intravenous lipid emulsions in term infants: impact on laboratory and clinical outcomes and long-term consequences.

PubMed

Hartman, Corina; Shamir, Raanan

2015-01-01

Parenteral nutrition (PN) in term newborns and older infants is often required for nutritional support for temporary or permanent intestinal failure from any reason. Lipid emulsions (LEs) are an essential source of high-density energy, essential fatty acids, and fat-soluble vitamins. Depending on the fatty acid type, LEs may also have significant immunomodulatory effects. All LEs, starting with soybean oil-based LE and subsequently with medium-chain triglycerides-, olive oil- and fish oil-based LEs, have been investigated in newborns and infants. Laboratory data (mainly liver enzymes, plasma lipid profiles and some metabolic markers) have been investigated for some LEs. The outcome of intestinal failure-associated liver disease after switching to new fish oil-based LEs has been sporadically reported. Long-term outcome data have only looked at the relationship between PN and mortality/morbidity, especially liver disease, and a few studies have looked at growth. There are no controlled studies in this age group that investigated the relationship between different types of LEs and long-term outcomes. In spite of their contribution to understanding the use and indications of various LEs as well as their advantages and adverse effects, most studies in newborns and infants have been observational or retrospective, and the investigated population has been heterogeneous, either in terms of the degree of maturation, age or diagnoses. High-quality studies, preferably randomized and controlled, in this particular population are needed, especially with the widespread use of PN and the emergence of new LEs. © 2015 S. Karger AG, Basel.

Interlaboratory evaluation of Hyalella azteca and Chironomus tentans short-term and long-term sediment toxicity tests

USGS Publications Warehouse

Norberg-King, T. J.; Sibley, P.K.; Burton, G.A.; Ingersoll, C.G.; Kemble, N.E.; Ireland, S.; Mount, D.R.; Rowland, C.D.

2006-01-01

Methods for assessing the long-term toxicity of sediments to Hyalella azteca and Chironomus tentans can significantly enhance the capacity to assess sublethal effects of contaminated sediments through multiple endpoints. Sublethal tests allow us to begin to understand the relationship between short-term and long-term effects for toxic sediments. We present an interlaboratory evaluation with long-term and 10-d tests using control and contaminated sediments in which we assess whether proposed and existing performance criteria (test acceptability criteria [TAC]) could be achieved. Laboratories became familiar with newly developed, long-term protocols by testing two control sediments in phase 1. In phase 2, the 10-d and long-term tests were examined with several sediments. Laboratories met the TACs, but results varied depending on the test organism, test duration, and endpoints. For the long-term tests in phase 1, 66 to 100% of the laboratories consistently met the TACs for survival, growth, or reproduction using H. azteca, and 70 to 100% of the laboratories met the TACs for survival and growth, emergence, reproduction, and hatchability using C. tentans. In phase 2, fewer laboratories participated in long-term tests: 71 to 88% of the laboratories met the TAC for H. azteca, whereas 50 to 67% met the TAC for C. tentans. In the 10-d tests with H. azteca, and C. tentans, 82 and 88% of the laboratories met the TAC for survival, respectively, and 80% met the TAC for C. tentans growth. For the 10-d and long-term tests, laboratories predicted similar toxicity. Overall, the interlaboratory evaluation showed good precision of the methods, appropriate endpoints were incorporated into the test protocols, and tests effectively predicted the toxicity of sediments.

Pneumococcal Vaccination Guidance for Post-Acute and Long-Term Care Settings: Recommendations From AMDA's Infection Advisory Committee.

PubMed

Nace, David A; Archbald-Pannone, Laurie R; Ashraf, Muhammad S; Drinka, Paul J; Frentzel, Elizabeth; Gaur, Swati; Mahajan, Dheeraj; Mehr, David R; Mercer, William C; Sloane, Philip D; Jump, Robin L P

2017-02-01

Efforts at preventing pneumococcal disease are a national health priority, particularly in older adults and especially in post-acute and long-term care settings The Advisory Committee on Immunization Practices recommends that all adults ≥65 years of age, as well as adults 18-64 years of age with specific risk factors, receive both the recently introduced polysaccharide-protein conjugate vaccine against 13 pneumococcal serotypes as well as the polysaccharide vaccine against 23 pneumococcal serotypes. Nursing facility licensure regulations require facilities to assess the pneumococcal vaccination status of each resident, provide education regarding pneumococcal vaccination, and administer the appropriate pneumococcal vaccine when indicated. Sorting out the indications and timing for 13 pneumococcal serotypes and 23 pneumococcal serotypes administration is complex and presents a significant challenge to healthcare providers. Here, we discuss the importance of pneumococcal vaccination for older adults, detail AMDA-The Society for Post-Acute and Long-Term Care Medicine (The Society)'s recommendations for pneumococcal vaccination practice and procedures, and offer guidance to postacute and long-term care providers supporting the development and effective implementation of pneumococcal vaccine policies. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

Anesthesiology Devices; Reclassification of Membrane Lung for Long-Term Pulmonary Support; Redesignation as Extracorporeal Circuit and Accessories for Long-Term Respiratory/Cardiopulmonary Failure. Final order.

PubMed

2016-02-12

The Food and Drug Administration (FDA) is issuing a final order to redesignate membrane lung devices for long-term pulmonary support, a preamendments class III device, as extracorporeal circuit and accessories for long-term respiratory/cardiopulmonary failure, and to reclassify the device to class II (special controls) in patients with acute respiratory failure or acute cardiopulmonary failure where other available treatment options have failed, and continued clinical deterioration is expected or the risk of death is imminent. A membrane lung device for long-term pulmonary support (>6 hours) refers to the oxygenator in an extracorporeal circuit used during long-term procedures, commonly referred to as extracorporeal membrane oxygenation (ECMO). Because a number of other devices and accessories are used with the oxygenator in the circuit, the title and identification of the regulation are revised to include extracorporeal circuit and accessories for long-term respiratory/cardiopulmonary failure. Although an individual device or accessory used in an ECMO circuit may already have its own classification regulation when the device or accessory is intended for short-term use (<=6 hours), such device or accessory will be subject to the same regulatory controls applied to the oxygenator (i.e., class II, special controls) when evaluated as part of the ECMO circuit for long-term use (>6 hours). On its own initiative, based on new information, FDA is revising the classification of the membrane lung device for long-term pulmonary support.

Long-Term Soil Experiments: A Key to Managing Earth's Rapidly Changing Critical Zones

NASA Astrophysics Data System (ADS)

Richter, D., Jr.

2014-12-01

In a few decades, managers of Earth's Critical Zones (biota, humans, land, and water) will be challenged to double food and fiber production and diminish adverse effects of management on the wider environment. To meet these challenges, an array of scientific approaches is being used to increase understanding of Critical Zone functioning and evolution, and one amongst these approaches needs to be long-term soil field studies to move us beyond black boxing the belowground Critical Zone, i.e., to further understanding of processes driving changes in the soil environment. Long-term soil experiments (LTSEs) provide direct observations of soil change and functioning across time scales of decades, data critical for biological, biogeochemical, and environmental assessments of sustainability; for predictions of soil fertility, productivity, and soil-environment interactions; and for developing models at a wide range of temporal and spatial scales. Unfortunately, LTSEs globally are not in a good state, and they take years to mature, are vulnerable to loss, and even today remain to be fully inventoried. Of the 250 LTSEs in a web-based network, results demonstrate that soils and belowground Critical Zones are highly dynamic and responsive to human management. The objective of this study is to review the contemporary state of LTSEs and consider how they contribute to three open questions: (1) can soils sustain a doubling of food production in the coming decades without further impinging on the wider environment, (2) how do soils interact with the global C cycle, and (3) how can soil management establish greater control over nutrient cycling. While LTSEs produce significant data and perspectives for all three questions, there is on-going need and opportunity for reviews of the long-term soil-research base, for establishment of an efficiently run network of LTSEs aimed at sustainability and improving management control over C and nutrient cycling, and for research teams that

Decoupling of long-term exhumation and short-term erosion rates in the Sikkim Himalaya

NASA Astrophysics Data System (ADS)

Abrahami, Rachel; van der Beek, Peter; Huyghe, Pascale; Hardwick, Elisabeth; Carcaillet, Julien

2016-01-01

Understanding the relative strengths of tectonic and climatic forcing on erosion at different spatial and temporal scales is important to understand the evolution of orogenic topography. To address this question, we quantified exhumation rates at geological timescales and erosion rates at millennial timescales in modern river sands from 10 sub-catchments of the Tista River drainage basin in the Sikkim Himalaya (northeast India) using detrital apatite fission-track thermochronology and cosmogenic 10Be analyses, respectively. We compare these rates to several potential geomorphic or climatic forcing parameters. Our results show that millennial erosion rates are generally higher and spatially more variable than long-term exhumation rates in Sikkim. They also show strongly contrasting spatial patterns, suggesting that the processes controlling these rates are decoupled. At geological timescales, exhumation rates decrease from south to north, with rates up to 1.2 ± 0.6 mm/yr recorded in southwest Sikkim and as low as 0.5 ± 0.2 mm/yr in the northernmost catchment. Long-term exhumation rates do not correlate with any geomorphic or climatic parameter. We suggest they are tectonically controlled: high rates in southwest Sikkim may be linked to the building of the Lesser Himalaya Rangit Duplex, whereas low rates in north Sikkim are consistent with cessation of extensional exhumation along the South Tibetan Detachment after 13 Ma. The highest apparent erosion rates recorded by cosmogenic nuclides (∼5 mm/yr) occur in catchments spanning the Main Central Thrust Zone, but these appear to be strongly influenced by recent landsliding. High millennial erosion rates (1-2 mm/yr) also occur in north Sikkim and may be climatically driven through strong glacial inheritance of the landscape, as attested by high channel-steepness values close to the maximum extent of glaciers during the Last Glacial Maximum. In contrast, variations in rainfall rate do not seem to strongly influence

GENDER DIFFERENCES IN QUALITY OF LIFE AMONG LONG-TERM COLORECTAL CANCER SURVIVORS WITH OSTOMIES

PubMed Central

Grant, Marcia; McMullen, Carmit K.; Altschuler, Andrea; Mohler, M. Jane; Hornbrook, Mark C.; Herrinton, Lisa J.; Wendel, Christopher S.; Baldwin, Carol M.; Krouse, Robert S.

2011-01-01

Objective To describe how gender shapes the concerns and adaptations of long-term (> 5 years) colorectal cancer (CRC) survivors with ostomies. Design Qualitative study using content analysis of focus group content. Setting Member of Kaiser Permanente, residing in either Oregon, Southwest Washington State, or Northern California. Sample Four female and four male focus groups selected from quantitative survey participants with health-related quality of life (HRQOL) scores in the highest or lowest quartile. Methods Eight focus groups, discussed challenges of living with an ostomy. Content was recorded, transcribed, and analyzed using directive and summative content analysis. Main Research Variables HRQOL domains of physical, psychological, social and spiritual well being. Findings All groups reported avoiding foods that cause gas or rapid transit, and discussed how limiting the amount of food eaten controlled the output. All groups discussed physical activities, getting support from friends and family, and the importance of being resilient. Both genders identified challenges with sexuality/intimacy. Coping and adjustment difficulties were discussed by women with men only discussing these issues to a small extent. Difficulties with sleep were primarily identified by Low HRQOL women. Problems with body image and depression were discussed only by Low HRQOL women. Conclusions Common issues included diet management, physical activity, social support and sexuality. Women with low HRQOL discussed problems with depression, body image, and sleep. Implications for Nursing Application of these gender-based differences can inform educational interventions for CRC survivors with ostomies. PMID:21875846

Long-Term Bridge Performance (LTBP) Program Protocols, Version 1

DOT National Transportation Integrated Search

2016-01-01

The Long-Term Bridge Performance (LTBP) Program is a long-term research effort to collect scientific performance data from a representative sample of bridges in the United States. Data will be collected for in-service bridges using a variety of techn...

What are the differences between long-term, short-term, and working memory?

PubMed Central

Cowan, Nelson

2008-01-01

In the recent literature there has been considerable confusion about the three types of memory: long-term, short-term, and working memory. This chapter strives to reduce that confusion and makes up-to-date assessments of these types of memory. Long- and short-term memory could differ in two fundamental ways, with only short-term memory demonstrating (1) temporal decay and (2) chunk capacity limits. Both properties of short-term memory are still controversial but the current literature is rather encouraging regarding the existence of both decay and capacity limits. Working memory has been conceived and defined in three different, slightly discrepant ways: as short-term memory applied to cognitive tasks, as a multi-component system that holds and manipulates information in short-term memory, and as the use of attention to manage short-term memory. Regardless of the definition, there are some measures of memory in the short term that seem routine and do not correlate well with cognitive aptitudes and other measures (those usually identified with the term “working memory”) that seem more attention demanding and do correlate well with these aptitudes. The evidence is evaluated and placed within a theoretical framework depicted in Fig. 1. PMID:18394484

Conversion of short-term to long-term memory in the novel object recognition paradigm.

PubMed

Moore, Shannon J; Deshpande, Kaivalya; Stinnett, Gwen S; Seasholtz, Audrey F; Murphy, Geoffrey G

2013-10-01

It is well-known that stress can significantly impact learning; however, whether this effect facilitates or impairs the resultant memory depends on the characteristics of the stressor. Investigation of these dynamics can be confounded by the role of the stressor in motivating performance in a task. Positing a cohesive model of the effect of stress on learning and memory necessitates elucidating the consequences of stressful stimuli independently from task-specific functions. Therefore, the goal of this study was to examine the effect of manipulating a task-independent stressor (elevated light level) on short-term and long-term memory in the novel object recognition paradigm. Short-term memory was elicited in both low light and high light conditions, but long-term memory specifically required high light conditions during the acquisition phase (familiarization trial) and was independent of the light level during retrieval (test trial). Additionally, long-term memory appeared to be independent of stress-mediated glucocorticoid release, as both low and high light produced similar levels of plasma corticosterone, which further did not correlate with subsequent memory performance. Finally, both short-term and long-term memory showed no savings between repeated experiments suggesting that this novel object recognition paradigm may be useful for longitudinal studies, particularly when investigating treatments to stabilize or enhance weak memories in neurodegenerative diseases or during age-related cognitive decline. Copyright © 2013 Elsevier Inc. All rights reserved.

Conversion of short-term to long-term memory in the novel object recognition paradigm

PubMed Central

Moore, Shannon J.; Deshpande, Kaivalya; Stinnett, Gwen S.; Seasholtz, Audrey F.; Murphy, Geoffrey G.

2013-01-01

It is well-known that stress can significantly impact learning; however, whether this effect facilitates or impairs the resultant memory depends on the characteristics of the stressor. Investigation of these dynamics can be confounded by the role of the stressor in motivating performance in a task. Positing a cohesive model of the effect of stress on learning and memory necessitates elucidating the consequences of stressful stimuli independently from task-specific functions. Therefore, the goal of this study was to examine the effect of manipulating a task-independent stressor (elevated light level) on short-term and long-term memory in the novel object recognition paradigm. Short-term memory was elicited in both low light and high light conditions, but long-term memory specifically required high light conditions during the acquisition phase (familiarization trial) and was independent of the light level during retrieval (test trial). Additionally, long-term memory appeared to be independent of stress-mediated glucocorticoid release, as both low and high light produced similar levels of plasma corticosterone, which further did not correlate with subsequent memory performance. Finally, both short-term and long-term memory showed no savings between repeated experiments suggesting that this novel object recognition paradigm may be useful for longitudinal studies, particularly when investigating treatments to stabilize or enhance weak memories in neurodegenerative diseases or during age-related cognitive decline. PMID:23835143

Strong and long: effects of word length on phonological binding in verbal short-term memory.

PubMed

Jefferies, Elizabeth; Frankish, Clive; Noble, Katie

2011-02-01

This study examined the effects of item length on the contribution of linguistic knowledge to immediate serial recall (ISR). Long words are typically recalled more poorly than short words, reflecting the greater demands that they place on phonological encoding, rehearsal, and production. However, reverse word length effects--that is, better recall of long than short words--can also occur in situations in which phonological maintenance is difficult, suggesting that long words derive greater support from long-term lexical knowledge. In this study, long and short words and nonwords (containing one vs. three syllables) were presented for immediate serial recall in (a) pure lists and (b) unpredictable mixed lists of words and nonwords. The mixed-list paradigm is known to disrupt the phonological stability of words, encouraging their phonemes to recombine with the elements of other list items. In this situation, standard length effects were seen for nonwords, while length effects for words were absent or reversed. A detailed error analysis revealed that long words were more robust to the mixed-list manipulation than short words: Their phonemes were less likely to be omitted and to recombine with phonemes from other list items. These findings support an interactive view of short-term memory, in which long words derive greater benefits from lexical knowledge than short words-especially when their phonological integrity is challenged by the inclusion of nonwords in mixed lists.

Cervical cancer survivorship: Long-term quality of life and social support

PubMed Central

Pfaendler, Krista S.; Wenzel, Lari; Mechanic, Mindy B.; Penner, Kristine R.

2015-01-01

Purpose Surgery, radiotherapy and chemotherapy are the mainstays of cervical cancer treatment. Many patients receive multiple treatment modalities, each with its own long-term effects. Given the high 5 year survival rate for cervical cancer patients, evaluation and improvement of long-term quality of life are essential. Methods Pertinent articles were identified through searches of PubMed for literature published from 1993-2014. We summarize quality of life data from long-term follow up studies of cervical cancer patients. We additionally summarize small group interviews of Hispanic and non-Hispanic cervical cancer survivors regarding social support and coping. Findings Data is varied in terms of the long term impact of treatment on quality of life but consistent in suggesting that patients who receive radiotherapy as part of their treatment have the highest risk of increased long term dysfunction of bladder and bowel, as well as sexual dysfunction and psychosocial consequences. Rigorous investigations regarding long-term consequences of treatment modalities are lacking. Implications Continued work to improve treatment outcomes and survival should also include a focus on reducing adverse long-term side effects. Providing supportive care during treatment, and evaluating the effects of supportive care, may reduce the prevalence and magnitude of long-term sequelae of cervical cancer, which will in turn improve quality of life and quality of care. PMID:25592090

Semantic and phonological contributions to short-term repetition and long-term cued sentence recall.

PubMed

Meltzer, Jed A; Rose, Nathan S; Deschamps, Tiffany; Leigh, Rosie C; Panamsky, Lilia; Silberberg, Alexandra; Madani, Noushin; Links, Kira A

2016-02-01

The function of verbal short-term memory is supported not only by the phonological loop, but also by semantic resources that may operate on both short and long time scales. Elucidation of the neural underpinnings of these mechanisms requires effective behavioral manipulations that can selectively engage them. We developed a novel cued sentence recall paradigm to assess the effects of two factors on sentence recall accuracy at short-term and long-term stages. Participants initially repeated auditory sentences immediately following a 14-s retention period. After this task was complete, long-term memory for each sentence was probed by a two-word recall cue. The sentences were either concrete (high imageability) or abstract (low imageability), and the initial 14-s retention period was filled with either an undemanding finger-tapping task or a more engaging articulatory suppression task (Exp. 1, counting backward by threes; Exp. 2, repeating a four-syllable nonword). Recall was always better for the concrete sentences. Articulatory suppression reduced accuracy in short-term recall, especially for abstract sentences, but the sentences initially recalled following articulatory suppression were retained better at the subsequent cued-recall test, suggesting that the engagement of semantic mechanisms for short-term retention promoted encoding of the sentence meaning into long-term memory. These results provide a basis for using sentence imageability and subsequent memory performance as probes of semantic engagement in short-term memory for sentences.

Short-Term and Long-Term Effects of Orthopedic Biodegradable Implants

PubMed Central

Amini, Ami R.; Wallace, James S.; Nukavarapu, Syam P.

2012-01-01

Presently, orthopedic and oral/maxillofacial implants represent a combined $2.8 billion market, a figure expected to experience significant and continued growth. Although traditional permanent implants have been proved clinically efficacious, they are also associated with several drawbacks, including secondary revision and removal surgeries. Non-permanent, biodegradable implants offer a promising alternative for patients, as they provide temporary support and degrade at a rate matching tissue formation, and thus, eliminate the need for secondary surgeries. These implants have been in clinical use for nearly 25 years, competing directly with, or maybe even exceeding, the performance of permanent implants. The initial implantation of biodegradable materials, as with permanent materials, mounts an acute host inflammatory response. Over time, the implant degradation profile and possible degradation product toxicity mediate long-term biodegradable implant-induced inflammation. However, unlike permanent implants, this inflammation is likely to cease once the material disappears. Implant-mediated inflammation is a critical determinant for implant success. Thus, for the development of a proactive biodegradable implant that has the ability to promote optimal bone regeneration and minimal detrimental inflammation, a thorough understanding of short- and long-term inflammatory events is required. Here, we discuss an array of biodegradable orthopedic implants, their associated short- and long- term inflammatory effects, and methods to mediate these inflammatory events. PMID:22043969

Long-term human exposure to lead from different media and intake pathways.

PubMed

Pizzol, Massimo; Thomsen, Marianne; Andersen, Mikael Skou

2010-10-15

Lead (Pb) is well known as an environmental pollutant: it can accumulate in various media, so actual lead exposure reflects both historical and present contaminations. Two main challenges then emerge: obtaining updated information to gain an overall picture of the sources of exposure, and predicting the resulting internal body exposure levels and effects that occur under long-term exposure conditions. In this paper, a modeling approach is used to meet these challenges with reference to Danish exposure conditions. Levels of lead content in various media have been coupled with data for lead intake and absorption in the human body, for both children and adults. An age-dependent biokinetic model allows then for determination of the blood lead levels resulting from chronic exposure. The study shows that the actual intake of lead is up to 27% of the Provisional Tolerable Daily Intake (PTDI) for children and around 8% for adults. It is confirmed that the critical route of exposure is via ingestion, accounting for 99% of total lead intake, while inhalation contributes only to 1% of total lead intake. The resulting lead levels in the blood after 2 years of exposure to actual contamination conditions have been estimated as up to 2.2μg/dl in children and almost 1μg/dl in adults. Impacts from lead can occur even at such levels. The role of historical and present sources to lead in the environment is discussed, and, for specific child and adult exposure scenarios, external-internal concentration relationships for the direct linkage between lead in environmental media and resulting concentrations of lead in blood are then presented. Copyright © 2010 Elsevier B.V. All rights reserved.

Embedded Ultrathin Cluster Electrodes for Long-Term Recordings in Deep Brain Centers

PubMed Central

Thorbergsson, Palmi Thor; Ekstrand, Joakim; Friberg, Annika; Granmo, Marcus; Pettersson, Lina M. E.; Schouenborg, Jens

2016-01-01

Neural interfaces which allow long-term recordings in deep brain structures in awake freely moving animals have the potential of becoming highly valuable tools in neuroscience. However, the recording quality usually deteriorates over time, probably at least partly due to tissue reactions caused by injuries during implantation, and subsequently micro-forces due to a lack of mechanical compliance between the tissue and neural interface. To address this challenge, we developed a gelatin embedded neural interface comprising highly flexible electrodes and evaluated its long term recording properties. Bundles of ultrathin parylene C coated platinum electrodes (N = 29) were embedded in a hard gelatin based matrix shaped like a needle, and coated with Kollicoat™ to retard dissolution of gelatin during the implantation. The implantation parameters were established in an in vitro model of the brain (0.5% agarose). Following a craniotomy in the anesthetized rat, the gelatin embedded electrodes were stereotactically inserted to a pre-target position, and after gelatin dissolution the electrodes were further advanced and spread out in the area of the subthalamic nucleus (STN). The performance of the implanted electrodes was evaluated under anesthesia, during 8 weeks. Apart from an increase in the median-noise level during the first 4 weeks, the electrode impedance and signal-to-noise ratio of single-units remained stable throughout the experiment. Histological postmortem analysis confirmed implantation in the area of STN in most animals. In conclusion, by combining novel biocompatible implantation techniques and ultra-flexible electrodes, long-term neuronal recordings from deep brain structures with no significant deterioration of electrode function were achieved. PMID:27159159

Towards personal health care with model-guided medicine: long-term PPPM-related strategies and realisation opportunities within 'Horizon 2020'.

PubMed

Lemke, Heinz U; Golubnitschaja, Olga

2014-01-01

At the international EPMA Summit carried out in the EU Parliament (September 2013), the main challenges in Predictive, Preventive and Personalised Medicine have been discussed and strategies outlined in order to implement scientific and technological innovation in medicine and healthcare utilising new strategic programmes such as 'Horizon 2020'. The joint EPMA (European Association for Predictive, Preventive and Personalised Medicine) / IFCARS (International Foundation for Computer Assisted Radiology and Surgery) paper emphasises the consolidate position of the leading experts who are aware of the great responsibility of being on a forefront of predictive, preventive and personalised medicine. Both societies consider long-term international partnerships and multidisciplinary projects to create PPPM relevant innovation in science, technological tools and practical implementation in healthcare. Personalisation in healthcare urgently needs innovation in design of PPPM-related medical services, new products, research, education, didactic materials, propagation of targeted prevention in the society and treatments tailored to the person. For the paradigm shift from delayed reactive to predictive, preventive and personalised medicine, a new culture should be created in communication between individual professional domains, between doctor and patient, as well as in communication with individual social (sub)groups and patient cohorts. This is a long-term mission in personalised healthcare with the whole spectrum of instruments available and to be created in the field.

Long-term socioeconomic impacts of flooding in Bangladesh

NASA Astrophysics Data System (ADS)

Jina, A.

2013-05-01

Natural disasters lead to myriad negative impacts upon society, causing loss of life, property, and income. Among disasters, floods annually affect the most people, and lead to widespread negative outcomes, particularly in developing countries. While immediate effects of disasters are readily observed, long-term socioeconomic effects have received little attention. Recent work in development economics finds that environmental exposure in early life can have negative impacts upon later outcomes in health, education, and labor markets. Such research is problematic for disasters, however, as objective measurements of hazard exposure are difficult to obtain. This study develops a remote sensing method to detect flooding in Bangladesh, one of the most flood-prone countries, using MODIS 8-day composite data. This approach addresses one of the main problems in the literature on the social impacts of disasters by deriving an objective measure rather than using self-reported damages. Flood data from 2000-2012 is matched to geolocated social surveys conducted by the Bangladesh government to identify impacts of exposure to floods at critical periods of life. While flooding is noted to be a natural and important part of ecosystem functioning in Bangladesh, we aim to understand the impacts of a flood of greater than normal magnitude or abnormal timing to identify the effects on human capital formation. We find that an increase in flooding of one standard deviation (SD) above the mean in the birth month leads to a 3% increase in stunting (2 SD below cohort height). This has implications for physical and cognitive development, shown elsewhere to persist to adulthood. We find that children from households that are exposed to floods while in elementary school are more likely to drop out. Other impacts will be identified in the course of this research. The stated impacts suggest that the long-term health and economic fortunes of the rural poor in Bangladesh are significantly

The contributions to long-term health-relevant particulate matter at the UK EMEP supersites between 2010 and 2013: Quantifying the mitigation challenge.

PubMed

Malley, Christopher S; Heal, Mathew R; Braban, Christine F; Kentisbeer, John; Leeson, Sarah R; Malcolm, Heath; Lingard, Justin J N; Ritchie, Stuart; Maggs, Richard; Beccaceci, Sonya; Quincey, Paul; Brown, Richard J C; Twigg, Marsailidh M

2016-10-01

Human health burdens associated with long-term exposure to particulate matter (PM) are substantial. The metrics currently recommended by the World Health Organization for quantification of long-term health-relevant PM are the annual average PM10 and PM2.5 mass concentrations, with no low concentration threshold. However, within an annual average, there is substantial variation in the composition of PM associated with different sources. To inform effective mitigation strategies, therefore, it is necessary to quantify the conditions that contribute to annual average PM10 and PM2.5 (rather than just short-term episodic concentrations). PM10, PM2.5, and speciated water-soluble inorganic, carbonaceous, heavy metal and polycyclic aromatic hydrocarbon components are concurrently measured at the two UK European Monitoring and Evaluation Programme (EMEP) 'supersites' at Harwell (SE England) and Auchencorth Moss (SE Scotland). In this work, statistical analyses of these measurements are integrated with air-mass back trajectory data to characterise the 'chemical climate' associated with the long-term health-relevant PM metrics at these sites. Specifically, the contributions from different PM concentrations, months, components and geographic regions are detailed. The analyses at these sites provide policy-relevant conclusions on mitigation of (i) long-term health-relevant PM in the spatial domain for which these sites are representative, and (ii) the contribution of regional background PM to long-term health-relevant PM. At Harwell the mean (±1 sd) 2010-2013 annual average concentrations were PM10=16.4±1.4μgm(-3) and PM2.5=11.9±1.1μgm(-3) and at Auchencorth PM10=7.4±0.4μgm(-3) and PM2.5=4.1±0.2μgm(-3). The chemical climate state at each site showed that frequent, moderate hourly PM10 and PM2.5 concentrations (defined as approximately 5-15μgm(-3) for PM10 and PM2.5 at Harwell and 5-10μgm(-3) for PM10 at Auchencorth) determined the magnitude of annual average PM10 and

NEON: Contributing continental-scale long-term environmental data for the benefit of society

NASA Astrophysics Data System (ADS)

Wee, B.; Aulenbach, S.

2011-12-01

The National Ecological Observatory Network (NEON) is a NSF funded national investment in physical and information infrastructure. Large-scale environmental changes pose challenges that straddle environmental, economic, and social boundaries. As we develop climate adaptation strategies at the Federal, state, local, and tribal levels, accessible and usable data are essential for implementing actions that are informed by the best available information. NEON's goal is to enable understanding and forecasting of the impacts of climate change, land use change and invasive species on continental-scale ecology by providing physical and information infrastructure. The NEON framework will take standardized, long-term, coordinated measurements of related environmental variables at each of its 62 sites across the nation. These observations, collected by automated instruments, field crews, and airborne instruments, will be processed into more than 700 data products that are provided freely over the web to support research, education, and environmental management. NEON is envisioned to be an integral component of an interoperable ecosystem of credible data and information sources. Other members of this information ecosystem include Federal, commercial, and non-profit entities. NEON is actively involved with the interoperability community via forums like the Foundation for Earth Science Information Partners and the USGS Community for Data Integration in a collective effort to identify the technical standards, best practices, and organizational principles that enable the emergence of such an information ecosystem. These forums have proven to be effective innovation engines for the experimentation of new techniques that evolve into emergent standards. These standards are, for the most part, discipline agnostic. It is becoming increasingly evident that we need to include socio-economic and public health data sources in interoperability initiatives, because the dynamics of coupled

Kernelized correlation tracking with long-term motion cues

NASA Astrophysics Data System (ADS)

Lv, Yunqiu; Liu, Kai; Cheng, Fei

2018-04-01

Robust object tracking is a challenging task in computer vision due to interruptions such as deformation, fast motion and especially, occlusion of tracked object. When occlusions occur, image data will be unreliable and is insufficient for the tracker to depict the object of interest. Therefore, most trackers are prone to fail under occlusion. In this paper, an occlusion judgement and handling method based on segmentation of the target is proposed. If the target is occluded, the speed and direction of it must be different from the objects occluding it. Hence, the value of motion features are emphasized. Considering the efficiency and robustness of Kernelized Correlation Filter Tracking (KCF), it is adopted as a pre-tracker to obtain a predicted position of the target. By analyzing long-term motion cues of objects around this position, the tracked object is labelled. Hence, occlusion could be detected easily. Experimental results suggest that our tracker achieves a favorable performance and effectively handles occlusion and drifting problems.

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.

Long-term sickness absence due to adjustment disorder.

PubMed

Catalina-Romero, C; Pastrana-Jiménez, J I; Tenas-López, M J; Martínez-Muñoz, P; Ruiz-Moraga, M; Fernández-Labandera, C; Calvo-Bonacho, E

2012-07-01

Although adjustment disorder is frequently reported in clinical settings, scientific evidence is scarce regarding its impact on sickness absence and the variables associated with sickness absence duration. To report sickness absence duration and to identify predictors of long-term sickness absence in patients with adjustment disorder. This observational, prospective study included subjects with non-work-related sickness absence (>15 days) after a diagnosis of adjustment disorder. A stepwise logistic regression analysis was conducted to identify the best predictors of long-term sickness absence (≥ 6 months). There were 1182 subjects in the final analysis. The median duration of sickness absence due to adjustment disorder was 91 days. Twenty-two per cent of the subjects reported long-term sickness absence. After multivariate analysis, comorbidity (OR = 2.23, 95% CI 1.43-3.49), age (25-34 years old versus <25 years old: OR = 2.78, 95% CI 1.27-6.07; 35-44 years old versus <25 years old: OR = 3.70, 95% CI 1.71-7.99; 45-54 years old versus <25 years old: OR = 3.58, 95% CI 1.60-8.02; ≥ 55 years old versus <25 years old: OR = 6.35, 95% CI 2.64-15.31) and occupational level (blue collar versus white collar: OR = 1.52, 95% CI 1.10-2.09) remained significantly associated with long-term sickness absence. Comorbidity was the strongest predictor. It is possible to predict long-term sickness absence due to adjustment disorder on the basis of demographic, work-related and clinical information available during the basic assessment of the patient.

Long-term solar activity explored with wavelet methods

NASA Astrophysics Data System (ADS)

Lundstedt, H.; Liszka, L.; Lundin, R.; Muscheler, R.

2006-03-01

Long-term solar activity has been studied with a set of wavelet methods. The following indicators of long-term solar activity were used; the group sunspot number, the sunspot number, and the 14C production rate. Scalograms showed the very long-term scales of 2300 years (Hallstat cycle), 900-1000 years, 400-500 years, and 200 years (de Vries cycle). Scalograms of a newly-constructed 14C production rate showed interesting solar modulation during the Maunder minimum. Multi-Resolution Analysis (MRA) revealed the modulation in detail, as well as peaks of solar activity not seen in the sunspot number. In both the group sunspot number scalogram and the 14C production rate scalogram, a process appeared, starting or ending in late 1700. This process has not been discussed before. Its solar origin is unclear.

The group sunspot number ampligram and the sunspot number ampligram showed the Maunder and the Dalton minima, and the period of high solar activity, which already started about 1900 and then decreased again after mid 1990. The decrease starts earlier for weaker components. Also, weak semiperiodic activity was found.

Time Scale Spectra (TSS) showed both deterministic and stochastic processes behind the variability of the long-term solar activity. TSS of the 14C production rate, group sunspot number and Mt. Wilson sunspot index and plage index were compared in an attempt to interpret the features and processes behind the long-term variability.

Building Capacity for a Long-Term, in-Situ, National-Scale Phenology Monitoring Network: Successes, Challenges and Lessons Learned

NASA Astrophysics Data System (ADS)

Weltzin, J. F.; Browning, D. M.

2014-12-01

The USA National Phenology Network (USA-NPN; www.usanpn.org) is a national-scale science and monitoring initiative focused on phenology - the study of seasonal life-cycle events such as leafing, flowering, reproduction, and migration - as a tool to understand the response of biodiversity to environmental variation and change. USA-NPN provides a hierarchical, national monitoring framework that enables other organizations to leverage the capacity of the Network for their own applications - minimizing investment and duplication of effort - while promoting interoperability. Network participants can leverage: (1) Standardized monitoring protocols that have been broadly vetted, tested and published; (2) A centralized National Phenology Database (NPDb) for maintaining, archiving and replicating data, with standard metadata, terms-of-use, web-services, and documentation of QA/QC, plus tools for discovery, visualization and download of raw data and derived data products; and/or (3) A national in-situ, multi-taxa phenological monitoring system, Nature's Notebook, which enables participants to observe and record phenology of plants and animals - based on the protocols and information management system (IMS) described above - via either web or mobile applications. The protocols, NPDb and IMS, and Nature's Notebook represent a hierarchy of opportunities for involvement by a broad range of interested stakeholders, from individuals to agencies. For example, some organizations have adopted (e.g., the National Ecological Observatory Network or NEON) -- or are considering adopting (e.g., the Long-Term Agroecosystems Network or LTAR) -- the USA-NPN standardized protocols, but will develop their own database and IMS with web services to promote sharing of data with the NPDb. Other organizations (e.g., the Inventory and Monitoring Programs of the National Wildlife Refuge System and the National Park Service) have elected to use Nature's Notebook to support their phenological monitoring

Long term acroecosystem research in the Southern Plains

Treesearch

Jean L. Steiner; Patrick J. Starks; Jurgen Garbrecht; Daniel Moriasi; Paul Bartholomew; Jim Neel; Kenneth E. Turner; Brian Northup

2016-01-01

The Southern Plains (SP) site of the Long Term Agroecosystem Research (LTAR) network is headquartered at the USDA-ARS Grazinglands Research Laboratory (GRL) in El Reno, Oklahoma. The GRL was established in 1948. A long-term watershed and climate research program was established in the Little Washita River Experimental Watershed (LWREW) in 1961 and in the Fort Cobb...

Long-Term Ecological Monitoring Field Sampling Plan for 2007

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

T. Haney

2007-07-31

This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used t determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007more » investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality.« less

Long-term outcomes of epilepsy surgery in Sweden

PubMed Central

Edelvik, Anna; Rydenhag, Bertil; Olsson, Ingrid; Flink, Roland; Kumlien, Eva; Källén, Kristina

2013-01-01

Objective: To investigate prospective, population-based long-term outcomes concerning seizures and antiepileptic drug (AED) treatment after resective epilepsy surgery in Sweden. Methods: Ten- and 5-year follow-ups were performed in 2005 to 2007 for 278/327 patients after resective epilepsy surgery from 1995 to 1997 and 2000 to 2002, respectively. All patients had been prospectively followed in the Swedish National Epilepsy Surgery Register. Ninety-three patients, who were presurgically evaluated but not operated, served as controls. Results: In the long term (mean 7.6 years), 62% of operated adults and 50% of operated children were seizure-free, compared to 14% of nonoperated adults (p < 0.001) and 38% of nonoperated children (not significant). Forty-one percent of operated adults and 44% of operated children had sustained seizure freedom since surgery, compared to none of the controls (p < 0.0005). Multivariate analysis identified ≥30 seizures/month at baseline and long epilepsy duration as negative predictors and positive MRI to be a positive predictor of long-term seizure-free outcome. Ten years after surgery, 86% of seizure-free children and 43% of seizure-free adults had stopped AEDs in the surgery groups compared to none of the controls (p < 0.0005). Conclusions: This population-based, prospective study shows good long-term seizure outcomes after resective epilepsy surgery. The majority of the patients who are seizure-free after 5 and 10 years have sustained seizure freedom since surgery. Many patients who gain seizure freedom can successfully discontinue AEDs, more often children than adults. Classification of evidence: This study provides Class III evidence that more patients are seizure-free and have stopped AED treatment in the long term after resective epilepsy surgery than nonoperated epilepsy patients. PMID:23966252

Sexual Function and Health-Related Quality of Life in Long-Term Rectal Cancer Survivors

PubMed Central

Sun, Virginia; Grant, Marcia; Wendel, Christopher S.; McMullen, Carmit K.; Bulkley, Joanna E.; Herrinton, Lisa J.; Hornbrook, Mark C.; Krouse, Robert S.

2016-01-01

Introduction Sexual dysfunction is a treatment sequela in rectal cancer (RC) survivors. Differences in health-related quality of life (HRQOL) may occur based on ostomy status (permanent ostomy versus anastomosis). Aim To describe alterations in sexual function and HRQOL based on ostomy status in long-term (≥ 5 years) RC survivors. Methods RC survivors with an ostomy (N=181) or anastomosis (N=394) were surveyed using validated HRQOL and functional status tools. We compared sexuality outcomes between the ostomy and anastomosis group, and reported differences adjusted for clinical and demographic characteristics. Qualitative data from one open-ended question on survivors’ greatest challenges since their surgery were analyzed to explore sexuality, symptoms, and relationships. Main Outcome Measures Whether sexually active, satisfaction with sexual activity, and select sexual dysfunction items from the Modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O). Results Survivors with a permanent ostomy were more likely to have been sexually inactive after surgery if it occurred before year 2000, and experience dissatisfaction with appearance, interference with personal relationships and intimacy, and lower overall HRQOL. Female RC survivors with an ostomy were more likely to have problems with vaginal strictures and vaginal pain after surgery that persisted at the time of survey (5+ years later). Radiation treatment, tumor stage, soilage of garments in bed, and higher Charlson-Deyo co-morbidity scores were negatively associated with outcomes. Six qualitative themes emerged: loss of and decreased sexual activity; psychological issues with sexual activity, physical issues with sexual activity; partner rejection; ostomy interference with sexual activity; and positive experiences with sexuality. Conclusions Sexual dysfunction is a common long-term sequela of RC treatment, with more problems observed in survivors with a permanent ostomy. This warrants widespread

Long-Term Information Management (LTIM) of Safeguards Data at Repositories: Phase II

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

Haddal, Risa N.

One of the challenges of implementing safeguards for geological repositories will be the long-term preservation of safeguards-related data for 100 years or more. While most countries considering the construction and operation of such facilities agree that safeguards information should be preserved, there are gaps with respect to standardized requirements, guidelines, timescales, and approaches. This study analyzes those gaps and explores research to clarify stakeholder needs, identify current policies, approaches, best practices and international standards, and explores existing safeguards information management infrastructure. The study also attempts to clarify what a safeguards data classification system might look like, how long data shouldmore » be retained, and how information should be exchanged between stakeholders at different phases of a repository’s life cycle. The analysis produced a variety of recommendations on what information to preserve, how to preserve it, where to store it, retention options and how to exchange information in the long term. Key findings include the use of the globally recognized international records management standard, ISO15489, for guidance on the development of information management systems, and the development of a Key Information File (KIF). The KIF could be used to identify only the most relevant, high-level safeguards information and the history of decision making about the repository. The study also suggests implementing on-site and off-site records storage in digital and physical form; developing a safeguards data classification system; long-term records retention with periodic reviews every 5 to 10 years during each phase of the repository life cycle; and establishing transition procedures well in advance so that data shepherds and records officers can transfer information with incoming facility managers effectively and efficiently. These and other recommendations are further analyzed in this study.« less

Risk factors for fecal colonization with multiple distinct strains of Escherichia coli among long-term care facility residents.

PubMed

Lautenbach, Ebbing; Tolomeo, Pam; Black, Nicole; Maslow, Joel N

2009-05-01

Of 49 long-term care facility residents, 21 (43%) were colonized with 2 or more distinct strains of Escherichia coli. There were no significant risk factors for colonization with multiple strains of E. coli. These results suggest that future efforts to efficiently identify the diversity of colonizing strains will be challenging.

Risk Factors for Fecal Colonization with Multiple Distinct Strains of Escherichia coli Among Long-Term Care Facility Residents

PubMed Central

Lautenbach, Ebbing; Tolomeo, Pam; Black, Nicole; Maslow, Joel N.

2009-01-01

Of 49 long-term care facility residents, 21 (43%) were colonized with two or more distinct strains of Escherichia coli. There were no significant risk factors for colonization with multiple strains of E. coli. These results suggest future efforts to efficiently identify diversity of colonizing strains will be challenging. PMID:19292660

Isolation of the posterior left atrium for patients with persistent atrial fibrillation: routine adenosine challenge for dormant posterior left atrial conduction improves long-term outcome.

PubMed

McLellan, Alex J A; Prabhu, Sandeep; Voskoboinik, Alex; Wong, Michael C G; Walters, Tomos E; Pathik, Bhupesh; Morris, Gwilym M; Nisbet, Ashley; Lee, Geoffrey; Morton, Joseph B; Kalman, Jonathan M; Kistler, Peter M

2017-12-01

Catheter ablation to achieve posterior left atrial wall (PW) isolation may be performed as an adjunct to pulmonary vein isolation (PVI) in patients with persistent atrial fibrillation (AF). We aimed to determine whether routine adenosine challenge for dormant posterior wall conduction improved long-term outcome. A total of 161 patients with persistent AF (mean age 59 ± 9 years, AF duration 6 ± 5 years) underwent catheter ablation involving circumferential PVI followed by PW isolation. Posterior left atrial wall isolation was performed with a roof and inferior wall line with the endpoint of bidirectional block. In 54 patients, adenosine 15 mg was sequentially administered to assess reconnection of the pulmonary veins and PW. Sites of transient reconnection were ablated and adenosine was repeated until no further reconnection was present. Holter monitoring was performed at 6 and 12 months to assess for arrhythmia recurrence. Posterior left atrial wall isolation was successfully achieved in 91% of 161 patients (procedure duration 191 ± 49 min, mean RF time 40 ± 19 min). Adenosine-induced reconnection of the PW was demonstrated in 17%. The single procedure freedom from recurrent atrial arrhythmia was superior in the adenosine challenge group (65%) vs. no adenosine challenge (40%, P < 0.01) at a mean follow-up of 19 ± 8 months. After multiple procedures, there was significantly improved freedom from AF between patients with vs. without adenosine PW challenge (85 vs. 65%, P = 0.01). Posterior left atrial wall isolation in addition to PVI is a readily achievable ablation strategy in patients with persistent AF. Routine adenosine challenge for dormant posterior wall conduction was associated with an improvement in the success of catheter ablation for persistent AF. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions please email: journals.permissions@oup.com.

Mobile GPU-based implementation of automatic analysis method for long-term ECG.

PubMed

Fan, Xiaomao; Yao, Qihang; Li, Ye; Chen, Runge; Cai, Yunpeng

2018-05-03

Long-term electrocardiogram (ECG) is one of the important diagnostic assistant approaches in capturing intermittent cardiac arrhythmias. Combination of miniaturized wearable holters and healthcare platforms enable people to have their cardiac condition monitored at home. The high computational burden created by concurrent processing of numerous holter data poses a serious challenge to the healthcare platform. An alternative solution is to shift the analysis tasks from healthcare platforms to the mobile computing devices. However, long-term ECG data processing is quite time consuming due to the limited computation power of the mobile central unit processor (CPU). This paper aimed to propose a novel parallel automatic ECG analysis algorithm which exploited the mobile graphics processing unit (GPU) to reduce the response time for processing long-term ECG data. By studying the architecture of the sequential automatic ECG analysis algorithm, we parallelized the time-consuming parts and reorganized the entire pipeline in the parallel algorithm to fully utilize the heterogeneous computing resources of CPU and GPU. The experimental results showed that the average executing time of the proposed algorithm on a clinical long-term ECG dataset (duration 23.0 ± 1.0 h per signal) is 1.215 ± 0.140 s, which achieved an average speedup of 5.81 ± 0.39× without compromising analysis accuracy, comparing with the sequential algorithm. Meanwhile, the battery energy consumption of the automatic ECG analysis algorithm was reduced by 64.16%. Excluding energy consumption from data loading, 79.44% of the energy consumption could be saved, which alleviated the problem of limited battery working hours for mobile devices. The reduction of response time and battery energy consumption in ECG analysis not only bring better quality of experience to holter users, but also make it possible to use mobile devices as ECG terminals for healthcare professions such as physicians and health

A Revised Model of Short-Term Memory and Long-Term Learning of Verbal Sequences

ERIC Educational Resources Information Center

Burgess, Neil; Hitch, Graham J.

2006-01-01

The interaction between short- and long-term memory is studied within a model in which phonemic and (temporal) contextual information have separate influences on immediate verbal serial recall via connections with short- and long-term plasticity [Burgess, N., & Hitch, G.J. (1999). Memory for serial order: a network model of the phonological loop…

Musical and Verbal Memory in Alzheimer's Disease: A Study of Long-Term and Short-Term Memory

ERIC Educational Resources Information Center

Menard, Marie-Claude; Belleville, Sylvie

2009-01-01

Musical memory was tested in Alzheimer patients and in healthy older adults using long-term and short-term memory tasks. Long-term memory (LTM) was tested with a recognition procedure using unfamiliar melodies. Short-term memory (STM) was evaluated with same/different judgment tasks on short series of notes. Musical memory was compared to verbal…

Synaptic correlates of increased cognitive vulnerability with aging: peripheral immune challenge and aging interact to disrupt theta-burst late-phase long-term potentiation in hippocampal area CA1.

PubMed

Chapman, Timothy R; Barrientos, Ruth M; Ahrendsen, Jared T; Maier, Steven F; Patterson, Susan L

2010-06-02

Variability in cognitive functioning increases markedly with age, as does cognitive vulnerability to physiological and psychological challenges. Exploring the basis of this vulnerability may provide important insights into the mechanisms underlying aging-associated cognitive decline. As we have previously reported, the cognitive abilities of aging (24-month-old) F344 x BN rats are generally good, but are more vulnerable to the consequences of a peripheral immune challenge (an intraperitoneal injection of live Escherichia coli) than those of their younger (3-month-old) counterparts. Four days after the injection, the aging, but not the young rats show profound memory deficits, specific to the consolidation of hippocampus-dependent memory processes. Here, we have extended these observations, using hippocampal slices to examine for the first time the combined effects of aging and a recent infection on several forms of synaptic plasticity. We have found that the specific deficit in long-lasting memory observed in the aged animals after infection is mirrored by a specific deficit in a form of long-lasting synaptic plasticity. The late-phase long-term potentiation induced in area CA1 using theta-burst stimulation is particularly compromised by the combined effects of aging and infection-a deficit that can be ameliorated by intra-cisterna magna administration of the naturally occurring antiinflammatory cytokine IL-1Ra (interleukin-1 receptor antagonist). These data support the idea that the combination of aging and a negative life event such as an infection might produce selective, early-stage failures of synaptic plasticity in the hippocampus, with corresponding selective deficits in memory.

Long-term effect of lime-fly ash treated soils.

DOT National Transportation Integrated Search

2003-12-01

In October of 2000 MDOT initiated State Study No. 147, entitled "Long-Term Effect of Lime-Fly Ash Treated Soils." The purpose of this study : was to evaluate the long-term performance of LFA stabilized soil as a base course material. Part of the impe...

Common Calibration Source for Monitoring Long-term Ozone Trends

NASA Technical Reports Server (NTRS)

Kowalewski, Matthew

2004-01-01

Accurate long-term satellite measurements are crucial for monitoring the recovery of the ozone layer. The slow pace of the recovery and limited lifetimes of satellite monitoring instruments demands that datasets from multiple observation systems be combined to provide the long-term accuracy needed. A fundamental component of accurately monitoring long-term trends is the calibration of these various instruments. NASA s Radiometric Calibration and Development Facility at the Goddard Space Flight Center has provided resources to minimize calibration biases between multiple instruments through the use of a common calibration source and standardized procedures traceable to national standards. The Facility s 50 cm barium sulfate integrating sphere has been used as a common calibration source for both US and international satellite instruments, including the Total Ozone Mapping Spectrometer (TOMS), Solar Backscatter Ultraviolet 2 (SBUV/2) instruments, Shuttle SBUV (SSBUV), Ozone Mapping Instrument (OMI), Global Ozone Monitoring Experiment (GOME) (ESA), Scanning Imaging SpectroMeter for Atmospheric ChartographY (SCIAMACHY) (ESA), and others. We will discuss the advantages of using a common calibration source and its effects on long-term ozone data sets. In addition, sphere calibration results from various instruments will be presented to demonstrate the accuracy of the long-term characterization of the source itself.

Long-term oceanographic observations in Massachusetts Bay, 1989-2006

USGS Publications Warehouse

Butman, Bradford; Alexander, P. Soupy; Bothner, Michael H.; Borden, Jonathan; Casso, Michael A.; Gutierrez, Benjamin T.; Hastings, Mary E.; Lightsom, Frances L.; Martini, Marinna A.; Montgomery, Ellyn T.; Rendigs, Richard R.; Strahle, William S.

2009-01-01

This data report presents long-term oceanographic observations made in western Massachusetts Bay at long-term site A (LT-A) (42 deg 22.6' N., 70 deg 47.0' W.; nominal water depth 32 meters) from December 1989 through February 2006 and long-term site B (LT-B) (42 deg 9.8' N., 70 deg 38.4' W.; nominal water depth 22 meters) from October 1997 through February 2004 (fig. 1). The observations were collected as part of a U.S. Geological Survey (USGS) study designed to understand the transport and long-term fate of sediments and associated contaminants in Massachusetts Bay. The observations include time-series measurements of current, temperature, salinity, light transmission, pressure, oxygen, fluorescence, and sediment-trapping rate. About 160 separate mooring or tripod deployments were made on about 90 research cruises to collect these long-term observations. This report presents a description of the 16-year field program and the instrumentation used to make the measurements, an overview of the data set, more than 2,500 pages of statistics and plots that summarize the data, and the digital data in Network Common Data Form (NetCDF) format. This research was conducted by the USGS in cooperation with the Massachusetts Water Resources Authority and the U.S. Coast Guard.

Advancing nursing leadership in long-term care.

PubMed

O'Brien, Jennifer; Ringland, Margaret; Wilson, Susan

2010-05-01

Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues. Through the St. Joseph's Health Centre Guelph demonstration site project, funded by the Nursing Secretariat of Ontario's Ministry of Health and Long-Term Care, the Excelling as a Nurse Leader in Long Term Care training program and the Mentor Team program were developed to address these needs. Evaluation results show that not only have individual nurses benefitted from taking part in these programs, but also that the positive effects were felt in other parts of the LTC home (as reported by Directors of Care). By creating a generally healthier work environment, it is anticipated that these programs will also have a positive effect on recruitment and retention.