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Sample records for main challenges long-term

  1. Air Force Research Laboratory’s Focused Long Term Challenges

    DTIC Science & Technology

    2008-04-01

    Air Force Research Laboratory ( AFRL ) mission is to provide support to the Air Force (AF) and the warfighters with... Air Force Research Laboratory’s Focused Long Term Challenges Leo J Rose Munitions Directorate, Air Force Research Laboratory , 101 W Eglin Blvd...This technology vision, which was born in our Air Force Research Laboratory , builds on the Air Force’s traditional kill

  2. Behavioral and systemic consequences of long-term inflammatory challenge.

    PubMed

    Fischer, Christina W; Elfving, Betina; Lund, Sten; Wegener, Gregers

    2015-11-15

    Inflammatory reactions are involved in a diversity of diseases, including major depressive disorder. Cytokines act as intercellular signaling molecules and mediators of inflammation between the periphery and the brain. Within the brain, evidence from animal studies of acute inflammation has shown that elevated cytokine levels are linked to behavioral responses of sickness and depression-like behavior. Although chronic inflammation is more translational to human depression than acute studies, little is known on central cytokine expression and associated behavioral responses following chronic immune challenges. The present study assessed behavioral changes and a selection of cytokines in the brain and in the blood in rats randomized to receive a single or 8week administration with either lipopolysaccharide (LPS, 600μg/kg, i.p.) or saline. Acute and long-term LPS treatments caused similar sickness and depression-like behavior. Chronic LPS administration did not have an effect on blood cytokine levels, indicating endotoxin tolerance, whereas increased fasting blood glucose was observed, indicating insulin resistance, a metabolic consequence of chronic inflammation. While a single LPS injection produced a generalized cytokine response in the brain, long-term LPS administration produced a specific central cytokine response with increased interleukin (IL)-1β and interferon (IFN)-γ. These cytokines can explain the behavioral changes observed, and could indicate microglia activation, although future studies are needed to uncover this assumption. Taken together, although the behavioral outcome was similar between acute and chronic LPS administration, the central cytokine response was distinct. As the long-term LPS paradigm also posed a metabolic demand, this setting may reflect a more translational insight into inflammatory reactions in human depression, and could prove useful for assessing cytokine down-stream effects and experimental antidepressant drug products.

  3. [Long-term care insurance in taiwan: theory and challenges].

    PubMed

    Lee, Jwo-Leun; Lung, Chi-Hsuan; Liu, Li-Fan

    2010-08-01

    Long-term care insurance, now being intensively discussed as part of the formal governmental agenda, is widely expected to be inaugurated by 2011. As all entitled citizens will be enrolled compulsorily in accordance with social insurance rules, tight scrutiny in the planning process is strongly advised. Equity of financial mechanisms and the efficiency of the delivery system for long-term care should also be carefully considered and maximized. This study explores major empirical suggestions for Taiwan's long-term care insurance scheme from a primarily theoretical point of view. The three relevant issues deliberated in this paper include risk sharing and financial equity in long-term care insurance and long-term care system delivery efficiency. Content focuses on concepts that may be easily misunderstood or misinterpreted by medical professionals.

  4. The Challenge of Long-Term Climate Change

    NASA Astrophysics Data System (ADS)

    Hasselmann, K.; Latif, M.; Hooss, G.; Azar, C.; Edenhofer, O.; Jaeger, C. C.; Johannessen, O. M.; Kemfert, C.; Welp, M.; Wokaun, A.

    2003-12-01

    Climate policy needs to address the multidecadal to centennial time scale of climate change. Although the realization of short-term targets is an important first step, to be effective climate policies need to be conceived as long-term programs that will achieve a gradual transition to an essentially emission-free economy on the time scale of a century. This requires a considerably broader spectrum of policy measures than the primarily market-based instruments invoked for shorter term mitigation policies. A successful climate policy must consist of a dual approach focusing on both short-term targets and long-term goals.

  5. 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.

  6. 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…

  7. Benefits and Challenges of the Passport Broadcast Intervention in Long-Term Care

    ERIC Educational Resources Information Center

    Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Demiris, George; Shaunfield, Sara

    2012-01-01

    Creative activities are a challenge for long-term care facilities. The Passport intervention uses web-based video technology to provide long-term care residents with a virtual travel experience. Passport broadcasts were conducted and staff and residents were interviewed about the experience. A thematic analysis of interviews was used to discern…

  8. Benefits and Challenges of the Passport Broadcast Intervention in Long-Term Care

    ERIC Educational Resources Information Center

    Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Demiris, George; Shaunfield, Sara

    2012-01-01

    Creative activities are a challenge for long-term care facilities. The Passport intervention uses web-based video technology to provide long-term care residents with a virtual travel experience. Passport broadcasts were conducted and staff and residents were interviewed about the experience. A thematic analysis of interviews was used to discern…

  9. Long-term weight status in regainers after weight loss by lifestyle intervention: status and challenges.

    PubMed

    Stelmach-Mardas, Marta; Mardas, Marcin; Walkowiak, Jarosław; Boeing, Heiner

    2014-11-01

    After having participated in a weight loss trial, most participants do not stabilise the obtained weight loss but return to their initial weight. The aim of this review is to describe the main determinants of continued low weight status after weight loss, and the effectiveness of physical activity (PA), energy restriction and macronutrient composition of the diet for low long-term weight regain. Studies with intervention periods of at least 3 months duration of weight reduction measures and a follow-up at least 2 years after the intervention period were considered as eligible for the review. Owing to limited data, the studies describing the role of PA in weight management were eligible with a follow-up of 1 year only. It appears that a diet with self-regulation of dietary intake seems to be given a prominent role in the strategy of successful long-term weight loss among the obese. This measure could be combined with behaviour therapy and PA and tailored to the individual situation. However, considering available evidence it is difficult to conclude regarding unambiguous measures and to recommend a specific dietary intervention. Nevertheless, interventions should be effective in promoting intrinsic motivation and self-efficacy. The harmonisation and standardisation of data collection in the follow-up period of long-term weight loss studies is a major challenge.

  10. Long-Term In-Service Monitoring and Performance Assessment of the Main Cables of Long-Span Suspension Bridges.

    PubMed

    Deng, Yang; Liu, Yang; Chen, Suren

    2017-06-16

    Despite the recent developments in structural health monitoring, there remain great challenges for accurately, conveniently, and economically assessing the in-service performance of the main cables for long-span suspension bridges. A long-term structural health monitoring technique is developed to measure the tension force with a conventional sensing technology and further provide the in-service performance assessment strategy of the main cable. The monitoring system adopts conventional vibrating strings transducers to monitor the tension forces of separate cable strands of the main cable in the anchor span. The performance evaluation of the main cable is conducted based on the collected health monitoring data: (1) the measured strand forces are used to derive the overall tension force of a main cable, which is further translated into load bearing capacity assessment using the concept of safety factor; and (2) the proposed technique can also evaluate the uniformity of tension forces from different cable strands. The assessment of uniformity of strand forces of a main cable offers critical information in terms of potential risks of partial damage and performance deterioration of the main cable. The results suggest the proposed low-cost monitoring system is an option to provide approximate estimation of tension forces of main cables for suspension bridges. With the long-term monitoring data, the proposed monitoring-based evaluation methods can further provide critical information to assess the safety and serviceability performance of main cables.

  11. Bayesian framework to identify the main effects of long term climatic constraints on soil moisture decline in conterminous United States

    NASA Astrophysics Data System (ADS)

    Guevara, M.; Vargas, R.

    2016-12-01

    We used a Bayesian regression framework based on Hamiltonian Monte Carlo simulations to identify the main effects of mean annual soil moisture, temperature, evapotranspiration, and precipitation, on long-term soil moisture decline across conterminous United States based on 36 years of remotely sensed available data. We found that mean soil moisture was a positive control of soil moisture decline in areas with long-term high precipitation but low evapotranspiration. Furthermore, mean soil moisture is a negative control on soil moisture decline in areas with long-term low precipitation and low evapotranspiration. In contrast, mean soil moisture had no effect on soil moisture decline in areas with long-term low precipitation and high evapotranspiration. These results highlight the importance of having accurate spatial soil moisture information to better inform earth system models to predict regional to global water balance and climate trends. These results support the current understanding of the basic physical mechanisms governing the coupling of soil moisture with temperature, precipitation, and evapotranspiration, but bring attention to high spatial heterogeneity in the constraints of soil moisture at the continental scale. The response of soil moisture to climate variability is considered to be one of the largest uncertainties for global land surface models, and resolving high spatial resolution of soil moisture is an ongoing challenge. Independent estimates of high spatial resolution of soil moisture could improve parameterizations of land surface models and cross-validate the current functions that mainly relay on precipitation, aerodynamic representation of the latent and sensible heat fluxes, and land surface cover type.

  12. Modified Vaccinia Ankara Virus Vaccination Provides Long-Term Protection against Nasal Rabbitpox Virus Challenge.

    PubMed

    Jones, Dorothy I; McGee, Charles E; Sample, Christopher J; Sempowski, Gregory D; Pickup, David J; Staats, Herman F

    2016-07-01

    Modified vaccinia Ankara virus (MVA) is a smallpox vaccine candidate. This study was performed to determine if MVA vaccination provides long-term protection against rabbitpox virus (RPXV) challenge, an animal model of smallpox. Two doses of MVA provided 100% protection against a lethal intranasal RPXV challenge administered 9 months after vaccination.

  13. Modified Vaccinia Ankara Virus Vaccination Provides Long-Term Protection against Nasal Rabbitpox Virus Challenge

    PubMed Central

    Jones, Dorothy I.; McGee, Charles E.; Sample, Christopher J.; Sempowski, Gregory D.; Pickup, David J.

    2016-01-01

    Modified vaccinia Ankara virus (MVA) is a smallpox vaccine candidate. This study was performed to determine if MVA vaccination provides long-term protection against rabbitpox virus (RPXV) challenge, an animal model of smallpox. Two doses of MVA provided 100% protection against a lethal intranasal RPXV challenge administered 9 months after vaccination. PMID:27146001

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

    SciTech Connect

    Šimon, Vojtech

    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 cycle (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.

  15. Organization and delivery of long-term care in Singapore: present issues and future challenges.

    PubMed

    Mehta, K K; Vasoo, S

    2001-01-01

    This paper focuses on the Singaporean model of long-term care for older people. With only about 2% of the older population living in institutions, the mainstay of long-term care is community care. The reader is provided an overview of the Singaporean services, including case management, followed by a discussion of the current issues and future challenges. In keeping with the prospect of a rapidly aging population profile, the Singapore government plays a leading role in framing policy and planning for future needs of this sector of the population.

  16. [Aging and long-term care in Chile: challenges in the OECD context].

    PubMed

    Villalobos Dintrans, Pablo

    2017-08-21

    Chile is fully in the process of demographic transition, with a rapidly aging population. This situation poses multiple public policy challenges, including those in the public health sector. Specifically, the association between aging and the loss of autonomy calls for the rapid design of a long-term care policy in the country. The purpose of this article is to describe Chile's current situation with respect to long-term care in aging, using the experience of the countries of the Organisation for Economic Co-operation and Development to draw attention to the need to move forward with the design and financing of a coordinated policy in the country that will permit early action to meet the challenges of aging in the coming decades.

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

    PubMed

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

    2017-02-01

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

  18. Changes in the long-term hydrological regimes and the impacts of human activities in the main Wei River, China

    NASA Astrophysics Data System (ADS)

    Zhang, Hongbo; Huang, Qiang; Zhang, Qiang; Gu, Lei; Chen, Keyu; Yu, Qijun

    2016-03-01

    Under the combined influence of climate changes and human activities, the hydrological regime of the Wei River shows remarkable variations which have caused many issues in the Wei River in recent decades, such as a lack of freshwater, water pollution, disastrous flooding and channel sedimentation. Hence, hydrological regime changes and potential human-induced impacts have been drawing increasing attention from local government and hydrologists. This study investigates hydrological regime changes in the natural and measured runoff series at four hydrological stations on the main Wei River and quantifies features of their long-term change by analysing their historical annual and seasonal runoff data using several approaches, i.e., continuous wavelet transform, cross-wavelet, wavelet coherence, trend-free pre-whitening Mann-Kendall test and detrended fluctuation analysis. By contrasting two different analysis results between natural and measured river runoff series, the impacts of human activities on the long-term hydrological regime were investigated via the changes of spatio-temporal distribution in dominant periods, the trends and long-range memory of river runoff. The results show : (a) that periodic properties of the streamflow changes are the result of climate, referring to precipitation changes in particular, while human activities play a minor role; (b) a significant decreasing trend can be observed in the natural streamflow series along the entire main stream of the Wei River and the more serious decrease emerging in measured flow should result from human-induced influences in recent decades; and (c) continuous decreasing streamflow in the Wei River will trigger serious shortages of freshwater in the future, which may challenge the sustainability and safety of water resources development in the river basin, and should be paid great attention before 2020.

  19. Geomagnetic paleointensity and the long-term history of the geodynamo: Challenges and perspectives

    NASA Astrophysics Data System (ADS)

    Smirnov, A. V.

    2016-12-01

    Data on the long-term evolution of Earth's magnetic field intensity are crucial for understanding the mechanisms of the geodynamo and planetary evolution. However, the paleointensity record in rocks may be adversely affected by a plethora of physical processes which must be taken into account when analyzing the paleointensity database. If not accounted for, these processes may lead to sometimes significant under- or overestimates of paleointensity. Complete understanding of these effects requires extensive experimental and theoretical rock magnetic, mineralogical and petrological studies. However, failure to recognize them may lead to some apparent paradoxes in the large-scale picture of geodynamo evolution derived from uncritical statistical treatments of the global paleointensity database. The fundamental challenges and perspectives of paleointensity determination will be discussed in the context of current models of the long-term geomagnetic and thermal evolution of our planet.

  20. Blunted autonomic reactivity to pharmacological panic challenge under long-term escitalopram treatment in healthy men

    PubMed Central

    Kellner, Michael; Stiedl, Oliver; Muhtz, Christoph; Wiedemann, Klaus; Demiralay, Cüneyt

    2015-01-01

    Background: Central serotonergic pathways influence brain areas involved in vagal cardiovascular regulation and, thereby, influence sympathetic efferent activity. Selective serotonin reuptake inhibitors (SSRIs) affect multiple serotonergic pathways, including central autonomic pathways. However, only a few studies have assessed SSRI-mediated effects on autonomic reactivity in healthy individuals using heart rate variability (HRV). Methods: The present study assessed the influence of long-term treatment with escitalopram (ESC) on autonomic reactivity to an intravenous application of 50 µg cholecystokinin tetrapeptide (CCK-4) in 30 healthy young men using a double-blind, placebo (PLA)-controlled, randomized, within-subject cross-over design. Main outcome measures were time- and frequency-domain HRV parameters, assessed at both baseline and immediately after CCK-4 application. Results: Results showed substantial effects for the treatment × CCK-4 challenge interaction with respect to heart rate (p < 0.001; pη2 = 0.499), SDNN (p < 0.001; pη2 = 576), RMSSD (p = 0.015; pη2 = 194), NN50% (p = 0.008; pη2 = 0.224), and LF% (p = 0.014; pη2 = 0.196), and moderate effects with respect HF% (p = 0.099; pη2 = 0.094), with PLA subjects showing a higher increase in HR and SDNN and a higher decrease in RMSSD, NN50, LF and HF than subjects in the ESC condition. Thus, ESC treatment significantly blunted the autonomic reactivity to CCK-4. Secondary analysis indicated no effect of the 5-HTTLPR polymorphism on CCK-4-induced autonomic response. Conclusions: Our results support findings suggesting an effect of SSRI treatment on autonomic regulation and provide evidence that ESC treatment is associated with blunted autonomic reactivity in healthy men. PMID:25522396

  1. Challenges and benefits on long-term eddy covariance measurements over lakes

    NASA Astrophysics Data System (ADS)

    Vesala, Timo; Golub, Malgorzata; Desai, Ankur; Heiskanen, Jouni; Provenzale, Maria; Rantakari, Miitta; Ojala, Anne; Mammarella, Ivan

    2017-04-01

    Eddy Covariance (EC) data on carbon dioxide fluxes is presently available on about 30 lakes but the time series are mostly short, order of one year. Longer EC series together with chamber measurements and appropriate auxiliary data on water column allow for more accurate estimates of the aquatic component in terrestrial carbon balance and analysis of the environmental controls. We discuss on challenges for long-term EC measurements over freshwater ecosystems and demonstrate the benefits of EC data for carbon cycle studies via examples from long-term sites EC sites in Finland. We discuss on the auxiliary measurements needed and the general design of the whole measurement set-up to get representative information. We discuss on challenges related to the CO2 flux partitioning for freshwater ecosystems and introduce a new method to estimate the net primary productivity (NPP) on EC data, which is superior to more traditional methods (bottle incubations, 14C technique) with a poor temporal resolution. Finally, we collected and analyzed CO2 fluxes from 19 globally distributed lakes and reservoirs representing six climate zones. The mean flux was c. 0.3 micro mole / m2 s. We applied a simple upscaling to the direct observations and ended up to the estimate which is about half of the current emission estimate for lentic systems.

  2. 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.

  3. Challenges and Opportunities of Long-Term Continuous Stream Metabolism Measurements at the National Ecological Observatory Network

    NASA Astrophysics Data System (ADS)

    Goodman, K. J.; Lunch, C. K.; Baxter, C.; Hall, R.; Holtgrieve, G. W.; Roberts, B. J.; Marcarelli, A. M.; Tank, J. L.

    2013-12-01

    Recent advances in dissolved oxygen sensing and modeling have made continuous measurements of whole-stream metabolism relatively easy to make, allowing ecologists to quantify and evaluate stream ecosystem health at expanded temporal and spatial scales. Long-term monitoring of continuous stream metabolism will enable a better understanding of the integrated and complex effects of anthropogenic change (e.g., land-use, climate, atmospheric deposition, invasive species, etc.) on stream ecosystem function. In addition to their value in the particular streams measured, information derived from long-term data will improve the ability to extrapolate from shorter-term data. With the need to better understand drivers and responses of whole-stream metabolism come difficulties in interpreting the results. Long-term trends will encompass physical changes in stream morphology and flow regime (e.g., variable flow conditions and changes in channel structure) combined with changes in biota. Additionally long-term data sets will require an organized database structure, careful quantification of errors and uncertainties, as well as propagation of error as a result of the calculation of metabolism metrics. Parsing of continuous data and the choice of modeling approaches can also have a large influence on results and on error estimation. The two main modeling challenges include 1) obtaining unbiased, low-error daily estimates of gross primary production (GPP) and ecosystem respiration (ER), and 2) interpreting GPP and ER measurements over extended time periods. The National Ecological Observatory Network (NEON), in partnership with academic and government scientists, has begun to tackle several of these challenges as it prepares for the collection and calculation of 30 years of continuous whole-stream metabolism data. NEON is a national-scale research platform that will use consistent procedures and protocols to standardize measurements across the United States, providing long-term

  4. China: facing a long-term care challenge on an unprecedented scale.

    PubMed

    Glass, Anne P; Gao, Yuan; Luo, Jing

    2013-07-01

    Population ageing is occurring in China at a breathtaking pace and rapidly becoming a major public health issue. Due to the one-child policy, rural/urban migration and other societal changes, the family-dependent long-term care (LTC) of the past will no longer suffice. Barely existent now, both institutional and community-based services will need to expand to meet the growing need. China is still at an earlier stage in economic development and will be challenged to build these services and train staff. Furthermore, many elders are not yet covered by financial and insurance support. This massive demographic transition requires political efforts to develop integrated and sustainable national LTC systems.

  5. 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

  6. 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.

  7. The Solar Neighborhood. XLI. A Study of the Wide Main Sequence for M Dwarfs—Long-term Photometric Variability

    NASA Astrophysics Data System (ADS)

    Clements, Tiffany D.; Henry, Todd J.; Hosey, Altonio D.; Jao, Wei-Chun; Silverstein, Michele L.; Winters, Jennifer G.; Dieterich, Sergio B.; Riedel, Adric R.

    2017-09-01

    We report findings from a long-term photometric variability study of M dwarfs carried out at the SMARTS 0.9 m telescope at the Cerro Tololo Inter-American Observatory. As part of a multi-faceted effort to investigate the range of luminosities of M dwarfs of a given color on the Hertzsprung–Russell Diagram, 76 M dwarfs have been observed for 3–17 years in the Johnson–Kron–Cousins V band. We find that stars elevated above the center of the main sequence distribution tend to have higher levels of variability, likely caused by magnetic activity, than their fainter counterparts below the center. This study provides insight into how the long-term magnetic activity of these stars may be affecting their sizes, luminosities, and thus positions on the H-R Diagram.

  8. 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

  9. Islet transplantation in type 1 diabetes: ongoing challenges, refined procedures, and long-term outcome.

    PubMed

    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.

  10. 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.

  11. Grand Challenges for Biological and Environmental Research: A Long-Term Vision

    SciTech Connect

    Arkin, A.; Baliga, N.; Braam, J.; Church, G.; Collins, J; Cottingham, R.; Ecker, J.; Gerstein, M.; Gilna, P.; Greenberg, J.; Handelsman, J.; Hubbard, S.; Joachimiak, A.; Liao, J.; Looger, L.; Meyerowitz, E.; Mjolness, E.; Petsko, G.; Sayler, G.; Simpson, M.; Stacey, G.; Sussman, M.; Tiedje, J.; Bader, D.; Cessi, P.; Collins, W.; Denning, S.; Dickinson, R.; Easterling, D.; Edmonds, J.; Feddema, J.; Field, C.; Fridlind, A.; Fung, I.; Held, I.; Jackson, R.; Janetos, A.; Large, W.; Leinen, M.; Leung, R.; Long, S.; Mace, G.; Masiello, C.; Meehl, G.; Ort, D.; Otto-Bliesner, B.; Penner, J.; Prather, M.; Randall, D.; Rasch, P.; Schneider, E.; Shugart, H.; Thornton, P.; Washington, W.; Wildung, R.; Wiscombe, W.; Zak, D.; Zhang, M.; Bielicki, J.; Buford, M.; Cleland, E.; Dale, V.; Duke, C.; Ehleringer, J.; Hecht, A.; Kammen, D.; Marland, G.; Pataki, D.; Riley, M. Robertson, P.; Hubbard, S.

    2010-12-01

    behaviors of complex biological and environmental systems, leading to robust solutions for DOE missions and strategic goals. In March 2010, the Biological and Environmental Research Advisory Committee held the Grand Challenges for Biological and Environmental Research: A Long-Term Vision workshop to identify scientific opportunities and grand challenges for BER science in the coming decades and to develop an overall strategy for drafting a long-term vision for BER. Key workshop goals included: (1) Identifying the greatest scientific challenges in biology, climate, and the environment that DOE will face over a 20-year time horizon. (2) Describing how BER should be positioned to address those challenges. (3) Determining the new and innovative tools needed to advance BER science. (4) Suggesting how the workforce of the future should be trained in integrative system science. This report lays out grand research challenges for BER - in biological systems, climate, energy sustainability, computing, and education and workforce training - that can put society on a path to achieve the scientific evidence and predictive understanding needed to inform decision making and planning to address future energy needs, climate change, water availability, and land use.

  12. Adaptation of the Main Peripheral Artery and Vein to Long Term Confinement (MARS 500)

    PubMed Central

    Arbeille, Philippe; Provost, Romain; Vincent, Nicole; Aubert, Andre

    2014-01-01

    Purpose The objective was to check if 520 days in confinement (MARS 500), may affect the main peripheral arterial diameter and wall thickness and the main vein size. Method Common carotid (CC) femoral artery (FA) portal vein (PV), jugular (JG), femoral vein (FV) and tibial vein were assessed during MARS 500 by echography, performed by the subjects. A hand free volumic echographic capture method and a delayed 3D reconstruction software developed by our lab were used for collecting and measuring the vascular parameters. Results During the MARS 500 experiment the subjects performed 6 sessions among which 80% of the echographic data were of sufficient quality to be processed. No significant change was found for the Common carotid, Jugular vein, femoral artery, femoral vein, portal vein, and tibial vein diameter. CC and FA IMT (intima media thickness) were found significantly increased (14% to 28% P<0.05) in all the 6 subjects, during the confinement period and also at +2 days after the confinement period, but there was no significant difference 6 month later compare to pre MARS 500. Conclusion The experiment confirmed that even untrained to performing echography the subjects were able to capture enough echographic data to reconstruct the vessel image from which the parameters were measured. The increase in both CC and FA IMT should be in relation with the stress generated by the confined environment or absence of solar radiation, as there was no change in gravity, temperature and air in the MARS 500 module, and minor changes in physical exercise and nutrition. PMID:24475025

  13. Long-term effects of precommercial thinning on small mammals in northern Maine

    USGS Publications Warehouse

    Homyack, J.A.; Harrison, D.J.; Krohn, W.B.

    2005-01-01

    Precommercial thinning (PCT) is being practiced increasingly throughout the Acadian forest of eastern North America to meet silvicultural objectives; however, effects of this practice on wildlife, both immediately and several years post-treatment are not well understood. Forest dependent small mammals have ecological roles as prey for numerous avian and mammalian predators, dispersers of seeds, fruit, and spores, and contribute to nutrient cycling. Researchers in the northwestern USA have suggested that thinning of young, regenerating clearcuts may increase the abundance and diversity of some forest-dependent small mammals by increasing rates of forest development and enhancing the ecological representation of mid-successional stands across managed landscapes. We examined the effects of PCT within conifer-dominated forest stands 1-, 6-, 11-, and 16-years post-treatment, on abundances of mice, voles, and shrews, and on within-stand structure in the commercially managed, Acadian forests of northern Maine. We live-trapped small mammals on 24 herbicide-treated clearcuts treated with PCT and on 13 similar, unthinned stands during summers of 2000 and 2001. Thinning of mid-successional conifer stands resulted in increased abundances, (red-backed voles, Clethrionomys gapperi, P = 0.008; masked shrews, Sorex cinereus, P < 0.001) or had no detectable effect on (deer mice, Peromyscus maniculatus, P = 0.544; short-tailed shrews, Blarina brevicauda, P = 0.517) the 4 most common species of Muridae and Soricidae in northern Maine. In general, abundance of deer mice responded more positively to increasing development class and to the number of years since thinning than other species of small mammals. Several within-stand habitat characteristics associated with stand maturity, such as larger stem diameters and a partially open canopy, occurred in thinned stands. Thus, PCT may accelerate the development of habitat attributes typical of mid-successional conifer stands in intensively

  14. On the Long-term Dynamical Evolution of the Main Satellites of Uranus

    NASA Astrophysics Data System (ADS)

    Verheylewegen, Emilie; Noyelles, B.; Karatekin, O.; Lemaître, A.

    2013-05-01

    Abstract (2,250 Maximum Characters): Voyager II mission that explored the Uranian system and its main satellites in 1986, revealed a combination of geophysical and dynamical abnormalities. These abnormalities can be explained as a set by a complete orbital-thermal model: in particular the resurfacing of Miranda combined with its high orbital inclination 4.338°) currently observed could be explained by a capture in the past in a 3:1 mean motion resonance with Umbriel. The dynamical part of the problem has already been studied by several authors 20 years ago (Dermott et al. 1988; Tittemore & Wisdom 1989; Malhotra 1990; Moons & Henrard 1993) and revisited by us with other powerful numerical tools (Verheylewegen et al. 2013, submitted). We have in particular analyzed the different secondary resonances that the system might have encountered. In parallel, we are working on a thermal model using the evolution of the temperature inside the satellite, with radiogenic and tidal heating sources. The analytical expressions of the viscosity and the rigidity allow to compute new tidal parameters at each step of the evolution to inject them in the orbital part of the model. The objective is to show the first results of the combination of the two parts during the evolution through the mean-motion resonance 3:1 between Miranda and Umbriel.

  15. A study of challenges and opportunities for long-term care dietitians in British Columbia.

    PubMed

    Black, Jennifer L; Dunham, Rebecca; Kafka, Tamar

    2013-01-01

    While demand for long-term care (LTC) in Canada is expected to grow in the coming years, little is known about the current LTC dietetic workforce or its members' practice-related concerns. A web-based survey was developed and distributed to and subsequently completed by 75 LTC dietitians in British Columbia. The survey was intended to characterize dietitians' demographic characteristics, educational and employment experiences, salaries and benefits, future employment plans, and concerns about current practice. Regression models were used to examine the associations between demographic, educational, and employment characteristics and self-reported hourly wages. The majority of respondents were employed at more than one facility (57%) and did not belong to a union (71%). The mean hourly wage for LTC dietetics positions was $37.50 ± $5.85, and was significantly higher for positions that did not provide additional employee benefits (p < 0.05). Hourly wages were not significantly higher for dietitians with more years of experience or graduate-level education. Concerns were raised about potential implications of revised residential care regulations for workload, and only 36% of respondents reported being committed to working in the area of LTC dietetics in the future. This study highlights practice-related challenges and future opportunities to build the LTC dietetic workforce, and can inform planning for training, recruitment, and retention.

  16. A Study of the Wide Main Sequence: The Long-Term Photometric Variability of Low Mass Stars

    NASA Astrophysics Data System (ADS)

    Pewett, Tiffany; Henry, Todd J.; Hosey, Altonio D.; Dieterich, Sergio; Jao, Wei-Chun; Winters, Jennifer G.; Riedel, Adric R.; RECONS Team

    2016-01-01

    The RECONS (REsearch Consortium On Nearby Stars, www.recons.org) team has carried out a long-term photometric variability study using the SMARTS 0.9m telescope at the Cerro Tololo Inter-American Observatory (CTIO). The program has obtained up to 15 years of observations in the V band for hundreds of M dwarf stars. This unique study has provided insight into how the ubiquitous M dwarfs change over decadal timescales, revealing their long-term magnetic cycles and how the presence or lack of such activity may affect their sizes and consequent luminosities, and thus their positions on the H-R Diagram.Using carefully vetted parallaxes and photometric colors, many measured by the RECONS team, we have created a highly accurate H-R Diagram of the nearest (within 25pc) stars using their V-K colors to represent temperatures and absolute V magnitudes as proxies for luminosities. We find that for M dwarfs, the main sequence widens significantly, by up to four magnitudes in MV, corresponding to a factor of almost 40 in optical flux. This spread implies a wide range of stellar radii for M dwarfs of the same temperature. Our study of long-term photometric variability indicates that there is a trend in cyclic activity that is highest for the most luminous red dwarfs and lowest for the rare, cool red subdwarfs. This provides valuable insight into the complex interplay of age, metallicity, and magnetic fields that molds the character of the red dwarfs.This effort has been supported by the NSF through grants AST-0908402, AST-1109445, and AST-1412026, STScI grant HST-GO-13724.001-A, and via observations made possible by the SMARTS Consortium.

  17. Interventions to improve long-term weight loss in patients following bariatric surgery: challenges and solutions

    PubMed Central

    McGrice, Melanie; Don Paul, Kathlene

    2015-01-01

    Bariatric surgery aims to provide long-term weight loss and improvement in weight-related comorbidities. Unfortunately, some patients do not achieve predicted weight loss targets and many regain a portion of their lost weight within 2–10 years postsurgery. A review of the literature found that behavioral, dietary, psychological, physical, and medical considerations can all play a role in suboptimal long-term weight loss. Recommendations to optimize long-term weight loss include ensuring that the patient understands how the procedure works, preoperative and postoperative education sessions, tailored nutritional supplements, restraint with liquid kilojoules, pureed foods, grazing and eating out of the home, an average of 60 minutes of physical activity per day, and lifelong annual medical, psychological, and dietary assessments. PMID:26150731

  18. 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…

  19. Long-Term Educational Programs in Nature Parks: Characteristics, Outcomes and Challenges

    ERIC Educational Resources Information Center

    Morag, Orly; Tal, Tali; Rotem-Keren, Tammy

    2013-01-01

    In this study on long-term educational programs (LTP) in nature, facilitated by an environmental agency we followed two distinct programs enacted in schools and in nature parks as case studies. Data were collected through observations of activities in schools and in the outdoors and through interviews with students, teachers and facilitators. In…

  20. 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 ...

  1. [Long-term informal care in Spain: challenges, views and solutions].

    PubMed

    Masana, Lina

    2017-01-01

    Caring for chronic illnesses at all ages represents a growing social and public health problem. Due to insufficient public coverage in Spain, around 80% of long-term care is provided by the sick person's social network. Based in ethnographic research on chronicity carried out between 2009 and 2013 in Spain, this article analyzes the problem of long-term informal care for middle-aged adults with chronic diseases. The results highlight the factors that condition, enhance or limit informal care: the personal, domestic and family situation of the sick person; the cyclical course of chronic diseases; and the social response to illness. The limitations of the informal care model suggest the need to listen to the voices of those affected in order to understand their real needs and adapt official programs oriented towards chronicity accordingly.

  2. The art and challenges of long-term and short-term democratic therapeutic communities.

    PubMed

    Norton, Kingsley; Bloom, Sandra L

    2004-01-01

    This paper, cowritten by Kingsley Norton, since 1989 Director of Henderson Hospital (a therapeutic community founded by Maxwell Jones in 1947 in the United Kingdom), and Sandra Bloom, Founder of the Sanctuary Model in the United States, compares and contrasts the practice of the democratic therapeutic community (TC) as applied to the notion of long-term care (up to twelve months), to that of the democratic therapeutic milieu (TM) as applied to short-term care (up to one month).

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

    SciTech Connect

    Peterson, Trevor; Pelletier, Steve; Giovanni, Matt

    2016-01-15

    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.

  4. Long-term photometric observations of pre-main sequence objects in the field of North America/Pelican Nebula

    NASA Astrophysics Data System (ADS)

    Poljančić, Beljan I.; Jurdana-Šepić, R.; Semkov, E. H.; Ibryamov, S.; Peneva, S. P.; Tsvetkov, M. K.

    2014-08-01

    To broaden the search and study stars in the early evolutionary phase, we investigated a sample of 17 pre-main sequence objects previously detected as either Hα emission-line pre-main sequence stars or T Tauri variables located in the field of the North America/Pelican Nebula complex. Johnson-Cousins B, V, Rc, Ic magnitudes and mean color indices for the program stars are determined from more than 12 400 measurements from archive photographic plates and from CCD data collected at 7 observatories covering the period of almost 60 years from 1954 up to 2013. We complemented previously rare insights on the photometry of the program stars and presented their photometric history, which for almost all program stars is the first long term photometric monitoring on a timescale of 6 decades. Eight program stars are found to be classical T Tauri stars of variability type II, while 6 program stars are weak-line T Tauri stars of variability type I. For the first time, periodicity is found for three stars: V1716 Cyg indicates a 4.15 day period, V2051 Cyg indicates a 384 day period, and V521 Cyg a period of 503 days. Full Tables 4 and 5 are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (ftp://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/568/A49

  5. Main medical conditions of elderly Japanese in urban areas requiring long-term care: improving the focus of preventive care.

    PubMed

    Onishi, Kiichiro

    2012-07-01

    To improve preventive care administration, this paper epidemiologically categorized causative illnesses of frail Japanese elderly living in urban areas by age and sex. Data from Japanese long-term care insurance (LTCI) documentation was used to categorize the patterns of disease incidence consisting of the main medical conditions and comorbid diseases among frail elders aged above 65 years (male: 193; female: 360) from the central area of Osaka prefecture. Logistic regression analysis was used to determine the diseases requiring intensive care: care level 3+. The fracture patients' ADL and cognitive functions were examined using the Cognitive Performance Scale (CPS). In the patterns of disease incidence, 43% of the men had lifestyle-related diseases, while 53% of the women had musculoskeletal disorders. The main medical conditions associated with care level 3+ in men were dementia (odds ratio, 5.4), cerebrovascular disease (CVD; 3.9), renal failure (8.9), and fracture and fracture sequelae (4.7); and in women, femoral fracture (42.7), CVD (8), vertebral fracture (6.2), dementia (4.4), and neoplasms (4.1). Further, 46% of the female patients with femoral fractures had dementia. Preventive measures should focus on lifestyle-related diseases, preventing dementia by early detection, treatment of hypertension and diabetes through medication, physical exercise and nutrition, and cancer screenings for both sexes, along with musculoskeletal disorders prevention for women. Since femoral fractures render patients (especially those over 80 years) bedridden with cognitive dysfunctions, fall prevention is essential.

  6. 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

  7. Long-term follow-up clinics after hematopoietic cell transplantation: its needs and challenges in Japan.

    PubMed

    Kurosawa, Saiko

    2017-01-01

    With a growing number of transplant survivors, long-term survivorship care has received more attention. In long-term survivors, mortality remains higher than that of the general population, and they are prone to a unique set of late complications. The common late effects are as follows: chronic graft-versus-host disease, organ failure, endocrine complication, secondary cancer, mental health problem, and financial burden due to factors including unemployment. Long-term follow-up (LTFU) clinic plays an important role in the screening and early intervention for late effects and in informing and supporting patients to improve their quality of life. The importance of LTFU has been recognized, and the guidelines for screening and preventive practices for long-term survivors after transplantation were first published in 2006 and updated in 2012 based on a consensus opinion of the international working group. The guidelines for LTFU have been recently published by the Japan society for hematopoietic cell transplantation; they highlight the recommended screening and intervention available in our country, utilizing the evidence on the late effects reported from our country and overseas. In this review, I would like to illustrate the background of the need for LTFU and discuss the challenges in operating an LTFU clinic to effectively provide physical, mental, and social care to transplant survivors.

  8. Methodological challenges in using routinely collected health data to investigate long-term effects of medication use during pregnancy

    PubMed Central

    Gilbert, Andrew L.; Morrison, Janna L.

    2013-01-01

    To date, the investigation of teratogenic effects of medications has largely focused on physical alterations present at birth (i.e. malformations) as opposed to functional alterations (i.e. neurodevelopment, metabolic function) that may not be apparent at birth but could influence an individual’s health and risk of disease in later life. The use of routinely collected health data represents one approach to better identifying, quantifying, and understanding the long-term risks or benefits of medication use during pregnancy. As such, the objective of this review was to identify and explore opportunities and challenges associated with using routinely collected health data to examine long-term effects of medication use during pregnancy. Drawing on published research several key methodological issues associated with their use in investigating long-term outcomes are reviewed. While significant opportunities exist to make greater use of routinely collected health data, there are a number of key challenges. Identified challenges relate to aspects of study design and analysis, and include obtaining access to data, the ability to match records across datasets and over long periods of time, how medication exposures are ascertained and classified, issues around loss to follow-up how outcomes are ascertained and classified, and the careful interpretation of results in light of study and data limitations. Understanding key challenges associated with using routinely collected health data to investigate long-term effects of medication use during pregnancy is essential in supporting their appropriate use and interpretation, which will contribute to improving the quality of research undertaken and ensure the reliability of results obtained. PMID:25083249

  9. Use of dewatered alum sludge as main substrate in treatment reed bed receiving agricultural wastewater: long-term trial.

    PubMed

    Zhao, Y Q; Zhao, X H; Babatunde, A O

    2009-01-01

    This study aims to explore a novel application of dewatered alum sludge cakes (DASC) as the main medium in a single model reed bed to treat phosphorus-rich animal farm wastewater under "tidal flow" operation on a long-term basis. It is expected that the cakes act as the carrier for developing biofilm and also serve as adsorbent to enhance phosphorus (P) immobilization. Results have demonstrated that average removal efficiencies of 73.3+/-15.9% for COD, 82.9+/-12.3% for BOD(5), 86.4+/-6.0% for RP (reactive P), 88.6+/-7.2% for soluble reactive P (SRP) and 77.6+/-17.5% for SS can be achieved during the two year's operation. More significantly, the "P-adsorption proportion" by DASC in the reed bed is 42% of the overall P removal. The remaining removal of P may be contributed by the trapping and filtration process of DASC. Therefore, the lifetime of the DASC in reed bed is reasonably longer than that determined from the batch isotherm test.

  10. 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

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

    PubMed Central

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

    2016-01-01

    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. PMID:27610048

  12. Long Term Preservation of Earth Observation Data in Europe - Challenge and Cooperation Activities

    NASA Astrophysics Data System (ADS)

    Molch, K.; Albani, M.

    2014-12-01

    Earth observation data are unique snapshots of the Earth and the atmosphere. As such they constitute a humankind asset in their importance for monitoring changes in global environmental conditions. With spaceborne Earth observation (EO) missions dating back to the 1970s, 40 years worth of observations are now available in EO data archives worldwide. Data holdings are growing exponentially, e.g. with the Sentinel series of high resolution EO satellites of the European Copernicus Program - which introduces a new dimension of data volumes to be handled. As other EO data holders around the globe, the European Space Agency (ESA) and its member states are committed to keeping the valuable EO data assets safe, accessible, and useable for an unlimited timespan. Rapidly evolving information technology and changing user requirements call for a dedicated and coordinated approach to EO data long term preservation. In Europe collaborative EO data stewardship activities are coordinated by ESA within the ESA long term data preservation (LTDP) program. With a view to the entire data set life cycle of historic and current missions an active LTDP working group addresses a wide range of relevant technical and organizational topics. Studies investigate archiving and access technologies, user expectations, or applicable standards; guidelines and best practices recommend preservation workflows, steps to take in curating individual data sets, the composition of the preserved data set, or concepts for introducing persistent identifiers. Fostering an active international exchange, the activities and documents developed within this European LTDP framework extend beyond Europe by being introduced to the Group on Earth Observations (GEO) and the Committee on Earth Observation Satellites (CEOS). The paper describes the European LTDP cooperation framework, discusses individual focus areas and current activities, and highlights the interaction with global data stewardship initiatives.

  13. Long-term BVRI light curves of 5 pre-main sequence stars in the field of "Gulf of Mexico"

    NASA Astrophysics Data System (ADS)

    Ibryamov, Sunay I.; Semkov, Evgeni H.; Peneva, Stoyanka P.

    2015-01-01

    We present new data from BVRI photometric observations of five PMS stars during the period from April 2013 to July 2014. The stars are located in the field of NGC 7000/IC 5070 ("Gulf of Mexico") -- a region with active star formation. The presented paper is a continuation of our long-term photometric investigations of the young stellar objects in this region. The long-term multicolor photometric observations of PMS stars are very important for their exact classification. Our results show that the studied stars exhibit different types of photometric variability in all bands. We tried to classify them using our data from the long-term photometry and data published by other authors.

  14. Challenging equipotency calculation for hydromorphone after long-term intravenous application.

    PubMed

    Luchting, Benjamin; Rachinger-Adam, Banafscheh; Hulde, Nikolai; Heyn, Jens; Azad, Shahnaz Christina

    2017-08-01

    In advanced stages, most cancer patients suffer from pain which can usually be well controlled following the World Health Organization (WHO) level scheme. While the majority of patients report adequate pain relief by strong opioids (WHO III), some require an opioid rotation. Despite the existence of conversion tables, these rotations mea lead to inadequate pain control or life threatening events. Here, we report about a patient with urothelial cell carcinoma presenting in our Department of Pain Medicine with massive pain aggravation up to NRS values of 10/10 despite administration of the highest dose of intravenously applied hydromorphone. After a small single dose of the far less potent opioid piritramide with exceptionally good response, we conducted a stepwise opioid rotation from hydromorphone to piritramide within one week without any signs of abstinence or withdrawal. After the opioid rotation, we discharged the patient nearly free of pain with piritramide doses far less than equianalgesic dose tables would have recommended. Our report impressively points out that even after long-term intravenous application of highly potent opioids, new titrations are necessary for rotation to avoid overdosage and discusses several mechanisms underlying individual response to different opioids.

  15. Case report: Benefits and challenges of long-term eculizumab in atypical hemolytic uremic syndrome.

    PubMed

    Cullinan, Noelle; Gorman, Kathleen Mary; Riordan, Michael; Waldron, Mary; Goodship, Timothy H J; Awan, Atif

    2015-06-01

    Atypical hemolytic uremic syndrome (aHUS) is caused by dysregulation of the complement system, leading to complement overactivation. A humanized anti-C5 monoclonal antibody, eculizumab, has been available for the treatment of aHUS since 2011. The long-term safety and efficacy of this novel drug in the pediatric population remain under review. We present a child with a hybrid CFH/CFHR3 gene who, having had multiple disease relapses despite optimal treatment with plasma exchange, commenced eculizumab therapy in August 2010. She remains relapse free in follow-up at 52 months, and treatment has been well tolerated. The risk of meningococcal disease during this treatment is recognized. Despite vaccination against meningococcal disease and appropriate antibiotic prophylaxis, our patient developed meningococcal bacteremia 30 months into treatment. She presented with nonspecific symptoms but recovered without sequelae with appropriate treatment. We recommend that children be vaccinated against invasive meningococcal infection before beginning eculizumab therapy and take appropriate antibiotic prophylaxis during treatment, and we suggest that vaccine responses should be checked and followed annually. Clinicians need to maintain a high index of suspicion for invasive meningococcal disease. Neither vaccination nor antibiotic prophylaxis provides complete protection in patients on eculizumab therapy. The appropriate dosage of eculizumab needed to achieve remission in aHUS in the pediatric population is unknown. Having achieved remission in our patient, we monitor eculizumab and CH50 levels to evaluate ongoing blockade of the terminal complement cascade. Such information may help guide dosing intervals in the future.

  16. 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

  17. Creation of a long-term data record of total O3 - issues and challenges in prescribing the uncertainties

    NASA Astrophysics Data System (ADS)

    Haffner, D. P.; Bhartia, P. K.; Li, J. Y.

    2012-12-01

    With the launch of the BUV instrument on NASA's Nimbus-4 satellite in April 1970, ozone became one of the first atmospheric variables to be measured from space with high accuracy. By 1980, the quality of total column ozone measured from the TOMS instrument on the Nimbus-7 satellite had improved to the point that it started to be used to identify poorly calibrated instruments in the venerable Dobson ground-based network. Now we have a total ozone record spanning 42 years created by more than a dozen instruments. We will discuss the issues and challenges that we have faced in creating a consistent long-term record and in providing uncertainty estimates. This work is not yet finished. We are currently developing a new algorithm (Version 9) that will be used to reprocess the entire record. The main motivation for developing this algorithm is not so much to improve the quality of the data, which is quite high already, but to provide better estimates of uncertainties when errors are spatially and temporally correlated, and to develop better techniques to catch "Black Swan" events (BSE). These are events that occur infrequently but cause errors larger than expected by Gaussian probability distribution. For example, the eruption of El Chichón revealed that our ozone algorithm had unexpected sensitivity to volcanic SO2, and evidence of the ozone hole was initially interpreted as a problem with the TOMS instrument. We also provide mathematical operators that can be applied by sophisticated users to compute their own uncertainties for their particular applications. This is necessary because uncertainties change in complex ways when the data are smoothed or averaged. The modern data archival system should be designed to accommodate such operators and provide software for using them.

  18. HDR Opportunities and Challenges Beyond the Long-Term Flow Test

    SciTech Connect

    Duchane, David

    1992-03-24

    The long term flow test (LTFT) of the worlds largest, deepest, and hottest hot dry rock (HDR) reservoir currently underway at Fenton Hill, NM, is expected to demonstrate that thermal energy can be mined from hot rock within the earth on a sustainable basis with minimal water consumption. This test will simulate the operations of a commercial facility in some ways, but it will not show that energy from HDR can be produced at a variety of locations with different geological settings. Since the Fenton Hill system was designed as a research facility rather than strictly for production purposes, it will also not demonstrate economic viability, although it may well give indications of system modifications needed for economic HDR operations. A second production site must be constructed, ideally under the direction of the private geothermal community, to begin the process of proving that the vast HDR resources can be accessed on a worldwide scale. This facility should be designed and engineered to produce and market energy at competitive prices. At the same time, a wide variety of techniques to advance the state-of-the-art of HDR technology must be pursued to develop this infant technology rapidly to its maximum potential. A number of design and operational techniques have been conceived which may lead to improved economics in HDR systems. After careful technical and economic scrutiny, those showing merit should be vigorously pursued. Finally, research and development work in areas such as reservoir interrogation, and system modeling must be accelerated to increase the competitiveness and geographical applications of HDR and the geothermal industry in general. This paper addresses the above issues in detail and outlines possible paths to future prosperity for the commercial geothermal industry.

  19. 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...

  20. Engineering challenges to the long term operation of the International Space Station.

    PubMed

    Kelly, T; Albert, T; Levin, G M

    2001-01-01

    The U.S. Congress has maintained an intense interest in the ISS program since its inception. In the Appropriations Act of 1997, the Senate of the United States included language directing National Aeronautics and Space Administration (NASA) to have the National Research Council (NRC) under take a study that evaluates the engineering challenges posed by extravehicular activity (EVA) requirements, United States and non-United States space launch requirements, the potential need to upgrade or replace equipment and components after Assembly Complete, and the requirement to decommission and disassemble the facility. NASA and the NRC decided the focus should be on the anticipated challenges in the continuous operation and maintenance of the ISS after assembly of the on-orbit facility has been completed. This would encompass the operational years, from late 2004 (if the current schedule holds) to 2020-2025. This executive summary overviews the results of this NRC study. It focuses on the U.S. operation of the ISS after Assembly Complete, including cooperative efforts by the United States and Russia. The paper summarizes the primary findings and recommendations in each of the areas considered during this two-year NRC study. c2001 Published by Elsevier Science Ltd.

  1. Challenges in long-term mechanical circulatory support and biological replacement of the failing heart.

    PubMed

    Lala, Anuradha; Joyce, Emer; Groarke, John D; Mehra, Mandeep R

    2014-01-01

    The burden of advanced heart failure is reaching epidemic proportions. Generally considered for cardiac transplantation, patients often cannot receive this therapy because of their advanced age, comorbidity or the scarcity of donors. Most transplants are concentrated in North America and Europe, with the average center performing fewer than 20 annual transplants. A search for nonbiological means of cardiac support has led to the advent of mechanical circulatory support (MCS), a concept now entrenched as a bridge to transplantation or, for those ineligible for transplantation, as lifetime therapy. In this review we discuss contemporary challenges posed by the changing epidemiology of cardiac transplant and MCS and outline the basis for an understanding of the future of this important therapeutic stance.  

  2. In vivo barrier challenge and long-term recovery in human facial skin.

    PubMed

    Gorcea, Mihaela; Hadgraft, Jonathan; Lane, Majella E; Moore, David J

    2013-06-01

    Recently, we developed a biophysical approach to characterize in vivo facial cheek skin as a function of stratum corneum (SC) depth, barrier function and during a 24-h recovery period. The current study extends this work and characterizes the human facial cheek after barrier challenge and, for the first time, facial SC barrier recovery over a 4-week period. Changes in the corneocyte size over the 4-week recovery period, and correlations with changes in Trans-Epidermal Water Loss (TEWL) were monitored. This approach allows complete characterization of SC barrier function after a full biological regeneration of the SC barrier following tape stripping. The structural and compositional changes in facial cheek were investigated using Attenuated Total Reflectance-Fourier Transform Infra Red (ATR-FTIR) spectroscopy, tape stripping, TEWL measurements and image analysis combined with optical microscopy to characterize the SC depth profile during the tape stripping stress and over 4-week recovery period. TEWL increased significantly from baseline after sequential tape stripping. Corneocyte size decreased with successive tape stripping. An inverse direct correlation was determined between TEWL and corneocyte surface area. After 4 weeks, the corneocyte size and TEWL for the facial cheek recovered 100% from the tape stripping procedure. The in vivo ATR-FTIR data demonstrated that lipid and sebum components on the surface of the facial cheek SC recovered within 24 h post tape stripping, whereas protein (Amide II) and water components recovered after 1 week.

  3. Challenges to producing a long-term stratospheric aerosol climatology for chemistry and climate

    NASA Astrophysics Data System (ADS)

    Thomason, Larry; Vernier, Jean-Paul; Bourassa, Adam; Rieger, Landon; Luo, Beiping; Peter, Thomas; Arfeuille, Florian

    2016-04-01

    Stratospheric aerosol data sets are key inputs for climate models (GCMs, CCMs) particularly for understanding the role of volcanoes on climate and as a surrogate for understanding the potential of human-derived stratospheric aerosol as mitigation for global warming. In addition to supporting activities of individual climate models, the data sets also act as a historical input to the activities of SPARC's Chemistry-Climate Model Initiative (CCMI) and the World Climate Research Programme's Coupled Model Intercomparison Project (CMIP). One such data set was produced in 2004 as a part of the SPARC Assessment of Stratospheric Aerosol Properties (ASAP), extending from 1979 and 2004. It was primarily constructed from the Stratospheric Aerosol and Gas Experiment series of instruments but supplemented by data from other space-based sources and a number of ground-based and airborne instruments. Updates to this data set have expanded the timeframe to span from 1850 through 2014 through the inclusion of data from additional sources, such as photometer data and ice core analyses. Fundamentally, there are limitations to the reliability of the optical properties of aerosol inferred from even the most complete single instrument data sets. At the same time, the heterogeneous nature of the underlying data to this historical data set produces considerable challenges to the production of a climate data set which is both homogeneous and reliable throughout its timespan. In this presentation, we will discuss the impact of this heterogeneity showing specific examples such as the SAGE II to OSIRIS/CALIPSO transition in 2005. Potential solutions to these issues will also be discussed.

  4. 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).

  5. An Old Challenge with New Promises: A Systematic Review on Comprehensive Geriatric Assessment in Long-Term Care Facilities.

    PubMed

    Panza, Francesco; Solfrizzi, Vincenzo; Lozupone, Madia; Barulli, Maria Rosaria; D'Urso, Francesca; Stallone, Roberta; Dibello, Vittorio; Noia, Alessia; Di Dio, Cristina; Daniele, Antonio; Bellomo, Antonello; Seripa, Davide; Greco, Antonio; Logroscino, Giancarlo

    2017-07-28

    Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by settings where the CGA is performed [i.e., hospital, posthospital discharge/long-term care facilities (LTCFs), or community/home] as well as the specific clinical conditions of older frail individuals. In this scenario, CGA and quality of care in LTCFs have been a challenge for decades. In the present article, we systematically reviewed evidence from the last three decades of clinical research devoted to systematic implementation of CGA programs in LTCFs, that is, nursing homes, care homes, residential homes, and rehabilitation facilities. In the United States, all LTC residents must undergo a CGA on a regular basis on admission to a facility, prompting the development of the Resident Assessment Instrument (RAI) Minimum Data Set, a specific CGA-based assessment tool in this population. In the LTCF setting, the present reviewed evidence suggested that most complex older subjects may benefit from a CGA in terms of improved quality of care and reduced hospitalization events and that CGA must be standardized across healthcare settings to promote greater health system integration and coordination. In the LTCF setting, particularly in nursing homes, other new and promising CGA programs have also been proposed to develop rapid screening CGA-based tools to enhance in the future the ability of primary care physicians to recognize and treat geriatric syndromes in this setting. However, at present, the interRAI suite of instruments represented an integrated health information system that has the potential to provide person-centered information transcending healthcare settings.

  6. 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…

  7. 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…

  8. 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

  9. 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.

  10. Reasons for crack nucleation in welded joints of main gas-pipelines after a long-term operation

    NASA Astrophysics Data System (ADS)

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

    2017-02-01

    A crack of operational origin in the welded joint of the main gas pipeline is analyzed. The reasons for its nucleation and impact on technological microdefects that were formed earlier during the welding are found. Micromechanisms and stages of nucleation and propagation of the crack are investigated.

  11. Structural and mechanical defects of materials of offshore and onshore main gas pipelines after long-term operation

    NASA Astrophysics Data System (ADS)

    Maruschak, Pavlo; Panin, Sergey; Danyliuk, Iryna; Poberezhnyi, Lyubomyr; Pyrig, Taras; Bishchak, Roman; Vlasov, Ilya

    2015-10-01

    The study has established the main regularities of a fatigue failure of offshore gas steel pipes installed using S-lay and J-lay methods.We have numerically analyzed the influence of preliminary deformation on the fatigue life of 09Mn2Si steel at different amplitudes of cyclic loading. The results have revealed the regularities of formation and development of a fatigue crack in 17Mn1Si steel after 40 years of underground operation. The quantitative analysis describes the regularities of occurrence and growth of fatigue cracks in the presence of a stress concentration.

  12. A long-term UBVRI photometric study of the pre-main sequence star V350 Cep

    NASA Astrophysics Data System (ADS)

    Ibryamov, Sunay; Semkov, Evgeni; Peneva, Stoyanka

    2014-10-01

    Results from UBVRI optical photometric observations of the pre-main sequence star V350 Cep during the period 2004-2014 are presented. The star was discovered in 1977 due to its remarkable increase in brightness by more than 5 mag (R). In previous studies, V350 Cep was considered to be a potential FUor or EXor eruptive variable. Our data suggest that during the period of observations the star maintains its maximum brightness with low amplitude photometric variations. Our conclusion is that V350 Cep was probably an intermediate object between FUors and EXors, similar to V1647 Ori.

  13. Long term monitoring of the micro-seismicity along the Main Marmara Fault, Turkey using template matching

    NASA Astrophysics Data System (ADS)

    Matrullo, Emanuela; Lengliné, Olivier; Schmittbuhl, Jean; Karabulut, Hayrullah; Bouchon, Michel

    2017-04-01

    The Main Marmara Fault (MMF) represents a 150 km un-ruptured segment of the North Anatolian Fault located below the Marmara Sea. It poses a significant hazard for the large cities surrounding the region and in particular for the megalopolis of Istanbul. The seismic activity has been continuously monitored since 2007 by various seismic networks. For this purpose it represents an extraordinary natural laboratory to study in details the whole seismicity bringing insights into the geometry of the faults systems at depth and mechanical properties at various space-time scales. Waveform similarity-based analysis is performed on the continuous recordings to construct a refined catalog of earthquakes from 2009 to 2014. High-resolution relocation was applied using the double-difference algorithm, using cross-correlation differential travel-time data. Seismic moment magnitudes (Mw) have been computed combining the inversion of earthquake S-wave displacement spectra for the larger events and the estimation of the relative size of multiplets using the singular value decomposition (SVD) thanks the highly coherent waveforms. The obtained catalog of seismicity includes more than 15,000 events. The seismicity strongly varying along the strike and depth exhibits a complex structure that confirms the segmentation of the fault with different mechanical behavior (Schmittbuhl et al., GGG, 2016). In the central part of the Marmara Sea, seismicity is poor and scattered. To the east, in the Cinarcick basin, along the MMF, the seismicity is mainly located around 8-15 km in depth, except at both ends of this basin where the seismicity extends vertically up to surface. In the Yalova and Gemlik region (to the east not on the MMF) the seismicity is distributed over a wide range of depth (from surface to 15 km deep) and is characterized by several clusters vertically elongated. The spatio-temporal evolution of earthquake sequences, which repeatedly occur in specific sub-areas, and the seismic

  14. Long-term evolution of three-planet systems to the post-main sequence and beyond

    NASA Astrophysics Data System (ADS)

    Mustill, Alexander J.; Veras, Dimitri; Villaver, Eva

    2014-01-01

    We study the stability of systems of three giant planets orbiting 3-8 M⊙ stars at orbital distances of >10 au as the host star ages through the main sequence (MS) and well into the white dwarf (WD) stage. Systems are stable on the MS if the planets are separated by more than ˜9 Hill radii. Most systems surviving the MS will remain stable until the WD phase, although planets scattered on to small pericentres in unstable systems can be swallowed by the expanding stellar envelope when the star ascends the giant branches. Mass-loss at the end of the asymptotic giant branch triggers delayed instability in many systems, leading to instabilities typically occurring at WD cooling ages of a few 100 Myr. This instability occurs both in systems that survived the star's previous evolution unscathed, and in systems that previously underwent scattering instabilities. The outcome of such instability around WDs is overwhelmingly the ejection of one of the planets from the system, with several times more ejections occurring during the WD phase than during the MS. Furthermore, few planets are scattered close to the WD, just outside the Roche limit, where they can be tidally circularized. Hence, we predict that planets in WD systems rarely dynamically evolve to become `hot Jupiters'. Nor does it appear that the observed frequency of metal pollution in WD atmospheres can be entirely explained by planetesimals being destabilized following instability in systems of multiple giant planets, although further work incorporating low-mass planets and planetesimals is needed.

  15. 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.

  16. Person-centeredness in home- and community-based long-term care: current challenges and new directions.

    PubMed

    Ruggiano, Nicole; Edvardsson, David

    2013-01-01

    Person-centered care (PCC) has demonstrated to be a viable and preferred model of providing health and institutionalized long-term care services. However, the concept of PCC has not been fully extended to home- and community-based long-term care services (HCBS) for older adults with chronic conditions. This review highlights the need for PCC in HCBS and suggests that social workers may play a role in overcoming cultural and structural barriers to extending PCC to HCBS that include: the fragmentation of the industry, financial structures, regulation of services, and paternalism in policy and practice. Recommendations for practice, policy, and research are provided.

  17. The challenges of long-term follow-up data collection in non-commercial, academically-led breast cancer clinical trials: the UK perspective.

    PubMed

    Kilburn, Lucy S; Banerji, Jane; Bliss, Judith M

    2014-09-27

    Improved survival rates in early breast cancer and the chronic nature of disease relapse result in a large cohort of patients being available for long-term follow-up (LTFUP) in randomised controlled trials. Whilst of recognised scientific value to assess long-term treatment-related sequelae, the volume of this activity can be challenging for trialists and participating sites, and comes at a considerable cost to research funders and the National Health Service (NHS). A National Cancer Research Institute Breast Clinical Studies Group supported project aimed to characterise UK LTFUP data collection procedures in order to propose improvements. Protocols and case report forms for UK non-commercial National Institute for Health Research portfolio early breast cancer randomised controlled trials were reviewed and a questionnaire sent to associated participating NHS sites. Responders were asked to give opinions on issues with follow-up and LTFUP data collection procedures and to suggest potential improvements to practice. Results were used to inform design of a proposed standard LTFUP case report form. Thirty-four trials, involving eight Clinical Trials Units were eligible for inclusion in the review. All trials requested follow-up at least annually up to 5 years, with two-thirds requesting LTFUP after that time point. Information relating to efficacy endpoints was captured for all trials via case report forms; however, precise detail on recording of recurrence, second malignancies and death varied. Separately, questionnaires were returned from 66 NHS sites. Main concerns identified included difficulties in identifying all adverse events from hospital notes, volume of work, bureaucratic data management practices in Clinical Trials Units and perceptions of prioritisation of recruitment over follow-up. Variation has existed with respect to detail of LTFUP information requested for UK trials. Improved communication, simplification and standardisation of data and associated

  18. Lipid-Lowering Effects of Tetradecylthioacetic Acid in Antipsychotic-Exposed, Female Rats: Challenges with Long-Term Treatment

    PubMed Central

    Skrede, Silje; Fernø, Johan; Bjørndal, Bodil; Brede, Wenche Rødseth; Bohov, Pavol; Berge, Rolf Kristian; Steen, Vidar Martin

    2012-01-01

    Background Psychiatric patients often require chronic treatment with antipsychotic drugs, and while rats are frequently used to study antipsychotic-induced metabolic adverse effects, long-term exposure has only partially mimicked the appetite-stimulating and weight-inducing effects found in the clinical setting. Antipsychotic-induced effects on serum lipids are also inconsistent in rats, but in a recent study we demonstrated that subchronic treatment with the orexigenic antipsychotic olanzapine resulted in weight-independent increase in serum triglycerides and activation of lipogenic gene expression in female rats. In addition, a recent long-term study in male rats showed that chronic treatment with antipsychotic drugs induced dyslipidemic effects, despite the lack of weight gain. Aims In the current study, we sought to examine long-term effects of antipsychotic drugs on weight gain, lipid levels and lipid composition after twice-daily administration of antipsychotics to female rats, and to investigate potential beneficial effects of the lipid-lowering agent tetradecylthioacetic acid (TTA), a modified fatty acid. Methods Female rats were exposed to orexigenic antipsychotics (olanzapine or clozapine), metabolically neutral antipsychotics (aripiprazole or ziprasidone), or TTA for 8 weeks. Separate groups received a combination of clozapine and TTA or olanzapine and TTA. The effects of TTA and the combination of olanzapine and TTA after 2 weeks were also investigated. Results The antipsychotic-induced weight gain and serum triglyceride increase observed in the subchronic setting was not present after 8 weeks of treatment with antipsychotics, while lipid-lowering effect of TTA was much more pronounced in the chronic than in the subchronic setting, with concomitant upregulation of key oxidative enzymes in the liver. Unexpectedly, TTA potentiated weight gain in rats treated with antipsychotics. Conclusion TTA is a promising candidate for prophylactic treatment of

  19. Lipid-lowering effects of tetradecylthioacetic acid in antipsychotic-exposed, female rats: challenges with long-term treatment.

    PubMed

    Skrede, Silje; Fernø, Johan; Bjørndal, Bodil; Brede, Wenche Rødseth; Bohov, Pavol; Berge, Rolf Kristian; Steen, Vidar Martin

    2012-01-01

    Psychiatric patients often require chronic treatment with antipsychotic drugs, and while rats are frequently used to study antipsychotic-induced metabolic adverse effects, long-term exposure has only partially mimicked the appetite-stimulating and weight-inducing effects found in the clinical setting. Antipsychotic-induced effects on serum lipids are also inconsistent in rats, but in a recent study we demonstrated that subchronic treatment with the orexigenic antipsychotic olanzapine resulted in weight-independent increase in serum triglycerides and activation of lipogenic gene expression in female rats. In addition, a recent long-term study in male rats showed that chronic treatment with antipsychotic drugs induced dyslipidemic effects, despite the lack of weight gain. In the current study, we sought to examine long-term effects of antipsychotic drugs on weight gain, lipid levels and lipid composition after twice-daily administration of antipsychotics to female rats, and to investigate potential beneficial effects of the lipid-lowering agent tetradecylthioacetic acid (TTA), a modified fatty acid. Female rats were exposed to orexigenic antipsychotics (olanzapine or clozapine), metabolically neutral antipsychotics (aripiprazole or ziprasidone), or TTA for 8 weeks. Separate groups received a combination of clozapine and TTA or olanzapine and TTA. The effects of TTA and the combination of olanzapine and TTA after 2 weeks were also investigated. The antipsychotic-induced weight gain and serum triglyceride increase observed in the subchronic setting was not present after 8 weeks of treatment with antipsychotics, while lipid-lowering effect of TTA was much more pronounced in the chronic than in the subchronic setting, with concomitant upregulation of key oxidative enzymes in the liver. Unexpectedly, TTA potentiated weight gain in rats treated with antipsychotics. TTA is a promising candidate for prophylactic treatment of antipsychotic-induced dyslipidemic effects, but a

  20. Long-Term Care

    MedlinePlus

    ... this page please turn Javascript on. Long-Term Care What Is Long-Term Care? Long-term care involves a variety of services ... the Escape (Esc) button on your keyboard.) Most Care Provided at Home Long-term care is provided ...

  1. 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

  2. Challenges of long-term nutrition intervention studies on cognition: discordance between observational and intervention studies of vitamin B12 and cognition.

    PubMed

    McCracken, Cherie

    2010-11-01

    Conducting long-term nutrition intervention studies on cognition can be challenging. The gaps in current methodology are addressed via a case study of the relationship between vitamin B(12) and cognition in people aged 60 and older. There is robust evidence from many observational studies, both cross-sectional and longitudinal, showing that a deficit of the vitamin is associated with poor or declining cognition in this age group, but supplementation of the vitamin in trials does not bring about improved cognition. The evidence from observational studies as well as clinical trials is reviewed here, and the potential difficulties in conducting long-term nutritional intervention studies in this area are highlighted. © 2010 ILSI Europe.

  3. Long-term in situ dynamics of the fungal communities in a multi-contaminated soil are mainly driven by plants.

    PubMed

    Thion, Cécile; Cébron, Aurélie; Beguiristain, Thierry; Leyval, Corinne

    2012-10-01

    The fungal communities of a multi-contaminated soil polluted by polycyclic aromatic hydrocarbons and heavy metals (NM) were studied within a long-term in situ experiment of natural attenuation assisted by plants. Three treatments were monitored: bare soil (NM-BS), soil planted with alfalfa and inoculated with mycorrhizal fungi (NM-Msm), and soil with spontaneous vegetation (NM-SV). The same soil after thermal desorption (TD) was planted with alfalfa and inoculated with mycorrhizal fungi (TD-Msm). Twice a year for 5 years, the fungal abundance and the community structure were evaluated by real-time PCR and temporal temperature gradient gel electrophoresis targeting 18S rRNA genes. The fungal abundance increased over time and was higher in planted than in bare NM soil and in TD than in NM soil. The Shannon diversity index (H') increased during the first 2 years with the emergence of more than 30 ribotypes, but decreased after 3 years with the selection of a few competitive species, mostly Ascomycetes. H' was higher under complex plant assemblage (NM-SV) than in the NM-BS plots but did not differ between NM and TD soils planted with alfalfa. These results indicated that even in a highly polluted soil, the plant cover was the main driver of the fungal community structure. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  4. Long-term follow-up (four years) of unprotected left main coronary artery disease treated with paclitaxel-eluting stents (from the TRUE Registry).

    PubMed

    Godino, Cosmo; Parodi, Guido; Furuichi, Shinichi; Latib, Azeem; Barbagallo, Rossella; Goktekin, Omer; Cera, Michela; Mueller, Ralf; Tamburino, Corrado; Grube, Eberhard; Di Mario, Carlo; Reimers, Bernard; Chieffo, Alaide; Antoniucci, David; Colombo, Antonio; Sangiorgi, Giuseppe M

    2010-04-01

    Limited data are available on the long-term outcome following PCI with paclitaxel-eluting stent (PES) implantation in patients with unprotected left main coronary artery (LMCA). The objective of this study was to evaluate "real world" long-term outcome following paclitaxel-eluting stent (PES) implantation for unprotected LMCA disease in patients enrolled in the TRUE registry. From March 2003 to October 2004, 93 consecutive patients (81.7% male) underwent PCI for unprotected LMCA disease. Surveillance angiography was performed at 6.8+/-3.3 months follow-up. The target lesion involved the distal LMCA in 68 (73.1%) patients. Double stenting techniques were performed in 46 (67.6%) distal LMCA, of these 50% were stented using the Crush technique. Clinical follow-up was complete in all patients with 85.8% angiographic follow-up rate. In-segment restenosis occurred in 16 (20.3%) patients and was focal in 72.4% of cases and significantly higher in patients with distal LMCA (36.8% vs. 13.6%, p<0.04). At a median follow-up of 1,450 days (IQR 1281-1595), the overall incidence of MACE was 35.5% and the TLR rate was 25.8% and significantly higher in patients with bifurcation stenting (32.3% vs. 8%, p<0.02). The estimated cardiac survival rate at one and four years was 96.7% and 93.3%, respectively. Total mortality rate was 14.1% and cardiac was 6.5%. There was one (1.1%) definite stent thrombosis (ST) and one (1.1%) probable ST. Treatment of unprotected LMCA disease with PES, after four years follow-up, appears to be safe and effective with a low rate of cardiac mortality and overall risk of ST. The need for target lesion revascularisation in 25.8% of patients highlights the need for more effective PCI especially in patients with distal LMCA disease.

  5. Long-term outcomes after moderate-to-severe traumatic brain injury among military veterans: Successes and challenges.

    PubMed

    Schulz-Heik, R Jay; Poole, John H; Dahdah, Marie N; Sullivan, Campbell; Date, Elaine S; Salerno, Rose M; Schwab, Karen; Harris, Odette

    2016-01-01

    To assess long-term outcomes after traumatic brain injury (TBI) among veterans and service members. Regional Veterans Affairs medical centre. One hundred and eighteen veterans and military personnel, aged 23-70 years (median = 35 years), 90% male, had moderate-to-severe TBI (82% in coma > 1 day, 85% amnesic > 7 days), followed by acute interdisciplinary rehabilitation 5-16 years ago (median = 8 years). Cross-sectional analysis of live interviews conducted via telephone. TBI follow-up interview (occupational, social, cognitive, neurologic and psychiatric ratings), Community Integration Questionnaire, Disability Rating Scale (four indices of independent function) and Satisfaction with Life Scale. At follow-up, 52% of participants were working or attending school; 34% ended or began marriages after TBI, but the overall proportion married changed little. Finally, 22% were still moderately-to-severely disabled. However, 62% of participants judged themselves to be as satisfied or more satisfied with life than before injury. Injury severity, especially post-traumatic amnesia, was correlated with poorer outcomes in all functional domains. After moderate-severe TBI, most veterans assume productive roles and are satisfied with life. However, widespread difficulties and functional limitations persist. These findings suggest that veteran and military healthcare systems should continue periodic, comprehensive follow-up evaluations long after moderate-to-severe TBI.

  6. Progress and challenges in the understanding of long term evolution of deep-seated gravitational slope deformations

    NASA Astrophysics Data System (ADS)

    Pánek, Tomáš

    2017-04-01

    Deep-seated gravitational slope deformations (DSGSDs; Agliardi et al., 2001) is a generic term for slow moving (mm year-1) rock-mass movements that encompass the entire mountain slopes or valley flanks occurring in a wide spectrum of terrestrial and extraterrestrial settings (Mège and Bourgeois, 2011). Current progress in mapping technologies, geophysics, modelling and monitoring has provided valuable insights into the distribution, internal structure, mechanics and recent movements of DSGSDs. However, amidst all this progress, long-term (≥102 years) temporal dynamics remains one of the least explored aspects of DSGSDs (Pánek and Klimeš, 2016). Based on both the in-depth review of published studies from all around the world and several detailed geochronological investigations in the Carpathians, the Crimean peninsula and the Taurus Mts, this paper accents recent progress in the understanding of the lifespan, long-term rates and potential catastrophic accelerations of DSGSDs. Major concern is paid to the differences between glaciated and non-glaciated mountain landscapes. Outcomes of this review can be summarized as follows: (i) DSGSDs occurring outside the limits of Quaternary glaciations reveal more complex and generally longer lifespans. (ii) Despite traditional views, the dating results show that immediate chronological response of DSGSDs to glacier withdrawal is rather rare. On the contrary, there tends to be a significant (millennial) time-lag due to a complex interaction of paraglacial processes. (iii) Some DSGSDs (or their parts) may originate episodically and relatively fast, which is in contradiction to traditional definitions. (iv) Recurrent catastrophic collapses of slopes (e.g. rock avalanches, rockfalls, earthflows) are frequently sourced within DSGSDs bodies, irrespective of whether localized within glaciated or non-glaciated areas. Although a boom in geochronological methods has significantly improved our knowledge of the temporal dynamics of

  7. [Oral health hygiene education programme for nursing personnel to improve oral health of residents in long-term care facilities 2010 in Frankfurt/Main, Germany].

    PubMed

    Czarkowski, G; Allroggen, S; Köster-Schmidt, A; Bausback-Schomakers, S; Frank, M; Heudorf, U

    2013-06-01

    demonstrated, significant for plaque index, cleanliness of the tongue and denture hygiene index. The positive assessment of the nursing personnel as well as the positive effects on oral hygiene in the residents are in agreement with the results of many other studies in many countries. Therefore, these education programmes will be continued in the long-term care facilities in Frankfurt/Main, Germany.· © Georg Thieme Verlag KG Stuttgart · New York.

  8. The interRAI Pediatric Home Care (PEDS HC) Assessment: Evaluating the Long-term Community-Based Service and Support Needs of Children Facing Special Healthcare Challenges

    PubMed Central

    Phillips, Charles D; Hawes, Catherine

    2015-01-01

    The vast majority of assessment instruments developed to assess children facing special healthcare challenges were constructed to assess children within a limited age range or children who face specific conditions or impairments. In contrast, the interRAI Pediatric Home Care (PEDS HC) Assessment Form was specifically designed to assess the long-term community-based service and support needs of children and youth aged from four to 20 years who face a wide range of chronic physical or behavioral health challenges. Initial research indicates that PEDS HC items exhibit good predictive validity—explaining significant proportions of the variance in parents’ perceptions of needs, case managers’ service authorizations, and Medicaid program expenditures for long-term community-based services and supports. In addition, PEDS HC items have been used to construct scales that summarize the strengths and needs of children facing special healthcare challenges. Versions of the PEDS HC are now being used in Medicaid programs in three states in the United States. PMID:26401100

  9. Quality of life, social challenges, and psychosocial support for long-term survivors after allogeneic hematopoietic stem-cell transplantation.

    PubMed

    Norkin, Maxim; Hsu, Jack W; Wingard, John R

    2012-01-01

    Over the last two decades quality of life (QoL) and the social challenges of allogeneic hematopoietic stem cell transplant (allo-HSCT) survivors have been emerging as subjects of extensive research and are now considered as very important aspects in the pretransplant evaluation and management of allo-HSCT recipients. Recognition of QoL challenges in allo-HSCT survivors allows timely interventions leading to improvement of post-transplant outcomes. It needs to be recognized that long-lasting life changes associated with survivorship after allo-HSCT also significantly affect QoL of partners of allo-HSCT survivors. Currently, resources should be focused on how research findings can be used by patients, their partners, and physicians to optimize QoL and psychosocial adjustment. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. People challenges in biospheric systems for long-term habitation in remote areas, space stations, moon, and Mars expeditions.

    PubMed

    Allen, John

    2002-01-01

    People who participate in remote and difficult expeditions, such as the 2-year (1991-1993) Biosphere 2 experiment or a future biospheric system on Mars or other long voyages, will face individual psycho-physiological, social, and cultural value challenges. The individual psycho-physiological vectors include the lure of being a hero/heroine and pushing it to the maximum, concealment of problems with the belief that he/she can overcome the obstacle alone, as well as the difficulty of keeping intact the critical differentiation of the risks associated with the overall expedition as opposed to the experimental objectives. The social challenges occur as a group dynamic context as well as for the individual, resulting in regressions and the need to "act out" one's difficulties. Cultural areas of importance that must be taken into consideration will include esthetic, ethical, cosmological, and epistemological values. The epistemological values must involve the five methods of scientific inquiry for a comprehensive total systems project to succeed fully.

  11. 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.

  12. 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

  13. Long Term Preservation of Digital Information.

    ERIC Educational Resources Information Center

    Lorie, Raymond A.

    The preservation of digital data for the long term presents a variety of challenges from technical to social and organizational. The technical challenge is to ensure that the information, generated today, can survive long term changes in storage media, devices, and data formats. This paper presents a novel approach to the problem. It distinguishes…

  14. 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.

  15. Long Term Prognosis

    MedlinePlus

    ... TERM PROGNOSIS The long-term outlook of pediatric cardiomyopathy continues to be unpredictable because it occurs with ... a child also depends on the type of cardiomyopathy and the stage the disease is first diagnosed. ...

  16. Main principles used for building up a data bank for the long-term storage and retrieval of scientific space data

    NASA Technical Reports Server (NTRS)

    Zlotin, G. N.; Bykov, A. B.; Roy, L. V.; Khovanskiy, Y. D.

    1975-01-01

    Methodological, technical, and practical organizational problems are considered of constructing a long term data bank. Data processing flowcharts are presented which are based on an analysis of the tasks which the data bank must fulfill, an estimate of the existing and predicted data flows in the processing center, and the selection of the data storage media and the forms in which the data are presented. Questions related to the use of standard and special hardware and software in the data bank are discussed. Reasons are presented for the adopted structure of the document-fact type information retrieval system which permits the mechanization and automation of various stages in the retrieval and selection of the data.

  17. 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

    2017-01-25

    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

  18. Challenges of nurse delivery of psychological interventions for long-term conditions in primary care: a qualitative exploration of the case of chronic fatigue syndrome/myalgic encephalitis

    PubMed Central

    2011-01-01

    Background The evidence base for a range of psychosocial and behavioural interventions in managing and supporting patients with long-term conditions (LTCs) is now well-established. With increasing numbers of such patients being managed in primary care, and a shortage of specialists in psychology and behavioural management to deliver interventions, therapeutic interventions are increasingly being delivered by general nurses with limited training in psychological interventions. It is unknown what issues this raises for the nurses or their patients. The purpose of the study was to examine the challenges faced by non-specialist nurses when delivering psychological interventions for an LTC (chronic fatigue syndrome/myalgic encephalomyelitis [CFS/ME]) within a primary care setting. Methods A qualitative study nested within a randomised controlled trial [ISRCTN 74156610] explored the experiences and acceptability of two different psychological interventions (pragmatic rehabilitation and supportive listening) from the perspectives of nurses, their supervisors, and patients. Semi structured in-depth interviews were conducted with three nurse therapists, three supervisors, and 46 patients. An iterative approach was used to develop conceptual categories from the dataset. Results Analyses identified four sets of challenges that were common to both interventions: (i) being a novice therapist, (ii) engaging patients in the therapeutic model, (iii) dealing with emotions, and (iv) the complexity of primary care. Each challenge had the potential to cause tension between therapist and patient. A number of strategies were developed by participants to manage the tensions. Conclusions Tensions existed for nurses when attempting to deliver psychological interventions for patients with CFS/ME in this primary care trial. Such tensions should be addressed before implementing psychological interventions within routine clinical practice. Similar tensions may be found for other LTCs. Our

  19. Challenges of nurse delivery of psychological interventions for long-term conditions in primary care: a qualitative exploration of the case of chronic fatigue syndrome/myalgic encephalitis.

    PubMed

    Peters, Sarah; Wearden, Alison; Morriss, Richard; Dowrick, Christopher F; Lovell, Karina; Brooks, Joanna; Cahill, Greg; Chew-Graham, Carolyn

    2011-12-22

    The evidence base for a range of psychosocial and behavioural interventions in managing and supporting patients with long-term conditions (LTCs) is now well-established. With increasing numbers of such patients being managed in primary care, and a shortage of specialists in psychology and behavioural management to deliver interventions, therapeutic interventions are increasingly being delivered by general nurses with limited training in psychological interventions. It is unknown what issues this raises for the nurses or their patients. The purpose of the study was to examine the challenges faced by non-specialist nurses when delivering psychological interventions for an LTC (chronic fatigue syndrome/myalgic encephalomyelitis [CFS/ME]) within a primary care setting. A qualitative study nested within a randomised controlled trial [ISRCTN 74156610] explored the experiences and acceptability of two different psychological interventions (pragmatic rehabilitation and supportive listening) from the perspectives of nurses, their supervisors, and patients. Semi structured in-depth interviews were conducted with three nurse therapists, three supervisors, and 46 patients. An iterative approach was used to develop conceptual categories from the dataset. Analyses identified four sets of challenges that were common to both interventions: (i) being a novice therapist, (ii) engaging patients in the therapeutic model, (iii) dealing with emotions, and (iv) the complexity of primary care. Each challenge had the potential to cause tension between therapist and patient. A number of strategies were developed by participants to manage the tensions. Tensions existed for nurses when attempting to deliver psychological interventions for patients with CFS/ME in this primary care trial. Such tensions should be addressed before implementing psychological interventions within routine clinical practice. Similar tensions may be found for other LTCs. Our findings have implications for developing

  20. Evidence for inflammation-mediated memory dysfunction in gastropods: putative PLA2 and COX inhibitors abolish long-term memory failure induced by systemic immune challenges

    PubMed Central

    2013-01-01

    Background Previous studies associate lipid peroxidation with long-term memory (LTM) failure in a gastropod model (Lymnaea stagnalis) of associative learning and memory. This process involves activation of Phospholipase A2 (PLA2), an enzyme mediating the release of fatty acids such as arachidonic acid that form the precursor for a variety of pro-inflammatory lipid metabolites. This study investigated the effect of biologically realistic challenges of L. stagnalis host defense response system on LTM function and potential involvement of PLA2, COX and LOX therein. Results Systemic immune challenges by means of β-glucan laminarin injections induced elevated H2O2 release from L. stagnalis circulatory immune cells within 3 hrs of treatment. This effect dissipated within 24 hrs after treatment. Laminarin exposure has no direct effect on neuronal activity. Laminarin injections disrupted LTM formation if training followed within 1 hr after injection but had no behavioural impact if training started 24 hrs after treatment. Intermediate term memory was not affected by laminarin injection. Chemosensory and motor functions underpinning the feeding response involved in this learning model were not affected by laminarin injection. Laminarin’s suppression of LTM induction was reversed by treatment with aristolochic acid, a PLA2 inhibitor, or indomethacin, a putative COX inhibitor, but not by treatment with nordihydro-guaiaretic acid, a putative LOX inhibitor. Conclusions A systemic immune challenge administered shortly before behavioural training impairs associative LTM function in our model that can be countered with putative inhibitors of PLA2 and COX, but not LOX. As such, this study establishes a mechanistic link between the state of activity of this gastropod’s innate immune system and higher order nervous system function. Our findings underwrite the rapidly expanding view of neuroinflammatory processes as a fundamental, evolutionary conserved cause of cognitive and

  1. Evidence for inflammation-mediated memory dysfunction in gastropods: putative PLA2 and COX inhibitors abolish long-term memory failure induced by systemic immune challenges.

    PubMed

    Hermann, Petra M; Park, Deborah; Beaulieu, Emily; Wildering, Willem C

    2013-08-06

    Previous studies associate lipid peroxidation with long-term memory (LTM) failure in a gastropod model (Lymnaea stagnalis) of associative learning and memory. This process involves activation of Phospholipase A2 (PLA2), an enzyme mediating the release of fatty acids such as arachidonic acid that form the precursor for a variety of pro-inflammatory lipid metabolites. This study investigated the effect of biologically realistic challenges of L. stagnalis host defense response system on LTM function and potential involvement of PLA2, COX and LOX therein. Systemic immune challenges by means of β-glucan laminarin injections induced elevated H2O2 release from L. stagnalis circulatory immune cells within 3 hrs of treatment. This effect dissipated within 24 hrs after treatment. Laminarin exposure has no direct effect on neuronal activity. Laminarin injections disrupted LTM formation if training followed within 1 hr after injection but had no behavioural impact if training started 24 hrs after treatment. Intermediate term memory was not affected by laminarin injection. Chemosensory and motor functions underpinning the feeding response involved in this learning model were not affected by laminarin injection. Laminarin's suppression of LTM induction was reversed by treatment with aristolochic acid, a PLA2 inhibitor, or indomethacin, a putative COX inhibitor, but not by treatment with nordihydro-guaiaretic acid, a putative LOX inhibitor. A systemic immune challenge administered shortly before behavioural training impairs associative LTM function in our model that can be countered with putative inhibitors of PLA2 and COX, but not LOX. As such, this study establishes a mechanistic link between the state of activity of this gastropod's innate immune system and higher order nervous system function. Our findings underwrite the rapidly expanding view of neuroinflammatory processes as a fundamental, evolutionary conserved cause of cognitive and other nervous system disorders.

  2. Long term impacts of combined sewer overflow remediation on water quality and population dynamics of Culex quinquefasciatus, the main urban West Nile virus vector in Atlanta, GA.

    PubMed

    Lund, Andrea; McMillan, Joseph; Kelly, Rosmarie; Jabbarzadeh, Shirin; Mead, Daniel G; Burkot, Thomas R; Kitron, Uriel; Vazquez-Prokopec, Gonzalo M

    2014-02-01

    Combined sewers are a significant source of urban water pollution due to periodic discharges into natural streams. Such events (called combined sewer overflows, or CSOs) contribute to the impairment of natural waterways and are associated with increased mosquito productivity and elevated risk of West Nile virus transmission. We investigated the impact of CSOs on water quality and immature mosquito productivity in the city of Atlanta, Georgia, one year before and four years after CSO facility remediation. Water quality (ammonia, phosphate, nitrate and dissolved oxygen concentrations), immature mosquitoes (larvae and pupae), water temperature and rainfall were quantified biweekly between June-October at two urban creeks during 2008-2012. A before-after control-intervention design tested the impact of remediation on mosquito productivity and water quality, whereas generalized linear mixed-effect models quantified the factors explaining the long term impacts of remediation on mosquito productivity. Ammonia and phosphate concentrations and late immature (fourth-instar and pupae) mosquito populations were significantly higher in CSO than in non-CSO creeks, while dissolved oxygen concentrations were lower. Remediation significantly improved water quality estimates (particularly ammonia and dissolved oxygen) and reduced the number of overflows, mosquito productivity and the overall contribution of CSO-affected streams as sources of vectors of West Nile virus. The quality of water in CSOs provided a suitable habitat for immature mosquitoes. Remediation of the CSO facility through the construction of a deep storage tunnel improved water quality indices and reduced the productivity of mosquito species that can serve as vectors of West Nile virus. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. 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.

  4. Long-term sequelae of electrical injury

    PubMed Central

    Wesner, Marni L.; Hickie, John

    2013-01-01

    Abstract Objective To summarize the current evidence-based knowledge about the long-term sequelae of injuries from electrical current. Quality of evidence MEDLINE was searched for English-language articles published in the past 20 years using the following search terms: electrical, injuries, wound, trauma, accident, sequelae, long-term, follow-up, and aftereffects. For obvious reasons, it is unethical to randomly study electrical injury in controlled clinical trials. By necessity, this topic is addressed in less-rigorous observational and retrospective work and case studies. Therefore, the strength of the literature pertaining to the long-term sequelae of electrical injury is impaired by the necessity of retrospective methods and case studies that typically describe small cohorts. Main message There are 2 possible consequences of electrical injury: the person either survives or dies. For those who survive electrical injury, the immediate consequences are usually obvious and often require extensive medical intervention. The long-term sequelae of the electrical injury might be more subtle, pervasive, and less well defined, but can include neurologic, psychological, and physical symptoms. In the field of compensation medicine, determining causation and attributing outcome to an injury that might not result in objective clinical findings becomes a considerable challenge. Conclusion The appearance of these consequences of electrical injury might be substantially delayed, with onset 1 to 5 or more years after the electrical injury. This poses a problem for patients and health care workers, making it hard to ascribe symptoms to a remote injury when they might not arise until well after the incident event. PMID:24029506

  5. 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.

  6. Long-term effects of main-body’s obliquity on satellite formation perturbed by third-body gravity in elliptical and inclined orbit

    NASA Astrophysics Data System (ADS)

    Bakhtiari, Majid; Daneshjou, Kamran; Fakoor, Mahdi

    2017-03-01

    A new non-simplified model of formation flying is derived in the presence of an oblate main-body and third-body perturbation. In the proposed model, considering the perturbation of the third-body in an inclined orbit, the effect of obliquity (axial tilt) of the main-body is becoming important and has been propounded in the absolute motion of a reference satellite and the relative motion of a follower satellite. From a new point of view, J 2 perturbed relative motion equations and considering a disturbing body in an elliptic inclined three dimensional orbit, are derived using Lagrangian mechanics based on accurate introduced perturbed reference satellite motion. To validate the accuracy of the model presented in this study, an auxiliary model was constructed as the Main-body Center based Relative Motion (MCRM) model. Finally, the importance of the main-body’s obliquity is demonstrated by several examples related to the Earth-Moon system in relative motion and lunar satellite formation keeping. The main-body’s obliquity has a remarkable effect on formation keeping in the examined in-track and projected circular orbit (PCO) formations.

  7. Antigen-specific B-1a antibodies induced by Francisella tularensis LPS provide long-term protection against F. tularensis LVS challenge

    PubMed Central

    Cole, Leah E.; Yang, Yang; Elkins, Karen L.; Fernandez, Ellen T.; Qureshi, Nilofer; Shlomchik, Mark J.; Herzenberg, Leonard A.; Herzenberg, Leonore A.; Vogel, Stefanie N.

    2009-01-01

    Francisella tularensis (Ft), a Gram-negative intracellular bacterium, is the etiologic agent of tularemia. Infection of mice with <10 Ft Live Vaccine Strain (Ft LVS) organisms i.p. causes a lethal infection that resembles human tularemia. Here, we show that immunization with as little as 0.1 ng Ft LVS lipopolysaccharide (Ft-LPS), but not Ft lipid A, generates a rapid antibody response that protects wild-type (WT) mice against lethal Ft LVS challenge. Protection is not induced in Ft-LPS-immunized B cell-deficient mice (μMT or JhD), male xid mice, or Ig transgenic mice that produce a single IgH (not reactive with Ft-LPS). Focusing on the cellular mechanisms that underlie this protective response, we show that Ft-LPS specifically stimulates proliferation of B-1a lymphocytes that bind fluorochrome-labeled Ft-LPS and the differentiation of these cells to plasma cells that secrete antibodies specific for Ft-LPS. This exclusively B-1a antibody response is equivalent in WT, T-deficient (TCRαβ−/−, TCRγδ−/−), and Toll-like receptor 4 (TLR4)-deficient (TLR4−/−) mice and thus is not dependent on T cells or typical inflammatory processes. Serum antibody levels peak ≈5 days after Ft-LPS immunization and persist at low levels for months. Thus, immunization with Ft-LPS activates a rare population of antigen-specific B-1a cells to produce a persistent T-independent antibody response that provides long-term protection against lethal Ft LVS infection. These data support the possibility of creating effective, minimally invasive vaccines that can provide effective protection against pathogen invasion. PMID:19251656

  8. Alexandrium fundyense cysts in the Gulf of Maine: long-term time series of abundance and distribution, and linkages to past and future blooms.

    PubMed

    Anderson, Donald M; Keafer, Bruce A; Kleindinst, Judith L; McGillicuddy, Dennis J; Martin, Jennifer L; Norton, Kerry; Pilskaln, Cynthia H; Smith, Juliette L; Sherwood, Christopher R; Butman, Bradford

    2014-05-01

    Here we document Alexandrium fundyense cyst abundance and distribution patterns over nine years (1997 and 2004-2011) in the coastal waters of the Gulf of Maine (GOM) and identify linkages between those patterns and several metrics of the severity or magnitude of blooms occurring before and after each autumn cyst survey. We also explore the relative utility of two measures of cyst abundance and demonstrate that GOM cyst counts can be normalized to sediment volume, revealing meaningful patterns equivalent to those determined with dry weight normalization. Cyst concentrations were highly variable spatially. Two distinct seedbeds (defined here as accumulation zones with > 300 cysts cm(-3)) are evident, one in the Bay of Fundy (BOF) and one in mid-coast Maine. Overall, seedbed locations remained relatively constant through time, but their area varied 3-4 fold, and total cyst abundance more than 10 fold among years. A major expansion of the mid-coast Maine seedbed occurred in 2009 following an unusually intense A. fundyense bloom with visible red-water conditions, but that feature disappeared by late 2010. The regional system thus has only two seedbeds with the bathymetry, sediment characteristics, currents, biology, and environmental conditions necessary to persist for decades or longer. Strong positive correlations were confirmed between the abundance of cysts in both the 0-1 and the 0-3 cm layers of sediments in autumn and geographic measures of the extent of the bloom that occurred the next year (i.e., cysts → blooms), such as the length of coastline closed due to shellfish toxicity or the southernmost latitude of shellfish closures. In general, these metrics of bloom geographic extent did not correlate with the number of cysts in sediments following the blooms (blooms → cysts). There are, however, significant positive correlations between 0-3 cm cyst abundances and metrics of the preceding bloom that are indicative of bloom intensity or vegetative cell abundance

  9. Alexandrium fundyense cysts in the Gulf of Maine: Long-term time series of abundance and distribution, and linkages to past and future blooms

    NASA Astrophysics Data System (ADS)

    Anderson, Donald M.; Keafer, Bruce A.; Kleindinst, Judith L.; McGillicuddy, Dennis J.; Martin, Jennifer L.; Norton, Kerry; Pilskaln, Cynthia H.; Smith, Juliette L.; Sherwood, Christopher R.; Butman, Bradford

    2014-05-01

    Here we document Alexandrium fundyense cyst abundance and distribution patterns over nine years (1997 and 2004-2011) in the coastal waters of the Gulf of Maine (GOM) and identify linkages between those patterns and several metrics of the severity or magnitude of blooms occurring before and after each autumn cyst survey. We also explore the relative utility of two measures of cyst abundance and demonstrate that GOM cyst counts can be normalized to sediment volume, revealing meaningful patterns equivalent to those determined with dry weight normalization. Cyst concentrations were highly variable spatially. Two distinct seedbeds (defined here as accumulation zones with>300 cysts cm-3) are evident, one in the Bay of Fundy (BOF) and one in mid-coast Maine. Overall, seedbed locations remained relatively constant through time, but their area varied 3-4 fold, and total cyst abundance more than 10 fold among years. A major expansion of the mid-coast Maine seedbed occurred in 2009 following an unusually intense A. fundyense bloom with visible red-water conditions, but that feature disappeared by late 2010. The regional system thus has only two seedbeds with the bathymetry, sediment characteristics, currents, biology, and environmental conditions necessary to persist for decades or longer. Strong positive correlations were confirmed between the abundance of cysts in both the 0-1 and the 0-3 cm layers of sediments in autumn and geographic measures of the extent of the bloom that occurred the next year (i.e., cysts→blooms), such as the length of coastline closed due to shellfish toxicity or the southernmost latitude of shellfish closures. In general, these metrics of bloom geographic extent did not correlate with the number of cysts in sediments following the blooms (blooms→cysts). There are, however, significant positive correlations between 0-3 cm cyst abundances and metrics of the preceding bloom that are indicative of bloom intensity or vegetative cell abundance (e

  10. Alexandrium fundyense cysts in the Gulf of Maine: long-term time series of abundance and distribution, and linkages to past and future blooms

    PubMed Central

    Anderson, Donald M.; Keafer, Bruce A.; Kleindinst, Judith L.; McGillicuddy, Dennis J.; Martin, Jennifer L.; Norton, Kerry; Pilskaln, Cynthia H.; Smith, Juliette L.; Sherwood, Christopher R.; Butman, Bradford

    2013-01-01

    Here we document Alexandrium fundyense cyst abundance and distribution patterns over nine years (1997 and 2004-2011) in the coastal waters of the Gulf of Maine (GOM) and identify linkages between those patterns and several metrics of the severity or magnitude of blooms occurring before and after each autumn cyst survey. We also explore the relative utility of two measures of cyst abundance and demonstrate that GOM cyst counts can be normalized to sediment volume, revealing meaningful patterns equivalent to those determined with dry weight normalization. Cyst concentrations were highly variable spatially. Two distinct seedbeds (defined here as accumulation zones with > 300 cysts cm−3) are evident, one in the Bay of Fundy (BOF) and one in mid-coast Maine. Overall, seedbed locations remained relatively constant through time, but their area varied 3-4 fold, and total cyst abundance more than 10 fold among years. A major expansion of the mid-coast Maine seedbed occurred in 2009 following an unusually intense A. fundyense bloom with visible red-water conditions, but that feature disappeared by late 2010. The regional system thus has only two seedbeds with the bathymetry, sediment characteristics, currents, biology, and environmental conditions necessary to persist for decades or longer. Strong positive correlations were confirmed between the abundance of cysts in both the 0-1 and the 0-3 cm layers of sediments in autumn and geographic measures of the extent of the bloom that occurred the next year (i.e., cysts → blooms), such as the length of coastline closed due to shellfish toxicity or the southernmost latitude of shellfish closures. In general, these metrics of bloom geographic extent did not correlate with the number of cysts in sediments following the blooms (blooms → cysts). There are, however, significant positive correlations between 0-3 cm cyst abundances and metrics of the preceding bloom that are indicative of bloom intensity or vegetative cell abundance

  11. Alexandrium fundyense cysts in the Gulf of Maine: long-term time series of abundance and distribution, and linkages to past and future blooms

    USGS Publications Warehouse

    Anderson, Donald M.; Keafer, Bruce A.; Kleindinst, Judith L.; McGillicuddy, Dennis J.; Martin, Jennifer L.; Norton, Kerry; Pilskaln, Cynthia H.; Smith, Juliette L.; Sherwood, Christopher R.; Butman, Bradford

    2014-01-01

    Here we document Alexandrium fundyense cyst abundance and distribution patterns over nine years (1997 and 2004–2011) in the coastal waters of the Gulf of Maine (GOM) and identify linkages between those patterns and several metrics of the severity or magnitude of blooms occurring before and after each autumn cyst survey. We also explore the relative utility of two measures of cyst abundance and demonstrate that GOM cyst counts can be normalized to sediment volume, revealing meaningful patterns equivalent to those determined with dry weight normalization. Cyst concentrations were highly variable spatially. Two distinct seedbeds (defined here as accumulation zones with>300 cysts cm−3) are evident, one in the Bay of Fundy (BOF) and one in mid-coast Maine. Overall, seedbed locations remained relatively constant through time, but their area varied 3–4 fold, and total cyst abundance more than 10 fold among years. A major expansion of the mid-coast Maine seedbed occurred in 2009 following an unusually intense A. fundyense bloom with visible red-water conditions, but that feature disappeared by late 2010. The regional system thus has only two seedbeds with the bathymetry, sediment characteristics, currents, biology, and environmental conditions necessary to persist for decades or longer. Strong positive correlations were confirmed between the abundance of cysts in both the 0–1 and the 0–3 cm layers of sediments in autumn and geographic measures of the extent of the bloom that occurred the next year (i.e., cysts→blooms), such as the length of coastline closed due to shellfish toxicity or the southernmost latitude of shellfish closures. In general, these metrics of bloom geographic extent did not correlate with the number of cysts in sediments following the blooms (blooms→cysts). There are, however, significant positive correlations between 0–3 cm cyst abundances and metrics of the preceding bloom that are indicative of bloom intensity or vegetative cell

  12. Long-term seafloor monitoring at an open ocean aquaculture site in the western Gulf of Maine, USA: development of an adaptive protocol.

    PubMed

    Grizzle, R E; Ward, L G; Fredriksson, D W; Irish, J D; Langan, R; Heinig, C S; Greene, J K; Abeels, H A; Peter, C R; Eberhardt, A L

    2014-11-15

    The seafloor at an open ocean finfish aquaculture facility in the western Gulf of Maine, USA was monitored from 1999 to 2008 by sampling sites inside a predicted impact area modeled by oceanographic conditions and fecal and food settling characteristics, and nearby reference sites. Univariate and multivariate analyses of benthic community measures from box core samples indicated minimal or no significant differences between impact and reference areas. These findings resulted in development of an adaptive monitoring protocol involving initial low-cost methods that required more intensive and costly efforts only when negative impacts were initially indicated. The continued growth of marine aquaculture is dependent on further development of farming methods that minimize negative environmental impacts, as well as effective monitoring protocols. Adaptive monitoring protocols, such as the one described herein, coupled with mathematical modeling approaches, have the potential to provide effective protection of the environment while minimize monitoring effort and costs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Long term follow up after elective percutaneous coronary intervention for unprotected non-bifurcational left main stenosis: is it time to change the guidelines?

    PubMed

    Brueren, B R G; Ernst, J M P G; Suttorp, M J; ten Berg, J M; Rensing, B J W M; Mast, E G; Bal, E T; Six, A J; Plokker, H W M

    2003-11-01

    According to the American College of Cardiology/American Heart Association guidelines, percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) stenosis is contraindicated and coronary artery bypass graft surgery (CABG) is preferred. However, PCI of the LMCA is performed under exceptional circumstances. To analyse the data of patients who underwent PCI of the unprotected LMCA in St Antonius Hospital, Nieuwegein, Netherlands. In a database of 17 683 PCI procedures, 71 patients (0.4%) were found with non-bifurcational LMCA stenosis who underwent an elective PCI between 1991 and 2001. Ages ranged from 26.7-86.5 years. Severe concomitant disease was the most frequent argument in favour of PCI instead of CABG. PCI consisted of only balloon angioplasty in 23 cases (32.4%). A stent was used in 46 cases (64.4%). Average follow up was 43 months (range 0-121 months). One patient died one day after the procedure. The total one year survival rate was 98.6% (70/71). Seven patients died during the follow up period, mostly because of non-cardiac reasons. The annual mortality rate was 2.5%. Recurrent elective percutaneous transluminal coronary angioplasty for restenosis of the LMCA was performed in one patient (1.4%) six weeks after the initial procedure. CABG was required in 13 patients (18.3%) throughout the follow up period. These results suggest that at highly experienced centres, elective PCI of the non-bifurcational LMCA can be performed safely where the anatomy is suitable.

  14. Long term follow up after elective percutaneous coronary intervention for unprotected non-bifurcational left main stenosis: is it time to change the guidelines?

    PubMed Central

    Brueren, B R G; Ernst, J M P G; Suttorp, M J; ten Berg, J M; Rensing, B J W M; Mast, E G; Bal, E T; Six, A J; Plokker, H W M

    2003-01-01

    Background: According to the American College of Cardiology/American Heart Association guidelines, percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) stenosis is contraindicated and coronary artery bypass graft surgery (CABG) is preferred. However, PCI of the LMCA is performed under exceptional circumstances. Objective: To analyse the data of patients who underwent PCI of the unprotected LMCA in St Antonius Hospital, Nieuwegein, Netherlands. Results: In a database of 17 683 PCI procedures, 71 patients (0.4%) were found with non-bifurcational LMCA stenosis who underwent an elective PCI between 1991 and 2001. Ages ranged from 26.7–86.5 years. Severe concomitant disease was the most frequent argument in favour of PCI instead of CABG. PCI consisted of only balloon angioplasty in 23 cases (32.4%). A stent was used in 46 cases (64.4%). Average follow up was 43 months (range 0–121 months). One patient died one day after the procedure. The total one year survival rate was 98.6% (70/71). Seven patients died during the follow up period, mostly because of non-cardiac reasons. The annual mortality rate was 2.5%. Recurrent elective percutaneous transluminal coronary angioplasty for restenosis of the LMCA was performed in one patient (1.4%) six weeks after the initial procedure. CABG was required in 13 patients (18.3%) throughout the follow up period. Conclusion: These results suggest that at highly experienced centres, elective PCI of the non-bifurcational LMCA can be performed safely where the anatomy is suitable. PMID:14594895

  15. 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

  16. Long-term testing

    SciTech Connect

    Ferber, M.; Graves, G.A. Jr.

    1994-12-31

    Land-based gas turbines are significantly different from automotive gas turbines in that they are designed to operate for 50,000 h or greater (compared to 5,000--10,000 h). The primary goal of this research is to determine the long-term survivability of ceramic materials for industrial gas turbine applications. Research activities in this program focus on the evaluation of the static tensile creep and stress rupture (SR) behavior of three commercially available structural ceramics which have been identified by the gas turbine manufacturers as leading candidates for use in industrial gas turbines. For each material investigated, a minimum of three temperatures and four stresses will be used to establish the stress and temperature sensitivities of the creep and SR behavior. Because existing data for many candidate structural ceramics are limited to testing times less than 2,000 h, this program will focus on extending these data to times on the order of 10,000 h, which represents the lower limit of operating time anticipated for ceramic blades and vanes in gas turbine engines. A secondary goal of the program will be to investigate the possibility of enhancing life prediction estimates by combining interrupted tensile SR tests and tensile dynamic fatigue tests in which tensile strength is measured as a function of stressing rate. The third goal of this program will be to investigate the effects of water vapor upon the SR behavior of the three structural ceramics chosen for the static tensile studies by measuring the flexural strength as a function of stressing rate at three temperatures.

  17. 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

  18. Long-Term Stable Adhesion for Conducting Polymers in Biomedical Applications: IrOx and Nanostructured Platinum Solve the Chronic Challenge.

    PubMed

    Boehler, Christian; Oberueber, Felix; Schlabach, Sabine; Stieglitz, Thomas; Asplund, Maria

    2017-01-11

    Conducting polymers (CPs) have frequently been described as outstanding coating materials for neural microelectrodes, providing significantly reduced impedance or higher charge injection compared to pure metals. Usability has until now, however, been limited by poor adhesion of polymers like poly(3,4-ethylenedioxythiophene) (PEDOT) to metallic substrates, ultimately precluding long-term applications. The aim of this study was to overcome this weakness of CPs by introducing two novel adhesion improvement strategies that can easily be integrated with standard microelectrode fabrication processes. Iridium Oxide (IrOx) demonstrated exceptional stability for PEDOT coatings, resulting in polymer survival over 10 000 redox cycles and 110 days under accelerated aging conditions at 60 °C. Nanostructured Pt was furthermore introduced as a purely mechanical adhesion promoter providing 10-fold adhesion improvement compared to smooth Pt substrates by simply altering the morphology of Pt. This layer can be realized in a very simple process that is compatible with any electrode design, turning nanostructured Pt into a universal adhesion layer for CP coatings. By the introduction of these adhesion-promoting strategies, the weakness of CP-based neural probes can ultimately be eliminated and true long-term stable use of PEDOT on neural probes will be possible in future electrode generations.

  19. Challenges in pediatric transplantation: the impact of chronic kidney disease and cardiovascular risk factors on long-term outcomes and recommended management strategies.

    PubMed

    Filler, Guido

    2011-02-01

    Barriers to successful outcomes following pediatric transplantation have shifted from ischemic reperfusion injury and rejection to more long-term complications. Of particular concern is the high prevalence of CKD owing to preexisting damage and nephrotoxicity, as well as other CV complications such as hypertension and cardiomyopathy. All of these contribute to graft loss and shortened life expectancy, thereby limiting the success story of solid-organ transplantation. Managing CKD and related CV morbidity should be integral to the care of pediatric transplant patients, and timely detection of any irregularities would increase the chances of restoring lost kidney function. GFR is still the widely accepted indicator of renal function, and nuclear medicine techniques are the gold standard measurement methods. These methods are limited by costs, radiation exposure and substrate injection, and current practice still uses the Schwartz estimate, despite its well-documented limitations. Newer endogenous markers of GFR, such as cystatin C clearance, give a more accurate measure of true GFR but have not been embraced in the management of pediatric transplant recipients. Furthermore, indirect markers (e.g., microalbuminuria and hypertension) could also aid early detection of renal damage. The effects of mainstay immunosuppressants on kidney and heart function are varied, with available data indicating favorable outcomes with tacrolimus compared with ciclosporin. There is a need for appropriately designed and powered randomized controlled trials to validate innovative concepts for tailored immunosuppression in the pediatric population. To date, very few studies have generated long-term data in pediatric renal transplant patients - results of 1-4-yr study favored tacrolimus over ciclosporin, but other immunosuppressive agents also need to be evaluated.

  20. Long-term environmental stewardship.

    SciTech Connect

    Nagy, Michael David

    2010-08-01

    The purpose of this Supplemental Information Source Document is to effectively describe Long-Term Environmental Stewardship (LTES) at Sandia National Laboratories/New Mexico (SNL/NM). More specifically, this document describes the LTES and Long-Term Stewardship (LTS) Programs, distinguishes between the LTES and LTS Programs, and summarizes the current status of the Environmental Restoration (ER) Project.

  1. 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.

  2. Presynaptic long-term plasticity

    PubMed Central

    Yang, Ying; Calakos, Nicole

    2013-01-01

    Long-term synaptic plasticity is a major cellular substrate for learning, memory, and behavioral adaptation. Although early examples of long-term synaptic plasticity described a mechanism by which postsynaptic signal transduction was potentiated, it is now apparent that there is a vast array of mechanisms for long-term synaptic plasticity that involve modifications to either or both the presynaptic terminal and postsynaptic site. In this article, we discuss current and evolving approaches to identify presynaptic mechanisms as well as discuss their limitations. We next provide examples of the diverse circuits in which presynaptic forms of long-term synaptic plasticity have been described and discuss the potential contribution this form of plasticity might add to circuit function. Finally, we examine the present evidence for the molecular pathways and cellular events underlying presynaptic long-term synaptic plasticity. PMID:24146648

  3. Long-term effectiveness and safety of the sirolimus-eluting BiOSS LIM® dedicated bifurcation stent in the treatment of distal left main stenosis: an international registry.

    PubMed

    Gil, Robert J; Bil, Jacek; Grundeken, Maik J; Iñigo Garcia, Luis A; Vassilev, Dobrin; Kern, Adam; Pawłowski, Tomasz; Wykrzykowska, Joanna J; Serruys, Patrick W

    2016-11-20

    The aim of this study was to assess prospectively the effectiveness and safety of a new version of the dedicated bifurcation BiOSS stent, the sirolimus-eluting BiOSS LIM, for the treatment of distal left main (LM) stenosis. This was a prospective international registry which enrolled patients with NSTE-ACS or stable angina. Provisional T-stenting was the mandated strategy. The primary endpoint was the cumulative rate of cardiac death, myocardial infarction (MI) and target lesion revascularisation (TLR) at 12 months. Twelve-month quantitative coronary angiography endpoints included late lumen loss and percent diameter stenosis. A total of 74 patients with distal LM stenosis were enrolled. Seventy-three of the 74 patients (aged 67±9 years, 23% women, 20.3% NSTE-ACS, SYNTAX score 22.4±4.4) were successfully treated with the BiOSS LIM stent, with additional side branch placement of regular DES in 11 patients (14.9%). Periprocedural MI occurred in one (1.4%) patient. The 12-month MACE rate was 9.5% without cardiac death or definite stent thrombosis. TLR and MI rates were 6.8% (n=5) and 2.7% (n=2), respectively. The use of the BiOSS LIM dedicated bifurcation stent for the treatment of distal LM stenosis was feasible and safe, with promising long-term clinical effectiveness.

  4. The impact of main branch restenosis on long term mortality following drug-eluting stent implantation in patients with de novo unprotected distal left main bifurcation coronary lesions: the Milan and New-Tokyo (MITO) Registry.

    PubMed

    Takagi, Kensuke; Ielasi, Alfonso; Basavarajaiah, Sandeep; Chieffo, Alaide; Shannon, Joanne; Godino, Cosmo; Hasegawa, Tasuku; Naganuma, Toru; Fujino, Yusuke; Latib, Azeem; Carlino, Mauro; Montorfano, Matteo; Nakamura, Sunao; Colombo, Antonio

    2014-09-01

    In-stent restenosis (ISR) remains one of the main limitations for percutaneous coronary intervention of unprotected distal left main (UDLM). This study aims to demonstrate the impact of main-branch ISR (MB-ISR) on mortality and to clarify the optimal strategy. Between 2002 and 2008, 482 consecutive UDLM patients treated with drug eluting stent (sirolimus and paclitaxel) were evaluated. During follow-up period (median 52.6 months), MB-ISR occurred in 29, SB-ISR in 65, and MB/SB-ISR in 24. Multivariable analysis demonstrated that the independent predictors of MB-ISR were calcification (HR 2.284, p = 0.016), true-bifurcation (HR 2.331, p = 0.024), insulin-dependent diabetes mellitus (insulin-DM) (HR 2.259, p = 0.048). Furthermore, final proximal postdilatation (FPPD) (HR 0.548, p = 0.077), full LM cover approach (FCA) (HR 0.605, p = 0.093) and greater MLD (HR 0.611, p = 0.062) had a tendency to reduce MB-ISR. Furthermore, the occurrence of MB-ISR within 1-year was associated with cardiac-death (HR 2.734, p = 0.017). The patients with MB-ISR had more comorbidities and complex lesions, resulting in higher risk of cardiac mortality as compared to the patients without MB-ISR. Presence of calcification, true-bifurcation and insulin-DM were associated with MB-ISR following UDLM intervention, while FCA, FPPD, and greater MLD seemed to be associated with the low occurrence of MB-ISR. © 2013 Wiley Periodicals, Inc.

  5. Challenging pharmaceutical industry political power in Maine and Vermont.

    PubMed

    Castellblanch, Ramón

    2003-02-01

    A comparison of the Vermont and Maine cases of attempting to control pharmaceutical prices in the year 2000 shows that the Maine legislators were more successful in challenging pharmaceutical industry political power. This comparison shows that challenging the industry was aided by (1) mobilizing public support through grassroots organizations, (2) including independent pharmacists in negotiations over the legislation, and (3) developing state purchasing power leverage.

  6. Comparison of long-term outcome after percutaneous coronary intervention versus coronary artery bypass grafting in patients with unprotected left main coronary artery disease (from the CREDO-Kyoto PCI/CABG Registry Cohort-2).

    PubMed

    Shiomi, Hiroki; Morimoto, Takeshi; Hayano, Mamoru; Furukawa, Yutaka; Nakagawa, Yoshihisa; Tazaki, Junichi; Imai, Masao; Yamaji, Kyohei; Tada, Tomohisa; Natsuaki, Masahiro; Saijo, Sayaka; Funakoshi, Shunsuke; Nagao, Kazuya; Hanazawa, Koji; Ehara, Natsuhiko; Kadota, Kazushige; Iwabuchi, Masashi; Shizuta, Satoshi; Abe, Mitsuru; Sakata, Ryuzo; Okabayashi, Hitoshi; Hanyu, Michiya; Yamazaki, Fumio; Shimamoto, Mitsuomi; Nishiwaki, Noboru; Imoto, Yutaka; Komiya, Tatsuhiko; Horie, Minoru; Fujiwara, Hisayoshi; Mitsudo, Kazuaki; Nobuyoshi, Masakiyo; Kita, Toru; Kimura, Takeshi

    2012-10-01

    The long-term outcome of percutaneous coronary intervention (PCI) compared to coronary artery bypass grafting (CABG) for unprotected left main coronary artery disease (ULMCAD) remains to be investigated. We identified 1,005 patients with ULMCAD of 15,939 patients with first coronary revascularization enrolled in the CREDO-Kyoto PCI/CABG Registry Cohort-2. Cumulative 3-year incidence of a composite of death/myocardial infarction (MI)/stroke was significantly higher in the PCI group than in the CABG group (22.7% vs 14.8%, p = 0.0006, log-rank test). However, the adjusted outcome was not different between the PCI and CABG groups (hazard ratio [HR] 1.30, 95% confidence interval [CI] 0.79 to 2.15, p = 0.30). Stratified analysis using the SYNTAX score demonstrated that risk for a composite of death/MI/stroke was not different between the 2 treatment groups in patients with low (<23) and intermediate (23 to 33) SYNTAX scores (adjusted HR 1.70, 95% CI 0.77 to 3.76, p = 0.19; adjusted HR 0.86, 95% CI 0.37 to 1.99, p = 0.72, respectively), whereas in patients with a high SYNTAX score (≥33), it was significantly higher after PCI than after CABG (adjusted HR 2.61, 95% CI 1.32 to 5.16, p = 0.006). In conclusion, risk of PCI for serious adverse events seemed to be comparable to that after CABG in patients with ULMCAD with a low or intermediate SYNTAX score, whereas PCI compared with CABG was associated with a higher risk for serious adverse events in patients with a high SYNTAX score.

  7. Determination of Functional Capabilities, the Level of Physical Performance and the State of Main Physiological Body Systems in the First Hours after the Accomplishment of Long-term Space Flights ("Field Test")

    NASA Technical Reports Server (NTRS)

    Kozlovskaya, Inesa; Tomilovskaya, Elena; Rukavishnikov, Ilya; Kitov, Vladimir; Reschke, Millard; Kofman, Igor

    2014-01-01

    Long-term stay in weightlessness is accompanied by alterations in the activity of main physiological body systems including sensory-motor, skeletal-muscular disturbances and cardiovascular deconditioning. However, up to now, there are no data on the state and level of functional performance of cosmonauts/astronauts directly after flight, nor are there data to help define the dynamic recovery of functional characteristics and work efficiency which are greatly needed to provide the safety and planning of their activity once they reach space objects. The Russian and American scientists are currently engaged in a joint experiment known as the "Field Test" with the goal of studying the functional performance and the state of main physiological body systems directly after landing and their temporal recovery dynamics. The functional performance is identified during the test by temporal characteristics of the movements of spatial translation, the stability of the vertical stance for 3.5 min, and the kinematic characteristics of walking - non-complicated and complicated. The following characteristics are identified as physiological characteristics of the test: a) orthostatic tolerance during stand test, b) back muscle tone; c) vertical stability - by characteristics of the correction responses to unexpected perturbations of the vertical stance, and d) support reactions during the performance of the full battery of tests. To date, a pilot version of the "Field Test" has been conducted with participation from four Russian cosmonauts. The results of studies have shown that in 1 - 5 hours after landing the functional abilities of the cosmonauts are considerably reduced. All the test movements at this time are considerably slower than preflight and the more complicated the task is, the greater significant reduction in orthostatic tolerance: during the first test that occurs 1 - 5 hours after landing. two of four cosmonauts declined to continue the task after the orthostatic test

  8. Long-term parenteral nutrition

    PubMed Central

    Ladefoged, Karin; Jarnum, Stig

    1978-01-01

    Nineteen patients (11 women and eight men) aged 20-68 received long-term parenteral nutrition, mostly at home, for six to 63 months (mean 19 months). Indications for LTPN were extensive, active Crohn's disease in three patients, intestinocutaneous fistulas in three, and short-bowel syndrome in the remaining 13 patients. Subclavian or intra-atrial (Broviac) catheters were most commonly used, for which the average life was four and seven months respectively. Complications of long-term parenteral nutrition included pneumothorax in four out of 48 subclavian vein punctures. Catheter-induced thrombosis of central veins was shown by phlebography 17 times in nine patients, and eight episodes of total occlusion occurred. Two of these patients had pulmonary infarction. Nineteen episodes of catheter sepsis occurred in 11 patients, but only one was fatal. Complications related to intestinal disease included intra-abdominal abscesses and intestinal fistulas, and disturbances of liver function. Five patients died, though in only two was death related to long-term parenteral nutrition. One of these patients died from catheter sepsis, the other had subdural haematoma possibly caused by anticoagulant treatment. Eight of the 14 surviving patients still needed parenteral nutrition. All received a disability pension, but six had an acceptable quality of life with almost normal social activities. Despite problems such as difficulties in maintaining standardised infusion programmes, it was concluded that long-term parenteral nutrition at home is practicable and consistent with an acceptable quality of life. ImagesFIG 2 PMID:98199

  9. Long-term data archiving

    SciTech Connect

    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 recreate 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 Web

  10. Long-term OH variability of Miras

    NASA Astrophysics Data System (ADS)

    Etoka, S.; Le Squeren, A. M.

    2000-10-01

    We present here the results and interpretation of a long-term OH variability program conducted with the French {Nançay} Radiotelescope from 1980 to 1995. It concerns seven Mira stars: R Aql, RS Vir, S CrB, R LMi, RR Aql, U Her and UX Cyg. This study deals with the three OH maser lines observed in the Miras at 1612, 1665 and 1667 MHz. These OH variable stars have periods ranging from 290 to 580 days. The study presents the first insight of the long-term temporal behaviour of OH integrated flux variations as well as spectral component variations. The main aims are to determine the temporal behaviour of the OH maser emission and the longevity and variability of the spectral components. We find that the shapes of the OH curve are closer to the IR than the optical shapes and that the emissions at 1665 and 1667 MHz have a very similar behaviour while the emission at 1612 MHz behaves differently. The 1612 MHz emission shows smoother temporal variations and greater component longevity than the main line emission, leading to the conclusion that the 1612 MHz emission is coming from an outer part of the circumstellar shell and is more saturated than the main line emission. The study also shows the existence of inhomogeneities, especially differences between the front and back parts of the shell can be seen, and that OH variability curves undergo long term variations over several cycles.

  11. The Challenge of Pediatric Hodgkin's Disease-Where is the Balance Between Cure and Long-Term Toxicity?: A report of the West German multicenter studies DAL-HD-78, DAL-HD-82 and DAL-HD-85.

    PubMed

    Brämswig, J H; Höornig-Franz, I; Riepenhausen, M; Schellong, G

    1990-01-01

    From June 1978 until December 1989 more than 600 children under the age of 16 were treated for Hodgkin's disease in West Germany. In three consecutive multicenter studies (DAL-HD-78, HD-82, HD-85) a combined modality treatment concept was used. The aim of all these studies was to reduce the total dose and the extent of radiotherapy as well as the intensity of chemotherapy. In addition, the invasive abdominal staging procedures and the indications for splenectomy were reappraised, so that the number of laparotomies and splenectomies could be restricted to cases with an high probability of abdominal and/or splenic involvement. Special attention was directed to the effects of radio-and chemotherapy on thyroid and gonadal function as well as the development of secondary malignancies. We conclude, that patients treated for Hodgkin's disease with the combined modality treatment regimen (HD-78, HD-82), which included procarbazine, had a high probability of long term survival in first continuous complete remission (CCR). Omitting procarbazine (HD-85) significantly reduced the number of patients in first CCR in stages IIB to IV demonstrating the efficacy of this drug in the treatment of Hodgkin's disease. On the other hand, procarbazine appeared to be the major gonadotoxic drug causing predominantly testicular injury affecting mainly spermatogenesis. Few secondary malignancies have been observed, until now, however long term follow-up will be needed, to document side effects as well as the efficacy of the different therapeutic regimen.

  12. 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...

  13. Long-term prophylaxis in bipolar disorder.

    PubMed

    Taylor, Matthew J; Goodwin, Guy M

    2006-01-01

    Bipolar disorder is a major cause of disability, and the prevention of relapse is a key management goal. Pharmacological interventions, effectively delivered through enhanced clinical care, are central to long-term management. This article summarises the available evidence for a range of pharmacological options, and provides guidance on common issues in clinical management in line with current practice guidelines. The use of medications for long-term prophylaxis should be considered in all patients meeting criteria for bipolar I disorder. Increasing high-quality evidence from randomised trials informs management decisions relating to both novel agents, such as lamotrigine and olanzapine, and longer-established therapies, such as lithium and valproate, in monotherapy. Medications taken long-term in bipolar disorder differ in the extent to which they protect against manic and depressive relapse. Consequently, the emerging challenge is to understand how combination treatments can enhance efficacy and effectiveness based on data from controlled trials rather than random polypharmacy. Clinical care can be enhanced with effective education about the illness, and the use of strategies to improve treatment adherence and the recognition and management of stressors or prodromal symptoms. Where available, a range of specific psychological interventions can be effective as an adjunct to medication. When discontinuation of prophylaxis is necessary, gradual tapering of dose over weeks or months is recommended.

  14. Motivating the paraprofessional in long-term care.

    PubMed

    Vance, A; Davidhizar, R

    1997-06-01

    Motivating the paraprofessional employee in the long-term care setting is one of the biggest challenges facing health care supervisors. Unlike their counterparts in industry, whose work may produce tangible results and rewards, long-term care professionals often must face patients who show little or no change over time. Supervisors must have understanding and knowledge of motivational techniques that will involve and challenge paraprofessionals.

  15. Reach Out to Enhance Wellness in Older Cancer Survivors (RENEW): Design, Methods and Recruitment Challenges of a Home-based Exercise and Diet Intervention to Improve Physical Function among Long-term Survivors of Breast, Prostate, and Colorectal Cancer

    PubMed Central

    Snyder, Denise Clutter; Morey, Miriam C.; Sloane, Richard; Stull, Valeda; Cohen, Harvey Jay; Peterson, Bercedis; Pieper, Carl; Hartman, Terryl J.; Miller, Paige E.; Mitchell, Diane C.; Demark-Wahnefried, Wendy

    2009-01-01

    Objective Cure rates for cancer are increasing, especially for breast, prostate, and colorectal cancer. Despite positive trends in survivorship, a cancer diagnosis can trigger accelerated functional decline that can threaten independence, reduce quality-of-life and increase health care costs, especially among the elderly who comprise the majority of survivors. Lifestyle interventions may hold promise in reorienting functional decline in older cancer survivors, but few studies have been conducted. Method We describe the design and methods of a randomized controlled trial, RENEW (Reach out to ENhancE Wellness), that tests whether a home-based multi-behavior intervention focused on exercise, and including a low-saturated fat, plant-based diet, would improve physical functioning among 641 older, long-term (≥5 years post-diagnosis) survivors of breast, prostate, or colorectal cancer. Challenges to recruitment are examined. Results 20,015 cases were approached, and screened using a two-step screening process to assure eligibility. This population of long-term, elderly cancer survivors had lower rates of response (∼11%) and higher rates of ineligibility (∼70%) than our previous intervention studies conducted on adults with newly diagnosed cancer. Significantly higher response rates were noted among survivors who were white, younger, and more proximal to diagnosis and breast cancer survivors (p-values < 0.001). Conclusions Older cancer survivors represent a vulnerable population for whom lifestyle interventions may hold promise. RENEW may provide guidance in allocating limited resources in order to maximize recruitment efforts aimed at this needy, but hard-to-reach population. PMID:19117329

  16. Long-term intake of a high prebiotic fiber diet but not high protein reduces metabolic risk after a high fat challenge and uniquely alters gut microbiota and hepatic gene expression.

    PubMed

    Saha, Dolan C; Reimer, Raylene A

    2014-09-01

    A mismatch between early developmental diet and adulthood may increase obesity risk. Our objective was to determine the effects of re-matching rats to their weaning diets high in protein or fiber after transient high-fat/high-sucrose challenge in adulthood. We hypothesize that a long-term high fiber diet will be associated with a gut microbiota and hepatic gene expression reflective of reduced adiposity. Wistar rat pups were fed a control (C), high prebiotic fiber (HF), or high protein (HP) diet from 3-15 weeks of age; a high-fat/high-sucrose diet from 15-21 weeks; their respective C, HF, or HP diets from 21-25 weeks. Gut microbiota of cecal contents and hepatic gene expression were measured when rats were terminated at 25 weeks of age. HF rats had higher total bacteria, bifidobacteria and Bacteroides/Prevotella spp than C and HP at 25 weeks (P < 0.05). Firmicutes, especially Clostridium leptum, decreased in HF compared to C and HP (P < .05). The ratio of Firmicutes:Bacteroidetes was markedly lower in HF versus C and HP at 25 weeks (P < .05). HF decreased hepatic cholesterol content compared to HP and C at 25 weeks. HF and HP increased 3-hydroxy-3-methylglutaryl-CoA reductase mRNA and decreased lecithin-cholesterol acyltransferase mRNA compared to C (P < .05). In conclusion, re-matching rats to a HF but not HP diet attenuated the typical increase in Firmicutes:Bacteroidetes ratio associated with consumption of a high fat diet. Lower hepatic cholesterol with long-term HF diet intake may be related to alterations in gut microbiota and hepatic lipid metabolism. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Long-term management of prolactinomas.

    PubMed

    Schlechte, Janet A

    2007-08-01

    Prolactinomas are a frequent cause of gonadal dysfunction and infertility, especially in young women. The regulation of prolactin secretion and the efficacy of dopamine agonists in the therapy of prolactinomas are well established. The current challenges in management of prolactinomas are related to follow-up after successful therapy. Issues and questions to be addressed in this approach to long-term management of prolactinomas include the frequency of radiographic monitoring, effect of pregnancy and menopause, safety of estrogen in women taking oral contraceptives, and the potential for discontinuation of dopamine agonist therapy.

  18. Infective endocarditis: determinants of long term outcome

    PubMed Central

    Netzer, R O M; Altwegg, S C; Zollinger, E; Täuber, M; Carrel, T; Seiler, C

    2002-01-01

    Objective: To evaluate predictors of long term prognosis in infective endocarditis. Design: Retrospective cohort study. Setting: Tertiary care centre. Patients: 212 consecutive patients with infective endocarditis between 1980 and 1995 Main outcome measures: Overall and cardiac mortality; event-free survival; and the following events: recurrence, need for late valve surgery, bleeding and embolic complications, cerebral dysfunction, congestive heart failure. Results: During a mean follow up period of 89 months (range 1–244 months), 56% of patients died. In 180 hospital survivors, overall and cardiac mortality amounted to 45% and 24%, respectively. By multivariate analysis, early surgical treatment, infection by streptococci, age < 55 years, absence of congestive heart failure, and > 6 symptoms or signs of endocarditis during active infection were predictive of improved overall long term survival. Independent determinants of event-free survival were infection by streptococci and age < 55 years. Event-free survival was 17% at the end of follow up both in medically–surgically treated patients and in medically treated patients. Conclusions: Long term survival following infective endocarditis is 50% after 10 years and is predicted by early surgical treatment, age < 55 years, lack of congestive heart failure, and the initial presence of more symptoms of endocarditis. PMID:12067947

  19. Long-Term Care Policy: Singapore's Experience.

    PubMed

    Chin, Chee Wei Winston; Phua, Kai-Hong

    2016-01-01

    Singapore, like many developed countries, is facing the challenge of a rapidly aging population and the increasing need to provide long-term care (LTC) services for elderly in the community. The Singapore government's philosophy on care for the elderly is that the family should be the first line of support, and it has relied on voluntary welfare organizations (VWOs) or charities for the bulk of LTC service provision. For LTC financing, it has emphasized the principles of co-payment and targeting of state support to the low-income population through means-tested government subsidies. It has also instituted ElderShield, a national severe disability insurance scheme. This paper discusses some of the challenges facing LTC policy in Singapore, particularly the presence of perverse financial incentives for hospitalization, the pitfalls of over-reliance on VWOs, and the challenges facing informal family caregivers. It discusses the role of private LTC insurance in LTC financing, bearing in mind demand- and supply-side failures that have plagued the private LTC insurance market. It suggests the need for more standardized needs assessment and portable LTC benefits, with reference to the Japanese Long-Term Care Insurance program, and also discusses the need to provide more support to informal family caregivers.

  20. 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

  1. Long-Term Recency in Anterograde Amnesia.

    PubMed

    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.

  2. Main results of the 4th International PIV Challenge

    NASA Astrophysics Data System (ADS)

    Kähler, Christian J.; Astarita, Tommaso; Vlachos, Pavlos P.; Sakakibara, Jun; Hain, Rainer; Discetti, Stefano; La Foy, Roderick; Cierpka, Christian

    2016-06-01

    In the last decade, worldwide PIV development efforts have resulted in significant improvements in terms of accuracy, resolution, dynamic range and extension to higher dimensions. To assess the achievements and to guide future development efforts, an International PIV Challenge was performed in Lisbon (Portugal) on July 5, 2014. Twenty leading participants, including the major system providers, i.e., Dantec (Denmark), LaVision (Germany), MicroVec (China), PIVTEC (Germany), TSI (USA), have analyzed 5 cases. The cases and analysis explore challenges specific to 2D microscopic PIV (case A), 2D time-resolved PIV (case B), 3D tomographic PIV (cases C and D) and stereoscopic PIV (case E). During the event, 2D macroscopic PIV images (case F) were provided to all 80 attendees of the workshop in Lisbon, with the aim to assess the impact of the user's experience on the evaluation result. This paper describes the cases and specific algorithms and evaluation parameters applied by the participants and reviews the main results. For future analysis and comparison, the full image database will be accessible at http://www.pivChallenge.org Challenge.org" TargetType="URL"/> .

  3. Long-term oxygen therapy.

    PubMed

    Christopher, Kent L; Porte, Phillip

    2011-02-01

    This article provides an overview of the status of long-term oxygen therapy (LTOT). In the United States, payment cutbacks are occurring as a result of congressionally mandated competitive bidding and capped rental programs. These Medicare programs are discussed. These legislative and regulatory changes may result in reduced patient access to appropriate oxygen-delivery systems that meet medical needs, including optimal ambulation. Prescribing LTOT is addressed in this article, as is the need for adequate patient education. The importance of appropriate monitoring and reassessment is presented. The use of an LTOT collaborative care model is discussed. Although the new intermittent flow oxygen-delivery systems have potential benefits, there is consensus that each patient should be tested on the specific device because of variability in delivery and patient response. Feasible locations for patient education and monitoring are identified.

  4. Medical care evaluation studies in long-term care facilities.

    PubMed

    Zimmer, J G

    1979-02-01

    This report describes the selection, design, conduct, analysis, and application of medical care evaluation studies in long-term care facilities (skilled nursing homes) in a regional program in the Rochester region of upstate New York. Eight examples are presented to highlight methodologic approaches and problems. They are classified under four general headings: Administration Audits, Diagnosis-specific Studies, Care Modality-specific Studies, and General Outcome Indicators. The implementation of results and recommendations from the studies is discussed and an application of "tracer" methodology for assessing the components of care activities in long-term facilities is described. Problems and challenges in long-term quality care are outlined.

  5. [Developing the core competencies of long-term care professionals].

    PubMed

    Chen, Huey-Tzy; Lee, Kuang-Ting

    2012-12-01

    Longer average life expectancies and an ageing society have made long-term care an urgent and important issue in Taiwan. Although the implementation of Long-Term Care Ten-year Project four years ago has begun showing success in terms of assessing Taiwan's needs in terms of long-term care services and resources, there has been little forward progress in terms of training, recruiting and maintaining more competent professionals in the long-term care sector. This paper explores the current state of long-term care competency in Taiwan and educational strategies in place to improve the competency of long-term care professionals. Results indicate that the term geriatric competency embraces sub-competencies in direct care, communication, assessment, teamwork, cultural sensitivities and career care competencies. The term long-term care competency embraces the sub-competencies of supervision, management, information technology, resource management, and organizational skill. As a main contributor to effective long-term care, the nursing profession must employ effective strategies to develop competency-based education. Also, the profession must have an adequate supply of competent manpower to effectively respond to Taiwan's aging society.

  6. Influenza in long-term care facilities: preventable, detectable, treatable.

    PubMed

    Mossad, Sherif B

    2009-09-01

    Influenza in long-term care facilities is an ever more challenging problem. Vaccination of residents and health care workers is the most important preventive measure. Although vaccine efficacy has been questioned, the preponderance of data favors vaccination. Antiviral resistance complicates postexposure chemoprophylaxis and treatment. Factors that limit the choice of antiviral agents in this patient population include limited vaccine supplies and impaired dexterity and confusion in long-term care residents.

  7. 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. ...

  8. Consumer Direction in Long-Term Care.

    ERIC Educational Resources Information Center

    Generations, 2000

    2000-01-01

    Issue includes 17 theme articles on long-term care, covering legal issues, federal role, state programs, demonstration programs, family caregivers, home health care, home care workers, culturally appropriate long-term care, financial support, and cognitive impairments. (SK)

  9. 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.

  10. Long Term Surface Salinity Measurements

    NASA Technical Reports Server (NTRS)

    Schmitt, Raymond W.; Brown, Neil L.

    2005-01-01

    Our long-term goal is to establish a reliable system for monitoring surface salinity around the global ocean. Salinity is a strong indicator of the freshwater cycle and has a great influence on upper ocean stratification. Global salinity measurements have potential to improve climate forecasts if an observation system can be developed. This project is developing a new internal field conductivity cell that can be protected from biological fouling for two years. Combined with a temperature sensor, this foul-proof cell can be deployed widely on surface drifters. A reliable in-situ network of surface salinity sensors will be an important adjunct to the salinity sensing satellite AQUARIUS to be deployed by NASA in 2009. A new internal-field conductivity cell has been developed by N Brown, along with new electronics. This sensor system has been combined with a temperature sensor to make a conductivity - temperature (UT) sensor suitable for deployment on drifters. The basic sensor concepts have been proven on a high resolution CTD. A simpler (lower cost) circuit has been built for this application. A protection mechanism for the conductivity cell that includes antifouling protection has also been designed and built. Mr. A.Walsh of our commercial partner E-Paint has designed and delivered time-release formulations of antifoulants for our application. Mr. G. Williams of partner Clearwater Instrumentation advised on power and communication issues and supplied surface drifters for testing.

  11. AB055. Long term NIV

    PubMed Central

    Siopi, Dimitra

    2016-01-01

    During the last decades, non-invasive mechanical ventilation has evolved into one of the most evidence-based areas of respiratory medicine, with many indications in acute or chronic respiratory failure. From the first application of negative pressure models during poliomyelitis epidemics to the new sophisticated positive pressure models, and the development of the “intelligent ventilators”, there has been a long time course. Undoubtedly the spur was given by better understanding of respiratory physiology during sleep and the shift of healthcare towards a chronic base. Novel randomized controlled trials (RCTs) established the use of NIV in acute respiratory failure due to exacerbations of COPD, as well as acute pulmonary edema and weaning from invasive mechanical ventilation. Long-term NIV has been used in neuromuscular diseases for many decades, first in Duchenne muscular dystrophy, and then spreading to other disorders of this category, increasing survival in inherited neuromuscular diseases. NIV should be initiated early in the course of the disease, when symptomatic nocturnal hypoventilation is detected. Combined with cough augmentation (physiotherapy, insufflation-exsufflation devices) and percutaneous gastrostomy feeding, it can delay tracheostomy and invasive ventilation. In ALS patients NIV improves the quality of life and increases survival, especially when there is no bulbar involvement. The right time to initiate ventilation in this group of patients is not well established since it is difficult to detect signs and symptom of respiratory impairment. Patients seem to benefit from an early application of NIV, and their personal decisions should always be considered before any intervention. In patients with chest wall disorders NIV—despite the fact that RCTs are lacking—has proved its value in many uncontrolled trials and numerous reports. It seems to improve the work of breathing, sleep architecture, nocturnal and daytime arterial blood gases. The

  12. Stapedectomy - long-term report.

    PubMed

    Shea, J J

    1982-01-01

    The long-term results with large fenestra stapedectomy with vein graft and Teflon piston are compared with results with the small fenestra stapedectomy with teflon piston directly into the vestibule. There were 1,943 operations in the former group and 2,155 in the latter when compared in 1970. One hundred consecutive patients from the beginning of each group with follow-up to present were compared. Results were generally the same with no great change in 15 and 20 years as compared to those at 5 years. The complication of perilymph fistula was caused by creating an opening in the footplate much larger than the prosthesis and was eliminated by interposing a living oval window seal if the opening was much larger than the prosthesis and a flap of lining membrane from the promontory when it was not. Other factors that influence a good result are discussed, including the type and the diameter of the piston used, the type of living oval window seal and the method of attachment to the incus. The small fenestra operation was found to be superior to the large, not only for the hearing gain achieved, but the case of performance and the freedom from complications due to migration of the prosthesis and/or the oval window seal. At present we have done about all that can be done for the conductive components. What remains is the sensorineural component which our studies indicate may be due to an autoimmune response.

  13. Long-term corrosion studies

    SciTech Connect

    Gdowski, G.

    1998-05-29

    The scope of this activity is to assess the long-term corrosion properties of metallic materials under consideration for fabricating waste package containers. Three classes of metals are to be assessed: corrosion resistant, intermediate corrosion resistant, and corrosion allowance. Corrosion properties to be evaluated are general, pitting and crevice corrosion, stress-corrosion cracking, and galvanic corrosion. The performance of these materials will be investigated under conditions that are considered relevant to the potential emplacement site. Testing in four aqueous solutions, and vapor phases above them, and at two temperatures are planned for this activity. (The environmental conditions, test metals, and matrix are described in detail in Section 3.0.) The purpose and objective of this activity is to obtain the kinetic and mechanistic information on degradation of metallic alloys currently being considered for waste package containers. This information will be used to provide assistance to (1) waste package design (metal barrier selection) (E-20-90 to E-20-92), (2) waste package performance assessment activities (SIP-PA-2), (3) model development (E-20-75 to E-20-89). and (4) repository license application.

  14. Long-Term Planning in Higher Education.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

    This report presents the concepts and issues discussed at a Regional Symposium on Long-term Planning in Higher Education held in Dhaka, Bangladesh, September 21-30, 1986. Chapter 1 explores some fundamental issues about the rationale for the objectives of long-term planning. It defines long-term planning in higher education, considers its…

  15. Long Term TOA - M Data and Information

    Atmospheric Science Data Center

    2015-06-30

    A Long-Term TOA and Constrained Surface Radiation Budget Project A Long-Term TOA and Constrained Surface Readiation Budget Dataset Using Merged CERES, ... and apply the knowledge to existing data to develop long-term (nearly 30 years) consistent and calibrated data product (TOA irradiances ...

  16. Long term perfusion system supporting adipogenesis

    PubMed Central

    Abbott, Rosalyn D.; Raja, Waseem K.; Wang, Rebecca Y.; Stinson, Jordan A.; Glettig, Dean L.; Burke, Kelly A.; Kaplan, David L.

    2015-01-01

    Adipose tissue engineered models are needed to enhance our understanding of disease mechanisms and for soft tissue regenerative strategies. Perfusion systems generate more physiologically relevant and sustainable adipose tissue models, however adipocytes have unique properties that make culturing them in a perfusion environment challenging. In this paper we describe the methods involved in the development of two perfusion culture systems (2D and 3D) to test their applicability for long term in vitro adipogenic cultures. It was hypothesized that a silk protein biomaterial scaffold would provide a 3D framework, in combination with perfusion flow, to generate a more physiologically relevant sustainable adipose tissue engineered model than 2D cell culture. Consistent with other studies evaluating 2D and 3D culture systems for adipogenesis we found that both systems successfully model adipogensis, however 3D culture systems were more robust, providing the mechanical structure required to contain the large, fragile adipocytes that were lost in 2D perfused culture systems. 3D perfusion also stimulated greater lipogenesis and lipolysis and resulted in decreased secretion of LDH compared to 2D perfusion. Regardless of culture configuration (2D or 3D) greater glycerol was secreted with the increased nutritional supply provided by perfusion of fresh media. These results are promising for adipose tissue engineering applications including long term cultures for studying disease mechanisms and regenerative approaches, where both acute (days to weeks) and chronic (weeks to months) cultivation are critical for useful insight. PMID:25843606

  17. The Long-Term Behavior of Known & Suspected Novae

    NASA Astrophysics Data System (ADS)

    Pagnotta, A.

    2017-03-01

    The long-term evolution of classical novae is poorly understood. I discuss here an in-progress project designed to better understand the post-eruption behavior of novae and test the Hibernation theory of nova evolution. The project has two main parts: (1) a modern survey of Galactic nova magnitudes, and (2) construction of long-term light curves using primarily archival photographic plates.

  18. Long-term Trend of Sunspot Numbers

    NASA Astrophysics Data System (ADS)

    Gao, P. X.

    2016-10-01

    Using the Hilbert-Huang Transform method, we investigate the long-term trend of yearly mean total sunspot numbers in the time interval of 1700-2015, which come from the World Data Center—the sunspot Index and long-term solar observations. The main findings of this study are summarized below. (1) From the adaptive trend, which is extracted from the yearly mean total sunspot numbers, we can find that the value gradually increases during the time period 1700-1975, then decreases gradually from 1975 to 2015. (2) The Centennial Gleissberg Cycle is extracted from the yearly mean total sunspot numbers and confirms that a new grand minimum is in progress; the Dalton Minimum, the Gleissberg Minimum, and low level of solar activity during solar cycle 24 (the part of the new grand minimum) all can be understood as minima of the Centennial Gleissberg Cycle. (3) Based on the adaptive (overall) trend, and the 100-year and longer timescale trend of yearly mean total sunspot numbers, we can infer that the level of solar activity during the new grand minimum may be close to that during the Gleissberg Minimum, slightly higher than that during the Dalton Minimum, and significantly higher than that during the Maunder Minimum. Our results do not support the suggestion that a new grand minimum, somewhat resembling the Maunder Minimum, is in progress.

  19. 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

  20. Climate Predictability and Long Term Memory

    NASA Astrophysics Data System (ADS)

    Zhu, X.; Blender, R.; Fraedrich, K.; Liu, Z.

    2010-09-01

    The benefit of climate Long Term Memory (LTM) for long term prediction is assessed using data from a millennium control simulation with the atmosphere ocean general circulation model ECHAM5/MPIOM. The forecast skills are evaluated for surface temperature time series at individual grid points. LTM is characterised by the Hurst exponent in the power-law scaling of the fluctuation function which is determined by detrended fluctuation analysis (DFA). LTM with a Hurst exponent close to 0.9 occurs mainly in high latitude oceans, which are also characterized by high potential predictability. Climate predictability is diagnosed in terms of potentially predictable variance fractions. Explicit prediction experiments for various time steps are conducted on a grid point basis using an auto-correlation (AR1) predictor: in regions with LTM, prediction skills are beyond that expected from red noise persistence; exceptions occur in some areas in the southern oceans and over the northern hemisphere continents. Extending the predictability analysis to the fully forced simulation shows large improvement in prediction skills.

  1. Managing Records for the Long Term - 12363

    SciTech Connect

    Montgomery, John V.; Gueretta, Jeanie

    2012-07-01

    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 and 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

  2. Lack of Protection of Pre-Immunization with Saliva of Long-Term Colonized Phlebotomus papatasi against Experimental Challenge with Leishmania major and Saliva of Wild-Caught P. papatasi

    PubMed Central

    Ahmed, Sami Ben Hadj; Kaabi, Belhassen; Chelbi, Ifhem; Derbali, Mohamed; Cherni, Saifedine; Laouini, Dhafer; Zhioua, Elyes

    2010-01-01

    Immunity to saliva of Phlebotomus papatasi protects against Leishmania major infection as determined by co-inoculation of parasites with salivary gland homogenates (SGHs) of this vector. These results were obtained with long-term colonized female P. papatasi. We investigated the effect of pre-immunization with SGH of long-term colonized P. papatasi against L. major infection co-inoculated with SGH of wild-caught P. papatasi. Our results showed that pre-exposure to SGH of long-term, colonized P. papatasi do not confer protection against infection with L. major co-inoculated with SGH of wild-caught P. papatasi. These preliminary results strongly suggest that the effectiveness of a vector saliva-based vaccine derived from colonized sand fly populations may be affected by inconsistent immune response after natural exposure. PMID:20810812

  3. Lack of protection of pre-immunization with saliva of long-term colonized Phlebotomus papatasi against experimental challenge with Leishmania major and saliva of wild-caught P. papatasi.

    PubMed

    Ahmed, Sami Ben Hadj; Kaabi, Belhassen; Chelbi, Ifhem; Derbali, Mohamed; Cherni, Saifedine; Laouini, Dhafer; Zhioua, Elyes

    2010-09-01

    Immunity to saliva of Phlebotomus papatasi protects against Leishmania major infection as determined by co-inoculation of parasites with salivary gland homogenates (SGHs) of this vector. These results were obtained with long-term colonized female P. papatasi. We investigated the effect of pre-immunization with SGH of long-term colonized P. papatasi against L. major infection co-inoculated with SGH of wild-caught P. papatasi. Our results showed that pre-exposure to SGH of long-term, colonized P. papatasi do not confer protection against infection with L. major co-inoculated with SGH of wild-caught P. papatasi. These preliminary results strongly suggest that the effectiveness of a vector saliva-based vaccine derived from colonized sand fly populations may be affected by inconsistent immune response after natural exposure.

  4. 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.

  5. 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.

  6. Advanced nuclear fuel cycles - Main challenges and strategic choices

    SciTech Connect

    Le Biez, V.; Machiels, A.; Sowder, A.

    2013-07-01

    A graphical conceptual model of the uranium fuel cycles has been developed to capture the present, anticipated, and potential (future) nuclear fuel cycle elements. The once-through cycle and plutonium recycle in fast reactors represent two basic approaches that bound classical options for nuclear fuel cycles. Chief among these other options are mono-recycling of plutonium in thermal reactors and recycling of minor actinides in fast reactors. Mono-recycling of plutonium in thermal reactors offers modest savings in natural uranium, provides an alternative approach for present-day interim management of used fuel, and offers a potential bridging technology to development and deployment of future fuel cycles. In addition to breeder reactors' obvious fuel sustainability advantages, recycling of minor actinides in fast reactors offers an attractive concept for long-term management of the wastes, but its ultimate value is uncertain in view of the added complexity in doing so,. Ultimately, there are no simple choices for nuclear fuel cycle options, as the selection of a fuel cycle option must reflect strategic criteria and priorities that vary with national policy and market perspectives. For example, fuel cycle decision-making driven primarily by national strategic interests will likely favor energy security or proliferation resistance issues, whereas decisions driven primarily by commercial or market influences will focus on economic competitiveness.

  7. [Perspectives in long-term care insurance].

    PubMed

    Pick, P

    2007-03-01

    Twelve years after its introduction, long-term care insurance is back on the agenda and up for political reform. This paper shows why long-term care insurance needs to be reformed. The two central aspects on which reform projects focus are addressed: firstly, the structural improvement of nursing care and long-term care insurance and, secondly, the creation of a sustained financing. The principal conclusion is that, while there is a broad consensus about the structural improvement of long-term care insurance, opinions differ widely in the matter of its sustained financing. As a consequence, a coherent financing concept has yet to emerge.

  8. Online Learning: Addressing Challenges and Seizing Opportunities. Maine

    ERIC Educational Resources Information Center

    Alliance for Excellent Education, 2010

    2010-01-01

    America's K-12 education system faces three significant challenges: (1) increased global demands for skilled workers, (2) significant financial shortfalls, and (3) a looming teacher shortage. Independently, these factors present significant challenges for U.S. schools. In combination, they create a national imperative for swift action to create a…

  9. 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…

  10. 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…

  11. Long-Term Nutrition: A Clinician's Guide to Successful Long-Term Enteral Access in Adults.

    PubMed

    Bechtold, Matthew L; Mir, Fazia A; Boumitri, Christine; Palmer, Lena B; Evans, David C; Kiraly, Laszlo N; Nguyen, Douglas L

    2016-09-22

    Long-term nutrition support requires long-term enteral access. To ensure the success of long-term enteral access, many factors need to be taken into consideration. This article represents a guide to placing and maintaining access in patients requiring long-term nutrition and addresses many of the common questions regarding long-term enteral access, such as indications, types of access, feeding after access placed, and recognition and treatment of potential complications. This guide will help the clinician establish and maintain access to maximize nutrition in patients requiring long-term nutrition.

  12. 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 ...

  13. 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…

  14. 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...

  15. 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…

  16. Paying for long-term care.

    PubMed Central

    Estes, C L; Bodenheimer, T

    1994-01-01

    Everyone agrees that insurance for long-term care is inadequate in the United States. Disagreement exists, however, on whether such insurance should be provided through the private or public sector. Private insurance generally uses the experience-rating principle that persons with higher risk of illness are charged higher premiums. For private insurance for long-term care, this principle creates a dilemma. Most policies will be purchased by the elderly; yet, because the elderly have a high risk of needing long-term care, only about 20% of them can afford the cost of premiums. A public-private partnership by which the government partially subsidizes private long-term-care insurance is unlikely to resolve this dilemma. Only a social insurance program for long-term care can provide universal, affordable, and equitable coverage. PMID:8128712

  17. Preparation of Main-Chain Polymers Based on Novel Monomers with D-π-A Structure for Application in Organic Second-Order Nonlinear Optical Materials with Good Long-Term Stability.

    PubMed

    Ouyang, Canbin; Liu, Jialei; Liu, Qi; Li, Yuan; Yan, Dongdong; Wang, Qiuxia; Guo, Meixia; Cao, Aocheng

    2017-03-29

    Main-chain nonlinear optical polymers based on novel chromophores with special structures presented good solubility in most of the organic solvents. Polymers PE-1 and PE-2 attained the thermal decomposition temperatures of 305 and 223 °C and glass transition temperatures of 113 and 108 °C, and exhibited only negligible decay in the SHG signal baked at 85 °C over hundreds of hours, respectively. The SHG coefficients of poled films from polymers PE-1 and PE-2 were 26.3 and 35.8 pm/V, respectively. These results indicated that this class of polymers can be used in the preparation of organic electro-optic devices.

  18. Relation between plaque progression and low-density lipoprotein cholesterol during aging as assessed with serial long-term (> or =12 months) follow-up intravascular ultrasound of the left main coronary artery.

    PubMed

    Hartmann, Marc; von Birgelen, Clemens; Mintz, Gary S; van Houwelingen, Gert K; Eggebrecht, Holger; Böse, Dirk; Wieneke, Heinrich; Verhorst, Patrick M J; Erbel, Raimund

    2006-12-01

    Because of the clinical benefit of lipid lowering in older patients, we hypothesized that the relation between low-density lipoprotein (LDL) cholesterol serum levels and coronary plaque progression may persist throughout aging. We analyzed serial intravascular ultrasound (IVUS) data of 60 left main stems (18 +/- 9 months apart) and evaluated the relation between LDL cholesterol levels and coronary plaque progression at different ages. The population (n = 60) was divided into 3 groups according to age: tertile 1 (n = 20) was a mean age of 48 +/- 6 years (median 51, range 33 to 55), tertile 2 (n = 20) was a mean age of 58 +/- 2 years (median 59, range 55 to 61), and tertile 3 (n = 20) was a mean age of 66 +/- 6 years (median 65, range 61 to 83). Between groups, there was no significant difference in non-age-related demographics, clinical data, lipid profiles, or medications (e.g., statins). There was a positive linear relation between LDL cholesterol and annual changes in plaque plus media area in all age tertiles, which was statistically significant in tertiles 2 and 3 (r = 0.56, p <0.01; r = 0.50, p <0.02) and showed a strong trend in tertile 1 (r = 0.41, p = 0.07). The estimated LDL cholesterol thresholds, which, as determined by regression analysis, would correspond to no plaque progression, were 74, 60, and 78 mg/dl, respectively, in tertiles 1, 2, and 3. In conclusion, serial IVUS data in left main coronary arteries suggest that the relation between LDL cholesterol serum levels and plaque progression persists during aging.

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

    PubMed Central

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

    2017-01-01

    Objective 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. Design 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. Participants 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. Results 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. Conclusions 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. PMID:28209606

  20. The Long-term Management of Used Nuclear Fuel in Canada: A Geoscientific Prespective

    NASA Astrophysics Data System (ADS)

    Belfadhel, B.

    2009-05-01

    The Nuclear Waste Management Organization (NWMO) is responsible for implementing Adaptive Phased Management, the approach selected by the Government of Canada for long-term management of used nuclear fuel waste generated by Canadian nuclear reactors. In support of this objective, NWMO is pursuing an active technical research and development program in areas such as repository engineering, repository geoscience and repository safety. The geoscience work program is designed to develop a geoscientific basis for understanding long-term geosphere barrier performance, as well as building confidence in deep geological repository safety in both sedimentary and crystalline settings. This is achieved through a multidisciplinary approach involving the coordinated effort of research groups drawn from universities, consultants, and international nuclear waste management organizations. The main objectives of the program are to: develop tools and methods to improve NWMO's geosphere characterization capabilities and develop readiness for evaluating potential candidate sites in willing host communities; advance the understanding of long-term physical and geochemical evolution of the geosphere at time scales relevant to repository safety; and improve numerical methods to assess the geosphere evolution and its response to long-term perturbations. The paper provides an overview of the geoscience issues and challenges associated with the development of deep geological repositories and key activities that the NWMO is pursuing to address them.

  1. 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.

  2. Long-term care of the tracheostomy patient.

    PubMed

    Wright, Shawn E; VanDahm, Kelly

    2003-09-01

    Care of the long-term tracheostomy patient is changing. By moving the initiation of tracheostomy out of the operating room and shifting responsibility for the procedure to the medical specialist, more patients are undergoing tracheostomy for a wider spectrum of diagnoses. With much of the aftercare now directed by the medical specialist, successful reintegration of the long-term tracheostomy patient into a productive life is dependent upon the collaborative care of several disciplines directed by the specialist. To effectively care for these challenging patients, it is critical for the physician who performs tracheostomy to be aware of the new caregiving role that is now theirs.

  3. Long-term visual tracking based on correlation filters

    NASA Astrophysics Data System (ADS)

    Wei, Quanlu; Lao, Songyang; Bai, Liang

    2017-03-01

    In order to accomplish the long term visual tracking task in complex scenes, solve problems of scale variation, appearance variation and tracking failure, a long term tracking algorithm is given based on the framework of collaborative correlation tracking. Firstly, we integrate several powerful features to boost the represent ability based on the kernel correlation filter, and extend the filter by embedding a scale factor into the kernelized matrix to handle the scale variation. Then, we use the Peak-Sidelobe Ratio to decide whether the object is tracked successfully, and a CUR filter for re-detection the object in case of tracking failure is learnt with random sampling. Corresponding experiment is performed on 17 challenging benchmark video sequences. Compared with the 8 existing state-of-the-art algorithms based on discriminative learning method, the results show that the proposed algorithm improves the tracking performance on several indexes, and is robust to complex scenes for long term visual tracking.

  4. Documenting Long-term Earth System Evolution With Satellite Observations

    NASA Astrophysics Data System (ADS)

    Kaye, J. A.; Koblinsky, C. J.; Cramer, B.; Karl, T.; Privette, J. L.

    2007-12-01

    Satellite observations play a critical role in documenting earth system evolution, both in terms of characterizing prior and current evolution of the Earth and providing a baseline against which future measurements can be compared. Given that the construction of the necessary long-term data sets requires the use of multiple instruments on multiple platforms, each of which may have their own characteristics, drifts, and degradation, this represents a significant challenge to the scientific community. Over the last 30-or so years, going back to the launch of the Nimbus 7 in 1978, earth scientists learned significant lessons about how to create accurate and stable long-term data records. Sponsoring agencies have tried to capture the lessons and use them as a basis for planning for future systems. This presentation will examine and present future approaches to maximize the quality of the long-term data records produced from earth satellites.

  5. 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.

  6. 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.

  7. Long-term predictions using natural analogues

    SciTech Connect

    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 directly 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.

  8. 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

  9. Hospital diversification into long-term care.

    PubMed

    Shah, A; Fennell, M; Mor, V

    2001-01-01

    In the 1990s, acute care hospitals in the United States encountered an unstable operating environment created by a series of transformations in the health care delivery system and long-term-care market. Confronted with an array of economic pressures and demographic changes, hospitals were motivated to engage in long-term-care diversification, such as establishing a long-term-care unit or providing home health services, as a means of entering new markets and ensuring financial stability. This article examines the organizational, market, and community factors associated with this strategic activity among a national sample of urban and rural hospitals.

  10. [The development of the long-term care service system in Taiwan].

    PubMed

    Chen, Shu-Fen; Teng, Sue-Wen

    2010-08-01

    The main purpose of this paper was to describe the present status of long-term care promotion in Taiwan and relevant developments. As currently envisioned, the main strategic aims of Taiwan's long-term service system will be to 1) plan and promote regulatory enforcement measures; 2) institute a community-oriented long-term care system for indigenous Malayo-Polynesian citizens living in remote areas and offshore islands; 3) manage the quality of care delivered by long-term care organizations; 4) ensure the availability of adequate professional human resources in long-term care; and 5) deliver appropriate care to the physically and mentally disabled. Executive authorities look to institute and sustain a long-term care system that meets the long-term care requirements of Taiwan.

  11. Long-term stability test of a triple GEM detector

    NASA Astrophysics Data System (ADS)

    Adak, R. P.; Biswas, S.; Das, S.; Ghosal, D.; Ghosh, S. K.; Mondal, A.; Nag, D.; Nayak, T. K.; Patra, R. N.; Prasad, S. K.; Raha, S.; Sahu, P. K.; Sahu, S.; Swain, S.

    2016-10-01

    The main aim of the study is to perform the long-term stability test of gain of the single mask triple GEM detector. A simple method is used for this long-term stability test using a radioactive X-ray source with high activity. The test is continued till accumulation of charge per unit area > 12.0 mC/mm2. The details of the chamber fabrication, the test set-up, the method of measurement and the test results are presented in this paper.

  12. Long Term Effects of Food Poisoning

    MedlinePlus

    ... develop chronic arthritis. Brain and nerve damage A Listeria infection can lead to meningitis, an inflammation of ... brain. If a newborn infant is infected with Listeria , long-term consequences may include mental retardation, seizures, ...

  13. Mental Health in Long Term Care Settings.

    ERIC Educational Resources Information Center

    Shore, Herbert

    1978-01-01

    There are many ways in which long-term care facilities attempt to cope with the mental health problems of the elderly. The author reviews five factors crucial to effective care for the aged in these facilities. (Author/RK)

  14. Roadmap to Long-Term Monitoring Optimization

    EPA Pesticide Factsheets

    This roadmap focuses on optimization of established long-term monitoring programs for groundwater. Tools and techniques discussed concentrate on methods for optimizing the monitoring frequency and spatial (three-dimensional) distribution of wells ...

  15. Long-term-care legal update.

    PubMed

    Fiesta, J

    1998-04-01

    As more nurses move from the acute care setting to long-term-care and home health care, different practice issues arise. To maximize liability protection, nurses must understand the legal issues unique to each delivery system.

  16. NAEP Trends: Main NAEP vs. Long-Term Trend

    ERIC Educational Resources Information Center

    Beaton, Albert E.; Chromy, James R.

    2010-01-01

    The objectives of this research are to (a) compare the trend lines after some adjustments for level and scale only and determine if and how they differ; (b) describe the methodology of each assessment and identify similarities and differences; and (c) attempt to explain any observed differences based on comparable subsets or on special analysis.…

  17. Evidence-based long term care design.

    PubMed

    Calkins, Margaret P

    2009-01-01

    Research on the impact of the built environment in long-term care settings continues to grow. This article focuses on work conducted and published since 2000, when an earlier review on research on dementia and design was published. The vast majority of research that addressed neurological conditions in residents in long-term care settings (assisted living and nursing homes) relates to Alzheimer's disease and related dementias.

  18. Long Term Outcomes after Pediatric Liver Transplantation

    PubMed Central

    2013-01-01

    Long term outcomes after liver transplantation are major determinants of quality of life and of the value of this heroic treatment. As short term outcomes are excellent, our community is turning to take a harder look at long term outcomes. The purpose of this paper is to review these outcomes, and highlight proposed treatments, as well as pressing topics needing to be studied. A systemic review of the English literature was carried in PubMed, covering all papers addressing long term outcomes in pediatric liver transplant from 2000-2013. Late outcomes after pediatric liver transplant affect the liver graft in the form of chronic liver dysfunction. The causes include rejection particularly humoral rejection, but also de novo autoimmune hepatitis, and recurrent disease. The metabolic syndrome is a major factor in long term cardiovascular complication risk. Secondary infections, kidney dysfunction and malignancy remain a reality of those patients. There is growing evidence of late cognitive and executive function delays affecting daily life productivity as well as likely adherence. Finally, despite a good health status, quality of life measures are comparable to those of children with chronic diseases. Long term outcomes are the new frontier in pediatric liver transplantation. Much is needed to improve graft survival, but also to avoid systemic morbidities from long term immunosuppression. Quality of life is a new inclusive measure that will require interventions and innovative approaches respectful not only on the patients but also of their social circle. PMID:24511516

  19. Long-term symptom relief after septoplasty.

    PubMed

    Sundh, Carolina; Sunnergren, Ola

    2015-10-01

    The results for long-term symptom relief after septoplasty are contradictory in reviewed publications but the findings suggest that results are unsatisfactory. In this study, we analyzed and compared short- and long-term symptom relief after septoplasty and factors possibly associated with symptom relief. 111 patients that underwent septoplasty between 2008 and 2010 were included in the study. Medical charts were reviewed for preoperative characteristics and assessments. Data on short-term symptom relief (6 months) were retrieved from the Swedish National Quality Registry for Septoplasty; data on long-term symptom relief (34-70 months) were collected through a questionnaire. Upon the 34-70 month follow-up, 53% of the patients reported that symptoms either remained or had worsened and 83% reported nasal obstruction. Degree of symptom relief was significantly higher among patients not reporting nasal obstruction than among patients reporting nasal obstruction at long-term follow-up. The proportion of patients that reported "my symptoms are gone" declined from 53% after 6 months to 18% after 34-70 months. None of the factors taken into consideration, age at surgery, gender, follow-up time, primary operation/reoperation, history of nasal trauma, self-reported allergy, rhinometric obstruction, or same sided rhinometric, clinical and subjective nasal obstruction were associated with symptom relief. The long-term results after septoplasty are unsatisfactory. A majority of patients report that their symptoms remain after septoplasty.

  20. 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.

  1. Long-term outcomes of autoimmune pancreatitis

    PubMed Central

    Ikeura, Tsukasa; Miyoshi, Hideaki; Shimatani, Masaaki; Uchida, Kazushige; Takaoka, Makoto; Okazaki, Kazuichi

    2016-01-01

    Autoimmune pancreatitis (AIP) has been considered a favorable-prognosis disease; however, currently, there is limited information on natural course of AIP during long-term follow-up. Recently published studies regarding the long-term outcomes of AIP has demonstrated the developments of pancreatic stone formation, exocrine insufficiency, and endocrine insufficiency are observed in 5%-41%, 34%-82%, and 38%-57% of patients having the disease. Furthermore, the incidence rate of developing pancreatic cancer ranges from 0% to 4.8% during the long-term follow-up. The event of death from AIP-related complications other than accompanying cancer is likely to be rare. During follow-up of AIP patients, careful surveillance for not only relapse of the disease but also development of complications at regular intervals is needed. PMID:27678359

  2. 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…

  3. 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.

  4. Keratoprosthesis: a long-term review.

    PubMed Central

    Barnham, J. J.; Roper-Hall, M. J.

    1983-01-01

    A keratoprosthesis (KP), is an artificial cornea which is inserted into an opacified cornea in an attempt to restore useful vision or, less commonly, to make the eye comfortable in painful keratopathy. Results o a retrospective study of 35 patients, with 55 KP insertions, are reviewed with regard to visual acuity, length of time vision is maintained, retention time, and complication. Overall there were a number of long-term real successes, eith retention of the KP and maintenance of improved vision in eyes not amenable to conventional treatment. Careful long-term follow-up was needed, with further surgical procedures often being necessary. Images PMID:6860613

  5. Long-term Outcomes after Severe Shock

    PubMed Central

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

    2014-01-01

    Background 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. Methods Seventy-six patients who were alive 90 days after severe shock (received ≥1 mcg/kg/min of norepinephrine equivalent) were eligible for the study. We measured three-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. Results The mean long-term survival was 5.1 years: 82% (62/76) 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 five years after hospital admission. The patients’ Physical Functioning scores were below US 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. Conclusions Early survivors of severe shock had a high three-year survival rate. Patients’ long term physical and psychological outcomes were similar to those reported for cohorts of less severely ill ICU 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

  6. [Fetal pain: immediate and long term consequences].

    PubMed

    Houfflin Debarge, Véronique; Dutriez, Isabelle; Pusniak, Benoit; Delarue, Eléonore; Storme, Laurent

    2010-06-01

    Several situations are potentially painful for fetuses, such as malformations and invasive procedures. Nociceptive pathways are known to be functional at 26 weeks. Even if it is not possible to evaluate the fetal experience of pain, it is essential to examine its immediate and long-term consequences. As early as the beginning of the second trimester, hemodynamic and hormonal responses are observed following fetal nociceptive stimulation, In experimental studies, long-term changes have been noted in the corticotrop axis, subsequent responses to pain, and behavior after perinatal nociceptive stimulation.

  7. 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

  8. 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

  9. Long Term Treatment Concepts and Proactive Therapy for Atopic Eczema

    PubMed Central

    Ehmann, Laura Maximiliane

    2012-01-01

    Atopic eczema, also known as atopic dermatitis, is a frequent, highly pruritic, chronic skin disease, which is typically running in flares. The traditional treatment mainly consists of the reactive application of topical anti-inflammatory agents such as topical corticosteroids and topical calcineurin inhibitors. The short term benefit of this approach is well known, but long term remission between flares is difficult to achieve. Therefore, innovative long-term treatment strategies targeting flare prevention and skin barrier stabilization are needed. We and others have shown that normal looking, non-lesional skin of atopic dermatitis patients is immunobiologially not normal but characterized by an invisible inflammation and barrier defect. This has led to the novel concept of proactive therapy, which is defined as long-term, low-dose intermittent application of anti-inflammatory therapy to the previously affected skin, together with an ongoing emollient treatment of unaffected skin. This review article describes the most important long-term treatment options for atopic dermatitis, which includes emollient therapy, the novel concept of proactive treatment, the different ultraviolet light modalities and a selection of systemic immunosuppressive drugs and biologics. Current trial data, licensed indications, off-label use and relevant side effects of the different treatment modalities are summarized. PMID:22879707

  10. 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…

  11. 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…

  12. Professionalism in Long-Term Care Settings

    ERIC Educational Resources Information Center

    Lubinski, Rosemary

    2006-01-01

    Speech-language pathologists who serve elders in a variety of long-term care settings have a variety of professional skills and responsibilities. Fundamental to quality service is knowledge of aging and communication changes and disorders associated with this process, institutional alternatives, and the changing nature of today's elders in…

  13. Long-Term Impacts of Educational Interventions

    ERIC Educational Resources Information Center

    Deming, David James

    2010-01-01

    The school accountability movement has led to a marked increase in the use of standardized test scores to measure school and teacher productivity, yet little is known about the correlation between test score gains and improvements in long-term outcomes. In the first chapter of my dissertation, I study the impact of a school choice policy in…

  14. 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.

  15. Long Term Care Aide. Course Outline.

    ERIC Educational Resources Information Center

    Wilbee, Judy

    This course outline is intended to assist the instructor in the development of a curriculum for a long-term care aide program by specifying one component of the curriculum--the objectives. These objectives, or competencies expected as outcomes for student performance on completion of the program, describe the capabilities an individual must…

  16. Long-term lysimeter data on evapotranspiration

    USDA-ARS?s Scientific Manuscript database

    Long term crop evapotranspiration (ET) data measured using large weighing lysimeters have only been gathered in a few places in the world, yet are of great importance for ground truthing of many models of plant water use, mesoscale climate, remote sensing estimation of ET, climate change and climate...

  17. Who Recommends Long-Term Care Matters

    ERIC Educational Resources Information Center

    Kane, Robert L.; Bershadsky, Boris; Bershadsky, Julie

    2006-01-01

    Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we…

  18. Professionalism in Long-Term Care Settings

    ERIC Educational Resources Information Center

    Lubinski, Rosemary

    2006-01-01

    Speech-language pathologists who serve elders in a variety of long-term care settings have a variety of professional skills and responsibilities. Fundamental to quality service is knowledge of aging and communication changes and disorders associated with this process, institutional alternatives, and the changing nature of today's elders in…

  19. Evaluating Long-Term Disability Insurance Plans.

    ERIC Educational Resources Information Center

    Powell, Jan

    1992-01-01

    This report analyzes the factors involved in reviewing benefits and services of employer-sponsored group long-term disability plans for higher education institutions. Opening sections describe the evolution of disability insurance and its shape today. Further sections looks at the complex nature of "value" within a plan, relationship…

  20. LONG TERM HYDROLOGICAL IMPACT ASSESSMENT (LTHIA)

    EPA Science Inventory

    LTHIA is a universal Urban Sprawl analysis tool that is available to all at no charge through the Internet. It estimates impacts on runoff, recharge and nonpoint source pollution resulting from past or proposed land use changes. It gives long-term average annual runoff for a lan...

  1. Long-Term Stability of Tutor Performance.

    ERIC Educational Resources Information Center

    Dolmans, Diana H. J. M.; And Others

    1996-01-01

    Examined the extent to which tutor ratings remained stable in the long term by evaluating 291 ratings of 140 tutors at Maastricht University in the Netherlands between 1992 and 1995. The results indicated that, if the aggregated score and overall judgement are used to interpret the precision of individual scores, four and two occasions,…

  2. Urethroplasty for hypospadias: long-term results.

    PubMed

    Glassman, C N; Machlus, B J; Kelalis, P P

    1980-06-01

    A retrospective study of patients who had undergone multi-staged hypospadias repair at the Mayo Clinic was undertaken to identify long-term problems associated with this surgery. Patients were queried concerning their satisfaction with quality of urinary stream; penile erection and ejaculation; sexual function and fertility; and cosmetic appearance.

  3. LONG TERM HYDROLOGICAL IMPACT ASSESSMENT (LTHIA)

    EPA Science Inventory

    LTHIA is a universal Urban Sprawl analysis tool that is available to all at no charge through the Internet. It estimates impacts on runoff, recharge and nonpoint source pollution resulting from past or proposed land use changes. It gives long-term average annual runoff for a lan...

  4. Very Long Term Memory for Tacit Knowledge.

    ERIC Educational Resources Information Center

    Allen, Rhianon; Reber, Arthur S.

    1980-01-01

    Very long-term memory for abstract materials was examined for subjects who had served in a synthetic grammar learning experiment two years earlier. Knowledge of these grammars was retained. The form and structure of knowledge and the manner in which it is put to use remained similar to the original. (Author/RD)

  5. Long-term opioid therapy reconsidered.

    PubMed

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

    2011-09-06

    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.

  6. Long-term fixed income market structure

    NASA Astrophysics Data System (ADS)

    Grilli, Luca

    2004-02-01

    Long-term fixed income market securities present a strong positive correlation in daily returns. By using a metrical approach and considering “modified” time series, I show how it is possible to show a more complex structure which depends strictly on the maturity date.

  7. Long-term function after restorative proctocolectomy.

    PubMed

    Wheeler, J M D; Banerjee, A; Ahuja, N; Jewell, D P; Mortensen, N J McC

    2005-05-01

    Early functional outcome after restorative proctocolectomy and formation of an ileoanal pouch is known to be good, but there are minimal data on the long-term function of the pouch. The aim of this study was to look at the long-term functional outcome in patients who had undergone restorative proctocolectomy and formation of an ileoanal pouch. A total of 151 consecutive patients (96 males, 55 females) who underwent ileoanal pouch surgery between April 1983 and May 1993 were identified. Functional outcomes from the previous 12 months were appraised by a standardized questionnaire. The median age at surgery was 31 years (range, 6-63 years), with a median follow-up of 142 months (range, 100-221 months). Eighteen patients have had their pouches excised, with another patient being defunctioned. Therefore 19 patients (13 percent) had suffered pouch failure. Altogether, 115 patients were available for follow-up, and 98 patients (85 percent) returned questionnaires. The median pouch-emptying frequency was five times (range, 1-17) during the day and one time (range, 0-6) at night. A total of 74 percent of patients had perfect continence during the day. Most of the patients had no life-style restrictions related to the pouch, and 98 percent of patients would recommend a pouch to others. Long-term functional outcome after ileoanal pouch surgery is good in most patients. For patients requiring proctocolectomy, ileoanal pouch surgery can now be recommended as an excellent long-term option.

  8. Long-Term Impacts of Educational Interventions

    ERIC Educational Resources Information Center

    Deming, David James

    2010-01-01

    The school accountability movement has led to a marked increase in the use of standardized test scores to measure school and teacher productivity, yet little is known about the correlation between test score gains and improvements in long-term outcomes. In the first chapter of my dissertation, I study the impact of a school choice policy in…

  9. Long-Term Stability of Tutor Performance.

    ERIC Educational Resources Information Center

    Dolmans, Diana H. J. M.; And Others

    1996-01-01

    Examined the extent to which tutor ratings remained stable in the long term by evaluating 291 ratings of 140 tutors at Maastricht University in the Netherlands between 1992 and 1995. The results indicated that, if the aggregated score and overall judgement are used to interpret the precision of individual scores, four and two occasions,…

  10. Who Recommends Long-Term Care Matters

    ERIC Educational Resources Information Center

    Kane, Robert L.; Bershadsky, Boris; Bershadsky, Julie

    2006-01-01

    Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we…

  11. Long-term disability in anxiety disorders.

    PubMed

    Hendriks, Sanne M; Spijker, Jan; Licht, Carmilla M M; Hardeveld, Florian; de Graaf, Ron; Batelaan, Neeltje M; Penninx, Brenda W J H; Beekman, Aartjan T F

    2016-07-19

    This longitudinal study aims to investigate differences in long-term disability between social anxiety disorder (SAD), panic disorder with agoraphobia (PDA), panic disorder without agoraphobia (PD), generalized anxiety disorder (GAD) and multiple anxiety disorders (multiple AD), focusing on the effects of different course trajectories (remission, recurrence and chronic course) and specific symptom dimensions (anxiety arousal and avoidance behaviour). Data were used from participants with no psychiatric diagnosis (healthy controls, n = 647) or with a current anxiety disorder (SAD, n = 191; PDA, n = 90; PD, n = 84; GAD, n = 110; multiple AD, n = 480). Severity of anxiety arousal and avoidance behaviour symptoms was measured using the Beck Anxiety Inventory and the Fear Questionnaire. The World Health Organization Disability Assessment Schedule II was used to measure disability. Long-term disability was most prevalent in participants with SAD and multiple AD, and lowest in PDA and PD. GAD had an intermediate position. Anxiety arousal and avoidance behaviour were associated with more long-term disability in anxiety disorders than course trajectories. Various anxiety disorders have different disability levels over 4 years of time, therefore diagnostic distinction is important for treatment focus. Anxiety arousal and avoidance behaviour are major predictors for long-term disability in anxiety disorders.

  12. Long-Term Stability of Social Participation

    ERIC Educational Resources Information Center

    Hyyppa, Markku T.; Maki, Juhani; Alanen, Erkki; Impivaara, Olli; Aromaa, Arpo

    2008-01-01

    The long-term stability of social participation was investigated in a representative urban population of 415 men and 579 women who had taken part in the nationwide Mini-Finland Health Survey in the years 1978-1980 and were re-examined 20 years later. Stability was assessed by means of the following tracking coefficients: kappa, proportion of…

  13. Long-Term Care Research and Policy

    ERIC Educational Resources Information Center

    Kemper, Peter

    2003-01-01

    This article provides a framework for understanding how long-term care (LTC) research contributes to policy, develops a typology of research contributions to policy with examples of each type, and suggests ways to ensure that contributions continue in the future. The article draws on in-depth interviews with LTC experts working at the interface…

  14. The long term characteristics of greenschist

    NASA Astrophysics Data System (ADS)

    Jang, Bo-An

    2016-04-01

    The greenschist in the Jinping II Hydropower Station in southwest China exhibits continuous creep behaviour because of the geological conditions in the region. This phenomenon illustrates the time-dependent deformation and progressive damage that occurs after excavation. In this study, the responses of greenschist to stress over time were determined in a series of laboratory tests on samples collected from the access tunnel walls at the construction site. The results showed that the greenschist presented time-dependent behaviour under long-term loading. The samples generally experienced two stages: transient creep and steady creep, but no accelerating creep. The periods of transient creep and steady creep increased with increasing stress levels. The long-term strength of the greenschist was identified based on the variation of creep strain and creep rate. The ratio of long-term strength to conventional strength was around 80% and did not vary much with confining pressures. A quantitative method for predicting the failure period of greenschist, based on analysis of the stress-strain curve, is presented and implemented. At a confining pressure of 40 MPa, greenschist was predicted to fail in 5000 days under a stress of 290 MPa and to fail in 85 days under the stress of 320 MPa, indicating that the long-term strength identified by the creep rate and creep strain is a reliable estimate.

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

    PubMed

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

    2016-01-01

    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. 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. 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. 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 experienced by temporary economic

  16. 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

  17. Long-term effect of maternal obesity on pancreatic beta cells of offspring: reduced beta cell adaptation to high glucose and high-fat diet challenges in adult female mouse offspring.

    PubMed

    Han, J; Xu, J; Epstein, P N; Liu, Y Qi

    2005-09-01

    Obesity is a global problem with high risks of cardiovascular diseases, stroke and type 2 diabetes. It is well known that maternal obesity affects offspring by inducing malformation, functional abnormalities in many organs and cells, and by increased risk of obesity and type 2 diabetes. However, little is known about abnormalities induced by maternal obesity in pancreatic beta cells of offspring. We used mouse mothers with the Agouti yellow modification on a C57BL/6 background as a maternal model of normoglycaemic obesity, and produced Agouti-negative offspring. Half of the offspring were fed a high-fat diet. Offspring glucose tolerance was tested at different ages, and animals were killed at 50 weeks of age for islet function analysis. Maternal obesity impaired glucose tolerance in female offspring fed a high-fat diet, and significantly reduced insulin secretion at 50 weeks of age in female offspring that had been fed a normal diet and high-fat diet. Insulin secretion and glucose potentiation from these islets were significantly reduced. Islet protein, DNA and insulin contents were increased while glyceraldehyde-3-phosphate dehydrogenase and transketolase activities were reduced in female offspring. Our results indicate that maternal obesity has a long-term effect on the beta cells of female, but not of male, offspring, and leads to increased risk of gestational diabetes and type 2 diabetes in the offspring's later lives.

  18. 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...

  19. 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...

  20. Workshop on long-term contraceptives.

    PubMed

    1996-01-01

    The National Population Council Secretariat (NPCS) of Ghana held a three-day workshop on long-term contraceptives in 1996 in collaboration with the Ministry of Health, the Association of Voluntary Surgical Contraception, and the Johns Hopkins Population Communication Services. The session was funded by USAID. The executive director of NPCS, Dr. Richard Turkson, said that the slow rate of contraceptive acceptance was an obstacle to population control despite political concern that rapid population growth exerted an adverse impact on the economy. Only 10% of married women were using long-term or permanent methods of contraception. The hope was voiced that the participants would devise practical and cost-effective education, information, and communication (IEC) strategies to boost the demand for long-term contraceptive methods among sexually active people in Ghana. It was essential that these strategies and activities were based on a realist assessment of the demographic and social situation of the country. The examination of case studies in cultures similar to Ghana would also offer valuable lessons. The factors that hinder the acceptance of long-term methods include misconceptions, myths, and false rumors rooted in a general lack of knowledge among the people. Participants were urged to come up with strategies to counter these problems, and service providers were encouraged to improve their knowledge about contraceptive methods and counseling skills. Male involvement in contraception was also advocated. Statistics show that most Ghanians practicing contraception were using short-term methods such as foaming tablets, pills, and condoms. However, it is necessary to shift to long-term methods such as injectables, implants, and sterilization in order to achieve significant reductions in fertility.

  1. 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.

  2. 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.

  3. Waste transmutation with minimal fuel cycle long-term risk

    SciTech Connect

    Slessarev, I.; Salvatores, M.; Uematsu, M.

    1995-10-01

    Hybrid systems (source-driven subcritical reactors), are investigated at CEA, mainly from a conceptual point of view, in order to assess their potential to transmute radioactive wastes (mainly long-lived fission products, LLFP) and their potential to insure a minimal long-term radiological risk related both to the fuel inventory inside the system and to the full fuel cycle (mass flows, reprocessing transport, waste disposal). The physics of these systems has been explored and work is in progress both in the field of basic data and INC code validation, in the frame of international collaborations and in the field of conceptual design studies. The most interesting feature of subcritical source-driven system is related to the possibility to obtain an {open_quotes}excess{close_quotes} of neutrons per fission, which can be used to reduce the long-term radiological risk. A specific example will be discussed here.

  4. Long term prediction and the SSC (Superconducting Super Collider)

    SciTech Connect

    Talman, R.

    1990-09-01

    Successful operation of the Superconducting Supercollider (SSC) will depend on the stable circulation of particles for tens of millions of turns around the rings, in the presence of small nonlinear deflecting fields. One design challenge is to set specifications for the maximum allowable field imperfections of this sort, consistent with the required. stability. Another challenge is to plan for the inclusion of field compensating elements that will ameliorate the effects of errors. The tools'' available for projecting the long term stability are theoretical, both analytic and numerical, and experimental. These aspects are reviewed. 19 refs.

  5. Long-term storage of surface-adsorbed protein machines.

    PubMed

    Albet-Torres, Nuria; Månsson, Alf

    2011-06-07

    The effective and simple long-term storage of complex functional proteins is critical in achieving commercially viable biosensors. This issue is particularly challenging in recently proposed types of nanobiosensors, where molecular-motor-driven transportation substitutes microfluidics and forms the basis for novel detection schemes. Importantly, therefore, we here describe that delicate heavy meromyosin (HMM)-based nanodevices (HMM motor fragments adsorbed to silanized surfaces and actin bound to HMM) fully maintain their function when stored at -20 °C for more than a month. The mechanisms for the excellent preservation of acto-HMM motor function upon repeated freeze-thaw cycles are discussed. The results are important to the future commercial implementation of motor-based nanodevices and are of more general value to the long-term storage of any protein-based bionanodevice.

  6. Pneumonia in nursing homes and long-term care facilities.

    PubMed

    Loeb, Mark B

    2005-12-01

    This article reviews the epidemiology of pneumonia in residents of nursing homes and other long-term care facilities (LTCFs). Streptococcus pneumoniae is the most important cause of pneumonia in residents of nursing homes and LTCFs. Factors suggestive of aspiration are the most important risk factors for pneumonia in this population. The clinical presentation of pneumonia among long-term care facility residents is challenging; residents tend to be older and more debilitated than their elderly community-dwelling counterparts. Data on optimal antimicrobial therapy in this setting is sparse. Functional status is an important predictor of outcome in this population. There are key management issues, such as site of care, which remain unresolved. Immunization with influenza and pneumococcal vaccines remains the mainstay of prevention.

  7. Long-term follow-up of congenital diaphragmatic hernia.

    PubMed

    Hollinger, Laura E; Harting, Matthew T; Lally, Kevin P

    2017-06-01

    Increased survival of patients with congenital diaphragmatic hernia has created a unique cohort of children, adolescent, and adult survivors with complex medical and surgical needs. Disease-specific morbidities offer the opportunity for multiple disciplines to unite together to provide long-term comprehensive follow-up, as well as an opportunity for research regarding late outcomes. These children can exhibit impaired pulmonary function, altered neurodevelopmental outcomes, nutritional insufficiency, musculoskeletal changes, and specialized surgical needs that benefit from regular monitoring and intervention, particularly in patients with increased disease severity. Below we aim to characterize the specific challenges that these survivors face as well as present an algorithm for a multidisciplinary long-term follow-up program. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Tinzaparin for Long-Term Treatment of Venous Thromboembolism in Patients With Cancer.

    PubMed

    Martínez-Zapata, M José; Mathioudakis, Alexander G; Mousa, Shaker A; Bauersachs, Rupert

    2017-01-01

    Patients with cancer are at increased risk of recurrent venous thromboembolism (VTE) and bleeding. Thus, long-term treatment with anticoagulants for secondary prevention is challenging. The objective of this review was to evaluate current evidence on the safety and efficacy of tinzaparin compared with other anticoagulants for long-term VTE treatment in patients with cancer. Based on a preregistered protocol, we identified randomized controlled trials (RCTs) comparing long-term tinzaparin (therapeutic dose: 175 IU/kg) versus other anticoagulants for at least 3 months after an acute episode of VTE that included adult patients with underlying malignancy. We extracted predefined, clinically relevant outcomes of patients with cancer and, using standard methodology, pooled available data and assessed risk of bias and quality of evidence for each study. Three open-label RCTs evaluating 1169 patients with cancer were included in the analysis. Tinzaparin was associated with a significantly lower risk of recurrent VTE at the end of treatment (relative risk [RR], [95% confidence interval] 0.67 [0.46-0.99]) and at longest follow-up (RR: 0.58 [0.39-0.88]) and showed a lower risk of clinically relevant non-major bleeding at the end of treatment (RR: 0.71 [0.51-1.00]). No significant between-treatment differences were found for all-cause mortality (RR: 1.09 [0.91-1.30]) or fatal and non-fatal major bleeding events (RR: 1.06 [0.56-1.99]). The overall quality of evidence was deemed moderate, mainly due to small sample size in 2 of the studies and limited number of events in the meta-analyses. In conclusion, both short- and long-term treatments with tinzaparin were found to be superior to vitamin K antagonists for avoiding recurrences of VTE.

  9. Long-term consequences of foodborne infections.

    PubMed

    Batz, Michael B; Henke, Evan; Kowalcyk, Barbara

    2013-09-01

    Foodborne infections with Campylobacter, E. coli O157:H7, Listeria monocytogenes, Salmonella, Shigella, Toxoplasma gondii, and other pathogens can result in long-term sequelae to numerous organ systems. These include irritable bowel syndrome, inflammatory bowel disease, reactive arthritis, hemolytic uremic syndrome, chronic kidney disease, Guillain-Barré Syndrome, neurological disorders from acquired and congenital listeriosis and toxoplasmosis, and cognitive and developmental deficits due to diarrheal malnutrition or severe acute illness. A full understanding of the long-term sequelae of foodborne infection is important both for individual patient management by clinicians, as well as to inform food safety and public health decision making. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Case presentation: long-term treatment.

    PubMed

    Glucksman, Myron L

    2013-01-01

    The long-term (14 years) psychodynamic psychotherapy and pharmacotherapy of a depressed, suicidal, self-mutilating female patient is described. Her diagnoses included Chronic Posttraumatic Stress Disorder, Borderline Personality Disorder, and Recurrent Major Depression. Treatment was punctuated with repeated hospitalizations for self-mutilation (cutting) and suicidal ideation. A major determinant for her psychopathology was sexual abuse by her father from ages 6 to 14. This resulted in feelings of guilt and rage that she repressed and acted out through self-mutilating and suicidal behavior. A prolonged negative transference gradually became ambivalent, then positive. This was associated with her internalization of the healing qualities of the therapeutic relationship. She also gained insight into the reasons for her need to punish herself. Her initial self-representation as unworthy and bad was transformed into perceiving herself as a worthwhile, loving person. This case illustrates the role of long-term treatment for a complex, life-threatening, psychiatric disorder.

  11. Modeling long-term collider performance

    SciTech Connect

    Ritson, D. Superconducting Super Collider Lab., Dallas, TX )

    1991-07-01

    A model for the SSC arcs is described with multipole lattice field errors agglomerated into 32 lattice points, and with first order lattice errors and modulation provided by discrete transfer elements. Numerical solutions for long term dynamic aperture studies are obtained by multipole kick-drift tracking. The CPU time required to track through one turn is minimal, and comparable to that required to implement a one-turn fifth-order Taylor series map. Comparisons with tracking results using a fine grained representation of the lattice are made, and found to be satisfactory. The effects of tune modulation are studied and can substantially degrade long-term dynamic aperture. The effects of small relativistic momentum corrections, usually neglected for the large momenta at the SSC, are shown to have negligible influence on tracking results. 5 refs., 7 figs.

  12. [Ambulatory long-term EEG monitors].

    PubMed

    John, K; Komärek, V; Lehovský, M

    1990-06-01

    Ambulatory EEG monitoring is indicated in patients with attacks of uncertain origin. The method is useful to distinguish non-epileptic and epileptic attacks and to differentiate the kind of epileptic seizures which is important for the choice of antiepileptic drugs and for prognosis. It is necessary to describe in detail behaviour and seizures of patient during monitoring. EEG long term monitoring is only useful if attacks were seen frequently, at least once or twice a week.

  13. LOP - Long-Term Orbit Predictor

    NASA Technical Reports Server (NTRS)

    Kwok, Johnny H.

    1992-01-01

    Long-Term Orbit Preditor (LOP) trajectory-propagation computer program is useful tool in analysis of lifetime of orbiting spacecraft. Suitable for studying planetary-orbit missions with reconnaissance (flyby) and exploratory (mapping) trajectories. Includes sample data for study of drift cycle of geosynchronous station, strategy for radar mapping of Venus, frozen orbit about Mars, and orbit characterized by repeating ground trace. Executed faster than such programs based on Cowell's method. Written in FORTRAN 77.

  14. Long term economic relationships from cointegration maps

    NASA Astrophysics Data System (ADS)

    Vicente, Renato; Pereira, Carlos de B.; Leite, Vitor B. P.; Caticha, Nestor

    2007-07-01

    We employ the Bayesian framework to define a cointegration measure aimed to represent long term relationships between time series. For visualization of these relationships we introduce a dissimilarity matrix and a map based on the sorting points into neighborhoods (SPIN) technique, which has been previously used to analyze large data sets from DNA arrays. We exemplify the technique in three data sets: US interest rates (USIR), monthly inflation rates and gross domestic product (GDP) growth rates.

  15. Breakthroughs in long term care design.

    PubMed

    Hiatt, L

    1991-01-01

    In summary, here is what design is trying to accomplish in long term care facilities: Functional access; Privacy as entitlement; Sensory optimization to improve vision and hearing; Reduced walking and wheeling distances that still allow people to be mobile; Effective or functional placement of space and equipment; The option of smaller scale, so neither residents nor staff feel like they are hanging out with a unit full of, perhaps 68, people all the time; Flexibility and adaptability

  16. 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.

  17. 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

  18. Electrodes for long-term esophageal electrocardiography.

    PubMed

    Niederhauser, Thomas; Haeberlin, Andreas; Marisa, Thanks; Jungo, Michael; Goette, Josef; Jacomet, Marcel; Abacherli, Roger; Vogel, Rolf

    2013-09-01

    The emerging application of long-term and high-quality ECG recording requires alternative electrodes to improve the signal quality and recording capability of surface skin electrodes. The esophageal ECG has the potential to overcome these limitations but necessitates novel recorder and lead designs. The electrode material is of particular interest, since the material has to ensure conflicting requirements like excellent biopotential recording properties and inertness. To this end, novel electrode materials like PEDOT and silver-PDMS as well as established electrode materials such as stainless steel, platinum, gold, iridium oxide, titanium nitride, and glassy carbon were investigated by long-term electrochemical impedance spectroscopy and model-based signal analysis using the derived in vitro interfacial properties in conjunction with a dedicated ECG amplifier. The results of this novel approach show that titanium nitride and iridium oxide featuring microstructured surfaces did not degrade when exposed to artificial acidic saliva. These materials provide low electrode potential drifts and insignificant signal distortion superior to surface skin electrodes making them compatible with accepted standards for ambulatory ECG. They are superior to the noble and polarizable metals such as platinum, silver, and gold that induced more signal distortions and are superior to esophageal stainless steel electrodes that corrode in artificial saliva. The study provides rigorous criteria for the selection of electrode materials for prolonged ECG recording by combining long-term in vitro electrode material properties with ECG signal quality assessment.

  19. Long term therapy of generalized anxiety disorder.

    PubMed

    Rouillon, Frédéric

    2004-04-01

    Generalized anxiety disorder (GAD) is a common (lifetime prevalence: 5.1%), recurrent condition, which often heralds other psychiatric disorders, notably depression. As by definition it is a disorder progressing over months, treatment should be designed on a long term basis. And yet, few studies have been conducted beyond the classical 6-8 weeks characterizing the acute treatment phase. This is especially true of anxiolytics, but also of antidepressants, with the exception of paroxetine and venlafaxine, which are the only drugs approved in this indication in Western countries. The efficacy of psychotherapy, notably relaxation and cognitive-behavioral therapy, is established in the treatment of GAD, but its preferred indications and possible combination with antidepressants are still to be specified. Long term, not to say very long term studies of GAD, as well as depression, will still be required in the future to improve its management and specify therapeutic modalities (combination treatment, optimal duration, continuous or intermittent therapy, choice of psychotherapeutic techniques or agents, em leader ). Early and adequately prolonged treatment should not only result in more numerous remission periods, but also in decreased frequency of co-morbidities whether depressive, addictive, or of another nature, and should also reduce the social impact of GAD.

  20. Titanium for long-term tritium storage

    SciTech Connect

    Heung, L.K.

    1994-12-01

    Due to the reduction of nuclear weapon stockpile, there will be an excess of tritium returned from the field. The excess tritium needs to be stored for future use, which might be several years away. A safe and cost effective means for long term storage of tritium is needed. Storing tritium in a solid metal tritide is preferred to storing tritium as a gas, because a metal tritide can store tritium in a compact form and the stored tritium will not be released until heat is applied to increase its temperature to several hundred degrees centigrade. Storing tritium as a tritide is safer and more cost effective than as a gas. Several candidate metal hydride materials have been evaluated for long term tritium storage. They include uranium, La-Ni-Al alloys, zirconium and titanium. The criteria used include material cost, radioactivity, stability to air, storage capacity, storage pressure, loading and unloading conditions, and helium retention. Titanium has the best combination of properties and is recommended for long term tritium storage.

  1. 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.

  2. Long-term memory deficits in temporal lobe epilepsy.

    PubMed

    Tramoni-Negre, E; Lambert, I; Bartolomei, F; Felician, O

    Memory complaints and deficits are common in patients with epilepsy, especially temporal lobe epilepsy (TLE), where memory-related brain structures are directly involved in the epileptic process. In recent years, substantial progress has been made in delineating memory impairment in TLE, challenging the traditional neuropsychological approach of the disorder. In particular, several lines of evidence have suggested that, beyond the apparent deficit demonstrable by standardized neuropsychological evaluations, TLE may also negatively interact with long-term memory, producing considerable loss of information of the patient's autobiographical history and an inability to maintain newly acquired information over a period of time. These observations have led to the development of innovative assessment techniques, and prompted a new domain of investigation focused on the relationships between interictal epileptiform activities and the integrity of anatomo-functional systems. The present paper reviews the available evidence for long-term memory deficits in TLE with respect to remote and very long-term memory, and discusses their putative pathophysiological mechanisms and the developing potential strategies to improve memory functioning. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Supramolecular hydrogels for long-term bioengineered stem cell therapy.

    PubMed

    Yeom, Junseok; Kim, Su Jin; Jung, Hyuntae; Namkoong, Hong; Yang, Jeonga; Hwang, Byung Woo; Oh, Kyunghoon; Kim, Kimoon; Sung, Young Chul; Hahn, Sei Kwang

    2015-01-28

    Synthetic hydrogels have been extensively investigated as artificial extracellular matrices (ECMs) for tissue engineering in vitro and in vivo. Crucial challenges for such hydrogels are sustaining long-term cytocompatible encapsulation and providing appropriate cues at the right place and time for spatio-temporal control of the cells. Here, in situ supramolecularly assembled and modularly modified hydrogels for long-term engineered mesenchymal stem cell (eMSC) therapy are reported using cucurbit[6]uril-conjugated hyaluronic acid (CB[6]-HA), diaminohexane conjugated HA (DAH-HA), and drug-conjugated CB[6] (drug-CB[6]). The eMSCs producing enhanced green fluorescence protein (EGFP) remain alive and emit the fluorescence within CB[6]/DAH-HA hydrogels in mice for more than 60 d. Furthermore, the long-term expression of mutant interleukin-12 (IL-12M) by eMSCs within the supramolecular hydrogels results in effective inhibition of tumor growth with a significantly enhanced survival rate. Taken together, these findings confirm the feasibility of supramolecular HA hydrogels as 3D artificial ECMs for cell therapies and tissue engineering applications.

  4. Long-term outcome after surgery for Crohn's anal fistula.

    PubMed

    Graf, W; Andersson, M; Åkerlund, J-E; Börjesson, L

    2016-01-01

    Treatment of Crohn's anal fistula remains challenging and little is known about factors associated with healing. The aim of this study was to assess the rate of healing after surgical treatment and analyse clinical variables related to healing. A total of 119 patients [63 women, mean age 36 (±13.7) years] with histopathologically verified Crohn's disease underwent a surgical procedure for anal fistula at four main referral centres in Sweden, January 1998 to December 2009. Baseline and treatment-related variables were recorded and analysed for correlation with fistula healing at a final follow-up after a mean of 7.2 (median 7.1, 1.0-17.5) years. Of the 119 patients 62 (52%) were healed at final follow-up. Fourteen healed after one procedure and the remaining 48 healed after a further median of 4.0 (2-20) procedures. Ten (8%) patients were subjected to a proctectomy. Final healing was more common in patients operated with a procedure aiming at eradicating the fistula (P = 0.0001), without proctitis (P = 0.02) and a shorter duration of Crohn's disease (P = 0.0019). Long-term healing of a Crohn's anal fistula can be expected in about half of the patients, usually after repeated surgical treatment. The probability for cure was higher when a curative operation was performed in a patient without proctitis and with a shorter duration of Crohn's disease. An attempt to close a Crohn's anal fistula is thus often worthwhile. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  5. Timber beams subjected to long - term loading

    NASA Astrophysics Data System (ADS)

    Sógel, K.

    2010-09-01

    Wood is a significant structural material, which is often used for timber bearing structures. Elements of timber structures must especially satisfy safety requirements, which are expressed by the ultimate limit states in the established standards. The structure must also satisfy the serviceability limit states. Local and global deformations make it impossible for the structure to serve the purpose it was designed for. It is important to take the deflections and their possible increase into account in the design to provide a structure which can be used during the whole period of service. Based on earlier examinations, it is known that a timber element over the course of long-term loading shows creep behavior. The structure of wood is able to adapt to the conditions of the surrounding environment. The properties of wood are especially affected by the relative humidity of the air and then by the type, intensity and duration of the loading. The most important factors affecting the serviceability of timber structures are volume changes caused by humidity and additional deflections caused by the effects of long-term loading. These phenomena emphasize the importance of serviceability limit states for timber structures. The paper deals with a long-term experimental investigation of timber girders that are currently often used. The aim was to obtain the deflection curves and mark the time dependence and the final deflections. The paper will also define the approximations for simulating the time-dependent deflections and obtain the creep coefficients for calculating the final deflections of the girders investigated.

  6. Human Behaviour in Long-Term Missions

    NASA Technical Reports Server (NTRS)

    1997-01-01

    In this session, Session WP1, the discussion focuses on the following topics: Psychological Support for International Space Station Mission; Psycho-social Training for Man in Space; Study of the Physiological Adaptation of the Crew During A 135-Day Space Simulation; Interpersonal Relationships in Space Simulation, The Long-Term Bed Rest in Head-Down Tilt Position; Psychological Adaptation in Groups of Varying Sizes and Environments; Deviance Among Expeditioners, Defining the Off-Nominal Act in Space and Polar Field Analogs; Getting Effective Sleep in the Space-Station Environment; Human Sleep and Circadian Rhythms are Altered During Spaceflight; and Methodological Approach to Study of Cosmonauts Errors and Its Instrumental Support.

  7. Long-Term Wind Power Variability

    SciTech Connect

    Wan, Y. H.

    2012-01-01

    The National Renewable Energy Laboratory started collecting wind power data from large commercial wind power plants (WPPs) in southwest Minnesota with dedicated dataloggers and communication links in the spring of 2000. Over the years, additional WPPs in other areas were added to and removed from the data collection effort. The longest data stream of actual wind plant output is more than 10 years. The resulting data have been used to analyze wind power fluctuations, frequency distribution of changes, the effects of spatial diversity, and wind power ancillary services. This report uses the multi-year wind power data to examine long-term wind power variability.

  8. Transverse dimension and long-term stability.

    PubMed

    Vanarsdall, R L

    1999-09-01

    This article emphasizes the critical importance of the skeletal differential between the width of the maxilla and the width of the mandible. Undiagnosed transverse discrepancy leads to adverse periodontal response, unstable dental camouflage, and less than optimal dentofacial esthetics. Hundreds of adult retreatment patients corrected for significant maxillary transverse deficiency using surgically assisted maxillary expansion (similar to osseous distraction) has produced excellent stability. Eliciting tooth movement for children (orthopedics, lip bumper, Cetlin plate) in all three planes of space by muscles, eruption, and growth, develops the broader arch form (without the mechanical forces of fixed or removable appliances) and has also demonstrated impressive long term stability.

  9. Terminating a long-term clinical trial.

    PubMed

    Klimt, C R; Canner, P L

    1979-05-01

    Long-term trials often include more than one active treatment group. These may be discontinued independently if found ineffective or possibly harmful. Certain subgroups of patients may be discovered, in the course of a clinical trial, who do not respond satisfactorily and are, therefore, excluded during the course of a trial. Yet anouther kind of termination comes when we have a therapeutic breakthrough or when hope has to be abandoned for demonstrating beneficial effects for one, several, or all treatments included in a trial. Examples from the authors' experience are presented, as are successful and unsuccessful techniques in managing terminations of various types.

  10. Terminating a long-term clinical trial.

    PubMed

    Klimt, C R

    1981-05-01

    Long-term clinical trials often include more than one active treatment group. These may be discontinued independently if found to be ineffective or possibly harmful. Certain subgroups of patients may be discovered, in the course of a clinical trial, who do not respond satisfactorily and are, therefore, excluded during the course of a trial. Yet another kind of termination comes when we have a therapeutic breakthrough or when hope has to be abandoned for demonstrating beneficial effects for one, several, or all treatments included in a trial. Examples from the authors' experience are presented, as are successful and unsuccessful techniques in managing terminations of various types.

  11. A long-term climatology of medicanes

    NASA Astrophysics Data System (ADS)

    Cavicchia, Leone; von Storch, Hans; Gualdi, Silvio

    2014-09-01

    Medicanes, intense and destructive mesoscale cyclones exhibiting several similarities with tropical hurricanes, are known to struck occasionally the Mediterranean Sea. Thanks to a high-resolution dynamical downscaling effort, we are able to study for the first time the long-term climatology of those rare storms in a systematic way. The distribution of medicanes frequency in space and time is discussed, and the environmental factors responsible for their formation are investigated. We find that medicanes develop in those areas of the Mediterranean region where intrusions of cold air in the upper troposphere can produce configurations of thermodynamical disequilibrium of the atmosphere similar to those associated with the formation of tropical cyclones.

  12. Performance considerations in long-term spaceflight

    NASA Technical Reports Server (NTRS)

    Akins, F. R.

    1979-01-01

    Maintenance of skilled performance during extended space flight is of critical importance to both the health and safety of crew members and to the overall success of mission goals. An examination of long term effects and performance requirements is therefore a factor of immense importance to the planning of future missions. Factors that were investigated include: definition of performance categories to be investigated; methods for assessing and predicting performance levels; in-flight factors which can affect performance; and factors pertinent to the maintenance of skilled performance.

  13. 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.

  14. 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.

  15. Long-term motor cortex stimulation for phantom limb pain.

    PubMed

    Pereira, Erlick A C; Moore, Tom; Moir, Liz; Aziz, Tipu Z

    2015-04-01

    We present the long-term course of motor cortex stimulation to relieve a case of severe burning phantom arm pain after brachial plexus injury and amputation. During 16-year follow-up the device continued to provide efficacious analgesia. However, several adjustments of stimulation parameters were required, as were multiple pulse generator changes, antibiotics for infection and one electrode revision due to lead migration. Steady increases in stimulation parameters over time were required. One of the longest follow-ups of motor cortex stimulation is described; the case illustrates challenges and pitfalls in neuromodulation for chronic pain, demonstrating strategies for maintaining analgesia and overcoming tolerance.

  16. Position paper on PRM and persons with long term disabilities.

    PubMed

    Takáč, P; Petrovičová, J; Delarque, A; Stibrant Sunnerhagen, K; Neumann, V; Vetra, A; Berteanu, M; Christodoulou, N

    2014-08-01

    In the current population we observe a rise of chronic health problems often with multiple characteristics. This results in a growing number of people who are experiencing long-term disabilities or difficulties in functioning because of disability. These conditions require a complex response over an extended period of time, that involves coordinated inputs from a wide range of health professionals. This paper argues the central role and benefit of rehabilitation and describes the rehabilitation as an integral component in the management of people with chronic disabilities. It also presents the most important related definitions: long-term care, rehabilitation for chronic disease and disability, the aim of physical and rehabilitation medicine (PRM). An interdisciplinary team is ideal for an effective implementation of rehabilitation for chronic disease and disability. However, the article mainly focuses on defining the role and contribution of the PRM physician in the rehabilitation of persons with long-term disabilities. The article includes: descriptions of his/her key role and competencies, particularly with regard to medical and functional status and prognosis, of the ability to comprehensively define the rehabilitation needs of the patient/person with respect to ICD-WHO classification domains, of the cooperation with other medical specialists and health professionals, of determining the rehabilitation potential, of developing the rehabilitation plan tailored to specific needs, as well as of the contribution of PRM physician in the follow-up care pathways.

  17. 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.

  18. Long-term neurotoxic effects of dimethylamine borane intoxication.

    PubMed

    Liu, Chi-Hung; Wang, Hsuan-Min; Lin, Kun-Ju; Kuo, Hung-Chou; Weng, Yi-Hsin; Shih, Tung-Sheng; Huang, Chin-Chang

    2012-08-15

    To investigate the long-term neurotoxic effects in a patient with acute dimethylamine borane (DMAB) intoxication. A 38-year-old man, working in a semiconductor factory, with acute DMAB intoxication presented with confusion, and drowsiness, followed by cognitive impairments and motor-predominant axonal polyneuropathy. We performed serial neurobehavioral assessments and functional neuroimaging studies, including brain (99m)Tc-TRODAT single photon emission computed tomography (SPECT) and brain positron emission tomography (PET) scan to monitor the long-term central nervous system (CNS) effects of DMAB intoxication. Neurobehavioral tests revealed a persistent impairment in episodic memory of visual retention semantic category retrieval and working memory of digit span (backward). Brain (99m)Tc-TRODAT SPECT scan showed a lower radioactivity uptake in the left striatum and F-18 FDG PET scan revealed a relatively decreased cerebral metabolism at the anterior cingulate gyrus and both frontal regions. Follow-up neurobehavioral tests showed that the cognitive improvements were mainly documented in intelligence, attention function, conceptual shift, perceptual motor speed, verbal learning and working memory but were limited in visual memory and executive functions. Patients with acute DMAB intoxication may have a long-lasting CNS toxicity on the cognitive dysfunction, parkinsonism, and an impaired metabolic activity of the brain. Clinical improvements may sustain during the long-term follow-up period. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Effectiveness of Heparin during Long-Term Tocolysis.

    PubMed

    Inagaki, Tetsunori; Makino, Shintaro; Yorifuji, Takashi; Sugimura, Motoi; Takeda, Satoru

    2013-01-01

    Objective. Drip infusion during long-term tocolysis causes mechanical and infectious vasculitis and increases the frequency of peripheral venous catheter exchange (PVC), thereby placing a burden on patients. Our study aim is to confirm whether heparin ameliorates pain due to vasculitis during long-term tocolysis and reduces the frequency of peripheral venous catheter exchange. Design. Prospective study. Setting and Sample. All the patients requiring admission because of the presence of uterine contraction or progressive cervical dilatation from August 2009 to June 2011 at Juntendo University in Japan. Methods. Heparin was used for patients at the time the total number of peripheral venous catheter exchanges exceeded 5 in two weeks, and we evaluated whether heparin reduced the frequency of peripheral venous catheter exchange and improved the visual analog scale (VAS) for patients. The main outcome measures frequency of PVC exchange and VAS. Results. This study demonstrated that heparin reduced the frequency of peripheral venous catheter exchange (P = 0.0069) and VAS (P = 0.042). No side effects were noted. Conclusion. Heparin could satisfy patients during long-term tocolysis in terms of ameliorating pain due to vasculitis and reducing the PVC exchange frequency.

  20. Long-term immunogenicity of two pediatric doses of combined hepatitis A and B or monovalent hepatitis B vaccine in 8 to 10-year-old children and the effect of a challenge dose given seven years later.

    PubMed

    Gilca, Vladimir; Dionne, Marc; Boulianne, Nicole; Murphy, Donald; De Serres, Gaston

    2009-10-01

    A total of 465 children aged 8 to 10 years were vaccinated with 2 doses of Recombivax-HB 2.5 microg (RB) or Twinrix-Junior 10 microg/360 EL.U (TX), according to a 0 and 6 months schedule. Seven years postsecond dose, a challenge dose of vaccine was given. All vaccinees in the TX and 98% in the RB group showed an anamnestic response. Vaccination at the age of 8 to 10 years with two-pediatric doses of TX or RB given with a 6 months interval induces a long-lasting immunity in most vaccinees.

  1. 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.

  2. Long-term nuclear waste management: Present status and alternatives

    NASA Astrophysics Data System (ADS)

    Schapira, J. P.

    1989-08-01

    Long-term nuclear waste management deals with the final and irreversible stage of waste disposal, on surface and in deep geological formations (according to the waste type), when institutional surveillance is over. There are presently two main options available to deal with the wastes generated by spent nuclear fuel unloaded from reactors and containing most of the radiotoxicity produced all along the nuclear fuel cycle. Since the end of Word War II, spent-fuel reprocessing technology has gone through three different stages, ending up with considerable technical achievements and large investments (construction of large facilities, UP3 in France and THORP in the UK). However, having to face spent-fuel risings and lack of reprocessing capacities, since the mid-seventies some countries are considering the possibility of direct spent-fuel disposal without reprocessing. These two options are discussed in terms of long-term waste management. Because of the types of waste conditioning and packaging adopted with present reprocessing technology, in that case long-term safety, after a few centuries, relies completely on the geological barriers. On the other hand, long-term safety with the second option is based essentially on the retention properties of uranium oxide with respect to actinides. Finally, alternatives such as chemical partitioning of minor actinides followed by their transmutation, either in reactors or using high-energy particle accelerators, are under discussion. Apart from the standard reprocessing (after a cooling period of 3-5 years), all the other options called for a long period (50 years) of interim storage, preventing the adoption of irreversible, costly and not well proved waste management solutions, and leaving time to develop and assess these alternative methods.

  3. [Nosocomial infections in long-term health care facilities].

    PubMed

    Serrano, Marcos; Barcenilla, Fernando; Limón, Enrique

    2014-03-01

    The long-term care facilities (LTCF) are the health care level that integrates medical assistance and social services according to the requirements of its beneficiaries. There is a great variability depending on the users profile, the professional staff and accessibility to technical resources for diagnosis, treatment or rehabilitation. In LTCF different factors are shaping a challenge in the infection control. These factors are high prevalence of infection and colonization by multiresistant microorganisms (MROs), a high rate of, often inadequate, antibiotic prescriptions, the high transfer of hospital patients, and the lack of diagnostic resources. In infection studies in LTCF, one of the main problems is the lack of standard, and well defined, infection criteria. The special features of infections in the elderly population, together with the limited resources, make it necessary to establish standard and worldwide validated criteria in order achieve appropriate monitoring and control of infection. The most common infection is the respiratory, followed by the urinary, skin and soft tissue, gastro-intestinal tract, and eyes. The problematic microorganisms most frequently identified in LTCF are enterobacteriaceae extended spectrum beta lactamase, Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). A successful infection control mainly depends on two actions. First, a high compliance of standard precautions and second, patient organization according to the risk of transmission of a particular MROs infection, especially MRSA. This risk classification may be a way to rationalize application measures, and the incorporation of ethical and legal issues. The level of stratification is established mainly according to the condition of being colonized or infected, the MROs anatomical location, and the degree of behavioral disorders suffered by the patient. Implementation of extensive screening programs or complex monitoring programs, as in acute care

  4. Sleep facilitates long-term face adaptation

    PubMed Central

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-01-01

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as ‘storage’. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation—which are usually not considered to play a relevant role in mnemonic processes—with learning and memory, and at the same time reveal a new function of sleep in cognition. PMID:23986109

  5. Craniopharyngioma in Children: Long-term Outcomes

    PubMed Central

    STEINBOK, Paul

    2015-01-01

    The survival rate for childhood craniopharyngioma has been improving, with more long-term survivors. Unfortunately it is rare for the patient to be normal, either from the disease itself or from the effects of treatment. Long-term survivors of childhood craniopharyngioma suffer a number of impairments, which include visual loss, endocrinopathy, hypothalamic dysfunction, cerebrovascular problems, neurologic and neurocognitive dysfunction. Pituitary insufficiency is present in almost 100%. Visual and hypothalamic dysfunction is common. There is a high risk of metabolic syndrome and increased risk of cerebrovascular disease, including stroke and Moyamoya syndrome. Cognitive, psychosocial, and emotional problems are prevalent. Finally, there is a higher risk of premature death among survivors of craniopharyngioma, and often this is not from tumor recurrence. It is important to consider craniopharyngioma as a chronic disease. There is no perfect treatment. The treatment has to be tailored to the individual patient to minimize dysfunction caused by tumor and treatments. So “cure” of the tumor does not mean a normal patient. The management of the patient and family needs multidisciplinary evaluation and should involve ophthalmology, endocrinology, neurosurgery, oncology, and psychology. Furthermore, it is also important to address emotional issues and social integration. PMID:26345668

  6. Sleep facilitates long-term face adaptation.

    PubMed

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-10-22

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as 'storage'. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation--which are usually not considered to play a relevant role in mnemonic processes--with learning and memory, and at the same time reveal a new function of sleep in cognition.

  7. Long term changes in the polar vortices

    NASA Astrophysics Data System (ADS)

    Braathen, Geir O.

    2015-04-01

    As the amount of halogens in the stratosphere is slowly declining and the ozone layer slowly recovers it is of interest to see how the meteorological conditions in the vortex develop over the long term since such changes might alter the foreseen ozone recovery. In conjunction with the publication of the WMO Antarctic and Arctic Ozone Bulletins, WMO has acquired the ERA Interim global reanalysis data set for several meteorological parameters. This data set goes from 1979 - present. These long time series of data can be used for several useful studies of the long term development of the polar vortices. Several "environmental indicators" for vortex change have been calculated, and a climatology, as well as trends, for these parameters will be presented. These indicators can act as yardsticks and will be useful for understanding past and future changes in the polar vortices and how these changes affect polar ozone depletion. Examples of indicators are: vortex mean temperature, vortex minimum temperature, vortex mean PV, vortex "importance" (PV*area), vortex break-up time, mean and maximum wind speed. Data for both the north and south polar vortices have been analysed at several isentropic levels from 350 to 850 K. A possible link between changes in PV and sudden stratospheric warmings will be investigated, and the results presented.

  8. Long-term Caspian Sea level change

    NASA Astrophysics Data System (ADS)

    Chen, J. L.; Pekker, T.; Wilson, C. R.; Tapley, B. D.; Kostianoy, A. G.; Cretaux, J.-F.; Safarov, E. S.

    2017-07-01

    Caspian Sea level (CSL) has undergone substantial fluctuations during the past several hundred years. The causes over the entire historical period are uncertain, but we investigate here large changes seen in the past several decades. We use climate model-predicted precipitation (P), evaporation (E), and observed river runoff (R) to reconstruct long-term CSL changes for 1979-2015 and show that PER (P-E + R) flux predictions agree very well with observed CSL changes. The observed rapid CSL increase (about 12.74 cm/yr) and significant drop ( -6.72 cm/yr) during the periods 1979-1995 and 1996-2015 are well accounted for by integrated PER flux predictions of +12.38 and -6.79 cm/yr, respectively. We show that increased evaporation rates over the Caspian Sea play a dominant role in reversing the increasing trend in CSL during the past 37 years. The current long-term decline in CSL is expected to continue into the foreseeable future, under global warming scenarios.

  9. Long term efficacy of a pen injector.

    PubMed

    Dinneen, S F; Cronin, C C; O'Sullivan, D J

    1991-09-01

    We assessed the long term efficacy of Novopen as a form of insulin administration. Records were obtained on 48 patients who were treated with Novopen between January '86 and October '88. Six patients were excluded due to insufficient data. The study group of 42 patients comprised 22 females and 20 males of average age 33 years (range 17-66). Mean Hb.A1 rose from 10.6% to 12.1% after Novopen therapy, a rise of 14.1%. This rise is both clinically and statistically significant (p less than 0.001; 99% confidence limits 0.59-2.78). Increases in weight and insulin dose were also noted, but did not reach statistical significance. The majority of patients felt Novopen was superior to twice daily insulin in terms of ease of administration (81%) and flexibility of lifestyle (95%), and all who were using Novopen wished to continue with it. More than 50% of patients admitted to altering their dietary habits while using Novopen. Despite continuing patient satisfaction with this form of insulin administration, its long-term use may be associated with sub-optimal metabolic control.

  10. Long-term phenotypic evolution of bacteria.

    PubMed

    Plata, Germán; Henry, Christopher S; Vitkup, Dennis

    2015-01-15

    For many decades comparative analyses of protein sequences and structures have been used to investigate fundamental principles of molecular evolution. In contrast, relatively little is known about the long-term evolution of species' phenotypic and genetic properties. This represents an important gap in our understanding of evolution, as exactly these proprieties play key roles in natural selection and adaptation to diverse environments. Here we perform a comparative analysis of bacterial growth and gene deletion phenotypes using hundreds of genome-scale metabolic models. Overall, bacterial phenotypic evolution can be described by a two-stage process with a rapid initial phenotypic diversification followed by a slow long-term exponential divergence. The observed average divergence trend, with approximately similar fractions of phenotypic properties changing per unit time, continues for billions of years. We experimentally confirm the predicted divergence trend using the phenotypic profiles of 40 diverse bacterial species across more than 60 growth conditions. Our analysis suggests that, at long evolutionary distances, gene essentiality is significantly more conserved than the ability to utilize different nutrients, while synthetic lethality is significantly less conserved. We also find that although a rapid phenotypic evolution is sometimes observed within the same species, a transition from high to low phenotypic similarity occurs primarily at the genus level.

  11. Long-term experience with indapamide.

    PubMed

    Beling, S; Vukovich, R A; Neiss, E S; Zisblatt, M; Webb, E; Losi, M

    1983-07-01

    Indapamide, 2.5 mg administered once daily for periods up to 36 months, was found to be safe and effective for the long-term control of mild to moderate hypertension. The effects of hydrochlorothiazide, 50 mg, and indapamide, 2.5 mg, were studied in two randomized, double-blind, multicenter trials. Data from the two multicenter trials (20 study sites) were pooled for purposes of comparison. Significant reductions in systolic and diastolic blood pressure, with patients in both supine and standing positions, occurred in both groups within the first 8 weeks of treatment. This effect was maintained throughout the active treatment period. Success, as determined by the therapeutic success rate (percentage of patients with decreases of standing phase V diastolic blood pressure of at least 10 mm Hg or to below 90 mm Hg), occurred in 53% of the patients given hydrochlorothiazide and in 56% of the indapamide-treated patients. During the study period, the nature, frequency, and severity of adverse reactions were similar for both groups. There was no clinically significant difference between the treatment groups for the laboratory assessments. Patients who completed the multicenter trials were eligible for participation in an ongoing long-term extension study of the safety of indapamide. Data are available for periods up to 36 months and demonstrate neither augmentation of clinical or laboratory adverse effects nor any potentially harmful indicators that could be attributed to prolonged treatment.

  12. Long Term Changes in the Polar Vortices

    NASA Astrophysics Data System (ADS)

    Braathen, Geir O.

    2016-04-01

    As the amount of halogens in the stratosphere is slowly declining and the ozone layer slowly recovers it is of interest to see how the meteorological conditions in the vortex develop over the long term since such changes might alter the foreseen ozone recovery. In conjunction with the publication of the WMO Antarctic and Arctic Ozone Bulletins, WMO has acquired the ERA Interim global reanalysis data set for several meteorological parameters. This data set goes from 1979 - present. These long time series of data can be used for several useful studies of the long term development of the polar vortices. Several "environmental indicators" for vortex change have been calculated, and a climatology, as well as trends, for these parameters will be presented. These indicators can act as yardsticks and will be useful for understanding past and future changes in the polar vortices and how these changes affect polar ozone depletion. Examples of indicators are: vortex mean temperature, vortex minimum temperature, vortex mean PV, vortex "importance" (PV*area), vortex break-up time, mean and maximum wind speed. Data for both the north and south polar vortices have been analysed at several isentropic levels from 350 to 850 K. A possible link between changes in PV and sudden stratospheric warmings will be investigated, and the results presented. The unusual meteorological conditions of the 2015 south polar vortex and the 2010/11 and 2015/16 north polar vortices will be compared to other recent years.

  13. Long term effects of Escherichia coli mastitis.

    PubMed

    Blum, Shlomo E; Heller, Elimelech D; Leitner, Gabriel

    2014-07-01

    Escherichia coli is one of the most frequently diagnosed causes of bovine mastitis, and is typically associated with acute, clinical mastitis. The objective of the present study was to evaluate the long term effects of intramammary infections by E. coli on milk yield and quality, especially milk coagulation. Twenty-four Israeli Holstein cows diagnosed with clinical mastitis due to intramammary infection by E. coli were used in this study. Mean lactation number, days in milk (DIM) and daily milk yield (DMY) at the time of infection was 3.3 ± 1.3, 131.7 days ± 78.6 and 45.7 L ± 8.4, respectively. DMY, milk constituents, somatic cells count (SCC), differential leukocytes count and coagulation parameters were subsequently assessed. Two patterns of inflammation were identified: 'short inflammation', characterized by <15% decrease in DMY and <30 days until return to normal (n = 5), and 'long inflammation', characterized by >15% decrease in DMY and >30 days to reach a new maximum DMY (n = 19). The estimated mean loss of marketable milk during the study was 200 L/cow for 'short inflammation' cases, and 1,500 L/cow for 'long inflammation' ones. Significant differences between 'short' and 'long inflammation' effects were found in almost all parameters studied. Long-term detrimental effects on milk quality were found regardless of clinical or bacteriological cure of affected glands.

  14. Returning and staying connected to work after long-term sickness absence.

    PubMed

    Petersen, K S; Labriola, M; Nielsen, C V; Ladekjaer Larsen, E

    2016-12-01

    Returning to work (RTW) after long-term sickness absence is a challenge for convalescent workers, co-workers, managers and organizations. Few studies have investigated the post-return phase after long-term sickness absence. To investigate the RTW process as experienced by returning workers, co-workers and managers at an emergency care service and a waste disposal company, exploring various perspectives related to early RTW before full recovery and changes in the returning workers' work positions. An ethnographic field work design was employed. Returning workers with musculoskeletal disorders, co-workers and managers at two different workplaces participated in individual and group interviews and underwent participant observation over 5 months. These were repeated in a 2-week period after a 4-month interval. Grounded theory analysis was used to identify themes of importance. Four main themes were identified: (1) return before full recovery, (2) changes in work tasks, (3) changes in work position and (4) individual responsibility. Our results illustrate how returning workers, co-workers and managers at two workplaces experienced the RTW process. The results highlight some of the challenges that occur when returning at an early stage before full recovery is obtained leading to changes in the returning worker's work position. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Long-term contraception in a small implant

    PubMed Central

    Fontaine, Christelle

    2015-01-01

    Rationale: Deslorelin (Suprelorin®; Virbac) is a gonadotropin-releasing hormone (GnRH) agonist licensed in select countries for the long-term suppression of fertility in adult male dogs and male ferrets. This article summarizes studies investigating the use of deslorelin implants for the long-term suppression of fertility in male and female domestic cats. Evidence base: Slow-release deslorelin implants have been shown to generate effective, safe and reversible long-term contraception in male and female cats. In pubertal cats, a 4.7 mg deslorelin implant suppressed steroid sex hormones for an average of approximately 20 months (range 15–25 months) in males and an average of approximately 24 months (range 16–37 months) in females. Reversibility has been demonstrated by fertile matings approximately 2 years post-treatment in both male and female adult cats. In prepubertal female cats of approximately 4 months of age, puberty was postponed to an average of approximately 10 months of age (range 6–15 months) by a 4.7 mg deslorelin implant. Challenges: The large variability in the duration of suppression of gonadal activity makes the definition of the optimal time for reimplantation quite challenging. In addition, the temporary stimulation phase occurring in the weeks following deslorelin implantation can induce in adult female cats a fertile estrus that needs to be managed to avoid unwanted pregnancy. Longer duration and larger scale controlled field studies implementing blinding, a negative control group and a carefully controlled randomization to each group are needed. Furthermore, the effects of repeated treatment need to be investigated. Finally, the effect of treatment on growth and bone quality of prepubertal cats needs to be assessed. However, the ease of use, long-lasting effects and reversibility of deslorelin implants are strong positive points supporting their use for controlling feline reproduction. PMID:26323800

  16. Managing soils for long-term productivity

    PubMed Central

    Syers, J. K.

    1997-01-01

    Meeting the goal of long-term agricultural productivity requires that soil degradation be halted and reversed. Soil fertility decline is a key factor in soil degradation and is probably the major cause of declining crop yields. There is evidence that the contribution of declining soil fertility to soil degradation has been underestimated.
    Sensitivity to soil degradation is implicit in the assessment of the sustainability of land management practices, with wide recognition of the fact that soils vary in their ability to resist change and recover subsequent to stress. The concept of resilience in relation to sustainability requires further elaboration and evaluation.
    In the context of soil degradation, a decline in soil fertility is primarily interpreted as the depletion of organic matter and plant nutrients. Despite a higher turnover rate of organic matter in the tropics there is no intrinsic difference between the organic matter content of soils from tropical and temperate regions. The level of organic matter in a soil is closely related to the above and below ground inputs. In the absence of adequate organic material inputs and where cultivation is continuous, soil organic matter declines progressively. Maintaining the quantity and quality of soil organic matter should be a guiding principle in developing management practices.
    Soil microbial biomass serves as an important reservoir of nitrogen (N), phosphorus (P) and sulphur (S), and regulates the cycling of organic matter and nutrients. Because of its high turnover rate, microbial biomass reacts quickly to changes in management and is a sensitive indicator for monitoring and predicting changes in soil organic matter. Modelling techniques have been reasonably successful in predicting changes in soil organic matter with different organic material inputs, but there is little information from the tropics.
    Nutrient depletion through harvested crop components and residue removal, and by leaching and soil

  17. Role of Atypical Protein Kinases in Maintenance of Long-Term Memory and Synaptic Plasticity.

    PubMed

    Borodinova, A A; Zuzina, A B; Balaban, P M

    2017-03-01

    Investigation of biochemical mechanisms underlying the long-term storage of information in nervous system is one of main problems of modern neurobiology. As a molecular basis of long-term memory, long-term changes in kinase activities, increase in the level and changes in the subunit composition of receptors in synaptic membranes, local activity of prion-like proteins, and epigenetic modifications of chromatin have been proposed. Perhaps a combination of all or of some of these factors underlies the storage of long-term memory in the brain. Many recent studies have shown an exclusively important role of atypical protein kinases (PKCζ, PKMζ, and PKCι/λ) in processes of learning, consolidation and maintenance of memory. The present review is devoted to consideration of mechanisms of transcriptional and translational control of atypical protein kinases and their roles in induction and maintenance of long-term synaptic plasticity and memory in vertebrates and invertebrates.

  18. 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.

  19. Neurotoxicity testing during long-term studies.

    PubMed

    Ivens, I

    1990-01-01

    Several tests and methods for the investigation of neurotoxicity were performed with female Wistar rats for up to 187 days. The methods were validated by testing 10 rats treated with beta,beta'-iminodipropionitrile (IDPN) and 10 control rats. Cage side observation of the animals revealed signs of altered behavior and motor dysfunction of the IDPN-treated rats. Results of a neuromuscular screen indicated changes in gait, righting reflex, grip strength and performance of the negative geotropism test. Investigation of the animals in activity monitors and on the accelerating rotarod showed changes of several parameters. The motor nerve conduction velocity, measured 6 months after the first treatment, was reduced by 6.7 meters per second in the IDPN group compared to controls. From the results of the tests it can be concluded that the methods chosen can be used during long-term studies but may be most useful for animals not older than 12 months.

  20. Long term cryogenic storage facility systems study

    NASA Technical Reports Server (NTRS)

    Schuster, John R.

    1987-01-01

    The Long Term Cryogenic Storage Facility Systems Study (LTCSFSS) is a Phase A study of a large capacity propellant depot for the space based, cryogenic orbital transfer vehicle. The study is being performed for Marshall Space Flight Center by General Dynamics Space Systems Division and has five principal objectives: (1) Definition of preliminary concept designs for four storage facility concepts; (2) Selection of preferred concepts through the application of trade studies to candidate propellant management system components; (3) Preparation of a conceptual design for an orbital storage facility; (4) Development of supporting research and technology requirements; and (5) Development of a test program to demonstrate facility performance. The initial study has been completed, and continuation activities are just getting under way to provide greater detail in key areas and accommodate changes in study guidelines and assumptions.

  1. Reducing long-term reservoir performance uncertainty

    SciTech Connect

    Lippmann, M.J.

    1988-04-01

    Reservoir performance is one of the key issues that have to be addressed before going ahead with the development of a geothermal field. In order to select the type and size of the power plant and design other surface installations, it is necessary to know the characteristics of the production wells and of the produced fluids, and to predict the changes over a 10--30 year period. This is not a straightforward task, as in most cases the calculations have to be made on the basis of data collected before significant fluid volumes have been extracted from the reservoir. The paper describes the methodology used in predicting the long-term performance of hydrothermal systems, as well as DOE/GTD-sponsored research aimed at reducing the uncertainties associated with these predictions. 27 refs., 1 fig.

  2. Long-term monitoring for closed sites

    SciTech Connect

    Golchert, N.W.; Sedlet, J.; Veluri, V.R.

    1985-01-01

    A procedure is presented for planning and implementing a long-term environmental monitoring program for closed low-level radioactive waste disposal sites. The initial task in this procedure is to collect the available information on the legal/regulatory requirements, site and area characteristics, source term, pathway analysis, and prior monitoring results. This information is coupled with parameters such as half-life and retardation factors to develop a monitoring program. As examples, programs are presented for a site that has had little or no waste migration, and for sites where waste has been moved by suface water, by ground water, and by air. Sampling techniques and practices are discussed relative to how a current program would be structured and projections are made on techniques and practices expected to be available in the future. 8 refs., 2 figs.

  3. Emotional behavior in long-term marriage.

    PubMed

    Carstensen, L L; Gottman, J M; Levenson, R W

    1995-03-01

    In exploring the emotional climate of long-term marriages, this study used an observational coding system to identify specific emotional behaviors expressed by middle-aged and older spouses during discussions of a marital problem. One hundred and fifty-six couples differing in age and marital satisfaction were studied. Emotional behaviors expressed by couples differed as a function of age, gender, and marital satisfaction. In older couples, the resolution of conflict was less emotionally negative and more affectionate than in middle-aged marriages. Differences between husbands and wives and between happy and unhappy marriages were also found. Wives were more affectively negative than husbands, whereas husbands were more defensive than wives, and unhappy marriages involved greater exchange of negative affect than happy marriages.

  4. Long Term Hydrological (Radiological) Site Monitoring Data

    EPA Pesticide Factsheets

    Quality Data Asset includes all current and historical data on the quality of water with regard to the presence of water pollutants of all kinds regulated by the Clean Water Act. Under the new Interagency Agreement with the Department of Energy (DOE), the Radiation & Indoor Environments National Laboratory (R&IE), Office of Radiation and Indoor Air (ORIA), EPA, located in Las Vegas, NV, conducts a Long-Term Hydrological Monitoring Program (LTHMP) providing laboratory sampling/analysis and Quality Assurance and Control to measure radioactivity concentrations in the water sources near the sites of former underground nuclear explosions. The results of the LTHMP provide assurance that radioactive material from the tests have not migrated into water supplies.

  5. Long-term U. S. energy outlook

    SciTech Connect

    Friesen, G.

    1984-01-01

    Each year Chase Econometrics offers its clients a brief summary of the assumptions underlying the long-term energy forecast for the U.S. To illustrate the uncertainty involved in forecasting for the period to the year 2000, they choose to compare forecasts with some recent projections prepared by the Department of Energy's Office of Policy, Planning and Analysis for the annual National Energy Policy Plan supplement. Particular emphasis is placed on Scenario B, which is the mid-range reference case. As the introduction to the supplement emphasizes, the NEPP projections should not be considered a statement of the policy goals of the Reagan Administration. They represent an analysis of the possible evolution of U.S. energy markets, given current information and existing policies. The purpose of providing Scenario B as a reference case as well as Scenarios A and C as alternate cases is to show the sensitivity of oil price projections to small swings in energy demand.

  6. Advanced long term cryogenic storage systems

    NASA Technical Reports Server (NTRS)

    Brown, Norman S.

    1987-01-01

    Long term, cryogenic fluid storage facilities will be required to support future space programs such as the space-based Orbital Transfer Vehicle (OTV), Telescopes, and Laser Systems. An orbital liquid oxygen/liquid hydrogen storage system with an initial capacity of approximately 200,000 lb will be required. The storage facility tank design must have the capability of fluid acquisition in microgravity and limit cryogen boiloff due to environmental heating. Cryogenic boiloff management features, minimizing Earth-to-orbit transportation costs, will include advanced thick multilayer insulation/integrated vapor cooled shield concepts, low conductance support structures, and refrigeration/reliquefaction systems. Contracted study efforts are under way to develop storage system designs, technology plans, test article hardware designs, and develop plans for ground/flight testing.

  7. Long term performance of radon mitigation systems

    SciTech Connect

    Prill, R.; Fisk, W.J.

    2002-03-01

    Researchers installed radon mitigation systems in 12 houses in Spokane, Washington and Coeur d'Alene, Idaho during the heating season 1985--1986 and continued to monitor indoor radon quarterly and annually for ten years. The mitigation systems included active sub-slab ventilation, basement over-pressurization, and crawlspace isolation and ventilation. The occupants reported various operational problems with these early mitigation systems. The long-term radon measurements were essential to track the effectiveness of the mitigation systems over time. All 12 homes were visited during the second year of the study, while a second set 5 homes was visited during the fifth year to determine the cause(s) of increased radon in the homes. During these visits, the mitigation systems were inspected and measurements of system performance were made. Maintenance and modifications were performed to improve system performance in these homes.

  8. Withdrawal from long-term benzodiazepine treatment.

    PubMed Central

    Petursson, H; Lader, M H

    1981-01-01

    Long-term, normal-dose benzodiazepine treatment was discontinued in 16 patients who were suspected of being dependent on their medication. The withdrawal was gradual, placebo-controlled, and double-blind. All the patients experienced some form of withdrawal reaction, which ranged from anxiety and dysphoria to moderate affective and perceptual changes. Symptom ratings rose as the drugs were discontinued, but usually subsided to prewithdrawal levels over the next two to four weeks. Other features of the withdrawal included disturbance of sleep and appetite and noticeable weight loss. Electroencephalography showed appreciable reduction in fast-wave activity as the drugs were withdrawn, and an improvement in psychological performance was recorded by the Digit Symbol Substitution Test. Because of the risk of dependence on benzodiazepines these agents should probably not be given as regular daily treatment for chronic anxiety. PMID:6114776

  9. [Enteral nutrition through long-term jejunostomy].

    PubMed

    Fernández, T; Neira, P; Enríquez, C

    2008-01-01

    We present the case of a female patient suffering a peritonitis episode after subtotal gastrectomy due to gastric neoplasm in relation to lesser curvature necrosis extending to the anterior esophageal wall. This an uncommon andsevere complication that made mandatory further aggressive surgery: transection of the abdominal esophagus, transection of the gastric stump, and cervical esophagostomy with creation of a jejunostomy with a needle catheter for feeding. This digestive tube access technique is generally used during major abdominal post-surgery until oral intake is reestablished. Our patient has been 187 days with this therapy since reconstruction of the GI tract was ruled out due to tumoral infiltration of the colon and tumor recurrence at the gastrohepatic omentum. To date, there has been no complication from permanence and/or long-term use of this technique.

  10. [Childhood liver transplantation. Long-term results].

    PubMed

    Jara, Paloma; Hierro, Loreto

    2010-05-01

    Liver transplantation allows long-term survival (10 years or more) in 75% of children receiving transplants before 2000. The risk of mortality after the first year is 4-10% in the next 10-20 years. Chronic rejection affects 6%. The need for late retransplantation is 3-5%. However, the follow-up of these patients involves the management of diverse problems in the graft (immunological, biliary, vascular) and others related to the use of immunosuppressants (renal dysfunction, lymphoproliferative syndrome). The transition from pediatric to adult care generates special needs. Adolescence and young adulthood are associated with a lack of compliance. Adult specialists should be aware of the special features of the original diagnosis and the surgical techniques used in childhood transplantation. Final quality of life is good overall but is lower than that in healthy young persons.

  11. Long-term leaching of photovoltaic modules

    NASA Astrophysics Data System (ADS)

    Nover, Jessica; Zapf-Gottwick, Renate; Feifel, Carolin; Koch, Michael; Metzger, Jörg W.; Werner, Jürgen H.

    2017-08-01

    Some photovoltaic module technologies use toxic materials. We report long-term leaching on photovoltaic module pieces of 5 × 5 cm2 size. The pieces are cut out from modules of the four major commercial photovoltaic technologies: crystalline and amorphous silicon, cadmium telluride as well as from copper indium gallium diselenide. To simulate different environmental conditions, leaching occurs at room temperature in three different water-based solutions with pH 3, 7, and 11. No agitation is performed to simulate more representative field conditions. After 360 days, about 1.4% of lead from crystalline silicon module pieces and 62% of cadmium from cadmium telluride module pieces are leached out in acidic solutions. The leaching depends heavily on the pH and the redox potential of the aqueous solutions and it increases with time. The leaching behavior is predictable by thermodynamic stability considerations. These predictions are in good agreement with the experimental results.

  12. Technology for long-term care.

    PubMed

    Tak, Sunghee H; Benefield, Lazelle E; Mahoney, Diane Feeney

    2010-01-01

    Severe staff shortages in long-term care (LTC) make it difficult to meet the demands of the growing aging population. Further, technology-savvy Baby Boomers are expected to reshape the current institutional environments toward gaining more freedom and control in their care and lives. Voices from business, academia, research, advocacy organizations, and government bodies suggest that innovative technological approaches are the linchpin that may prepare society to cope with these projected demands. In this article, we review the current state of aging-related technology, identify potential areas for efficacy testing on improving the quality of life of LTC residents in future research, and discuss barriers to implementation of LTC technology. Finally, we present a vision of future technology use that could transform current care practices.

  13. Radiation risk during long-term spaceflight.

    PubMed

    Petrov, V M

    2002-01-01

    Cosmonauts' exposure to cosmic rays during long-term spaceflight can cause unfavorable effects in health and risk for the crew members' lives. All unfavorable effects induced by exposure should be taken into consideration for the risk estimation. They should include both the acute deterministic effects and delayed effects called stochastic. On the ground the limitation of unfavorable consequences of acute exposure is achieved by means of establishing dose limits. But in space applications this approach can't be acceptable. Establishing a fixed dose limit is adequate to introducing indefinite reserve coefficient and therefore ineffective usage of spacecraft resource. The method of radiation risk calculation caused by acute and delayed effects of cosmonauts' exposure is discussed and substantiated in the report. Peculiarities of the impact of permanent radiation sources (galactic cosmic rays and trapped radiation) and the variable one (solar cosmic rays) are taken into consideration. c2002 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

  14. Long-term control of root growth

    SciTech Connect

    Burton, F.G.; Cataldo, D.A.; Cline, J.F.; Skiens, W.E.

    1992-05-26

    A method and system for long-term control of root growth without killing the plants bearing those roots involves incorporating a 2,6-dinitroaniline in a polymer and disposing the polymer in an area in which root control is desired. This results in controlled release of the substituted aniline herbicide over a period of many years. Herbicides of this class have the property of preventing root elongation without translocating into other parts of the plant. The herbicide may be encapsulated in the polymer or mixed with it. The polymer-herbicide mixture may be formed into pellets, sheets, pipe gaskets, pipes for carrying water, or various other forms. The invention may be applied to other protection of buried hazardous wastes, protection of underground pipes, prevention of root intrusion beneath slabs, the dwarfing of trees or shrubs and other applications. The preferred herbicide is 4-difluoromethyl-N,N-dipropyl-2,6-dinitro-aniline, commonly known as trifluralin. 7 figs.

  15. Long-term control of root growth

    DOEpatents

    Burton, Frederick G.; Cataldo, Dominic A.; Cline, John F.; Skiens, W. Eugene

    1992-05-26

    A method and system for long-term control of root growth without killing the plants bearing those roots involves incorporating a 2,6-dinitroaniline in a polymer and disposing the polymer in an area in which root control is desired. This results in controlled release of the substituted aniline herbicide over a period of many years. Herbicides of this class have the property of preventing root elongation without translocating into other parts of the plant. The herbicide may be encapsulated in the polymer or mixed with it. The polymer-herbicide mixture may be formed into pellets, sheets, pipe gaskets, pipes for carrying water, or various other forms. The invention may be applied to other protection of buried hazardous wastes, protection of underground pipes, prevention of root intrusion beneath slabs, the dwarfing of trees or shrubs and other applications. The preferred herbicide is 4-difluoromethyl-N,N-dipropyl-2,6-dinitro-aniline, commonly known as trifluralin.

  16. Long-term dynamics of Typha populations

    USGS Publications Warehouse

    Grace, J.B.; Wetzel, R.G.

    1998-01-01

    The zonation of Typha populations in an experimental pond in Michigan was re-examined 15 years after the original sampling to gain insight into the long-term dynamics. Current distributions of Typha populations were also examined in additional experimental ponds at the site that have been maintained for 23 years. The zonation between T. latifolia and T. angustifolia in the previously studied pond 15 years after the initial sampling revealed that the density and distribution of shoots had not changed significantly. Thus, it appears that previously reported results (based on 7- year old populations) have remained consistent over time. Additional insight into the interaction between these two taxa was sought by comparing mixed and monoculture stands in five experimental ponds that have remained undisturbed for their 23-year history. The maximum depth of T. latifolia, the shallow- water species, was not significantly reduced when growing in the presence of the more flood tolerant T. angustifolia. In contrast, the minimum depth of T. angustifolia was reduced from 0 to 37 cm when in the presence of T. latifolia. When total populations were compared between monoculture and mixed stands, the average density of T. angustifolia shoots was 59.4 percent lower in mixed stands while the density of T. latifolia was 32 percent lower, with T. angustifolia most affected at shallow depths (reduced by 92 percent) and T. latifolia most affected at the deepest depths (reduced by 60 percent). These long-term observations indicate that competitive displacement between Typha taxa has remained stable over time.

  17. Reconstructing the long-term aa index

    NASA Astrophysics Data System (ADS)

    Clilverd, Mark A.; Clarke, Ellen; Ulich, Thomas; Linthe, Joachim; Rishbeth, Henry

    2005-07-01

    The robustness of the aa geomagnetic index is of critical importance to the debate about the previously reported doubling of the solar coronal magnetic field in the last 100 years, inferred from an increasing trend in this index. To test the trend in aa, we have reconstructed the aa index using two long-running European stations (Sodankylä from 1914 and Niemegk from 1890) to provide data for the northern component of the index that are independent of data from the UK observatories used in the "official" aa index. Both the fully "reconstructed" aa series, based on Sodankylä (67°N, L = 5.2 RE) and Niemegk (52°N, L = 2.3 RE) data in combination with the official aa Southern Hemisphere data, confirm the increasing trend in the index. The Niemegk-based index shows little solar cycle variation in its deviation from the official index, probably because of the midlatitude location of the station. The high-latitude station, Sodankylä, is more affected by active geomagnetic conditions during solar maximum because of the proximity of the auroral oval to the station. Nevertheless, its index also clearly confirms the increasing trend in the aa index and hence supports the idea of a long-term increase in solar coronal magnetic field strength. As an added test, we reconstructed the aa index from a single site using data from two long-running UK stations, Eskdalemuir and Lerwick, applying a technique known as interhourly variation (IHV) proposed by Svalgaard et al. (2004). The resulting series is designed to be primarily sensitive to solar wind conditions. Both the reconstructed aaIHV also showed an increasing trend with time and high consistency with the official aa index. Overall, we conclude that the robustness of the trend in the aa index supports the idea of a long-term increase in solar coronal magnetic field strength.

  18. Posterior urethral valves: long-term outcome.

    PubMed

    Caione, Paolo; Nappo, Simona Gerocarni

    2011-10-01

    Posterior urethral valves represent the most common cause of bladder outlet obstruction in infancy that impairs renal and bladder function. Long-term outcome of patients with previous PUV is evaluated. Patients over 18 years of age, treated from 1982 to 1995 before the age of 3 years were considered. Previous surgery, renal function, bladder activity, urinary incontinence, and fertility/sexual activity were evaluated. Clinical interview, creatinine clearance, uroflowmetry with ultrasound post-void urine residue, and self-administered questionnaire were recorded. Out of 45 identified records, 24 patients (53.3%) accepted to be enrolled (age 18-34 years, mean 23 years). The mean follow-up was 19.5 years (16-30 years). Out of the 21 excluded patients, 20 did not reply to the clinical interview and 1 died at age of 6 years. All the 24 patients had early endoscopic section of PUV; nine also received transient ureterocutaneostomy or vesicostomy. Ureteroneocystostomy was performed in five patients and ureterocystoplasty with unilateral nephrectomy in two. At follow-up chronic renal failure was detected in 13 patients (54.1%) and 9 (37.5%) had arterial hypertension. End-stage renal disease developed in five patients (20.8%): three had successful renal transplantation and two were in dialysis. Lower urinary tract symptoms were present in seven patients (29.1%). No significant fertility deficit and sexual dysfunction were observed in 23 patients, while 1 patient was azoospermic. No paternity was reported so far. Long-term outcome of patients with previously treated PUV is mandatory. Kidney, bladder, and sexual functions should be monitored till adulthood to verify any modified behaviour.

  19. Long term results of pneumatic retinopexy

    PubMed Central

    Ellakwa, Amin F

    2012-01-01

    Background Rhegmatogenous retinal detachment is a commonly encountered retinal problem where rapid treatment can prevent irreversible vision loss. Pneumatic retinopexy (PR) is a simple, minimally invasive procedure for retinal reattachment. Purpose This study aimed to assess the long-term anatomical and functional outcome of pneumatic retinopexy in primary rhegmatogenous retinal detachment. Patients and methods A prospective interventional study was performed. Subjects with rhegmatogenous retinal detachment who underwent pneumatic retinopexy from May 2006 to May 2007 at Menoufiya University Hospital were included in this study with at least 3 years follow-up. Results A total of 40 cases were included in the study. The mean age of patients was 44.25 ± 10.85 years. Reattachment of the retina was achieved in 100% of cases. In 75% of cases, the primary intervention was successful. However, the retina redetached in 20% of these during the first 6 months, requiring reinjection or another procedure. Three years after the first intervention, follow-up measurement of the mean visual acuity of the eyes without reoperation was 0.40 ± 0.21 while the mean visual acuity of the eyes which needed additional operations was 0.22 ± 0.13. Conclusion Sixty percent of the cases obtained long-term retinal reattachment with a single operation success (SOS), with good visual recovery and less morbidity than other more invasive procedures like scleral buckling or pars plana vitrectomy, translating to higher productivity for the patient. This procedure, being quicker than the alternatives, also saves the surgeon’s time, making PR a good choice for managing primary rhegmatogenous retinal detachment in developing countries. PMID:22275808

  20. Dynamics of long-term genomic selection

    PubMed Central

    2010-01-01

    Background Simulation and empirical studies of genomic selection (GS) show accuracies sufficient to generate rapid gains in early selection cycles. Beyond those cycles, allele frequency changes, recombination, and inbreeding make analytical prediction of gain impossible. The impacts of GS on long-term gain should be studied prior to its implementation. Methods A simulation case-study of this issue was done for barley, an inbred crop. On the basis of marker data on 192 breeding lines from an elite six-row spring barley program, stochastic simulation was used to explore the effects of large or small initial training populations with heritabilities of 0.2 or 0.5, applying GS before or after phenotyping, and applying additional weight on low-frequency favorable marker alleles. Genomic predictions were from ridge regression or a Bayesian analysis. Results Assuming that applying GS prior to phenotyping shortened breeding cycle time by 50%, this practice strongly increased early selection gains but also caused the loss of many favorable QTL alleles, leading to loss of genetic variance, loss of GS accuracy, and a low selection plateau. Placing additional weight on low-frequency favorable marker alleles, however, allowed GS to increase their frequency earlier on, causing an initial increase in genetic variance. This dynamic led to higher long-term gain while mitigating losses in short-term gain. Weighted GS also increased the maintenance of marker polymorphism, ensuring that QTL-marker linkage disequilibrium was higher than in unweighted GS. Conclusions Losing favorable alleles that are in weak linkage disequilibrium with markers is perhaps inevitable when using GS. Placing additional weight on low-frequency favorable alleles, however, may reduce the rate of loss of such alleles to below that of phenotypic selection. Applying such weights at the beginning of GS implementation is important. PMID:20712894

  1. Evidence-based medicine (EBM): what long-term care providers need to know.

    PubMed

    Cheng, Huai Y

    2011-05-01

    Evidence-based medicine (EBM) has been widely used in medicine for 2 decades. Recently, EBM has become a central part of reforming nursing homes and quality improvement. It is very important for long-term care providers to practice EBM. This article briefly introduces the concept of EBM; addresses some potential benefits, harms, and challenges of practicing EBM in long-term care settings; and promotes EBM and its appropriate use among long-term care providers. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Innovative use of tele-ICU in long-term acute care hospitals.

    PubMed

    Mullen-Fortino, Margaret; Sites, Frank D; Soisson, Michael; Galen, Julie

    2012-01-01

    Tele-intensive care units (ICUs) typically provide remote monitoring for ICUs of acute care, short-stay hospitals. As part of a joint venture project to establish a long-term acute level of care, Good Shepherd Penn Partners became the first facility to use tele-ICU technology in a nontraditional setting. Long-term acute care hospitals care for patients with complex medical problems. We describe describes the benefits and challenges of integrating a tele-ICU program into a long-term acute care setting and the impact this model of care has on patient care outcomes.

  3. Tolerance to benzodiazepines among long-term users in primary care.

    PubMed

    Willems, Inge A T; Gorgels, Wim J M J; Oude Voshaar, Richard C; Mulder, Jan; Lucassen, Peter L B J

    2013-08-01

    Tolerance towards the effects of benzodiazepines is observed in various animal and human studies. Therefore, it is assumed that patients who use benzodiazepines for a longer period of time need to increase their dose over time to experience the same effect. To observe whether long-term benzodiazepine users increase their dose over time. From the Dutch National Information Network of Family Practices, a group of long-term benzodiazepine users was identified. This group was divided into an incident long-term benzodiazepine users group (N = 113) and a prevalent long-term benzodiazepine users group (N = 992). Long-term use of benzodiazepines was defined as usage for at least 6 months. The main outcome was a change in prescribed dose from baseline until 24 months after baseline. Linear regression analysis was performed to evaluate dose change. Neither incident long-term benzodiazepine users nor prevalent long-term benzodiazepine users were prescribed increasing dosages during follow-up. There is no increase in prescribed dose among long-term users, as might be expected due to the development of tolerance to the effects of benzodiazepines.

  4. [Long-term care services in Spain: an overview].

    PubMed

    Casado-Marín, David

    2006-03-01

    To date, both in Spain and virtually all the other European Union (EU) countries, dependency has been seen to be a fundamentally private problem to be dealt with by the family concerned. In this way, whether through informal carers or contracted professionals, in the domestic environment or in care homes, it is the dependent person themselves and their families who currently bear the majority of the costs. In light of this, current concern lies in the social change that is coming on, mainly the accelerated aging process and the increased participation of middle-aged women in the labour market, which heighten the need for collective organisation of that which until now has been resolved within family circles. In this context, at the same time that the Government announces to issue a <Long Term Care Law> by the end of 2005, our paper briefly analyzes what we consider the four crucial issues in this area: the current scope of dependency problems and its possible future evolution, the characteristics of the current spanish long-term care system and its main problems; the role that health services should have in the dependency issue; and finally, the benefits and drawbacks of the main alternatives that the Administration could manage in case it intends to increase its involvement in this field.

  5. The Starkey project: long-term research for long-term management solutions.

    Treesearch

    Thomas M. Quigley; Michael J. Wisdom

    2004-01-01

    The Starkey Project is a unique, long-term research program designed to study the effects of key resource uses of national forests on mule deer (Odocoileus hemionus) and elk (Cervus elaphus) habitats and populations located at the Starkey Experimental Forest and Range (Starkey). The purpose of the project was to fill knowledge...

  6. 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.

  7. 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.

  8. Kidney autotransplantation: long-term outcomes and complications. Experience in a tertiary hospital and literature review.

    PubMed

    Ruiz, Mercedes; Hevia, Vital; Fabuel, Jose-Javier; Fernández, Alvaro-Amancio; Gómez, Victoria; Burgos, Francisco-Javier

    2017-08-21

    To analyze indications, surgical technique, complications and long-term outcomes of kidney autotransplantation (KAT) after 26-year experience at a single institution. A retrospective observational study of patients who underwent KAT at our institution (January 1990-December 2016) was carried out. Data collected included indications, surgical technique, complications (Clavien-Dindo), hospital stay and long-term outcomes. Literature review was performed through MEDLINE and ClinicalKey databases including "kidney," "renal," "autotransplantation" and "autograft." Fifteen patients underwent a KAT, with a mean age of 41 years (range 34-59). Indications were vascular abnormalities in 8 cases and ureteral injury in 7. Nephrectomy was performed through laparoscopy in 2 cases (13.3%) and open in 13 (86.7%). Vascular grafts to reperfuse the kidney were used in 8 patients, and ureteral reimplantation was performed in 11 cases. Mean hospital stay was 9.1 days (range 3-20). Seven patients (46.7%) developed postoperative complications: 6 minor (Clavien I-II) and 1 major (Clavien III). After a mean follow-up of 73.1 months (range 7-312), 80% of the patients have a functioning graft. Most common indication reported in the literature is ureteral stricture, especially in the most recent years. Graft survival is variable, and complications are frequent, but usually minor. KAT is an effective treatment for complex ureteral lesions and kidney vascular abnormalities, with good results in the long term. Surgical complications are frequent, but usually minor. As a challenging surgery, it should be performed by experienced kidney transplant surgeons. Complex and proximal ureteral injuries are nowadays the main indication of this procedure.

  9. 17 CFR 256.224 - Other long-term debt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 6. Long-Term Debt § 256.224 Other long-term debt. This account shall include all long...

  10. 17 CFR 256.224 - Other long-term debt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 6. Long-Term Debt § 256.224 Other long-term debt. This account shall include all long...

  11. Treatment for childhood cancer -- long-term risks

    MedlinePlus

    ... ency/patientinstructions/000849.htm Treatment for childhood cancer - long-term risks To use the sharing features on this ... has. Being aware of your child's risk of long-term health problems can help you follow-up with ...

  12. 22 CFR 228.12 - Long-term leases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SERVICES FINANCED BY USAID Conditions Governing Source and Nationality of Commodity Procurement Transactions for USAID Financing § 228.12 Long-term leases. Any commodity obtained under a long-term lease...

  13. 22 CFR 228.18 - Long-term leases.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... USAID Conditions Governing Source and Nationality of Commodity and Service Procurement Transactions for USAID Financing § 228.18 Long-term leases. Any commodity obtained under a long-term lease agreement as...

  14. 22 CFR 228.18 - Long-term leases.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... USAID Conditions Governing Source and Nationality of Commodity and Service Procurement Transactions for USAID Financing § 228.18 Long-term leases. Any commodity obtained under a long-term lease agreement as...

  15. 22 CFR 228.18 - Long-term leases.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... USAID Conditions Governing Source and Nationality of Commodity and Service Procurement Transactions for USAID Financing § 228.18 Long-term leases. Any commodity obtained under a long-term lease agreement as...

  16. 22 CFR 228.12 - Long-term leases.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SERVICES FINANCED BY USAID Conditions Governing Source and Nationality of Commodity Procurement Transactions for USAID Financing § 228.12 Long-term leases. Any commodity obtained under a long-term lease...

  17. LONG-TERM MONITORING SENSOR NETWORK

    SciTech Connect

    Stephen P. Farrington; John W. Haas; Neal Van Wyck

    2003-10-16

    Long-term monitoring (LTM) associated with subsurface contamination sites is a key element of Long Term Stewardship and Legacy Management across the Department of Energy (DOE) complex. However, both within the DOE and elsewhere, LTM is an expensive endeavor, often exceeding the costs of the remediation phase of a clean-up project. The primary contributors to LTM costs are associated with labor. Sample collection, storage, preparation, analysis, and reporting can add a significant financial burden to project expense when extended over many years. Development of unattended, in situ monitoring networks capable of providing quantitative data satisfactory to regulatory concerns has the potential to significantly reduce LTM costs. But survival and dependable operation in a difficult environment is a common obstacle to widespread use across the DOE complex or elsewhere. Deploying almost any sensor in the subsurface for extended periods of time will expose it to chemical and microbial degradation. Over the time-scales required for in situ LTM, even the most advanced sensor systems may be rendered useless. Frequent replacement or servicing (cleaning) of sensors is expensive and labor intensive, offsetting most, if not all, of the cost savings realized with unattended, in situ sensors. To enable facile, remote monitoring of contaminants and other subsurface parameters over prolonged periods, Applied Research Associates, Inc has been working to develop an advanced LTM sensor network consisting of three key elements: (1) an anti-fouling sensor chamber that can accommodate a variety of chemical and physical measurement devices based on electrochemical, optical and other techniques; (2) two rapid, cost effective, and gentle means of emplacing sensor packages either at precise locations directly in the subsurface or in pre-existing monitoring wells; and (3) a web browser-based data acquisition and control system (WebDACS) utilizing field-networked microprocessor-controlled smart

  18. Robotics for Long-Term Monitoring

    SciTech Connect

    Shahin, Sarkis; Duran, Celso

    2002-07-01

    While long-term monitoring and stewardship means many things to many people, DOE has defined it as The physical controls, institutions, information, and other mechanisms needed to ensure protection of people and the environment at sites where DOE has completed or plans to complete cleanup (e.g., landfill closures, remedial actions, and facility stabilization). Across the United States, there are thousands of contaminated sites with multiple contaminants released from multiple sources where contaminants have transported and commingled. The U.S. government and U.S. industry are responsible for most of the contamination and are landowners of many of these contaminated properties. These sites must be surveyed periodically for various criteria including structural deterioration, water intrusion, integrity of storage containers, atmospheric conditions, and hazardous substance release. The surveys, however, are intrusive, time-consuming, and expensive and expose survey personnel to radioactive contamination. In long-term monitoring, there's a need for an automated system that will gather and report data from sensors without costly human labor. In most cases, a SCADA (Supervisory Control and Data Acquisition) unit is used to collect and report data from a remote location. A SCADA unit consists of an embedded computer with data acquisition capabilities. The unit can be configured with various sensors placed in different areas of the site to be monitored. A system of this type is static, i.e., the sensors, once placed, cannot be moved to other locations within the site. For those applications where the number of sampling locations would require too many sensors, or where exact location of future problems is unknown, a mobile sensing platform is an ideal solution. In many facilities that undergo regular inspections, the number of video cameras and air monitors required to eliminate the need for human inspections is very large and far too costly. HCET's remote harsh

  19. Long-term Changes in Tropospheric Ozone

    NASA Astrophysics Data System (ADS)

    Oltmans, S.; Lefohn, A.; Galbally, I.; Scheel, E.; Bodeker, G.; Brunke, E.; Claude, H.; Tarasick, D.; Simmonds, P.; Anlauf, K.; Schmidlin, F.; Akagi, K.; Redondas, A.

    2006-05-01

    Tropospheric ozone measurements from a selected network of surface and ozonesonde sites are used to give a broad geographic picture of long-term variations. The picture of long-term tropospheric ozone changes is a varied one in terms of both the sign and magnitude of trends and in the possible causes for the changes. At mid latitudes of the S.H. three time series of ~20 years in length agree in showing increases that are strongest in the austral spring (August-October). Profile measurements show this increase extending through the mid troposphere but not into the highest levels of the troposphere. In the N.H. in the Arctic a period of declining ozone in the troposphere through the 1980s into the mid 1990s has reversed and the overall change is small. The decadal-scale variations in the troposphere in this region are related in part to changes in the lowermost stratosphere. At mid latitudes in the N.H., continental Europe and Japan showed significant increases in the 1970s and 1980s. Over North America rises in the 1970s are less than those seen in Europe and Japan, suggesting significant regional differences. In all three of these mid latitude, continental regions tropospheric ozone amounts appear to have leveled off or in some cases declined in the more recent decades. Over the North Atlantic three widely separated sites show significant increases since the late 1990s that may have peaked in recent years. In the N.H. tropics both the surface record and the ozonesondes in Hawaii show a significant increase in the autumn months in the most recent decade compared to earlier periods that drives the overall increase seen in the 30 year record. This appears to be related to a shift in the transport pattern during this season with more frequent flow from higher latitudes in the latest decade. The pattern of change, with the largest increases in the N.H. coming prior to the mid 1980s, suggests that increased positive radiative forcing due to tropospheric ozone was felt

  20. Long-term results after acute therapy of obstructive pyelonephritis.

    PubMed

    Vahlensieck, Winfried; Friess, Doris; Fabry, Werner; Waidelich, Raphaela; Bschleipfer, Thomas

    2015-01-01

    To evaluate therapeutic results till 5 years after therapy of obstructive pyelonephritis (OPN) emphasizing regular follow-up. During 5 years, 57 patients with OPN were treated. The patients' charts were reviewed retrospectively for clinical data. These were completed by a questionnaire. In the group of 57 patients (average age 56 years), about two third were women. Urolithiasis (65%) and tumors (21%) were the main causes of obstruction; fever (91%) and loin pain (86%) the main symptoms. Three fourth of the patients showed renal insufficiency and nearly 50% anemia. E. coli and Proteus spp. were the dominating organisms. Sonography detected obstruction in 93% cases. In one third of cases, CT scan was added; 81% percutaneous nephrostomy and 19% ureteral stenting were the initial methods of urinary drainage. During therapy, 23% nephrectomies (19% complete, 4% partial) were performed. Long-term follow-up showed 11% recurrent OPN and 33% recurrent UTI. After diagnosis of OPN, primary nephrostomy or ureteral stenting and antibiotic therapy are the first measures. If recurrent urinary tract infections or OPN occur, long-term follow-up and low-dose antibiotic prophylaxis may be discussed. © 2015 S. Karger AG, Basel.

  1. Seismic Performance of Dry Casks Storage for Long- Term Exposure

    SciTech Connect

    Ibarra, Luis; Sanders, David; Yang, Haori; Pantelides, Chris

    2016-12-30

    The main goal of this study is to evaluate the long-term seismic performance of freestanding and anchored Dry Storage Casks (DSCs) using experimental tests on a shaking table, as well as comprehensive numerical evaluations that include the cask-pad-soil system. The study focuses on the dynamic performance of vertical DSCs, which can be designed as free-standing structures resting on a reinforced concrete foundation pad, or casks anchored to a foundation pad. The spent nuclear fuel (SNF) at nuclear power plants (NPPs) is initially stored in fuel-storage pools to control the fuel temperature. After several years, the fuel assemblies are transferred to DSCs at sites contiguous to the plant, known as Interim Spent Fuel Storage Installations (ISFSIs). The regulations for these storage systems (10 CFR 72) ensure adequate passive heat removal and radiation shielding during normal operations, off-normal events, and accident scenarios. The integrity of the DSCs is important, even if the overpack does not breach, because eventually the spent fuel-rods need to be shipped either to a reprocessing plant or a repository. DSCs have been considered as a temporary storage solution, and usually are licensed for 20 years, although they can be relicensed for operating periods of up to 60 years. In recent years, DSCs have been reevaluated as a potential mid-term solution, in which the operating period may be extended for up to 300 years. At the same time, recent seismic events have underlined the significant risks DSCs are exposed. The consideration of DCSs for storing spent fuel for hundreds of years has created new challenges. In the case of seismic hazard, longer-term operating periods not only lead to larger horizontal accelerations, but also increase the relative effect of vertical accelerations that usually are disregarded for smaller seismic events. These larger seismic demands could lead to casks sliding and tipping over, impacting the concrete pad or adjacent casks. The casks

  2. Evaluating Long-Term Care Through the Humanbecoming Lens.

    PubMed

    Hart, Judith D

    2015-10-01

    The author describes evaluating long-term care from the humanbecoming perspective. Three core ideas are presented related to dignity and living quality, and how the humanbecoming perspective can be incorporated into long-term care evaluations that make a difference to the residents, caregivers, management, and to the outcomes of long-term care. This approach from the humanbecoming perspective can enrich evaluative information, influence long-term care outcomes, and ensure human dignity for all concerned.

  3. Long-term Variability of Beach Cusps

    NASA Astrophysics Data System (ADS)

    Pianca, C.; Holman, R. A.; Siegle, E.

    2016-02-01

    The most curious morphological features observed on beaches are the cusps. Due to their rhythmic spacing, beach cusps have attracted many observers and many, often contradictory, theories as to their form. Moreover, most of the research about beach cusps has focused on their formation. Few had available long time series to study such things as the variability of alongshore and cross-shore position and spacing on the cusp field, the presence, longevity and interactions between higher and lower sets of cusps, and the processes by which cusp fields extend, shrink or change length scale. The purpose of this work is to use long-term data sets of video images from two study sites, an intermediate (Duck, USA, 26 years) and a reflective beach (Massaguaçu, Brazil, 3 years), to investigate the temporal and spatial changes of cusps conditions. Time-evolving shoreline data were first extracted using an algorithm called ASLIM (Pianca et al 2015). Cusps were then identified based on the band-passed variability of time exposure image data about this shoreline as a function of elevation relative to MSL. The identified beaches cusps will be analyzed for cusp spacing, positions (upper or lower cusps), alongshore variability, merging events, percentage of cusp events, patterns of the events and time scales of variability. Finally, the relationship of these characteristics to environmental conditions (wave, tides, beach conditions) will be studied.

  4. Long-term adequacy of metal resources

    USGS Publications Warehouse

    Singer, D.A.

    1977-01-01

    Although the earth's crust contains vast quantities of metals, extraction technologies and associated costs are inextricably bound to three fundamental geological factors - the amount of metal available in the earth's crust in each range of grades, the mineralogical form and chemical state of the metal, and the spatial distribution of the metal. The energy required to recover a given amount of metal increases substantially as grade declines. Most metal is produced from sulphide or oxide minerals, whereas most metal in the crust may be locked in the structures of the more refractory silicates. Recovery from silicate minerals could require orders of magnitude more energy than that used at present as also could exploitation of small, widely scattered or thin, deeply buried deposits. Although specific information on the fundamental factors is not available, each factor must in turn tend to further restrict exploitation. Independence of average grade and tonnage for many deposit types further reduces the availability of rock as a source of metal. In the long term, effects of these factors will be large increases in price for many metals. ?? 1977.

  5. Long term results of childhood dysphonia treatment.

    PubMed

    Mackiewicz-Nartowicz, Hanna; Sinkiewicz, Anna; Bielecka, Arleta; Owczarzak, Hanna; Mackiewicz-Milewska, Magdalena; Winiarski, Piotr

    2014-05-01

    The aim of this study was to assess the long term results of treatment and rehabilitation of childhood dysphonia. This study included a group of adolescents (n=29) aged from 15 to 20 who were treated due to pediatric hyperfunctional dysphonia and soft vocal fold nodules during their pre-mutational period (i.e. between 5 and 12 years of age). The pre-mutational therapy was comprised of proper breathing pattern training, voice exercises and psychological counseling. Laryngostroboscopic examination and perceptual analysis of voice were performed in each patient before treatment and one to four years after mutation was complete. The laryngostroboscopic findings, i.e. symmetry, amplitude, mucosal wave and vocal fold closure, were graded with NAPZ scale, and the GRBAS scale was used for the perceptual voice analysis. Complete regression of the childhood dysphonia was observed in all male patients (n=14). Voice disorders regressed completely also in 8 out of 15 girls, but symptoms of dysphonia documented on perceptual scale persisted in the remaining seven patients. Complex voice therapy implemented in adolescence should be considered as either the treatment or preventive measure of persistent voice strain, especially in girls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Long-term corrosion testing pan.

    SciTech Connect

    Wall, Frederick Douglas; Brown, Neil R.

    2008-08-01

    This document describes the testing and facility requirements to support the Yucca Mountain Project long-term corrosion testing needs. The purpose of this document is to describe a corrosion testing program that will (a) reduce model uncertainty and variability, (b) reduce the reliance upon overly conservative assumptions, and (c) improve model defensibility. Test matrices were developed for 17 topical areas (tasks): each matrix corresponds to a specific test activity that is a subset of the total work performed in a task. A future document will identify which of these activities are considered to be performance confirmation activities. Detailed matrices are provided for FY08, FY09 and FY10 and rough order estimates are provided for FY11-17. Criteria for the selection of appropriate test facilities were developed through a meeting of Lead Lab and DOE personnel on October 16-17, 2007. These criteria were applied to the testing activities and recommendations were made for the facility types appropriate to carry out each activity. The facility requirements for each activity were assessed and activities were identified that can not be performed with currently available facilities. Based on this assessment, a total of approximately 10,000 square feet of facility space is recommended to meet all future testing needs, given that all testing is consolidated to a single location. This report is a revision to SAND2007-7027 to address DOE comments and add a series of tests to address NWTRB recommendations.

  7. Long-term data storage in diamond.

    PubMed

    Dhomkar, Siddharth; Henshaw, Jacob; Jayakumar, Harishankar; Meriles, Carlos A

    2016-10-01

    The negatively charged nitrogen vacancy (NV(-)) center in diamond is the focus of widespread attention for applications ranging from quantum information processing to nanoscale metrology. Although most work so far has focused on the NV(-) optical and spin properties, control of the charge state promises complementary opportunities. One intriguing possibility is the long-term storage of information, a notion we hereby introduce using NV-rich, type 1b diamond. As a proof of principle, we use multicolor optical microscopy to read, write, and reset arbitrary data sets with two-dimensional (2D) binary bit density comparable to present digital-video-disk (DVD) technology. Leveraging on the singular dynamics of NV(-) ionization, we encode information on different planes of the diamond crystal with no cross-talk, hence extending the storage capacity to three dimensions. Furthermore, we correlate the center's charge state and the nuclear spin polarization of the nitrogen host and show that the latter is robust to a cycle of NV(-) ionization and recharge. In combination with super-resolution microscopy techniques, these observations provide a route toward subdiffraction NV charge control, a regime where the storage capacity could exceed present technologies.

  8. Long-term physiological consequences of pneumonectomy.

    PubMed

    Deslauriers, Jean; Ugalde, Paula; Miro, Santiago; Deslauriers, Deborah R; Ferland, Sylvie; Bergeron, Sébastien; Lacasse, Yves; Provencher, Steeve

    2011-01-01

    Ever since the first successful pneumonectomy for lung cancer was performed in 1933, a number of largely historical reports have attempted to look at the physiological consequences of this operation in order to define patient long-term functional status. The pertinence of these contributions is, however, limited because most were performed in patients who had their pneumonectomy for benign diseases or were carried out in small and heterogeneous populations. Thus, several surgical myths and beliefs such as phrenic nerve interruption at the time of operation might be desirable, marked hyperinflation of the residual lung is associated with reduced lung function, and patients develop pulmonary hypertension over time and have poor exercise tolerance have persisted over the years. Our findings based on a study of 100 patients evaluated 5 or more years after surgery (mean follow-up time, 9.1 ± 2.8 years [5.0-14.7 years]) show that most patients can adjust to living with only one lung and are thus able to live a near-normal life. Although diaphragmatic paralysis is characterized by significant alterations in respiratory function, hyperinflation of the residual lung is beneficial. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Long-term corrosion testing plan.

    SciTech Connect

    Wall, Frederick Douglas; Brown, Neil R.

    2009-02-01

    This document describes the testing and facility requirements to support the Yucca Mountain Project long-term corrosion testing program. The purpose of this document is to describe a corrosion testing program that will (a) reduce model uncertainty and variability, (b) reduce the reliance upon overly conservative assumptions, and (c) improve model defensibility. Test matrices were developed for 17 topical areas (tasks): each matrix corresponds to a specific test activity that is a subset of the total work performed in a task. A future document will identify which of these activities are considered to be performance confirmation activities. Detailed matrices are provided for FY08, FY09 and FY10 and rough order estimates are provided for FY11-17. Criteria for the selection of appropriate test facilities were developed through a meeting of Lead Lab and DOE personnel on October 16-17, 2007. These criteria were applied to the testing activities and recommendations were made for the facility types appropriate to carry out each activity. The facility requirements for each activity were assessed and activities were identified that can not be performed with currently available facilities. Based on this assessment, a total of approximately 10,000 square feet of facility space is recommended to accommodate all future testing, given that all testing is consolidated to a single location. This report is a revision to SAND2008-4922 to address DOE comments.

  10. Long-term treatment outcome in acromegaly.

    PubMed

    Holdaway, I M; Rajasoorya, C R; Gamble, G D; Stewart, A W

    2003-08-01

    A number of groups have developed guidelines to indicate whether an individual with acromegaly has been cured by treatment. However, studies to date do not provide a robust definition of biochemical remission of the disorder based on correlation with long-term outcome. Available data suggest that those with a random serum growth hormone (GH) level of <2.5 microg/l, or a glucose-suppressed GH level of <1 microg/l following treatment have mortality figures indistinguishable from the general population. However, the confidence limits for these mortality estimates are quite wide. It remains possible that growth hormone levels lower than 1 microg/l for random samples, or even lower when using ultrasensitive GH assays, may indicate superior outcome, but this remains to be confirmed. There are limited data relating serum insulin-like growth factor-I (IGF-I) levels to outcome, although normalisation of serum IGF-I clearly improves outcome compared with continued elevation of measurements after treatment. Current evidence suggests that a post-treatment random serum GH <2.5 microg/l and a normal serum IGF-I value defines biochemical cure. Available data suggest that achieving similar growth hormone levels after treatment also reduces the prevalence of chronic complications of the disorder, which is subsequently reflected in improved mortality.

  11. Dental hygienists and long-term care.

    PubMed

    Ablah, C R; Pickard, R B

    1998-01-01

    This study examined the willingness of dental hygienists to work in long-term care (LTC) facilities providing oral health care to the elderly. In August 1995, a mail survey of all 839 licensed and practicing dental hygienists in Kansas was conducted. Respondents were asked about their reasons for choosing dental hygiene as a career, perceptions of the adequacy of their education, satisfaction with their work, interest in working with elderly patients, and whether general supervision would influence their willingness to practice in LTC settings. Response rate was 69 percent, with 582 usable questionnaires returned. Data were analyzed using descriptive statistics and chi-square tests of significance. The results showed an overwhelming majority (94 percent) of respondents would be willing to work, at least on occasion, in a LTC facility. However, few were interested in full-time geriatric practice. Those indicating a willingness to practice regularly with the elderly, at least part time, were typically less experienced in their field and more likely to perceive their education as having adequately prepared them to care for older patients. The findings demonstrate dental hygienists' willingness to provide dental care for older adults. To optimize this resource, appropriate education is needed so that students and current practitioners master the distinctive skills necessary to care for this population.

  12. Long-Term Consequences of Neonatal Injury

    PubMed Central

    Beggs, Simon

    2015-01-01

    The maturation of the central nervous system’s (CNS’s) sensory connectivity is driven by modality-specific sensory input in early life. For the somatosensory system, this input is the physical, tactile interaction with the environment. Nociceptive circuitry is functioning at the time of birth; however, there is still considerable organization and refinement of this circuitry that occurs postnatally, before full discrimination of tactile and noxious input is possible. This fine-tuning involves separation of tactile and nociceptive afferent input to the spinal cord’s dorsal horn and the maturation of local and descending inhibitory circuitry. Disruption of that input in early postnatal life (for example, by tissue injury or other noxious stimulus), can have a profound influence on subsequent development, and consequently the mature functioning of pain systems. In this review, the impact of neonatal surgical incision on nociceptive circuitry is discussed in terms of the underlying developmental neurobiology. The changes are complex, occurring at multiple anatomical sites within the CNS, and including both neuronal and glial cell populations. The altered sensory input from neonatal injury selectively modulates neuronal excitability within the spinal cord, disrupts inhibitory control, and primes the immune system, all of which contribute to the adverse long-term consequences of early pain exposure. PMID:26174217

  13. Intermediate- and long-term earthquake prediction.

    PubMed

    Sykes, L R

    1996-04-30

    Progress in long- and intermediate-term earthquake prediction is reviewed emphasizing results from California. Earthquake prediction as a scientific discipline is still in its infancy. Probabilistic estimates that segments of several faults in California will be the sites of large shocks in the next 30 years are now generally accepted and widely used. Several examples are presented of changes in rates of moderate-size earthquakes and seismic moment release on time scales of a few to 30 years that occurred prior to large shocks. A distinction is made between large earthquakes that rupture the entire downdip width of the outer brittle part of the earth's crust and small shocks that do not. Large events occur quasi-periodically in time along a fault segment and happen much more often than predicted from the rates of small shocks along that segment. I am moderately optimistic about improving predictions of large events for time scales of a few to 30 years although little work of that type is currently underway in the United States. Precursory effects, like the changes in stress they reflect, should be examined from a tensorial rather than a scalar perspective. A broad pattern of increased numbers of moderate-size shocks in southern California since 1986 resembles the pattern in the 25 years before the great 1906 earthquake. Since it may be a long-term precursor to a great event on the southern San Andreas fault, that area deserves detailed intensified study.

  14. Intermediate- and long-term earthquake prediction.

    PubMed Central

    Sykes, L R

    1996-01-01

    Progress in long- and intermediate-term earthquake prediction is reviewed emphasizing results from California. Earthquake prediction as a scientific discipline is still in its infancy. Probabilistic estimates that segments of several faults in California will be the sites of large shocks in the next 30 years are now generally accepted and widely used. Several examples are presented of changes in rates of moderate-size earthquakes and seismic moment release on time scales of a few to 30 years that occurred prior to large shocks. A distinction is made between large earthquakes that rupture the entire downdip width of the outer brittle part of the earth's crust and small shocks that do not. Large events occur quasi-periodically in time along a fault segment and happen much more often than predicted from the rates of small shocks along that segment. I am moderately optimistic about improving predictions of large events for time scales of a few to 30 years although little work of that type is currently underway in the United States. Precursory effects, like the changes in stress they reflect, should be examined from a tensorial rather than a scalar perspective. A broad pattern of increased numbers of moderate-size shocks in southern California since 1986 resembles the pattern in the 25 years before the great 1906 earthquake. Since it may be a long-term precursor to a great event on the southern San Andreas fault, that area deserves detailed intensified study. Images Fig. 1 PMID:11607658

  15. Transuranic waste: long-term planning

    SciTech Connect

    Young, K.C.

    1985-07-01

    Societal concerns for the safe handling and disposal of toxic waste are behind many of the regulations and the control measures in effect today. Transuranic waste, a specific category of toxic (radioactive) waste, serves as a good example of how regulations and controls impact changes in waste processing - and vice versa. As problems would arise with waste processing, changes would be instituted. These changes improved techniques for handling and disposal of transuranic waste, reduced the risk of breached containment, and were usually linked with regulatory changes. Today, however, we face a greater public awareness of and concern for toxic waste control; thus, we must anticipate potential problems and work on resolving them before they can become real problems. System safety analyses are valuable aids in long-term planning for operations involving transuranic as well as other toxic materials. Examples of specific system safety analytical methods demonstrate how problems can be anticipated and resolution initiated in a timely manner having minimal impacts upon allocation of resource and operational goals. 7 refs., 1 fig.

  16. The long-term variability of Vega

    NASA Astrophysics Data System (ADS)

    Butkovskaya, V.; Plachinda, S.; Valyavin, G.; Baklanova, D.; Lee, B.-C.

    2011-12-01

    Over the time of 60 years Vega (α Lyrae = HD 172167, A0V) has been generally accepted as a standard star in the near-infrared, optical, and ultraviolet regions. But is the spectrophotometric standard Vega really non-variable star? Researchers give very different answers to this question. We aim to search a periodicity in our results of spectropolarimetric study of Vega, namely periodic variations in equivalent width of the spectral lines and longitudinal magnetic field measurements. High-accuracy spectropolarimetric observations of Vega have been performed during 26 nights from 1997 to 2010 using the Coudé spectrograph of the 2.6-m Shain reflector at the Crimean Astrophysical Observatory (CrAO, Ukraine) and during 4 nights in 2007 and 2008 using the echelle spectrograph BOES at the Bohyunsan Optical Astronomy Observatory (BOAO, South Korea). The long-term (year-to-year) variability of Vega was confirmed. It was concluded that this variability does not have magnetic nature. The paper is dedicated to the memory of V.P. Merezhin.

  17. Economic efficiency, IRPs and long term contracts

    SciTech Connect

    Sutherland, R.J.

    1993-04-30

    There is no market failure that warrants utility regulation of the construction of new generating plants, the supply of energy efficiency or the purchase of fuel under contract. The natural monopoly problem applies to the distribution of electricity and gas, not to generation, energy conservation, or gas purchases. Utility regulation magnifies a market failure, which is the principal agent problem. Regulatory allowance of utilities signing long term fixed price contracts and undertaking conservation measures result in costs and risks being shifted to ratepayers that would not occur under competitive market conditions. Economic efficiency would be enhanced if cost of service regulation of electric and gas utilities were replaced by a competitive market process for the construction of new power plants, utility conservation programs and contracts to purchase fuel. Conservation measures could be supplied by energy service companies. Gas merchants could provide gas and energy conservation directly to ultimate customers, if they had access to LDC pipelines. With a competitive market established to sell gas and energy services, contracts and conservation measures would not require cost-of- service regulation.

  18. Long-Term Soft Denture Lining Materials

    PubMed Central

    Chladek, Grzegorz; Żmudzki, Jarosław; Kasperski, Jacek

    2014-01-01

    Long-term soft denture lining (LTSDL) materials are used to alleviate the trauma associated with wearing complete dentures. Despite their established clinical efficacy, the use of LTSDLs has been limited due to the unfavorable effects of the oral environment on some of their mechanical and performance characteristics. The unresolved issue of LTSDL colonization by Candida albicans is particularly problematic. Silicone-based LTSDL (SLTSDL) materials, which are characterized by more stable hardness, sorption and solubility than acrylic-based LTSDLs (ALTSDLs), are currently the most commonly used LTSDLs. However, SLTSDLs are more prone to debonding from the denture base. Moreover, due to their limitations, the available methods for determining bond strength do not fully reflect the actual stability of these materials under clinical conditions. SLTSDL materials exhibit favorable viscoelastic properties compared with ALTSDLs. Furthermore, all of the lining materials exhibit an aging solution-specific tendency toward discoloration, and the available cleansers are not fully effective and can alter the mechanical properties of LTSDLs. Future studies are needed to improve the microbiological resistance of LTSDLs, as well as some of their performance characteristics. PMID:28788163

  19. Long-term data storage in diamond

    PubMed Central

    Dhomkar, Siddharth; Henshaw, Jacob; Jayakumar, Harishankar; Meriles, Carlos A.

    2016-01-01

    The negatively charged nitrogen vacancy (NV−) center in diamond is the focus of widespread attention for applications ranging from quantum information processing to nanoscale metrology. Although most work so far has focused on the NV− optical and spin properties, control of the charge state promises complementary opportunities. One intriguing possibility is the long-term storage of information, a notion we hereby introduce using NV-rich, type 1b diamond. As a proof of principle, we use multicolor optical microscopy to read, write, and reset arbitrary data sets with two-dimensional (2D) binary bit density comparable to present digital-video-disk (DVD) technology. Leveraging on the singular dynamics of NV− ionization, we encode information on different planes of the diamond crystal with no cross-talk, hence extending the storage capacity to three dimensions. Furthermore, we correlate the center’s charge state and the nuclear spin polarization of the nitrogen host and show that the latter is robust to a cycle of NV− ionization and recharge. In combination with super-resolution microscopy techniques, these observations provide a route toward subdiffraction NV charge control, a regime where the storage capacity could exceed present technologies. PMID:27819045

  20. Long-term potentiation: peeling the onion.

    PubMed

    Nicoll, Roger A; Roche, Katherine W

    2013-11-01

    Since the discovery of long-term potentiation (LTP), thousands of papers have been published on this phenomenon. With this massive amount of information, it is often difficult, especially for someone not directly involved in the field, not to be overwhelmed. The goal of this review is to peel away as many layers as possible, and probe the core properties of LTP. We would argue that the many dozens of proteins that have been implicated in the phenomenon are not essential, but rather modulate, often in indirect ways, the threshold and/or magnitude of LTP. What is required is NMDA receptor activation followed by CaMKII activation. The consequence of CaMKII activation is the rapid recruitment of AMPA receptors to the synapse. This recruitment is independent of AMPA receptor subunit type, but absolutely requires an adequate pool of surface receptors. An important unresolved issue is how exactly CaMKII activation leads to modifications in the PSD to allow rapid enrichment. This article is part of the Special Issue entitled 'Glutamate Receptor-Dependent Synaptic Plasticity'.

  1. Neurological long term consequences of deep diving.

    PubMed Central

    Todnem, K; Nyland, H; Skeidsvoll, H; Svihus, R; Rinck, P; Kambestad, B K; Riise, T; Aarli, J A

    1991-01-01

    Forty commercial saturation divers, mean age 34.9 (range 24-49) years, were examined one to seven years after their last deep dive (190-500 metres of seawater). Four had by then lost their divers' licence because of neurological problems. Twenty seven (68%) had been selected by neurological examination and electroencephalography before the deep dives. The control group consisted of 100 men, mean age 34.0 (range 22-48) years. The divers reported significantly more symptoms from the nervous system. Concentration difficulties and paraesthesia in feet and hands were common. They had more abnormal neurological findings by neurological examination compatible with dysfunction in the lumbar spinal cord or roots. They also had a larger proportion of abnormal electroencephalograms than the controls. The neurological symptoms and findings were highly significantly correlated with exposure to deep diving (depth included), but even more significantly correlated to air and saturation diving and prevalence of decompression sickness. Visual evoked potentials, brainstem auditory evoked potentials, and magnetic resonance imaging of the brain did not show more abnormal findings in the divers. Four (10%) divers had had episodes of cerebral dysfunction during or after the dives; two had had seizures, one had had transitory cerebral ischaemia and one had had transitory global amnesia. It is concluded that deep diving may have a long term effect on the nervous system of the divers. PMID:2025592

  2. Long-term in vivo pineal microdialysis.

    PubMed

    Sun, Xing; Liu, Tiecheng; Deng, Jie; Borjigin, Jimo

    2003-09-01

    This study describes the development of a new technique for long-term measurement of daily 5-hydroxytryptamine (5-HT) and melatonin contents in the pineal gland of freely moving rats. The technique features a number of novel improvements over previous protocols. It allows visualization of the pineal gland for accurate targeting of the guide cannula, which minimizes bleeding; incurs no direct injury to the surrounding brain tissues; and causes no interference with the sympathetic innervation from the superior cervical ganglia. Robust releases of melatonin and indole precursors were continuously monitored quantitatively and reproducibly for more than 2 wk in the same animal. In addition, effects of pharmacological agents on in vivo pineal circadian rhythms can be studied reproducibly over time, and gene expression profiles can be correlated with physiological consequences in single animals. Using these approaches, it is found that beta-adrenergic activation leads to decreased release of 5-HT, and that increased cAMP signaling in vivo results in activation of N-acetyltransferase gene induction and melatonin production. These studies will enhance the understanding of signaling pathways that regulate pineal 5-HT and melatonin synthesis and secretion.

  3. [Long-term stability of orthodontic treatment].

    PubMed

    Kuijpers-Jagtman, A M; Al Yami, E A; van 't Hof, M A

    2000-04-01

    Aim of this study was to assess long-term stability of orthodontic treatment in a sample of 1016 patients until 10 years postretention. Treatment outcome was measured with the PAR-index at 6 different stages. The mean age of the patients was 12.0 +/- 3.1 year at the start of treatment to 26.3 +/- 2.9 year 10 years postretention. The results show that 67% of the orthodontic treatment result, as measured with the PAR-index, was maintained 10 years postretention. The PAR-scores for the midline and the open bite remained about the same over the years. However, the scores for the lateral occlusion, overjet, reversed overjet, overbite, and contact point displacement of the upper and lower front teeth increased gradually over time. Nearly 50% of the total relapse took place the first two years after retention. The largest change was found for the position of the lower incisors. Ten years postretention their position was even worse than at the start of treatment.

  4. 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…

  5. 3 CFR - Long-Term Gulf Coast Restoration Support Plan

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Long-Term Gulf Coast Restoration Support Plan Presidential Documents Other Presidential Documents Memorandum of June 30, 2010 Long-Term Gulf Coast... help the Gulf Coast and its people recover from this tragedy. A long-term plan to restore the unique...

  6. Long-term trajectories and service needs for military families.

    PubMed

    Link, Patrick E; Palinkas, Lawrence A

    2013-12-01

    The deployment of US military personnel to recent conflicts has been a significant stressor for their families; yet, we know relatively little about the long-term family effects of these deployments. Using data from prior military service eras, we review our current understanding of the long-term functioning and needs of military families. These data suggest that overseas deployment, exposure to combat, experiencing or participating in violence during war deployment, service member injury or disability, and combat-related post-traumatic stress disorder (PTSD) all have profound impacts on the functioning of military families. We offer several recommendations to address these impacts such as the provision of family-centered, trauma-informed resources to families of veterans with PTSD and veterans who experienced high levels of combat and war violence. Recent efforts to address the needs of caregivers of veterans should be evaluated and expanded, as necessary. We should also help military families plan for predictable life events likely to challenge their resilience and coping capacities. Future research should focus on the following: factors that mediate the relationship between PTSD, war atrocities, caregiver burden, and family dysfunction; effective family-centered interventions that can be scaled-up to meet the needs of a dispersed population; and system-level innovations necessary to ensure adequate access to these interventions.

  7. Multiobjective long-term planning of biopharmaceutical manufacturing facilities.

    PubMed

    Lakhdar, K; Savery, J; Papageorgiou, L G; Farid, S S

    2007-01-01

    Biopharmaceutical companies with large portfolios of clinical and commercial products typically need to allocate production across several multiproduct facilities, including third party contract manufacturers. This poses several capacity planning challenges which are further complicated by the need to satisfy different stakeholders often with conflicting objectives. This work addresses the question of how a biopharmaceutical manufacturer can make better long-term capacity planning decisions given multiple strategic criteria such as cost, risk, customer service level, and capacity utilization targets. A long-term planning model that allows for multiple facilities and accounts for multiple objectives via goal programming is developed. An industrial case study based on a large scale biopharmaceutical manufacturer is used to illustrate the functionality of the model. A single objective model is used to identify how best to use existing capacity so as to maximize profits for different demand scenarios. Mitigating risk due to unforeseen circumstances by including a dual facility constraint is shown to be a reasonable strategy at base case demand levels but unacceptable if demands are 150% higher than expected. The capacity analysis identifies where existing capacity fails to meet demands given the constraints. A multiobjective model is used to demonstrate how key performance measures change given different decision making policies where different weights are assigned to cost, customer service level, and utilization targets. The analysis demonstrates that a high profit can still be achieved while meeting key targets more closely. The sensitivity of the optimal solution to different limits on the targets is illustrated.

  8. Long Term Data Preservation for CDF at INFN-CNAF

    NASA Astrophysics Data System (ADS)

    Amerio, S.; Chiarelli, L.; dell'Agnello, L.; De Girolamo, D.; Gregori, D.; Pezzi, M.; Prosperini, A.; Ricci, P.; Rosso, F.; Zani, S.

    2014-06-01

    Long-term preservation of experimental data (intended as both raw and derived formats) is one of the emerging requirements coming from scientific collaborations. Within the High Energy Physics community the Data Preservation in High Energy Physics (DPHEP) group coordinates this effort. CNAF is not only one of the Tier-1s for the LHC experiments, it is also a computing center providing computing and storage resources to many other HEP and non-HEP scientific collaborations, including the CDF experiment. After the end of data taking in 2011, CDF is now facing the challenge to both preserve the large amount of data produced during several years of data taking and to retain the ability to access and reuse it in the future. CNAF is heavily involved in the CDF Data Preservation activities, in collaboration with the Fermilab National Laboratory (FNAL) computing sector. At the moment about 4 PB of data (raw data and analysis-level ntuples) are starting to be copied from FNAL to the CNAF tape library and the framework to subsequently access the data is being set up. In parallel to the data access system, a data analysis framework is being developed which allows to run the complete CDF analysis chain in the long term future, from raw data reprocessing to analysis-level ntuple production. In this contribution we illustrate the technical solutions we put in place to address the issues encountered as we proceeded in this activity.

  9. General practitioners' management of the long-term sick role.

    PubMed

    Higgins, Angela; Porter, Sam; O'Halloran, Peter

    2014-04-01

    In this paper, we use qualitative research techniques to examine the role of general practitioners in the management of the long-term sickness absence. In order to uncover the perspectives of all the main agents affected by the actions of general practitioners, a case study approach focussing on one particular employment sector, the public health service, is adopted. The role of family physicians is viewed from the perspectives of health service managers, occupational health physicians, employees/patients, and general practitioners. Our argument is theoretically framed by Talcott Parsons's model of the medical contribution to the sick role, along with subsequent conceptualisations of the social role and position of physicians. Sixty one semi-structured interviews and three focus group interviews were conducted in three Health and Social Care Trusts in Northern Ireland between 2010 and 2012. There was a consensus among respondents that general practitioners put far more weight on the preferences and needs of their patients than they did on the requirements of employing organisations. This was explained by respondents in terms of the propinquity and longevity of relationships between doctors and their patients, and by the ideology of holistic care and patient advocacy that general practitioners viewed as providing the foundations of their approach to patients. The approach of general practitioners was viewed negatively by managers and occupational health physicians, and more positively by general practitioners and patients. However, there is some evidence that general practitioners would be prepared to forfeit their role as validators of sick leave. Given the imperatives of both state and capital to reduce the financial burden of long-term sickness, this preparedness puts into doubt the continued role of general practitioners as gatekeepers to legitimate long-term sickness absence.

  10. [Bone and joint problems in long-term dialysis].

    PubMed

    Brunner, F P

    1992-05-09

    Bone and joint pathology in patients undergoing long-term dialysis for end-stage renal failure is presented in the light of typical cases and a brief review of the literature. Osteomalacia with bone pain and fractures is caused mainly by aluminium overload due to enteral uptake from aluminium-containing phosphate binders. This is why calcium acetate or calcium carbonate should be used exclusively to lower enteral phosphate reabsorption. If--due to hypercalcemia--aluminium containing phosphate binders--cannot be entirely avoided, they should never be administered together with citrate (citrate-containing medication, fruit juice, etc.), which chelates aluminium and thereby massively increases enteral aluminium uptake. Secondary hyperparathyroidism with overt radiologically demonstrable bone disease develops in many patients on long-term dialysis despite efforts to maintain plasma calcium within or slightly above the upper normal range and concomitant treatment with calcitriol. Intravenous administration of relatively high-dose calcitriol or 1-alpha-OH-D3 (neither readily available at the present time), as well as the newly developed experimental vitamin D analogs such as 22-oxa-(OH)2-D3, which appear to suppress the parathyroid glands without increasing enteral calcium reabsorption, may in future reduce the high incidence of parathyroidectomy in patients on maintenance dialysis. beta 2-microglobulin amyloidosis is a new disease entity which develops in the majority of long-term dialysis patients. Apart from carpal tunnel syndrome, trigger fingers and tendon ruptures, it is associated with acute and chronic painful erosive arthropathy with joint effusions and fractures, particularly around the hip, due to cystic bone lesions where bone is replaced by nodular amyloid deposits.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Dietary antioxidants and long-term risk of dementia

    PubMed Central

    Devore, Elizabeth E.; Grodstein, Francine; van Rooij, Frank J.A.; Hofman, Albert; Stampfer, Meir J.; Witteman, Jacqueline C.M.; Breteler, Monique M.B.

    2010-01-01

    OBJECTIVE To study consumption of major dietary antioxidants in relation to long-term risk of dementia. DESIGN AND SETTING The Rotterdam Study, a population-based, prospective cohort study in the Netherlands. PARTICIPANTS A total of 5,395 participants, aged 55+ years, who were free of dementia and provided dietary information at study baseline. MAIN OUTCOME MEASURES Incidence of dementia and Alzheimer’s disease (AD), based on internationally accepted criteria, in relation to dietary intake of vitamin E, vitamin C, beta carotene, and flavonoids. RESULTS During an average follow-up period of 9.6 years, dementia developed in 465 participants, of whom 365 were diagnosed with AD. In multivariate models adjusted for age, education, APOE ε4 genotype, total energy intake, alcohol intake, smoking habits, body-mass index (BMI), and supplement use, higher intake of vitamin E at baseline was associated with a lower long-term risk of dementia (p-trend=0.02). Compared to participants in the lowest tertile of vitamin E intake, those in the highest tertile were 25% less likely to develop dementia (HR, 0.75; 95% CI, 0.59–0.95 with adjustment for potential confounders). Dietary intakes of vitamin C, beta carotene, and flavonoids were not associated with dementia risk (after multivariate adjustment, p-trend=1.0 for both vitamin C and beta carotene and p-trend=0.6 for flavonoids). Results were similar when AD risk was specifically examined. CONCLUSION Higher intake of foods rich in vitamin E may modestly reduce long-term risk of dementia and AD. PMID:20625087

  12. 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.

  13. Using Workflow Diagrams to Address Hand Hygiene in Pediatric Long-Term Care Facilities.

    PubMed

    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.

  14. Requirements of e-science and Grid projects towards long-term archiving of scientific data

    NASA Astrophysics Data System (ADS)

    Klump, J.

    2009-04-01

    The enormous amounts of data from Grid projects and the complexity of data from e-science projects suggest that these new types of projects also have new requirements towards long-term archiving of data. These types of projects are becoming increasingly important in Earth and Space Science Informatics, posing new challenges in data curation and the long-term availability of geoscience data. The study "Requirements of e-science and Grid projects towards long-term archiving of scientific and scholarly data" was commissioned by the German "Network of Expertise in Digital Long-term Preservation" (nestor). The study investigates from a technological and from a management perspective whether existing infrastructures in data producing research e-science and Grid communities meet the requirements of long-term digital preservation. The study also investigates, whether technologies and best practices from e-science and Grid project can be transferred to organisations and systems in the field of long-term digital preservation. The interviews conducted as part of this study showed considerable differences between projects in the way they approached long-term digital preservation of data. Their achievements -but also their deficits- are analysed and discussed. The recommendations given in this study are derived from this analysis and discussion. The results of this study were discussed and validated in workshops with stakeholders from German Grid and eScience projects.

  15. 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.

  16. Demonstrating the Safety of Long-Term Dry Storage - 13468

    SciTech Connect

    McCullum, Rod; Brookmire, Tom; Kessler, John; Leblang, Suzanne; Levin, Adam; Martin, Zita; Nesbit, Steve; Nichol, Marc; Pickens, Terry

    2013-07-01

    Commercial nuclear plants in the United States were originally designed with the expectation that used nuclear fuel would be moved directly from the reactor pools and transported off site for either reprocessing or direct geologic disposal. However, Federal programs intended to meet this expectation were never able to develop the capability to remove used fuel from reactor sites - and these programs remain stalled to this day. Therefore, in the 1980's, with reactor pools reaching capacity limits, industry began developing dry cask storage technology to provide for additional on-site storage. Use of this technology has expanded significantly since then, and has today become a standard part of plant operations at most US nuclear sites. As this expansion was underway, Federal programs remained stalled, and it became evident that dry cask systems would be in use longer than originally envisioned. In response to this challenge, a strong technical basis supporting the long term dry storage safety has been developed. However, this is not a static situation. The technical basis must be able to address future challenges. Industry is responding to one such challenge - the increasing prevalence of high burnup (HBU) used fuel and the need to provide long term storage assurance for these fuels equivalent to that which has existed for lower burnup fuels over the past 25 years. This response includes a confirmatory demonstration program designed to address the aging characteristics of HBU fuel and set a precedent for a learning approach to aging management that will have broad applicability across the used fuel storage landscape. (authors)

  17. 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

  18. 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

  19. The neuronal response at extended timescales: long-term correlations without long-term memory

    PubMed Central

    Soudry, Daniel; Meir, Ron

    2014-01-01

    Long term temporal correlations frequently appear at many levels of neural activity. We show that when such correlations appear in isolated neurons, they indicate the existence of slow underlying processes and lead to explicit conditions on the dynamics of these processes. Moreover, although these slow processes can potentially store information for long times, we demonstrate that this does not imply that the neuron possesses a long memory of its input, even if these processes are bidirectionally coupled with neuronal response. We derive these results for a broad class of biophysical neuron models, and then fit a specific model to recent experiments. The model reproduces the experimental results, exhibiting long term (days-long) correlations due to the interaction between slow variables and internal fluctuations. However, its memory of the input decays on a timescale of minutes. We suggest experiments to test these predictions directly. PMID:24744724

  20. Dietetic students' experiences providing meal assistance in long-term care facilities.

    PubMed

    Osinga, Nicole; Keller, Heather

    2013-01-01

    This qualitative study involved describing the experiences of dietetic students who provided meal help to older adults. Of interest were benefits and challenges, and how training could be enhanced. Individual, face-to-face, semi-structured interviews were conducted with nine undergraduate dietetic students. In the preceding year, these students had volunteered as meal helpers in a long-term care home. Interviews were digitally recorded and transcribed verbatim. Qualitative thematic analysis was used to analyze the transcripts. All participating students were female and from one undergraduate program. Three main themes emerged: growing into the role, learning outside the classroom, and providing quality assistance. This study provides an understanding of how meal helping can be a valuable experience for emerging dietitians. It also gives insights into training and the development of the meal helper role.

  1. 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.

  2. A structured review of long-term care demand modelling.

    PubMed

    Worrall, Philip; Chaussalet, Thierry J

    2015-06-01

    Long-term care (LTC) represents a significant and substantial proportion of healthcare spends across the globe. Its main aim is to assist individuals suffering with more or more chronic illnesses, disabilities or cognitive impairments, to carry out activities associated with daily living. Shifts in several economic, demographic and social factors have raised concerns surrounding the sustainability of current systems of LTC. Substantial effort has been put into modelling the LTC demand process itself so as to increase understanding of the factors driving demand for LTC and its related services. Furthermore, such modeling efforts have also been used to plan the operation and future composition of the LTC system itself. The main aim of this paper is to provide a structured review of the literature surrounding LTC demand modeling and any such industrial application, whilst highlighting any potential direction for future researchers.

  3. Modeling Maintenance of Long-Term Potentiation in Clustered Synapses: Long-Term Memory without Bistability

    PubMed Central

    Smolen, Paul

    2015-01-01

    Memories are stored, at least partly, as patterns of strong synapses. Given molecular turnover, how can synapses maintain strong for the years that memories can persist? Some models postulate that biochemical bistability maintains strong synapses. However, bistability should give a bimodal distribution of synaptic strength or weight, whereas current data show unimodal distributions for weights and for a correlated variable, dendritic spine volume. Thus it is important for models to simulate both unimodal distributions and long-term memory persistence. Here a model is developed that connects ongoing, competing processes of synaptic growth and weakening to stochastic processes of receptor insertion and removal in dendritic spines. The model simulates long-term (>1 yr) persistence of groups of strong synapses. A unimodal weight distribution results. For stability of this distribution it proved essential to incorporate resource competition between synapses organized into small clusters. With competition, these clusters are stable for years. These simulations concur with recent data to support the “clustered plasticity hypothesis” which suggests clusters, rather than single synaptic contacts, may be a fundamental unit for storage of long-term memory. The model makes empirical predictions and may provide a framework to investigate mechanisms maintaining the balance between synaptic plasticity and stability of memory. PMID:25945261

  4. Modeling maintenance of long-term potentiation in clustered synapses: long-term memory without bistability.

    PubMed

    Smolen, Paul

    2015-01-01

    Memories are stored, at least partly, as patterns of strong synapses. Given molecular turnover, how can synapses maintain strong for the years that memories can persist? Some models postulate that biochemical bistability maintains strong synapses. However, bistability should give a bimodal distribution of synaptic strength or weight, whereas current data show unimodal distributions for weights and for a correlated variable, dendritic spine volume. Thus it is important for models to simulate both unimodal distributions and long-term memory persistence. Here a model is developed that connects ongoing, competing processes of synaptic growth and weakening to stochastic processes of receptor insertion and removal in dendritic spines. The model simulates long-term (>1 yr) persistence of groups of strong synapses. A unimodal weight distribution results. For stability of this distribution it proved essential to incorporate resource competition between synapses organized into small clusters. With competition, these clusters are stable for years. These simulations concur with recent data to support the "clustered plasticity hypothesis" which suggests clusters, rather than single synaptic contacts, may be a fundamental unit for storage of long-term memory. The model makes empirical predictions and may provide a framework to investigate mechanisms maintaining the balance between synaptic plasticity and stability of memory.

  5. 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.

  6. LONG TERM IN SITU DISPOSAL ENGINEERING STUDY

    SciTech Connect

    ADAMS; CARLSON; BROCKMAN

    2003-07-23

    Patent application pulled per Ken Norris (FH General Counsel). The objective of this study is to devise methods, produce conceptual designs, examine and select alternatives, and estimate costs for the demonstration of long-term (300-year) in situ disposal of an existing waste disposal site. The demonstration site selected is the 216-A-24 Crib near the 200 East Area. The site contains a fission product inventory and has experienced plant, animal, and inadvertent than intrusion. Of the potential intrusive events and transport pathways at the site, potential human intrusion has been given primary consideration in barrier design. Intrusion by wind, plants, and animals has been given secondary consideration. Groundwater modeling for a number of barrier configurations has been carried out to help select a barrier that will minimize water infiltration and waste/water contact time. The estimated effective lifetime and cost of 20 barrier schemes, using a variety of materials, have been evaluated. The schemes studied include single component surface barriers, multicomponent barriers, and massively injected grout barriers. Five barriers with high estimated effective lifetimes and relatively low costs have been selected for detailed evaluation. They are basalt riprap barriers, massive soil barriers, salt basin barriers, multi-component fine/coarse barriers, and cemented basalt barriers. A variety of materials and configurations for marking the site have also been considered. A decision analysis was completed to select a barrier scheme for demonstration. The analysis indicated that the basalt riprap alternative would be the preferred choice for a full-scale demonstration. The recommended approach is to demonstrate the basalt riprap barrier at the 216-A-24 Crib as soon as possible. Methods and costs of assessing effectiveness of the demonstration are also described. Preliminary design modifications and costs for applying the five selected barrier schemes to other site types are

  7. Long-term Behavior of DNAPL Residuals

    NASA Astrophysics Data System (ADS)

    Liu, Y.; Illangasekare, T.; Kitanidis, P. K.

    2012-12-01

    Understanding and being able to predict the long-term behavior of DNAPL (i.e., TCE) residuals in the source zone are significant in the evaluation of plume spreading. We apply both theoretical analysis and pore-scale simulations to investigate the mass transfer and the effect of reductive dechlorination, in which the contaminant behaves as electron acceptor. At the upfront of the source zone, where the boundary layer has not fully developed, the mass transfer increases as a power-law function of the Peclet number, and is enhanced by biodegradation. These results are consistent with past findings. Under certain conditions, further downstream inside the source zone, the rate of dissolution is slower due to the diluted mass from upstream. Widely applied first-order biodegradation implicitly assumes that the reaction solely depends on the concentration of the contaminant. However, in the slow dilution region, the limitation of electron donor on biodegradation is not negligible. For the reaction between an electron donor and an electron acceptor with intrinsic second-order kinetics, the late-time bio-reaction demonstrates a first-order decay macroscopically with respect to the mass of electron donor, not with respect to that of the contaminant. The late-time decay rate only depends on the intrinsic rate and the solubility of the contaminant. During the intermediate time, affecting by both the concentrations of electron donor and electron acceptor, the first-order decay is not valid. We show that the electron donor decays as exp(-t^2), instead of exp(-t). Moreover, the intermediate-time decay rate is a function of the spatial distribution of DNAPL residuals and the initial conditions.he relationship of the Sherwood number and Peclet number (Comparison of pore-scale simulations and best-fitting curve) he decay of electron donor as a function of t^2

  8. Long term cultivation of larger benthic Foraminifera

    NASA Astrophysics Data System (ADS)

    Wöger, Julia; Eder, Wolfgang; Kinoshita, Shunichi; Antonino, Briguglio; Carles, Ferrandes-Cañadell; Hohenegger, Johann

    2015-04-01

    Benthic Foraminifera are used in a variety of applications employing numerous different methods, i.e. ecological monitoring, studying the effects of ocean acidification, reconstructing palaeo-bathymetry or investigating palaeo-salinity and palaeo-temperature to name only a few. To refine our understanding of ecological influences on larger benthic foraminiferal biology and to review inferences from field observations, culture experiments have become an indispensable tool. While culture experiments on smaller benthic foraminifera have become increasingly frequent in the past century, reports of the cultivation of symbiont bearing larger Foraminifera are rare. Generally, cultivation experiments can be divided into two groups: Culturing of populations and cultivation of single specimens allowing individual investigation. The latter differ form the former by several restrictions resulting from the need to limit individual motility without abridging microenvironmental conditions in the Foraminiferans artificial habitat, necessary to enable the individual to development as unfettered as possible. In this study we present first experiences and preliminary results of the long-term cultivation of larger benthic Foraminifera conducted at the 'Tropical Biosphere Research Station Sesoko Island, University of the Ryukyus', Japan, trying to reproduce natural conditions as closely as possible. Individuals of three species of larger benthic Foraminifera (Heterostegina depressa, Palaeonummulites venosus and Operculina complanata) have been cultured since April 2014. At the time of the general assembly the cultivation experiments will have been going on for more than one year, with the aim to investigate growth rates, longevities and reproduction strategies for comparison with results statistically inferred from application of the of the 'natural laboratory' method. The most important factor influencing foraminiferal health and development was found to be light intensity and light

  9. Use of opioids in long-term management of temporomandibular joint dysfunction.

    PubMed

    Bouloux, Gary F

    2011-07-01

    The long-term treatment of patients with chronic temporomandibular joint dysfunction has been challenging. The long-term use of opioids in these patients can be neither supported nor refuted based on current evidence. However, evidence is available to support the long-term use of opioids in other chronic noncancer pain states with reduced pain, improved function, and improved quality of life. One group of patients with chronic temporomandibular joint pain, for whom both noninvasive and invasive treatment has failed, might benefit from long-term opioid medication. The choices include morphine, fentanyl, oxycodone, tramadol, hydrocodone, and methadone. Adjunct medication, including antidepressant and anticonvulsant drugs, can also be used. The safety of these medications has been well established, but the potential for adverse drug-related behavior does exist, requiring appropriate patient selection, adequate monitoring, and intervention when needed.

  10. Ranked motives of long-term care providing family caregivers.

    PubMed

    Beneken Genaamd Kolmer, Deirdre; Tellings, Agnes; Gelissen, John; Garretsen, Henk; Bongers, Inge

    2008-03-01

    Family caregivers provide long-term care to their chronically ill loved ones and as a consequence they experience physical, relational and financial problems. This study investigates how long-term family caregivers rank 12 motives for caregiving. Motives are derived from the views of four philosophical anthropologists and are related to self-reported stress and joy and to several different background characteristics of respondents. Motives that focus on feelings concerning the relationship between caregiver and care recipient are more popular as a first choice than motives stemming from feelings of obligation or a general feeling of happiness and are also more popular than more self-directed motives. An analysis of full ranking data shows that two groups can be distinguished, one group of family caregivers with mixed motives and one group of family caregivers with motives that focus on reciprocal mutually equal relationships. The latter are mainly women taking care for a partner or a child, the former report high levels of stress. Implications for intervention programmes and health policy are being discussed.

  11. Mediation in long-term care facilities: a pilot project.

    PubMed

    Persson, Diane; Castro, Carmen

    2008-06-01

    To describe the development and implementation of a mediation model appropriate for long-term care facilities. The recruitment and training of mediators; the role of the ombudsman; and approaches to educating facility staff, families, and residents are described. Disputes identified as suitable for mediation include care disputes, resident-to-resident issues, and family matters. Pilot project results indicate cases that reach mediation generally come to a mutual agreement that is upheld over time. Only a small number of cases referred for mediation are actually mediated. A main barrier to using mediation as an option is lack of knowledge of its availability and potential benefits. Intensive outreach within facilities is essential if residents, families, and staff are to recognize and refer cases. Mediation must be considered broadly as an approach, not as a single process. Mediation can help to involve residents and families in constructive decision making that improves care, and could be a part of the overall dispute resolution system in long-term care.

  12. Long-term outcome of focal dystonia in string instrumentalists.

    PubMed

    Schuele, Stephan; Lederman, Richard J

    2004-01-01

    This study describes the clinical characteristics and long-term outcome in string instrumentalists with focal task-specific dystonia. We present the results of a follow-up telephone survey of 21 violin and viola players with focal dystonia. Eighteen musicians responded to the questionnaire. Information on long-term outcome was available on average 13.8 years after onset of symptoms. Main complaints were playing-related loss of control and involuntary movements affecting the fingering hand in 16 and the bow arm in 5 patients. In 18 patients (86%), signs of abnormal posture could be detected by watching them play their instrument. Treatment attempts included nerve decompression, physical therapy, retraining, and anticholinergic medication. In selected patients, botulinum toxin injections or splint devices were offered. Only 38% of the performing artists were able to maintain their professional careers, among them none with bow arm dystonia. Focal dystonia may affect the fingering hand or bow arm in violin and viola instrumentalists. Treatment benefit is limited and in more than half of the patients, dystonia leads to the end of their musical career.

  13. Long-term outcome after anterior cervical discectomy without fusion

    PubMed Central

    Bartels, Ronald H. M. A.

    2007-01-01

    To retrospectively study the long-term outcome of patients after anterior cervical discectomy without fusion (ACD) compared to results published on the long-term outcome after ACD with fusion (ACDF). We reviewed the charts of all patients receiving ACD surgery between 1985 and 2000 to analyze the direct post-operative results as well as complications of the surgery. Moreover, 102 patients, randomly selected, were interviewed with the neck disability index to study possible persisting complaints up to 18 years after ACD surgery. A total of 551 Patients were identified. Two months post-operative follow up at the outpatient clinic revealed that 90.1% of patients were satisfied with the result of ACD surgery. At the time of the survey, this percentage had dropped to 67.6%. In addition, 20.6% and 11.8% had obtained moderate to severe complaints, respectively, in daily-life activities. Complaints were mainly localized in the neck region and occasionally provoked radiating pain in the arm. On the short term, ACD leads to a satisfied outcome. Over the longer term, patients report increasing complaints. The increase in complaints at the time of the survey may be the result of ongoing degenerative effects. Compared to published data on ACDF, there is no superiority of any fusion technique compared to ACD alone. PMID:17262184

  14. 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.

  15. Correcting Radial Velocities for Long-Term Magnetic Activity Variations.

    PubMed

    Saar; Fischer

    2000-05-01

    We study stars in the Lick planetary survey for correlations between simultaneous measurements of high-precision radial velocities vr and magnetic activity (as measured in an SIR emission index from Ca ii lambda8662). We find significant correlations in approximately 30% of the stars. After removing linear trends between SIR and vr, we find that the dispersion in vr in these stars is decreased by an average of 17%, or approximately 45% of the dispersion above the measurement noise. F stars and less active stars with variable Ca ii H and K lines are the most successfully corrected. The magnitude of the slope of the SIR versus vr relations increases proportional to vsini and (excepting M dwarfs) tends to decrease with decreasing Teff. We argue that the main cause of these effects is modification of the mean line bisector shape brought on by long-term, magnetic activity-induced changes in the surface brightness and convective patterns. The correlations can be used to partially correct vr data for the effects of long-term activity variations, potentially permitting study of planets around some (higher mass) younger stars and planets producing smaller stellar reflex velocities.

  16. Prediction of long-term aging of cellular plastics

    SciTech Connect

    Fan, Y.; Kokko, E.

    1995-09-01

    Chlorofluorocarbon(CFC)-based cellular plastics are facing the challenge of environmental protection. The cellular plastic industry has been looking for new blowing agents as alternatives for CFCs since the Montreal Protocol was signed in 1987. The prediction of long-term thermal performance of newly developed cellular plastics thus becomes apparent. In this paper, the model ACP aging of cellular plastic is introduced. This model was originally developed for evaluating the thermal performance of carbon dioxide, CFC-11, CFC-12, CFC-22, n-Pentane, neo-Pentane and cyclo-Pentane. In comparison with short-term measurements, the ACP program now is able to predict the aging performance of cellular plastics is to combine the short-term measurements and model simulation. 21 refs., 5 figs., 4 tabs.

  17. Improving students' long-term knowledge retention through personalized review.

    PubMed

    Lindsey, Robert V; Shroyer, Jeffery D; Pashler, Harold; Mozer, Michael C

    2014-03-01

    Human memory is imperfect; thus, periodic review is required for the long-term preservation of knowledge and skills. However, students at every educational level are challenged by an ever-growing amount of material to review and an ongoing imperative to master new material. We developed a method for efficient, systematic, personalized review that combines statistical techniques for inferring individual differences with a psychological theory of memory. The method was integrated into a semester-long middle-school foreign-language course via retrieval-practice software. Using a cumulative exam administered after the semester's end, we compared time-matched review strategies and found that personalized review yielded a 16.5% boost in course retention over current educational practice (massed study) and a 10.0% improvement over a one-size-fits-all strategy for spaced study.

  18. Effects of acute exercise on long-term memory.

    PubMed

    Labban, Jeffrey D; Etnier, Jennifer L

    2011-12-01

    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 three groups: exercise prior to exposure, exercise after exposure, or no-exercise. Exercise consisted of 30 min on a cycle ergometer including 20 min at moderate intensity. Only the exercise prior group recalled significantly more than the control group (p < .05). Differences among the exercise groups failed to reach significance (p = .09). Results indicated that acute exercise positively influenced recall and that exercise timing relative to memory task may have an impact on this effect.

  19. Medication management for nurses working in long-term care.

    PubMed

    Ellis, Wendy; Kaasalainen, Sharon; Baxter, Pamela; Ploeg, Jenny

    2012-09-01

    In long-term care (LTC), the complexity of residents' conditions and their treatment requirements present challenges for nurses managing medications. The purpose of this qualitative descriptive study was to explore medication management as described by licensed nurses working in LTC. A total of 22 licensed nurses from 2 LTC facilities located in the Canadian province of Ontario participated in 4 focus groups. Thematic content analysis was used to organize data into themes and a conceptual model was developed. The overarching theme was that nurses are "racing against time" to manage medications and 3 subthemes described how they coped with this important care process: preparing to race, running the race, and finishing the race. Barriers to safe medication management included time restraints, knowledge limitations, interruptions and distractions, and poor communication. The findings can be used to better inform health-care providers and to guide future research. They also have the potential to directly impact outcomes related to safe medication management in LTC.

  20. Molecular early main group metal hydrides: synthetic challenge, structures and applications.

    PubMed

    Harder, Sjoerd

    2012-11-25

    Within the general area of early main group metal chemistry, the controlled synthesis of well-defined metal hydride complexes is a rapidly developing research field. As group 1 and 2 metal complexes are generally highly dynamic and lattice energies for their [MH](∞) and [MH(2)](∞) salts are high, the synthesis of well-defined soluble hydride complexes is an obvious challenge. Access to molecular early main group metal hydrides, however, is rewarding: these hydrocarbon-soluble metal hydrides are highly reactive, have found use in early main group metal catalysis and are potentially also valuable molecular model systems for polar metal hydrides as a hydrogen storage material. The article focusses specifically on alkali and alkaline-earth metal hydride complexes and discusses the synthetic challenge, molecular structures, reactivity and applications.

  1. 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%.

  2. Long term effects of oral contraception.

    PubMed

    Koetsawang, S; Chiemprasert, T; Premyodhin, M

    1972-01-01

    This study attempts to assess the long-term effects of oral contraceptives on Asian women. At the Family Planning Clinic, Siniray Hospital, Thailand, 181 of the more than 800 women who had used oral contraceptives for more than 4 years prior to May 31, 1971, were studied. All had completed premedical examinations before beginning the drugs. In addition to being studied for changes in body weight, blood pressure, hematocrit, liver function, thyroid function, oral glucose tolerance, and blood urea nitrogen, they were interviewed on their experience with oral contraception. Most were between ages 25-29 years, had only primary education, were housewives, and more than half were in the lower income group. Living children ranged from 1 to 10 with 52.5% having 4 or more. They had been started on a variety or oral contraceptives but in the last 2 years all were given Ovral (norgestrel .5 mg with ethinyl estradiol .05 mg). A total of 10,830 cycles were recorded. Only 9 requested anotehr method. Culdoscopic tubal sterilization was done on 6 and 3 discontinued because they wanted to get pregnant. All had heard rumors of adverse effects but few believed them because 89.3% had no adverse effects. 81.2% said they were in better physical and mental condition because of absence of pregnancy and a majority reported better socioeconomic status. Neurotic complaints were noted in 6.1%. Libido was unchanged in a majority, decreased in a few, but rarely increased. Weight gain of 2.5 kg or more was present in 68%. Slight increase in blood pressure was noted in 17.1%, mostly in those starting with increased pressure. Hematocrit values changed only slightly may have been due to other causes. Liver function tests showed prolonged bromsulphthalein retention in a considerable number. Thyroid function tests were normal except for increased TBG level in 17.8%. Carbohydrate metabolism remained normal in all but a few. Pretreatment glucose tolerance tests not been recorded. Normal findings were

  3. LOP- LONG-TERM ORBIT PREDICTOR

    NASA Technical Reports Server (NTRS)

    Kwok, J. H.

    1994-01-01

    The Long-Term Orbit Predictor (LOP) trajectory propagation program is a useful tool in lifetime analysis of orbiting spacecraft. LOP is suitable for studying planetary orbit missions with reconnaissance (flyby) and exploratory (mapping) trajectories. Sample data is included for a geosynchronous station drift cycle study, a Venus radar mapping strategy, a frozen orbit about Mars, and a repeat ground trace orbit. LOP uses the variation-of-parameters method in formulating the equations of motion. Terms involving the mean anomaly are removed from numerical integrations so that large step sizes, on the order of days, are possible. Consequently, LOP executes much faster than programs based on Cowell's method, such as the companion program ASAP (the Artificial Satellite Analysis Program, NPO-17522, also available through COSMIC). The program uses a force model with a gravity field of up to 21 by 21, lunisolar perturbation, drag, and solar radiation pressure. The input includes classical orbital elements (either mean or oscillating), orbital elements of the sun relative to the planet, reference time and dates, drag coefficients, gravitational constants, planet radius, rotation rate. The printed output contains the classical elements for each time step or event step, and additional orbital data such as true anomaly, eccentric anomaly, latitude, longitude, periapsis altitude, and the rate of change per day of certain elements. Selected output is additionally written to a plot file for postprocessing by the user. LOP is written in FORTRAN 77 for batch execution on IBM PC compatibles running MS-DOS with a minimum of 256K RAM. Recompiling the source requires the Lahey F77 v2.2 compiler. The LOP package includes examples that use LOTUS 1-2-3 for graphical displays, but any graphics software package should be able to handle the ASCII plot file. The program is available on two 5.25 inch 360K MS-DOS format diskettes. The program was written in 1986 and last updated in 1989. LOP is

  4. LOP- LONG-TERM ORBIT PREDICTOR

    NASA Technical Reports Server (NTRS)

    Kwok, J. H.

    1994-01-01

    The Long-Term Orbit Predictor (LOP) trajectory propagation program is a useful tool in lifetime analysis of orbiting spacecraft. LOP is suitable for studying planetary orbit missions with reconnaissance (flyby) and exploratory (mapping) trajectories. Sample data is included for a geosynchronous station drift cycle study, a Venus radar mapping strategy, a frozen orbit about Mars, and a repeat ground trace orbit. LOP uses the variation-of-parameters method in formulating the equations of motion. Terms involving the mean anomaly are removed from numerical integrations so that large step sizes, on the order of days, are possible. Consequently, LOP executes much faster than programs based on Cowell's method, such as the companion program ASAP (the Artificial Satellite Analysis Program, NPO-17522, also available through COSMIC). The program uses a force model with a gravity field of up to 21 by 21, lunisolar perturbation, drag, and solar radiation pressure. The input includes classical orbital elements (either mean or oscillating), orbital elements of the sun relative to the planet, reference time and dates, drag coefficients, gravitational constants, planet radius, rotation rate. The printed output contains the classical elements for each time step or event step, and additional orbital data such as true anomaly, eccentric anomaly, latitude, longitude, periapsis altitude, and the rate of change per day of certain elements. Selected output is additionally written to a plot file for postprocessing by the user. LOP is written in FORTRAN 77 for batch execution on IBM PC compatibles running MS-DOS with a minimum of 256K RAM. Recompiling the source requires the Lahey F77 v2.2 compiler. The LOP package includes examples that use LOTUS 1-2-3 for graphical displays, but any graphics software package should be able to handle the ASCII plot file. The program is available on two 5.25 inch 360K MS-DOS format diskettes. The program was written in 1986 and last updated in 1989. LOP is

  5. Pulmonary complications after long term amiodarone treatment.

    PubMed Central

    Roca, J; Heras, M; Rodriguez-Roisin, R; Magriñà, J; Xaubet, A; Sanz, G

    1992-01-01

    BACKGROUND: Amiodarone hydrochloride is an antiarrhythmic agent useful in arrhythmias refractory to standard therapy. Although interstitial pneumonitis is known to be its most serious side effect, several aspects of amiodarone lung toxicity are still controversial. METHODS: Pulmonary side effects were examined in a sample of 61 symptomless patients (mean (SD) age 55 (7) years) who had had long term treatment with amiodarone (daily maintenance dose 400 mg), selected from 482 men attending the University of Barcelona myocardial infarction project. To allow for the confounding effects of coronary artery disease and tobacco history on lung function, 46 patients who had taken amiodarone for more than one year were matched with a control group from the same population. Subjects underwent measurement of lung volumes, arterial blood gas analysis and an incremental bicycle exercise test. RESULTS: Most lung function values were close to predicted values, though there was a small increase in resting alveolar-arterial oxygen tension difference (A-aDO2) at rest (4.8 (1.4) kPa in both groups). There were no differences in the results of forced spirometry or static lung volumes between the two groups, or in the fall in A-aDO2 from rest to exercise. There was a small difference between the amiodarone and the control group in transfer factor for carbon monoxide corrected for lung volume (KCO 1.67 (0.3) and 1.83 (0.3) mmol min-1 kPa-1 l-1 respectively) and in exercise capacity (140 (25) and 120 (30)w). Only three patients showed lung function impairment consistent with pneumonitis. No relation between lung function measures and cumulative doses of amiodarone or desethylamiodarone was found. CONCLUSIONS: The prevalence of clinically evident pulmonary side effects was 4.9%, which is lower than that reported in studies in which higher daily maintenance doses of amiodarone were given. The slightly lower KCO values and lower work load achieved by the patients taking amiodarone suggest a

  6. Long-Term Space Astrophysics Program

    NASA Technical Reports Server (NTRS)

    Nowark, Michael A.

    2001-01-01

    This is the final report for our Long-Term Space Astrophysics Program (NRA 94-OSS-12) grant NAG 5-3225. The proposal is entitled 'Spectral and Temporal Properties of Black Hole Candidates', and began funding in May 1995, and ran through 31 Aug 2000. The project summary from the original proposal was as follows: 'We will study the spectral and temporal properties of black hole candidates (BHC) by using data from archival sources (e.g., EXOSAT, Ginga, ROSAT) and proposed follow-up observations with modern instruments (e.g., ASCA, XTE). Our spectral studies will focus on identifying the basic characteristics and luminosities of the emission components in the various 'states' of BHC. We hope to understand and quantify the global energetics of these states. Our temporal studies will focus on expanding and classifying our knowledge of BHC variability properties in each state. We will explore the nature of quasi-periodic oscillations in BHC. We will combine our spectral and temporal studies by analyzing time lags and variability coherence between energy channels. In addition, we will investigate ways of correlating observed variability behavior with specific emission components.' We have accomplished many of these goals laid out within the original proposal. As originally proposed, we have utilized both archival and proprietary satellite data. In terms of archival data, we have utilized data from the Advanced Satellite for Cosmology and Astrophysics (ASCA), ROSAT, and the Rossi X-ray Timing Explorer (RXTE). We also obtained proprietary data from ASCA, RXTE, and the Extreme Ultraviolet Explorer (EUVE). In terms of sources, we have examined a wide variety of both galactic black hole candidates and extra-galactic black holes. For the galactic black holes we have observed and analyzed both the low/hard state and the high/soft state. We have performed both spectral and timing analyses on all of these objects. In addition, we have also examined a number of neutron stars or

  7. 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...

  8. 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.

  9. 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.

  10. Physical long-term side-effects in young adult cancer survivors: germ cell tumors model.

    PubMed

    Kourie, Hampig Raphael; Klastersky, Jean A

    2017-07-01

    After the important advances in the treatment of germ cell tumors (GCTs) leading to high cure rates, physical long-term side-effects represent an important cause of death in these young adult survivors. Highlighting these physical long-term side-effects, their monitoring and their prevention modalities is necessary for a better management of these cancer survivors. Impaired fertility, increased risk of developing a second cancer, cardiac, pulmonary, renal and neural toxicity, hearing and vision impairment are the major physical side-effects in young adult cancer survivors. Long-term cardiac toxicity, next to second malignancies, represents life-threatening conditions in testicular cancer survivors. The long-term nephrotoxity in testicular GCTs survivors is most frequently associated to the treatment either in those treated with cisplatin-based chemotherapy, mainly Bleomycine, Etoposide, Cisplatin, or those receiving infradiaphragmatic radiation therapy, whereas pulmonary toxicity is mainly attributed to bleomycin related toxicities. There are no clear and comprehensive data concerning the monitoring and prevention of long-term side-effects in testicular cancer survivors. Physical activity and interventions in modifiable cardiovascular risk factors and lifestyles may reduce the incidence of long-term side-effects in these cancer survivors.

  11. Long-term treatment of severe hypertension with minoxidil.

    PubMed Central

    Nawar, T.; Nolin, L.; Plante, G. E.; Caron, C.; Montambault, P.

    1977-01-01

    Minoxidil, a new potent hypotensive agent, was used as the primary antihypertensive agent in 11 patients--10 men and 1 woman aged 35 to 54 years with severe hypertension that was refractory to treatment with maximal (or maximally tolerated) doses of conventional antihypertensive agents. Six patients had severely impaired renal function and three of them were undergoing long-term hemodialysis. The patients were given 2.5 to 40 mg/d of minoxidil for periods of 2 to 29 months. All except one who was almost anuric received propranolol and diuretics. Blood pressure was controlled satisfactorily in all patients. In two patients the hypertension became partially resistant after 1 year of treatment. The main side effects were sodium retention, tachycardia and hirsutism. Renal function remained stable or improved and hemodialysis was discontinued in two patients. Minoxidil is a remarkably potent hypotensive with relatively few side effects and seems particularly advantageous in patients with chronic renal failure. PMID:603847

  12. [Prognosis-criteria after long-term imprisonment (author's transl)].

    PubMed

    Albrecht, P A

    1981-02-01

    This report shows a series of prognosis-data drawn from an examination of the social situation of all "lifers", who were released from prison in Lower Saxony between 1945 and 1973. The main point of the analysis is the high rate of over 90% of successful post-institutional legal behaviour. For most of the ex-convicts an increase in income and a higher job satisfaction (upward social mobility) were registered after release from prison; family integration is another explanation for the high rate of successful behaviour. On the other hand a long term of imprisonment destroys prisoners' ability to fit into society. The potentiality to social activity diminishes, family ties break down and the burden of the results of imprisonment -- a dangerous influence on the process of reintegration -- increases. Age and prison adjustment behaviour are mostly irrelevant as prognosis-criteria.

  13. Sacral-level myelomeningocele: long-term outcome in adults.

    PubMed

    Selber, P; Dias, L

    1998-01-01

    We reviewed long-term outcome of 46 adult patients with sacral-level myelomeningocele with an average age of 23 years (range, 18-38). Data were collected from the medical records, computerized database, and a questionnaire. Thirty patients had high sacral lesions (weak gluteus medius, gluteus maximums, and gastroc/soleus), and 16 had low sacral lesions (fair to normal-strength gluteus medius, gluteus maximus, and gastroc/soleus). Thirteen patients had signs of tethered-cord syndrome, and 12 underwent neurosurgical release. Thirty-nine patients underwent a total of 217 orthopaedic surgeries. At the final follow-up, 41 (89.13%) patients were community ambulators. Thirty-two required no external support for walking. Twenty-nine patients used some kind of orthosis. Aggressive management of tethered-cord syndrome, surgical correction of musculoskeletal deformities, and avoidance of arthrodesis at the foot level may be the main factors in accounting for these results.

  14. Rett syndrome and long-term disorder profile.

    PubMed

    Smeets, Eric E J; Chenault, Mickey; Curfs, Leopold M G; Schrander-Stumpel, Connie T R M; Frijns, Jean-Pierre

    2009-02-01

    In a cohort of 103 females clinically diagnosed with Rett syndrome (RTT), 91 had a detectable MECP2 mutation. Emphasis on details of natural history facilitated grouping of females with the same MECP2 mutation and the development of so-called disorder profiles. Some examples of disorder profiles of different recurrent MECP2 mutations are discussed. RTT females with the frequently recurrent R133C and R306C missense mutations and those with intragenic deletions in the C-terminus of MECP2 deserve more attention in larger studies as their development is different and milder in the long term. RTT females with the T158M missense mutation are often atypical with mainly behavioral characteristics in infancy and childhood but become classic RTT in adolescence after a slower, protracted course.

  15. Incestuous Abuse: Its Long-Term Effects.

    ERIC Educational Resources Information Center

    Russell, Diana E. H.

    Despite the growing recognition of the prevalence of incest which is challenging traditional views about the family as a safe haven for children, there is a serious paucity of scientific research on incest in South Africa in the new field of family violence. Almost a century after Sigmund Freud dismissed most women's reports of incest…

  16. Cuts Threaten Long-Term Vision

    ERIC Educational Resources Information Center

    Etherington, Stuart

    2010-01-01

    All corners of the media are scrutinising David Cameron's "Big Society", from every conceivable angle. While the concept has caught the public's imagination, the greater challenge of fleshing out what the Big Society will actually offer and require of communities is unfinished business. The National Council for Voluntary Organisations…

  17. 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

  18. 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

  19. Balancing cure and long-term risks in acute lymphoblastic leukemia.

    PubMed

    Silverman, Lewis B

    2014-12-05

    Cure rates for children and adolescents with acute lymphoblastic leukemia (ALL) have improved dramatically over the last few decades. With this success has come increasing recognition of the adverse late effects of treatment. The significant long-term sequelae in the earliest cohort of long-term survivors treated in the 1970s and 1980s are well documented. To reduce the incidence of these late effects, the majority of pediatric patients treated on more contemporary regimens receive less intensive treatment than did those treated 30-40 years ago. However, current therapies are not risk free; children treated with contemporary regimens remain at risk for developing long-term toxicities, including cardiac dysfunction, osteonecrosis, neurocognitive impairment, and second malignant neoplasms. One of the great challenges facing clinical investigators today is to identify interventions that will reduce the frequency and severity of long-term toxicities without adversely affecting cure rates. The use of dexrazoxane as a cardioprotectant (to prevent anthracycline-associated cardiotoxicity) and alternate-week dosing of dexamethasone (to reduce the risk of osteonecrosis) are examples of 2 such successful strategies. This article provides an overview of the long-term toxicities associated with current therapies and reviews results of clinical trials designed to minimize the burden of cure in long-term survivors.

  20. Organic agriculture and undernourishment in developing countries: main potentials and challenges.

    PubMed

    Schoonbeek, Sanne; Azadi, Hossein; Mahmoudi, Hossein; Derudder, Ben; De Maeyer, Philippe; Witlox, Frank

    2013-01-01

    While much has been published on the advantages of organic agriculture, less has addressed its potentials and challenges to fight undernourishment in developing countries. This article aims at reviewing the main potentials and challenges of this approach when dealing with "undernourishment" as a multifaceted concept in developing countries. Accordingly, 2 main issues of the concept which are "food security" and "food safety" are discussed in the context of both developed and developing countries to understand their different food policies' priorities. Next, the main potentials, challenges and tradeoffs of the organic approach are analyzed to understand whether the approach is capable to provide a secure or a safe food-production system which can meet the food policy priorities in developing countries. With respect to food security, the article concludes that conventional and biotechnological approaches still produce higher yields than organic agriculture. However, considering the many advantages of organic agriculture, it can in a long run, be more conducive than now to meet food security. Thus, conventional approach is still needed to feed the hungers in developing countries [corrected]. Accordingly, the article emphasizes on the importance of providing farmers in developing countries with the possibility of implementing different approaches. Therefore, policy makers should be aware of a realistic and gradual transition from the other approaches to the organic that should be projected only in "long run," and after conducting a series of risk assessment studies on the bases of both "crop-case" and "region-case."

  1. Stochastic Induction of Long-Term Potentiation and Long-Term Depression

    PubMed Central

    Antunes, G.; Roque, A. C.; Simoes-de-Souza, F. M.

    2016-01-01

    Long-term depression (LTD) and long-term potentiation (LTP) of granule-Purkinje cell synapses are persistent synaptic alterations induced by high and low rises of the intracellular calcium ion concentration ([Ca2+]), respectively. The occurrence of LTD involves the activation of a positive feedback loop formed by protein kinase C, phospholipase A2, and the extracellular signal-regulated protein kinase pathway, and its expression comprises the reduction of the population of synaptic AMPA receptors. Recently, a stochastic computational model of these signalling processes demonstrated that, in single synapses, LTD is probabilistic and bistable. Here, we expanded this model to simulate LTP, which requires protein phosphatases and the increase in the population of synaptic AMPA receptors. Our results indicated that, in single synapses, while LTD is bistable, LTP is gradual. Ca2+ induced both processes stochastically. The magnitudes of the Ca2+ signals and the states of the signalling network regulated the likelihood of LTP and LTD and defined dynamic macroscopic Ca2+ thresholds for the synaptic modifications in populations of synapses according to an inverse Bienenstock, Cooper and Munro (BCM) rule or a sigmoidal function. In conclusion, our model presents a unifying mechanism that explains the macroscopic properties of LTP and LTD from their dynamics in single synapses. PMID:27485552

  2. Long-term depression of excitatory synaptic transmission and its relationship to long-term potentiation.

    PubMed

    Artola, A; Singer, W

    1993-11-01

    In many brain areas, including the cerebellar cortex, neocortex, hippocampus, striatum and nucleus accumbens, brief activation of an excitatory pathway can produce long-term depression (LTD) of synaptic transmission. In most preparations, induction of LTD has been shown to require a minimum level of postsynaptic depolarization and a rise in the intracellular Ca2+ concentration [Ca2+]i in the postsynaptic neurone. Thus, induction conditions resemble those described for the initiation of associative long-term potentiation (LTP). However, data from structures susceptible to both LTD and LTP suggest that a stronger depolarization and a greater increase in [Ca2+]i are required to induce LTP than to initiate LTD. The source of Ca2+ appears to be less critical for the differential induction of LTP and LTD than the amplitude of the Ca2+ surge, since the activation of voltage- and ligand-gated Ca2+ conductances as well as the release from intracellular stores have all been shown to contribute to both LTD and LTP induction. LTD is induceable even at inactive synapses if [Ca2+]i is raised to the appropriate level by antidromic or heterosynaptic activation, or by raising the extracellular Ca2+ concentration [Ca2+]o. These conditions suggest a rule (called here the ABS rule) for activity-dependent synaptic modifications that differs from the classical Hebb rule and that can account for both homosynaptic LTD and LTP as well as for heterosynaptic competition and associativity.

  3. 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.

  4. Long-term outcome of abusive head trauma.

    PubMed

    Chevignard, Mathilde P; Lind, Katia

    2014-12-01

    Abusive head trauma is a severe inflicted traumatic brain injury, occurring under the age of 2 years, defined by an acute brain injury (mostly subdural or subarachnoidal haemorrhage), where no history or no compatible history with the clinical presentation is given. The mortality rate is estimated at 20-25% and outcome is extremely poor. High rates of impairments are reported in a number of domains, such as delayed psychomotor development; motor deficits (spastic hemiplegia or quadriplegia in 15-64%); epilepsy, often intractable (11-32%); microcephaly with corticosubcortical atrophy (61-100%); visual impairment (18-48%); language disorders (37-64%), and cognitive, behavioral and sleep disorders, including intellectual deficits, agitation, aggression, tantrums, attention deficits, memory, inhibition or initiation deficits (23-59%). Those combined deficits have obvious consequences on academic achievement, with high rates of special education in the long term. Factors associated with worse outcome include demographic factors (lower parental socioeconomic status), initial severe presentation (e.g., presence of a coma, seizures, extent of retinal hemorrhages, presence of an associated cranial fracture, extent of brain lesions, cerebral oedema and atrophy). Given the high risk of severe outcome, long-term comprehensive follow-up should be systematically performed to monitor development, detect any problem and implement timely adequate rehabilitation interventions, special education and/or support when necessary. Interventions should focus on children as well as families, providing help in dealing with the child's impairment and support with psychosocial issues. Unfortunately, follow-up of children with abusive head trauma has repeatedly been reported to be challenging, with very high attrition rates.

  5. 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.

  6. 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.

  7. Determining long-term regional erosion rates using impact craters

    NASA Astrophysics Data System (ADS)

    Hergarten, Stefan; Kenkmann, Thomas

    2015-04-01

    More than 300,000 impact craters have been found on Mars, while the surface of Moon's highlands is even saturated with craters. In contrast, only 184 impact craters have been confirmed on Earth so far with only 125 of them exposed at the surface. The spatial distribution of these impact craters is highly inhomogeneous. Beside the large variation in the age of the crust, consumption of craters by erosion and burial by sediments are the main actors being responsible for the quite small and inhomogeneous crater record. In this study we present a novel approach to infer long-term average erosion rates at regional scales from the terrestrial crater inventory. The basic idea behind this approach is a dynamic equilibrium between the production of new craters and their consumption by erosion. It is assumed that each crater remains detectable until the total erosion after the impact exceeds a characteristic depth depending on the crater's diameter. Combining this model with the terrestrial crater production rate, i.e., the number of craters per unit area and time as a function of their diameter, allows for a prediction of the expected number of craters in a given region as a function of the erosion rate. Using the real crater inventory, this relationship can be inverted to determine the regional long-term erosion rate and its statistical uncertainty. A limitation by the finite age of the crust can also be taken into account. Applying the method to the Colorado Plateau and the Deccan Traps, both being regions with a distinct geological history, yields erosion rates in excellent agreement with those obtained by other, more laborious methods. However, these rates are formally exposed to large statistical uncertainties due to the small number of impact craters. As higher crater densities are related to lower erosion rates, smaller statistical errors can be expected when large regions in old parts of the crust are considered. Very low long-term erosion rates of less than 4

  8. 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

  9. Collaborative Establishment of a Long-Term Archive for Stewardship of Interdisciplinary Scientific Data

    NASA Astrophysics Data System (ADS)

    Downs, R. R.; Chen, R. S.; Cartolano, R. T.; Bose, R.

    2008-12-01

    Much of the scientific data that are being collected today cannot be recreated if they are not properly preserved and documented. Establishment of reliable long-term digital archives is essential to preserving these data and associated documentation beyond the working lifetimes of current scientists. Numerous challenges, both technical and institutional, need to be addressed before these data or their documentation become lost or inaccessible. Direct collaboration between university research libraries and active scientific data centers is one approach to addressing these challenges. We report here on the collaboration between the Columbia Libraries / Information Services and the Center for International Earth Science Information Network (CIESIN) to establish an interdisciplinary long-term archive for data from the NASA Socioeconomic Data and Applications Center (SEDAC). The SEDAC long-term archive serves as a trustworthy digital repository to support preparation, submission, appraisal, ingest, discovery, integration, and interoperability of scientific data that are expected to be of long-term interest to both natural and social scientists. Significant progress has been made in establishing the necessary policies and procedures, implementing needed standards and technologies, and assessing strengths and possible weaknesses in the long-term sustainability of the archive. Benefits have included sharing approaches and best practices for information technology solutions and scientific data stewardship. A key issue is the expected future integration of this specialized archive into the long-term digital repository currently being developed by the University. Planned activities include testing the migration of selected data from the SEDAC long-term archive to the forthcoming Libraries repository and the development of interfaces between the digital object management systems being implemented by SEDAC and the Libraries, which are both based on the Flexible Extensible

  10. 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.

  11. Long-term effects of social stress on antiviral immunity in pigs.

    PubMed

    de Groot, J; Ruis, M A; Scholten, J W; Koolhaas, J M; Boersma, W J

    2001-05-01

    Mixing of unfamiliar pigs is common practice in intensive pig husbandry. Since pigs maintain a dominance hierarchy, mixing often leads to vigorous fighting. Apart from the negative impact that fighting has on welfare, there is evidence that the social stress associated with fighting suppresses immune function. In the present experiment, we investigated the impact of mixing on specific long-term immune responses and protection against challenge infection after vaccination with pseudorabies virus (PRV). Specific pathogen-free (SPF) pigs were mixed pairwise with an unfamiliar same-gender conspecific or left undisturbed with a same-gender littermate at 3 days after vaccination with PRV. Half of the pigs were females (gilts) and half were castrated males (barrows). Mixing increased agonistic behavior to the same degree in gilts and barrows. Cortisol concentrations in saliva and catecholamine excretion in urine were increased in mixed pigs, and these effects were independent of dominance status and gender. Subsequently, the effects of mixing, gender, dominance status and interactions between these factors on immune response parameters were studied. The main result was that mixed barrows showed suppressed immune responses after vaccination and increased clinical symptoms after challenge infection compared to control barrows. Mixed gilts however did not differ from control gilts. It also appeared that mixed dominants were more seriously affected than mixed subordinates were. We conclude that, in some pigs, social stress after mixing suppresses the immune response to a viral vaccine and consequently impairs protection against challenge infection.

  12. Enhanced Polyhydroxybutyrate Production for Long-Term Spaceflight Applications

    NASA Technical Reports Server (NTRS)

    Putman, Ryan J.; Rahman, Asif; Miller, Charles D.; Hadi, Masood Z.

    2015-01-01

    Synthetic biology holds the promise of advancing long term space fight by the production of medicine, food, materials, and energy. One such application of synthetic biology is the production of biomaterials, specifically polyhydroxyalkanoates (PHAs), using purposed organisms such as Escherichia coli. PHAs are a group of biodegradable bioplastics that are produced by a wide variety of naturally occurring microorganisms, mainly as an energy storage intermediate. PHAs have similar melting point to polypropylene and a Youngs modulus close to polystyrene. Due to limited resources and cost of transportation, large-scale extraction of biologically produced products in situ is extremely cumbersome during space flight. To that end, we are developing a secretion systems for exporting PHA from the cell in order to reduce unit operations. PHAs granules deposited inside bacteria are typically associated with proteins bound to the granule surface. Phasin, a granule bound protein, was targeted for type I secretion by fusion with HlyA signal peptide for indirect secretion of PHAs. In order to validate our secretion strategy, a green fluorescent protein (GFP) was tagged to the PHA polymerase enzyme (phaC), this three part gene cassette consists of phaA and phaB and are required for PHA production. Producing PHAs in situ during space flight or planet colonization will enable mission success by providing a valuable source of biomaterials that can have many potential applications thereby reducing resupply requirements. Biologically produced PHAs can be used in additive manufacturing such as three dimensional (3D) printing to create products that can be made on demand during space flight. After exceeding their lifetime, the PHAs could be melted and recycled back to 3D print other products. We will discuss some of our long term goals of this approach.

  13. Long-term variations of noctilucent clouds at ALOMAR

    NASA Astrophysics Data System (ADS)

    Fiedler, Jens; Baumgarten, Gerd; Berger, Uwe; Lübken, Franz-Josef

    2017-09-01

    Noctilucent clouds (NLC) are measured by the Rayleigh/Mie/Raman-lidar at the ALOMAR research facility in Northern Norway (69°N, 16°E) since 1994. The data set contains about 2860 h of NLC detections and is investigated for the first time regarding trends. NLC properties depend on cloud brightness which is taken into account by the use of several cloud classes, related to brightness ranges. For NLC brighter than the long-term detection limit and strong NLC, respectively, the trend terms show increasing occurrence frequency (+9%/dec and+5%/dec) and brightness (+1.7×10-10 m-1 sr-1/dec and +1.5×-10 m-1 sr-1/dec) from 1998 to 2015. In the same period the altitude of faint and long-term limit clouds decreases (-66 m/dec and -108 m/dec). Over the entire time period of 22 years strong clouds show an increasing altitude by +76 m/dec. NLC properties are affected differently by solar and atmospheric parameters. In general, Lyman-α and stratospheric ozone impact all three NLC parameters, temperature at 83 km impacts mainly the NLC altitude. Time series of RMR lidar and SBUV satellite instruments match best for NLC occurrence frequency and brightness when restricting SBUV to the morning data at longitudes around ALOMAR (64-74°N, 8-24°E/0-9 LT). This suggests longitudinal dependent trends, which is confirmed by trend investigations of longitudinal subsets of the SBUV data set.

  14. 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.

  15. Long-term dynamical evolution of Tundra-type orbits

    NASA Astrophysics Data System (ADS)

    Zhang, Ming-Jiang; Zhao, Chang-Yin; Hou, Yong-Gang; Zhu, Ting-Lei; Wang, Hong-Bo; Sun, Rong-Yu; Zhang, Wei

    2017-01-01

    Tundra-type orbits are elliptical geosynchronous orbits located at the critical inclination. The long-term dynamical evolution of this type of special orbit is investigated in this paper. First, the effect of Earth's gravitational potential is examined. A simplified Hamiltonian of Tundra-type orbits subjected to Earth's gravitational potential is presented through a strict magnitude comparison of the involved terms. Based on this simplified Hamiltonian with two degrees of freedom, the equilibrium points of the orbits subjected to Earth's gravitational potential and their stabilities are discussed. This simplified Hamiltonian is then reduced to a one-degree-of-freedom system dominating the intermediate-period motion of the orbits approximately. In particular, the main characteristic parameters of the intermediate-period motion for nominal Tundra-type orbits and the corresponding specific results for three Sirius satellites in such orbits are presented. Second, the effect of lunisolar perturbations is examined. A magnitude comparison elementarily illustrates that the effect of tesseral harmonics of the Earth's gravitational potential on the long timespan evolution of Tundra-type orbits is negligible compared to that of lunisolar perturbations. A simplified dynamical model including lunisolar perturbations is then presented. Based on this simplified dynamical model, the influences of lunar precession, the initial longitude of the ascending node, the initial argument of perigee, and the initial epoch on the long-term dynamical evolution of the orbits are comparatively analyzed. Finally, numerical calculations with exact perturbation models are conducted to verify the theoretical analysis and to provide more information about the dynamical evolution of Tundra-type orbits.

  16. Long-term training effects on masticatory muscles.

    PubMed

    Hellmann, D; Giannakopoulos, N N; Blaser, R; Eberhard, L; Rues, S; Schindler, H J

    2011-12-01

    Neuromuscular adaptations during skill acquisition have been extensively investigated for skeletal muscles. Motor rehabilitation is the main target for application of motor training. Such measures are also relevant for the musculature of the jaw, but few data are available for motor adaptation of the masticatory system. The objective of this study was to evaluate and compare long-term training effects of different motor tasks on masseter and temporal muscles. In 20 healthy subjects, the electromyographic response to unilateral and bilateral maximum voluntary tooth clenching, balancing the mandible on a hydrostatic system under force-feedback-controlled conditions, and unilateral chewing was investigated in an initial session and then in two follow-up sessions separated by 2 and 10 weeks from baseline. Motor tasks were repeated three times for chewing, nine times for maximum biting (MB) and 24 times for the coordination tasks (CT). The sequences of the various motor tasks were applied once in the first session and twice in the second and third sessions. No effects of training were observed for MB tasks except for MB in intercuspation, for which significant yet transient avoidance behaviour occurred in the second session. No significant effects were found for chewing tests. For the CT, however, a robust significant long-term training effect was detected which reduced the electric muscle activity in session 2 by approximately 20% and in session 3 by approximately 40% compared with the initial measurements. The study showed that the masticatory muscles are remarkably prone to motor adaptation if demanding CT must be accomplished.

  17. 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.

  18. Resistive magnetohydrodynamic reconnection: Resolving long-term, chaotic dynamics

    SciTech Connect

    Keppens, R.; Restante, A. L.; Lapenta, G.; Porth, O.; Galsgaard, K.; Frederiksen, J. T.; Parnell, C.

    2013-09-15

    In this paper, we address the long-term evolution of an idealised double current system entering reconnection regimes where chaotic behavior plays a prominent role. Our aim is to quantify the energetics in high magnetic Reynolds number evolutions, enriched by secondary tearing events, multiple magnetic island coalescence, and compressive versus resistive heating scenarios. Our study will pay particular attention to the required numerical resolutions achievable by modern (grid-adaptive) computations, and comment on the challenge associated with resolving chaotic island formation and interaction. We will use shock-capturing, conservative, grid-adaptive simulations for investigating trends dominated by both physical (resistivity) and numerical (resolution) parameters, and confront them with (visco-)resistive magnetohydrodynamic simulations performed with very different, but equally widely used discretization schemes. This will allow us to comment on the obtained evolutions in a manner irrespective of the adopted discretization strategy. Our findings demonstrate that all schemes used (finite volume based shock-capturing, high order finite differences, and particle in cell-like methods) qualitatively agree on the various evolutionary stages, and that resistivity values of order 0.001 already can lead to chaotic island appearance. However, none of the methods exploited demonstrates convergence in the strong sense in these chaotic regimes. At the same time, nonperturbed tests for showing convergence over long time scales in ideal to resistive regimes are provided as well, where all methods are shown to agree. Both the advantages and disadvantages of specific discretizations as applied to this challenging problem are discussed.

  19. Cutaneous T cell lymphoma complicating severe atopic dermatitis. Is making a diagnosis the main challenge?

    PubMed

    Meyer, Nicolas; Mazereeuw-Hautier, Juliette; Launay, François; Lamant, Laurence; Paul, Carle

    2009-01-01

    The association between severe long-term atopic dermatitis (AD) and the risk of skin lymphoma is still a matter of debate, since epidemiological studies have shown contradictory results. We report 2 cases of patients with a documented history of severe longstanding atopic disease, who had never been treated with topical or systemic calcineurin inhibitors, and who developed a cytotoxic cutaneous T cell lymphoma (CTCL). For these 2 patients, clinical manifestations preceded the diagnosis of CTCL. The diagnosis was based on histological findings and molecular analysis of the T cell receptor (TCR) clonality. These cases illustrate the difficulty in diagnosing CTCL in patients with severe AD and extensive inflammatory skin lesions. The transition between severe AD and CTCL is progressive; histological findings and molecular evidence of TCR clonality are detected after the clinical changes. These 2 cases lend further support to the hypothesis of an association between severe long-term AD and CTCL. Copyright (c) 2008 S. Karger AG, Basel.

  20. 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.

  1. Long-Term Orientation and Educational Performance. Working Paper 174

    ERIC Educational Resources Information Center

    Figlio, David; Giuliano, Paola; Özek, Umut; Sapienza, Paola

    2017-01-01

    We use remarkable population-level administrative education and birth records from Florida to study the role of Long-Term Orientation on the educational attainment of immigrant students living in the US. Controlling for the quality of schools and individual characteristics, students from countries with long-term oriented attitudes perform better…

  2. 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…

  3. Long-Term Retention of Electronic Theses and Dissertations.

    ERIC Educational Resources Information Center

    Teper, Thomas H.; Kraemer, Beth

    2002-01-01

    Examines the increasing trend of universities to pursue electronic thesis and dissertation (ETD) programs. Although the goal of most programs is similar, procedural variations impact a program's long-term success. As primary research generators, responsibility for providing long-term access to unique materials must be borne by universities.…

  4. 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…

  5. Perceptions of control and long-term recovery from rape.

    PubMed

    Regehr, C; Cadell, S; Jansen, K

    1999-01-01

    The relationship between perceptions of control and symptoms of both long-term depression and post-traumatic stress was examined. Enduring beliefs of personal competence and control were found to be associated with lower rates of depression and stress and to be stronger predictors of long-term recovery than were rape-specific attributions. Implications for clinical practice are discussed.

  6. 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…

  7. Adaptive Long-Term Monitoring at Environmental Restoration Sites

    DTIC Science & Technology

    2009-11-01

    bounds value that is a potential concern. .............. 27 Figure 6. Conceptual example to illustrate temporal interpolation issue...Force Base HMSI Hazard Management Systems, Inc. IDW inverse distance weighting LTM long term monitoring LTMO long-term monitoring...provided the best representation of the plumes with Model Builder. • SO provided useful trade-off curves of sampling cost versus the interpolation

  8. 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...

  9. 47 CFR 54.303 - Long term support.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... base-level of Long Term Support for 1998, the Administrator shall calculate the difference between the.... (2) To calculate Long Term Support for calendar year 1998, the Administrator shall adjust the base...; and (4) The line port costs in excess of basic analog service pursuant to § 69.130 of this...

  10. 47 CFR 54.303 - Long term support.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... base-level of Long Term Support for 1998, the Administrator shall calculate the difference between the.... (2) To calculate Long Term Support for calendar year 1998, the Administrator shall adjust the base...; and (4) The line port costs in excess of basic analog service pursuant to § 69.130 of this...

  11. Ensuring climate information guides long-term development

    NASA Astrophysics Data System (ADS)

    Jones, Lindsey; Dougill, Andrew; Jones, Richard G.; Steynor, Anna; Watkiss, Paul; Kane, Cheikh; Koelle, Bettina; Moufouma-Okia, Wilfran; Padgham, Jon; Ranger, Nicola; Roux, Jean-Pierre; Suarez, Pablo; Tanner, Thomas; Vincent, Katharine

    2015-09-01

    Many sub-Saharan countries are failing to include climate information in long-term development planning. Ensuring climate-resilient development requires a step change in how medium- to long-term climate information is produced, communicated and utilized in sub-Saharan Africa and elsewhere.

  12. 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)

  13. 7 CFR 1773.44 - Long-term debt.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Long-term debt. 1773.44 Section 1773.44 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Required Audit Procedures and Documentation § 1773.44 Long-term debt. The CPA's workpapers must document that he/she: (a) Confirmed RUS, FFB, and RTB debt to...

  14. 7 CFR 1773.44 - Long-term debt.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Long-term debt. 1773.44 Section 1773.44 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Required Audit Procedures and Documentation § 1773.44 Long-term debt. The CPA's workpapers must document that he/she: (a) Confirmed RUS, FFB, and RTB debt to...

  15. Long Term Agroecosystem Research in the southern plains

    USDA-ARS?s Scientific Manuscript database

    The Southern Plains (SP) site of the Long Term Agroecosystem Research (LTAR) network is headquartered at USDA-ARS’s 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 ...

  16. 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-...

  17. The Effect of Modality on Long-Term Recognition Memory.

    ERIC Educational Resources Information Center

    Dean, Raymond S.; And Others

    1988-01-01

    The effects of visual and auditory modes of input on long-term memory were examined in two experiments, each with 40 and 80 undergraduates, respectively. In both experiments, visual stimulus attributes were a more salient dimension than were auditory features in the long-term encoding and retrieval process. (SLD)

  18. 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…

  19. 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...

  20. 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...

  1. 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…

  2. 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...

  3. Long-term agroecosystem research in the Central Mississippi River Basin: introduction, establishment, and overview

    USDA-ARS?s Scientific Manuscript database

    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), a 12-, 31-, and 73-km2 nested watershed located in northeastern Missouri, USA. The watershed is prone to surface run...

  4. 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…

  5. Dignity Versus Dehumanization in Long-Term Care Settings for Older Persons: A Training Outline.

    ERIC Educational Resources Information Center

    Kampfe, Charlene M.

    This paper describes the types of attitudes and behaviors that might be destructive to an individual's sense of self-worth, and suggests that counselors in long-term care settings face the challenge of changing these. One strategy for counteracting potential dehumanization, offering in-service training to all levels of staff and administrators, is…

  6. 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...

  7. Reintegration Services for Long-Term Dangerous Offenders: A Case Study and Discussion

    ERIC Educational Resources Information Center

    Day, Andrew; Ward, Tony; Shirley, Lyn

    2011-01-01

    Successfully reintegrating long-term prisoners back into the community often presents significant challenges for service providers. Ex-prisoners typically experience high levels of social stigma; present with multiple needs; and can struggle to find meaningful employment, stable accommodation, and to maintain supportive relationships. There have,…

  8. Sustaining School Colleagues' Commitment to a Long-Term Professional Experience Partnership

    ERIC Educational Resources Information Center

    Peters, Judith

    2011-01-01

    This paper presents findings from a qualitative study that investigated school participants' perceptions of the benefits, challenges and supportive factors related to their involvement in a long-term school/university professional experience partnership. Data were collected through interviews with coordinators and a written survey completed by…

  9. Reintegration Services for Long-Term Dangerous Offenders: A Case Study and Discussion

    ERIC Educational Resources Information Center

    Day, Andrew; Ward, Tony; Shirley, Lyn

    2011-01-01

    Successfully reintegrating long-term prisoners back into the community often presents significant challenges for service providers. Ex-prisoners typically experience high levels of social stigma; present with multiple needs; and can struggle to find meaningful employment, stable accommodation, and to maintain supportive relationships. There have,…

  10. 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…

  11. Pregnancy and lactation during long-term total parenteral nutrition: A case report and literature review.

    PubMed

    Borbolla Foster, Ailsa; Dixon, Steven; Tyrrell-Price, J; Trinder, Johanna

    2016-12-01

    There is a paucity of clinical data regarding the management of pregnancy and lactation in women requiring long-term total parenteral nutrition with complex nutritional needs. This case report and literature review highlights common challenges in care and presents evidence which can guide the obstetrician's approach to care.

  12. 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.

  13. Environmental Management Long-Term Stewardship Transition Guidance

    SciTech Connect

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after the completion of facility cleanup. Long-term stewardship is administered and overseen by the U.S. Department of Energy Environmental Management Office of Science and Technology. This report describes the background of long-term stewardship and gives general guidance about considerations when ownership and/or responsibility of a site should be transferred to a long-term stewardship program. This guidance document will assist the U.S. Department of Energy in: (a) ensuring that the long-term stewardship program leads transition planning with respect to facility and site areas, and (b) describing the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete.

  14. A perspective on long-term care for the elderly

    PubMed Central

    Scanlon, William J.

    1988-01-01

    Long-term care represents a significant burden to the approximately 7 million elderly in need, their families, and the Medicaid program. Concerns exist about access, quality, cost, and the distribution of the burden of care. In this article each area is discussed, highlighting the principal issues, identifying the unique aspects that pertain to long-term care, and exploring the implications for research and policy development. Future trends, especially the growth of the elderly population, are expected to affect significantly the provision of long-term care. The considerable uncertainty about how these trends may impact on long-term care is described, and the critical role social choice will play in shaping the future long-term care system is emphasized. PMID:10312975

  15. The relationship between interannual and long-term cloud feedbacks

    SciTech Connect

    Zhou, Chen; Zelinka, Mark D.; Dessler, Andrew E.; Klein, Stephen A.

    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 and 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.

  16. Collaboration in long-term stewardship at DOE Hanford Site

    SciTech Connect

    Moren, R. J.; Zeisloft, J. H.; Feist, E. T.; Brown, D.; Grindstaff, K. D.

    2013-01-10

    The U.S. Department of Energy's (DOE) Hanford Site comprises approximately 1,517 km{sup 2} (586 mi{sup 2}) of land in southeastern Washington. The site was established in 1943 as part of the Manhattan Project to produce plutonium for the nation's nuclear weapons program. As the Cold War era came to an end, the mission of the site transitioned from weapons production to environmental cleanup. As the River Corridor area of the site cleanup is completed, the mission for that portion of the site will transition from active cleanup to continued protection of environment through the Long-Term Stewardship (LTS) Program. The key to successful transition from cleanup to LTS is the unique collaboration among three (3) different DOE Programs and three (3) different prime contractors with each contractor having different contracts. The LTS Program at the site is a successful model of collaboration resulting in efficient resolution of issues and accelerated progress that supports DOE's Richland Office 2015 Vision for the Hanford Site. The 2015 Vision for the Hanford Site involves shrinking the active cleanup footprint of the surface area of the site to approximately 20 mi{sup 2} on the Central Plateau. Hanford's LTS Program is defined in DOE's planning document, Hanford Long-Term Stewardship Program Plan, DOE/RL-2010-35 Rev 1. The Plan defines the relationship and respective responsibilities between the federal cleanup projects and the LTS Program along with their respective contractors. The LTS Program involves these different parties (cleanup program and contractors) who must work together to achieve the objective for transition of land parcels. Through the collaborative efforts with the prime contractors on site over the past two years, 253.8 km{sup 2} (98 mi{sup 2}) of property has been successfully transitioned from the cleanup program to the LTS Program upon completion of active surface cleanup. Upcoming efforts in the near term will include transitioning another large

  17. Long-Term Delivery of Protein Therapeutics

    PubMed Central

    Vaishya, Ravi; Khurana, Varun; Patel, Sulabh; Mitra, Ashim K

    2015-01-01

    Introduction Proteins are effective biotherapetics with applications in diverse ailments. Despite being specific and potent, their full clinical potential has not yet been realized. This can be attributed to short half-lives, complex structures, poor in vivo stability, low permeability frequent parenteral administrations and poor adherence to treatment in chronic diseases. A sustained release system, providing controlled release of proteins, may overcome many of these limitations. Areas covered This review focuses on recent development in approaches, especially polymer-based formulations, which can provide therapeutic levels of proteins over extended periods. Advances in particulate, gel based formulations and novel approaches for extended protein delivery are discussed. Emphasis is placed on dosage form, method of preparation, mechanism of release and stability of biotherapeutics. Expert opinion Substantial advancements have been made in the field of extended protein delivery via various polymer-based formulations over last decade despite the unique delivery-related challenges posed by protein biologics. A number of injectable sustained-release formulations have reached market. However, therapeutic application of proteins is still hampered by delivery related issues. A large number of protein molecules are under clinical trials and hence there is an urgent need to develop new methods to deliver these highly potent biologics. PMID:25251334

  18. Corrosion of Spent Nuclear Fuel: The Long-Term Assessment

    SciTech Connect

    Ewing, Rodney C.

    2003-09-14

    The successful disposal of spent nuclear fuel (SNF) is one of the most serious challenges to the successful completion of the nuclear fuel cycle and the future of nuclear power generation. In the United States, 21 percent of the electricity is generated by 107 commercial nuclear power plants (NPP), each of which generates 20 metric tons of spent nuclear fuel annually. In 1996, the total accumulation of spent nuclear fuel was 33,700 metric tons of heavy metal (MTHM) stored at 70 sites around the country. The end-of-life projection for current nuclear power plants (NPP) is approximately 86,000 MTHM. In the proposed nuclear waste repository at Yucca Mountain over 95% of the radioactivity originates from spent nuclear fuel. World-wide in 1998, approximately 130,000 MTHM of SNF have accumulated, most of it located at 236 NPP in 36 countries. Annual production of SNF is approximately 10,000 MTHM, containing about 100 tons of ''reactor grade'' plutonium. Any reasonable increase in the proportion of energy production by NPP, i.e., as a substitute for hydrocarbon-based sources of energy, will significantly increase spent nuclear fuel production. Spent nuclear fuel is essentially UO{sub 2} with approximately 4-5 atomic percent actinides and fission product elements. A number of these elements have long half-lives hence, the long-term behavior of the UO{sub 2} is an essential concern in the evaluation of the safety and risk of a repository for spent nuclear fuel. One of the unique and scientifically most difficult aspects of the successful disposal of spent nuclear fuel is the extrapolation of short-term laboratory data (hours to years) to the long time periods (10{sup 3} to 10{sup 5} years) as required by the performance objectives set in regulations, i.e. 10 CFR 60. The direct verification of these extrapolations or interpolations is not possible, but methods must be developed to demonstrate compliance with government regulations and to satisfy the public that there is a

  19. Exploring patient priorities among long-term conditions in multimorbidity: A qualitative secondary analysis

    PubMed Central

    Morden, Andrew; Bower, Peter; Kennedy, Anne; Rogers, Anne; Richardson, Jane; Sanders, Tom; Stevenson, Fiona; Ong, Bie N

    2013-01-01

    Objective: A lack of agreement between health-care providers and patient priorities can impact the health-care provider–patient relationship, treatment concordance and potentially health outcomes. Evidence suggests that people living with multiple morbidities do prioritise among their long-term conditions. However, the evidence revealing the underlying reasons behind this prioritisation remains limited. Given the potential implications for day-to-day self-management activity and ultimately patient outcomes, this study aims to explore how and why people with multimorbidity prioritise some long-term conditions over others and what the potential implications may be for self-management activity, and in turn, suggest how such information may help clinicians negotiate the management of multimorbidity patients. Methods: A secondary analysis of qualitative data was conducted utilising four existing data sets collated from the three research centres involved. Purposive sampling provided a sample of 41 participants who had multimorbidity. The research team collectively coded and analysed the data thematically. Results: All participants, except two, identified one ‘main’ priority long-term condition. Current priorities were arrived at by participants making comparisons between their long-term conditions, specifically by trading off the various attributes, impacts and perceived consequences of their individual long-term conditions. Two main themes emerged as to why participants identified a particular main long-term condition: (a) proximate issues surrounding barriers to functional health and (b) prioritisation of long-term conditions perceived to have a particular future risk. Conclusions: The recent focus on multimorbidity within the medical literature reflects its prevalence. It is therefore important to understand the complexities of the multimorbidity illness experience. We have added to the limited literature on condition prioritisation by revealing some novel

  20. [Urinary tract infection in elderly residents of long-term care facilities].

    PubMed

    Stærkind, Mette; Dalager-Pedersen, Michael; Nielsen, Henrik

    2015-03-16

    Urinary tract infection is the most prevalent bacterial infection among residents in Danish long-term care facilities, and it is the most common reason for antibiotic therapy as prevention or treatment in this population. Diagnosis and management of urinary tract infection in the elderly is challenging because of benign asymptomatic bacteriuria, chronic indwelling urinary tract catheters, cognitive impairment and other co-morbidities. This review covers updated information on diagnosis, treatment and prophylaxis of urinary tract infection in elderly residents of long-term care facilities.

  1. Natural history of multiple sclerosis: have available therapies impacted long-term prognosis?

    PubMed

    Trojano, Maria; Paolicelli, Damiano; Tortorella, Carla; Iaffaldano, Piero; Lucchese, Guglielmo; Di Renzo, Vita; D'Onghia, Mariangela

    2011-05-01

    Since the mid-1990s several disease-modifying drugs (DMDs), such as β-interferons and glatiramer acetate, have become available to treat patients with relapse-remitting multiple sclerosis (MS). These therapies have known short- and medium-term benefit in reducing relapses, disability progression, and accrual of new inflammatory lesions. However, the short duration of the randomized pivotal MS trials have provided little to no information about benefit from such treatment over periods of extended (>5 years) use. Whether DMDs may significantly alter the development of long-term disability remains uncertain, thus it remains challenging how to best approach the issue of long-term benefits from these treatments.

  2. Long term performance stability of silicon sensors

    NASA Astrophysics Data System (ADS)

    Mori, R.; Betancourt, C.; Kühn, S.; Hauser, M.; Messmer, I.; Hasenfratz, A.; Thomas, M.; Lohwasser, K.; Parzefall, U.; Jakobs, K.

    2015-10-01

    The HL-LHC investigations on silicon particle sensor performance are carried out with the intention to reproduce the harsh environments foreseen, but usually in individual short measurements. Recently, several groups have observed a decrease in the charge collection of silicon strip sensors after several days, in particular on sensors showing charge multiplication. This phenomenon has been explained with a surface effect, the increase of charge sharing due to the increment of positive charge in the silicon oxide coming from the source used for charge collection measurements. Observing a similar behaviour in other sensors for which we can exclude this surface effect, we propose and investigate alternative explanations, namely trapping related effects (change of polarization) and annealing related effects. Several n-on-p strip sensors, as-processed and irradiated with protons and neutrons up to 5 ×1015neq /cm2, have been subjected to charge collection efficiency measurements for several days, while parameters like the impedance have been monitored. The probable stressing conditions have been changed in an attempt to recover the collected charge in case of a decrease. The results show that for the investigated sensors the effect of charge sharing induced by a radioactive source is not important, and a main detrimental factor is due to very high voltage, while at lower voltages the performance is stable.

  3. An electric propulsion long term test facility

    NASA Technical Reports Server (NTRS)

    Trump, G.; James, E.; Vetrone, R.; Bechtel, R.

    1979-01-01

    An existing test facility was modified to provide for extended testing of multiple electric propulsion thruster subsystems. A program to document thruster subsystem characteristics as a function of time is currently in progress. The facility is capable of simultaneously operating three 2.7-kW, 30-cm mercury ion thrusters and their power processing units. Each thruster is installed via a separate air lock so that it can be extended into the 7m x 10m main chamber without violating vacuum integrity. The thrusters exhaust into a 3m x 5m frozen mercury target. An array of cryopanels collect sputtered target material. Power processor units are tested in an adjacent 1.5m x 2m vacuum chamber or accompanying forced convection enclosure. The thruster subsystems and the test facility are designed for automatic unattended operation with thruster operation computer controlled. Test data are recorded by a central data collection system scanning 200 channels of data a second every two minutes. Results of the Systems Demonstration Test, a short shakedown test of 500 hours, and facility performance during the first year of testing are presented.

  4. An electric propulsion long term test facility

    NASA Technical Reports Server (NTRS)

    Trump, G.; James, E.; Vetrone, R.; Bechtel, R.

    1979-01-01

    An existing test facility was modified to provide for extended testing of multiple electric propulsion thruster subsystems. A program to document thruster subsystem characteristics as a function of time is currently in progress. The facility is capable of simultaneously operating three 2.7-kW, 30-cm mercury ion thrusters and their power processing units. Each thruster is installed via a separate air lock so that it can be extended into the 7m x 10m main chamber without violating vacuum integrity. The thrusters exhaust into a 3m x 5m frozen mercury target. An array of cryopanels collect sputtered target material. Power processor units are tested in an adjacent 1.5m x 2m vacuum chamber or accompanying forced convection enclosure. The thruster subsystems and the test facility are designed for automatic unattended operation with thruster operation computer controlled. Test data are recorded by a central data collection system scanning 200 channels of data a second every two minutes. Results of the Systems Demonstration Test, a short shakedown test of 500 hours, and facility performance during the first year of testing are presented.

  5. 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,…

  6. 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…

  7. 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,…

  8. A Relativistic Long-term Precession of the Earth

    NASA Astrophysics Data System (ADS)

    Tang, K.

    2016-05-01

    A long-term precession represents a secular motion of the ecliptic and th equator in a long time interval. With Vondrák et al. (2011), we assume that precession covers all periods longer than 100 centuries, while the shorter ones are included in the nutation. This thesis deals with the long-term precession in a relativistic framework. Compared with the P03 precession theory which is only valid for several centuries around the epoch J2000.0, the new theory better reflects the realistic long-term behavior of precession. All previous works are not fully consistent with General Relativity. They only consider the dominant relativistic corrections: the first-order post-Newtonian corrections due to the Sun and the geodetic precession. Their standard way to account for the geodetic precession is to solve the purely Newtonian equations of rotational motion and add the geodetic precession as a correction to the solution. In this thesis, we aim to determine the acceleration of the SSB from astrometric and geodetic observations obtained by Very Long Baseline Interferometry (VLBI), which is a technique using the telescopes globally distributed on the Earth to observe a radio source simultaneously, and with the capacity of angular positioning for compact radio sources at 10-milliarcsecond level. The method of the global solution, which allows the acceleration vector to be estimated as a global parameter in the data analysis, is developed. Through the formal error given by the solution, this method shows directly the VLBI observations' capability to constrain the acceleration of the SSB, and demonstrates the significance level of the result. In the next step, the impact of the acceleration on the ICRS is studied in order to obtain the correction of the celestial reference frame (CRF) orientation. Recently, Klioner, Gerlach, and Soffel (2010) have constructed a relativistic theory of Earth's rotation. According to the post-Newtonian equations of rotational motion given by Klioner

  9. Lymphocyte markers and prediction of long-term renal allograft acceptance.

    PubMed

    Babel, Nina; Reinke, Petra; Volk, Hans-Dieter

    2009-11-01

    Long-term allograft acceptance is the main goal of posttransplant care. Modern immunosuppression has reduced the incidence of acute rejection, the major risk factor for long-term allograft survival, and improved the 1-year results, despite increasing use of marginal donor organs. However, the long-term results are still unsatisfactory. Chronic allograft injury and side effects of chronic immunosuppression are the main causes. Therefore, preemptive reduced long-term immunosuppression is required. Present 'trial-and-error' strategies appear to be remarkably harmful for patients not suitable for partial drug weaning. In addition, preemptive interventions have been shown to be the only successful strategy for improving the long-term transplant outcome in animal models. These findings underline the importance of early identification of biomarkers in detecting the individual's risk. Recent technological advances have provided evidence of successful approaches to this goal. A set of parameters/tests are showing promise for guiding personalized immunosuppression, including different technology platforms such as antidonor responsiveness/nonresponsiveness, cellular parameters predicting risk of virus-associated complications, gene expression analysis etc. Although the data are very promising, multicentric, prospective, randomized clinical trials are crucial prerequisites for introducing immune monitoring into routine clinical use. International networks, such as RISET and ITN, can help to facilitate this process.

  10. Comment on ``Long-Term Global Heating From Energy Use''

    NASA Astrophysics Data System (ADS)

    Fleming, James R.

    2008-12-01

    In a prominent article published in Tellus in 1969, Mikhail I. Budyko, with the Main Geophysical Observatory, Leningrad, Soviet Union, wrote that ``all the energy used by man is transformed into heat, the main portion of this energy being an additional source of heat as compared to the present radiation gain'' [Budyko, 1969, p. 618]. He pointed out that this heating was over and above any climate forcing from anthropogenic greenhouse gases and-since energy use was growing geometrically-it was likely to result in the retreat of the cryosphere, accompanied by excessive and potentially damaging global warming, perhaps in 200 years or less. Eric J. Chaisson, in Eos (``Long-Term Global Heating From Energy Use,'' 89(28), 253-254, 2008), does not acknowledge Budyko's research. Chaisson cites cosmic history and the history of the human species, but he provides no references to the conceptual history of the idea that human energy use could result in global heating. Budyko first published on the Earth's heat budget in 1948 and in 1998 received the Blue Planet Prize, sponsored by the Asahi Glass Foundation, for his lifetime accomplishments in quantitative climatology. His work on the energy budget of the Earth and anthropogenic influences really should have been cited (see a selection of key articles in the online National Science Digital Library, at http://wiki.nsdl.org/index.php/PALE:ClassicArticles/GlobalWarming).

  11. 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.

  12. Estimated long-term health effects

    SciTech Connect

    Cardis, F.; Okeanov, A.E.; Likthariev, I.; Prisyazhniuk; Anspaugh, L.R.; Mabuchi, K.; Ivanov, V.K.

    1996-04-01

    Apart from the dramatic increase in thyroid cancer in those exposed as children, there is no evidence to date of a major public health impact of the radiation exposure from the Chernobyl accident in the three most affected countries. Although some increases in the frequency of cancer in exposed populations have been reported, these results are difficult to interpret, mainly because of differences in the intensity and method of follow-up between exposed populations and the general population to which they are compared. If the experience of atomic bomb survivors and of other exposed populations is applicable, the major radiological impact of the accident will be cancer and the total lifetime numbers of excess cancers will be greatest among the liquidators and among the residents of contaminated territories, of the order of 2,000 to 2,500. These increases would be difficult to detect epidemiologically against an expected background number of 41,500 and 433,000 respectively (size of the exposed populations: 200,000 and 3,700,000, respectively). It is noted, however, that the exposures received by populations exposed as a result of Chernobyl are different (in type and pattern) from those of atomic bomb survivors. Predictions derived from these populations are therefore uncertain. Indeed, the extent of the increase in thyroid cancer incidence in persons exposed as children was not foreseen. In addition, only ten years have passed since the accident. It is essential therefore that monitoring of the health of the population be continued in order to assess the public health impact of the accident, even if, apart from leukemia among liquidators, little detectable increase of cancers due to radiation from the Chernobyl accident is expected.

  13. Fracture risk assessment in long-term care: a survey of long-term care physicians.

    PubMed

    Wall, Michelle; Lohfeld, Lynne; Giangregorio, Lora; Ioannidis, George; Kennedy, Courtney C; Moser, Andrea; Papaioannou, Alexandra; Morin, Suzanne N

    2013-10-18

    The majority of frail elderly who live in long-term care (LTC) are not treated for osteoporosis despite their high risk for fragility fractures. Clinical Practice Guidelines for the diagnosis and management of osteoporosis provide guidance for the management of individuals 50 years and older at risk for fractures, however, they cannot benefit LTC residents if physicians perceive barriers to their application. Our objectives are to explore current practices to fracture risk assessment by LTC physicians and describe barriers to applying the recently published Osteoporosis Canada practice guidelines for fracture assessment and prevention in LTC. A cross-sectional survey was conducted with the Ontario Long-Term Care Physicians Association using an online questionnaire. The survey included questions that addressed members' attitudes, knowledge, and behaviour with respect to fracture risk assessment in LTC. Closed-ended responses were analyzed using descriptive statistics and thematic framework analysis for open-ended responses. We contacted 347 LTC physicians; 25% submitted completed surveys (81% men, mean age 60 (Standard Deviation [SD] 11) years, average 32 [SD 11] years in practice). Of the surveyed physicians, 87% considered prevention of fragility fractures to be important, but a minority (34%) reported using validated fracture risk assessment tools, while 33% did not use any. Clinical risk factors recommended by the OC guidelines for assessing fracture risk considered applicable included; glucocorticoid use (99%), fall history (93%), age (92%), and fracture history (91%). Recommended clinical measurements considered applicable included: weight (84%), thyroid-stimulating hormone (78%) and creatinine (73%) measurements, height (61%), and Get-Up-and-Go test (60%). Perceived barriers to assessing fracture risk included difficulty acquiring necessary information, lack of access to tests (bone mineral density, x-rays) or obtaining medical history; resource constraints

  14. Long-term use of stimulants in children with attention deficit hyperactivity disorder: safety, efficacy, and long-term outcome.

    PubMed

    Hechtman, Lily; Greenfield, Brian

    2003-01-01

    The purpose of this review is to summarize existing data on the long-term safety and efficacy of stimulant treatment, and how long-term stimulant treatment of children with attention deficit hyperactivity disorder (ADHD) affects their outcome. Existing controlled studies of children with ADHD treated and untreated with stimulants, as well as long-term prospective follow-up studies, are reviewed. Children with ADHD treated with stimulants for as long as 2 years continue to benefit from the treatment, with improvements observed in ADHD symptoms, comorbid oppositional defiant disorder, and academic and social functioning, with no significant problems of tolerance or adverse effects. Long-term, prospective follow-up studies into adulthood show that stimulant treatment in childhood has slight benefits regarding social skills and self-esteem. Long-term adverse effects from stimulant treatment in childhood regarding adult height or future substance abuse have not been supported by existing studies.

  15. Long-Term Care Nurse Residency Program: Evaluation of New Nurse Experiences and Lessons Learned.

    PubMed

    Salmond, Susan W; Cadmus, Edna; Black, Katherine Kuren; Bohnarczyk, Nancy; Hassler, Linda

    2017-10-01

    Transitioning to long-term care environments presents a significant challenge for new nurses and their directors of nursing. The complexity of this environment, instability of the workforce, and the lack of support structures frequently affect a new nurse's decision not to apply to long-term care, but to look for positions in acute care hospitals. To address these issues, a long-term care new nurse residency program was developed, implemented, and evaluated in New Jersey through the work of the New Jersey Action Coalition. The purpose of this study was to determine the effects of the residency program on new nurses' confidence, competence, retention, job satisfaction, and perceptions of organizational safety. J Contin Educ Nurs. 2017;48(10):474-484. Copyright 2017, SLACK Incorporated.

  16. Geriatric pain competencies and knowledge assessment for nurses in long term care settings

    PubMed Central

    Swafford, Kristen L.; Miller, Lois L.; Herr, Keela; Forcucci, Chris; Kelly, Anne Marie L.; Bakerjian, Debra

    2015-01-01

    Pain in older adults is a prevalent problem that affects quality of life and challenges nurses, particularly those caring for older adults living in long term care settings. Despite the national priority of pain management, insufficient knowledge of nurses about geriatric pain is a documented barrier to effective geriatric pain management in all long term care settings. To address this knowledge gap, a website (GeriatricPain.org) was developed by the National Geriatric Pain Collaborative with a grant from the MayDay Fund to provide a single site for evidenced-based, easy-to-use, downloadable resources on pain management. This paper describes the development of the most recent addition to the website, a set of evidence-based core geriatric pain management competencies and a geriatric pain knowledge assessment, and discusses their potential uses in improving pain care for older adults. Geriatric Pain Competencies and Knowledge Assessment for Nurses in Long Term Care Settings. PMID:25037079

  17. Lessons to Exchange: A Comparison of Long-Term Care Between Two Cultures: Uganda and Singapore.

    PubMed

    Tam, Wai Jia; Yap, Philip

    2015-12-01

    Today, both the developed and developing world are facing fast-aging populations. Projections show that by 2050, 80% of the world's older persons will live in low and middle-income countries. As developed countries look to institutionalization as one of the means to cope with the challenges of long-term care of seniors, the developing world, with a different cultural, socioeconomic, and environmental context, may yet offer insights that instruct and inspire. By analyzing and comparing the approaches, context, and progress of Singapore and Uganda in coping with frail and dependent seniors, this article provides lessons about what the developing and developed world can offer each other, and in turn, teach us about long-term care of seniors. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  18. Long-term employment and health inequalities in Canadian communities.

    PubMed

    Safaei, Jalil

    2008-01-01

    This study examines the long-term unemployment rate and various health outcomes across Canadian communities to estimate employment-related health inequalities in these communities. The study uses cross-sectional community-level health data along with data on the long-term employment rate for various communities across Canada to quantify health inequalities among these communities. The health outcomes that are considered in this study include total and disease specific mortality rates; health conditions such as high blood pressure, diabetes, injuries, and self rated health; and life expectancies at birth and at age 65. Health inequalities are estimated using the concentration index, which is used to measure health inequalities along socioeconomic dimensions. The concentration index is estimated by a regression of weighted relative health (ill health) over weighted cumulative relative rank of the populations. All the estimates are provided separately for males and females. The findings of the study support the existence of inequalities in community health outcomes as related to the long-term employment rates in those communities. Communities with lower long term employment rates (higher unemployment rates) have poorer health outcomes in terms of higher mortality rates, worse health conditions, and shorter life expectancies. Health inequalities related to long-term employment have important policy implications. They call for policies that would increase and maintain long term employment rates as part of a broader socioeconomic approach to health. Long term employment ensures income security and prevents the psychosocial experiences leading to mental and physical ill health.

  19. Long term volcanic hazard analysis in the Canary Islands

    NASA Astrophysics Data System (ADS)

    Becerril, L.; Galindo, I.; Laín, L.; Llorente, M.; Mancebo, M. J.

    2009-04-01

    Historic volcanism in Spain is restricted to the Canary Islands, a volcanic archipelago formed by seven volcanic islands. Several historic eruptions have been registered in the last five hundred years. However, and despite the huge amount of citizens and tourist in the archipelago, only a few volcanic hazard studies have been carried out. These studies are mainly focused in the developing of hazard maps in Lanzarote and Tenerife islands, especially for land use planning. The main handicap for these studies in the Canary Islands is the lack of well reported historical eruptions, but also the lack of data such as geochronological, geochemical or structural. In recent years, the use of Geographical Information Systems (GIS) and the improvement in the volcanic processes modelling has provided an important tool for volcanic hazard assessment. Although this sophisticated programs are really useful they need to be fed by a huge amount of data that sometimes, such in the case of the Canary Islands, are not available. For this reason, the Spanish Geological Survey (IGME) is developing a complete geo-referenced database for long term volcanic analysis in the Canary Islands. The Canarian Volcanic Hazard Database (HADA) is based on a GIS helping to organize and manage volcanic information efficiently. HADA includes the following groups of information: (1) 1:25.000 scale geologic maps, (2) 1:25.000 topographic maps, (3) geochronologic data, (4) geochemical data, (5) structural information, (6) climatic data. Data must pass a quality control before they are included in the database. New data are easily integrated in the database. With the HADA database the IGME has started a systematic organization of the existing data. In the near future, the IGME will generate new information to be included in HADA, such as volcanological maps of the islands, structural information, geochronological data and other information to assess long term volcanic hazard analysis. HADA will permit

  20. 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