Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice

PubMed Central

Snyder, Jeremy; Crooks, Valorie A.; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

2015-01-01

Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and ‘black sheep’; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated. PMID:25865122

Long-term no-tillage and organic input management enhanced the diversity and stability of soil microbial community.

PubMed

Wang, Yi; Li, Chunyue; Tu, Cong; Hoyt, Greg D; DeForest, Jared L; Hu, Shuijin

2017-12-31

Intensive tillage and high inputs of chemicals are frequently used in conventional agriculture management, which critically depresses soil properties and causes soil erosion and nonpoint source pollution. Conservation practices, such as no-tillage and organic farming, have potential to enhance soil health. However, the long-term impact of no-tillage and organic practices on soil microbial diversity and community structure has not been fully understood, particularly in humid, warm climate regions such as the southeast USA. We hypothesized that organic inputs will lead to greater microbial diversity and a more stable microbial community, and that the combination of no-tillage and organic inputs will maximize soil microbial diversity. We conducted a long-term experiment in the southern Appalachian mountains of North Carolina, USA to test these hypotheses. The results showed that soil microbial diversity and community structure diverged under different management regimes after long term continuous treatments. Organic input dominated the effect of management practices on soil microbial properties, although no-tillage practice also exerted significant impacts. Both no-tillage and organic inputs significantly promoted soil microbial diversity and community stability. The combination of no-tillage and organic management increased soil microbial diversity over the conventional tillage and led to a microbial community structure more similar to the one in an adjacent grassland. These results indicate that effective management through reducing tillage and increasing organic C inputs can enhance soil microbial diversity and community stability. Copyright © 2017 Elsevier B.V. All rights reserved.

How do general practitioners contribute to preventing long-term work disability of their patients suffering from depressive disorders? A qualitative study.

PubMed

Sylvain, Chantal; Durand, Marie-José; Maillette, Pascale; Lamothe, Lise

2016-06-07

Depression is a major cause of work absenteeism that general practitioners (GPs) face directly since they are responsible for sickness certification and for supervising the return to work (RTW). These activities give GPs a key role in preventing long-term work disability, yet their practices in this regard remain poorly documented. The objectives of this study were therefore to describe GPs' practices with people experiencing work disability due to depressive disorders and explore how GPs' work context may impact on their practices. We conducted semi-structured individual interviews with 13 GPs and six mental healthcare professionals in two sub-regions of Quebec. The sub-regions differed in terms of availability of specialized resources offering public mental health services. Data were anonymized and transcribed verbatim. Thematic analysis was performed to identify patterns in the GPs' practices and highlight impacting factors in their work context. Our results identified a set of practices common to all the GPs and other practices that differentiated them. Two profiles were defined on the basis of the various practices documented. The first is characterized by the integration of the RTW goal into the treatment goal right from sickness certification and by interventions that include the workplace, albeit indirectly. The second is characterized by a lack of early RTW-oriented action and by interventions that include little workplace involvement. Regardless of the practice profile, actions intended to improve collaboration with key stakeholders remain the exception. However, two characteristics of the work context appear to have an impact: the availability of a dedicated mental health nurse and the regular provision of clinical information by psychotherapists. These conditions are rarely present but tend to make a significant difference for the GPs. Our results highlight the significant role of GPs in the prevention of long-term work disability and their need for support through the organization of mental health services at the primary care level.

Long-term research and monitoring of conservation practice effects in Iowa watersheds

USDA-ARS?s Scientific Manuscript database

Impacts of conservation practices on water quality can be demonstrated at the plot and field scales in research or on-farm settings. Watershed-scale monitoring is often used to examine the cumulative effects of conservation practice implementation for that drainage area. The Upper Mississippi River ...

Sustained Transfer of Knowledge to Practice in Long-Term Care: Facilitators and Barriers of a Mental Health Learning Initiative

ERIC Educational Resources Information Center

Stolee, Paul; McAiney, Carrie A.; Hillier, Loretta M.; Harris, Diane; Hamilton, Pam; Kessler, Linda; Madsen, Victoria; Le Clair, J. Kenneth

2009-01-01

This article explores facilitators and barriers to the impact and sustainability of a learning initiative to increase capacity of long-term care (LTC) homes to manage the mental health needs of older persons, through development of in-house Psychogeriatric Resource Persons (PRPs). Twenty interviews were conducted with LTC staff. Management…

The impact of professional development on classroom teaching for science educators participating in a long term community of practice

NASA Astrophysics Data System (ADS)

Jensen, Aaron C.

Efforts to modify and improve science education in the United States have seen minimal success (Crawford, 2000; Borko & Putman, 1996; Puntambekar, Stylianou & Goldstein, 2007; Lustick, 2011). One important reason for this is the professional development that teachers go through in order to learn about and apply these new ideas is generally of poor quality and structured incorrectly for long-term changes in the classroom (Little, 1993; Fullen, 1996; Porter, 2000; Jeanpierre, Oberhauser, & Freeman, 2005). This grounded theory study explores a science community of practice and how the professional development achieved through participation in that community has effected the instruction of the teachers involved, specifically the incorporation of researched based effective science teaching instructional strategies. This study uses personal reflection papers written by the participants, interviews, and classroom observations to understand the influence that the science community of practice has had on the participants. Results indicate that participation in this science community of practice has significant impact on the teachers involved. Participants gained greater understanding of science content knowledge, incorporated effective science instructional strategies into their classroom, and were able to practice both content knowledge and strategies in a non-threatening environment thus gaining a greater understanding of how to apply them in the classrooms. These findings motivate continued research in the role that communities of practice may play in teacher professional develop and the effectiveness of quality professional development in attaining long-term, sustained improvement in science education.

Can ESD Reach the Year 2020?

ERIC Educational Resources Information Center

Lenglet, Frans

2014-01-01

In order to have long-term impact ESD concepts, practices and policies should move into societal, policy and research arenas with high visibility and traction. In the process of going "transboundary", the ESD label may fade but the practice and organization of social and collaborative learning may gain.

Football Players' Head-Impact Exposure After Limiting of Full-Contact Practices.

PubMed

Broglio, Steven P; Williams, Richelle M; O'Connor, Kathryn L; Goldstick, Jason

2016-07-01

Sporting organizations limit full-contact football practices to reduce concussion risk and based on speculation that repeated head impacts may result in long-term neurodegeneration. To directly compare head-impact exposure in high school football players before and after a statewide restriction on full-contact practices. Cross-sectional study. High school football field. Participants were varsity football athletes from a single high school. Before the rule change, 26 athletes (age = 16.2 ± 0.8 years, height = 179.6 ± 6.4 cm, weight = 81.9 ± 13.1 kg) participated. After the rule change, 24 athletes (age = 15.9 ± 0.8 years, height = 178.3 ± 6.5 cm, weight = 76.2 ± 11.6 kg) participated. Nine athletes participated in both years of the investigation. Head-impact exposure was monitored using the Head Impact Telemetry System while the athletes participated in football games and practices in the seasons before and after the rule change. Head-impact frequency, location, and magnitude (ie, linear acceleration, rotational acceleration, and Head Impact Telemetry severity profile [HITsp], respectively) were measured. A total of 15 398 impacts (592 impacts per player per season) were captured before the rule change and 8269 impacts (345 impacts per player per season) after the change. An average 42% decline in impact exposure occurred across all players, with practice-exposure declines occurring among linemen (46% decline); receivers, cornerbacks, and safeties (41% decline); and tight ends, running backs (including fullbacks), and linebackers (39% decline). Impact magnitudes remained largely unchanged between the years. A rule change limiting full-contact high school football practices appears to have been effective in reducing head-impact exposure across all players, with the largest reduction occurring among linemen. This finding is likely associated with the rule modification, particularly because the coaching staff and offensive scheme remained consistent, yet how this reduction influences concussion risk and long-term cognitive health remains unknown.

Statistical package for improved analysis of hillslope monitoring data collected as part of the Board of Forestry's long-term monitoring program

Treesearch

Jack Lewis; Jim Baldwin

1997-01-01

The State of California has embarked upon a Long-Term Monitoring Program whose primary goal is to assess the effectiveness of the Forest Practice Rules and Review Process in protecting the beneficial uses of waters from the impacts of timber operations on private timberlands. The Board of Forestry's Monitoring Study Group concluded that hillslope monitoring should...

Dealing with the death of a long term patient; what is the impact and how do podiatrists cope?

PubMed

Robson, Kristy; Williams, Cylie M

2017-01-01

It is common for podiatrists and patients to develop long term professional relationships. Patient's decline in health or death may impact a practitioner's mental wellbeing. This research aimed to understand the impact of long term patient death on podiatrists and identify coping strategies. Australian podiatrists were eligible to participate if they had been practicing longer than 5 years and experienced the death of a long term patient in the previous 12 months. Individual semi-structured interviews were conducted with podiatrists and were audio-recorded, transcribed verbatim and individually analysed to identify key themes. Interpretative phenomenological analysis was used to explore the perceptions of podiatrists on the personal and professional impact following the death of a long term patient. Fifteen podiatrists (11 female) with a median of 15 (range 8-50) years' experience participated. Three major themes emerged: acknowledging connections, willing to share and listen, and creating support through starting the conversation. Participants indicated importance in recognition of the emotional influence of professional-patient relationships. They also discussed the importance of debriefing about death with the right person, which was most commonly colleagues. Participants talked about the emotional impact of death, suggesting the need for supporting discussion and resources, especially for new graduates. Death and dying can be an emotive topic and one which podiatrists may not be prepared for, yet likely to have to deal with throughout their career. These findings enable a better understanding of the impact of patient death and provide possible future directions for the profession to better support podiatrists in this area.

Cardiorespiratory interaction with continuous positive airway pressure

PubMed Central

Bonafini, Sara; Fava, Cristiano; Steier, Joerg

2018-01-01

The treatment of choice for obstructive sleep apnoea (OSA) is continuous positive airway pressure therapy (CPAP). Since its introduction in clinical practice, CPAP has been used in various clinical conditions with variable and heterogeneous outcomes. In addition to the well-known effects on the upper airway CPAP impacts on intrathoracic pressures, haemodynamics and blood pressure (BP) control. However, short- and long-term effects of CPAP therapy depend on multiple variables which include symptoms, underlying condition, pressure used, treatment acceptance, compliance and usage. CPAP can alter long-term cardiovascular risk in patients with cardiorespiratory conditions. Furthermore, the effect of CPAP on the awake patient differs from the effect on the patients while asleep, and this might contribute to discomfort and removal of the use interface. The purpose of this review is to highlight the physiological impact of CPAP on the cardiorespiratory system, including short-term benefits and long-term outcomes. PMID:29445529

Quantifying the effects of conservation practice implementation on predicted runoff and chemical losses under climate change

USDA-ARS?s Scientific Manuscript database

The Soil and Water Assessment Tool with downscaled weather data generated using the MarkSim weather file generator was used to evaluate the impact of long-term conservation practice implementation on runoff, sediment, atrazine, nitrogen (N) and phosphorus (P) losses in the AXL Watershed located in n...

Effects of long-term soil management on the mutual interaction among soil organic matter, microbial activity and aggregates in vineyard

USDA-ARS?s Scientific Manuscript database

Vineyard management practices to enhance soil conservation principally focus on increasing carbon (C) input, whereas mitigating impacts of disturbance through reduced tillage has been rarely considered. Furthermore, information is lacking on the effects of soil management practices adopted in the un...

Team Action Imagery and Team Cognition: Imagery of Game Situations and Required Team Actions Promotes a Functional Structure in Players' Representations of Team-Level Tactics.

PubMed

Frank, Cornelia; Linstromberg, Gian-Luca; Hennig, Linda; Heinen, Thomas; Schack, Thomas

2018-02-01

A team's cognitions of interpersonally coordinated actions are a crucial component for successful team performance. Here, we present an approach to practice team action by way of imagery and examine its impact on team cognitions in long-term memory. We investigated the impact of a 4-week team action imagery intervention on futsal players' mental representations of team-level tactics. Skilled futsal players were assigned to either an imagery training group or a no imagery training control group. Participants in the imagery training group practiced four team-level tactics by imagining team actions in specific game situations for three times a week. Results revealed that the imagery training group's representations were more similar to that of an expert representation after the intervention compared with the control group. This study indicates that team action imagery training can have a significant impact on players' tactical skill representations and thus order formation in long-term memory.

The Impact of Feedback Frequency on Performance in a Novel Speech Motor Learning Task.

PubMed

Lowe, Mara Steinberg; Buchwald, Adam

2017-06-22

This study investigated whether whole nonword accuracy, phoneme accuracy, and acoustic duration measures were influenced by the amount of feedback speakers without impairment received during a novel speech motor learning task. Thirty-two native English speakers completed a nonword production task across 3 time points: practice, short-term retention, and long-term retention. During practice, participants received knowledge of results feedback according to a randomly assigned schedule (100%, 50%, 20%, or 0%). Changes in nonword accuracy, phoneme accuracy, nonword duration, and initial-cluster duration were compared among feedback groups, sessions, and stimulus properties. All participants improved phoneme and whole nonword accuracy at short-term and long-term retention time points. Participants also refined productions of nonwords, as indicated by a decrease in nonword duration across sessions. The 50% group exhibited the largest reduction in duration between practice and long-term retention for nonwords with native and nonnative clusters. All speakers, regardless of feedback schedule, learned new speech motor behaviors quickly with a high degree of accuracy and refined their speech motor skills for perceptually accurate productions. Acoustic measurements may capture more subtle, subperceptual changes that may occur during speech motor learning. https://doi.org/10.23641/asha.5116324.

Management of long term sickness absence: a systematic realist review.

PubMed

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

2012-09-01

The increasing impact and costs of long term sickness absence have been well documented. However, the diversity and complexity of interventions and of the contexts in which these take place makes a traditional review problematic. Therefore, we undertook a systematic realist review to identify the dominant programme theories underlying best practice, to assess the evidence for these theories, and to throw light on important enabling or disabling contextual factors. A search of the scholarly literature from 1950 to 2011 identified 5,576 articles, of which 269 formed the basis of the review. We found that the dominant programme theories in relation to effective management related to: early intervention or referral by employers; having proactive organisational procedures; good communication and cooperation between stakeholders; and workplace-based occupational rehabilitation. Significant contextual factors were identified as the level of support for interventions from top management, the size and structure of the organisation, the level of financial and organisational investment in the management of long-term sickness absence, and the quality of relationships between managers and staff. Consequently, those with responsibility for managing absence should bear in mind the contextual factors that are likely to have an impact on interventions, and do what they can to ensure stakeholders have at least a mutual understanding (if not a common purpose) in relation to their perceptions of interventions, goals, culture and practice in the management of long term sickness absence.

The use of touch to enhance nursing care of older person in long-term mental health care facilities.

PubMed

Gleeson, M; Timmins, F

2004-10-01

The self-care deficits experienced by older clients in long-term mental health settings, because of cognitive impairment, are likely to impact upon the clients' higher-order needs. The practice of nursing the elderly involves a lot of personal contact, during the delivery of fundamental physical care. While physiological and safety needs are crucial to clients in long-term settings, higher-order needs need also to be addressed. From the clients' perspective nurse's use of touch provides comfort, warmth and security, although there is a dearth of empirical evidence of these benefits. This paper explores the nurse's use of touch, the impact of touch and the experiences of touch on the older person in long-term settings. Because of the dearth of research in the use of touch with elderly clients in long-term care mental health facilities, a review of the literature was performed on the topic. This revealed that touch by nurses is frequently associated with routine tasks within nursing, and is less likely to be a caring touch intervention. Recommendations include further research on the topic and caution with widespread adoption of caring touch as an intervention.

Methods That Examine the Extent to Which the Quality of Children's Experiences in Elementary School Moderate the Long-Term Impacts of Head Start

ERIC Educational Resources Information Center

Mashburn, Andrew J.; Downer, Jason T.

2013-01-01

The goals of the Head Start Impact Study (HSIS) are to: (1) determine the impacts of Head Start on children's school readiness and parental practices that support children's development; and (2) to determine under what circumstances Head Start achieves its greatest impacts and for which children (US Department of Health and Human Services, 2010).…

Electronic health records in four community physician practices: impact on quality and cost of care.

PubMed

Welch, W Pete; Bazarko, Dawn; Ritten, Kimberly; Burgess, Yo; Harmon, Robert; Sandy, Lewis G

2007-01-01

To assess the impact of the electronic health record (EHR) on cost (i.e., payments to providers) and process measures of quality of care. Retrospective before-after-study-control. From the database of a large managed care organization (MCO), we obtained the claims of patients from four community physician practices that implemented the EHR and from about 50 comparison practices without the EHR in the same counties. The diverse patient and practice populations were chosen to be a sample more representative of typical private practices than has previously been studied. For four chronic conditions, we used commercially-available software to analyze cost per episode over a year and the rate of adherence to clinical guidelines as a measure of quality. The implementation of the EHR had a modest positive impact on the quality measure of guideline adherence for hypertension and hyperlipidemia, but no significant impact for diabetes and coronary artery disease. No measurable impact on the short-term cost per episode was found. Discussions with the study practices revealed that the timing and comprehensiveness of EHR implementation varied across practices, creating an intervention variable that was heterogeneous. Guideline adherence increased across practices without EHRs and slightly faster in practices with EHRs. Measuring the impact of EHRs on cost per episode was challenging, because of the difficulty of completely capturing the long-term episodic costs of a chronic condition. Few practices associated with the study MCO had implemented EHRs in any form, much less utilizing standardized protocols.

Football Players' Head-Impact Exposure After Limiting of Full-Contact Practices

PubMed Central

Broglio, Steven P.; Williams, Richelle M.; O'Connor, Kathryn L.; Goldstick, Jason

2016-01-01

Context:  Sporting organizations limit full-contact football practices to reduce concussion risk and based on speculation that repeated head impacts may result in long-term neurodegeneration. Objective:  To directly compare head-impact exposure in high school football players before and after a statewide restriction on full-contact practices. Design:  Cross-sectional study. Setting:  High school football field. Patients or Other Participants:  Participants were varsity football athletes from a single high school. Before the rule change, 26 athletes (age = 16.2 ± 0.8 years, height = 179.6 ± 6.4 cm, weight = 81.9 ± 13.1 kg) participated. After the rule change, 24 athletes (age = 15.9 ± 0.8 years, height = 178.3 ± 6.5 cm, weight = 76.2 ± 11.6 kg) participated. Nine athletes participated in both years of the investigation. Main Outcome Measure(s):  Head-impact exposure was monitored using the Head Impact Telemetry System while the athletes participated in football games and practices in the seasons before and after the rule change. Head-impact frequency, location, and magnitude (ie, linear acceleration, rotational acceleration, and Head Impact Telemetry severity profile [HITsp], respectively) were measured. Results:  A total of 15 398 impacts (592 impacts per player per season) were captured before the rule change and 8269 impacts (345 impacts per player per season) after the change. An average 42% decline in impact exposure occurred across all players, with practice-exposure declines occurring among linemen (46% decline); receivers, cornerbacks, and safeties (41% decline); and tight ends, running backs (including fullbacks), and linebackers (39% decline). Impact magnitudes remained largely unchanged between the years. Conclusions:  A rule change limiting full-contact high school football practices appears to have been effective in reducing head-impact exposure across all players, with the largest reduction occurring among linemen. This finding is likely associated with the rule modification, particularly because the coaching staff and offensive scheme remained consistent, yet how this reduction influences concussion risk and long-term cognitive health remains unknown. PMID:27333460

Adolescent Literacy Practices and Positive Youth Development through Fink's Taxonomy of Significant Learning

ERIC Educational Resources Information Center

Taylor-Greathouse, Paula

2013-01-01

The purpose of this study was not to disprove the effects of the current, common remedial literacy course design and the literacy practices within that help adolescent RLLs pass statewide assessment tests, but to describe the potential long-term impact of an innovative comprehensive approach to literacy (CAL) framed through an integrated course…

Factors associated with the effectiveness of continuing education in long-term care.

PubMed

Stolee, Paul; Esbaugh, Jacquelin; Aylward, Sandra; Cathers, Tamzin; Harvey, David P; Hillier, Loretta M; Keat, Nancy; Feightner, John W

2005-06-01

This article examines factors within the long-term-care work environment that impact the effectiveness of continuing education. In Study 1, focus group interviews were conducted with staff and management from urban and rural long-term-care facilities in southwestern Ontario to identify their perceptions of the workplace factors that affect transfer of learning into practice. Thirty-five people were interviewed across six focus groups. In Study 2, a Delphi technique was used to refine our list of factors. Consensus was achieved in two survey rounds involving 30 and 27 participants, respectively. Management support was identified as the most important factor impacting the effectiveness of continuing education. Other factors included resources (staff, funding, space) and the need for ongoing expert support. Organizational support is necessary for continuing education programs to be effective and ongoing expert support is needed to enable and reinforce learning.

Long-Term Impact of a Cell Phone-Enhanced Parenting Intervention.

PubMed

Lefever, Jennifer E Burke; Bigelow, Kathryn M; Carta, Judith J; Borkowski, John G; Grandfield, Elizabeth; McCune, Luke; Irvin, Dwight W; Warren, Steven F

2017-11-01

Home visiting programs support positive parenting in populations at-risk of child maltreatment, but their impact is often limited by poor retention and engagement. The current study assessed whether a cellular phone-supported version (PCI-C) of the Parent-Child Interactions (PCI) intervention improved long-term parenting practices, maternal depression, and children's aggression. Low-income mothers ( n = 371) of preschool-aged children were assigned to one of the three groups: PCI-C, PCI, and a wait-list control (WLC) group. Parenting improved in both intervention groups between baseline and 12-month follow-up compared to the WLC. Children in the PCI-C group were rated to be more cooperative and less aggressive than children in the WLC. The results offer evidence of the long-term effectiveness of PCI and the additional benefits of cellular phone supports for promoting intervention retention and improving children's behavior.

The perceived impact of public involvement in palliative care in a provincial palliative care network in the Netherlands: a qualitative study.

PubMed

Haarsma, Frederike; Moser, Albine; Beckers, Manon; van Rijswijk, Henk; Stoffers, Esther; Beurskens, Anna

2015-12-01

Public involvement in palliative care is challenging and difficult, because people in need of palliative care are often not capable of speaking up for themselves. Patient representatives advocate for their common interests. The aim of our study was to examine in depth the current practice of public involvement in palliative care. The study was conducted in the province of Limburg in the Netherlands, with six palliative care networks. Study participants were 16 patient representatives and 12 professionals. This study had a descriptive design using qualitative methods: 18 in-depth interviews and three focus groups were conducted. The critical incident technique was used. The data were analysed using an analytical framework based on Arnstein's involvement classification and the process of decision making. Impact categories as well as facilitators and barriers were analysed using content analysis. The perceived impact of public involvement in palliative care in terms of citizen control and partnership is greatest with regard to quality of care, information development and dissemination, and in terms of policymaking with regard to the preparation and implementation phases of decision making. The main difference in perceived impact between patient representatives and professionals relates to the tension between operational and strategic involvement. Patient representatives experienced more impact regarding short-term solutions to practical problems, while professionals perceived great benefits in long-term, strategic processes. Improving public involvement in palliative care requires positive attitudes, open communication, sufficient resources and long-term support, to build a solid basis for pursuing meaningful involvement in the entire decision-making process. © 2014 John Wiley & Sons Ltd.

Relationships among leadership practices, work environments, staff communication and outcomes in long-term care.

PubMed

Tourangeau, Ann; Cranley, Lisa; Spence Laschinger, Heather K; Pachis, Jaime

2010-11-01

To examine the role that work relationships have on two long-term care outcomes: job satisfaction and turnover intention. It is easy to overlook the impact that human relations have in shaping work environments that are conducive to organizational effectiveness. Employee job satisfaction and retention are important organizational outcomes. Six hundred and seventy-five nursing and other staff from 26 long-term care facilities were surveyed about their work environments, work group relationships, observed leadership practices, organizational support, job satisfaction and turnover intention. Higher job satisfaction was associated with lower emotional exhaustion burnout, higher global empowerment, higher organizational support, higher psychological empowerment, stronger work group cohesion and higher personal accomplishment. Higher turnover intention was associated with lower job satisfaction, higher emotional exhaustion burnout, more outside job opportunities, weaker work group cohesion, lower personal accomplishment and higher depersonalization. No relationship was found between leadership practices and job satisfaction or turnover intention. Stronger work group relationships, stronger sense of personal accomplishment and lower emotional exhaustion have direct effects on increasing job satisfaction and lowering turnover intention. To retain long-term care staff, attention should be paid to fostering positive work group cohesion, supporting and acknowledging staff accomplishments and minimizing staff burnout. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Possible global environmental impacts of solid waste practices

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

Davis, M.M.; Holter, G.M.; DeForest, T.J.

1994-09-01

Pollutants resulting from the management of solid waste have been shown to affect the air, land, oceans, and waterways. In addition, solid wastes have other, more indirect impacts such as reduction in feedstocks of natural resources, because useful materials are disposed of rather than recycled. The objective of this study is to evaluate solid waste management practices that have negative implications on the global environment and develop recommendations for reducing such impacts. Recommendations identifying needed changes are identified that will reduce global impacts of solid waste practices in the future. The scope of this study includes the range of non-hazardousmore » solid wastes produced within our society, including municipal solid waste (MSW) and industrial solid waste (ISW), as well as industry-specific wastes from activities such as construction, demolition, and landclearing. Most solid waste management decisions continue to be made and implemented at very local levels, predominantly with a short-term focus to respond to relatively immediate pressures of landfill shortages, funding problems, political considerations, and the like. In this rush to address immediate local problems, little consideration is being given to potential impacts, either short- or long-term, at the national or global level resulting from solid waste management practices. More and more, the cumulative impacts from local decisions concerning solid waste management are beginning to manifest themselves in broader, longer-term impacts than are being addressed by the decision-makers or, at the very least, are presenting a greater and greater potential for such impacts.« less

Teaching long-term science investigations: A matter of talk, text, and time

NASA Astrophysics Data System (ADS)

Bills, Patricia Susan

Science educators regard long-term investigations as one impactful form of teaching science through inquiry in K-12 classrooms. While we have idealized notions of what this work looks like, we have few, if any, descriptive studies about investigations that engage students in sustained, focused work over a period of time longer than a few days or even weeks. In a policy context that calls for teachers to develop strategies for engaging students in authentic science practices, such as those that can come from long-term science investigations, we would do well to learn from experienced teachers. This study followed three middle school science teachers in a large U. S. urban school district as they conducted long-term investigations. Using discourse analysis and taking a sociocultural perspective, this study documented the classroom talk and interaction of teachers and their students. The study's goals were to describe how teachers engage students in long-term investigations and the ways that classroom interaction involved specific reform-based science practices. Data include field notes and transcripts of audio recordings from 15 observations of three experienced middle school science teachers, three semi-structured interviews with each teacher, curriculum materials, student work, and classroom demographic data. Teachers engaged students in whole group, small group, and one-on-one conversations about several stages of the long-term investigations. Teachers most often discussed two of the eight science practices: 1) planning and carrying out investigations; and 2) obtaining, evaluating, and communicating information. The planning discussions involved conversations about identifying and describing variables, measuring and recording data, and concerns about data collection procedures. Conversations about using and communicating scientific information included talk about formal science writing conventions, and using background information to support all other parts of the investigation process. In all of the observed lessons, regardless of the practice or types of investigations students were to engage, teachers used curricular tools to support students' work, scaffolding students' introduction to and use of scientific content, practices, and discourse. In these ways, teachers helped students master a science-specific vocabulary and set of practices that allow for the authentic exploration of science concepts. This study describes how teachers who generate opportunities for students to experience two science practices more often than others, which may have implications for science education and science education research - especially concerning how science practices are engaged in classrooms - moving forward.

Effect of Drainage and Management Practices on Hydrology of Pine Plantation

Treesearch

R. Wayne Skaggs; Devendra M. Amatya; G. M. Chescheir; C. D. Blanton; J. W. Gilliam

2006-01-01

This paper reviews results of long-term studies, initiated in the late 1980s, to determine the hydrologic and water quality impacts of drainage and related water and forest management practices on a poorly drained site in Carteret County, North Carolina. Three watersheds, each approximately 25 ha, were instrumented to measure and record drainage rate, water table depth...

Learning Processes and Learning Outcomes

DTIC Science & Technology

1992-06-01

establish and maintain activation levels) may process information faster because the relevant traces in long - term memory are already activated...drill and practice, and discovery. Finally, implications for the design of computerized instructional environments are indicated. 14. SUBJECT TERMS lI...outcome. This impact may be direct, or may interact with characteristics of the learner to effect learning outcome. INITIAL STATES Conative and cognitive

The long-term financial impact of electronic health record implementation.

PubMed

Howley, Michael J; Chou, Edgar Y; Hansen, Nancy; Dalrymple, Prudence W

2015-03-01

To examine the financial impact of electronic health record (EHR) implementation on ambulatory practices. We tracked the practice productivity (ie, number of patient visits) and reimbursement of 30 ambulatory practices for 2 years after EHR implementation and compared each practice to their pre-EHR implementation baseline. Reimbursements significantly increased after EHR implementation even though practice productivity (ie, the number of patient visits) decreased over the 2-year observation period. We saw no evidence of upcoding or increased reimbursement rates to explain the increased revenues. Instead, they were associated with an increase in ancillary office procedures (eg, drawing blood, immunizations, wound care, ultrasounds). The bottom line result-that EHR implementation is associated with increased revenues-is reassuring and offers a basis for further EHR investment. While the productivity losses are consistent with field reports, they also reflect a type of efficiency-the practices are receiving more reimbursement for fewer seeing patients. For the practices still seeing fewer patients after 2 years, the solution likely involves advancing their EHR functionality to include analytics. Although they may still see fewer patients, with EHR analytics, they can focus on seeing the right patients. Practice reimbursements increased after EHR implementation, but there was a long-term decrease in the number of patient visits seen in this ambulatory practice context. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Invigorating Pedagogic Change. Suggestions from Findings of the Development of Secondary Science Teachers' Practice and Cognisance of the Learning Process

ERIC Educational Resources Information Center

McGregor, Debra; Gunter, Barry

2006-01-01

A long-term, 2 year in-service provision to develop pupils thinking capability was provided for 91 secondary schools during the period 1998-2002. The science teachers involved reported that the in-service experience impacted on their pedagogic practice. The evidence was gathered through reflective surveys and interviews. The in-service programme…

Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study.

PubMed

Stumbo, Scott P; Ford, James H; Green, Carla A

2017-11-01

A greater understanding of the factors that influence long-term sustainment of quality improvement (QI) initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007-2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1) finding alignment between business- and client-centered practices; (2) staff engagement early in QI process added legitimacy which facilitated sustainment; (3) commitment to integrating data into monitoring practices and the identification of a data champion; and (4) adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1) lack of evidence of impact on business practices led to discontinuation; (2) disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3) no data integration into overall business practices and no identified data champion; and (4) high staff turnover. In addition, we found that many agencies' current use of NIATx methods and tools suggested a legacy effect that might improve quality elsewhere, even absent overall sustainment of original study outcome goals. Available quantitative data on wait-time reduction demonstrated general concordance between agency perceptions of, and evidence for, sustainment 2 years following the end of the intervention. Additional quantitative data suggested that greater engagement during the intervention period showed some association with sustainment. Factors identified in QI frameworks as important for short-term sustainment-organizational capacity (e.g. staffing and leadership) and intervention characteristics (e.g. flexibility and fit)-are also important to long-term sustainment.

The effects of arts-in-medicine programming on the medical-surgical work environment

PubMed Central

Sonke, Jill; Pesata, Virginia; Arce, Lauren; Carytsas, Ferol P.; Zemina, Kristen; Jokisch, Christine

2015-01-01

Background: Arts in medicine programs have significant impacts on patients and staff in long-term care environments, but the literature lacks evidence of effectiveness on hospital units with shorter average lengths of stay. Methods: The qualitative study used individual structured interviews to assess the impacts of arts programming on job satisfaction, stress, unit culture, support, quality of care, and patient outcomes on a short-term medical-surgical unit, and used a qualitative cross comparison grounded theory methodology to analyze data. Results: The study confirmed that arts programming can positively affect unit culture, nursing practice, and quality of care on short-stay medical-surgical units. Significant insights related to nursing practice and the art program were found, including that music can cause negative distraction for staff. Conclusions: While positive impacts of arts programming on the medical-surgical environment are clear, potential negative effects also need to be considered in the development of practice protocols for artists. PMID:25544861

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.

33 CFR 337.9 - Identification and use of disposal areas.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) evaluation and environmental assessment or environmental impact statement should also address long-term... ARMY, DEPARTMENT OF DEFENSE PRACTICE AND PROCEDURE § 337.9 Identification and use of disposal areas. (a... life of existing disposal areas. Requests for water quality certification and/or coastal zone...

Impact assessment and recommendation of alternative conjunctive water use strategies for salt affected agricultural lands through a field scale decision support system - a case study.

PubMed

Kaur, Ravinder; Paul, Madhumita; Malik, Rashmi

2007-06-01

Conjunctive use of saline/non-saline irrigation waters is generally aimed at minimizing yield losses and enhancing flexibility of cropping, without much alteration in farming operations. Recommendation of location-specific suitable conjunctive water use plans requires assessment of their long-term impacts on soil salinization/sodification and crop yield reductions. This is conventionally achieved through long-term field experiments. However such impact evaluations are site specific, expensive and time consuming. Appropriate decision support systems (DSS) can be time-efficient and cost-effective means for such long-term impact evaluations. This study demonstrates the application of one such (indigenously developed) DSS for recommending best conjunctive water use plans for a, rice-wheat growing, salt affected farmer's field in Gurgaon district of Haryana (India). Before application, the DSS was extensively validated on several farmers and controlled experimental fields in Gurgaon and Karnal districts of Haryana (India). Validation of DSS showed its potential to give realistic estimates of root zone soil salinity (with R = 0.76-0.94; AMRE = 0.03-0.06; RMSPD = 0.51-0.90); sodicity (with R = 0.99; AMRE = 0.02; RMSPD = 0.84) and relative crop yield reductions (AMRE = 0.24), under existing (local) resource management practices. Long term (10 years) root zone salt build ups and associated rice/wheat crop yield reductions, in a salt affected farmer's field, under varied conjunctive water use scenarios were evaluated with the validated DSS. It was observed that long-term applications of canal (CW) and tube well (TW) waters in a cycle and in 1:1 mixed mode, during Kharif season, predicted higher average root zone salt reductions (2-9%) and lower rice crop yield reductions (4-5%) than the existing practice of 3-CW, 3-TW, 3-CW. Besides this, long-term application of 75% CW mixed with 25% TW, during Rabi season, predicted about 17% lower average root-zone salt reductions than the cyclic applications of (1-CW, 1-TW, 2-CW) and (2-CW, 1-TW, 1-CW, i.e., existing irrigation strategy). However, average wheat crop yield reductions (16-17%) simulated under all these strategies were almost at par. In general, cyclic-conjunctive water use strategies emerged as better options than the blending modes. These results were in complete confirmation with actual long-term conjunctive water use experiments on similar soils. It was thus observed that such pre-validated tools could be efficient means for designing, local resource and target crop yield-specific, appropriate conjunctive water use plans for irrigated agricultural lands.

A Comparison of the Long-Term Learning Effects of Comprehensive and Topic-Specific Practice Set Assignments

ERIC Educational Resources Information Center

Fatemi, Darius; Marley, Robert; Marquis, Linda M.

2015-01-01

The authors examined the long-term learning effects of two different practice set assignment approaches on business students' long-term learning: a comprehensive, multiple-period practice set and a topic-specific practice set. Student learning was measured longitudinally across semesters. The authors found evidence that students using a…

Recommendations From the International Consortium on Professional Nursing Practice in Long-Term Care Homes.

PubMed

McGilton, Katherine S; Bowers, Barbara J; Heath, Hazel; Shannon, Kay; Dellefield, Mary Ellen; Prentice, Dawn; Siegel, Elena O; Meyer, Julienne; Chu, Charlene H; Ploeg, Jenny; Boscart, Veronique M; Corazzini, Kirsten N; Anderson, Ruth A; Mueller, Christine A

2016-02-01

In response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the Consortium) was formed to develop nursing leadership capacity and address the concerns regarding the current state of professional nursing practice in LTCHs. At its invitational, 2-day inaugural meeting, the Consortium brought together international nurse experts to explore the potential of registered nurses (RNs) who work as supervisors or charge nurses within the LTCHs and the value of their contribution in nursing homes, consider what RN competencies might be needed, discuss effective educational (curriculum and practice) experiences, health care policy, and human resources planning requirements, and to identify what sustainable nurse leadership strategies and models might enhance the effectiveness of RNs in improving resident, family, and staff outcomes. The Consortium made recommendations about the following priority issues for action: (1) define the competencies of RNs required to care for older adults in LTCHs; (2) create an LTCH environment in which the RN role is differentiated from other team members and RNs can practice to their full scope; and (3) prepare RN leaders to operate effectively in person-centered care LTCH environments. In addition to clear recommendations for practice, the Consortium identified several areas in which further research is needed. The Consortium advocated for a research agenda that emphasizes an international coordination of research efforts to explore similar issues, the pursuit of examining the impact of nursing and organizational models, and the showcasing of excellence in nursing practice in care homes, so that others might learn from what works. Several studies already under way are also described. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Short- and long-term impact of subtotal parathyroidectomy on the achievement of bone and mineral parameters recommended by clinical practice guidelines in dialysis patients: a 12-year single-center experience.

PubMed

Tsai, Wan-Chuan; Peng, Yu-Sen; Yang, Ju-Yeh; Hsu, Shih-Ping; Wu, Hon-Yen; Pai, Mei-Fen; Chang, Jia-Feng; Chen, Hung-Yuan

2013-01-01

The short- and long-term impact of parathyroidectomy (PTX) on the parameters of mineral bone disease in dialysis patients with severe secondary hyperparathyroidism (HPT) remains unclear. A retrospective chart review of 401 consecutive dialysis patients who underwent subtotal PTX by one surgeon was performed. We checked serum levels of calcium (Ca), phosphorus (P), and intact parathyroid hormone (iPTH) for 3 consecutive days, and then monthly for Ca, P, and tri-monthly for iPTH postoperatively. Patients with available laboratory data within the 1st to 6th postoperative months were included in the short-term follow-up group and those with at least 6 months available data were in the long-term follow-up one. Patients (short-term group, n = 401, and long-term group, n = 94) had severely uncontrolled serum iPTH levels, Ca, P and Ca × P before PTX. In the short-term group, percentages of cases achieving K/DOQI targets for serum Ca, Ca × P, and iPTH and KDIGO ones for serum Ca, P, and iPTH after PTX, significantly improved compared with those before operation (all p < 0.05). In the long-term group (mean follow-up of 43 ± 29 months), the percentage of achieved targets for serum iPTH in both guidelines and for serum Ca and Ca × P in the K/DOQI recommendation also improved postoperatively (all p < 0.05). Achievements of K/DOQI recommended values for serum Ca, Ca × P, iPTH and KDIGO recommendations for iPTH can be successfully reached by subtotal PTX in medically refractory, secondary HPT in dialysis patients both during short- and long-term follow-ups. © 2013 S. Karger AG, Basel.

Effect of different agronomic management practices on greenhouse gas emissions and nutrient cycling in a long-term field trial

NASA Astrophysics Data System (ADS)

Koal, Philipp; Schilling, Rolf; Gerl, Georg; Pritsch, Karin; Munch, Jean Charles

2015-04-01

In order to achieve a reduction of greenhouse gas emissions, modern agronomic management practices need to be established. Therefore, to assess the effect of different farming practices on greenhouse gas emissions, reliable data are required. The experiment covers and compares two main aspects of agricultural management for a better implementation of sustainable land use. The focus lies on the determination and interpretation of greenhouse gas emissions, however, regarding in each case a different agricultural management system, namely an organic farming system and an integrated farming system where the effect of diverse tillage systems and fertilisation practices are observed. In addition, with analysis of the alterable biological, physical and chemical soil properties a link between the impact of different management systems on greenhouse gas emissions and the observed cycle of matter in the soil, especially the nitrogen and carbon cycle, will be enabled. Measurements have been carried out on long-term field trials at the Research Farm Scheyern located in a Tertiary hilly landscape approximately 40 km north of Munich (South Germany). The long-term field trials of the organic and integrated farming system were started in 1992. Since then parcels of land (each around 0.2-0.4 ha) with a particular interior plot set-up have been conducted with the same crop rotation, tillage and fertilisation practice referring to organic and integrated farming management. Thus, the management impacts on the soil of more than 20 years are being examined. Fluxes of CH4, N2O and CO2 have been monitored since 2007 for the integrated farming system trial and since 2012 for the organic farming system trial using an automated system which consists of chambers (0.4 m2 area) with a motor-driven lid, an automated gas sampling unit, an on-line gas chromatographic analysis system, and a control and data logging unit. Precipitation and temperature data have been observed for each experimental field to include weather effects. The main outcomes are the analysis of temporal and spatial dynamics of greenhouse gas emissions influenced by management practice events (i.a. fertilisation, crop incorporation and tillage) and weather effects (drying-rewetting, freezing-thawing, intense rainfall and dry periods) and the creation of impact studies comparing the farming systems (organic vs integrated) and the management practices (minimum tillage vs conventional tillage; high vs low fertilisation). Physical, chemical and biological soil properties (i.a. texture, mineral nitrogen, soil organic carbon and microbial biomass) have been examined in short time intervals to aggregate the parameters and processes influencing the greenhouse gas emissions and to build a linkage between soil organic matter and greenhouse gas emissions. Moreover, with the comparison of the investigated similar long-term field experiments and the collected agronomic data (harvest, tillage and fertilisation practices) the study could contribute to a contemporary set of "best management practices" and could provide a help to create decision tools for stakeholders such as farmers.

Children with ADHD Treated with Long-Term Methylphenidate and Multimodal Psychosocial Treatment: Impact on Parental Practices

ERIC Educational Resources Information Center

Hechtman, Lily; Abikoff, Howard; Klein, Rachel G.; Greenfield, Brian; Etcovitch, Joy; Cousins, Lorne; Fleiss, Karen; Weiss, Margaret; Pollack, Simcha

2004-01-01

Objective: To test the hypothesis that multimodal psychosocial intervention, which includes parent training, combined with methylphenidate significantly enhances the behavior of parents of children with attention-deficit/hyperactivity disorder (ADHD), compared with methylphenidate alone and compared with methylphenidate and nonspecific…

An integrated approach to climate adaptation at the Chicago Transit Authority.

DOT National Transportation Integrated Search

2013-08-01

CTA was selected as one of seven pilots funded by FTA to advance the state of practice for adapting transit systems to the impacts of : climate change. This effort is in keeping with broader long-term goals to address state-of-good-repair needs and t...

Soil water improvements with the long-term use of a winter rye cover crop

USDA-ARS?s Scientific Manuscript database

The Midwestern United States is projected to experience increasing rainfall variability. One approach to mitigate climate impacts is to utilize crop and soil management practices that enhance soil water storage, reducing the risks of flooding as well as drought-induced crop water stress. While some ...

Soil water improvements with the long-term use of a winter rye cover crop

USDA-ARS?s Scientific Manuscript database

The Midwestern United States, a region that produces one-third of maize and one-quarter of soybeans globally, is projected to experience increasing rainfall variability with future climate change. One approach to mitigate climate impacts is to utilize crop and soil management practices that enhance ...

Effects of TRIAD on Mathematics Achievement: Long-Term Impacts

ERIC Educational Resources Information Center

Clements, Douglas H.; Sarama, Julie; Layzer, Carolyn; Unlu, Fatih; Wolfe, Christopher B.; Spitler, Mary Elaine; Weiss, Daniel

2016-01-01

Although some research-based educational practices have shown promise, many fail to be implemented at a scale that affects more than a small proportion of children. Further, research on interventions for young children includes mixed results, with most documenting "fadeout" of effects after several years, but some showing lasting…

The Impact of High School Science Teachers' Beliefs, Curricular Enactments and Experience on Student Learning during an Inquiry-Based Urban Ecology Curriculum

ERIC Educational Resources Information Center

McNeill, Katherine L.; Pimentel, Diane Silva; Strauss, Eric G.

2013-01-01

Inquiry-based curricula are an essential tool for reforming science education yet the role of the teacher is often overlooked in terms of the impact of the curriculum on student achievement. Our research focuses on 22 teachers' use of a year-long high school urban ecology curriculum and how teachers' self-efficacy, instructional practices,…

Impacts of waste from concentrated animal feeding operations on water quality

USGS Publications Warehouse

Burkholder, J.; Libra, B.; Weyer, P.; Heathcote, S.; Kolpin, D.; Thorne, P.S.; Wichman, M.

2007-01-01

Waste from agricultural livestock operations has been a long-standing concern with respect to contamination of water resources, particularly in terms of nutrient pollution. However, the recent growth of concentrated animal feeding operations (CAFOs) presents a greater risk to water quality because of both the increased volume of waste and to contaminants that may be present (e.g., antibiotics and other veterinary drugs) that may have both environmental and public health importance. Based on available data, generally accepted livestock waste management practices do not adequately or effectively protect water resources from contamination with excessive nutrients, microbial pathogens, and pharmaceuticals present in the waste. Impacts on surface water sources and wildlife have been documented in many agricultural areas in the United States. Potential impacts on human and environmental health from long-term inadvertent exposure to water contaminated with pharmaceuticals and other compounds are a growing public concern. This workgroup, which is part of the Conference on Environmental Health Impacts of Concentrated Animal Feeding Operations: Anticipating Hazards-Searching for Solutions, identified needs for rigorous ecosystem monitoring in the vicinity of CAFOs and for improved characterization of major toxicants affecting the environment and human health. Last, there is a need to promote and enforce best practices to minimize inputs of nutrients and toxicants from CAFOs into freshwater and marine ecosystems.

Impacts of Waste from Concentrated Animal Feeding Operations on Water Quality

PubMed Central

Burkholder, JoAnn; Libra, Bob; Weyer, Peter; Heathcote, Susan; Kolpin, Dana; Thorne, Peter S.; Wichman, Michael

2007-01-01

Waste from agricultural livestock operations has been a long-standing concern with respect to contamination of water resources, particularly in terms of nutrient pollution. However, the recent growth of concentrated animal feeding operations (CAFOs) presents a greater risk to water quality because of both the increased volume of waste and to contaminants that may be present (e.g., antibiotics and other veterinary drugs) that may have both environmental and public health importance. Based on available data, generally accepted livestock waste management practices do not adequately or effectively protect water resources from contamination with excessive nutrients, microbial pathogens, and pharmaceuticals present in the waste. Impacts on surface water sources and wildlife have been documented in many agricultural areas in the United States. Potential impacts on human and environmental health from long-term inadvertent exposure to water contaminated with pharmaceuticals and other compounds are a growing public concern. This work-group, which is part of the Conference on Environmental Health Impacts of Concentrated Animal Feeding Operations: Anticipating Hazards—Searching for Solutions, identified needs for rigorous ecosystem monitoring in the vicinity of CAFOs and for improved characterization of major toxicants affecting the environment and human health. Last, there is a need to promote and enforce best practices to minimize inputs of nutrients and toxicants from CAFOs into freshwater and marine ecosystems. PMID:17384784

Assessing the impacts of tillage and fertilization management on nitrous oxide emissions in a cornfield using the DNDC model

NASA Astrophysics Data System (ADS)

Deng, Qi; Hui, Dafeng; Wang, Junming; Yu, Chih-Li; Li, Changsheng; Reddy, K. Chandra; Dennis, Sam

2016-02-01

Quantification and prediction of N2O emissions from croplands under different agricultural management practices are vital for sustainable agriculture and climate change mitigation. We simulated N2O emissions under tillage and no-tillage,and different nitrogen (N) fertilizer types and application methods (i.e., nitrification inhibitor, chicken manure, and split applications) in a cornfield using the DeNitrification-DeComposition (DNDC) model. The model was parameterized with field experimental data collected in Nashville, Tennessee, under various agricultural management treatments and run for a short term (3 years) and a long term (100 years). Results showed that the DNDC model could adequately simulate N2O emissions as well as soil properties under different agricultural management practices. The modeled emissions of N2O significantly increased by 35% with tillage, and decreased by 24% with the use of nitrification inhibitor, compared with no-tillage and normal N fertilization. Chicken manure amendment and split applications of N fertilizer had minor impact on N2O emission in a short term, but over a long term (100 years) the treatments significantly altered N2O emission (+35%, -10%, respectively). Sensitivity analysis showed that N2O emission was sensitive to mean annual precipitation, mean annual temperature, soil organic carbon, and the amount of total N fertilizer application. Our model results provide valuable information for determining agricultural best management practice to maintain highly productive corn yield while reducing greenhouse gas emissions.

Human Land-Use Practices Lead to Global Long-Term Increases in Photosynthetic Capacity

NASA Technical Reports Server (NTRS)

Mueller, Thomas; Tucker, Compton J.; Dressler, Gunnar; Pinzon, Jorge E.; Leimgruber, Peter; Dubayah, Ralph O.; Hurtt, George C.; Boehning-Gaese, Katrin; Fagan, William F.

2014-01-01

Long-term trends in photosynthetic capacity measured with the satellite-derived Normalized Difference Vegetation Index (NDVI) are usually associated with climate change. Human impacts on the global land surface are typically not accounted for. Here, we provide the first global analysis quantifying the effect of the earth's human footprint on NDVI trends. Globally, more than 20% of the variability in NDVI trends was explained by anthropogenic factors such as land use, nitrogen fertilization, and irrigation. Intensely used land classes, such as villages, showed the greatest rates of increase in NDVI, more than twice than those of forests. These findings reveal that factors beyond climate influence global long-term trends in NDVI and suggest that global climate change models and analyses of primary productivity should incorporate land use effects.

The long-term physical and psychological health impacts of flooding: A systematic mapping.

PubMed

Zhong, Shuang; Yang, Lianping; Toloo, Sam; Wang, Zhe; Tong, Shilu; Sun, Xiaojie; Crompton, David; FitzGerald, Gerard; Huang, Cunrui

2018-06-01

Flooding has caused significant and wide ranging long-term health impacts for affected populations. However, until now, the long-term health outcomes, epidemiological trends and specific impact factors of flooding had not been identified. In this study, the relevant literature was systematically mapped to create the first synthesis of the evidence of the long-term health impacts of flooding. The systematic mapping method was used to collect and categorize all the relevant literature. A study was included if it had a description or measurement of health impacts over six months after flooding. The search was limited to peer reviewed articles and grey literature written in English, published from 1996 to 2016. A total of 56 critical articles were extracted for the final map, including 5 qualitative and 51 quantitative studies. Most long-term studies investigated the psychological impacts of flooding, including PTSD, depression, anxiety, psychiatric disorders, sleep disorder and suicide. Others investigated the physiological impacts, including health-related quality of life, acute myocardial infarction, chronic diseases, and malnutrition. Social support was proved to be protective factors that can improve health outcomes in the long-term after flooding. To date, there have been relatively few reviews had focused on the long-term health impacts of flooding. This study coded and catalogued the existing evidence across a wide range of variables and described the long-term health consequences within a conceptual map. Although there was no boundary between the short-term and the long-term impacts of flooding, the identified health outcomes in this systematic mapping could be used to define long-term health impacts. The studies showed that the prevalence of psychological diseases had a reversed increasing trend occurred even in the long-term in relatively poor post-flooding environments. Further cohort or longitudinal research focused on disability, chronic diseases, relocation population, and social interventions after flooding, are urgently required. Copyright © 2018 Elsevier B.V. All rights reserved.

Impact of a Tutored Theoretical-Practical Training to Develop Undergraduate Students’ Skills for the Detection of Caries Lesions: Study Protocol for a Multicenter Controlled Randomized Study

PubMed Central

Ferreira, Fernanda Rosche; Mendes, Fausto Medeiros; Raggio, Daniela Prócida; Imparato, José Carlos; Bonecker, Marcelo; Magalhães, Ana Carolina; Wang, Linda; Rios, Daniela; Pessan, Juliano Pelim; Duque, Cristiane; Rebelo, Maria Augusta Bessa; Alves Filho, Ary Oliveira; Lima, Marina De Deus Moura; Moura, Marcoeli Silva; De Carli, Alessandro Diogo; Sanabe, Mariane Emi; Cenci, Maximiliano Sergio; Oliveira, Elenara Ferreira; Correa, Marcos Britto; Rocha, Rachel Oliveira; Zenkner, Julio Eduardo; Murisí, Pedroza Uribe; Martignon, Stefania; Lara, Juan Sebastian; Aquino, Fatima Gabriela; Carrillo, Alfredo; Chu, Chun Hung; Deery, Chris; Ricketts, David; Melo, Paulo; Antunes, José Leopoldo Ferreira; Ekstrand, Kim Rud

2017-01-01

Background Tutored laboratorial activities could be a manner of improving the competency development of students. However, its impact over conventional theoretical classes has not yet been tested. Additionally, different university contexts could influence this issue and should be explored. Objective To assess the impact of a tutored theoretical-practical training for teaching undergraduate students to detect caries lesions as compared with theoretical teaching activities. The impact of these teaching/learning activities will be assessed in terms of efficacy, cost/benefit, retention of knowledge/acquired competences, and student acceptability. Methods Sixteen centers (7 centers from Brazil and 9 centers from other countries throughout the world) are involved in the inclusion of subjects for this protocol. A randomized controlled study with parallel groups will be conducted. One group (control) will be exposed to a 60- to 90-minute conventional theoretical class and the other group (test) will be exposed to the same theoretical class and also a 90-minute laboratory class, including exercises and discussions based on the evaluation of a pool of images and extracted teeth. The mentioned outcomes will be evaluated immediately after the teaching activities and also in medium- and long-term analyses. To compare the long-term outcomes, students who enrolled in the university before the participating students will be interviewed for data collection and these data will be used as a control and compared with the trained group. This stage will be a nonrandomized phase of this study, nested in the main study. Appropriate statistical analysis will be performed according to the aims of this study. Variables related to the centers will also be analyzed and used to model adjustment as possible sources of variability among results. Results This ongoing study is funded by a Brazilian national funding agency (CNPq- 400736/2014-4). We expect that the tutored theoretical-practical training will improve the undergraduate students’ performance in the detection of caries lesions and subsequent treatment decisions, mainly in terms of long-term retention of knowledge. Our hypothesis is that tutored theoretical-practical training is a more cost-effective option for teaching undergraduate students to detect caries lesions. Conclusions If our hypothesis is confirmed, the use of laboratory training in conjunction with theoretical classes could be used as an educational strategy in Cariology to improve the development of undergraduate students’ skills in the detection of caries lesions and clinical decision-making. PMID:28814381

Analysis of the impacts of well yield and groundwater depth on irrigated agriculture

NASA Astrophysics Data System (ADS)

Foster, T.; Brozović, N.; Butler, A. P.

2015-04-01

Previous research has found that irrigation water demand is relatively insensitive to water price, suggesting that increased pumping costs due to declining groundwater levels will have limited effects on agricultural water management practices. However, non-linear changes in well yields as aquifer saturated thickness is reduced may have large impacts on irrigated production that are currently neglected in projections of the long-term sustainability of groundwater-fed irrigation. We conduct empirical analysis of observation data and numerical simulations for case studies in Nebraska, USA, to compare the impacts of changes in well yield and groundwater depth on agricultural production. Our findings suggest that declining well pumping capacities reduce irrigated production areas and profits significantly, whereas increased pumping costs reduce profits but have minimal impacts on the intensity of groundwater-fed irrigation. We suggest, therefore, that management of the dynamic relationship between well yield and saturated thickness should be a core component of policies designed to enhance long-term food security and support adaptation to climate change.

Long-term no-till and stover retention each decrease the global warming potential of irrigated continuous corn.

PubMed

Jin, Virginia L; Schmer, Marty R; Stewart, Catherine E; Sindelar, Aaron J; Varvel, Gary E; Wienhold, Brian J

2017-07-01

Over the last 50 years, the most increase in cultivated land area globally has been due to a doubling of irrigated land. Long-term agronomic management impacts on soil organic carbon (SOC) stocks, soil greenhouse gas (GHG) emissions, and global warming potential (GWP) in irrigated systems, however, remain relatively unknown. Here, residue and tillage management effects were quantified by measuring soil nitrous oxide (N 2 O) and methane (CH 4 ) fluxes and SOC changes (ΔSOC) at a long-term, irrigated continuous corn (Zea mays L.) system in eastern Nebraska, United States. Management treatments began in 2002, and measured treatments included no or high stover removal (0 or 6.8 Mg DM ha -1  yr -1 , respectively) under no-till (NT) or conventional disk tillage (CT) with full irrigation (n = 4). Soil N 2 O and CH 4 fluxes were measured for five crop-years (2011-2015), and ΔSOC was determined on an equivalent mass basis to ~30 cm soil depth. Both area- and yield-scaled soil N 2 O emissions were greater with stover retention compared to removal and for CT compared to NT, with no interaction between stover and tillage practices. Methane comprised <1% of total emissions, with NT being CH 4 neutral and CT a CH 4 source. Surface SOC decreased with stover removal and with CT after 14 years of management. When ΔSOC, soil GHG emissions, and agronomic energy usage were used to calculate system GWP, all management systems were net GHG sources. Conservation practices (NT, stover retention) each decreased system GWP compared to conventional practices (CT, stover removal), but pairing conservation practices conferred no additional mitigation benefit. Although cropping system, management equipment/timing/history, soil type, location, weather, and the depth to which ΔSOC is measured affect the GWP outcomes of irrigated systems at large, this long-term irrigated study provides valuable empirical evidence of how management decisions can impact soil GHG emissions and surface SOC stocks. © 2017 John Wiley & Sons Ltd.

White Matter Microstructural Correlates of Superior Long-term Skill Gained Implicitly under Randomized Practice

PubMed Central

Song, Sunbin; Sharma, Nikhil; Buch, Ethan R.

2012-01-01

We value skills we have learned intentionally, but equally important are skills acquired incidentally without ability to describe how or what is learned, referred to as implicit. Randomized practice schedules are superior to grouped schedules for long-term skill gained intentionally, but its relevance for implicit learning is not known. In a parallel design, we studied healthy subjects who learned a motor sequence implicitly under randomized or grouped practice schedule and obtained diffusion-weighted images to identify white matter microstructural correlates of long-term skill. Randomized practice led to superior long-term skill compared with grouped practice. Whole-brain analyses relating interindividual variability in fractional anisotropy (FA) to long-term skill demonstrated that 1) skill in randomized learners correlated with FA within the corticostriatal tract connecting left sensorimotor cortex to posterior putamen, while 2) skill in grouped learners correlated with FA within the right forceps minor connecting homologous regions of the prefrontal cortex (PFC) and the corticostriatal tract connecting lateral PFC to anterior putamen. These results demonstrate first that randomized practice schedules improve long-term implicit skill more than grouped practice schedules and, second, that the superior skill acquired through randomized practice can be related to white matter microstructure in the sensorimotor corticostriatal network. PMID:21914632

Enhancing a rainfall-runoff model to assess the impacts of BMPs and LID practices on storm runoff.

PubMed

Liu, Yaoze; Ahiablame, Laurent M; Bralts, Vincent F; Engel, Bernard A

2015-01-01

Best management practices (BMPs) and low impact development (LID) practices are increasingly being used as stormwater management techniques to reduce the impacts of urban development on hydrology and water quality. To assist planners and decision-makers at various stages of development projects (planning, implementation, and evaluation), user-friendly tools are needed to assess the effectiveness of BMPs and LID practices. This study describes a simple tool, the Long-Term Hydrologic Impact Assessment-LID (L-THIA-LID), which is enhanced with additional BMPs and LID practices, improved approaches to estimate hydrology and water quality, and representation of practices in series (meaning combined implementation). The tool was used to evaluate the performance of BMPs and LID practices individually and in series with 30 years of daily rainfall data in four types of idealized land use units and watersheds (low density residential, high density residential, industrial, and commercial). Simulation results were compared with the results of other published studies. The simulated results showed that reductions in runoff volume and pollutant loads after implementing BMPs and LID practices, both individually and in series, were comparable with the observed impacts of these practices. The L-THIA-LID 2.0 model is capable of assisting decision makers in evaluating environmental impacts of BMPs and LID practices, thereby improving the effectiveness of stormwater management decisions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Workplace practices with mental health implications impacting on recruitment and retention of overseas nurses in the context of nursing shortages.

PubMed

Omeri, Akram

2006-01-01

In response to nursing workforce shortages, health agencies in Australia and elsewhere have sought to meet the demand for nursing services by recruiting nurses internationally. While there is a major focus on recruitment, little attention is given to factors that could enhance retention of overseas qualified nurses. There are a host of factors reported in the literature that impact upon retention of overseas nurses in the workforce, including: impact of re-settlement experiences in the new country; discriminatory practices in accessing employment and negative experiences in the work place. For the benefit of long term retention of overseas nurse graduates in the workforce in Australia and globally, these experiences are major issues needing urgent attention. This discussion paper reviews the literature to explore the impact of aggression and discriminatory practices in nursing as evidence for nurses leaving the profession, and discusses the mental health implications and consequences of such practices relating to overseas nurse graduates.

UBC's Centre for Interactive Research on Sustainability (CIRS) Will Serve as Test Bed for Innovation

ERIC Educational Resources Information Center

Neary, Tim

2012-01-01

The University of British Columbia (UBC) recently celebrated the opening of its Centre for Interactive Research on Sustainability (CIRS), a living laboratory for researchers to teach, test, and study the long-term impact of sustainable practices and technologies. Featuring advanced building controls, sensing technology, and management software…

The Developmental Impact of Child Abuse on Adulthood: Implications for Counselors

ERIC Educational Resources Information Center

Sikes, April; Hays, Danica G.

2010-01-01

Many adults are exposed to maltreatment during their childhood. As a result, they may experience long-term negative outcomes in a range of developmental areas. The purpose of this article was to examine the social, physical, and mental health consequences of child abuse in adulthood. Implications for counseling practice are provided.

Impacts of pine species, stump removal, cultivation, and fertilization on soil properties half a century after planting

Treesearch

John R. Butnor; Kurt H. Johnsen; Felipe G Sanchez; C. Dana Nelson

2012-01-01

To better understand the long-term effects of species selection and forest management practices on soil quality and soil C retention, we analyzed soil samples from an experimental planting of loblolly (Pinus taeda L.), longleaf ((Pinus palustris Mill.), and slash ((Pinus elliottii Engelm.) pines under...

Improving the Resilience of Best Management Practices in a Changing Environment: Urban Stormwater Modeling Studies (Final Report)

EPA Science Inventory

The purpose of this report is to respond to EPA's identified need for an improved understanding of the potential impacts of changes in long term weather conditions on the occurrence and management of urban stormwater runoff. EPA conducted continuous simulation modeling of the hy...

Tillage, crop rotation, and cultural practice impact on nitrogen balance under dryland cropping systems

USDA-ARS?s Scientific Manuscript database

Accounting of N inputs and outputs and N retention in the soil provides N balance that measures agroecosystem performance and environmental sustainability. Because of the complexity of measurements of some N inputs and outputs, studies on N balance in long-term experiments are scanty. We examined th...

Managing type 1 diabetes in school: Recommendations for policy and practice

PubMed Central

Lawrence, Sarah E; Cummings, Elizabeth A; Pacaud, Danièle; Lynk, Andrew; Metzger, Daniel L

2015-01-01

Diabetes requiring insulin is increasingly common and likely to impact students in most, if not all, schools. Diabetes and its complications have major personal, social and economic impact, and improved diabetes control reduces the risk of both short- and long-term complications. Evidence shows that more intensive management of diabetes – through frequent blood glucose monitoring, insulin administration with injections and/or insulin pumps, and careful attention to diet and exercise – leads to better control. Since children spend 30 to 35 hours per week at school, effectively managing their diabetes while there is integral to their short- and long-term health. The Canadian Paediatric Society and the Canadian Pediatric Endocrine Group recommend that minimum standards for supervision and care be established across Canada to support children and youth with type 1 diabetes in schools. These recommendations are derived from evidence-based clinical practice guidelines, with input from diabetes care providers from across Canada, and are consistent with the Canadian Diabetes Association’s Guidelines for the Care of Students Living with Diabetes at School. PMID:25722642

Fingolimod hydrochloride for the treatment of relapsing remitting multiple sclerosis.

PubMed

Thomas, Katja; Proschmann, Undine; Ziemssen, Tjalf

2017-10-01

Fingolimod was the first oral and the first in class disease modifying treatment in multiple sclerosis that acts as sphingosine-1-phospathe receptor agonist. Since approval in 2010 there is a growing experience with fingolimod use in clinical practice, but also next-generation sphingosin-1-receptor agonists in ongoing clinical trials. Growing evidence demonstrates additional effects beyond impact on lymphocyte circulation, highlighting further promising targets in multiple sclerosis therapy. Areas covered: Here we present a systematic review using PubMed database searching and expert opinion on fingolimod use in clinical practice. Long-term data of initial clinical trials and post-marketing evaluations including long-term efficacy, safety, tolerability and management especially within growing disease modifying treatment options and pre-treatment constellation in multiple sclerosis patients are critically discussed. Furthermore novel findings in mechanism of actions and prospective on additional use in progressive forms in multiple sclerosis are presented. Expert opinion: There is an extensive long-term experience on fingolimod use in clinical practice demonstrating the favorable benefit-risk of this drug. Using a defined risk management approach experienced MS clinicians should apply fingolimod after critical choice of patients and review of clinical aspects. Further studies are essential to discuss additional benefit in progressive forms in multiple sclerosis.

Temporal variability of CO2 and N2O emissions in an agricultural long-term field trial regarding effects of different management practices and extreme weather effects

NASA Astrophysics Data System (ADS)

Koal, Philipp; Schilling, Rolf; Gerl, Georg; Pritsch, Karin; Munch, Jean Charles

2016-04-01

In order to achieve a reduction of greenhouse gas emissions, modern agronomic management practices need to be established. Therefore, to assess the effect of different farming practices on greenhouse gas emissions, reliable data are required. The experiment covers and compares main aspects of agricultural management for a better implementation of sustainable land use. The focus lies on the determination and interpretation of greenhouse gas emissions, where the effects of diverse tillage systems and fertilisation practices of an integrated farming system as well as the impacts of extreme weather conditions are observed. In addition, with analysis of the alterable biological, physical and chemical soil properties a link between the impact of different management systems on greenhouse gas emissions and the observed cycle of matter in the soil, especially the nitrogen and carbon cycle, is enabled. Measurements have been carried out on long-term field trials at the Research Farm Scheyern located in a Tertiary hilly landscape approximately 40 km north of Munich (South Germany). The long-term integrated farming system trial was started in 1992. Since then parcels of land (each around 0.2-0.4 ha) with a particular interior plot set-up have been conducted with the same crop rotation, tillage and fertilisation practice referring to integrated farming management. Thus, the management impacts on the soil of more than 20 years have been examined. Fluxes of CH4, N2O and CO2 have been monitored since 2007 for the integrated farming system trial using an automated system which consists of chambers (0.4 m2 area) with a motor-driven lid, an automated gas sampling unit, an on-line gas chromatographic analysis system, and a control and data logging unit. Precipitation and temperature data have been observed for the experimental field to include weather effects. The main outcomes are the analysis of temporal and spatial dynamics of greenhouse gas emissions influenced by management practice events (i.a. fertilisation, crop incorporation and tillage) and weather effects (drying-rewetting, freezing-thawing, intense rainfall and dry periods) and the creation of impact studies comparing the management practices (minimum tillage vs conventional tillage; high vs low fertilisation). Physical, chemical and biological soil properties (i.a. texture, mineral nitrogen, soil organic carbon and microbial biomass) have been examined in short time intervals to aggregate the parameters and processes influencing the greenhouse gas emissions and to build a linkage between soil organic matter and greenhouse gas emissions. Moreover, with the collected soil and agronomic data (harvest, tillage and fertilisation practices) the study contributes to a process quantification supporting modelling approaches.

Insights into interventions in managing COPD patients: lessons from the TORCH and UPLIFT® studies

PubMed Central

Miravitlles, Marc; Anzueto, Antonio

2009-01-01

Influencing the progression of COPD has long been an elusive goal of drug therapy. Directly or indirectly, this has again been investigated in two of the largest, long-term drug trials in COPD: Towards a Revolution in COPD Health (TORCH) and Understanding Potential Long-Term Impacts on Function with Tiotropium (UPLIFT®). Neither trial achieved statistical significance in their respective primary outcomes; however, both make considerable contributions to understanding of how the progression of COPD may be influenced. The objective of this article is to review the data from these different trials with a view to what can be learnt about the management of COPD. The long-term improvements in lung function, health-related quality of life, and possibly survival from the use of long-acting bronchodilators in these trials suggest an influence on progression of the disease. With the more optimistic view of benefits from drug treatment of COPD that these trials provide, a review of prescribing practices is warranted. PMID:19516917

Developing a green lending model for renewable energy project (case study electricity from biogas fuel at Palm Oil Industry)

NASA Astrophysics Data System (ADS)

Sukirman, Y. A.

2018-03-01

In the last two decades, development initiatives solely aimed to generate economic growth has been placed under scrutiny, particularly amidst the rampant discussion on the quality decline of the environment, growing social divide and climate change along with its implications thereof. Considerations of the negative impacts brought about by the economic development process prompted the move to adopt the sustainable financing model that gives precedence to economic, environmental and social aspects. We introduced Green Lending Model for Renewable Energy Project (Case Study Electricity From Biogas at Palm Oil Industry) based on sustainability financing, which is used as variable to implementing financial institutions’ lending policies. There are two major trends in the literature relating to sustainability and the banking industry: external and internal practices. The external practices strand analyzes the relevance of sustainability to the bank’s communication with shareholders and other stakeholders, and how investors use it as a measure to help achieve optimal portfolio allocation. The internal practices literature, more relevant to the present work, studies how sustainability criteria are integrated into risk management models and lending practices. Its first implementation is in the Palm Oil industry at South Sumatera. The results explained that sustainability is not related to profit either from a short- or long-term perspective. The Sustainable Green Lending Model is related to the Equator Principles and its application is driven to project financing. It also related with short- and long-term risks and opportunities, instead of short-term sustainability impacts.

Reducing the Environmental Impact of Clinical Laboratories.

PubMed

Lopez, Joseph B; Jackson, David; Gammie, Alistair; Badrick, Tony

2017-02-01

Healthcare is a significant contributor to environmental impact but this has received little attention. The typical laboratory uses far more energy and water per unit area than the typical office building. There is a need to sensitise laboratories to the importance of adopting good environmental practices. Since this comes at an initial cost, it is vital to obtain senior management support. Convincing management of the various tangible and intangible benefits that can accrue in the long run should help achieve this support. Many good environmental practices do not have a cost but will require a change in the culture and mind-set of the organisation. Continuing education and training are important keys to successful implementation of good practices. There is a need to undertake a rigorous cost-benefit analysis of every change that is introduced in going green. The adoption of good practices can eventually lead to ISO certification if this is desired. This paper provides suggestions that will allow a laboratory to start going green. It will allow the industry to enhance its corporate citizenship whilst improving its competitive advantage for long-term.

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.

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

PubMed

Choe, Kwisoon; Kang, Hyunwook; Lee, Aekyung

2018-03-01

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

Long-term athletic development- part 1: a pathway for all youth.

PubMed

Lloyd, Rhodri S; Oliver, Jon L; Faigenbaum, Avery D; Howard, Rick; De Ste Croix, Mark B A; Williams, Craig A; Best, Thomas M; Alvar, Brent A; Micheli, Lyle J; Thomas, D Phillip; Hatfield, Disa L; Cronin, John B; Myer, Gregory D

2015-05-01

The concept of developing talent and athleticism in youth is the goal of many coaches and sports systems. Consequently, an increasing number of sporting organizations have adopted long-term athletic development models in an attempt to provide a structured approach to the training of youth. It is clear that maximizing sporting talent is an important goal of long-term athletic development models. However, ensuring that youth of all ages and abilities are provided with a strategic plan for the development of their health and physical fitness is also important to maximize physical activity participation rates, reduce the risk of sport- and activity-related injury, and to ensure long-term health and well-being. Critical reviews of independent models of long-term athletic development are already present within the literature; however, to the best of our knowledge, a comprehensive examination and review of the most prominent models does not exist. Additionally, considerations of modern day issues that may impact on the success of any long-term athletic development model are lacking, as are proposed solutions to address such issues. Therefore, within this 2-part commentary, Part 1 provides a critical review of existing models of practice for long-term athletic development and introduces a composite youth development model that includes the integration of talent, psychosocial and physical development across maturation. Part 2 identifies limiting factors that may restrict the success of such models and offers potential solutions.

Long-Term Impacts of a Faculty Development Program for the Internationalization of Curriculum in Higher Education

ERIC Educational Resources Information Center

Urban, Emily; Navarro, Maria; Borron, Abigail

2017-01-01

Faculty development programs for internationalization of the curriculum in higher education are often evaluated for short- and medium-term outcomes, but more long-term assessments are needed to determine impact. This study examined the long-term (6 years) impacts on faculty from colleges of agriculture after participating in a one-year…

Effects of air pollution on human health and practical measures for prevention in Iran

PubMed Central

Ghorani-Azam, Adel; Riahi-Zanjani, Bamdad; Balali-Mood, Mahdi

2016-01-01

Air pollution is a major concern of new civilized world, which has a serious toxicological impact on human health and the environment. It has a number of different emission sources, but motor vehicles and industrial processes contribute the major part of air pollution. According to the World Health Organization, six major air pollutants include particle pollution, ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. Long and short term exposure to air suspended toxicants has a different toxicological impact on human including respiratory and cardiovascular diseases, neuropsychiatric complications, the eyes irritation, skin diseases, and long-term chronic diseases such as cancer. Several reports have revealed the direct association between exposure to the poor air quality and increasing rate of morbidity and mortality mostly due to cardiovascular and respiratory diseases. Air pollution is considered as the major environmental risk factor in the incidence and progression of some diseases such as asthma, lung cancer, ventricular hypertrophy, Alzheimer's and Parkinson's diseases, psychological complications, autism, retinopathy, fetal growth, and low birth weight. In this review article, we aimed to discuss toxicology of major air pollutants, sources of emission, and their impact on human health. We have also proposed practical measures to reduce air pollution in Iran. PMID:27904610

Effects of air pollution on human health and practical measures for prevention in Iran.

PubMed

Ghorani-Azam, Adel; Riahi-Zanjani, Bamdad; Balali-Mood, Mahdi

2016-01-01

Air pollution is a major concern of new civilized world, which has a serious toxicological impact on human health and the environment. It has a number of different emission sources, but motor vehicles and industrial processes contribute the major part of air pollution. According to the World Health Organization, six major air pollutants include particle pollution, ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. Long and short term exposure to air suspended toxicants has a different toxicological impact on human including respiratory and cardiovascular diseases, neuropsychiatric complications, the eyes irritation, skin diseases, and long-term chronic diseases such as cancer. Several reports have revealed the direct association between exposure to the poor air quality and increasing rate of morbidity and mortality mostly due to cardiovascular and respiratory diseases. Air pollution is considered as the major environmental risk factor in the incidence and progression of some diseases such as asthma, lung cancer, ventricular hypertrophy, Alzheimer's and Parkinson's diseases, psychological complications, autism, retinopathy, fetal growth, and low birth weight. In this review article, we aimed to discuss toxicology of major air pollutants, sources of emission, and their impact on human health. We have also proposed practical measures to reduce air pollution in Iran.

Nitrogen mobility, ammonia volatilization, and estimated leaching loss from long-term manure incorporation in red soil

USDA-ARS?s Scientific Manuscript database

Nitrogen (N) loss from fertilization in agricultural fields has an unavoidable negative impact on the environment, and a better understanding of the major pathways can assist in developing best management practices. The aim of this study was to evaluate the fate of N fertilizers applied to acidic re...

Building a University Brand Community: The Long-Term Impact of Shared Experiences

ERIC Educational Resources Information Center

McAlexander, James H.; Koenig, Harold F.; Schouten, John W.

2004-01-01

Relationship marketing has made its way into the practices of university administrations. With it have also arrived many problems associated with the aggressive use of CRM technologies. One particularly effective and healthy approach to relationship marketing in higher education is to treat the university, with all of its stakeholders, as a brand…

Impact of biosolids and tillage on soil organic matter fractions: Implications of carbon saturation for conservation management in the Virginia Coastal Plain

USDA-ARS?s Scientific Manuscript database

Long-term soil conservation management decreases soil bulk density, increases water infiltration and water holding capacity. In the Virginia Coastal Plain, growers have been practicing rotational no-tillage and continuous no-tillage with and without biosolid application over 20 years to improve soi...

Impact of eLearning course on nurses' professional competence in seclusion and restraint practices: 9-month follow-up results of a randomized controlled study (ISRCTN32869544).

PubMed

Kontio, R; Hätönen, H; Joffe, G; Pitkänen, A; Lahti, M; Välimäki, M

2013-04-01

eLearning may facilitate continuing vocational education, but data on the long-term effects of an eLearning course are lacking. The aim of this study was to explore the long-term impact of an eLearning course entitled ePsychNurse.Net on psychiatric nurses' professional competence in practicing seclusion and restraint and on their job satisfaction and general self-efficacy at 9-month follow-up. In a randomized controlled study, 12 wards were randomly assigned to the ePsychNurse.Net (intervention) or training as usual (control). Baseline and 9-month follow-up data on nurses' knowledge of coercion-related legislation, physical restraint and seclusion, their attitudes towards physical restraint and seclusion, job satisfaction and general self-efficacy were analysed for 137 completers (those who participated in the 9-month follow-up assessment). No between-group differences were found on any variable, with the exception of a change in attitude to seclusion in favour of the control group. The findings of the long-term effects did not differ from the immediate outcomes (3-month follow-up) and the improved level of knowledge acquired and further consolidation of that knowledge did not take place in the 6-month period after the 3-month ePsychNurse.Net course. The ePsychNurse.Net should be further developed and its future modifications will require additional studies, probably with some new outcome measures. © 2012 Blackwell Publishing.

Rocky Flats Environmental Technology Site Ecological Monitoring Program 1995 annual report

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

NONE

1995-05-31

The Ecological Monitoring Program (ECMP) was established at the Rocky Flats Environmental Technology Site (Site) in September 1992. At that time, EcMP staff developed a Program Plan that was peer-reviewed by scientists from western universities before submittal to DOE RFFO in January 1993. The intent of the program is to measure several quantitative variables at different ecological scales in order to characterize the Rocky Flats ecosystem. This information is necessary to document ecological conditions at the Site in impacted and nonimpacted areas to determine if Site practices have had ecological impacts, either positive or negative. This information can be usedmore » by managers interested in future use scenarios and CERCLA activities. Others interested in impact analysis may also find the information useful. In addition, these measurements are entered into a database which will serve as a long-term information repository that will document long-term trends and potential future changes to the Site, both natural and anthropogenic.« less

Magnitude of Head Impact Exposures in Individual Collegiate Football Players

PubMed Central

Wilcox, Bethany J.; Machan, Jason T.; McAllister, Thomas W.; Duhaime, Ann-Christine; Duma, Stefan M.; Rowson, Steven; Beckwith, Jonathan G.; Chu, Jeffrey J.; Greenwald, Richard M.

2013-01-01

The purpose of this study was to quantify the severity of head impacts sustained by individual collegiate football players and to investigate differences between impacts sustained during practice and game sessions, as well as by player position and impact location. Head impacts (N = 184,358) were analyzed for 254 collegiate players at three collegiate institutions. In practice, the 50th and 95th percentile values for individual players were 20.0 g and 49.5 g for peak linear acceleration, 1187 rad/s2 and 3147 rad/s2 for peak rotational acceleration, and 13.4 and 29.9 for HITsp, respectively. Only the 95th percentile HITsp increased significantly in games compared with practices (8.4%, p= .0002). Player position and impact location were the largest factors associated with differences in head impacts. Running backs consistently sustained the greatest impact magnitudes. Peak linear accelerations were greatest for impacts to the top of the helmet, whereas rotational accelerations were greatest for impacts to the front and back. The findings of this study provide essential data for future investigations that aim to establish the correlations between head impact exposure, acute brain injury, and long-term cognitive deficits. PMID:21911854

Influenza in long-term care facilities.

PubMed

Lansbury, Louise E; Brown, Caroline S; Nguyen-Van-Tam, Jonathan S

2017-09-01

Long-term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. As the population ages over the coming decades, increased provision of such facilities seems likely. The need for robust infection prevention and control practices will therefore remain of paramount importance if the impact of outbreaks is to be minimised. In this review, we discuss the nature of the problem of influenza in long-term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

The Impact of Long-Term Climate Change on Nitrogen Runoff at the Watershed Scale.

NASA Astrophysics Data System (ADS)

Dorley, J.; Duffy, C.; Arenas Amado, A.

2017-12-01

The impact of agricultural runoff is a major concern for water quality of mid-western streams. This concern is largely due to excessive use of agricultural fertilizer, a major source of nutrients in many Midwestern watersheds. In order to improve water quality in these watersheds, understanding the long-term trends in nutrient concentration and discharge is an important water quality problem. This study attempts to analyze the role of long-term temperature and precipitation on nitrate runoff in an agriculturally dominated watershed in Iowa. The approach attempts to establish the concentration-discharge (C-Q) signature for the watershed using time series analysis, frequency analysis and model simulation. The climate data is from the Intergovernmental Panel on Climate Change (IPCC), model GFDL-CM3 (Geophysical Fluid Dynamic Laboratory Coupled Model 3). The historical water quality data was made available by the IIHR-Hydroscience & Engineering at the University of Iowa for the clear creek watershed (CCW). The CCW is located in east-central Iowa. The CCW is representative of many Midwestern watersheds with humid-continental climate with predominantly agricultural land use. The study shows how long-term climate changes in temperature and precipitation affects the C-Q dynamics and how a relatively simple approach to data analysis and model projections can be applied to best management practices at the site.

Pro-sustainability choices and child deaths averted: from project experience to investment strategy.

PubMed

Sarriot, Eric G; Swedberg, Eric A; Ricca, James G

2011-05-01

The pursuit of the Millennium Development Goals and advancing the 'global health agenda' demand the achievement of health impact at scale through efficient investments. We have previously offered that sustainability-a necessary condition for successful expansion of programmes-can be addressed in practical terms. Based on benchmarks from actual child survival projects, we assess the expected impact of translating pro-sustainability choices into investment strategies. We review the experience of Save the Children US in Guinea in terms of investment, approach to sustainability and impact. It offers three benchmarks for impact: Entry project (21 lives saved of children under age five per US$100 000), Expansion project (37 LS/US$100k), and Continuation project (100 LS/US$100k). Extrapolating this experience, we model the impact of a traditional investment scenario against a pro-sustainability scenario and compare the deaths averted per dollar spent over five project cycles. The impact per dollar spent on a pro-sustainability strategy is 3.4 times that of a traditional one over the long run (range from 2.2 to 5.7 times in a sensitivity analysis). This large efficiency differential between two investment approaches offers a testable hypothesis for large-scale/long-term studies. The 'bang for the buck' of health programmes could be greatly increased by following a pro-sustainability investment strategy.

Land use, water and Mediterranean landscapes: modelling long-term dynamics of complex socio-ecological systems.

PubMed

Barton, C Michael; Ullah, Isaac I; Bergin, Sean

2010-11-28

The evolution of Mediterranean landscapes during the Holocene has been increasingly governed by the complex interactions of water and human land use. Different land-use practices change the amount of water flowing across the surface and infiltrating the soil, and change water's ability to move surface sediments. Conversely, water amplifies the impacts of human land use and extends the ecological footprint of human activities far beyond the borders of towns and fields. Advances in computational modelling offer new tools to study the complex feedbacks between land use, land cover, topography and surface water. The Mediterranean Landscape Dynamics project (MedLand) is building a modelling laboratory where experiments can be carried out on the long-term impacts of agropastoral land use, and whose results can be tested against the archaeological record. These computational experiments are providing new insights into the socio-ecological consequences of human decisions at varying temporal and spatial scales.

Preventing Occupational Skin Disease: A Review of Training Programs.

PubMed

Zack, Bethany; Arrandale, Victoria H; Holness, D Linn

Occupational contact dermatitis (OCD) is a common occupational disease that impacts a variety of worker groups. Skin protection and disease prevention training programs have shown promise for improving prevention practices and reducing the incidence of OCD. This review details the features of training programs for primary prevention of OCD and identifies gaps in the literature. Twelve studies were identified for in-depth review: many studies included wet workers employed in health care, hairdressing, cleaning, and food preparation; 1 program featured manufacturing workers. Few programs provided content on allergic contact dermatitis, and only 1 was evaluated for long-term effectiveness. Effective programs were similar in content, delivery method, and timing and were characterized by industry specificity, multimodal learning, participatory elements, skin care resource provision, repeated sessions, and management engagement. Long-term effectiveness, generalizability beyond OCD, workplace health and safety culture impact, and translation of programs in the North American context represent areas for future research.

A review on effectiveness of best management practices in improving hydrology and water quality: Needs and opportunities.

PubMed

Liu, Yaoze; Engel, Bernard A; Flanagan, Dennis C; Gitau, Margaret W; McMillan, Sara K; Chaubey, Indrajeet

2017-12-01

Best management practices (BMPs) have been widely used to address hydrology and water quality issues in both agricultural and urban areas. Increasing numbers of BMPs have been studied in research projects and implemented in watershed management projects, but a gap remains in quantifying their effectiveness through time. In this paper, we review the current knowledge about BMP efficiencies, which indicates that most empirical studies have focused on short-term efficiencies, while few have explored long-term efficiencies. Most simulation efforts that consider BMPs assume constant performance irrespective of ages of the practices, generally based on anticipated maintenance activities or the expected performance over the life of the BMP(s). However, efficiencies of BMPs likely change over time irrespective of maintenance due to factors such as degradation of structures and accumulation of pollutants. Generally, the impacts of BMPs implemented in water quality protection programs at watershed levels have not been as rapid or large as expected, possibly due to overly high expectations for practice long-term efficiency, with BMPs even being sources of pollutants under some conditions and during some time periods. The review of available datasets reveals that current data are limited regarding both short-term and long-term BMP efficiency. Based on this review, this paper provides suggestions regarding needs and opportunities. Existing practice efficiency data need to be compiled. New data on BMP efficiencies that consider important factors, such as maintenance activities, also need to be collected. Then, the existing and new data need to be analyzed. Further research is needed to create a framework, as well as modeling approaches built on the framework, to simulate changes in BMP efficiencies with time. The research community needs to work together in addressing these needs and opportunities, which will assist decision makers in formulating better decisions regarding BMP implementation in watershed management projects. Copyright © 2017 Elsevier B.V. All rights reserved.

Quantifying the effects of overgrazing on mountainous watershed vegetation dynamics under a changing climate.

PubMed

Hao, Lu; Pan, Cen; Fang, Di; Zhang, Xiaoyu; Zhou, Decheng; Liu, Peilong; Liu, Yongqiang; Sun, Ge

2018-10-15

Grazing is a major ecosystem disturbance in arid regions that are increasingly threatened by climate change. Understanding the long-term impacts of grazing on rangeland vegetation dynamics in a complex terrain in mountainous regions is important for quantifying dry land ecosystem services for integrated watershed management and climate change adaptation. However, data on the detailed long-term spatial distribution of grazing activities are rare, which prevents trend detection and environmental impact assessments of grazing. This study quantified the impacts of grazing on vegetation dynamics for the period of 1983-2010 in the Upper Heihe River basin, a complex multiple-use watershed in northwestern China. We also examined the relative contributions of grazing and climate to vegetation change using a dynamic grazing pressure method. Spatial grazing patterns and temporal dynamics were mapped at a 1 km × 1 km pixel scale using satellite-derived leaf area index (LAI) data. We found that overgrazing was a dominant driver for LAI reduction in alpine grasslands and shrubs, especially for the periods of 1985-1991 and 1997-2004. Although the recent decade-long active grazing management contributed to the improvement of LAI and partially offset the negative effects of increased livestock, overgrazing has posed significant challenges to shrub-grassland ecosystem recovery in the eastern part of the study basin. We conclude that the positive effects of a warming and wetting climate on vegetation could be underestimated if the negative long-term grazing effects are not considered. Findings from the present case study show that assessing long-term climate change impacts on watersheds must include the influences of human activities. Our study provides important guidance for ecological restoration efforts in locating vulnerable areas and designing effective management practices in the study watershed. Such information is essential for natural resource management that aims at meeting multiple demands of watershed ecosystem services in arid and semiarid rangelands. Copyright © 2018 Elsevier B.V. All rights reserved.

The impact of logging on biodiversity and carbon sequestration in tropical forests

NASA Astrophysics Data System (ADS)

Cazzolla Gatti, R.

2012-04-01

Tropical deforestation is one of the most relevant environmental issues at planetary scale. Forest clearcutting has dramatic effect on local biodiversity, on the terrestrial carbon sink and atmospheric GHGs balance. In terms of protection of tropical forests selective logging is, instead, often regarded as a minor or even positive management practice for the ecosystem and it is supported by international certifications. However, few studies are available on changes in the structure, biodiversity and ecosystem services due to the selective logging of African forests. This paper presents the results of a survey on tropical forests of West and Central Africa, with a comparison of long-term dynamics, structure, biodiversity and ecosystem services (such as the carbon sequestration) of different types of forests, from virgin primary to selectively logged and secondary forest. Our study suggests that there is a persistent effect of selective logging on biodiversity and carbon stock losses in the long term (up to 30 years since logging) and after repeated logging. These effects, in terms of species richness and biomass, are greater than the expected losses from commercial harvesting, implying that selective logging in West and Central Africa is impairing long term (at least until 30 years) ecosystem structure and services. A longer selective logging cycle (>30 years) should be considered by logging companies although there is not yet enough information to consider this practice sustainable.

Facilitating long-term changes in student approaches to learning science.

PubMed

Buchwitz, Brian J; Beyer, Catharine H; Peterson, Jon E; Pitre, Emile; Lalic, Nevena; Sampson, Paul D; Wakimoto, Barbara T

2012-01-01

Undergraduates entering science curricula differ greatly in individual starting points and learning needs. The fast pace, high enrollment, and high stakes of introductory science courses, however, limit students' opportunities to self-assess and modify learning strategies. The University of Washington's Biology Fellows Program (BFP) intervenes through a 20-session, premajors course that introduces students to the rigor expected of bioscience majors and assists their development as science learners. This study uses quantitative and qualitative approaches to assess whether the 2007-2009 BFP achieved its desired short- and long-term impacts on student learning. Adjusting for differences in students' high school grade point average and Scholastic Aptitude Test scores, we found that participation in the BFP was associated with higher grades in two subsequent gateway biology courses, across multiple quarters and instructors. Two to 4 yr after participating in the program, students attributed changes in how they approached learning science to BFP participation. They reported having learned to "think like a scientist" and to value active-learning strategies and learning communities. In addition, they reported having developed a sense of belonging in bioscience communities. The achievement of long-term impacts for a short-term instructional investment suggests a practical means to prepare diverse students for the rigors of science curricula.

Facilitating Long-Term Changes in Student Approaches to Learning Science

PubMed Central

Buchwitz, Brian J.; Beyer, Catharine H.; Peterson, Jon E.; Pitre, Emile; Lalic, Nevena; Sampson, Paul D.; Wakimoto, Barbara T.

2012-01-01

Undergraduates entering science curricula differ greatly in individual starting points and learning needs. The fast pace, high enrollment, and high stakes of introductory science courses, however, limit students’ opportunities to self-assess and modify learning strategies. The University of Washington's Biology Fellows Program (BFP) intervenes through a 20-session, premajors course that introduces students to the rigor expected of bioscience majors and assists their development as science learners. This study uses quantitative and qualitative approaches to assess whether the 2007–2009 BFP achieved its desired short- and long-term impacts on student learning. Adjusting for differences in students’ high school grade point average and Scholastic Aptitude Test scores, we found that participation in the BFP was associated with higher grades in two subsequent gateway biology courses, across multiple quarters and instructors. Two to 4 yr after participating in the program, students attributed changes in how they approached learning science to BFP participation. They reported having learned to “think like a scientist” and to value active-learning strategies and learning communities. In addition, they reported having developed a sense of belonging in bioscience communities. The achievement of long-term impacts for a short-term instructional investment suggests a practical means to prepare diverse students for the rigors of science curricula. PMID:22949424

Consolidation of episodic memories during sleep: long-term effects of retrieval practice.

PubMed

Racsmány, Mihály; Conway, Martin A; Demeter, Gyula

2010-01-01

Two experiments investigated the long-term effects of retrieval practice. In the retrieval-practice procedure, selected items from a previously studied list are repeatedly recalled. The typical retrieval-practice effects are considerably enhanced memory for practiced items accompanied by low levels of recall, relative to baseline, for previously studied items that are associated with the practiced items but were not themselves practiced. The two experiments demonstrated that the former effect persisted over 12 hr; the latter effect also persisted over 12 hr, but only if a period of nocturnal sleep occurred during the retention interval. We propose that consolidation processes occurring during sleep, and possibly featuring some form of off-line rehearsal, mediate these long-term effects of retrieval practice.

Modeling the long-term effect of winter cover crops on nitrate transport in artificially drained fields across the Midwest U.S.

USDA-ARS?s Scientific Manuscript database

A fall-planted cover crop is a management practice with multiple benefits including reducing nitrate losses from artificially drained fields. We used the Root Zone Water Quality Model (RZWQM) to simulate the impact of a cereal rye cover crop on reducing nitrate losses from drained fields across five...

Selecting and Designing Questions to Facilitate Spatial Thinking

ERIC Educational Resources Information Center

Jo, Injeong; Bednarz, Sarah; Metoyer, Sandra

2010-01-01

One measure of the impact of a new idea in geography education is how well it is incorporated into teachers' everyday practice. "Spatial thinking" is not really a new idea in geography education; spatial analysis has long been one of its core traditions, but the use of the term is novel and only beginning to be widely used. By spatial thinking the…

Forest Management Effects on Surface Soil Carbon and Nitrogen

Treesearch

Jennifer D. Knoepp; Wayne T. Swank

1997-01-01

Changes in surface soil C and N can result from forest management practices and may provide an index of impacts on long-term site productivity. Soil C and N were measured over time for five water- sheds in the southern Appalachians: two aggrading hardwood forests, one south- and one north-facing, undisturbed since the 1920s;a white pine (PinussfrobusL.) plantation...

Sustained transfer of knowledge to practice in long-term care: facilitators and barriers of a mental health learning initiative.

PubMed

Stolee, Paul; McAiney, Carrie A; Hillier, Loretta M; Harris, Diane; Hamilton, Pam; Kessler, Linda; Madsen, Victoria; Le Clair, J Kenneth

2009-01-01

This article explores facilitators and barriers to the impact and sustainability of a learning initiative to increase capacity of long-term care (LTC) homes to manage the mental health needs of older persons, through development of in-house Psychogeriatric Resource Persons (PRPs). Twenty interviews were conducted with LTC staff. Management support, particularly designation of time for PRP activities, development of PRP teams, and supportive learning strategies were significant factors affecting sustained knowledge transfer. Continuing education that is provided and evaluated on an ongoing basis, secures management commitment, is integrated within a broader system strategy, and provides on-the-job support has the greatest potential to affect care.

Physicochemical and microbiological effects of long- and short-term winery wastewater application to soils.

PubMed

Mosse, K P M; Patti, A F; Smernik, R J; Christen, E W; Cavagnaro, T R

2012-01-30

Application of winery wastewaters to soils for irrigation of various crops or landscapes is a common practice in the wine industry. In this study, we sought to investigate the effects of this practice, by comparing the physicochemical and microbiological soil properties in paired sites that differed in having had a history of winery waste application or not. We also compared the effects of a single application of untreated winery wastewater, to application of treated winery wastewater (sequencing batch reactor) and pure water to eliminate the effects of wetting alone. Long-term application of winery wastes was found to have significant impacts on soil microbial community structure, as determined by phospholipid fatty acid analysis, as well as on many physicochemical properties including pH, EC, and cation concentrations. (13)C NMR revealed only slight differences in the nature of the carbon present at each of the paired sites. A single application of untreated winery wastewater was shown to have significant impacts upon soil respiration, nitrogen cycling and microbial community structure, but the treated wastewater application showed no significant differences to wetting alone. Results are discussed in the context of sustainable winery wastewater disposal. Copyright © 2011 Elsevier B.V. All rights reserved.

Long-term Outcomes of the FRESH START Trial: Exploring the Role of Self-efficacy in Cancer Survivors’ Maintenance of Dietary Practices and Physical Activity

PubMed Central

Mosher, Catherine E.; Lipkus, Isaac; Sloane, Richard; Snyder, Denise C.; Lobach, David F.; Demark-Wahnefried, Wendy

2012-01-01

Objective This study examined whether changes in self-efficacy explain the effects of a mailed print intervention on long-term dietary practices of breast and prostate cancer survivors. The relationship between change in self-efficacy and long-term physical activity (PA) also was examined. Methods Breast and prostate cancer survivors (N=543) from 39 U.S. states and two Canadian provinces participated in the FRESH START intervention trial. Participants were randomly assigned to receive a 10-month program of mailed print materials on diet and PA available in the public domain or a 10-month program of tailored materials designed to increase fruit and vegetable (F&V) intake, decrease fat intake, and/or increase PA. Changes in self-efficacy for F&V intake and fat restriction were analyzed as potential mediators of the intervention’s effects on diet at 2-year follow-up. Because we previously found that change in self-efficacy for PA did not vary by group assignment, the relationship between change in self-efficacy and PA at 2-year follow-up was examined across study conditions. Results Results suggest that change in self-efficacy for fat restriction partially explained the intervention’s effect on fat intake (mean indirect effect=-.28), and change in self-efficacy for F&V consumption partially explained the intervention’s effect on daily F&V intake (mean indirect effect=.11). Change in self-efficacy for fat restriction partially accounted for the intervention’s impact on overall diet quality among men only (mean indirect effect=.60). Finally, change in self-efficacy for PA predicted PA at 2-year follow-up. Conclusions Findings suggest that self-efficacy may influence long-term maintenance of healthy lifestyle practices among cancer survivors. PMID:22544562

The impact of organizational factors on the urinary incontinence care quality in long-term care hospitals: a longitudinal correlational study.

PubMed

Yoon, Ju Young; Lee, Ji Yun; Bowers, Barbara J; Zimmerman, David R

2012-12-01

With the rapid increase in the number of long-term care hospitals in Korea, care quality has become an important issue. Urinary incontinence is an important condition affecting many residents' quality of life. Thus, it is important that urinary incontinence be amenable to improving conditions with appropriate interventions, since a change in urinary incontinence status can reflect care quality in long-term care facilities if patient level factors are adjusted. We aim to examine the impact of organizational factors on urinary incontinence care quality defined as the improvement of urinary incontinence status or maintenance of continent status post-admission to Korean long-term care hospitals. DESIGN AND DATA: This is a longitudinal correlation study. Data came from two sources: monthly patient assessment reports using the Patient Assessment Instrument and the hospital information system from the Health Insurance Review and Assessment Services. The final analysis includes 5271 elderly adults without indwelling urinary catheter or urostomy who were admitted to 534 Korean long-term care hospitals in April 2008. Multi-level logistic analysis was used to explore the organizational factors that influence urinary incontinence care quality controlling for patient level factors. With respect to the organizational factors, the findings showed that location and RN/total nursing staff ratio variables were statistically significant, controlling for risk factors at the patient level. The odds of urinary incontinence improvement from admission in urban long-term care hospitals were 1.28 times higher than rural long-term care hospitals. In addition, when a long-term care hospital increased one standard deviation (0.19) in the RN ratio, the odds of urinary incontinence status improvement or maintenance of continence status from admission increased about 1.8 times. The most significant finding was that a higher RN to patient ratio and urban location were associated with better resident outcomes of urinary incontinence among organizational factors. For a better understanding of how these significant organizational factors influence positive care outcomes and provide more practical implications, studies should examine concrete care process measures as well as structure and outcome measures based on systematic conceptual models. Copyright © 2012 Elsevier Ltd. All rights reserved.

Preservice Teachers' Memories of Their Secondary Science Education Experiences

NASA Astrophysics Data System (ADS)

Hudson, Peter; Usak, Muhammet; Fančovičová, Jana; Erdoğan, Mehmet; Prokop, Pavol

2010-12-01

Understanding preservice teachers' memories of their education may aid towards articulating high-impact teaching practices. This study describes 246 preservice teachers' perceptions of their secondary science education experiences through a questionnaire and 28-item survey. ANOVA was statistically significant about participants' memories of science with 15 of the 28 survey items. Descriptive statistics through SPSS further showed that a teacher's enthusiastic nature (87%) and positive attitude towards science (87%) were regarded as highly memorable. In addition, explaining abstract concepts well (79%), and guiding the students' conceptual development with practical science activities (73%) may be considered as memorable secondary science teaching strategies. Implementing science lessons with one or more of these memorable science teaching practices may "make a difference" towards influencing high school students' positive long-term memories about science and their science education. Further research in other key learning areas may provide a clearer picture of high-impact teaching and a way to enhance pedagogical practices.

Soil phosphorus depletion and shifts in plant communities change bacterial community structure in a long-term grassland management trial.

PubMed

Adair, Karen L; Wratten, Steve; Lear, Gavin

2013-06-01

Agricultural systems rely on healthy soils and their sustainability requires understanding the long-term impacts of agricultural practices on soils, including microbial communities. We examined the impact of 17 years of land management on soil bacterial communities in a New Zealand randomized-block pasture trial. Significant variation in bacterial community structure related to mowing and plant biomass removal, while nitrogen fertilizer had no effect. Changes in soil chemistry and legume abundance described 52% of the observed variation in the bacterial community structure. Legumes (Trifolium species) were absent in unmanaged plots but increased in abundance with management intensity; 11% of the variation in soil bacterial community structure was attributed to this shift in the plant community. Olsen P explained 10% of the observed heterogeneity, which is likely due to persistent biomass removal resulting in P limitation; Olsen P was significantly lower in plots with biomass removed (14 mg kg(-1) ± 1.3SE) compared with plots that were not mown, or where biomass was left after mowing (32 mg kg(-1) ± 1.6SE). Our results suggest that removal of plant biomass and associated phosphorus, as well as shifts in the plant community, have greater long-term impacts on soil bacterial community structure than application of nitrogen fertilizers. © 2013 John Wiley & Sons Ltd and Society for Applied Microbiology.

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

PubMed

Leach, Belinda; Joseph, Gillian

2011-06-01

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

Surgical Education and Health Care Reform: Defining the Role and Value of Trainees in an Evolving Medical Landscape.

PubMed

Fayanju, Oluwadamilola M; Aggarwal, Reena; Baucom, Rebeccah B; Ferrone, Cristina R; Massaro, David; Terhune, Kyla P

2017-03-01

Health care reform and surgical education are often separated functionally. However, especially in surgery, where resident trainees often spend twice as much time in residency and fellowship than in undergraduate medical education, one must consider their contributions to health care. In this short commentary, we briefly review the status of health care in the United States as well as some of the recent and current changes in graduate medical education that pertain to surgical trainees. This is a perspective piece that draws on the interests and varied background of the multiinstitutional and international group of authors. The authors propose 3 main areas of focus for research and practice- (1) accurately quantifying the care provided currently by trainees, (2) determining impact to trainees and hospital systems of training parameters, focusing on long-term outcomes rather than short-term outcomes, and (3) determining practice models of education that work best for both health care delivery and trainees. The authors propose that surgical education must align itself with rather than separate itself from overall health care reform measures and even individual hospital financial pressures. This should not be seen as additional burden of service, but rather practical education in training as to the pressures trainees will face as future employees. Rethinking the contributions and training of residents and fellows may also synergistically work to impress to hospital administrators that providing better, more focused and applicable education to residents and fellows may have long-term, strategic, positive impacts on institutions.

Modeling framework for representing long-term effectiveness of best management practices in addressing hydrology and water quality problems: Framework development and demonstraton using a Bayesian method

USDA-ARS?s Scientific Manuscript database

Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water q...

Modelling the impacts of agricultural management practices on river water quality in Eastern England.

PubMed

Taylor, Sam D; He, Yi; Hiscock, Kevin M

2016-09-15

Agricultural diffuse water pollution remains a notable global pressure on water quality, posing risks to aquatic ecosystems, human health and water resources and as a result legislation has been introduced in many parts of the world to protect water bodies. Due to their efficiency and cost-effectiveness, water quality models have been increasingly applied to catchments as Decision Support Tools (DSTs) to identify mitigation options that can be introduced to reduce agricultural diffuse water pollution and improve water quality. In this study, the Soil and Water Assessment Tool (SWAT) was applied to the River Wensum catchment in eastern England with the aim of quantifying the long-term impacts of potential changes to agricultural management practices on river water quality. Calibration and validation were successfully performed at a daily time-step against observations of discharge, nitrate and total phosphorus obtained from high-frequency water quality monitoring within the Blackwater sub-catchment, covering an area of 19.6 km(2). A variety of mitigation options were identified and modelled, both singly and in combination, and their long-term effects on nitrate and total phosphorus losses were quantified together with the 95% uncertainty range of model predictions. Results showed that introducing a red clover cover crop to the crop rotation scheme applied within the catchment reduced nitrate losses by 19.6%. Buffer strips of 2 m and 6 m width represented the most effective options to reduce total phosphorus losses, achieving reductions of 12.2% and 16.9%, respectively. This is one of the first studies to quantify the impacts of agricultural mitigation options on long-term water quality for nitrate and total phosphorus at a daily resolution, in addition to providing an estimate of the uncertainties of those impacts. The results highlighted the need to consider multiple pollutants, the degree of uncertainty associated with model predictions and the risk of unintended pollutant impacts when evaluating the effectiveness of mitigation options, and showed that high-frequency water quality datasets can be applied to robustly calibrate water quality models, creating DSTs that are more effective and reliable. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Induction Mentor Voice: A Phenomenological Study of Effective Practices for High Quality K-12 Teacher Induction Mentoring

ERIC Educational Resources Information Center

Doering, Sagui Araceli

2018-01-01

In education, mentoring is pivotal in the early development and long-term success and self-directed efficacy of new teachers. With increasing acknowledgment of the importance of mentoring as the preferred means of induction support for new teachers, mentors can serve to positively impact the overall quality of teaching and learning. Yet, like the…

Dry creek long-term watershed study: effects of timber harvest on hydrology and sediment export in headwater streams in Southwest Georgia

Treesearch

W.B. Summer; C. Rhett Jackson; D. Jones; M. Miwa

2006-01-01

Properly established streamside management zones (SMZs) reduce potential impacts of timber harvesting on stream hydro-period and sediment fluxes. Effects of upland silvicultural practices on stream hydrology and effects of partial harvesting within SMZs on water quality are not well documented. The objectives of this study are to determine the effects of these forest...

Simulating long-term impacts of cover crops and climate change on crop production and environmental outcomes in the midwestern United States

USDA-ARS?s Scientific Manuscript database

It is critical to evaluate conservation practices that protect soil and water resources from climate change in the Midwestern United States, a region that produces one-quarter of the world’s soybeans and one-third of the world’s maize. An over-winter cover crop in a maize-soybean rotation offers mul...

Advanced system demonstration for utilization of biomass as an energy source. Technical Appendix D: terrestrial ecosystems and forestry. Environmental report

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

McCollom, M.

1979-01-01

The existing terrestrial ecosystems at the plant site and impacts on them are described. The following are discussed for the fuelwood harvest region: forest soils, forest types and ecological succession, nutrient cycles in the forest ecosystem, fauna of the ecosystem, forest practices in the harvest region, and long-term productivity of the forest resource. (MHR)

Long-term care financing: options for the future.

PubMed

Mulvey, Janemarie; Li, Annelise

2002-01-01

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

78 FR 48716 - Notice of Availability of the Final Environmental Impact Statement for the Arkansas Valley...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

... Reservoir to store up to 29,938 acre-feet of water. A long-term storage contract, rather than short-term... Availability of the Final Environmental Impact Statement for the Arkansas Valley Conduit and Long-Term Excess... Valley Conduit (AVC) and Long-Term Excess Capacity Contract, Fryingpan-Arkansas Project, Colorado, is...

Long-term environmental monitoring for assessment of change: measurement inconsistencies over time and potential solutions.

PubMed

Ellingsen, Kari E; Yoccoz, Nigel G; Tveraa, Torkild; Hewitt, Judi E; Thrush, Simon F

2017-10-30

The importance of long-term environmental monitoring and research for detecting and understanding changes in ecosystems and human impacts on natural systems is widely acknowledged. Over the last decades, a number of critical components for successful long-term monitoring have been identified. One basic component is quality assurance/quality control protocols to ensure consistency and comparability of data. In Norway, the authorities require environmental monitoring of the impacts of the offshore petroleum industry on the Norwegian continental shelf, and in 1996, a large-scale regional environmental monitoring program was established. As a case study, we used a sub-set of data from this monitoring to explore concepts regarding best practices for long-term environmental monitoring. Specifically, we examined data from physical and chemical sediment samples and benthic macroinvertebrate assemblages from 11 stations from six sampling occasions during the period 1996-2011. Despite the established quality assessment and quality control protocols for this monitoring program, we identified several data challenges, such as missing values and outliers, discrepancies in variable and station names, changes in procedures without calibration, and different taxonomic resolution. Furthermore, we show that the use of different laboratories over time makes it difficult to draw conclusions with regard to some of the observed changes. We offer recommendations to facilitate comparison of data over time. We also present a new procedure to handle different taxonomic resolution, so valuable historical data is not discarded. These topics have a broader relevance and application than for our case study.

Distribution of Practice and Metacognition in Learning and Long-Term Retention of a Discrete Motor Task

ERIC Educational Resources Information Center

Dail, Teresa K.; Christina, Robert W.

2004-01-01

This study examined judgments of learning and the long-term retention of a discrete motor task (golf putting) as a function of practice distribution. The results indicated that participants in the distributed practice group performed more proficiently than those in the massed practice group during both acquisition and retention phases. No…

Long-Term Experience of Chinese Calligraphic Handwriting Is Associated with Better Executive Functions and Stronger Resting-State Functional Connectivity in Related Brain Regions

PubMed Central

He, Yong; Gao, Yang; Zhang, Cuiping; Chen, Chuansheng; Bi, Suyu; Yang, Pin; Wang, Yiwen; Wang, Wenjing

2017-01-01

Chinese calligraphic handwriting (CCH) is a traditional art form that requires high levels of concentration and motor control. Previous research has linked short-term training in CCH to improvements in attention and memory. Little is known about the potential impacts of long-term CCH practice on a broader array of executive functions and their potential neural substrates. In this cross-sectional study, we recruited 36 practitioners with at least 5 years of CCH experience and 50 control subjects with no more than one month of CCH practice and investigated their differences in the three components of executive functions (i.e., shifting, updating, and inhibition). Valid resting-state fMRI data were collected from 31 CCH and 40 control participants. Compared with the controls, CCH individuals showed better updating (as measured by the Corsi Block Test) and inhibition (as measured by the Stroop Word-Color Test), but the two groups did not differ in shifting (as measured by a cue-target task). The CCH group showed stronger resting-state functional connectivity (RSFC) than the control group in brain areas involved in updating and inhibition. These results suggested that long-term CCH training may be associated with improvements in specific aspects of executive functions and strengthened neural networks in related brain regions. PMID:28129407

Long-Term Experience of Chinese Calligraphic Handwriting Is Associated with Better Executive Functions and Stronger Resting-State Functional Connectivity in Related Brain Regions.

PubMed

Chen, Wen; He, Yong; Gao, Yang; Zhang, Cuiping; Chen, Chuansheng; Bi, Suyu; Yang, Pin; Wang, Yiwen; Wang, Wenjing

2017-01-01

Chinese calligraphic handwriting (CCH) is a traditional art form that requires high levels of concentration and motor control. Previous research has linked short-term training in CCH to improvements in attention and memory. Little is known about the potential impacts of long-term CCH practice on a broader array of executive functions and their potential neural substrates. In this cross-sectional study, we recruited 36 practitioners with at least 5 years of CCH experience and 50 control subjects with no more than one month of CCH practice and investigated their differences in the three components of executive functions (i.e., shifting, updating, and inhibition). Valid resting-state fMRI data were collected from 31 CCH and 40 control participants. Compared with the controls, CCH individuals showed better updating (as measured by the Corsi Block Test) and inhibition (as measured by the Stroop Word-Color Test), but the two groups did not differ in shifting (as measured by a cue-target task). The CCH group showed stronger resting-state functional connectivity (RSFC) than the control group in brain areas involved in updating and inhibition. These results suggested that long-term CCH training may be associated with improvements in specific aspects of executive functions and strengthened neural networks in related brain regions.

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

PubMed

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

2010-01-01

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

42 CFR 483.13 - Resident behavior and facility practices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Resident behavior and facility practices. 483.13... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES Requirements for Long Term Care Facilities § 483.13 Resident behavior and facility practices. (a) Restraints...

Modelling impacts and recovery in benthic communities exposed to localised high CO2.

PubMed

Lessin, Gennadi; Artioli, Yuri; Queirós, Ana M; Widdicombe, Stephen; Blackford, Jerry C

2016-08-15

Regulations pertaining to carbon dioxide capture with offshore storage (CCS) require an understanding of the potential localised environmental impacts and demonstrably suitable monitoring practices. This study uses a marine ecosystem model to examine a comprehensive range of hypothetical CO2 leakage scenarios, quantifying both impact and recovery time within the benthic system. Whilst significant mortalities and long recovery times were projected for the larger and longer term scenarios, shorter-term or low level exposures lead to reduced projected impacts. This suggests that efficient monitoring and leak mitigation strategies, coupled with appropriate selection of storage sites can effectively limit concerns regarding localised environmental impacts from CCS. The feedbacks and interactions between physiological and ecological responses simulated reveal that benthic responses to CO2 leakage could be complex. This type of modelling investigation can aid the understanding of impact potential, the role of benthic community recovery and inform the design of baseline and monitoring surveys. Copyright © 2016 Elsevier Ltd. All rights reserved.

Personal characteristics and experiences of long-term allied health professionals in rural and northern British Columbia.

PubMed

Manahan, Candice M; Hardy, Cindy L; MacLeod, Martha L P

2009-01-01

Health sciences programs are being designed to attract students who are likely to stay and practice in rural and northern Canada. Consequently, student recruitment and screening are increasingly including assessment of suitability for rural practice. Although retention factors among rural physicians and nurses have been investigated, little is known about factors that contribute to the retention of other healthcare professionals who work in rural areas. The primary objective of this project was to identify the personal characteristics and experiences of allied health professionals who have worked long term in northern British Columbia (BC), Canada. The study used a qualitative descriptive approach. Six speech language pathologists, four psychologists, four occupational therapists, eight social workers, and four physiotherapists practicing long term in northern BC were recruited, using a convenience sample and the snowball technique, to participate in semi-structured telephone interviews. The interviews were audiotaped and transcribed verbatim. A thematic content analysis identified the motivations for their decision to begin or stay working in northern communities, the reasons for choosing rural or northern education and key themes concerning personal characteristics and experiences. A process of member checking and an external audit validated the analysis and findings. There were two major themes for choosing rural and northern education. For some, selection of rural or northern training was based on accessibility to health education programs; all participants who chose rural and northern education had already decided that they were going to practice rurally. Generally, participants identified past positive experiences and rural background as influencing their practice location decision. Participants named the community's need for healthcare professionals, career advancement opportunities, welcoming employers, peer support, as well as promises of continuing education and interprofessional teamwork as key to their decision. Professional preferences for variety, challenges, and trying new aspects of the job such as teaching also impacted their decision. Also identified were individual factors and personal preferences such as the need for adventure, wilderness, and outdoor recreation, and community factors (eg people's friendliness and the slow pace). Such factors also influenced retention; however, retention was also affected by factors such as job satisfaction, and some community factors were only associated with retention. The analysis revealed a number of personal characteristics and experiences shared by long-term healthcare professionals, and that there is not one particular factor that determines duration of practice in rural and northern communities. The findings imply a combination of varying personal values impact the decision to come or stay in rural and northern communities. Personal characteristics and experiences help to shape these personal values. Over time and depending on stage of life, personal values change. Age and stage of life, rural background, and location of family members also have bearing on personal values, which in turn impact recruitment and retention. An explicit identification of values that have emerged out of personal characteristics and experiences may be useful in the selection of students for rural health education programs, as well as the recruitment and retention of healthcare professionals in rural and northern areas.

The use of non-steroidal anti-inflammatory drugs for patent ductus arteriosus closure in preterm infants.

PubMed

Benitz, William E; Bhombal, Shazia

2017-10-01

Over the last four decades, non-steroidal anti-inflammatory drugs have been widely used to induce closure of the patent ductus arteriosus (PDA) in preterm infants. Evidence to support this practice is lacking, despite performance of >50 randomized trials. The credibility of those trials may have been compromised by high rates of open treatment in controls, era of study prior to advent of modern practices, or inclusion of insufficient numbers of very immature infants. Meta-analyses show little impact of those factors on main conclusions. Essentially all trials reporting important long-term outcomes (other than mortality) initiated treatment within five days after birth, so no evidence regarding later treatment is available. Accruing clinical experience suggests that long-term outcomes are not compromised, and may be improved, with non-interventional management strategies. Future studies to identify preterm infants at greatest risk of potential harm from a persistent PDA, particularly after the second postnatal week, are urgently needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

A conceptual framework for a long-term economic model for the treatment of attention-deficit/hyperactivity disorder.

PubMed

Nagy, Balázs; Setyawan, Juliana; Coghill, David; Soroncz-Szabó, Tamás; Kaló, Zoltán; Doshi, Jalpa A

2017-06-01

Models incorporating long-term outcomes (LTOs) are not available to assess the health economic impact of attention-deficit/hyperactivity disorder (ADHD). Develop a conceptual modelling framework capable of assessing long-term economic impact of ADHD therapies. Literature was reviewed; a conceptual structure for the long-term model was outlined with attention to disease characteristics and potential impact of treatment strategies. The proposed model has four layers: i) multi-state short-term framework to differentiate between ADHD treatments; ii) multiple states being merged into three core health states associated with LTOs; iii) series of sub-models in which particular LTOs are depicted; iv) outcomes collected to be either used directly for economic analyses or translated into other relevant measures. This conceptual model provides a framework to assess relationships between short- and long-term outcomes of the disease and its treatment, and to estimate the economic impact of ADHD treatments throughout the course of the disease.

Differential impacts of care-giving across three caregiver groups in Canada: end-of-life care, long-term care and short-term care

PubMed Central

Williams, Allison M; Wang, Li; Kitchen, Peter

2014-01-01

Using data from Statistic Canada's General Social Survey Cycle 21 (GSS 2007), this study explores whether differences exist in the impacts of care-giving among three groups of caregivers providing informal care either in the caregiver's or recipient's home, or in other locations within the community: (i) those providing end-of-life (EOL) care (n = 471); (ii) those providing long-term care (more than 2 years) for someone with a chronic condition or long-term illness (n = 2722); and (iii) those providing short-term care (less than 2 years) for someone with a chronic condition or long-term illness (n = 2381). This study lays out the variation in sociodemographic characteristics across the three caregiver groups while also building on our understanding of the differential impacts of care-giving through an analysis of determinants. All three groups of caregivers shared a number of sociodemographic characteristics, including being female, married, employed and living in a Census Metropolitan Area (CMA). With respect to health, EOL caregivers were found to have significantly higher levels of ‘fair or poor’ self-assessed health than the other two groups. Overall, the findings suggest that EOL caregivers are negatively impacted by the often additional role of care-giving, more so than both short-term and long-term caregivers. EOL caregivers experienced a higher proportion of negative impacts on their social and activity patterns. Furthermore, EOL caregivers incurred greater financial costs than the other two types of informal caregivers. The impacts of EOL care-giving also negatively influence employment for caregivers when compared with the other caregiver groups. Consequently, EOL caregivers, overall, experienced greater negative impacts, including negative health outcomes, than did long-term or short-term caregivers. This provides the evidence for the assertion that EOL care-giving is the most intense type of care-giving, potentially causing the greatest caregiver burden; this is shown through the greater negative impacts experienced by the EOL caregivers when compared with the short-term and long-term caregivers. PMID:24172162

Training Medical Students for Rural, Underserved Areas: A Rural Medical Education Program in California.

PubMed

Eidson-Ton, W Suzanne; Rainwater, Julie; Hilty, Donald; Henderson, Stuart; Hancock, Christine; Nation, Cathryn L; Nesbitt, Thomas

2016-01-01

The Association of American Medical Colleges projects an increasing shortage of physicians in rural areas. Medical schools have developed specialty track programs to improve the recruitment and retention of physicians who can serve rural populations. One such program in California includes a variety of unique elements including outreach, admissions, rural clinical experiences, focused mentorship, scholarly and leadership opportunities, and engagement with rural communities. Preliminary outcomes demonstrate that this rural track program has achieved some success in the recruitment, retention, and training of students interested in future rural practice and in the placement of students in primary care residencies. Long-term outcomes, such as graduates entering rural practice, are still unknown, but will be monitored to assess the impact and sustainability of the rural program. This article illustrates the opportunities and challenges of training medical students for rural practice and provides lessons learned to inform newly-established and long standing rural medical education programs.

[Impact of nurse, nurses' aid staffing and turnover rate on inpatient health outcomes in long term care hospitals].

PubMed

Kim, Yunmi; Lee, Ji Yun; Kang, Hyuncheol

2014-02-01

This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

Dental hygiene intervention to prevent nosocomial pneumonias.

PubMed

Barnes, Caren M

2014-06-01

Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists. Nosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings. A comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested. Dental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias. Copyright © 2014 Elsevier Inc. All rights reserved.

The Use of Cover Crops as Climate-Smart Management in Midwest Cropping Systems

NASA Astrophysics Data System (ADS)

Basche, A.; Miguez, F.; Archontoulis, S.; Kaspar, T.

2014-12-01

The observed trends in the Midwestern United States of increasing rainfall variability will likely continue into the future. Events such as individual days of heavy rain as well as seasons of floods and droughts have large impacts on agricultural productivity and the natural resource base that underpins it. Such events lead to increased soil erosion, decreased water quality and reduced corn and soybean yields. Winter cover crops offer the potential to buffer many of these impacts because they essentially double the time for a living plant to protect and improve the soil. However, at present, cover crops are infrequently utilized in the Midwest (representing 1-2% of row cropped land cover) in particular due to producer concerns over higher costs and management, limited time and winter growing conditions as well as the potential harm to corn yields. In order to expand their use, there is a need to quantify how cover crops impact Midwest cropping systems in the long term and namely to understand how to optimize the benefits of cover crops while minimizing their impacts on cash crops. We are working with APSIM, a cropping systems platform, to specifically quantify the long term future impacts of cover crop incorporation in corn-based cropping systems. In general, our regional analysis showed only minor changes to corn and soybean yields (<1% differences) when a cover crop was or was not included in the simulation. Further, a "bad spring" scenario (where every third year had an abnormally wet/cold spring and cover crop termination and planting cash crop were within one day) did not result in any major changes to cash crop yields. Through simulations we estimate an average increase of 4-9% organic matter improvement in the topsoil and an average decrease in soil erosion of 14-32% depending on cover crop planting date and growth. Our work is part of the Climate and Corn-based Cropping Systems Coordinated Agriculture Project (CSCAP), a collaboration of eleven Midwestern institutions established to evaluate how conservation practices, including cover crops, improve the resilience of Midwest agriculture to future change. Such collaborations can help better quantify long term impacts of conservation practices on the landscape that ultimately lead to more climate-smart management of such agricultural systems.

Impacts of vegetation change on groundwater recharge

NASA Astrophysics Data System (ADS)

Bond, W. J.; Verburg, K.; Smith, C. J.

2003-12-01

Vegetation change is the accepted cause of increasing river salt concentrations and the salinisation of millions of hectares of farm land in Australia. Replacement of perennial native vegetation by annual crops and pastures following European settlement has altered the water balance causing increased groundwater recharge and mobilising the naturally saline groundwater. The Redesigning Agriculture for Australian Landscapes Program, of which the work described here is a part, was established to develop agricultural practices that are more attuned to the delicate water balance described above. Results of field measurements will be presented that contrast the water balance characteristics of native vegetation with those of conventional agricultural plants, and indicate the functional characteristics required of new agricultural practices to reduce recharge. New agricultural practices may comprise different management of current crops and pastures, or may involve introducing totally new species. In either case, long-term testing is required to examine their impact on recharge over a long enough climate record to encompass the natural variability of rainfall that is characteristic of most Australian farming regions. Field experimentation therefore needs to be complemented and extended by computer simulation. This requires a modelling approach that is more robust than conventional crop modelling because (a) it needs to be sensitive enough to predict small changes in the residual recharge term, (b) it needs to be able to simulate a variety of vegetation in different sequences, (c) it needs to be able to simulate continuously for several decades of input data, and (d) it therefore needs to be able to simulate the period between crops, which often has a critical impact on recharge. The APSIM simulation framework will be used to illustrate these issues and to explore the effect of different vegetation combinations on recharge.

Long-Term Economic Benefits of Preschool Services and the Potential Impact of Privatization.

ERIC Educational Resources Information Center

Kendall, Earline D.

This paper addresses the importance of a high quality preschool education for children living in poverty, the long-term effects of such an educational experience, the long-term economic benefits to the children enrolled and their families, and the potential impact of privatization on preschool services. The cost-effectiveness and cost-benefits of…

The impact of a haemophilia education intervention on the knowledge and health related quality of life of parents of Indian children with haemophilia.

PubMed

Phadnis, S; Kar, A

2017-01-01

The impact of haemophilia education on the quality of life of parents of children with haemophilia from low income settings has not been studied. The purpose of this study was to determine the impact of an education intervention on health related quality of life (HRQOL) of parents of children with haemophilia, parent's knowledge about haemophilia and its management, and to determine whether education about haemophilia can positively impact these outcomes. One hundred thirty-three parents from across Maharashtra state, India were provided information about haemophilia, care of child and self-care. The impact of the intervention was measured as changes occurring from baseline to 6 months and 1 year after intervention. Knowledge and practice of management of bleeding was measured using pretested structured questionnaires. HRQOL was measured using a validated Peds Quality of Life ™ Family Impact Module (PedsQL ™ FIM) tool. There was improvement in knowledge scores immediately after intervention, which remained significantly higher than baseline 1 year after intervention. HRQOL showed significant improvement at 6 months but reduced to baseline levels 1 year after intervention. There were statistically significant changes in terms of practice of management of bleeding episodes at 6 months and 1 year after intervention. Education about haemophilia resulted in improvement of knowledge, and practice of management of bleeding which was retained till a year after the intervention. However, a long-term effect on the HRQOL of parents could not be observed after administration of a single education intervention. © 2016 John Wiley & Sons Ltd.

The Time Is Now: Using Graduates' Practice Data to Drive Medical Education Reform.

PubMed

Triola, Marc M; Hawkins, Richard E; Skochelak, Susan E

2018-06-01

Medical educators are not yet taking full advantage of the publicly available clinical practice data published by federal, state, and local governments, which can be attributed to individual physicians and evaluated in the context of where they attended medical school and residency training. Understanding how graduates fare in actual practice, both in terms of the quality of the care they provide and the clinical challenges they face, can aid educators in taking an evidence-based approach to medical education. Although in their infancy, efforts to link clinical outcomes data to educational process data hold the potential to accelerate medical education research and innovation. This approach will enable unprecedented insight into the long-term impact of each stage of medical education on graduates' future practice. More work is needed to determine best practices, but the barrier to using these public data is low, and the potential for early results is immediate. Using practice data to evaluate medical education programs can transform how the future physician workforce is trained and better align continuously learning medical education and health care systems.

Impact of franchisee-protection legislation on the performance of a marketing system: the case of gasoline retailing. [Petroleum Marketing Practices Act of 1978

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

Heinzelmann, R.

1982-01-01

The Petroleum Marketing Practices Act of 1978 intended to protect franchisee dealers, preserve competition, and maintain trends towards productivity improvements. As such, it represented an expression of countervailing power, service station dealers against their suppliers - large oil companies. This dissertation examines the impact of similar previous laws on the performance of the gasoline-marketing system. Marketing theory and previous research findings suggest that focus towards greater efficiency supporting competitor conditions contribute more performance benefits than legislation of franchisee dealer protection. Such laws, as the Robinson-Patman Act and the Automobile Dealers' Good Faith Act, were found to have only a limitedmore » impact. Their long-term benefits did not materialize. It is, therefore, hypothesized that the law will not have favorable results and serve its purpose satisfactorily.« less

Is "the perfect model" really needed? - Analysis of the quality level of climate information necessary for supporting adaptation in agriculture and forestry

NASA Astrophysics Data System (ADS)

Gálos, Borbála; Ostler, Wolf-Uwe; Csáki, Péter; Bidló, András; Panferov, Oleg

2016-04-01

Recent results of climate science (e.g. IPCC AR5, 2013) and statements of climate policy (e.g. Paris Agreement) confirm that climate change is an ongoing issue. The consequences will be noticeable for a long time even if the 2 Degree goal is reached. Therefore, action plans are necessary for adaptation and mitigation on national and international level. Forestry and agriculture are especially threatened by the probable increase of the frequency and/or intensity of climate extremes. Severe impacts of recurrent droughts/heat waves that were observed in the last decades in the sensitive and vulnerable ecosystems and regions are very likely to occur with increasing probability throughout the 21st century. For the adequate climate impact assessments, for adaptation strategies as well as for supporting decisions in the above mentioned sectors the reliable information on the long-term climate tendencies and on ecosystem responses are required. Here are the two major problems: on the one hand the information on current climate and future climate developments are highly uncertain. On the other hand, due to limited knowledge on ecosystem responses, it is difficult to define how certain or accurate the provided climate data should be for the plausible application in agricultural/forestry research and practice. Considering agriculture and forestry, our research is focusing on the following questions: • What is the climate information demand of practice and impact research in the two sectors? • What quality level of climate information is necessary for adaptation support? • How does the accuracy of climate input affect the results of the climate impact assessments? The agriculture and forestry operate at two very different time scales and have a different reaction times and adaptation capacities. Agriculture requires short-term information on current conditions and short-/medium-term weather forecast. To assess the degree of information accuracy required by practical agriculture a questionnaire has been carried out among 180 farms of different sizes and specializations (mostly arable farming and viniculture) in Reinland-Palatine, Germany. The results show that almost all farmers use the weather information daily and are in need of weather forecast. More than a half requires also the forecast on extreme events. However the farmers require more qualitative (e.g. temperature coarser than 1°C) than high-precision quantitative information in short and medium-term forecasts. Forestry requires long-term (30-100 years) climate projections. For the assessment of climate change impacts on forest distribution, production and tree species selection, monthly temperature means and precipitation sums are sufficient. Based on the results of regional climate models it will be shown how the bias, the spread and spatial resolution of the simulation results are affecting the accuracy of impact assessments. Our analyses can help to fill the gap between climate services and the needs of impact researchers and end users in agriculture and forestry. User-relevant climate information can contribute to appropriate adaptation support services and management options in the two sectors. Keywords: regional climate projections, climate impact assessment, agriculture, forestry, adaptation support, accuracy of climate information Funding: The research is supported by the "Agroclimate-2" (VKSZ_12-1-2013-0034) joint EU-national research project.

Air quality impacts from prescribed forest fires under different management practices.

PubMed

Tian, Di; Wang, Yuhang; Bergin, Michelle; Hu, Yongtao; Liu, Yongqiang; Russell, Armistead G

2008-04-15

Large amounts of air pollutants are emitted during prescribed forest fires. Such emissions and corresponding air quality impacts can be modulated by different forest management practices. The impacts of changing burning seasons and frequencies and of controlling emissions during smoldering on regional air quality in Georgia are quantified using source-oriented air quality modeling, with modified emissions from prescribed fires reflecting effects of each practice. Equivalent fires in the spring and winter are found to have a greater impact on PM2.5 than those in summer, though ozone impacts are larger from spring and summer fires. If prescribed fires are less frequent more biofuel is burnt in each fire, leading to larger emissions and air quality impacts per fire. For example, emissions from a fire with a 5-year fire return interval (FRI) are 72% larger than those from a fire of the same acreage with a 2-year FRI. However, corresponding long-term regional impacts are reduced with the longer FRI since the annual burned area is reduced. Total emissions for fires in Georgia with a 5-year FRI are 32% less than those with a 2-year FRI. Smoldering emissions can lead to approximately 1.0 or 1.9 microg/m3 of PM2.5 in the Atlanta PM2.5 nonattainment area during March 2002.

Reflections on an Innovative Approach to Studying Abroad in Nursing.

PubMed

Napolitano, Nancy; Duhamel, Karen V

2017-02-01

Nursing students are largely excluded from travel-abroad studies because of demanding curricula, lack of time, and cost. A poll was conducted and distributed to bachelor of science in nursing (BSN) and master of science in nursing (MSN) students who participated in 8-day observational trips. Questions were framed around the themes of cultural awareness, global health care perspective, translating theory into practice, and personal and professional growth. The results were compared with traditional long-term study-abroad outcomes. Participants reported increased cultural awareness through personal interactions and personal growth through continued reflection. Perceived impact on nursing practice was rated as neutral, but narrative comments implied actual influence on practice.

Breeding Bird Community Continues to Colonize Riparian Buffers Ten Years after Harvest

PubMed Central

2015-01-01

Riparian ecosystems integrate aquatic and terrestrial communities and often contain unique assemblages of flora and fauna. Retention of forested buffers along riparian habitats is a commonly employed practice to reduce potential negative effects of land use on aquatic systems. However, very few studies have examined long-term population and community responses to buffers, leading to considerable uncertainty about effectiveness of this practice for achieving conservation and management outcomes. We examined short- (1–2 years) and long-term (~10 years) avian community responses (occupancy and abundance) to riparian buffer prescriptions to clearcut logging silvicultural practices in the Pacific Northwest USA. We used a Before-After-Control-Impact experimental approach and temporally replicated point counts analyzed within a Bayesian framework. Our experimental design consisted of forested control sites with no harvest, sites with relatively narrow (~13m) forested buffers on each side of the stream, and sites with wider (~30m) and more variable width unharvested buffer. Buffer treatments exhibited a 31–44% increase in mean species richness in the post-harvest years, a pattern most evident 10 years post-harvest. Post-harvest, species turnover was much higher on both treatments (63–74%) relative to the controls (29%). We did not find evidence of local extinction for any species but found strong evidence (no overlap in 95% credible intervals) for an increase in site occupancy on both Narrow (short-term: 7%; long-term 29%) and Wide buffers (short-term: 21%; long-term 93%) relative to controls after harvest. We did not find a treatment effect on total avian abundance. When assessing relationships between buffer width and site level abundance of four riparian specialists, we did not find strong evidence of reduced abundance in Narrow or Wide buffers. Silviculture regulations in this region dictate average buffer widths on small and large permanent streams that range from ~22–25 m. Guidelines for this region are within the range of buffers included in our study, in which we observed no evidence for avian species loss or for a decline in species abundance (including riparian associated species). PMID:26637120

Pathways for best practice diffusion: the structure of informal relationships in Canada's long-term care sector.

PubMed

Dearing, James W; Beacom, Amanda M; Chamberlain, Stephanie A; Meng, Jingbo; Berta, Whitney B; Keefe, Janice M; Squires, Janet E; Doupe, Malcolm B; Taylor, Deanne; Reid, Robert Colin; Cook, Heather; Cummings, Greta G; Baumbusch, Jennifer L; Knopp-Sihota, Jennifer; Norton, Peter G; Estabrooks, Carole A

2017-02-03

Initiatives to accelerate the adoption and implementation of evidence-based practices benefit from an association with influential individuals and organizations. When opinion leaders advocate or adopt a best practice, others adopt too, resulting in diffusion. We sought to identify existing influence throughout Canada's long-term care sector and the extent to which informal advice-seeking relationships tie the sector together as a network. We conducted a sociometric survey of senior leaders in 958 long-term care facilities operating in 11 of Canada's 13 provinces and territories. We used an integrated knowledge translation approach to involve knowledge users in planning and administering the survey and in analyzing and interpreting the results. Responses from 482 senior leaders generated the names of 794 individuals and 587 organizations as sources of advice for improving resident care in long-term care facilities. A single advice-seeking network appears to span the nation. Proximity exhibits a strong effect on network structure, with provincial inter-organizational networks having more connections and thus a denser structure than interpersonal networks. We found credible individuals and organizations within groups (opinion leaders and opinion-leading organizations) and individuals and organizations that function as weak ties across groups (boundary spanners and bridges) for all studied provinces and territories. A good deal of influence in the Canadian long-term care sector rests with professionals such as provincial health administrators not employed in long-term care facilities. The Canadian long-term care sector is tied together through informal advice-seeking relationships that have given rise to an emergent network structure. Knowledge of this structure and engagement with its opinion leaders and boundary spanners may provide a route for stimulating the adoption and effective implementation of best practices, improving resident care and strengthening the long-term care advice network. We conclude that informal relational pathways hold promise for helping to transform the Canadian long-term care sector.

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

PubMed

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

2005-04-01

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

Knowledge translation interventions to sustain direct care provider behaviour change in long-term care: A process evaluation.

PubMed

Slaughter, Susan E; Bampton, Erin; Erin, Daniel F; Ickert, Carla; Wagg, Adrian S; Allyson Jones, C; Schalm, Corinne; Estabrooks, Carole A

2018-02-01

Process evaluation can be used to understand the factors influencing the impact of knowledge translation (KT) interventions. The aim of this mixed methods process evaluation was to evaluate the processes and perceived outcomes of eight KT interventions that were used with healthcare aides (HCAs) to introduce a mobility innovation into their daily care practices. The study examined the perceived effectiveness of various KT interventions in sustaining daily performance of the sit-to-stand mobility innovation by HCAs with residents in long-term care. In-person interviews were conducted with four leaders across three long-term care facilities. Seven focus groups with 27 HCAs were conducted across the three facilities. All participants were asked to rank the eight interventions involved in the trial according to their perceived effectiveness and, for the leaders, their perceived ease of implementation. Focus group and interview questions asked participants to discuss the relative merits of each KT intervention. Two research assistants coded all of the transcripts independently using content analysis. Both HCAs and their leaders perceived reminders, followed by discussion groups, to be the most effective KT interventions to sustain practice change. Healthcare aide champions were deemed least effective by both leaders and HCAs. Leaders identified both the focus group discussion and audit and feedback posters in the study as the most difficult to implement. Participants valued interventions that were strategically visible, helped to clarify misconceptions about the new care innovation, supported teamwork, and made visible the resident benefits of the care innovation. Logistical issues, such as staff scheduling and workload, influenced the perceived feasibility of the various KT interventions. Understanding how care staff in long-term care settings perceive KT interventions can inform the choice of future use of these interventions to move research evidence into practice. © 2017 John Wiley & Sons, Ltd.

The role of model dynamics in ensemble Kalman filter performance for chaotic systems

USGS Publications Warehouse

Ng, G.-H.C.; McLaughlin, D.; Entekhabi, D.; Ahanin, A.

2011-01-01

The ensemble Kalman filter (EnKF) is susceptible to losing track of observations, or 'diverging', when applied to large chaotic systems such as atmospheric and ocean models. Past studies have demonstrated the adverse impact of sampling error during the filter's update step. We examine how system dynamics affect EnKF performance, and whether the absence of certain dynamic features in the ensemble may lead to divergence. The EnKF is applied to a simple chaotic model, and ensembles are checked against singular vectors of the tangent linear model, corresponding to short-term growth and Lyapunov vectors, corresponding to long-term growth. Results show that the ensemble strongly aligns itself with the subspace spanned by unstable Lyapunov vectors. Furthermore, the filter avoids divergence only if the full linearized long-term unstable subspace is spanned. However, short-term dynamics also become important as non-linearity in the system increases. Non-linear movement prevents errors in the long-term stable subspace from decaying indefinitely. If these errors then undergo linear intermittent growth, a small ensemble may fail to properly represent all important modes, causing filter divergence. A combination of long and short-term growth dynamics are thus critical to EnKF performance. These findings can help in developing practical robust filters based on model dynamics. ?? 2011 The Authors Tellus A ?? 2011 John Wiley & Sons A/S.

Understanding the effects of fire management practices on forest health: Implications for weeds and vegetation structure (Project INT-F-04-01) [Chapter 14

Treesearch

Anne E. Black; Peter Landres

2011-01-01

Current fire policy to restore ecosystem function and resiliency and reduce buildup of hazardous fuels implies a larger future role for fire (both natural and human ignitions) (USDA and USDOI 2000). Yet some fire management (such as building fire line, spike camps, or heli-spots) potentially causes both short- and long-term impacts to forest health. In the short run,...

Overweight and diabetes prevention: is a low-carbohydrate-high-fat diet recommendable?

PubMed

Brouns, Fred

2018-03-14

In the past, different types of diet with a generally low-carbohydrate content (< 50-< 20 g/day) have been promoted, for weight loss and diabetes, and the effectiveness of a very low dietary carbohydrate content has always been a matter of debate. A significant reduction in the amount of carbohydrates in the diet is usually accompanied by an increase in the amount of fat and to a lesser extent, also protein. Accordingly, using the term "low carb-high fat" (LCHF) diet is most appropriate. Low/very low intakes of carbohydrate food sources may impact on overall diet quality and long-term effects of such drastic diet changes remain at present unknown. This narrative review highlights recent metabolic and clinical outcomes of studies as well as practical feasibility of low LCHF diets. A few relevant observations are as follows: (1) any diet type resulting in reduced energy intake will result in weight loss and related favorable metabolic and functional changes; (2) short-term LCHF studies show both favorable and less desirable effects; (3) sustained adherence to a ketogenic LCHF diet appears to be difficult. A non-ketogenic diet supplying 100-150 g carbohydrate/day, under good control, may be more practical. (4) There is lack of data supporting long-term efficacy, safety and health benefits of LCHF diets. Any recommendation should be judged in this light. (5) Lifestyle intervention in people at high risk of developing type 2 diabetes, while maintaining a relative carbohydrate-rich diet, results in long-term prevention of progression to type 2 diabetes and is generally seen as safe.

The social implications of using drones for biodiversity conservation.

PubMed

Sandbrook, Chris

2015-11-01

Unmanned aerial vehicles, or 'drones', appear to offer a flexible, accurate and affordable solution to some of the technical challenges of nature conservation monitoring and law enforcement. However, little attention has been given to their possible social impacts. In this paper, I review the possible social impacts of using drones for conservation, including on safety, privacy, psychological wellbeing, data security and the wider understanding of conservation problems. I argue that negative social impacts are probable under some circumstances and should be of concern for conservation for two reasons: (1) because conservation should follow good ethical practice; and (2) because negative social impacts could undermine conservation effectiveness in the long term. The paper concludes with a call for empirical research to establish whether the identified social risks of drones occur in reality and how they could be mitigated, and for self-regulation of drone use by the conservation sector to ensure good ethical practice and minimise the risk of unintended consequences.

Testing Memories of Personally Experienced Events: The Testing Effect Seems Not to Persist in Autobiographical Memory

PubMed Central

Emmerdinger, Kathrin J.; Kuhbandner, Christof

2018-01-01

Numerous studies have shown that retrieving contents from memory in a test improves long-term retention for those contents, even when compared to restudying (i.e., the “testing effect”). The beneficial effect of retrieval practice has been demonstrated for many different types of memory representations; however, one particularly important memory system has not been addressed in previous testing effect research: autobiographical memory. The aim of the present study was to examine the effect of retrieving memories for personally experienced events on long-term memory for those events. In an initial elicitation session, participants described memories for personally experienced events in response to a variety of cue words. In a retrieval practice/restudy session the following day, they repeatedly practiced retrieval for half of their memories by recalling and writing down the previously described events; the other half of memories was restudied by rereading and copying the event descriptions. Long-term retention of all previously collected memories was assessed at two different retention intervals (2 weeks and 13 weeks). In the retrieval practice session, a hypermnesic effect emerged, with memory performance increasing across the practice cycles. Long-term memory performance significantly dropped from the 2-weeks to the 13-weeks retention interval, but no significant difference in memory performance was observed between previously repeatedly retrieved and previously repeatedly restudied memories. Thus, in autobiographical memory, retrieval practice seems to be no more beneficial for long-term retention than repeated re-exposure. PMID:29881365

Testing Memories of Personally Experienced Events: The Testing Effect Seems Not to Persist in Autobiographical Memory.

PubMed

Emmerdinger, Kathrin J; Kuhbandner, Christof

2018-01-01

Numerous studies have shown that retrieving contents from memory in a test improves long-term retention for those contents, even when compared to restudying (i.e., the "testing effect"). The beneficial effect of retrieval practice has been demonstrated for many different types of memory representations; however, one particularly important memory system has not been addressed in previous testing effect research: autobiographical memory. The aim of the present study was to examine the effect of retrieving memories for personally experienced events on long-term memory for those events. In an initial elicitation session, participants described memories for personally experienced events in response to a variety of cue words. In a retrieval practice/restudy session the following day, they repeatedly practiced retrieval for half of their memories by recalling and writing down the previously described events; the other half of memories was restudied by rereading and copying the event descriptions. Long-term retention of all previously collected memories was assessed at two different retention intervals (2 weeks and 13 weeks). In the retrieval practice session, a hypermnesic effect emerged, with memory performance increasing across the practice cycles. Long-term memory performance significantly dropped from the 2-weeks to the 13-weeks retention interval, but no significant difference in memory performance was observed between previously repeatedly retrieved and previously repeatedly restudied memories. Thus, in autobiographical memory, retrieval practice seems to be no more beneficial for long-term retention than repeated re-exposure.

Long-Term Climatic and Anthropogenic Impacts on Streamwater Salinity in New York State: INCA Simulations Offer Cautious Optimism.

PubMed

Gutchess, Kristina; Jin, Li; Ledesma, José L J; Crossman, Jill; Kelleher, Christa; Lautz, Laura; Lu, Zunli

2018-02-06

The long-term application of road salts has led to a rise in surface water chloride (Cl - ) concentrations. While models have been used to assess the potential future impacts of continued deicing practices, prior approaches have not incorporated changes in climate that are projected to impact hydrogeology in the 21st century. We use an INtegrated CAtchment (INCA) model to simulate Cl - concentrations in the Tioughnioga River watershed. The model was run over a baseline period (1961-1990) and climate simulations from a range of GCMs run over three 30-year intervals (2010-2039; 2040-2069; 2070-2099). Model projections suggest that Cl - concentrations in the two river branches will continue to rise for several decades, before beginning to decline around 2040-2069, with all GCM scenarios indicating reductions in snowfall and associated salt applications over the 21st century. The delay in stream response is most likely attributed to climate change and continued contribution of Cl - from aquifers. By 2100, surface water Cl - concentrations will decrease to below 1960s values. Catchments dominated by urban lands will experience a decrease in average surface water Cl - , although moderate compared to more rural catchments.

Long term management practices influenced soil aggregation and carbon dynamics

USDA-ARS?s Scientific Manuscript database

Soil aggregation protects soil organic C (SOC) against rapid decomposition, improves soil quality, and reduces soil erosion potential. The objectives of this study are to evaluate the effects of long-term (21 yrs.) management practices on SOC, water stable aggregate (WSA), and aggregate-associated ...

The impact of experimental measurement errors on long-term viscoelastic predictions. [of structural materials

NASA Technical Reports Server (NTRS)

Tuttle, M. E.; Brinson, H. F.

1986-01-01

The impact of flight error in measured viscoelastic parameters on subsequent long-term viscoelastic predictions is numerically evaluated using the Schapery nonlinear viscoelastic model. Of the seven Schapery parameters, the results indicated that long-term predictions were most sensitive to errors in the power law parameter n. Although errors in the other parameters were significant as well, errors in n dominated all other factors at long times. The process of selecting an appropriate short-term test cycle so as to insure an accurate long-term prediction was considered, and a short-term test cycle was selected using material properties typical for T300/5208 graphite-epoxy at 149 C. The process of selection is described, and its individual steps are itemized.

Nursing unit leaders' influence on the long-term sustainability of evidence-based practice improvements.

PubMed

Fleiszer, Andrea R; Semenic, Sonia E; Ritchie, Judith A; Richer, Marie-Claire; Denis, Jean-Louis

2016-04-01

To describe how actions of nursing unit leaders influenced the long-term sustainability of a best practice guidelines (BPG) program on inpatient units. Several factors influence the initial implementation of evidence-based practice improvements in nursing, with leadership recognized as essential. However, there is limited knowledge about enduring change, including how frontline nursing leaders influence the sustainability of practice improvements over the long term. A qualitative descriptive case study included 39 in-depth interviews, observations, and document reviews. Four embedded nursing unit subcases had differing levels of program sustainability at 7 years (average) following implementation. Higher levels of BPG sustainability occurred on units where formal leadership teams used an integrated set of strategies and activities. Two key strategies were maintaining priorities and reinforcing expectations. The coordinated use of six activities (e.g., discussing, evaluating, integrating) promoted the continuation of BPG practices among staff. These leadership processes, fostering exchange and learning, contributed to sustainability-promoting environments characterized by teamwork and accountability. Unit leaders are required to strategically orchestrate several overlapping and synergistic efforts to achieve long-term sustainability of BPG-based practice improvements. As part of managing overall unit performance, unit leaders may influence practice improvement sustainability by aligning vision, strategies, and activities. © 2015 John Wiley & Sons Ltd.

Effectiveness of psychological interventions to improve quality of life in people with long-term conditions: rapid systematic review of randomised controlled trials.

PubMed

Anderson, Niall; Ozakinci, Gozde

2018-03-27

Long-term conditions may negatively impact multiple aspects of quality of life including physical functioning and mental wellbeing. The rapid systematic review aimed to examine the effectiveness of psychological interventions to improve quality of life in people with long-term conditions to inform future healthcare provision and research. EBSCOhost and OVID were used to search four databases (PsychInfo, PBSC, Medline and Embase). Relevant papers were systematically extracted by one researcher using the predefined inclusion/exclusion criteria based on titles, abstracts, and full texts. Randomized controlled trial psychological interventions conducted between 2006 and February 2016 to directly target and assess people with long-term conditions in order to improve quality of life were included. Interventions without long-term condition populations, psychological intervention and/or patient-assessed quality of life were excluded. From 2223 citations identified, 6 satisfied the inclusion/exclusion criteria. All 6 studies significantly improved at least one quality of life outcome immediately post-intervention. Significant quality of life improvements were maintained at 12-months follow-up in one out of two studies for each of the short- (0-3 months), medium- (3-12 months), and long-term (≥ 12 months) study duration categories. All 6 psychological intervention studies significantly improved at least one quality of life outcome immediately post-intervention, with three out of six studies maintaining effects up to 12-months post-intervention. Future studies should seek to assess the efficacy of tailored psychological interventions using different formats, durations and facilitators to supplement healthcare provision and practice.

Globalization, women's migration, and the long-term-care workforce.

PubMed

Browne, Colette V; Braun, Kathryn L

2008-02-01

With the aging of the world's population comes the rising need for qualified direct long-term-care (DLTC) workers (i.e., those who provide personal care to frail and disabled older adults). Developed nations are increasingly turning to immigrant women to fill these needs. In this article, we examine the impact of three global trends-population aging, globalization, and women's migration-on the supply and demand for DLTC workers in the United States. Following an overview of these trends, we identify three areas with embedded social justice issues that are shaping the DLTC workforce in the United States, with a specific focus on immigrant workers in these settings. These include world poverty and economic inequalities, the feminization and colorization of labor (especially in long-term care), and empowerment and women's rights. We conclude with a discussion of the contradictory effects that both population aging and globalization have on immigrant women, source countries, and the long-term-care workforce in the United States. We raise a number of policy, practice, and research implications and questions. For policy makers and long-term-care administrators in receiver nations such as the United States, the meeting of DLTC worker needs with immigrants may result in greater access to needed employees but also in the continued devaluation of eldercare as a profession. Source (supply) nations must balance the real and potential economic benefits of remittances from women who migrate for labor with the negative consequences of disrupting family care traditions and draining the long-term-care workforce of those countries.

Long term impacts of invasive grasses and subsequent fire in seasonally dry Hawaiian woodlands

Treesearch

Carla M. D’Antonio; Flint Hughes; J. T. Tunison

2011-01-01

Invasive nonnative grasses have altered the composition of seasonally dry shrublands and woodlands throughout the world. In many areas they coexist with native woody species until fire occurs, after which they become dominant. Yet it is not clear how long their impacts persist in the absence of further fire. We evaluated the long-term impacts of grass invasions and...

Long-Term Impact of Famine: Enduring Disasters and Opportunities for Progress. Staff Report No. AGES870212.

ERIC Educational Resources Information Center

Mabbs-Zeno, Carl C.

Throughout history, famine has been linked to many of the most severe crises of humanity. Even with millenary of collective experience, the reaction of the world community to the an intense food crises fails to address the long-term impacts of famine. As governments and populations strive to cope with famine, many long-term changes take place in…

Application experience of grade 10Kh9MFB chromium steel for steam shutoff and control valve bodies

NASA Astrophysics Data System (ADS)

Skorobogatykh, V. N.; Schenkova, I. A.; Danyushevskiy, I. A.; Grin', E. A.; Levkov, L. Ya.; Prudnikov, D. A.; Zhuravlev, D. N.; Bazhenov, A. M.

2017-04-01

In 2014-2015, the engineers of JSC "NPO "TsNIITMash", in cooperation with JSC "Energomash (Chekhov)—ChZEM", developed a technology for manufacturing D u = 250 mm valve bodies from 10Kh9MFB chromium steel by electroslag melting (ESM) and produced their pilot copies within the frame of import substitution program. This article provides results of research into determining the design values of metal characteristics, including short-term mechanical properties at working temperatures and impact and long-term strength. The test specimens have been sampled from the following four zones: bottom, central, branch-pipe, and head. Tensile short-term rupture testing has been performed at temperatures of 350, 450, 500, 550, 600, and 650°C. Testing for long-term strength has been carried out at temperatures of 550, 575, 600, and 625°C and stresses of 156.8, 137.2, 117.6, and 98 MPa. To estimate brittle fracture resistance, impact-strength tests have been run at temperatures of-20 and-10°C; 20 and 50°C. The specimens have been sampled from the middle of the blank section. All short-term mechanical properties and impact strength are in agreement with the requirements imposed on the metal of hot-deformed steam piping made of 10Kh9MFB steel as per TU (Technical Conditions) 14-3R-55-2001. The absence of microliquation of alloying elements and the high homogeneity of chemical composition (as demonstrated with nine specimens) have also been experimentally confirmed. Metallographic analysis has shown that the structure of the tested metal is that of tempered martensite with local areas of tempered bainite. Overall, the microscopic structure of metal is practically the same in all the studied zones. Service-life calculation of pilot valve bodies has proved conformity with the safety-margin regulations. Such properties of electroslag melting blank as long-term strength and allowable stress correspond to the level of deformed metal and to regulations.

National variability in provision of health services for major long-term conditions in New Zealand (a report from the ABCC NZ study).

PubMed

Connolly, Martin J; Kenealy, Timothy; Barber, P Alan; Carswell, Peter; Clinton, Janet; Dyall, Lorna; Devlin, Gerard; Doughty, Robert N; Kerse, Ngaire; Kolbe, John; Lawrenson, Ross; Moffitt, Allan; Sheridan, Nicolette

2011-10-14

Chronic illness is the leading cause of morbidity, mortality, and inequitable health outcomes in New Zealand. The ABCCNZ Stocktake aimed to identify extent of long-term conditions management evidence-based practices in stroke, cardiovascular disease, chronic obstructive pulmonary disease and congestive heart failure in New Zealand's District Health Boards (DHBs). Eleven 'dimensions' of care for long-term conditions, identified by literature review and confirmed at workshops with long-term conditions professionals, formed the basis of the Stocktake of all 21 DHBs. It comprised two questionnaires: a generic component capturing perceptions of practice; and a disease-specific component assessing service provision. Fifteen DHBs completed all or parts of the questionnaires. Data accrual was completed in July 2008. Although most DHBs had developed long-term conditions management strategies to a moderate degree, there was considerable variability of practice between DHBs. DHBs thought their PHOs had developed strategies in some areas to a low to moderate level, though cardiovascular disease provision rated more highly. Regarding disease-specific services, larger DHBs had greater long-term conditions management provision not only of tertiary services, but of standard care, leadership, self-management, case-management, and audit. There is considerable variability in perceptions of long-term conditions management service provision across DHBs. In many instances variability in actual disease-specific service provision appears to relate to DHB size.

Optimal implementation of green infrastructure practices to reduce adverse impacts of urban areas on hydrology and water quality

NASA Astrophysics Data System (ADS)

Liu, Y.; Collingsworth, P.; Pijanowski, B. C.; Engel, B.

2016-12-01

Nutrient loading from Maumee River watershed is a significant reason for the harmful algal blooms (HABs) problem in Lake Erie. Although studies have explored strategies to reduce nutrient loading from agricultural areas in the Maumee River watershed, the nutrient loading in urban areas also needs to be reduced. Green infrastructure practices are popular approaches for stormwater management and useful for improving hydrology and water quality. In this study, the Long-Term Hydrologic Impact Assessment-Low Impact Development 2.1 (L-THIA-LID 2.1) model was used to determine how different strategies for implementing green infrastructure practices can be optimized to reduce impacts on hydrology and water quality in an urban watershed in the upper Maumee River system. Community inputs, such as the types of green infrastructure practices of greatest interest and environmental concerns for the community, were also considered during the study. Based on community input, the following environmental concerns were considered: runoff volume, Total Suspended Solids (TSS), Total Phosphorous (TP), Total Kjeldahl Nitrogen (TKN), and Nitrate+Nitrite (NOx); green infrastructure practices of interest included rain barrel, cistern, green roof, permeable patio, porous pavement, grassed swale, bioretention system, grass strip, wetland channel, detention basin, retention pond, and wetland basin. Spatial optimization of green infrastructure practice implementation was conducted to maximize environmental benefits while minimizing the cost of implementation. The green infrastructure practice optimization results can be used by the community to solve hydrology and water quality problems.

Long-term Effect of Pig Slurry Application on Soil Carbon Storage, Quality and Yield Sustainability in Murcia Region, Spain

NASA Astrophysics Data System (ADS)

Büyükkılıç Yanardaǧ, Asuman

2013-04-01

Sustainability of agriculture is now a major global concern, especially since the 1980s. Soil organic matter is very important in the proper functions of the soil, which is also a good indicator of soil quality. This is due to its influence on many of the chemical, physical, and biological processes that control the capacity of a soil to perform properly. Understanding of nutrient supply through organic matter mineralization in agricultural systems is essential for maintaining long-term quality and productivity. The composition of pig manure will have a profound impact on soil properties, quality and crop yield when used in agriculture. We studied the effects of pig slurry (PS) application as an organic fertilizer, trying to determine the optimum amount that can be added to the soil, and the effect on soil properties, quality, and productivity. We applied 3 different doses on silty loam soils: Single (D1), Double (D2), Triple (D3) and unfertilized plots (C) served as controls. Samples were collected at two different levels, surface (0-30 cm) and subsurface (30-60 cm). D1 application dose, which is the agronomic rate of N-requirement (170 kg N/ha/yr) (European Directive 91/676/CEE), is very appropriate in term of sustainable agriculture and also can improve physical, chemical and biological soil properties. Therefore that the long-term use of PS with low dose may necessarily enhance soil quality in the long term. There are many factors to be considered when attempting to assess the overall net impact of a management practice on productivity. Additions of pig manure to soils at agronomic rates (170 kg N ha-1 yr-1) to match crop nutrient requirements are expected to have a positive impact on soil productivity. Therefore, the benefits from the use of application depend on the management of PS, carbon and environmental quality. However, PS have high micronutrient contents, and for this reason the application of high doses can pollute soils and damage human, animal and plant health, which is not suitable in term of sustainable agriculture. Keywords: Management, Pig slurry, Productivity, Quality, Soil.

Quantifying Head Impacts in Collegiate Lacrosse.

PubMed

Reynolds, Bryson B; Patrie, James; Henry, Erich J; Goodkin, Howard P; Broshek, Donna K; Wintermark, Max; Druzgal, T Jason

2016-11-01

Concussion and repetitive head impact in sports has increased interest and concern for clinicians, scientists, and athletes. Lacrosse is the fastest growing sport in the United States, but the burden of head impact in lacrosse is unknown. The goal of this pilot study was to quantify head impact associated with practicing and playing collegiate lacrosse while subjects were fitted with wearable accelerometers. Descriptive epidemiology study. In a single year, a collegiate cohort of 14 women's and 15 men's lacrosse players wore mastoid-patch accelerometers to measure the frequency and severity of head impacts during official practices and games. Average impact severity, mean number of impacts, and cumulative acceleration were evaluated, stratified by sport and event type. Men's and women's collegiate lacrosse players did not significantly differ in the number of head impacts received during games (11.5 for men vs 9.2 for women) or practices (3.1 vs 3.1). Men's lacrosse players had significantly higher average head acceleration per impact during games compared with women (21.1g vs 14.7g) but not during practices (21.3g vs 18.1g). For both men and women, more impacts occurred during games than during practices (men, 11.5 vs 3.1; women, 9.2 vs 3.1), but impact severity did not significantly differ between events for either sport (men, 21.1g vs 21.3g; women, 14.7g vs 18.1g). The study data suggest a higher impact burden during games compared with practices, but this effect is driven by the quantity rather than severity of impacts. In contrast, sex-based effects in impact burden are driven by average impact severity rather than quantity. Data collected from larger multisite trials and/or different age groups could be used to inform ongoing debates, including headgear and practice regulations, that might appreciably affect the burden of head impacts in lacrosse. While most head impacts do not result in a clinical diagnosis of concussion, evidence indicates that subconcussive head impacts may increase susceptibility to concussion and contribute to long-term neurodegeneration. © 2016 The Author(s).

Simulating soil organic carbon in a wheat–fallow system using the Daycent model

USDA-ARS?s Scientific Manuscript database

Crop management practices that contribute to soil organic carbon (SOC) sequestration can improve productivity and long-term sustainability. We present a modeling study on influence of (>80 years) various long-term crop residue and nutrient management practices on SOC dynamics under conventional and ...

Management and prevalence of long-term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population-based cohort study.

PubMed

Cooper, Sally-Ann; Hughes-McCormack, Laura; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, Marion; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

2018-01-01

In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term conditions was determined, and associated factors were investigated via logistic regression analyses. Adults with intellectual disabilities received significantly poorer management of all long-term conditions on 38/57 (66.7%) indicators. Achievement was high (75.1%-100%) for only 19.6% of adults with intellectual disabilities, compared with 76.8% of the general population. Adults with intellectual disabilities had higher rates of epilepsy, psychosis, hypothyroidism, asthma, diabetes and heart failure. There were no clear associations with neighbourhood deprivation. Adults with intellectual disabilities receive poorer care, despite conditions being more prevalent. The imperative now is to find practical, implementable means of supporting the challenges that general practices face in delivering equitable care. © 2017 John Wiley & Sons Ltd.

Model-Based Analysis of the Long-Term Effects of Fertilization Management on Cropland Soil Acidification.

PubMed

Zeng, Mufan; de Vries, Wim; Bonten, Luc T C; Zhu, Qichao; Hao, Tianxiang; Liu, Xuejun; Xu, Minggang; Shi, Xiaojun; Zhang, Fusuo; Shen, Jianbo

2017-04-04

Agricultural soil acidification in China is known to be caused by the over-application of nitrogen (N) fertilizers, but the long-term impacts of different fertilization practices on intensive cropland soil acidification are largely unknown. Here, we further developed the soil acidification model VSD+ for intensive agricultural systems and validated it against observed data from three long-term fertilization experiments in China. The model simulated well the changes in soil pH and base saturation over the last 20 years. The validated model was adopted to quantify the contribution of N and base cation (BC) fluxes to soil acidification. The net NO 3 - leaching and NO 4 + input accounted for 80% of the proton production under N application, whereas one-third of acid was produced by BC uptake when N was not applied. The simulated long-term (1990-2050) effects of different fertilizations on soil acidification showed that balanced N application combined with manure application avoids reduction of both soil pH and base saturation, while application of calcium nitrate and liming increases these two soil properties. Reducing NH 4 + input and NO 3 - leaching by optimizing N management and increasing BC inputs by manure application thus already seem to be effective approaches to mitigating soil acidification in intensive cropland systems.

Influence of long-term Sahaja Yoga meditation practice on emotional processing in the brain: An ERP study.

PubMed

Reva, N V; Pavlov, S V; Loktev, K V; Korenyok, V V; Aftanas, L I

2014-12-05

Despite growing interest in meditation as a tool for alternative therapy of stress-related and psychosomatic diseases, brain mechanisms of beneficial influences of meditation practice on health and quality of life are still unclear. We propose that the key point is a persistent change in emotional functioning, specifically the modulation of the early appraisal of motivational significance of events. The main aim was to study the effects of long-term meditation practice on event-related brain potentials (ERPs) during affective picture viewing. ERPs were recorded in 20 long-term Sahaja Yoga meditators and 20 control subjects without prior experience in meditation. The meditators' mid-latency (140-400ms) ERPs were attenuated for both positive and negative pictures (i.e. there were no arousal-related increases in ERP positivity) and this effect was more prominent over the right hemisphere. However, we found no differences in the long latency (400-800ms) responses to emotional images, associated with meditation practice. In addition we found stronger ERP negativity in the time window 200-300ms for meditators compared to the controls, regardless of picture valence. We assume that long-term meditation practice enhances frontal top-down control over fast automatic salience detection, based on amygdala functions. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

Impact of Water, Sanitation, and Hygiene Interventions on Improving Health Outcomes among School Children

PubMed Central

Joshi, Ashish

2013-01-01

Purpose. This review was done to explore the impact of water treatment, hygiene, and sanitary interventions on improving child health outcomes such as absenteeism, infections, knowledge, attitudes, and practices and adoption of point-of-use water treatment. Methods. A literature search was conducted using the databases PubMed and Google scholar for studies published between 2009 and 2012 and focusing on the effects of access to safe water, hand washing facilities, and hygiene education among school-age children. Studies included were those that documented the provision of water and sanitation in schools for children less than 18 years of age, interventions which assessed WASH practices, and English-language, full-text peer reviewed papers. Results. Fifteen studies were included in the final analysis. 73% (n = 11) of the studies were conducted in developing countries and were rural based (53%, n = 8). The child's age, gender, grade level, socioeconomic index, access to hygiene and sanitary facilities, and prior knowledge of hygiene practices were significantly associated with the outcomes. Nutrition practices which are key factors associated with the outcomes were rarely assessed. Conclusion. Further research is required to assess the long-term impact of such interventions in different settings. PMID:24454415

A qualitative study explaining nurses' perceptions of quality care for older people in long-term care settings in Ireland.

PubMed

Murphy, Kathy

2007-03-01

The aim of this research was to explore nurses' perceptions of the attributes of quality care and the factors that facilitate or hinder high-quality nursing care in long-term care. The quality of care for older people living in long-term care has been identified as an issue of concern in many nursing research studies. While many factors have been identified, it is difficult to determine key factors from current research. The study was a qualitative exploration of nurses' perceptions of quality care for older people and the factors that facilitate or hinder quality care. It involved 20 interviews with nurses. Respondents were asked to illustrate their accounts with examples from practice. This phase of the research was guided by the principles of hermeneutic phenomenology and the analysis process by Van Manen. The findings indicated that nurses perceived quality care for older people in Ireland as holistic, individualized and focused on promoting independence and choice. The research revealed, however, that care in many practice areas was not individualized, patient choice and involvement in decision making was limited and some areas engendered dependency. While staffing was identified as a factor which had an impact on the provision of patient choice, other issues, such as the motivation of staff, the role of the ward manager and the dominance of routine were also highlighted. There is a need to review organizational approaches to care, develop patient centred approaches to care and provide educational support for managers. This research focuses on care for older people; it helps practitioners identify key factors in the provision of quality care for older people living in long-term care.

Practical issues in the measurement of child survival in health systems trials: experience developing a digital community-based mortality surveillance programme in rural Nepal.

PubMed

Harsha Bangura, Alex; Ozonoff, Al; Citrin, David; Thapa, Poshan; Nirola, Isha; Maru, Sheela; Schwarz, Ryan; Raut, Anant; Belbase, Bishal; Halliday, Scott; Adhikari, Mukesh; Maru, Duncan

2016-01-01

Child mortality measurement is essential to the impact evaluation of maternal and child healthcare systems interventions. In the absence of vital statistics systems, however, assessment methodologies for locally relevant interventions are severely challenged. Methods for assessing the under-5 mortality rate for cross-country comparisons, often used in determining progress towards development targets, pose challenges to implementers and researchers trying to assess the population impact of targeted interventions at more local levels. Here, we discuss the programmatic approach we have taken to mortality measurement in the context of delivering healthcare via a public-private partnership in rural Nepal. Both government officials and the delivery organisation, Possible , felt it was important to understand child mortality at a fine-grain spatial and temporal level. We discuss both the short-term and the long-term approach. In the short term, the team chose to use the under-2 mortality rate as a metric for mortality measurement for the following reasons: (1) as overall childhood mortality declines, like it has in rural Nepal, deaths concentrate among children under the age of 2; (2) 2-year cohorts are shorter and thus may show an impact more readily in the short term of intervention trials; and (3) 2-year cohorts are smaller, making prospective census cohorts more feasible in small populations. In the long term, Possible developed a digital continuous surveillance system to capture deaths as they occur, at which point under-5 mortality assessment would be desirable, largely owing to its role as a global standard.

Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses.

PubMed

Saramma, P P; Raj, L Suja; Dash, P K; Sarma, P S

2016-04-01

Cardiopulmonary resuscitation (CPR) and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS) and advanced cardiac life support (ACLS) skills among them. However, very little data are available in the literature highlighting the long-term impact of these training. To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses. Tertiary care hospital, Prospective, repeated-measures design. A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3-4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses. SPSS for Windows version 21.0. The majority of the 206 nurses (93 CPR certified and 113 noncertified) were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000). However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140). Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification.

Modeling the effects of LID practices on streams health at watershed scale

NASA Astrophysics Data System (ADS)

Shannak, S.; Jaber, F. H.

2013-12-01

Increasing impervious covers due to urbanization will lead to an increase in runoff volumes, and eventually increase flooding. Stream channels adjust by widening and eroding stream bank which would impact downstream property negatively (Chin and Gregory, 2001). Also, urban runoff drains in sediment bank areas in what's known as riparian zones and constricts stream channels (Walsh, 2009). Both physical and chemical factors associated with urbanization such as high peak flows and low water quality further stress aquatic life and contribute to overall biological condition of urban streams (Maxted et al., 1995). While LID practices have been mentioned and studied in literature for stormwater management, they have not been studied in respect to reducing potential impact on stream health. To evaluate the performance and the effectiveness of LID practices at a watershed scale, sustainable detention pond, bioretention, and permeable pavement will be modeled at watershed scale. These measures affect the storm peak flows and base flow patterns over long periods, and there is a need to characterize their effect on stream bank and bed erosion, and aquatic life. These measures will create a linkage between urban watershed development and stream conditions specifically biological health. The first phase of this study is to design and construct LID practices at the Texas A&M AgriLife Research and Extension Center-Dallas, TX to collect field data about the performance of these practices on a smaller scale. The second phase consists of simulating the performance of LID practices on a watershed scale. This simulation presents a long term model (23 years) using SWAT to evaluate the potential impacts of these practices on; potential stream bank and bed erosion, and potential impact on aquatic life in the Blunn Watershed located in Austin, TX. Sub-daily time step model simulations will be developed to simulate the effectiveness of the three LID practices with respect to reducing potential erosion from stream beds and banks by studying annual average excess shear and reducing potential impact on aquatic life by studying rapid changes and variation in flow regimes in urban streams. This study will contribute to develop a methodology that evaluates the impact of hydrological changes that occur due to urban development, on aquatic life, stream bank and bed erosion. This is an ongoing research project and results will be shared and discussed at the conference.

Impact of spirometry feedback and brief motivational counseling on long term smoking outcomes: A comparison of smokers with and without lung impairment

PubMed Central

McClure, Jennifer B.; Ludman, Evette J.; Grothaus, Lou; Pabiniak, Chester; Richards, Julie

2009-01-01

Objective We compared long-term outcomes among smokers with and without impaired lung functioning who received brief counseling highlighting their spirometric test results. Methods Participants in this analysis all received a brief motivational intervention for smoking cessation including spirometric testing and feedback (~20 minutes), were advised to quit smoking, offered free access to a phone-based smoking cessation program, and followed for one year. Outcomes were analyzed for smokers with (n = 99) and without (n = 168) impaired lung function. Results Participants with lung impairment reported greater use of self-help cessation materials at 6 months, greater use of non-study-provided counseling services at 6 and 12 months, higher 7-day PPA rates at 6 months, and were more likely to talk with their doctor about their spirometry results. Conclusion Further research is warranted to determine if spirometry feedback has a differential treatment effect among smokers with and without lung impairment. Practice Implications It is premature to make practice recommendations based on these data. PMID:20434863

Link Worker social prescribing to improve health and well-being for people with long-term conditions: qualitative study of service user perceptions

PubMed Central

Moffatt, Suzanne; Steer, Mel; Lawson, Sarah; Penn, Linda; O’Brien, Nicola

2017-01-01

Objectives To describe the experiences of patients with long-term conditions who are referred to and engage with a Link Worker social prescribing programme and identify the impact of the Link Worker programme on health and well-being. Design Qualitative study using semistructured interviews with thematic analysis of the data. Intervention Link Worker social prescribing programme comprising personalised support to identify meaningful health and wellness goals, ongoing support to achieve agreed objectives and linkage into appropriate community services. Setting Inner-city area in West Newcastle upon Tyne, UK (population n=132 000) ranked 40th most socioeconomically deprived in England, served by 17 general practices. Participants Thirty adults with long-term conditions, 14 female, 16 male aged 40–74 years, mean age 62 years, 24 white British, 1 white Irish, 5 from black and minority ethnic communities. Results Most participants experienced multimorbidity combined with mental health problems, low self-confidence and social isolation. All were adversely affected physically, emotionally and socially by their health problems. The intervention engendered feelings of control and self-confidence, reduced social isolation and had a positive impact on health-related behaviours including weight loss, healthier eating and increased physical activity. Management of long-term conditions and mental health in the face of multimorbidity improved and participants reported greater resilience and more effective problem-solving strategies. Conclusions Findings suggest that tackling complex and long-term health problems requires an extensive holistic approach not possible in routine primary care. This model of social prescribing, which takes into account physical and mental health, and social and economic issues, was successful for patients who engaged with the service. Future research on a larger scale is required to assess when and for whom social prescribing is clinically effective and cost-effective. PMID:28713072

Link Worker social prescribing to improve health and well-being for people with long-term conditions: qualitative study of service user perceptions.

PubMed

Moffatt, Suzanne; Steer, Mel; Lawson, Sarah; Penn, Linda; O'Brien, Nicola

2017-07-16

To describe the experiences of patients with long-term conditions who are referred to and engage with a Link Worker social prescribing programme and identify the impact of the Link Worker programme on health and well-being. Qualitative study using semistructured interviews with thematic analysis of the data. Link Worker social prescribing programme comprising personalised support to identify meaningful health and wellness goals, ongoing support to achieve agreed objectives and linkage into appropriate community services. Inner-city area in West Newcastle upon Tyne, UK (population n=132 000) ranked 40th most socioeconomically deprived in England, served by 17 general practices. Thirty adults with long-term conditions, 14 female, 16 male aged 40-74 years, mean age 62 years, 24 white British, 1 white Irish, 5 from black and minority ethnic communities. Most participants experienced multimorbidity combined with mental health problems, low self-confidence and social isolation. All were adversely affected physically, emotionally and socially by their health problems. The intervention engendered feelings of control and self-confidence, reduced social isolation and had a positive impact on health-related behaviours including weight loss, healthier eating and increased physical activity. Management of long-term conditions and mental health in the face of multimorbidity improved and participants reported greater resilience and more effective problem-solving strategies. Findings suggest that tackling complex and long-term health problems requires an extensive holistic approach not possible in routine primary care. This model of social prescribing, which takes into account physical and mental health, and social and economic issues, was successful for patients who engaged with the service. Future research on a larger scale is required to assess when and for whom social prescribing is clinically effective and cost-effective. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Retrofitting LID Practices into Existing Neighborhoods: Is It Worth It?

NASA Astrophysics Data System (ADS)

Wright, Timothy J.; Liu, Yaoze; Carroll, Natalie J.; Ahiablame, Laurent M.; Engel, Bernard A.

2016-04-01

Low-impact development (LID) practices are gaining popularity as an approach to manage stormwater close to the source. LID practices reduce infrastructure requirements and help maintain hydrologic processes similar to predevelopment conditions. Studies have shown LID practices to be effective in reducing runoff and improving water quality. However, little has been done to aid decision makers in selecting the most effective practices for their needs and budgets. The long-term hydrologic impact assessment LID model was applied to four neighborhoods in Lafayette, Indiana using readily available data sources to compare LID practices by analyzing runoff volumes, implementation cost, and the approximate period needed to achieve payback on the investment. Depending on the LID practice and adoption level, 10-70 % reductions in runoff volumes could be achieved. The cost per cubic meter of runoff reduction was highly variable depending on the LID practice and the land use to which it was applied, ranging from around 3 to almost 600. In some cases the savings from reduced runoff volumes paid back the LID practice cost with interest in less than 3 years, while in other cases it was not possible to generate a payback. Decision makers need this information to establish realistic goals and make informed decisions regarding LID practices before moving into detailed designs, thereby saving time and resources.

Disaster risk assessment case study: Recent drought on the Navajo Nation, USA

USGS Publications Warehouse

Hiza, Margaret; Kelley, Klara B.; Francis, Harris; Block, Debra

2011-01-01

The Navajo Nation is an ecologically sensitive semi-arid to arid section of the southern Colorado Plateau. In this remote part of the United States, located at the Four Corners (Arizona, New Mexico, Colorado, and Utah), traditional people live a subsistence lifestyle that is inextricably tied to, and dependent upon, landscape conditions and water supplies. Soft bedrock lithologies and sand dunes dominate the region, making it highly sensitive to fluctuations in precipitation intensity, percent vegetation cover, and local land use practices. However, this region has sparse and discontinuous meteorological monitoring records. As a complement to the scant long-term meteorological records and historical documentation, we conducted interviews with 50 Native American elders from the Navajo Nation and compiled their lifetime observations on the changes in water availability, weather, and sand or dust storms. We then used these observations to further refine our understanding of the historical trends and impacts of climate change and drought for the region. In addition to altered landscape conditions due to climatic change, drought, and varying land use practices over the last 130 years, the Navajo people have been affected by federal policies and harsh economic conditions which weaken their cultural fabric. We conclude that a long-term drying trend and decreasing snowpack, superimposed on regional drought cycles, will magnify drought impacts on the Navajo Nation and leave its people increasingly vulnerable.

A model to advance nursing science in trauma practice and injury outcomes research.

PubMed

Richmond, Therese S; Aitken, Leanne M

2011-12-01

This discussion paper reports development of a model to advance nursing science and practice in trauma care based on an analysis of the literature and expert opinion. The continuum of clinical care provided to trauma patients extends from the time of injury through to long-term recovery and final outcomes. Nurses bring a unique expertise to meet the complex physical and psychosocial needs of trauma patients and their families to influence outcomes across this entire continuum. Literature was obtained by searching CINAHL, PubMed and OvidMedline databases for 1990-2010. Search terms included trauma, nursing, scope of practice and role, with results restricted to those published in English. Manual searches of relevant journals and websites were undertaken. Core concepts in this trauma outcomes model include environment, person/family, structured care settings, long-term outcomes and nursing interventions. The relationships between each of these concepts extend across all phases of care. Intermediate outcomes are achieved in each phase of care and influence and have congruence with long-term outcomes. Implications for policy and practice.  This model is intended to provide a framework to assist trauma nurses and researchers to consider the injured person in the context of the social, economic, cultural and physical environment from which they come and the long-term goals that each person has during recovery. The entire model requires testing in research and assessment of its practical contribution to practice. Planning and integrating care across the trauma continuum and recognition of the role of the injured person's background, family and resources will lead to improved long-term outcomes. © 2011 Blackwell Publishing Ltd.

Health economic evaluation of treatments for Alzheimer's disease: impact of new diagnostic criteria.

PubMed

Wimo, A; Ballard, C; Brayne, C; Gauthier, S; Handels, R; Jones, R W; Jonsson, L; Khachaturian, A S; Kramberger, M

2014-03-01

The socio-economic impact of Alzheimer's disease (AD) and other dementias is enormous, and the potential economic challenges ahead are clear given the projected future numbers of individuals with these conditions. Because of the high prevalence and cost of dementia, it is very important to assess any intervention from a cost-effectiveness viewpoint. The diagnostic criteria for preclinical AD suggested by the National Institute on Aging and Alzheimer's Association workgroups in combination with the goal of effective disease-modifying treatment (DMT) are, however, a challenge for clinical practice and for the design of clinical trials. Key issues for future cost-effectiveness studies include the following: (i) the consequences for patients if diagnosis is shifted from AD-dementia to predementia states, (ii) bridging the gap between clinical trial populations and patients treated in clinical practice, (iii) translation of clinical trial end-points into measures that are meaningful to patients and policymakers/payers and (iv) how to measure long-term effects. To improve cost-effectiveness studies, long-term population-based data on disease progression, costs and outcomes in clinical practice are needed not only in dementia but also in predementia states. Reliable surrogate end-points in clinical trials that are sensitive to detect effects even in predementia states are also essential as well as robust and validated modelling methods from predementia states that also take into account comorbidities and age. Finally, the ethical consequences of early diagnosis should be considered. © 2014 The Association for the Publication of the Journal of Internal Medicine.

Quality geriatric care as perceived by nurses in long-term and acute care settings.

PubMed

Barba, Beth Ellen; Hu, Jie; Efird, Jimmy

2012-03-01

This study focused on differences in nurses' satisfaction with the quality of care of older people and with organisational characteristics and work environment in acute care and long-term care settings. Numerous studies have explored links between nurses' satisfaction with care and work environments on the one hand and a variety of physical, behavioural and psychological reactions of nurses on the other. One key to keeping nurses in the workplace is a better understanding of nurses' satisfaction with the quality of care they provide. Descriptive design. The self-selected sample included 298 registered nurses and licensed practical nurses who provide care to minority, underserved and disadvantaged older populations in 89 long-term care and <100 bed hospitals in 38 rural counties and eight metropolitan areas in a Southern state. All completed the Agency Geriatric Nursing Care survey, which consisted of a 13-item scale measuring nurses' satisfaction with the quality of geriatric care in their practice settings and an 11-item scale examining obstacles to providing quality geriatric care. Demographic variables were compared with chi-square. Independent t-tests were used to examine differences between nurses in long-term care and acute care settings. Significant differences were found in level of satisfaction and perceived obstacles to providing quality care to older adults between participants from acute and long-term care. Participants in long-term care had greater satisfaction with the quality of geriatric care than those in acute facilities. Nurses in long-term care were more satisfied that care was evidence-based; specialised to individual needs of older adults; promoted autonomy and independence of elders; and was continuous across settings. Participants in acute facilities perceived more obstacles to providing quality geriatric care than nurses in long-term care facilities. Modification of hospital geriatric practice environments and leadership commitment to evidence-based practice guidelines that promote autonomy and independence of patients and staff could improve acute care nurses' perceptions of quality of geriatric care. © 2011 Blackwell Publishing Ltd.

Managing anorexia nervosa.

PubMed

Nicholls, Dasha; Hudson, Lee; Mahomed, Fermeda

2011-10-01

Clinical confidence and coordinated multidisciplinary care can influence the course of anorexia nervosa in children and adolescents. Sicker and younger patients with anorexia nervosa often present first to a paediatrician, requiring early recognition and appropriate management. Paediatric knowledge and skills are also needed to manage the impact of eating disorders on growth and development. This review provides practical guidance on the management of anorexia nervosa for paediatricians, in the areas of assessment, acute management and re-feeding, and long-term monitoring. In the absence of a strong evidence base for some of these recommendations, local protocols based on best practice guidelines can reduce anxiety, increase cooperation and reduce risk.

75 FR 52754 - Submission for OMB Review; Comment Request; Assessing the Long-Term Impacts of the John E...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... studies of the long-term impacts of Fogarty's research and training programs on educational institutions..., mechanical, or other technological collection techniques or other forms of information technology. Direct...

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

PubMed

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

2015-07-01

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

Current state of pediatric cardiac transplantation

PubMed Central

2018-01-01

Pediatric heart transplantation is standard of care for children with end-stage heart failure. The diverse age range, diagnoses, and practice variations continue to challenge the development of evidence-based practices and new technologies. Outcomes in the most recent era are excellent, especially with the more widespread use of ventricular assist devices (VADs). Waitlist mortality remains high and knowledge of risk factors for death while waiting and following transplantation contributes to decision-making around transplant candidacy and timing of listing. The biggest gap impacting both waitlist and overall survival remains mechanical support options for infants and patients with single ventricle physiology. Though acute rejection has decreased progressively, both diagnosis and management of antibody-mediated rejection has become increasingly challenging and complex, as has the ability to understand the implication of anti-HLA antibodies detected both pre- and post-transplantation—including when and how to intervene. Trends in immunosuppression protocols include more use of induction therapy and steroid avoidance or withdrawal protocols. Common long-term morbidities include renal insufficiency, which can be mitigated with surveillance and renal-sparing strategies, and infections. Functional outcomes are excellent, but significant psychosocial challenges exist in relation to neurodevelopment, non-adherence, and transition from child-centered to adult-centered care. Cardiac allograft vasculopathy (CAV) remains a barrier to long-term survival, though it is more apparent that objective evidence of an impact on the allograft is important with regards to impact on outcomes. Retransplantation is rare in pediatric heart transplant recipients. Pediatric heart transplantation continues to evolve in order to address the challenges of the diverse group of patients that reach end-stage heart failure during childhood. PMID:29492382

Fatigue, Pain, Anxiety and Depression in Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy.

PubMed

Merkies, Ingemar S J; Kieseier, Bernd C

2016-01-01

In the clinical evaluation of patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), scant attention is paid to symptoms such as fatigue, pain and anxiety/depression. We aimed at addressing seminal studies that focused on the burden of these symptoms and their impact on quality of life (QoL) in these conditions. Fatigue, pain, and anxiety/depression are increasingly being recognized in patients with GBS and CIDP, although their pathophysiological provenance remains unknown. Fatigue and pain are significant in terms of prevalence and intensity, may be a presenting symptom, and can persist for years after apparent functional recovery, suggesting residual injury. Anxiety/depression has also been examined although studies are limited. Despite their negative impact on QoL, the long-term dynamics of these symptoms in patients with GBS and particularly CIDP receiving therapy in routine clinical practice have not been systematically evaluated. Such observations formed the basis for the ongoing (GAMEDIS) studies evaluating the effect of Gamunex on fatigue and depression in patients with CIDP, of which some preliminary data are presented. Strength and sensory deficits are the main areas of focus in patients with GBS and CIDP, but they do not explain the total reduction in QoL, suggesting the possible role of other complaints. A more comprehensive approach to patient care demands that factors such as pain, fatigue and anxiety/depression receive greater attention. The non-interventional GAMEDIS studies are expected to provide valuable insight into the long-term effectiveness of Gamunex in everyday practice. © 2016 S. Karger AG, Basel.

Overview of escalator applications in rail transit

NASA Technical Reports Server (NTRS)

Deshpande, G.; Rubenstein, L.

1980-01-01

The difference in operating environment and in construction between escalators in transit and nontransit use, the impact of recent escalator innovations, and areas which could benefit from urban mass transportation administration sponsored research and development are determined. Several factors causing a more severe transit escalator operating environment are identified. There are no significant design differences between transit and nontransit escalators. Recent innovations that have affected performance and cost include outdoor escalators, extra flat steps at both landings, and modular escalators. Data were collected by interviews at transit agencies. Long term, unscheduled, escalator maintenance records were available for analysis from one property. A description of escalator operating principles is provided. Transit represents less than 5% of the U.S. escalator market. Transit agencies have limited leverage on escalator industry practices. A substantial impact on transit escalator cost and performance can be achieved by research identifying when and how to apply and specify several of the more recent innovations. Purchase of escalators under long term (25 year) maintenance contracts is one method that has been used to promote escalators manufactured for minimum life cycle cost.

What does it take to show that a cognitive training procedure is useful? A critical evaluation.

PubMed

Jacoby, Nori; Ahissar, Merav

2013-01-01

Individuals substantially improve with training, indicating that a large degree of plasticity is retained across ages. In the past 20 years, many studies explored the ability to boost cognitive skills (reasoning, linguistic abilities, working memory, and attention) by training with other tasks that exploit limited cognitive resources. Indeed, individuals with long-term training on challenging skills (musicians and action video gamers) show impressive behavior on related tasks (linguistic and visual attention, respectively). However, a critical evaluation of training studies that last weeks to months shows typically mild effects, mainly with respect to control groups that either did not practice or practiced with less challenging, rewarding, or exciting conditions. These findings suggest that future training studies should evaluate these factors carefully and assess whether they mainly impact the testing sessions or actual longer-term skills, and whether their impact can be further strengthened. The lack of a comprehensive theory of learning that integrates cognitive, motivational, and alertness aspects poses a bottleneck to improving current training procedures. © 2013 Elsevier B.V. All rights reserved.

Retrieval practice in the form of online homework improved information retention more when spaced 5 days rather than 1 day after class in two physiology courses.

PubMed

Cadaret, Caitlin N; Yates, Dustin T

2018-06-01

Studies have shown that practicing temporally spaced retrieval of previously learned information via formal assessments increases student retention of the information. Our objective was to determine the impact of online homework administered as a first retrieval practice 1 or 5 days after introduction of physiology topics on long-term information retention. Students in two undergraduate courses, Anatomy and Physiology (ASCI 240) and Animal Physiological Systems (ASCI 340), were presented with information on a specific physiological system during each weekly laboratory and then completed an online homework assignment either 1 or 5 days later. Information retention was assessed via an in-class quiz the following week and by a comprehensive final exam at semester's end (4-13 wk later). Performance on homework assignments was generally similar between groups for both courses. Information retention at 1 wk did not differ due to timing of homework in either course. In both courses, however, students who received homework 5 days after class performed better on final exam questions relevant to that week's topic compared with their day 1 counterparts. These findings indicate that the longer period between introducing physiology information in class and assigning the first retrieval practice was more beneficial to long-term information retention than the shorter period, despite seemingly equivalent benefits in the shorter term. Since information is typically forgotten over time, we speculate that the longer interval necessitates greater retrieval effort in much the same way as built-in desirable difficulties, thus allowing for stronger conceptual connections and deeper comprehension.

The Role of Pest Control Advisers in Preventative Management of Grapevine Trunk Diseases.

PubMed

Hillis, Vicken; Lubell, Mark; Kaplan, Jonathan; Doll, David; Baumgartner, Kendra

2016-04-01

Vineyards with trunk diseases (Botryosphaeria dieback, Esca, Eutypa dieback, and Phomopsis dieback) can have negative returns in the long run. Minimizing economic impacts depends on effective management, but adopting a preventative practice after infection occurs may not improve yields. Pest control advisers may reduce grower uncertainty about the efficacy of and need for prevention, which often entails future and unobservable benefits. Here, we surveyed advisers in California to examine their influence over grower decision-making, in the context of trunk diseases, which significantly limit grape production and for which curative practices are unavailable. Our online survey revealed adviser awareness of high disease incidence, and reduced yields and vineyard lifespan. Advisers rated both preventative and postinfection practices positively. Despite higher cost estimates given to postinfection practices, advisers did not recommend preventative practices at higher rates. High recommendation rates were instead correlated with high disease incidence for both preventative and postinfection practices. Recommendation rates declined with increasing cost for preventative, but not for postinfection, practices. Our findings suggest that even when advisers acknowledge the risks of trunk diseases, they may not recommend preventative practices before infection occurs. This underscores the importance of clear outreach, emphasizing both the need for prevention and its long-term cost efficacy.

End-task versus in-task feedback to increase procedural learning retention during spinal anaesthesia training of novices.

PubMed

Lean, Lyn Li; Hong, Ryan Yee Shiun; Ti, Lian Kah

2017-08-01

Communication of feedback during teaching of practical procedures is a fine balance of structure and timing. We investigate if continuous in-task (IT) or end-task feedback (ET) is more effective in teaching spinal anaesthesia to medical students. End-task feedback was hypothesized to improve both short-term and long-term procedural learning retention as experiential learning promotes active learning after encountering errors during practice. Upon exposure to a 5-min instructional video, students randomized to IT or ET feedbacks were trained using a spinal simulator mannequin. A blinded expert tested the students using a spinal anaesthesia checklist in the short term (immediate) and long-term (average 4 months). Sixty-five students completed the training and testing. There were no differences in demographics of age or gender within IT or ET distributions. Both short-term and long-term learning retention of spinal anaesthesia ET feedback proved to be better (P < 0.01) than IT feedback. The time taken for ET students was shorter at long-term testing. End-task feedback improves both short-term and long-term procedural learning retention.

36 CFR 294.44 - Prohibition on linear construction zones.

Code of Federal Regulations, 2013 CFR

2013-07-01

... zone will not diminish, over the long-term, conditions in the water influence zone and the extent of... diminish, over the long-term, roadless area characteristics; and (6) That watershed conservation practices... area characteristics over the long-term. Upon completion of the installation of a linear facility via...

36 CFR 294.44 - Prohibition on linear construction zones.

Code of Federal Regulations, 2014 CFR

2014-07-01

... zone will not diminish, over the long-term, conditions in the water influence zone and the extent of... diminish, over the long-term, roadless area characteristics; and (6) That watershed conservation practices... area characteristics over the long-term. Upon completion of the installation of a linear facility via...

Application of a forest-simulation model to assess the energy yield and ecological impact of forest utilization for energy

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

Doyle, T W; Shugart, H H; West, D C

1981-01-01

This study examines the utilization and management of natural forest lands to meet growing wood-energy demands. An application of a forest simulation model is described for assessing energy returns and long-term ecological impacts of wood-energy harvesting under four general silvicultural practices. Results indicate that moderate energy yields could be expected from mild cutting operations which would significantly effect neither the commercial timber market nor the composition, structure, or diversity of these forests. Forest models can provide an effective tool for determining optimal management strategies that maximize energy returns, minimize environmental detriment, and complement existing land-use plans.

Supporting evidence-based practice for nurses through information technologies.

PubMed

Doran, Diane M; Haynes, R Brian; Kushniruk, André; Straus, Sharon; Grimshaw, Jeremy; Hall, Linda McGillis; Dubrowski, Adam; Di Pietro, Tammie; Newman, Kristine; Almost, Joan; Nguyen, Ha; Carryer, Jennifer; Jedras, Dawn

2010-03-01

To evaluate the usability of mobile information terminals, such as personal digital assistants (PDAs) or Tablet personal computers, to improve access to information resources for nurses and to explore the relationship between PDA or Tablet-supported information resources and outcomes. The authors evaluated an initiative of the Nursing Secretariat, Ontario Ministry of Health and Long-Term Care, which provided nurses with PDAs and Tablet PCs, to enable Internet access to information resources. Nurses had access to drug and medical reference information, best practice guidelines (BPGs), and to abstracts of recent research studies. The authors took place over a 12-month period. Diffusion of Innovation theory and the Promoting Action on Research Implementation in Health Services (PARIHS) model guided the selection of variables for study. A longitudinal design involving questionnaires was used to evaluate the impact of the mobile technologies on barriers to research utilization, perceived quality of care, and on nurses' job satisfaction. The setting was 29 acute care, long-term care, home care, and correctional organizations in Ontario, Canada. The sample consisted of 488 frontline-nurses. Nurses most frequently consulted drug and medical reference information, Google, and Nursing PLUS. Overall, nurses were most satisfied with the Registered Nurses Association of Ontario (RNAO) BPGs and rated the RNAO BPGs as the easiest resource to use. Among the PDA and Tablet users, there was a significant improvement in research awareness/values, and in communication of research. There was also, for the PDA users only, a significant improvement over time in perceived quality of care and job satisfaction, but primarily in long-term care settings. It is feasible to provide nurses with access to evidence-based practice resources via mobile information technologies to reduce the barriers to research utilization.

Post-fire logging produces minimal persistent impacts on understory vegetation in northeastern Oregon, USA

Treesearch

David W. Peterson; Erich Dodson

2016-01-01

Post-fire forest management commonly requires accepting some negative ecological impacts from management activities in order to achieve management objectives. Managers need to know, however, whether ecological impacts from post-fire management activities are transient or cause long-term ecosystem degradation. We studied the long-term response of understory vegetation...

Study Abroad for Global Engagement: The Long-Term Impact of Mobility Experiences

ERIC Educational Resources Information Center

Paige, R. Michael; Fry, Gerald W.; Stallman, Elizabeth M.; Josic, Jasmina; Jon, Jae-Eun

2009-01-01

This paper reports on the preliminary results of a research project "'Beyond immediate impact: Study abroad for global engagement' (SAGE)" which examines the long-term impact of study abroad on various forms of global engagement. The study employs a retrospective tracer study and mixed methods research design. Survey results from 6391 study-abroad…

The Results of Short-Term Bilingual Exchanges Keep on Ticking: Long-Term Impacts of Brief Bilingual Exchanges

ERIC Educational Resources Information Center

Mady, Callie

2011-01-01

This article presents the long-term impacts of brief bilingual (English/French) exchanges as identified by past exchange participants through questionnaire and interview responses. The findings indicate that former exchange participants (a) have confidence in their language abilities, (b) continue to use their second language, (c) choose leisure…

Upweighting rare favourable alleles increases long-term genetic gain in genomic selection programs.

PubMed

Liu, Huiming; Meuwissen, Theo H E; Sørensen, Anders C; Berg, Peer

2015-03-21

The short-term impact of using different genomic prediction (GP) models in genomic selection has been intensively studied, but their long-term impact is poorly understood. Furthermore, long-term genetic gain of genomic selection is expected to improve by using Jannink's weighting (JW) method, in which rare favourable marker alleles are upweighted in the selection criterion. In this paper, we extend the JW method by including an additional parameter to decrease the emphasis on rare favourable alleles over the time horizon, with the purpose of further improving the long-term genetic gain. We call this new method dynamic weighting (DW). The paper explores the long-term impact of different GP models with or without weighting methods. Different selection criteria were tested by simulating a population of 500 animals with truncation selection of five males and 50 females. Selection criteria included unweighted and weighted genomic estimated breeding values using the JW or DW methods, for which ridge regression (RR) and Bayesian lasso (BL) were used to estimate marker effects. The impacts of these selection criteria were compared under three genetic architectures, i.e. varying numbers of QTL for the trait and for two time horizons of 15 (TH15) or 40 (TH40) generations. For unweighted GP, BL resulted in up to 21.4% higher long-term genetic gain and 23.5% lower rate of inbreeding under TH40 than RR. For weighted GP, DW resulted in 1.3 to 5.5% higher long-term gain compared to unweighted GP. JW, however, showed a 6.8% lower long-term genetic gain relative to unweighted GP when BL was used to estimate the marker effects. Under TH40, both DW and JW obtained significantly higher genetic gain than unweighted GP. With DW, the long-term genetic gain was increased by up to 30.8% relative to unweighted GP, and also increased by 8% relative to JW, although at the expense of a lower short-term gain. Irrespective of the number of QTL simulated, BL is superior to RR in maintaining genetic variance and therefore results in higher long-term genetic gain. Moreover, DW is a promising method with which high long-term genetic gain can be expected within a fixed time frame.

The future of pharmacy practice research - Perspectives of academics and practitioners from Australia, NZ, United Kingdom, Canada and USA.

PubMed

Babar, Zaheer-Ud-Din; Scahill, Shane; Nagaria, Raveena Amee; Curley, Louise E

2018-01-11

Healthcare is under significant pressure with the explosion of long term conditions, shift in worldwide demographics and is evolving through advances in technology. Aligned with this is the changing role of pharmacy from the traditional dispenser of medicines to having (in addition) a more advanced clinical role. This study aimed to understand what the pharmacy practice research agenda might look like from the viewpoint of pharmacy academics and practitioners across five high-income countries. Qualitative methods were used, and thirty one-hour interviews were undertaken with practitioners and academics from five economically advanced countries. These nations have comparable socio-economic status but differing health systems and include; Australia, Canada, New Zealand, United Kingdom and United States of America. Six key informants were chosen from each country, three academics and three community pharmacists. A general inductive analysis was undertaken to analyse the most common and recurring themes. These themes of research were based around current community pharmacy practice issues and the enablers to changing the profession. Specific areas pharmacy practice could be more involved with included long term health conditions. Some community pharmacists also believed that research into the impact of professional standards and policy change would be beneficial. The findings of this research suggest that current pharmacy practice research methods are sufficient, but need to be used more effectively. Participants identified a wide range of issues within community pharmacy practice. Academics largely focused on how research can be utilised in the community and how to implement findings to ensure sustainability of pharmacy practice research. Issues that community pharmacists would like to research are related to the current practice model, such as allocating time to provide patient-focused services in addition to managing a business. Copyright © 2018 Elsevier Inc. All rights reserved.

Messages, limitations and future needs of research into environmental impacts and mitigating and remediation measures of oil palm and forest land-use and land management in SE Asia

NASA Astrophysics Data System (ADS)

Walsh, Rory; Bidin, Kawi; Nurhidayu, Siti; Nainar, Anand; Annammala, Kogilavani; Blake, William; Higton, Sam; Wall, Katy; Darling, Isabella

2017-04-01

Oil palm and forest logging land-uses have expanded immensely in recent decades in SE Asia and other parts of the humid tropics - and increasingly into steeplands where adverse biophysical in situ and downstream impacts are particularly severe. With a focus on recent and current projects in Sabah (Malaysian Borneo) and Peninsular Malaysia, this paper examines the changing nature of research foci and approaches of research projects to assess impacts and develop and test mitigation strategies. Early projects focussed on comparing slope- and catchment-scale hydrology and erosion of selectively logged forest and primary forest and on ways of reducing logging impacts. The second phase of research focussed increasingly on (1) longer-term recovery from logging and (2) the likely impacts of climate change. With repeat logging and conversion of areas of forest to oil palm (and conservation of remaining primary forest was secured), the focus of attention has moved to (1) assessing impacts of oil palm conversion and land management practices, (2) testing existing (and potentially more effective) Roundtable for Sustainable Palm Oil (RSPO) guidelines and Government Regulations aimed at reducing impacts and (3) developing and testing ways of restoring and rehabilitating forest within both badly degraded logged forest areas and largely oil palm landscapes - with attention focussed on the landscape scale, the long-term, downstream as well as in situ impacts and the more vulnerable steepland areas. Two multidisciplinary umbrella projects - the SAFE (Stability of Altered Forest Ecosystems) Project and the SEnSOR Programme - have formed the backbone of this latest phase. The SAFE Project is a ten-year programme assessing the effectiveness of retention of differing widths of riparian forest buffers and different- sized forest 'islands' within converted oil palm landscapes in reducing their adverse ecological, emissions, hydrological, erosional and water pollution impacts. The SEnSOR Programme is specifically testing the effectiveness of RSPO guidelines and possible improved land management measures. After a brief overview of some of the approaches and key findings of these studies, the paper focuses on some of the advantages, limitations and future needs of these studies. Important features of the projects are (1) the involvement of industry, Government and local people from the start in the projects, (2) the focus on the landscape scale and long-term (for example with use of current monitoring as well as a historical approach involving sediment dating and fingerprinting), (3) simultaneous consideration of impacts on a wide variety of environmental impacts, as impacts of land management practices can be beneficial to some but adverse to others. Key limitations and needs are then identified and discussed. The most important of these include how to reconcile the sometimes conflicting impacts of land management practices (and remedial measures) on different environmental parameters and concerns - what is good for Peter is sometimes very bad for Paul. A key need identified, therefore, is for methodologies to evaluate comparative environmental and socioeconomic benefits and costs of sometimes conflicting or alternative land management practices and options that emerge from usually separate scientific investigations of how to reduce impacts of, for example, soil erosion, landslide risk, streamwater pollution, atmospheric emissions, river ecology and landscape biodiversity (and its components). There is also a key need for involvement of social scientists in projects.

Futility, autonomy, and informed consent.

PubMed

Trau, J M

1994-03-01

If clinicians deem a treatment medically futile, is it appropriate to mention such a treatment to patients? Do healthcare professionals violate informed consent if they do not offer patients an opportunity to decline futile treatments? The notion of futility involves an assessment of patient best interest--both short-term and long-term therapeutic benefit for a patient and the community in which he or she intends to survive and flourish. Although survival interests may be construed as long term, a treatment that offers survival without any promise of flourishing is not the goal of medicine and is futile. Flourishing requires some cognitive and affective function. The goal of informed consent practices is to ensure that patients accept the benefits of treatment with cognizance of the burdens and risks. Given the impact of illness on the emotional and psychological states of patients and their families and their resultant vulnerability, the omission of futile options from treatment plans is logical and exemplifies the best of paternalistic behavior. The claim that requests for futile treatment must be honored is based on a perverse understanding of patient autonomy. Rational medicine demands that patients' requests be reasonable from a clinical perspective, as well as from a subjective one. The practice of informed consent can be implemented as a balance between these two interests.

Checklist Model to Improve Work Practices in Small-Scale Demolition Operations with Silica Dust Exposures

PubMed Central

Muianga, Custodio; Rice, Carol; Lentz, Thomas; Lockey, James; Niemeier, Richard; Succop, Paul

2012-01-01

A systematic approach was developed to review, revise and adapt existing exposure control guidance used in developed countries for use in developing countries. One-page employee and multiple-page supervisor guidance sheets were adapted from existing documents using a logic framework and workers were trained to use the information to improve work practices. Interactive, hands-on training was delivered to 26 workers at five small-scale demolition projects in Maputo City, Mozambique, and evaluated. A pre-and-post walkthrough survey used by trained observers documented work practice changes. Worker feedback indicated that the training was effective and useful. Workers acquired knowledge (84% increase, p < 0.01) and applied the work practice guidance. The difference of proportions between use of work practice components before and after the intervention was statistically significant (p < 0.05). Changes in work practices following training included preplanning, use of wet methods and natural ventilation and end-of-task review. Respirable dust measurements indicated a reduction in exposure following training. Consistency in observer ratings and observations support the reliability and validity of the instruments. This approach demonstrated the short-term benefit of training in changing work practices; follow-up is required to determine the long-term impact on changes in work practices, and to evaluate the need for refresher training. PMID:22470296

Baseline Management Practices at Providers in Better Jobs Better Care

ERIC Educational Resources Information Center

Stott, Amy L.; Brannon, S. Diane; Vasey, Joseph; Dansky, Kathryn H.; Kemper, Peter

2007-01-01

High turnover and difficult recruitment of direct care workers are challenges for long-term care providers. This study reports the extent and variation of the use of management practices for direct care workers and their supervisors across four long-term care settings in the Better Jobs Better Care demonstration. Overall, there is limited use of…

Simulating Soil Organic Matter with CQESTR (v.2.0): Model Description and Validation against Long-term Experiments across North America

USDA-ARS?s Scientific Manuscript database

Soil carbon (C) models are important tools for examining complex interactions between climate, crop and soil management practices, and to evaluate the long-term effects of management practices on C-storage potential in soils. CQESTR is a process-based carbon balance model that relates crop residue a...

Long-term N fertilization and conservation tillage practices conserve surface but not profile SOC stocks under semi-arid irrigated corn

USDA-ARS?s Scientific Manuscript database

No tillage (NT) and N fertilization can increase surface soil organic C (SOC) stocks, but the effects deeper in the soil profile are uncertain. Subsequent tillage could counter SOC stabilized through NT practices by disrupting soil aggregation and promoting decomposition. We followed a long-term ti...

Practice variation in the Dutch long-term care and the role of supply-sensitive care: Is access to the Dutch long-term care equitable?

PubMed

Duell, Daisy; Koolman, Xander; Portrait, France

2017-12-01

Universal access and generous coverage are important goals of the Dutch long-term care (LTC) system. It is a legal requirement that everyone eligible for LTC should be able to receive it. Institutional care (IC) made up for 90% of Dutch LTC spending. To investigate whether access to IC is as equitable as the Dutch government aspires, we explored practice variation in entitlements to IC across Dutch regions. We used a unique dataset that included all individual applications for Dutch LTC in January 2010-December 2013 (N = 3,373,358). This dataset enabled an accurate identification of the need for care. We examined the local variation in the probability of being granted long-term IC and in the intensity of the care granted given that individuals have applied for LTC. We also investigated whether the variation observed was related to differences in the local availability of care facilities. Although our analyses indicated the presence of some practice variation, its magnitude was very small by national and international standards (up to 3%). Only a minor part of the practice variation could be accounted for by local supply differences in care facilities. Overall, we conclude that, unlike many other developed countries, the Dutch system ensured equitable access to long-term IC. © 2017 The Authors. Health Economics Published by John Wiley & Sons Ltd.

Perinatal support to protect maternal mental health.

PubMed

McCaul, Anthony; Stokes, Jayne

Family Action is a charity that helps more than 45,000 vulnerable families and children across England a year by offering emotional, practical and financial support. A pilot of a perinatal support project in Southwark, London was found to reduce mental health problems in vulnerable women and is now being extended. Such schemes complement the work of health visitors and other health professionals. Commissioners need to be aware of the long-term impact of such low-cost interventions in the early years.

'I didn't know why you had to wait': an evaluation of NHS infant-feeding workshops amongst women living in areas of high deprivation.

PubMed

Andrews, E J; Symon, A; Anderson, A S

2015-12-01

Inappropriate maternal and infant-feeding practices are known to have a major impact on morbidity in infancy, childhood and later life. Ring-fenced funding over 3 years from the Scottish Government to the National Health Service (NHS) in Scotland has allowed the development of a range of nutrition interventions for women of childbearing age and infants living in areas of deprivation to help address these issues. The present study aimed to determine mothers' knowledge of appropriate infant-feeding practices, opinions about feeding advice and any changes in practice following attendance at workshops. Fifteen semi-structured interviews with women who participated in NHS infant-feeding workshops. Verbatim transcripts were analysed using framework analysis. Participants appreciated the opportunity to enhance their knowledge and there was evidence of a reasonable understanding and awareness of appropriate infant-feeding behaviours following workshop attendance. However, the findings highlight the challenge of multiple sources of advice and identify persistent uncertainties about feeding practice. Reported feeding behaviour following workshops was encouraging (e.g. delayed weaning, increased use of -prepared fruits and vegetables), although there was also evidence of resistance to change. The legacy of the workshop in terms of reported confidence in infant feeding was also apparent. The workshops appears to aid current knowledge and practice about infant feeding but further work is needed to examine the long term impact of these interventions on maternal and infant dietary behaviours. © 2014 The British Dietetic Association Ltd.

Evaluation of a Short-term Training Program in Bedside Emergency Ultrasound in Southwestern Tanzania.

PubMed

Shaffer, Mark; Brown, Heather A; McCoy, Chloé; Bashaka, Prosper

2017-03-01

To evaluate the effect of a short-term training program in emergency ultrasound on physician skills and attitudes in southwestern Tanzania. Eight registrar physicians at Mbeya Zonal Referral Hospital (Mbeya, Tanzania) underwent a 5-day course in bedside emergency ultrasound, focusing primarily on the focused assessment with sonography for trauma examination, including didactic sessions, practical sessions, and on-job training. The impact on ultrasound knowledge was assessed by pretest and posttest evaluations. Provider skill was evaluated by a standardized observed simulated patient encounter. Attitudes toward ultrasound training, utility, and self-confidence were assessed by a post-training questionnaire. All 8 physicians who began the training completed the course and successfully passed their objective structured clinical examination. There was a statistically significant improvement in written ultrasound test scores from 31% to 66% (P < .01) after the course. Most trainees felt confident performing and interpreting a basic focused assessment with sonography for trauma examination at the end of the course, and 7 of 8 stated that they would consider paying tuition for similar courses in the future. Main concerns with the course revolved around insufficient time dedicated to practicing under supervision. Registrar physicians in Tanzania can effectively learn basic emergency ultrasound skills in a short-term training program. Similar future programs may consider heavier emphasis on practical hands-on training with experts. Ongoing data collection is required to understand the true impact of such training on long-term ultrasound use and patient outcomes. © 2017 by the American Institute of Ultrasound in Medicine.

Descriptive Characteristics of Long-Term Private Practice Psychotherapy Clients.

ERIC Educational Resources Information Center

Koss, Mary P.

Data from public and private sectors reveal that few persons stay in psychotherapy long enough to be classified as "long-term" clients. Those who do remain in psychotherapy for a long time are rarely studied because attention has generally been focused on terminators. Demographic, treatment, and psychometric characteristics of 64 long-term…

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...

Episodic Disturbance from Boat Anchoring Is a Major Contributor to, but Does Not Alter the Trajectory of, Long-Term Coral Reef Decline.

PubMed

Forrester, Graham E; Flynn, Rebecca L; Forrester, Linda M; Jarecki, Lianna L

2015-01-01

Isolating the relative effects of episodic disturbances and chronic stressors on long-term community change is challenging. We assessed the impact of an episodic disturbance associated with human visitation (boat anchoring) relative to other drivers of long-term change on coral reefs. A one-time anchoring event at Crab Cove, British Virgin Islands, in 2004 caused rapid losses of coral and reef structural complexity that were equal to the cumulative decline over 23 years observed at an adjacent site. The abundance of small site-attached reef fishes dropped by approximately one quarter after the anchoring event, but this drop was not immediate and only fully apparent two years after the anchoring event. There was no obvious recovery from the impact, and no evidence that this episodic impact accelerated or retarded subsequent declines from other causes. This apparent lack of synergism between the effect of this episodic human impact and other chronic stressors is consistent with the few other long-term studies of episodic impacts, and suggests that action to mitigate anchor damage should yield predictable benefits.

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

PubMed

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

2016-04-15

Plastic mulching has become a globally applied agricultural practice for its instant economic benefits such as higher yields, earlier harvests, improved fruit quality and increased water-use efficiency. However, knowledge of the sustainability of plastic mulching remains vague in terms of both an environmental and agronomic perspective. This review critically discusses the current understanding of the environmental impact of plastic mulch use by linking knowledge of agricultural benefits and research on the life cycle of plastic mulches with direct and indirect implications for long-term soil quality and ecosystem services. Adverse effects may arise from plastic additives, enhanced pesticide runoff and plastic residues likely to fragment into microplastics but remaining chemically intact and accumulating in soil where they can successively sorb agrochemicals. The quantification of microplastics in soil remains challenging due to the lack of appropriate analytical techniques. The cost and effort of recovering and recycling used mulching films may offset the aforementioned benefits in the long term. However, comparative and long-term agronomic assessments have not yet been conducted. Furthermore, plastic mulches have the potential to alter soil quality by shifting the edaphic biocoenosis (e.g. towards mycotoxigenic fungi), accelerate C/N metabolism eventually depleting soil organic matter stocks, increase soil water repellency and favour the release of greenhouse gases. A substantial process understanding of the interactions between the soil microclimate, water supply and biological activity under plastic mulches is still lacking but required to estimate potential risks for long-term soil quality. Currently, farmers mostly base their decision to apply plastic mulches rather on expected short-term benefits than on the consideration of long-term consequences. Future interdisciplinary research should therefore gain a deeper understanding of the incentives for farmers and public perception from both a psychological and economic perspective in order to develop new support strategies for the transition into a more environment-friendly food production. Copyright © 2016 Elsevier B.V. All rights reserved.

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...

[Long-term therapy of osteoarthritis of the hip and the knee by sulindac (a cooperative trial in general practice) (author's transl)].

PubMed

Maestracci, D; Sarre, J

Long-term trial of sulindac (in general practice): 2,040 patients with osteoarthritis of the hip or of the knee been treated, 86,5% of them have been following the treatment for one year. This trial let us pointing out the non-improverishment of effectiveness of sulindac and the keepint of its good tolerance for long term. Some epidemiological data have been collected, among which: the importance of ponderal overload in patients studied and the prevalence of the right joints diseases on the left one's.

Capacity, responsibility, and motivation: a critical qualitative evaluation of patient and practitioner views about barriers to self-management in people with multimorbidity.

PubMed

Coventry, Peter A; Fisher, Louise; Kenning, Cassandra; Bee, Penny; Bower, Peter

2014-10-31

Primary care is increasingly focussed on the care of people with two or more long-term conditions (multimorbidity). The UK Department of Health strategy for long term conditions is to use self-management support for the majority of patients but there is evidence of limited engagement among primary care professionals and patients with multimorbidity. Furthermore, multimorbidity is more common in areas of socioeconomic deprivation but deprivation may act as a barrier to patient engagement in self-management practices. Effective self-management is considered critical to meet the needs of people living with long term conditions but achieving this is a significant challenge in patients with multimorbidity. This study aimed to explore patient and practitioner views on factors influencing engagement in self-management in the context of multimorbidity. A qualitative study using individual semi-structured interviews with 20 patients and 20 practitioners drawn from four general practices in Greater Manchester situated in areas of high and low social deprivation. Three main factors were identified as influencing patient engagement in self-management: capacity (access and availability of socio-economic resources and time; knowledge; and emotional and physical energy), responsibility (the degree to which patients and practitioners agreed about the division of labour about chronic disease management, including self-management) and motivation (willingness to take-up types of self-management practices). Socioeconomic deprivation negatively impacted on all three factors. Motivation was especially reduced in the presence of mental and physical multimorbidity. Full engagement in self-management practices in multimorbidity was only present where patients' articulated a sense of capacity, responsibility, and motivation. Patient 'know-how' or interpretive capacity to self-manage multimorbidity is potentially an important precursor to responsibility and motivation, and might be a critical target for intervention. However, individual and social resources are needed to generate capacity, responsibility, and motivation for self-management, pointing to a balanced role for health services and wider enabling networks.

Strategic Communication Intervention to Stimulate Interest in Research and Evidence-Based Practice: A 12-Year Follow-Up Study With Registered Nurses.

PubMed

Morténius, Helena; Hildingh, Cathrine; Fridlund, Bengt

2016-02-01

Bridging the research-practice gap is a challenge for health care. Fostering awareness of and interest in research and development (R & D) can serve as a platform to help nurses and others bridge this gap. Strategic communication is an interdisciplinary field that has been used to achieve long-term interest in adopting and applying R & D in primary care. The aim of the study was to evaluate the impact of a strategic communication intervention on long-term interest in R & D among primary care staff members (PCSMs) in general and registered nurses (RNs) in particular. This prospective intervention study included all members of the PCSMs, including RNs, in a Swedish primary care area. The interest of PCSMs in R & D was measured on two occasions, at 7 and 12 years, using both bivariate and multivariate tests. A total of 99.5% of RNs gained awareness of R & D after the first 7 years of intervention versus 95% of the remaining PCSMs (p = .004). A comparison of the two measurements ascertained stability and improvement of interest in R & D among RNs, compared with all other PCSMs (odds ratio 1.81; confidence interval 1.08-3.06). Moreover, the RNs who did become interested in R & D also demonstrated increased intention to adopt innovative thinking in their work over time (p = .005). RNs play an important role in reducing the gap between theory and practice. Strategic communication was a significant tool for inspiring interest in R & D. Application of this platform to generate interest in R & D is a unique intervention and should be recognized for future interventions in primary care. Positive attitudes toward R & D may reinforce the use of evidence-based practice in health care, thereby making a long-term contribution to the patient benefit. © 2015 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

Lessons from Honors: National Scholarships, High-Impact Practices, and Student Success

ERIC Educational Resources Information Center

Cobane, Craig T.; Jennings, Audra

2017-01-01

High-impact educational practices (HIPs) have long been central to honors pedagogy. From undergraduate research to service learning, study abroad, internships, and writing-intensive courses, these practices shape the honors educational experience and influence retention successes in honors. These practices also inform the synergy between honors…

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.

An Instrument for Every Child: A Study on Long-Term Effects of Extended Music Education in German Primary Schools

ERIC Educational Resources Information Center

Krupp-Schleußner, Valerie; Lehmann-Wermser, Andreas

2018-01-01

Does extended music education during primary school foster long-term musical participation? What other factors contribute to long-term musical participation? In our study on "Impacts and Long-Term Effects of Musical Participation," we investigate how the German programme "An Instrument for Every Child (JeKi)," which fosters the…

Short-term and long-term plasticity in the visual-attention system: Evidence from habituation of attentional capture.

PubMed

Turatto, Massimo; Pascucci, David

2016-04-01

Attention is known to be crucial for learning and to regulate activity-dependent brain plasticity. Here we report the opposite scenario, with plasticity affecting the onset-driven automatic deployment of spatial attention. Specifically, we showed that attentional capture is subject to habituation, a fundamental form of plasticity consisting in a response decrement to repeated stimulations. Participants performed a visual discrimination task with focused attention, while being occasionally exposed to a distractor consisting of a high-luminance peripheral onset. With practice, short-term and long-term habituation of attentional capture emerged, making the visual-attention system fully immune to distraction. Furthermore, spontaneous recovery of attentional capture was found when the distractor was temporarily removed. Capture, however, once habituated was surprisingly resistant to spontaneous recovery, taking from several minutes to days to recover. The results suggest that the mechanisms subserving exogenous attentional orienting are subject to profound and enduring plastic changes based on previous experience, and that habituation can impact high-order cognitive functions. Copyright © 2016 Elsevier Inc. All rights reserved.

The Long-Term Impacts of Teachers: Teacher Value-Added and Student Outcomes in Adulthood. NBER Working Paper No. 17699

ERIC Educational Resources Information Center

Chetty, Raj; Friedman, John N.; Rockoff, Jonah E.

2011-01-01

Are teachers' impacts on students' test scores ("value-added") a good measure of their quality? This question has sparked debate largely because of disagreement about (1) whether value-added (VA) provides unbiased estimates of teachers' impacts on student achievement and (2) whether high-VA teachers improve students' long-term outcomes.…

Interactive effects of environmental change and management strategies on regional forest carbon emissions.

PubMed

Hudiburg, Tara W; Luyssaert, Sebastiaan; Thornton, Peter E; Law, Beverly E

2013-11-19

Climate mitigation activities in forests need to be quantified in terms of the long-term effects on forest carbon stocks, accumulation, and emissions. The impacts of future environmental change and bioenergy harvests on regional forest carbon storage have not been quantified. We conducted a comprehensive modeling study and life-cycle assessment of the impacts of projected changes in climate, CO2 concentration, and N deposition, and region-wide forest management policies on regional forest carbon fluxes. By 2100, if current management strategies continue, then the warming and CO2 fertilization effect in the given projections result in a 32-68% increase in net carbon uptake, overshadowing increased carbon emissions from projected increases in fire activity and other forest disturbance factors. To test the response to new harvesting strategies, repeated thinnings were applied in areas susceptible to fire to reduce mortality, and two clear-cut rotations were applied in productive forests to provide biomass for wood products and bioenergy. The management strategies examined here lead to long-term increased carbon emissions over current harvesting practices, although semiarid regions contribute little to the increase. The harvest rates were unsustainable. This comprehensive approach could serve as a foundation for regional place-based assessments of management effects on future carbon sequestration by forests in other locations.

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

NASA Astrophysics Data System (ADS)

Carlson, C.; Goldman, G. T.

2014-12-01

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

Impact of a Tutored Theoretical-Practical Training to Develop Undergraduate Students' Skills for the Detection of Caries Lesions: Study Protocol for a Multicenter Controlled Randomized Study.

PubMed

Braga, Mariana Minatel; Lenzi, Tathiane Larissa; Ferreira, Fernanda Rosche; Mendes, Fausto Medeiros; Raggio, Daniela Prócida; Imparato, José Carlos; Bonecker, Marcelo; Magalhães, Ana Carolina; Wang, Linda; Rios, Daniela; Pessan, Juliano Pelim; Duque, Cristiane; Rebelo, Maria Augusta Bessa; Alves Filho, Ary Oliveira; Lima, Marina De Deus Moura; Moura, Marcoeli Silva; De Carli, Alessandro Diogo; Sanabe, Mariane Emi; Cenci, Maximiliano Sergio; Oliveira, Elenara Ferreira; Correa, Marcos Britto; Rocha, Rachel Oliveira; Zenkner, Julio Eduardo; Murisí, Pedroza Uribe; Martignon, Stefania; Lara, Juan Sebastian; Aquino, Fatima Gabriela; Carrillo, Alfredo; Chu, Chun Hung; Deery, Chris; Ricketts, David; Melo, Paulo; Antunes, José Leopoldo Ferreira; Ekstrand, Kim Rud

2017-08-16

Tutored laboratorial activities could be a manner of improving the competency development of students. However, its impact over conventional theoretical classes has not yet been tested. Additionally, different university contexts could influence this issue and should be explored. To assess the impact of a tutored theoretical-practical training for teaching undergraduate students to detect caries lesions as compared with theoretical teaching activities. The impact of these teaching/learning activities will be assessed in terms of efficacy, cost/benefit, retention of knowledge/acquired competences, and student acceptability. Sixteen centers (7 centers from Brazil and 9 centers from other countries throughout the world) are involved in the inclusion of subjects for this protocol. A randomized controlled study with parallel groups will be conducted. One group (control) will be exposed to a 60- to 90-minute conventional theoretical class and the other group (test) will be exposed to the same theoretical class and also a 90-minute laboratory class, including exercises and discussions based on the evaluation of a pool of images and extracted teeth. The mentioned outcomes will be evaluated immediately after the teaching activities and also in medium- and long-term analyses. To compare the long-term outcomes, students who enrolled in the university before the participating students will be interviewed for data collection and these data will be used as a control and compared with the trained group. This stage will be a nonrandomized phase of this study, nested in the main study. Appropriate statistical analysis will be performed according to the aims of this study. Variables related to the centers will also be analyzed and used to model adjustment as possible sources of variability among results. This ongoing study is funded by a Brazilian national funding agency (CNPq- 400736/2014-4). We expect that the tutored theoretical-practical training will improve the undergraduate students' performance in the detection of caries lesions and subsequent treatment decisions, mainly in terms of long-term retention of knowledge. Our hypothesis is that tutored theoretical-practical training is a more cost-effective option for teaching undergraduate students to detect caries lesions. If our hypothesis is confirmed, the use of laboratory training in conjunction with theoretical classes could be used as an educational strategy in Cariology to improve the development of undergraduate students' skills in the detection of caries lesions and clinical decision-making. ©Mariana Minatel Braga, Tathiane Larissa Lenzi, Fernanda Rosche Ferreira, Fausto Medeiros Mendes, Daniela Prócida Raggio, José Carlos Imparato, Marcelo Bonecker, Ana Carolina Magalhães, Linda Wang, Daniela Rios, Juliano Pelim Pessan, Cristiane Duque, Maria Augusta Bessa Rebelo, Ary Oliveira Alves Filho, Marina De Deus Moura Lima, Marcoeli Silva Moura, Alessandro Diogo De Carli, Mariane Emi Sanabe, Maximiliano Sergio Cenci, Elenara Ferreira Oliveira, Marcos Britto Correa, Rachel Oliveira Rocha, Julio Eduardo Zenkner, Pedroza Uribe Murisí, Stefania Martignon, Juan Sebastian Lara, Fatima Gabriela Aquino, Alfredo Carrillo, Chun Hung Chu, Chris Deery, David Ricketts, Paulo Melo, José Leopoldo Ferreira Antunes, Kim Rud Ekstrand, IuSTC Group. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 16.08.2017.

Assessing anthropogenic impact on boreal lakes with historical fish species distribution data and hydrogeochemical modeling.

PubMed

Valinia, Salar; Englund, Göran; Moldan, Filip; Futter, Martyn N; Köhler, Stephan J; Bishop, Kevin; Fölster, Jens

2014-09-01

Quantifying the effects of human activity on the natural environment is dependent on credible estimates of reference conditions to define the state of the environment before the onset of adverse human impacts. In Europe, emission controls that aimed at restoring ecological status were based on hindcasts from process-based models or paleolimnological reconstructions. For instance, 1860 is used in Europe as the target for restoration from acidification concerning biological and chemical parameters. A more practical problem is that the historical states of ecosystems and their function cannot be observed directly. Therefore, we (i) compare estimates of acidification based on long-term observations of roach (Rutilus rutilus) populations with hindcast pH from the hydrogeochemical model MAGIC; (ii) discuss policy implications and possible scope for use of long-term archival data for assessing human impacts on the natural environment and (iii) present a novel conceptual model for interpreting the importance of physico-chemical and ecological deviations from reference conditions. Of the 85 lakes studied, 78 were coherently classified by both methods. In 1980, 28 lakes were classified as acidified with the MAGIC model, however, roach was present in 14 of these. In 2010, MAGIC predicted chemical recovery in 50% of the lakes, however roach only recolonized in five lakes after 1990, showing a lag between chemical and biological recovery. Our study is the first study of its kind to use long-term archival biological data in concert with hydrogeochemical modeling for regional assessments of anthropogenic acidification. Based on our results, we show how the conceptual model can be used to understand and prioritize management of physico-chemical and ecological effects of anthropogenic stressors on surface water quality. © 2014 The Authors Global Change Biology Published by John Wiley & Sons Ltd.

Active Costorage of Cryogenic Propellants for Exploration

NASA Technical Reports Server (NTRS)

Canavan, Edgar R.; Boyle, Rob; Mustafi, Shuvo

2008-01-01

Long-term storage of cryogenic propellants is a critical requirement for NASA's effort to return to the moon. Liquid hydrogen and liquid oxygen provide the highest specific impulse of any practical chemical propulsion system, and thus provides the greatest payload mass per unit of launch mass. Future manned missions will require vehicles with the flexibility to remain in orbit for months, necessitating long-term storage of these cryogenic liquids. For decades cryogenic scientific satellites have used cryogens to cool instruments. In many cases, the lifetime of the primary cryogen tank has been extended by intercepting much of the heat incident on the tank at an intermediate-temperature shield cooled either by a second cryogen tank or a mechanical cryocooler. For an LH2/LO2 propellant system, a combination of these ideas can be used, in which the shield around the LO2 tank is attached to, and at the same temperature as, the LO2 tank, but is actively cooled so as to remove all heat impinging on the tank and shield. This configuration eliminates liquid oxygen boil-off and cuts the liquid hydrogen boil-off to a small fraction of the unshielded rate. This paper studies the concept of active costorage as a means of long-term cryogenic propellant storage. The paper describes the design impact of an active costorage system for the Crew Exploration Vehicle (CEV). This paper also compares the spacecraft level impact of the active costorage concept with a passive storage option in relation to two different scales of spacecraft that will be used for the lunar exploration effort, the CEV and the Earth Departure Stage (EDS). Spacecraft level studies are performed to investigate the impact of scaling of the costorage technologies for the different components of the Lunar Architecture and for different mission durations.

Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses

PubMed Central

Saramma, P. P.; Raj, L. Suja; Dash, P. K.; Sarma, P. S.

2016-01-01

Context: Cardiopulmonary resuscitation (CPR) and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS) and advanced cardiac life support (ACLS) skills among them. However, very little data are available in the literature highlighting the long-term impact of these training. Aims: To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses. Setting and Design: Tertiary care hospital, Prospective, repeated-measures design. Subjects and Methods: A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3–4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses. Statistical Analysis Used: SPSS for Windows version 21.0. Results: The majority of the 206 nurses (93 CPR certified and 113 noncertified) were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000). However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140). Conclusions: Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification. PMID:27303137

Assessing anthropogenic impact on boreal lakes with historical fish species distribution data and hydrogeochemical modeling

PubMed Central

Valinia, Salar; Englund, Göran; Moldan, Filip; Futter, Martyn N; Köhler, Stephan J; Bishop, Kevin; Fölster, Jens

2014-01-01

Quantifying the effects of human activity on the natural environment is dependent on credible estimates of reference conditions to define the state of the environment before the onset of adverse human impacts. In Europe, emission controls that aimed at restoring ecological status were based on hindcasts from process-based models or paleolimnological reconstructions. For instance, 1860 is used in Europe as the target for restoration from acidification concerning biological and chemical parameters. A more practical problem is that the historical states of ecosystems and their function cannot be observed directly. Therefore, we (i) compare estimates of acidification based on long-term observations of roach (Rutilus rutilus) populations with hindcast pH from the hydrogeochemical model MAGIC; (ii) discuss policy implications and possible scope for use of long-term archival data for assessing human impacts on the natural environment and (iii) present a novel conceptual model for interpreting the importance of physico-chemical and ecological deviations from reference conditions. Of the 85 lakes studied, 78 were coherently classified by both methods. In 1980, 28 lakes were classified as acidified with the MAGIC model, however, roach was present in 14 of these. In 2010, MAGIC predicted chemical recovery in 50% of the lakes, however roach only recolonized in five lakes after 1990, showing a lag between chemical and biological recovery. Our study is the first study of its kind to use long-term archival biological data in concert with hydrogeochemical modeling for regional assessments of anthropogenic acidification. Based on our results, we show how the conceptual model can be used to understand and prioritize management of physico-chemical and ecological effects of anthropogenic stressors on surface water quality. PMID:24535943

Performance study of galactic cosmic ray shield materials

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Wilson, John W.; Thibeault, Sheila A.; Nealy, John E.; Badavi, Francis F.; Kiefer, Richard L.

1994-01-01

The space program is faced with two difficult radiation protection issues for future long-term operations. First, retrofit of shield material or conservatism in shield design is prohibitively expensive and often impossible. Second, shielding from the cosmic heavy ions is faced with limited knowledge on the physical properties and biological responses of these radiations. The current status of space shielding technology and its impact on radiation health is discussed herein in terms of conventional protection practice and a test biological response model. The impact of biological response on the selection of optimum materials for cosmic ray shielding is presented in terms of the transmission characteristics of the shield material. Although the systematics of nuclear cross sections are able to demonstrate the relation of exposure risk to shield-material composition, the current uncertainty in-nuclear cross sections will not allow an accurate evaluation of risk reduction. This paper presents a theoretical study of risk-related factors and a pilot experiment to study the effectiveness of choice of shield materials to reduce the risk in space operations.

Who Is Responsible? A Man With Dementia Wanders From Home, Is Hit by a Train, and Dies.

PubMed

Young, Yuchi; Papenkov, Maksim; Nakashima, Taeko

2018-07-01

The impact of dementia and Alzheimer's disease extends far beyond the healthcare needs of the person with dementia. As the disease progresses, individuals with dementia often require ongoing formal or informal care for their basic daily routine because of behavior changes and continuing loss of cognitive function. Most of the care for people with dementia takes place at home, and the unpaid, informal caregivers are often spouses or other relatives. Providing long-term informal care at home for someone with dementia is psychologically, physically, and financially draining. The tragedy described in this case elucidates the far-reaching societal impact of dementia care and the implicit health policy considerations. In 2007, a 91-year-old Japanese man with dementia was in the care of his wife when he wandered from home, was hit by a train, and died, immediately affecting the Central Japan Railway Company operations and, subsequently, legal practice as well as Japanese elder care policy. The railway sued the man's wife and son for negligence and lost revenue, winning both trials at the local and district courts. This ruling shocked families and caregivers in Japan, where care for elderly parents traditionally falls on the oldest son, and brought attention to the complex issues related to dementia care. A decade later, we revisit this case to provoke a renewed dialogue about the matrix of responsibilities and liabilities associated with caregiving; to illuminate the unmet needs of the person with dementia, as well as his or her informal caregivers; and the financial implications related to long-term care policy. We close with 2 practical suggestions which preserve the dignity of the individual and provide reassurance for caregivers. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

An educational video to promote multi-factorial approaches for fall and injury prevention in long-term care facilities

PubMed Central

2014-01-01

Background Older adults living in long term care (LTC) settings are vulnerable to fall-related injuries. There is a need to develop and implement evidence-based approaches to address fall injury prevention in LTC. Knowledge translation (KT) interventions to support the uptake of evidence-based approaches to fall injury prevention in LTC need to be responsive to the learning needs of LTC staff and use mediums, such as videos, that are accessible and easy-to-use. This article describes the development of two unique educational videos to promote fall injury prevention in long-term care (LTC) settings. These videos are unique from other fall prevention videos in that they include video footage of real life falls captured in the LTC setting. Methods Two educational videos were developed (2012–2013) to support the uptake of findings from a study exploring the causes of falls based on video footage captured in LTC facilities. The videos were developed by: (1) conducting learning needs assessment in LTC settings via six focus groups (2) liaising with LTC settings to identify learning priorities through unstructured conversations; and (3) aligning the content with principles of adult learning theory. Results The videos included footage of falls, interviews with older adults and fall injury prevention experts. The videos present evidence-based fall injury prevention recommendations aligned to the needs of LTC staff and: (1) highlight recommendations deemed by LTC staff as most urgent (learner-centered learning); (2) highlight negative impacts of falls on older adults (encourage meaning-making); and, (3) prompt LTC staff to reflect on fall injury prevention practices (encourage critical reflection). Conclusions Educational videos are an important tool available to researchers seeking to translate evidence-based recommendations into LTC settings. Additional research is needed to determine their impact on practice. PMID:24884899

Longitudinal adoption rates of complex decision support tools in primary care.

PubMed

McCullagh, Lauren; Mann, Devin; Rosen, Lisa; Kannry, Joseph; McGinn, Thomas

2014-12-01

Translating research findings into practice promises to standardise care. Translation includes the integration of evidence-based guidelines at the point of care, discerning the best methods to disseminate research findings and models to sustain the implementation of best practices.By applying usability testing to clinical decision support(CDS) design, overall adoption rates of 60% can be realised.What has not been examined is how long adoption rates are sustained and the characteristics associated with long-term use. We conducted secondary analysis to decipher the factors impacting sustained use of CD Stools. This study was a secondary data analysis from a clinical trial conducted at an academic institution in New York City. Study data was identified patients electronic health records (EHR). The trial was to test the implementation of an integrated clinical prediction rule(iCPR) into the EHR. The primary outcome variable was iCPR tool acceptance of the tool. iCPR tool completion and iCPR smartest completion were additional outcome variables of interest. The secondary aim was to examine user characteristics associated with iCPR tool use in later time periods. Characteristics of interest included age, resident year, use of electronic health records (yes/no) and use of best practice alerts (BPA) (yes/no). Generalised linear mixed models (GLiMM) were used to compare iCPR use over time for each outcome of interest: namely, iCPR acceptance, iCPR completion and iCPR smartset completion.GLiMM was also used to examine resident characteristics associated with iCPR tool use in later time periods; specifically, intermediate and long-term (ie, 90+days). The tool was accepted, on average, 82.18% in the first 90 days (short-term period). The use decreases to 56.07% and 45.61% in intermediate and long-term time periods, respectively. There was a significant association between iCPR tool completion and time periods(p<0.0001). There was no significant difference in iCPR tool completion between resident encounters in the intermediate and long-term periods (p<0.6627). There was a significant association between iCPR smartset completion and time periods (p<0.0021). There were no significant associations between iCPR smartest completion and any of the four predictors of interest. We examined the frequencies of components of the iCPR tool being accepted over time by individual clinicians. Rates of adoption of the different components of the tool decreased substantially over time. The data suggest that over time and prolonged exposure to CDS tools, providers are less likely to utilise the tool. It is not clear if it is fatigue with the CDS tool, acquired knowledge of the clinical prediction rule, or gained clinical experience and gestalt that are influencing adoption rates. Further analysis of individual adoption rates over time and the impact it has on clinical outcomes should be conducted.

Innovative culture in long-term care settings: the influence of organizational characteristics.

PubMed

Nieboer, Anna P; Strating, Mathilde M H

2012-01-01

Innovative cultures have been reported to enhance the creation and implementation of new ideas and working methods in organizations. Although there is considerable research on the impact of organizational context on the innovativeness of organizations, the same is not the case for research on the organizational characteristics responsible for an innovative culture in (long-term) care settings. The aim of this study was to identify organizational characteristics that explain innovative culture in the (long-term) care sector. A large cross-sectional study in Dutch long-term care-nursing homes and/or elderly homes, care organizations for the handicapped, and long-term mental health care organizations-was conducted. A total of 432 managers and care professionals in 37 organizations participated. The Group Innovation Inventory was used to measure innovative culture in long-term care organizations. Structural characteristics of the organization were centralization and formalization, environmental dynamism and competitiveness, internal and external exchange of information, leadership style, commitment to quality improvement, and the organization's innovative strategy. The determinants of an innovative culture were estimated with a two-level random-intercepts and fixed-slopes model. Multilevel regression models were used to account for the organizational clustering of individuals within the 37 care organizations. Environmental dynamism, job codification, formal external exchange of information, transformational leadership, commitment to quality, and an exploratory and exploitative innovation strategy were all significantly correlated with an innovative culture in the multivariate multilevel analysis; the other characteristics were not. The explained organizational- and individual-level variance was 52.5% and 49.2%, respectively. The results point to substantial differences in innovative cultures between and within care organizations that can, in part, be explained by organizational characteristics. Efforts must be made to ensure that organizational characteristics such as environmental dynamism do not hamper the development of innovative cultures in long-term care organizations. Organizations' human resource practices and knowledge management are particularly promising in strengthening innovative cultures.

Impacts of 120 years of fertilizer addition on a temperate grassland ecosystem

PubMed Central

Kidd, Jonathan; Manning, Peter; Simkin, Janet; Peacock, Simon; Stockdale, Elizabeth

2017-01-01

The widespread application of fertilizers has greatly influenced many processes and properties of agroecosystems, and agricultural fertilization is expected to increase even further in the future. To date, most research on fertilizer impacts has used short-term studies, which may be unrepresentative of long-term responses, thus hindering our capacity to predict long-term impacts. Here, we examined the effects of long-term fertilizer addition on key ecosystem properties in a long-term grassland experiment (Palace Leas Hay Meadow) in which farmyard manure (FYM) and inorganic fertilizer treatments have been applied consistently for 120 years in order to characterize the experimental site more fully and compare ecosystem responses with those observed at other long-term and short-term experiments. FYM inputs increased soil organic carbon (SOC) stocks, hay yield, nutrient availability and acted as a buffer against soil acidification (>pH 5). In contrast, N-containing inorganic fertilizers strongly acidified the soil (

Modeling the impact of interventions on an epidemic of ebola in sierra leone and liberia.

PubMed

Rivers, Caitlin M; Lofgren, Eric T; Marathe, Madhav; Eubank, Stephen; Lewis, Bryan L

2014-11-06

An Ebola outbreak of unparalleled size is currently affecting several countries in West Africa, and international efforts to control the outbreak are underway. However, the efficacy of these interventions, and their likely impact on an Ebola epidemic of this size, is unknown. Forecasting and simulation of these interventions may inform public health efforts. We use existing data from Liberia and Sierra Leone to parameterize a mathematical model of Ebola and use this model to forecast the progression of the epidemic, as well as the efficacy of several interventions, including increased contact tracing, improved infection control practices, the use of a hypothetical pharmaceutical intervention to improve survival in hospitalized patients. Model forecasts until Dec. 31, 2014 show an increasingly severe epidemic with no sign of having reached a peak. Modeling results suggest that increased contact tracing, improved infection control, or a combination of the two can have a substantial impact on the number of Ebola cases, but these interventions are not sufficient to halt the progress of the epidemic. The hypothetical pharmaceutical intervention, while impacting mortality, had a smaller effect on the forecasted trajectory of the epidemic. Near-term, practical interventions to address the ongoing Ebola epidemic may have a beneficial impact on public health, but they will not result in the immediate halting, or even obvious slowing of the epidemic. A long-term commitment of resources and support will be necessary to address the outbreak.

Modeling the impact of interventions on an epidemic of ebola in sierra leone and liberia.

PubMed

Rivers, Caitlin M; Lofgren, Eric T; Marathe, Madhav; Eubank, Stephen; Lewis, Bryan L

2014-10-16

An Ebola outbreak of unparalleled size is currently affecting several countries in West Africa, and international efforts to control the outbreak are underway. However, the efficacy of these interventions, and their likely impact on an Ebola epidemic of this size, is unknown. Forecasting and simulation of these interventions may inform public health efforts. We use existing data from Liberia and Sierra Leone to parameterize a mathematical model of Ebola and use this model to forecast the progression of the epidemic, as well as the efficacy of several interventions, including increased contact tracing, improved infection control practices, the use of a hypothetical pharmaceutical intervention to improve survival in hospitalized patients. Model forecasts until Dec. 31, 2014 show an increasingly severe epidemic with no sign of having reached a peak. Modeling results suggest that increased contact tracing, improved infection control, or a combination of the two can have a substantial impact on the number of Ebola cases, but these interventions are not sufficient to halt the progress of the epidemic. The hypothetical pharmaceutical intervention, while impacting mortality, had a smaller effect on the forecasted trajectory of the epidemic. Near-term, practical interventions to address the ongoing Ebola epidemic may have a beneficial impact on public health, but they will not result in the immediate halting, or even obvious slowing of the epidemic. A long-term commitment of resources and support will be necessary to address the outbreak.

Effect of Long-Term Physical Activity Practice after Cardiac Rehabilitation on Some Risk Factors

ERIC Educational Resources Information Center

Freyssin, Celine, Jr.; Blanc, Philippe; Verkindt, Chantal; Maunier, Sebastien; Prieur, Fabrice

2011-01-01

The objective of this study was to evaluate the effects of long-term physical activity practice after a cardiac rehabilitation program on weight, physical capacity and arterial compliance. The Dijon Physical Activity Score was used to identify two groups: sedentary and active. Weight, distance at the 6-min walk test and the small artery elasticity…

Exploring the Long- and Short-Term Planning Practices of Head Start Teachers for Children with and without Disabilities.

ERIC Educational Resources Information Center

Venn, Martha L.; McCollum, Jeanette

2002-01-01

An investigation into the long- and short-term planning practices of 21 Head Start teachers found the calendar, classroom environment, schedule, and classroom activities appeared to be the primary foci of the teachers' planning decisions. Teachers primarily used personal files, curriculum books, and other teaching personnel as planning resources.…

The Multi-Frequency Correlation Between Eua and sCER Futures Prices: Evidence from the Emd Approach

NASA Astrophysics Data System (ADS)

Zhang, Yue-Jun; Huang, Yi-Song

2015-05-01

Currently European Union Allowances (EUA) and secondary Certified Emission Reduction (sCER) have become two dominant carbon trading assets for investors and their linkage attracts much attention from academia and practitioners in recent years. Under this circumstance, we use the empirical mode decomposition (EMD) approach to decompose the two carbon futures contract prices and discuss their correlation from the multi-frequency perspective. The empirical results indicate that, first, the EUA and sCER futures price movements can be divided into those triggered by the long-term, medium-term and short-term market impacts. Second, the price movements in the EUA and sCER futures markets are primarily caused by the long-term impact, while the short-term impact can only explain a small fraction. Finally, the long-term (short-term) effect on EUA prices is statistically uncorrelated with the short-term (long-term) effect of sCER prices, and there is a medium or strong lead-and-lag correlation between the EUA and sCER price components with the same time scales. These results may provide some important insights of price forecast and arbitraging activities for carbon futures market investors, analysts and regulators.

Rules, culture, and fitness

PubMed Central

Baum, William M.

1995-01-01

Behavior analysis risks intellectual isolation unless it integrates its explanations with evolutionary theory. Rule-governed behavior is an example of a topic that requires an evolutionary perspective for a full understanding. A rule may be defined as a verbal discriminative stimulus produced by the behavior of a speaker under the stimulus control of a long-term contingency between the behavior and fitness. As a discriminative stimulus, the rule strengthens listener behavior that is reinforced in the short run by socially mediated contingencies, but which also enters into the long-term contingency that enhances the listener's fitness. The long-term contingency constitutes the global context for the speaker's giving the rule. When a rule is said to be “internalized,” the listener's behavior has switched from short- to long-term control. The fitness-enhancing consequences of long-term contingencies are health, resources, relationships, or reproduction. This view ties rules both to evolutionary theory and to culture. Stating a rule is a cultural practice. The practice strengthens, with short-term reinforcement, behavior that usually enhances fitness in the long run. The practice evolves because of its effect on fitness. The standard definition of a rule as a verbal statement that points to a contingency fails to distinguish between a rule and a bargain (“If you'll do X, then I'll do Y”), which signifies only a single short-term contingency that provides mutual reinforcement for speaker and listener. In contrast, the giving and following of a rule (“Dress warmly; it's cold outside”) can be understood only by reference also to a contingency providing long-term enhancement of the listener's fitness or the fitness of the listener's genes. Such a perspective may change the way both behavior analysts and evolutionary biologists think about rule-governed behavior. ImagesFigure 1 PMID:22478201

Health promotion through employee assistance programs: a role for occupational therapists.

PubMed

Maynard, M

1986-11-01

Health promotion is predicted to have a major impact on occupational therapy practice. Keeping people well and promoting a healthy life-style will be the focus for the future. Many companies and agencies are taking the lead by instituting employee assistance programs (EAPs). With the de-emphasis on long-term hospital care, many occupational therapists will be seeking employment with community health programs. This paper advocates a role for occupational therapists in health promotion and disease prevention in an EAP. A description of EAPs and the contributions that occupational therapists can make to these programs is offered. Practice and education considerations for occupational therapists' roles in EAPs are provided.

Growing trees where trees grow best: short-term research sheds light on long-term productivity.

Treesearch

Jonathan Thompson

2008-01-01

In 1999, the Fall River Long-Term Site Productivity study began in coastal Washington to investigate how intensive management practices affect soil processes and forest productivity. By comparing conventional harvests to more intensive wood removal treatments, researchers are answering long-standing questions about how residual organic matter influences future growth....

Characteristics of a long-term forest soil productivity research site in Missouri

Treesearch

Felix, Jr. Ponder; Nancy M. Mikkelson

1995-01-01

Problems with soil quality and maintenance of soil productivity occur when management activities are improperly planned and carried out. To ensure that Forest Service management practices do not reduce long-term soil productivity (LTSP), a network of coordinated long-term experiments is being established across the United States. The first LTSP study in the Central...

Long-term changes in soil organic carbon and nitrogen under semiarid tillage and cropping practices

USDA-ARS?s Scientific Manuscript database

Understanding long-term changes in soil organic carbon (SOC) and total soil nitrogen (TSN) is important for evaluating C fluxes and optimizing N management. We evaluated long-term SOC and TSN changes under dryland rotations for historical stubble-mulch (HSM) and graded terrace (GT) plots on a clay l...

Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school

PubMed Central

Yu, Tzu-Chieh; Wilson, Nichola C; Singh, Primal P; Lemanu, Daniel P; Hawken, Susan J; Hill, Andrew G

2011-01-01

Introduction International interest in peer-teaching and peer-assisted learning (PAL) during undergraduate medical programs has grown in recent years, reflected both in literature and in practice. There, remains however, a distinct lack of objective clarity and consensus on the true effectiveness of peer-teaching and its short- and long-term impacts on learning outcomes and clinical practice. Objective To summarize and critically appraise evidence presented on peer-teaching effectiveness and its impact on objective learning outcomes of medical students. Method A literature search was conducted in four electronic databases. Titles and abstracts were screened and selection was based on strict eligibility criteria after examining full-texts. Two reviewers used a standard review and analysis framework to independently extract data from each study. Discrepancies in opinions were resolved by discussion in consultation with other reviewers. Adapted models of “Kirkpatrick’s Levels of Learning” were used to grade the impact size of study outcomes. Results From 127 potential titles, 41 were obtained as full-texts, and 19 selected after close examination and group deliberation. Fifteen studies focused on student-learner outcomes and four on student-teacher learning outcomes. Ten studies utilized randomized allocation and the majority of study participants were self-selected volunteers. Written examinations and observed clinical evaluations were common study outcome assessments. Eleven studies provided student-teachers with formal teacher training. Overall, results suggest that peer-teaching, in highly selective contexts, achieves short-term learner outcomes that are comparable with those produced by faculty-based teaching. Furthermore, peer-teaching has beneficial effects on student-teacher learning outcomes. Conclusions Peer-teaching in undergraduate medical programs is comparable to conventional teaching when utilized in selected contexts. There is evidence to suggest that participating student-teachers benefit academically and professionally. Long-term effects of peer-teaching during medical school remain poorly understood and future research should aim to address this. PMID:23745087

The Good Behavior Game: a best practice candidate as a universal behavioral vaccine.

PubMed

Embry, Dennis D

2002-12-01

A "behavioral vaccine" provides an inoculation against morbidity or mortality, impacting physical, mental, or behavior disorders. An historical example of a behavioral vaccine is antiseptic hand washing to reduce childbed fever. In current society, issues with high levels of morbidity, such as substance abuse, delinquency, youth violence, and other behavioral disorders (multiproblems), cry out for a low-cost, widespread strategy as simple as antiseptic hand washing. Congruent research findings from longitudinal studies, twin studies, and other investigations suggest that a possibility might exist for a behavioral vaccine for multiproblem behavior. A simple behavioral strategy called the Good Behavior Game (GBG), which reinforces inhibition in a group context of elementary school, has substantial previous research to consider its use as a behavioral vaccine. The GBG is not a curriculum but rather a simple behavioral procedure from applied behavior analysis. Approximately 20 independent replications of the GBG across different grade levels, different types of students, different settings, and some with long-term follow-up show strong, consistent impact on impulsive, disruptive behaviors of children and teens as well as reductions in substance use or serious antisocial behaviors. The GBG, named as a "best practice" for the prevention of substance abuse or violent behavior by a number of federal agencies, is unique because it is the only practice implemented by individual teachers that is documented to have long-term effects. Presently, the GBG is only used in a small number of settings. However, near universal use of the GBG, in major political jurisdictions during the elementary years, could substantially reduce the incidence of substance use, antisocial behavior, and other adverse developmental or social consequences at a very modest cost, with very positive cost-effectiveness ratios.

Nursing care of children after a traumatic incident.

PubMed

Mulvihill, Deanna

2007-01-01

The objective of this study was to describe the nursing interventions with children and their parents to reduce the impact of a traumatic incident. A traumatic incident can be a natural disaster, a plane or car accident, or child abuse. The author has conducted an interdisciplinary integrative review of the research literature on the health impact of childhood trauma. This research is summarized and the results are synthesized and presented in a diagram that demonstrates the strong relationships that trauma has to both short and long-term health status. The impact of post-traumatic stress disorder (PTSD) and interventions to reduce its impact are described. Predictability and continuity in nursing care grounded in both routine and personnel are important. Nurses can teach self-soothing techniques and coping skills prior to using exploratory dialogue to assist the child and the parent in reviewing the traumatic incident. Nurses can also act as advocates for unsafe situations and practices, such as corporal punishment. Assessment of children for history of trauma is indicated, especially children who exhibit signs of short-term health effects. Areas for health education and future research are also presented.

Verbal Short-Term Memory Reflects the Organization of Long-Term Memory: Further Evidence from Short-Term Memory for Emotional Words

ERIC Educational Resources Information Center

Majerus, Steve; D'Argembeau, Arnaud

2011-01-01

Many studies suggest that long-term lexical-semantic knowledge is an important determinant of verbal short-term memory (STM) performance. This study explored the impact of emotional valence on word immediate serial recall as a further lexico-semantic long-term memory (LTM) effect on STM. This effect is particularly interesting for the study of…

Long-term prognostic impact of the attenuated plaque in patients with acute coronary syndrome.

PubMed

Okura, Hiroyuki; Kataoka, Toru; Yoshiyama, Minoru; Yoshikawa, Junichi; Yoshida, Kiyoshi

2016-01-01

Several intravascular ultrasound studies have reported that culprit lesion-attenuated plaque (AP) is related to slow flow/no reflow after percutaneous coronary intervention (PCI). Long-term prognostic impact of the AP is unknown. The aim of this study was to investigate acute and long-term clinical impact of the AP in patients with acute coronary syndrome (ACS). A total of 110 ACS patients who underwent successful PCI were enrolled. Acute and long-term clinical outcomes were compared between patients with AP (AP group: n = 73) and those without AP (non-AP group: n = 37). Long-term cardiac event was defined as a composite of death and ACS. Baseline characteristics in 2 groups were similar. AP was associated with higher TIMI frame count immediately after the first balloon inflation. After thrombectomy and intracoronary drug administration, final TIMI frame count became similar between AP and non-AP group. Although AP was associated with higher incidence of fatal arrhythmia during hospitalization, in-hospital mortality did not differ between the 2 groups. During follow-up (median 6.2 years), cardiac event-free survival did not differ between the 2 groups. Despite the initial unfavorable effect on coronary reflow, presence of AP did not affect acute as well as long-term clinical outcome in patients with ACS.

Medical homes versus individual practice in primary care: impact on health care expenditures.

PubMed

Perelman, Julian; Roch, Isabelle; Heymans, Isabelle; Moureaux, Catherine; Lagasse, Raphael; Annemans, Lieven; Closon, Marie-Christine

2013-08-01

The medical home (MH) model has prompted increasing attention given its potential to improve quality of care while reducing health expenditures. We compare overall and specific health care expenditures in Belgium, from the third-party payer perspective (compulsory social insurance), between patients treated at individual practices (IP) and at MHs. We compare the sociodemographic profile of MH and IP users. This is a retrospective study using public insurance claims data. Generalized linear models estimate the impact on health expenditures of being treated at a MH versus IP, controlling for individual, and area-based sociodemographic characteristics. The choice of primary care setting is modeled using logistic regressions. A random sample of 43,678 persons followed during the year 2004. Third-party payer expenditures for primary care, secondary care consultations, pharmaceuticals, laboratory tests, acute and long-term inpatient care. Overall third-party payer expenditures do not differ significantly between MH and IP users (€+27). Third-party payer primary care expenditures are higher for MH than for IP users (€+129), but this difference is offset by lower expenditures for secondary care consultations (€-11), drugs (€-40), laboratory tests (€-5) and acute and long-term inpatient care (€-53). MHs attract younger and more underprivileged populations. MHs induce a shift in expenditures from secondary care, drugs, and laboratory tests to primary care, while treating a less economically favored population. Combined with positive results regarding quality, MH structures are a promising way to tackle the challenges of primary care.

Developmental Activities that Lead to Dropout and Investment in Sport

ERIC Educational Resources Information Center

Wall, Michael; Cote, Jean

2007-01-01

Background: Studies suggest that expert performance in sport is the result of long-term engagement in a highly specialized form of training termed deliberate practice. The relationship between accumulated deliberate practice and performance predicts that those who begin deliberate practice at a young age accumulate more practice hours over time…

Management and Prevalence of Long-Term Conditions in Primary Health Care for Adults with Intellectual Disabilities Compared with the General Population: A Population-Based Cohort Study

ERIC Educational Resources Information Center

Cooper, Sally-Ann; Hughes-McCormack, Laura; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, Marion; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

2018-01-01

Background: In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. Method: Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term…

Listening to old beech and young cherry trees - long-term research in the Alleghenies

Treesearch

Susan L. Stout; Coeli M. Hoover; Todd E. Ristau

2006-01-01

Long-term research results have been a foundation of forestry practice on the Allegheny Plateau since the 1970s. This includes results from monitoring reference conditions in areas set aside for this purpose and from long-running manipulative studies, some dating back to the 1920s. The success of long-term research in this region reflects the commitment of a handful of...

Assessment of long-term wastewater irrigation impacts on the soil geochemical properties and the bioaccumulation of heavy metals to the agricultural products.

PubMed

Christou, Anastasis; Eliadou, Elena; Michael, Costas; Hapeshi, Evroula; Fatta-Kassinos, Despo

2014-08-01

An extensive field survey was employed for assessing the impacts of long-term wastewater irrigation of forage crops and orange orchards in three suburban agricultural areas in Cyprus (areas I, II, and III), as compared to rainfed agriculture, on the soil geochemical properties and the bioaccumulation of heavy metals (Zn, Ni, Mn, Cu, Co) to the agricultural products. Both ryegrass fields and orange orchards in areas I and II were continuously wastewater irrigated for 10 years, whereas clover fields in area III for 0.5, 4, and 8 years. The results revealed that wastewater reuse for irrigation caused a slight increase in soil salinity and Cl(-) content in areas I and II, and a remarkable increase, having strong correlation with the period in which wastewater irrigation was practiced, in area III. Soil salinization in area III was due to the high electrical conductivity (EC) of the wastewater applied for irrigation, attributed to the influx of seawater to the sewage collection network in area III. In addition, the wastewater irrigation practice resulted in a slight decrease of the soil pH values in area III, while a subtle impact was identified regarding the CaCO3, Fe, and heavy metal content in the three areas surveyed. The heavy metal content quantified in the forage plants' above-ground parts was below the critical levels of phytotoxicity and the maximum acceptable concentration in dairy feed, whereas heavy metals quantified in orange fruit pulp were below the maximum permissible levels (MPLs). Heavy metal phytoavailability was confined due to soil properties (high pH and clay content), as evidenced by the calculated low transfer factor (TF).

Impact of the 2004-2005 Influenza Vaccine Shortage on Immunization Practices in Long-Term Care Facilities

PubMed Central

Mody, Lona; Langa, Kenneth M.; Malani, Preeti N.

2012-01-01

Objective To assess the response of long-term care facilities (LTCFs) to the 2004-2005 influenza vaccine shortage and the impact on resident and healthcare worker (HCW) immunization rates. Methods A 12-item questionnaire was sent to 824 randomly selected LTCFs in December 2004. The following 2 open-ended questions were also asked: “How did you cope with the vaccine shortage?” and “Who helped you get your supply?” Immunization rates reported by LTCF administrators for 2003-2003 and 2003-2004 were compared with those for 2004-2005. Immunization rates were defined as the proportion of all eligible residents and HCWs who received influenza vaccine. Results Responses were received from 380 LTCFs (46.3%), which had a total of 38,447 beds. Resident mean influenza immunization rates (±SD) decreased from 85% ± 15.3% in 2002-2003 and 85.1% ± 15.3% in 2003-2004 to 81.9% ± 19.4% in the 2004-2005 influenza season (P = .025). The immunization rates among HCWs also decreased from 51% in 2002-2003 and 2003-2004 to 38.4% in 2004-2005 (P < .001). In response to one of the open-ended questions, 96 facilities (25.3%) reported that they obtained vaccine from 2 or more sources. Eight percent commented on specific intensified infection control efforts, and only 2.3% commented on emergency preparedness. Conclusions The influenza vaccine shortage in 2004-2005 impacted immunization practices of LTCFs across the United States, leading to decreases in both resident and HCW vaccination rates. The significant decrease in vaccination rates in LTCFs is of concern and has broad implications for policy makers working on emergency preparedness for a possible pandemic of influenza. PMID:16622817

Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long-term care settings: a cross-sectional survey.

PubMed

Beck, Esther-Ruth; McIlfatrick, Sonja; Hasson, Felicity; Leavey, Gerry

2017-09-01

To examine nursing home managers' knowledge, attitudes, beliefs and current practice regarding advance care planning for people with dementia in long-term care settings informed by the theory of planned behaviour. Internationally, advance care planning is advocated for people with dementia. However, evidence suggests that discussions with people with dementia are rare, particularly in long-term care settings. Whilst nursing home managers can be considered central to implementation in this setting, there is a dearth of research that has examined their perspective. This study reports on their role with regard to advance care planning and the perceived factors which influence this. A cross-sectional postal survey was carried out as part of a larger scale sequential explanatory mixed-methods study between January-March 2015. Nursing home managers in a region in the UK (n = 178). A response rate of 66% (n = 116) was achieved. Nursing home managers demonstrated a lack of knowledge of advance care planning, with negative attitudes underpinned by concerns regarding the capacity and lack of perceived benefits to the person with dementia. Currently, they do not view advance care planning as part of their role, with lack of ownership impacting upon current practice behaviours. Whilst nursing home managers recognise the potential benefits of advance care planning, barriers and challenges create a reluctance to facilitate. Targeted training to address the knowledge deficit is required, with the wider components of advance care planning promoted. There is a need for greater role clarification to ensure nurses in long-term care settings identify with the process in the future. A gap between rhetoric and reality of implementation is evident; therefore, long-term care settings must critically examine system, organisational and individual factors for failure to implement advance care planning for people with dementia. Increased cognisance of the context in which advance care planning takes place is vital for improved implementation in this context. In addition strong nursing leadership is imperative to facilitate initiation, engagement and re-evaluation of the process of advance care planning. © 2016 John Wiley & Sons Ltd.

The long-term effects of birthing interventions on childhood empathy.

PubMed

Cassels, Tracy G

2014-04-01

birthing practices have changed drastically over the past century. It is now more common for women to birth in a hospital, receive drug interventions, and to birth via caesarean section, yet there is a paucity of research on long-term outcomes associated with practices. The research was designed to determine if there were any long-term effects of the birthing experience on child empathic behaviour. two-hundred-and-sixty-four mother-child dyad (M(child_age)=5.92 years; SD=.85 years; 127 boys) completed either a questionnaire on birthing practices (mothers) or a modified Stickers Task to assess empathic behaviour (child). there was a non-significant effect (Δ=.22, p=.395) of home versus hospital birth and a small-moderate, significant (Δ=.33, p=.017) effect of the use of epidurals during, with children of mothers who did not use an epidural or who birthed at home showing greater empathic behaviour. the birthing location and the decision to have an epidural can have long-term consequences on children's empathy. While researchers need to further examine the mechanisms behind these findings, parents should be made aware of the potential long-term effects in order to allow them to make fully informed decisions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Long-term Career Goals for Professional Women in Agriculture.

ERIC Educational Resources Information Center

Klepper, Betty

1986-01-01

Encourages the formation of long-term career goals for women in agronomy. Offers perspectives and practical suggestions for obtaining positions, maintaining professional credentials, and managing personal and career related obligations. (ML)

Impact of continuous training through distributed practice for acquisition of minimally invasive surgical skills.

PubMed

Nakata, Bruce Negrello; Cavalini, Worens; Bonin, Eduardo A; Salvalaggio, Paolo R; Loureiro, Marcelo P

2017-10-01

Minimally invasive surgery (MIS) requires the mastery of manual skills and a specific training is required. Apart from residencies and fellowships in MIS, other learning opportunities utilize massive training, mainly with use of simulators in short courses. A long-term postgraduate course represents an opportunity to learn through training using distributed practice. The objective of this study is to assess the use of distributed practice for acquisition of basic minimally invasive skills in surgeons who participated in a long-term MIS postgraduate course. A prospective, longitudinal and quantitative study was conducted among surgeons who attended a 1-year postgraduate course of MIS in Brazil, from 2012 to 2014. They were tested through five different exercises in box trainers (peg-transfer, passing, cutting, intracorporeal knot, and suture) in the first (t0), fourth (t1) and last, eighth, (t2) meetings of this course. The time and penalties of each exercise were collected for each participant. Participant skills were assessed based on time and accuracy on a previously tested score. Fifty-seven surgeons (participants) from three consecutive groups participated in this study. There was a significant improvement in scores in all exercises. The average increase in scores between t0 and t2 was 88% for peg-transfer, 174% for passing, 149% for cutting, 130% for intracorporeal knot, and 120% for suture (p < 0.001 for all exercises). Learning through distributed practice is effective and should be integrated into a MIS postgraduate course curriculum for acquisition of core skills.

Empirical evaluation of the conceptual model underpinning a regional aquatic long-term monitoring program using causal modelling

USGS Publications Warehouse

Irvine, Kathryn M.; Miller, Scott; Al-Chokhachy, Robert K.; Archer, Erik; Roper, Brett B.; Kershner, Jeffrey L.

2015-01-01

Conceptual models are an integral facet of long-term monitoring programs. Proposed linkages between drivers, stressors, and ecological indicators are identified within the conceptual model of most mandated programs. We empirically evaluate a conceptual model developed for a regional aquatic and riparian monitoring program using causal models (i.e., Bayesian path analysis). We assess whether data gathered for regional status and trend estimation can also provide insights on why a stream may deviate from reference conditions. We target the hypothesized causal pathways for how anthropogenic drivers of road density, percent grazing, and percent forest within a catchment affect instream biological condition. We found instream temperature and fine sediments in arid sites and only fine sediments in mesic sites accounted for a significant portion of the maximum possible variation explainable in biological condition among managed sites. However, the biological significance of the direct effects of anthropogenic drivers on instream temperature and fine sediments were minimal or not detected. Consequently, there was weak to no biological support for causal pathways related to anthropogenic drivers’ impact on biological condition. With weak biological and statistical effect sizes, ignoring environmental contextual variables and covariates that explain natural heterogeneity would have resulted in no evidence of human impacts on biological integrity in some instances. For programs targeting the effects of anthropogenic activities, it is imperative to identify both land use practices and mechanisms that have led to degraded conditions (i.e., moving beyond simple status and trend estimation). Our empirical evaluation of the conceptual model underpinning the long-term monitoring program provided an opportunity for learning and, consequently, we discuss survey design elements that require modification to achieve question driven monitoring, a necessary step in the practice of adaptive monitoring. We suspect our situation is not unique and many programs may suffer from the same inferential disconnect. Commonly, the survey design is optimized for robust estimates of regional status and trend detection and not necessarily to provide statistical inferences on the causal mechanisms outlined in the conceptual model, even though these relationships are typically used to justify and promote the long-term monitoring of a chosen ecological indicator. Our application demonstrates a process for empirical evaluation of conceptual models and exemplifies the need for such interim assessments in order for programs to evolve and persist.

The Price of Fame: The Impact of Stimulus Familiarity on Proactive Interference Resolution

PubMed Central

Prabhakaran, Ranjani; Thompson-Schill, Sharon L.

2013-01-01

Interference from previously learned information, known as proactive interference (PI), limits our memory retrieval abilities. Previous studies of PI resolution have focused on the role of short-term familiarity, or recency, in causing PI. In the present study, we investigated the impact of long-term stimulus familiarity on PI resolution processes. In two behavioral experiments and one event-related fMRI experiment, long-term familiarity was manipulated through the use of famous and nonfamous stimuli, and short-term familiarity was manipulated through the use of recent and nonrecent probe items in an item recognition task. The right middle frontal gyrus demonstrated greater sensitivity to famous stimuli, suggesting that long-term stimulus familiarity plays a role in influencing PI resolution processes. Further examination of the effect of long-term stimulus familiarity on PI resolution revealed a larger behavioral interference effect for famous stimuli, but only under speeded response conditions. Thus, models of memory retrieval—and of the cognitive control mechanisms that guide retrieval processes—should consider the impact of and interactions among sources of familiarity on multiple time scales. PMID:20429858

The price of fame: the impact of stimulus familiarity on proactive interference resolution.

PubMed

Prabhakaran, Ranjani; Thompson-Schill, Sharon L

2011-04-01

Interference from previously learned information, known as proactive interference (PI), limits our memory retrieval abilities. Previous studies of PI resolution have focused on the role of short-term familiarity, or recency, in causing PI. In the present study, we investigated the impact of long-term stimulus familiarity on PI resolution processes. In two behavioral experiments and one event-related fMRI experiment, long-term familiarity was manipulated through the use of famous and nonfamous stimuli, and short-term familiarity was manipulated through the use of recent and nonrecent probe items in an item recognition task. The right middle frontal gyrus demonstrated greater sensitivity to famous stimuli, suggesting that long-term stimulus familiarity plays a role in influencing PI resolution processes. Further examination of the effect of long-term stimulus familiarity on PI resolution revealed a larger behavioral interference effect for famous stimuli, but only under speeded response conditions. Thus, models of memory retrieval--and of the cognitive control mechanisms that guide retrieval processes--should consider the impact of and interactions among sources of familiarity on multiple time scales.

Modeling the Complex Impacts of Timber Harvests to Find Optimal Management Regimes for Amazon Tidal Floodplain Forests

PubMed Central

Fortini, Lucas B.; Cropper, Wendell P.; Zarin, Daniel J.

2015-01-01

At the Amazon estuary, the oldest logging frontier in the Amazon, no studies have comprehensively explored the potential long-term population and yield consequences of multiple timber harvests over time. Matrix population modeling is one way to simulate long-term impacts of tree harvests, but this approach has often ignored common impacts of tree harvests including incidental damage, changes in post-harvest demography, shifts in the distribution of merchantable trees, and shifts in stand composition. We designed a matrix-based forest management model that incorporates these harvest-related impacts so resulting simulations reflect forest stand dynamics under repeated timber harvests as well as the realities of local smallholder timber management systems. Using a wide range of values for management criteria (e.g., length of cutting cycle, minimum cut diameter), we projected the long-term population dynamics and yields of hundreds of timber management regimes in the Amazon estuary, where small-scale, unmechanized logging is an important economic activity. These results were then compared to find optimal stand-level and species-specific sustainable timber management (STM) regimes using a set of timber yield and population growth indicators. Prospects for STM in Amazonian tidal floodplain forests are better than for many other tropical forests. However, generally high stock recovery rates between harvests are due to the comparatively high projected mean annualized yields from fast-growing species that effectively counterbalance the projected yield declines from other species. For Amazonian tidal floodplain forests, national management guidelines provide neither the highest yields nor the highest sustained population growth for species under management. Our research shows that management guidelines specific to a region’s ecological settings can be further refined to consider differences in species demographic responses to repeated harvests. In principle, such fine-tuned management guidelines could make management more attractive, thus bridging the currently prevalent gap between tropical timber management practice and regulation. PMID:26322896

Modeling the complex impacts of timber harvests to find optimal management regimes for Amazon tidal floodplain forests

USGS Publications Warehouse

Fortini, Lucas B.; Cropper, Wendell P.; Zarin, Daniel J.

2015-01-01

At the Amazon estuary, the oldest logging frontier in the Amazon, no studies have comprehensively explored the potential long-term population and yield consequences of multiple timber harvests over time. Matrix population modeling is one way to simulate long-term impacts of tree harvests, but this approach has often ignored common impacts of tree harvests including incidental damage, changes in post-harvest demography, shifts in the distribution of merchantable trees, and shifts in stand composition. We designed a matrix-based forest management model that incorporates these harvest-related impacts so resulting simulations reflect forest stand dynamics under repeated timber harvests as well as the realities of local smallholder timber management systems. Using a wide range of values for management criteria (e.g., length of cutting cycle, minimum cut diameter), we projected the long-term population dynamics and yields of hundreds of timber management regimes in the Amazon estuary, where small-scale, unmechanized logging is an important economic activity. These results were then compared to find optimal stand-level and species-specific sustainable timber management (STM) regimes using a set of timber yield and population growth indicators. Prospects for STM in Amazonian tidal floodplain forests are better than for many other tropical forests. However, generally high stock recovery rates between harvests are due to the comparatively high projected mean annualized yields from fast-growing species that effectively counterbalance the projected yield declines from other species. For Amazonian tidal floodplain forests, national management guidelines provide neither the highest yields nor the highest sustained population growth for species under management. Our research shows that management guidelines specific to a region’s ecological settings can be further refined to consider differences in species demographic responses to repeated harvests. In principle, such fine-tuned management guidelines could make management more attractive, thus bridging the currently prevalent gap between tropical timber management practice and regulation.

Lines of Practice: A Practice-Centered Theory of Interest Relationships

ERIC Educational Resources Information Center

Azevedo, Flavio S.

2011-01-01

Based on a three-year-long ethnography of the hobby of model rocketry, I present a practice-centered theory of interest relationships--that is, the pattern of long-term, self-motivated engagement in open-ended practices that has been theorized under the concept of "individual interests". In contrast to extant theories of individual interests, in…

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 = 0.30–0.42; p<0.0001). Conclusions Early initiation and sustained use of interferon-beta-1b has a beneficial impact on long-term outcome in MS. Our analysis strategy provides a methodological framework for bias-mitigation in the analysis of non-randomized clinical data. Trial Registration Clinicaltrials.gov NCT00206635 PMID:22140424

Biogeochemical Research Priorities for Sustainable Biofuel and Bioenergy Feedstock Production in the Americas.

PubMed

Gollany, Hero T; Titus, Brian D; Scott, D Andrew; Asbjornsen, Heidi; Resh, Sigrid C; Chimner, Rodney A; Kaczmarek, Donald J; Leite, Luiz F C; Ferreira, Ana C C; Rod, Kenton A; Hilbert, Jorge; Galdos, Marcelo V; Cisz, Michelle E

2015-12-01

Rapid expansion in biomass production for biofuels and bioenergy in the Americas is increasing demand on the ecosystem resources required to sustain soil and site productivity. We review the current state of knowledge and highlight gaps in research on biogeochemical processes and ecosystem sustainability related to biomass production. Biomass production systems incrementally remove greater quantities of organic matter, which in turn affects soil organic matter and associated carbon and nutrient storage (and hence long-term soil productivity) and off-site impacts. While these consequences have been extensively studied for some crops and sites, the ongoing and impending impacts of biomass removal require management strategies for ensuring that soil properties and functions are sustained for all combinations of crops, soils, sites, climates, and management systems, and that impacts of biomass management (including off-site impacts) are environmentally acceptable. In a changing global environment, knowledge of cumulative impacts will also become increasingly important. Long-term experiments are essential for key crops, soils, and management systems because short-term results do not necessarily reflect long-term impacts, although improved modeling capability may help to predict these impacts. Identification and validation of soil sustainability indicators for both site prescriptions and spatial applications would better inform commercial and policy decisions. In an increasingly inter-related but constrained global context, researchers should engage across inter-disciplinary, inter-agency, and international lines to better ensure the long-term soil productivity across a range of scales, from site to landscape.

Digital technologies and chronic disease management.

PubMed

Georgeff, Michael

2014-12-01

Digital technologies will become a major part of our healthcare system, with particular impact in primary care. However, many healthcare professionals are not sufficiently informed of the digital technologies available today and how they and their patients can gain substantial benefit from adoption of these technologies. To raise awareness of the potential benefits of using digital technologies for improving practice efficiencies and patient health outcomes. Implementing best practice care for patients with chronic and complex conditions is one of the greatest challenges facing general practice and other primary care providers. It has been suggested that digital technologies could assist by decreasing the administrative burden of care delivery, improving quality of care, increasing practice efficiencies and better supporting patient self-management. In this paper, we consider some areas in the management of chronic and long-term conditions where digital and mobile health solutions can make a difference today.

Barriers and Facilitators in Pain Management in Long-Term Care Institutions: A Qualitative Study

ERIC Educational Resources Information Center

Fox, Patricia; Solomon, Patricia; Raina, Parminder; Jadad, Alejandro R.

2004-01-01

The purpose of this study was to identify barriers to the management of pain in long-term care institutions. Formal caregivers practising in four long-term care institutions in Hamilton, Ontario participated in eight focus groups. Participants included 6 physicians, 19 registered nurses, 8 registered practical nurses, 13 health care aides and 8…

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2011 CFR

2011-07-01

... percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw process... concentration value reflecting a reduction in the long-term average daily COD load in the raw (untreated...

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2010 CFR

2010-07-01

... percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw process... concentration value reflecting a reduction in the long-term average daily COD load in the raw (untreated...

Consolidation of Episodic Memories During Sleep

PubMed Central

Racsmány, Mihály; Conway, Martin A.; Demeter, Gyula

2009-01-01

Two experiments investigated the long-term effects of retrieval practice. In the retrieval-practice procedure, selected items from a previously studied list are repeatedly recalled. The typical retrieval-practice effects are considerably enhanced memory for practiced items accompanied by low levels of recall, relative to baseline, for previously studied items that are associated with the practiced items but were not themselves practiced. The two experiments demonstrated that the former effect persisted over 12 hr; the latter effect also persisted over 12 hr, but only if a period of nocturnal sleep occurred during the retention interval. We propose that consolidation processes occurring during sleep, and possibly featuring some form of off-line rehearsal, mediate these long-term effects of retrieval practice. PMID:20424027

Episodic Disturbance from Boat Anchoring Is a Major Contributor to, but Does Not Alter the Trajectory of, Long-Term Coral Reef Decline

PubMed Central

Forrester, Graham E.; Flynn, Rebecca L.; Forrester, Linda M.; Jarecki, Lianna L.

2015-01-01

Isolating the relative effects of episodic disturbances and chronic stressors on long-term community change is challenging. We assessed the impact of an episodic disturbance associated with human visitation (boat anchoring) relative to other drivers of long-term change on coral reefs. A one-time anchoring event at Crab Cove, British Virgin Islands, in 2004 caused rapid losses of coral and reef structural complexity that were equal to the cumulative decline over 23 years observed at an adjacent site. The abundance of small site-attached reef fishes dropped by approximately one quarter after the anchoring event, but this drop was not immediate and only fully apparent two years after the anchoring event. There was no obvious recovery from the impact, and no evidence that this episodic impact accelerated or retarded subsequent declines from other causes. This apparent lack of synergism between the effect of this episodic human impact and other chronic stressors is consistent with the few other long-term studies of episodic impacts, and suggests that action to mitigate anchor damage should yield predictable benefits. PMID:26717208

Interparental violence and children's long-term psychosocial adjustment: the mediating role of parenting practices.

PubMed

Gámez-Guadix, Manuel; Almendros, Carmen; Carrobles, José Antonio; Muñoz-Rivas, Marina

2012-03-01

The objectives of this study were: (a) to examine the direct and indirect relationships among witnessing interparental violence, parenting practices, and children's long-term psychosocial adjustment; (b) to analyze the possible gender differences in the relationships specified. The sample consisted of 1295 Spanish university students (M age = 21.21, SD = 4.04). We performed statistical analyses using structural equation modeling. The results showed that witnessing parental violence as a child is related to poor long-term psychosocial adjustment during the child's adult years. Furthermore, we found that parenting practices fully mediated the relation between witnessing interparental violence and the child's long-term adjustment. The multigroup analyses showed that most of the relations among the variables did not differ significantly by gender. However, the relation between harsh discipline and antisocial behavior was stronger for males, whereas the relation between harsh discipline and depressive symptoms was stronger for females. Finally, we discuss the implications of these findings for the clinicians and specialists who plan and develop intervention programs for populations at risk.

Temporary practice pause then resumption (TPPR) study design: an extension of the withdrawal study design to complementary and alternative medicine mind and body interventions (CAM-MABI).

PubMed

Braun, M Miles

2013-10-01

Study of complementary and alternative medicine's mind and body interventions (CAM-MABI) is hindered not only by the inability to mask participants and their teachers to the study intervention but also by the major practical hurdles of long-term study of practices that can be lifelong. Two other important methodological problems are that study of newly trained practitioners cannot directly address long-term practice, and that long-term practitioners likely self-select in ways that make finding appropriate controls (or a comparison group) challenging. The temporary practice pause then resumption study design (TPPR) introduced here is a new tool that extends the withdrawal study design, established in the field of drug evaluation, to the field of CAM-MABI. With the exception of the inability to mask, TPPR can address the other methodological problems noted above. Of great interest to investigators will likely be measures in practitioners of CAM-MABI that change with temporary pausing of CAM-MABI practice, followed by return of the measures to pre-pause levels with resumption of practice; this would suggest a link of the practice to measured changes. Such findings using this tool may enhance our insight into fundamental biological processes, leading to beneficial practical applications.

Impacts of dwarf mistletoe on the physiology of host Tsuga heterophylla trees as recorded in tree ring C and O stable isotopes

EPA Science Inventory

• Dwarf mistletoes, obligate, parasitic plants with diminutive aerial shoots, have long-term effects on host tree water relations, hydraulic architecture, and photosynthetic gas exchange and can eventually induce tree death. • To investigate long-term impacts of dwarf mistletoe...

Immediate and Long-Term Impacts of Child Sexual Abuse.

ERIC Educational Resources Information Center

Briere, John N.; Elliott, Diana M.

1994-01-01

Summarizes what is currently known about the potential, immediate, and long-term impact of child sexual abuse. The various problems and symptoms described in the literature on child sexual abuse are reviewed in a series of broad categories including posttraumatic stress, cognitive distortions, emotional pain, avoidance, an impaired sense of self,…

75 FR 46946 - Proposed Collection; Comment Request; Assessing the Long-Term Impacts of the John E. Fogarty...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... countries. The primary objective of the study is to develop detailed case studies of the long- term impacts... income countries. The findings will provide valuable information concerning return on the Center's... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment...

Long-term impacts of cropping systems and landscape positions on grain crop production on claypan soils

USDA-ARS?s Scientific Manuscript database

Sustainable grain crop production on vulnerable claypan soils requires improved knowledge of long-term impacts of conservation cropping systems (CS) with reduced inputs. Therefore, effects of CS and landscape positions (LP) on corn (Zea mays L.), soybean [Glycine max (L.) Merr.], and wheat (Triticum...

Long-Term Impact of Service Learning in Environmental Studies

ERIC Educational Resources Information Center

MacFall, Janet

2012-01-01

Long-term impacts from a senior course in Environmental Studies were evaluated by a survey of program graduates (36 respondents, 50% response rate) who had participated in the course over an 8-year permiod. Each year, the Senior Seminar used a service-learning pedagogy with a different environmentally focused project ranging from web resource…

A Grateful Recollecting: A Qualitative Study of the Long-Term Impact of Service-Learning on Graduates

ERIC Educational Resources Information Center

Fullerton, Ann; Reitenauer, Vicki L.; Kerrigan, Seanna M.

2015-01-01

Service-learning practitioners design community engagement activities to affect students in powerful and even transformative ways. This qualitative study explores the long-term impacts (3-16 years after graduation) of participation in a senior-level service-learning course. Through interviews with 20 randomly selected participants, the researchers…

Assessing the performances of low impact development alternatives by long-term simulation for a semi-arid area in Tianjin, northern China.

PubMed

Huang, Jinhui Jeanne; Li, Yu; Niu, Shuai; Zhou, Shu H

2014-01-01

For areas that are urbanized rapidly, the practice of low impact development (LID) has gained an important place in stormwater management and urban planning due to its capability and beneficial effects in restoring the original hydrological cycle. The performances of LID alternatives can vary substantially due to different climate conditions. This study investigated the performances of five LID alternatives under a semi-arid climate in northern China on water balance and flood control. A numerical model, Storm Water Management Model version 5 (US Environmental Protection Agency), was employed to run 10 years' rainfall events for these objectives. Two evaluation methods were proposed in this study: the efficiency index for water balance and a performance radar chart. The investigation of the five LID alternatives revealed that these LID alternatives functioned differently in flood control and water balance, and porous pavement performed best in all indices except the lag time. The two evaluation methods, in conjunction with the long-term numerical simulation, can facilitate design and decision making by providing a clear picture of the performance and functions for these LID alternatives.

Long-term changes of fisheries landings in enclosed gulf lagoons (Amvrakikos gulf, W Greece): Influences of fishing and other human impacts

NASA Astrophysics Data System (ADS)

Katselis, George N.; Moutopoulos, Dimitrios K.; Dimitriou, Evagelos N.; Koutsikopoulos, Constantin

2013-10-01

The present study analyses long-term annual fishery landings time series (1980-2007) for species derived from six lagoons (covering about 70 km2) around an important European wetland, the fjord-like Amvrakikos gulf. Landing trends for most abundant species revealed that typical lagoon fish species-groups, such as Mugilidae (Mugil cephalus, Chelon labrosus, Liza saliens, Liza aurata and Liza ramada), eels (Anguilla anguilla) and Gobies (mainly Zosteriosessor ophiocephalus) had largely decreased, while the landings of Sparus aurata increased during the entire study period. These trends led to a significant change in species composition during recent years that might be attributed to large-scale climatic changes as well as serious anthropogenic impacts that degraded the water quality and altered the hydrology within the gulf and lagoons, the increase of fishing exploitation in Amvrakikos gulf, the expansion of aquaculture activities within the gulf, the application of new fishing management practices in lagoons, and the increase of fish-eating sea-bird populations. The findings are needed for the implementation of an efficient and integrated management tool for the study of coastal systems.

Humanities in undergraduate medical education: a literature review.

PubMed

Ousager, Jakob; Johannessen, Helle

2010-06-01

Humanities form an integral part of undergraduate medical curricula at numerous medical schools all over the world, and medical journals publish a considerable quantity of articles in this field. The aim of this study was to determine the extent to which the literature on humanities in undergraduate medical education seeks to provide evidence of a long-term impact of this integration of humanities in undergraduate medical education. Medline was searched for publications concerning the humanities in undergraduate medical education appearing from January 2000 to December 2008. All articles were manually sorted by the authors. Two hundred forty-five articles were included in the study. Following a qualitative analysis, the references included were categorized as "pleading the case," "course descriptions and evaluations," "seeking evidence of long-term impact," or "holding the horses." Two hundred twenty-four articles out of 245 either praised the (potential) effects of humanities on medical education or described existing or planned courses without offering substantial evidence of any long-term impact of these curricular activities on medical proficiency. Only 9 articles provided evidence of attempts to document long-term impacts using diverse test tools, and 10 articles presented relatively reserved attitudes toward humanities in undergraduate medical education. Evidence on the positive long-term impacts of integrating humanities into undergraduate medical education is sparse. This may pose a threat to the continued development of humanities-related activities in undergraduate medical education in the context of current demands for evidence to demonstrate educational effectiveness.

A possible connection between thermal comfort and health

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

Stoops, John L.

It is a well-established fact that cardiovascular health requires periodic exercise during which the human body often experiences significant physical discomfort. It is not obvious to the exerciser that the short-term pain and discomfort has a long-term positive health impact. Many cultures have well-established practices that involve exposing the body to periodic thermal discomfort. Scandinavian saunas and American Indian sweat lodges are two examples. Both are believed to promote health and well-being. Vacations often intentionally include significant thermal discomfort as part of the experience (e.g., sunbathing, and downhill skiing). So people often intentionally make themselves thermally uncomfortable yet the entiremore » foundation of providing the thermal environment in our buildings is done to minimize the percentage of people thermally dissatisfied. We must provide an environment that does not negatively impact short-term health and we need to consider productivity but are our current thermal comfort standards too narrowly defined and do these standards actually contribute to longer-term negative health impacts? This paper examines the possibility that the human body thermoregulatory system has a corollary relationship to the cardiovascular system. It explores the possibility that we have an inherent need to exercise our thermoregulatory system. Potential, physiological, sociological and energy ramifications of these possibilities are discussed.« less

Head Impact Biomechanics in Women's College Soccer.

PubMed

Lynall, Robert C; Clark, Michael D; Grand, Erin E; Stucker, Jaclyn C; Littleton, Ashley C; Aguilar, Alain J; Petschauer, Meredith A; Teel, Elizabeth F; Mihalik, Jason P

2016-09-01

There are limited nonlaboratory soccer head impact biomechanics data. This is surprising given soccer's global popularity. Epidemiological data suggest that female college soccer players are at a greater concussion injury risk than their male counterparts. Therefore, the purposes of our study were to quantify head impact frequency and magnitude during women's soccer practices and games in the National Collegiate Athletic Association and to characterize these data across event type, playing position, year on the team, and segment of game (first and second halves). Head impact biomechanics were collected from female college soccer players (n = 22; mean ± SD age = 19.1 ± 0.1 yr, height = 168.0 ± 3.5 cm, mass = 63.7 ± 6.0 kg). We employed a helmetless head impact measurement device (X2 Biosystems xPatch) before each competition and practice across a single season. Peak linear and rotational accelerations were categorized based on impact magnitude and subsequently analyzed using appropriate nonparametric analyses. Overall, women's college soccer players experience approximately seven impacts per 90 min of game play. The overwhelming majority (~90%) of all head impacts were categorized into our mildest linear acceleration impact classification (10g-20g). Interestingly, a higher percentage of practice impacts in the 20g-40g range compared with games (11% vs 7%) was observed. Head impact biomechanics studies have provided valuable insights into understanding collision sports and for informing evidence-based rule and policy changes. These have included changing the football kickoff, ice hockey body checking ages, and head-to-head hits in both sports. Given soccer's global popularity, and the growing public concern for the potential long-term neurological implications of collision and contact sports, studying soccer has the potential to impact many athletes and the sports medicine professionals caring for them.

A Sustainable Early Warning System for Climate Change Impacts on Water Quality Management

NASA Astrophysics Data System (ADS)

Lee, T.; Tung, C.; Chung, N.

2007-12-01

In this era of rapid social and technological change leading to interesting life complexity and environmental displacement, both positive and negative effects among ecosystems call for a balance in which there are impacts by climate changes. Early warning systems for climate change impacts are necessary in order to allow society as a whole to properly and usefully assimilate the masses of new information and knowledge. Therefore, our research addresses to build up a sustainable early warning mechanism. The main goal is to mitigate the cumulative impacts on the environment of climate change and enhance adaptive capacities. An effective early warning system has been proven for protection. However, there is a problem that estimate future climate changes would be faced with high uncertainty. In general, take estimations for climate change impacts would use the data from General Circulation Models and take the analysis as the Intergovernmental Panel on Climate Change declared. We follow the course of the method for analyzing climate change impacts and attempt to accomplish the sustainable early warning system for water quality management. Climate changes impact not only on individual situation but on short-term variation and long-term gradually changes. This kind characteristic should adopt the suitable warning system for long-term formulation and short- term operation. To continue the on-going research of the long-term early warning system for climate change impacts on water quality management, the short-term early warning system is established by using local observation data for reappraising the warning issue. The combination of long-term and short-term system can provide more circumstantial details. In Taiwan, a number of studies have revealed that climate change impacts on water quality, especially in arid period, the concentration of biological oxygen demand may turn into worse. Rapid population growth would also inflict injury on its assimilative capacity to degenerate. To concern about those items, the sustainable early warning system is established and the initiative fall into the following categories: considering the implications for policies, applying adaptive strategies and informing the new climate changes. By setting up the framework of early warning system expectantly can defend stream area from impacts damaging and in sure the sustainable development.

Tolerance in liver transplantation: Biomarkers and clinical relevance

PubMed Central

Baroja-Mazo, Alberto; Revilla-Nuin, Beatriz; Parrilla, Pascual; Martínez-Alarcón, Laura; Ramírez, Pablo; Pons, José Antonio

2016-01-01

Transplantation is the optimal treatment for end-stage organ failure, and modern immunosuppression has allowed important progress in short-term outcomes. However, immunosuppression poorly influences chronic rejection and elicits chronic toxicity in current clinical practice. Thus, a major goal in transplantation is to understand and induce tolerance. It is well established that human regulatory T cells expressing the transcription factor FoxP3 play important roles in the maintenance of immunological self-tolerance and immune homeostasis. The major regulatory T cell subsets and mechanisms of expansion that are critical for induction and long-term maintenance of graft tolerance and survival are being actively investigated. Likewise, other immune cells, such as dendritic cells, monocyte/macrophages or natural killer cells, have been described as part of the process known as “operational tolerance”. However, translation of these results towards clinical practice needs solid tools to identify accurately and reliably patients who are going to be tolerant. In this way, a plethora of genetic and cellular biomarkers is raising and being validated worldwide in large multi-center clinical trials. Few of the studies performed so far have provided a detailed analysis of the impact of immunosuppression withdrawal on pre-existing complications derived from the long-term administration of immunosuppressive drugs and the side effects associated with them. The future of liver transplantation is aimed to develop new therapies which increase the actual low tolerant vs non-tolerant recipients ratio. PMID:27678350

Controlling Explosive Sensitivity of Energy-Related Materials by Means of Production and Processing in Electromagnetic Fields

NASA Astrophysics Data System (ADS)

Rodzevich, A. P.; Gazenaur, E. G.; Kuzmina, L. V.; Krasheninin, V. I.; Sokolov, P. N.

2016-08-01

The present work is one of the world first attempts to develop effective methods for controlling explosive sensitivity of energy-related materials with the help of weak electric (up to 1 mV/cm) and magnetic (0.001 T) fields. The resulting experimental data can be used for purposeful alternation of explosive materials reactivity, which is of great practical importance. The proposed technology of producing and processing materials in a weak electric field allows forecasting long-term stability of these materials under various energy impacts.

Long-Term Outcomes of a Dental Postbaccalaureate Program: Increasing Dental Student Diversity and Oral Health Care Access

PubMed Central

Wides, Cynthia D.; Brody, Harvey A.; Alexander, Charles J.; Gansky, Stuart A.; Mertz, Elizabeth A.

2013-01-01

The University of California, San Francisco School of Dentistry established the Dental Postbaccalaureate Program in 1998 to provide reapplication assistance to students from economically and/or educationally disadvantaged backgrounds who were previously denied admission to dental school. The goals were to increase diversity in the dental school student population and improve access to dental services for underserved populations. This article assesses the program’s short-, mid-, and long-term outcomes and is the first to examine long-term practice patterns after a dental postbaccalaureate program. Data collected on all participant (n=94) demographics, pre/post-program DAT scores, and post-program dental school admission results were used to assess short- and mid-term outcomes. Long-term outcomes and practice patterns were assessed using results of a census survey administered between 2009 and 2011 to the participants who had completed dental school and been in practice for at least two years (n=57). The survey had a response rate of 93 percent (n=53). Descriptive statistical techniques were used to examine the responses and to compare them to U.S. Census Bureau data and nationally available practice data for new dental graduates. Program participants’ DAT scores improved by an average of two points, and 98 percent were accepted to dental school. All survey respondents were practicing dentistry, and 81 percent reported serving underserved populations. These participants treat more Medicaid recipients than do most dentists, and their patient population is more diverse than the general population. The outcomes demonstrate that the program’s graduates are increasing diversity in the dental student population and that their practices are providing access to care for underserved populations. PMID:23658398

Factors Associated with the Effectiveness of Continuing Education in Long-Term Care

ERIC Educational Resources Information Center

Stolee, Paul; Esbaugh, Jacquelin; Aylward, Sandra; Cathers, Tamzin; Harvey, David P.; Hillier, Loretta M.; Keat, Nancy; Feightner, John W.

2005-01-01

Purpose: This article examines factors within the long-term-care work environment that impact the effectiveness of continuing education. Design & Methods: In Study 1, focus group interviews were conducted with staff and management from urban and rural long-term-care facilities in southwestern Ontario to identify their perceptions of the…

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2011 CFR

2011-07-01

... limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily BOD5 load of... to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

40 CFR 439.52 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2012 CFR

2012-07-01

..., kg) per day, must reflect not less than 74 percent reduction in the long-term average daily COD load... long-term average daily BOD5 or COD mass loading of the raw process wastewater (i.e., the base number..., calculation of the long-term average daily BOD5 or COD load in the influent to the wastewater treatment system...

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2013 CFR

2013-07-01

... average limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily... subject to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2010 CFR

2010-07-01

... limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily BOD5 load of... to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

40 CFR 439.52 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., kg) per day, must reflect not less than 74 percent reduction in the long-term average daily COD load... long-term average daily BOD5 or COD mass loading of the raw process wastewater (i.e., the base number..., calculation of the long-term average daily BOD5 or COD load in the influent to the wastewater treatment system...

40 CFR 439.52 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., kg) per day, must reflect not less than 74 percent reduction in the long-term average daily COD load... long-term average daily BOD5 or COD mass loading of the raw process wastewater (i.e., the base number..., calculation of the long-term average daily BOD5 or COD load in the influent to the wastewater treatment system...

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2013 CFR

2013-07-01

... than 90 percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw..., calculation of the long-term average daily BOD5 load in the influent to the wastewater treatment system must...

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2012 CFR

2012-07-01

... than 90 percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw..., calculation of the long-term average daily BOD5 load in the influent to the wastewater treatment system must...

40 CFR 439.12 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2014 CFR

2014-07-01

... than 90 percent reduction in the long-term average daily BOD5 load of the raw (untreated) process wastewater, multiplied by a variability factor of 3.0. (1) The long-term average daily BOD5 load of the raw..., calculation of the long-term average daily BOD5 load in the influent to the wastewater treatment system must...

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2014 CFR

2014-07-01

... average limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily... subject to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

40 CFR 439.22 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2012 CFR

2012-07-01

... average limitation for BOD5 that is less than the equivalent of 45 mg/L. (1) The long-term average daily... subject to this subpart, calculation of the long-term average daily BOD5 load in the influent to the... this section is higher than a concentration value reflecting a reduction in the long-term average daily...

Risks and Benefits of Swaddling Healthy Infants: An Integrative Review.

PubMed

Nelson, Antonia M

Swaddling has been practiced since antiquity; however, there is controversy about its safety. The purpose of this review is to update and build upon previous reviews and synthesize evidence on risks and benefits of swaddling in healthy-term, near-term, or older infants. MEDLINE (1960-May 13, 2016) and CINAHL (1963-May 13, 2016) searches were conducted, relevant articles retrieved, and citation lists reviewed for other references. A table summarizes study details. Selected older references and supporting literature are integrated into the synthesis to provide context. Swaddling calms infants and promotes sleep, but it is equally or less effective than other nonpharmacological methods in managing pain. There may be a slight risk for sudden infant death syndrome associated with supine swaddling, although the impact of confounding variables is unclear. Early skin-to-skin contact supports early breastfeeding, but swaddling does not have a negative impact on breastfeeding long term. Swaddling tightly around the hips is strongly associated with developmental dysplasia of the hip. More research is needed on the impact of swaddling on pain in term infants, infant vital signs, arousal thresholds, and a possible association between swaddling, vitamin D deficiency, and acute lower respiratory tract infection. The number of studies was small, with few randomized control trials, and researchers used different definitions of swaddling. If a few precautions are taken, such as swaddling securely to minimize risk of unwrapping, avoiding overheating, placing infants to sleep supine, and discontinuing swaddling when infants first show signs of rolling over, swaddling presents minimal risk. Maternity and neonatal nurses should model swaddling practices based on the evidence and promote informed decision-making among infant caregivers.

The effects of spiritual practices on recovery from substance abuse.

PubMed

Carter, T M

1998-10-01

Twelve-step programs have stressed the importance of spiritual practices for over four decades. The spiritual principles embodied in the twelve-step programs may be key in their success of recovering addicts/alcoholics with an overall recovery rate of 34%. A literature search revealed little available data on spiritual principles and practices and their effects on long-term recovery from substance abuse. This study compared two groups of recovering addicts, those with one year of recovery and those with less than one year and a history of relapse. Spiritual practices were measured using a five-point Likert scale questionnaire. The results of the study indicated a relationship between spiritual practices and long-term recovery from substance abuse.

Beyond Comprehension Strategy Instruction: What's Next?

PubMed

Elleman, Amy M; Compton, Donald L

2017-04-20

In this article, we respond to Catts and Kamhi's (2017) argument that reading comprehension is not a single ability. We provide a brief review of the impact of strategy instruction, the importance of knowledge in reading comprehension, and possible avenues for future research and practice. We agree with Catts and Kamhi's argument that reading comprehension is a complex endeavor and that current recommended practices do not reflect the complexity of the construct. Knowledge building, despite its important role in comprehension, has been relegated to a back seat in reading comprehension instruction. In the final section of the article, we outline possible avenues for research and practice (e.g., generative language instruction, dialogic approaches to knowledge building, analogical reasoning and disciplinary literacy, the use of graphics and media, inference instruction) for improving reading-comprehension outcomes. Reading comprehension is a complex ability, and comprehension instruction should reflect this complexity. If we want to have an impact on long-term growth in reading comprehension, we will need to expand our current repertoire of instructional methods to include approaches that support the acquisition and integration of knowledge across a variety of texts and topics.

Long-Term Impacts of the Chicago School Readiness Project on Children's Behavior in Kindergarten: The Moderating Role of Child Baseline Characteristics and Kindergarten School Quality

ERIC Educational Resources Information Center

Jones, Stephanie M.; Zhai, Fuhua; Raver, C. Cybele

2010-01-01

This paper investigates the long-term impact of participation in the Chicago School Readiness Project (CSRP) during the Head Start year on children's behavioral outcomes at the end of their Kindergarten year. The primary questions addressed in the paper are: (1) What is the experimental impact of CSRP on two-year change (from Fall Head Start to…

The long-term impact of community mobilisation through participatory women's groups on women's agency in the household: A follow-up study to the Makwanpur trial

PubMed Central

Skordis-Worrall, Jolene; Manandhar, Dharma S.; Strachan, Daniel; Morrison, Joanna; Saville, Naomi; Osrin, David; Tumbahangphe, Kirti M.; Costello, Anthony; Heys, Michelle

2018-01-01

Women’s groups practicing participatory learning and action (PLA) in rural areas have been shown to improve maternal and newborn survival in low-income countries, but the pathways from intervention to impact remain unclear. We assessed the long-term impact of a PLA intervention in rural Nepal on women’s agency in the household. In 2014, we conducted a follow-up study to a cluster randomised controlled trial on the impact of PLA women’s groups from 2001–2003. Agency was measured using the Relative Autonomy Index (RAI) and its subdomains. Multi-level regression analyses were performed adjusting for baseline socio-demographic characteristics. We additionally adjusted for potential exposure to subsequent PLA groups based on women’s pregnancy status and conduct of PLA groups in areas of residence. Sensitivity analyses were performed using two alternative measures of agency. We analysed outcomes for 4030 mothers (66% of the cohort) who survived and were recruited to follow-up at mean age 39.6 years. Across a wide range of model specifications, we found no association between exposure to the original PLA intervention with women’s agency in the household approximately 11.5 years later. Subsequent exposure to PLA groups was not associated with greater agency in the household at follow-up, but some specifications found evidence for reduced agency. Household agency may be a prerequisite for actualising the benefits of PLA groups rather than a consequence. PMID:29758071

Customers' perspectives on the impact of the Pathways to Work condition management programme on their health, well-being and vocational activity.

PubMed

Secker, Jenny; Pittam, Gail; Ford, Fiona

2012-11-01

Pathways to Work is a UK initiative aimed at supporting customers on incapacity benefits to return to work. This qualitative study complements previous evaluations of Pathways to Work by exploring customers' perceptions of the impact of the Condition Management Programme (CMP) offered to claimants with long-term health conditions. 39 customers took part in focus groups held at the seven sites where Pathways was originally piloted. The main focus of the discussions was on perceptions of the ways in which participation had impacted on health, well-being and return to work. The discussions were audio-recorded and fully transcribed for analysis using a text analysis framework to enable the development and refinement of categories and overarching patterns in the data. Perceived impacts on health and well-being included a more positive outlook, social contact, changed perceptions of conditions and improvements in health. Some customers also reported an increase in their vocational activity and others felt ready to embark on new activities. Factors associated with positive outcomes included the extent and quality of contact with CMP staff and practical advice about condition management. Factors impeding positive employment outcomes related mainly to obstacles to returning to work. The results indicated that CMP can assist customers to learn about and manage their health conditions and increase their vocational activity, and that CMP therefore provides a promising means of enabling people with long-term health conditions to regain a fulfilling, productive life.

Practice-induced and sequential modulations of the Simon effect.

PubMed

Soetens, Eric; Maetens, Kathleen; Zeischka, Peter

2010-05-01

People react more quickly and more accurately to stimuli presented in locations corresponding to the response, as compared with noncorresponding locations, even when stimulus location is irrelevant (Simon effect [SE]). The explanation that SEs are caused by the automatic priming of a corresponding response has been questioned, because of the many exceptions to the effect. We replicated practice-induced and sequential modulations of the SE in two experiments--first, by training participants with blocks of location-relevant stimuli, and second, by mixing location-relevant and location-irrelevant trials. The decrease of the SE with incompatible training was relatively permanent in the blocked experiment, whereas the effect was temporary in the mixed experiment. The difference was caused by a more permanent reversal of the SE after incongruent trials, showing that sequential modulations depend on long-term practice effects. We suggest that there is a formation of a contralateral long-term memory stimulus-response link in blocked conditions and that short-term and long-term memory links are primed by preceding events.

Is there an environmental benefit from remediation of a contaminated site? Combined assessments of the risk reduction and life cycle impact of remediation.

PubMed

Lemming, Gitte; Chambon, Julie C; Binning, Philip J; Bjerg, Poul L

2012-12-15

A comparative life cycle assessment is presented for four different management options for a trichloroethene-contaminated site with a contaminant source zone located in a fractured clay till. The compared options are (i) long-term monitoring (ii) in-situ enhanced reductive dechlorination (ERD), (iii) in-situ chemical oxidation (ISCO) with permanganate and (iv) long-term monitoring combined with treatment by activated carbon at the nearby waterworks. The life cycle assessment included evaluation of both primary and secondary environmental impacts. The primary impacts are the local human toxic impacts due to contaminant leaching into groundwater that is used for drinking water, whereas the secondary environmental impacts are related to remediation activities such as monitoring, drilling and construction of wells and use of remedial amendments. The primary impacts for the compared scenarios were determined by a numerical risk assessment and remedial performance model, which predicted the contaminant mass discharge over time at a point of compliance in the aquifer and at the waterworks. The combined assessment of risk reduction and life cycle impacts showed that all management options result in higher environmental impacts than they remediate, in terms of person equivalents and assuming equal weighting of all impacts. The ERD and long-term monitoring were the scenarios with the lowest secondary life cycle impacts and are therefore the preferred alternatives. However, if activated carbon treatment at the waterworks is required in the long-term monitoring scenario, then it becomes unfavorable because of large secondary impacts. ERD is favorable due to its low secondary impacts, but only if leaching of vinyl chloride to the groundwater aquifer can be avoided. Remediation with ISCO caused the highest secondary impacts and cannot be recommended for the site. Copyright © 2012 Elsevier Ltd. All rights reserved.

Faculty Development in Higher Education: Long-Term Impact of a Summer Teaching and Learning Workshop

ERIC Educational Resources Information Center

Persellin, Diane; Goodrick, Terry

2010-01-01

Past participants of the Associated Colleges of the South Summer Teaching and Learning Workshop were surveyed to determine long-term impact of this type of professional development experience. Results indicate a large majority of participants across rank and academic discipline continued to view the workshop as effective and valued feedback from…

Field-scale monitoring of the long-term impact and sustainability of drainage water reuse using ECa-directed soil sampling

USDA-ARS?s Scientific Manuscript database

Diminishing freshwater resources have brought attention to the reuse of degraded water as a water resource rather than a disposal problem. Drainage water from tile-drained, irrigated agricultural land is degraded water that is often in large supply, but the long-term impact and sustainability of it...

Assessing the Long-Term Impacts of Water Quality Outreach and Education Efforts on Agricultural Landowners

ERIC Educational Resources Information Center

Jackson-Smith, Douglas B.; McEvoy, Jamie P.

2011-01-01

We assess the long-term effectiveness of outreach and education efforts associated with a water quality improvement project in a watershed located in northern Utah, USA. Conducted 15 years after the original project began, our research examines the lasting impacts of different extension activities on landowners' motivations to participate and…

Child Abuse in Religiously-Affiliated Institutions: Long-Term Impact on Men's Mental Health

ERIC Educational Resources Information Center

Wolfe, David A.; Francis, Karen J.; Straatman, Anna-Lee

2006-01-01

Objective: To describe the long-term impact of physical and sexual abuse of boys by someone in a trusting, non-familial relationship. This clinical study reports on the psychological functioning of men (N=76) with substantiated claims against a residential religiously-affiliated institution for multiple and severe incidents of sexual, physical,…

The Long-Term Impact of Admission Policies: A Comparative Study of Two Emergent Research Institutions in Texas

ERIC Educational Resources Information Center

Crisp, Gloria; Horn, Catherine; Dizinno, Gerry; Barlow, Libby

2013-01-01

The present study explored the long-term impact of admission policies at two aspiring research institutions in Texas. Six years of longitudinal institutional data were analyzed for all full-time first time in college undergraduate students at both universities. Descriptive and inferential statistics were used to identify relationships and…

Impacts of Early Childhood Education on Medium- and Long-Term Educational Outcomes

ERIC Educational Resources Information Center

McCoy, Dana Charles; Yoshikawa, Hirokazu; Ziol-Guest, Kathleen M.; Duncan, Greg J.; Schindler, Holly S.; Magnuson, Katherine; Yang, Rui; Koepp, Andrew; Shonkoff, Jack P.

2017-01-01

Despite calls to expand early childhood education (ECE) in the United States, questions remain regarding its medium- and long-term impacts on educational outcomes. We use meta-analysis of 22 high-quality experimental and quasi-experimental studies conducted between 1960 and 2016 to find that on average, participation in ECE leads to statistically…

Effects of two prairie dog rodenticides on ground-dwelling invertebrates in western South Dakota

Treesearch

Michele S. Deisch; Daniel W. Uresk; Raymond L. Linder

1989-01-01

Immediate and long-term effects of 3 rodenticide treatments on nontarget invertebrates were evaluated on prairie dog colonies. Immediate impacts indicated zinc phosphide reduced ants, strychnine alone reduced wolf spiders, and prebaited strychnine had no impacts. Long-term changes showed increases in wolf spiders and ground beetles and densities were contributed to...

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

ERIC Educational Resources Information Center

Jensen, Eric Allen

2016-01-01

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

Speech-language pathology in the long-term care setting: it isn't your grandmother's nursing home anymore.

PubMed

Casper, Mary L

2013-04-01

This article considers the career of speech-language pathologists practicing in long-term care/skilled nursing facility settings. The range of conditions that lead to communication, cognition, and/or swallowing disorders that are evaluated and treated by the speech-language pathologist in the long-term care setting are examined. Various methodologies for reimbursement are discussed, including the Medicare Physicians' Fee Schedule associated with Medicare Part B and the Prospective Payment System associated with Medicare Part A. Suggestions for effective clinical service delivery are reviewed, along with best practices for interdisciplinary team communication. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comprehensive Coach Education Reduces Head Impact Exposure in American Youth Football.

PubMed

Kerr, Zachary Y; Yeargin, Susan W; Valovich McLeod, Tamara C; Mensch, James; Hayden, Ross; Dompier, Thomas P

2015-10-01

Despite little evidence that defines a threshold of head impact exposure or that participation in youth sports leads to long-term cognitive impairments, it is prudent to identify methods of reducing the frequency of head impacts. To compare the mean number of head impacts between youth football players in practice and games between leagues that implemented the Heads Up Football (HUF) educational program and those that did not (NHUF). Cohort study; Level of evidence, 2. During the 2014 season, head impact exposure was measured using xPatch accelerometers from 70 youth football players aged 8 to 15 years from 5 leagues. Data were collected during both games and practices. The NHUF group comprised 32 players from 8 teams within 3 leagues. The HUF group comprised 38 players from 7 teams within 2 leagues. Independent-sample t tests evaluated differences in head impact exposure across groups (ie, HUF and NHUF). Players (mean ± SD: age, 11.7 ± 1.4 years; height, 152.2 ± 10.5 cm; weight, 51.6 ± 9.6 kg) experienced a total of 7478 impacts over 10g, of which 4250 (56.8%) and 3228 (43.2%) occurred in practices and games, respectively. The majority of impacts occurred within the NHUF group (62.0%), followed by the HUF group (38.0%). With a 10g impact threshold, the mean number of impacts during practice per individual event was lower in the HUF group (mean ± SD, 5.6 ± 2.9) than in the NHUF group (mean ± SD, 8.9 ± 3.1; difference, 3.4; 95% CI, 2.9-3.9). This difference was attenuated when the threshold was changed to 20g but remained significant (difference, 1.0; 95% CI, 0.7-1.3). At both the 10g and 20g impact thresholds, no differences were found in games. Players who participated in HUF leagues accumulated fewer head impacts per practice at both the 10g and 20g thresholds. Youth football leagues should consider the HUF educational program, while exploring additional interventions, to help reduce the number of head impacts in players.

Comprehensive Coach Education Reduces Head Impact Exposure in American Youth Football

PubMed Central

Kerr, Zachary Y.; Yeargin, Susan W.; Valovich McLeod, Tamara C.; Mensch, James; Hayden, Ross; Dompier, Thomas P.

2015-01-01

Background: Despite little evidence that defines a threshold of head impact exposure or that participation in youth sports leads to long-term cognitive impairments, it is prudent to identify methods of reducing the frequency of head impacts. Purpose: To compare the mean number of head impacts between youth football players in practice and games between leagues that implemented the Heads Up Football (HUF) educational program and those that did not (NHUF). Study Design: Cohort study; Level of evidence, 2. Methods: During the 2014 season, head impact exposure was measured using xPatch accelerometers from 70 youth football players aged 8 to 15 years from 5 leagues. Data were collected during both games and practices. The NHUF group comprised 32 players from 8 teams within 3 leagues. The HUF group comprised 38 players from 7 teams within 2 leagues. Independent-sample t tests evaluated differences in head impact exposure across groups (ie, HUF and NHUF). Results: Players (mean ± SD: age, 11.7 ± 1.4 years; height, 152.2 ± 10.5 cm; weight, 51.6 ± 9.6 kg) experienced a total of 7478 impacts over 10g, of which 4250 (56.8%) and 3228 (43.2%) occurred in practices and games, respectively. The majority of impacts occurred within the NHUF group (62.0%), followed by the HUF group (38.0%). With a 10g impact threshold, the mean number of impacts during practice per individual event was lower in the HUF group (mean ± SD, 5.6 ± 2.9) than in the NHUF group (mean ± SD, 8.9 ± 3.1; difference, 3.4; 95% CI, 2.9-3.9). This difference was attenuated when the threshold was changed to 20g but remained significant (difference, 1.0; 95% CI, 0.7-1.3). At both the 10g and 20g impact thresholds, no differences were found in games. Conclusion: Players who participated in HUF leagues accumulated fewer head impacts per practice at both the 10g and 20g thresholds. Youth football leagues should consider the HUF educational program, while exploring additional interventions, to help reduce the number of head impacts in players. PMID:26779546

Self-Reported Long-Term Benefits of Mindfulness-Based Cognitive Therapy in Patients with Bipolar Disorder.

PubMed

Weber, Béatrice; Sala, Loretta; Gex-Fabry, Marianne; Docteur, Aurélie; Gorwood, Philip; Cordera, Paolo; Bondolfi, Guido; Jermann, Françoise; Aubry, Jean-Michel; Mirabel-Sarron, Christine

2017-07-01

This study focused on patients with bipolar disorder (BD), several years after their participation in mindfulness-based cognitive therapy (MBCT). It aimed at documenting sustained mindfulness practice, perceived long-term benefit from the program, and changes regarded as direct consequences of the intervention. This cross-sectional survey took place at least 2 years after MBCT for 70.4% of participants. It was conducted in two specialized outpatient units for BDs that are part of the Geneva University Hospitals (Switzerland) and the Sainte-Anne Hospital in Paris (France). Eligibility criteria were a diagnosis of BD according to DSM-IV and participation in at least four MBCT sessions. Response rate was 66.4%. The final sample included 71 outpatients (71.8% bipolar I, 28.2% bipolar II). A questionnaire retrospectively assessed patient-perceived change, benefit from MBCT, and current mindfulness practice. Proportions of respondents who practiced mindfulness at least once a week were 54.9% for formal practice (body scan, sitting meditation, mindful walking, or movements) and 57.7% for informal practice (mindful daily activities). Perceived benefit for the prevention of relapse was moderate, but patients acknowledged long-lasting effects and persistent changes in their way of life. Formal mindfulness practice at least once a week tended to be associated with increased long-lasting effects (p = 0.052), whereas regular informal practice and mindful breathing were significantly associated with persistent changes in daily life (p = 0.038) and better prevention of depressive relapse (p = 0.035), respectively. The most frequently reported positive change was increased awareness of being able to improve one's health. Despite methodological limitations, this survey allowed documenting mindfulness practice and perceived sustained benefit from MBCT in patients with BD. Participants particularly valued increased awareness that they can influence their own health. Both informal and formal practices, when sustained in the long term, might promote long-lasting changes.

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

PubMed

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

2016-11-01

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

Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes

PubMed Central

Congdon, Peter

2016-01-01

Background: Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. Methods: This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. Results: As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Conclusions: Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables. PMID:27598184

Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes.

PubMed

Congdon, Peter

2016-09-01

Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables.

Crop Establishment Practices Are a Driver of the Plant Microbiota in Winter Oilseed Rape (Brassica napus)

PubMed Central

Rathore, Ridhdhi; Dowling, David N.; Forristal, Patrick D.; Spink, John; Cotter, Paul D.; Bulgarelli, Davide; Germaine, Kieran J.

2017-01-01

Gaining a greater understanding of the plant microbiota and its interactions with its host plant heralds a new era of scientific discovery in agriculture. Different agricultural management practices influence soil microbial populations by changing a soil’s physical, chemical and biological properties. However, the impact of these practices on the microbiota associated with economically important crops such as oilseed rape, are still understudied. In this work we investigated the impact of two contrasting crop establishment practices, conventional (plow based) and conservation (strip–tillage) systems, on the microbiota inhabiting different plant microhabitats, namely rhizosphere, root and shoot, of winter oilseed rape under Irish agronomic conditions. Illumina 16S rRNA gene sequence profiling showed that the plant associated microhabitats (root and shoot), are dominated by members of the bacterial phyla Proteobacteria, Actinobacteria and Bacteroidetes. The root and shoot associated bacterial communities displayed markedly distinct profiles as a result of tillage practices. We observed a very limited ‘rhizosphere effect’ in the root zone of WOSR, i.e., there was little or no increase in bacterial community richness and abundance in the WOSR rhizosphere compared to the bulk soil. The two tillage systems investigated did not appear to lead to any major long term differences on the bulk soil or rhizosphere bacterial communities. Our data suggests that the WOSR root and shoot microbiota can be impacted by management practices and is an important mechanism that could allow us to understand how plants respond to different management practices and environments. PMID:28848510

Long term microparticle impact fluxes on LDEF determined from optical survey of Interplanetary Dust Experiment (IDE) sensors

NASA Technical Reports Server (NTRS)

Simon, C. G.; Oliver, J. P.; Cooke, W. J.; Downey, K. I.; Kassel, P. C.

1995-01-01

Many of the IDE metal-oxide-silicon (MOS) capacitor-discharge impact sensors remained active during the entire Long Duration Exposure Facility (LDEF) mission. An optical survey of impact sites on the active surfaces of these sensors has been extended to include all sensors from the low-flux sides of LDEF (i.e. the west or trailing side, the earth end, and the space end) and 5-7 active sensors from each LDEF's high-flux sides (i.e. the east or leading side, the south side, and the north side). This survey was facilitated by the presence of a relatively large (greater than 50 micron diameter) optical signature associated with each impact site on the active sensor surfaces. Of the approximately 4700 impacts in the optical survey data set, 84% were from particles in the 0.5 to 3 micron size range. An estimate of the total number of hypervelocity impacts on LDEF from particles greater than 0.5 micron diameter yields a value of approximately 7 x 10(exp 6). Impact feature dimensions for several dozen large craters on MOS sensors and germanium witness plates are also presented. Impact fluxes calculated from the IDE survey data closely matched surveys of similar size impacts (greater than or equal to 3 micron diameter craters in Al, or marginal penetrations of a 2.4 micron thick Al foil) by other LDEF investigators. Since the first year IDE data were electronically recorded, the flux data could be divided into three long term time periods: the first year, the entire 5.8 year mission, and the intervening 4.8 years (by difference). The IDE data show that there was an order of magnitude decrease in the long term microparticle impact flux on the trailing side of LDEF, from 1.01 to 0.098 x 10(exp -4) m(exp 2)/s, from the first year in orbit compared to years 2-6. The long term flux on the leading edge showed an increase from 8.6 to 11.2 x 10(exp -4) m(exp -2)/s over this same time period. (Short term flux increases up to 10,000 times the background rate were recorded on the leading side during LDEF's first year in orbit.) The overall east/west ratio was 44, but during LDEF's first year in orbit the ratio was 8.5, and during years 2-6 the ratio was 114. Long term microparticle impact fluxes on the space end decreased from 1.12 to 0.55 x 10(exp -4) m(exp -2)/s from the first year in orbit compared to years 2-6. The earth end showed the opposite trend with an increase from 0.16 to 0.38 x 10(exp -4) m(exp -2)/s. Fluxes on rows 6 and 12 decreased from 6.1 to 3.4 and 6.7 to 3.7 x 10(exp -4) m(exp -2)/s, respectively, over the same time periods. This resulted in space/earth microparticle impact flux ratios of 7.1 during the first year and 1.5 during years 2-6, while the south/north, space/north and space/south ratios remained constant at 1.1, 0.16 and 0.17, respectively, during the entire mission. This information indicates the possible identification of long term changes in discrete microparticle orbital debris component contributions to the total impact flux experienced by LDEF. A dramatic decrease in the debris population capable of striking the trailing side was detected that could possibly be attributed to the hiatus of western launch activity experienced from 1986-1989. A significant increase in the debris population that preferentially struck the leading side was also observed and could possibly be attributed to a single breakup event that occurred in September of 1986. A substantial increase in the microparticle debris population that struck the earth end of LDEF, but not the space end, was also detected and could possibly be the result of a single breakup event at low altitude. These results point to the importance of including discrete orbital debris component contribution changes in flux models in order to achieve accurate predictions of the microparticle environment that a particular spacecraft will experience in earth orbit. The only reliable, verified empirical measurements of these changes are reported in this paper. Further time-resolved in-situ measurements of these debris populations are needed to accurately assess model predictions and mitigation practices.

Prevention of fall-related injuries in long-term care: a randomized controlled trial of staff education.

PubMed

Ray, Wayne A; Taylor, Jo A; Brown, Anne K; Gideon, Patricia; Hall, Kathi; Arbogast, Patrick; Meredith, Sarah

2005-10-24

Fall-related injuries, a major public health problem in long-term care, may be reduced by interventions that improve safety practices. Previous studies have shown that safety practice interventions can reduce falls; however, in long-term care these have relied heavily on external funding and staff. The aim of this study was to test whether a training program in safety practices for staff could reduce fall-related injuries in long-term care facilities. A cluster randomization clinical trial with 112 qualifying facilities and 10,558 study residents 65 years or older and not bedridden. The intervention was an intensive 2-day safety training program with 12-month follow-up. The training program targeted living space and personal safety; wheelchairs, canes, and walkers; psychotropic medication use; and transferring and ambulation. The main outcome measure was serious fall-related injuries during the follow-up period. There was no difference in injury occurrence between the intervention and control facilities (adjusted rate ratio, 0.98; 95% confidence interval, 0.83-1.16). For residents with a prior fall in facilities with the best program compliance, there was a nonsignificant trend toward fewer injuries in the intervention group (adjusted rate ratio, 0.79; 95% confidence interval, 0.57-1.10). More intensive interventions are required to prevent fall-related injuries in long-term care facilities.

Nurses' experiences of practice and political reform in long-term aged care in Australia: implications for the retention of nursing personnel.

PubMed

Venturato, Lorraine; Kellett, Ursula; Windsor, Carol

2007-01-01

The aim of the study was to explore registered nurses' experiences in long-term aged care in light of the political reform of aged care services in Australia. In Australia, the aged care industry has undergone a lengthy period of political and structural reform. Despite reviews into various aspects of these reforms, there has been little consideration of the effect these are having on the practice experiences and retention of nursing staff in long-term care. In this critical hermeneutic study, 14 nurses from long-term care facilities in Australia were interviewed about their experiences during the reform period. The data revealed a sense of tension and conflict between nurses' traditional values, roles and responsibilities and those supported by the reforms. Nurses struggled to re-negotiate both their practice roles and values as the reforms were implemented and the system evolved. Nursing management support was an important aspect in mediating the effect of reforms on nursing staff. This research highlights both the tensions experienced by nurses in long-term aged care in Australia and the need to re-negotiate nursing roles, responsibilities and values within an evolving care system. This research supports a role for sensitive and proactive nursing management during periods of industry reform as a retention strategy for qualified nursing personnel.

Effects of sea-level rise and freshwater management on long-term water levels and water quality in the Florida Coastal Everglades.

PubMed

Dessu, Shimelis B; Price, René M; Troxler, Tiffany G; Kominoski, John S

2018-04-01

Since the 1880s, hydrological modification of the Greater Florida Everglades has reduced water levels and flows in Everglades National Park (ENP). The Comprehensive Everglades Restoration Program (CERP) began in 2000 to restore pre-drainage flows and preserve the natural landscape of the Everglades. However, sea-level rise (SLR) was not considered in the development of CERP. We used long-term data (2001-2016) from the Florida Coastal Everglades-Long Term Ecological Research Program to quantify and model the spatial dynamics of water levels, salinity, and nutrients in response to changes in climate, freshwater management and SLR in the Shark River Slough (SRS), ENP. Results indicate that fresh-to-marine head difference (FMHD) was the single most important factor affecting marine-to-freshwater hydrologic connectivity and transport of salinity and phosphorous upstream from the Gulf of Mexico. Sea-level has increasingly exceeded ground surface elevation at the most downstream freshwater site in SRS, thereby reducing the FMHD. We showed a higher impact of SLR in the dry season when there was practically no freshwater inflow to raise FMHD. We also demonstrated effectiveness of inflow depends more on the monthly distribution than the total annual volume. Hence, the impact per unit volume of inflow is significantly higher in the dry season in preventing high salinity and marine-derived nutrient levels. We advocate that FMHD needs to be factored into water management decisions to reduce adverse and likely irreversible effects of SLR throughout the Everglades landscape. Published by Elsevier Ltd.

The protective role of long-term meditation on the decline of the executive component of attention in aging: a preliminary cross-sectional study.

PubMed

Sperduti, Marco; Makowski, Dominique; Piolino, Pascale

2016-11-01

Life expectancy is constantly increasing. However, a longer life not always corresponds to a healthier life. Indeed, even normal aging is associated with a decline in different cognitive functions. It has been proposed that a central mechanism that could contribute to this widespread cognitive decline is an ineffective inhibitory attentional control. Meditation, to the other hand, has been associated, in young adults, to enhancement of several attentional processes. Nevertheless, attention is not a unitary construct. An influent model proposed the distinction of three subsystems: the alerting (the ability to reach and maintain a vigilance state), the orienting (the capacity of focusing attention on a subset of stimuli), and the conflict resolution or executive component (the ability to resolve conflict or allocate limited resources between competing stimuli). Here, we investigated, employing the Attentional Network Task (ANT), the specific impact of age on these three subcomponents, and the protective role of long-term meditation testing a group of older adults naïve to meditation, a group of age-matched adults with long-term practice of meditation, and a group of young adults with no previous meditation experience. We reported a specific decline of the efficiency of the executive component in elderly that was not observed in age-matched meditators. Our results are encouraging for the investigation of the potential beneficial impact of meditation on other cognitive processes that decline in aging such as memory. Moreover, they could inform geriatric healthcare prevention and intervention strategies, proposing a new approach for cognitive remediation in elderly populations.

Ecological legacies of Indigenous fire management in high-latitude coastal temperate rainforests, Canada

NASA Astrophysics Data System (ADS)

Hoffman, K.; Lertzman, K. P.; Starzomski, B. M.

2016-12-01

Anthropogenic burning is considered to have little impact on coastal temperate rainforest fire regimes in the Pacific Northwest (PNW) of North America, yet few long-term fire histories have been reconstructed in these forests. We use a multidisciplinary approach to reconstruct the ecological impact, scale, and legacies of historic fire regime variability in high-latitude coastal temperate rainforests located in British Columbia, Canada. We map seven centuries of fire activity with fire scars and records of stand establishment, and examine patterns in the distribution and composition of vegetation to assess whether fire was historically used as a tool for resource management. We conduct a paired study of 20 former Indigenous habitation and control sites across a 100 km2 island group to relate historic fire activity with long-term patterns of human land use and contemporary lightning strike densities. Fires were significantly associated with the locations of former Indigenous habitation sites, low and mixed in severity, and likely intentionally used to influence the composition and structure of vegetation, thus increasing the productivity of culturally important plants such as western redcedar, berry-producing shrubs, and bracken fern. Centuries of repeated anthropogenic burning have resulted in a mosaic of vegetation types in different stages of succession. These data are directly relevant to the management of contemporary forests as they do not support the widespread contention that old growth coastal temperate rainforests in this region are pristine landscapes where fire is rare, but more likely the result of long-term human land use practices.

Rationale and Methodology of the SARAH Trial: Long-Term Cardiovascular Outcomes in Patients With Resistant Hypertension and Obstructive Sleep Apnea.

PubMed

Sapiña-Beltrán, Esther; Torres, Gerard; Martínez-Alonso, Montserrat; Sánchez-de-la-Torre, Manuel; Franch, Maria; Bravo, Carmen; Masa, Juan F; Felez, Miquel; Fortuna-Gutierrez, Ana Maria; Abad, Jorge; García-Río, Francisco; Drager, Luciano F; Lee Chi-Hang, Ronald; Martínez-García, Miguel Ángel; Barbé, Ferran; Dalmases, Mireia

2018-05-22

Patients with resistant hypertension (RH) have a high risk of developing cardiovascular events; therefore, new therapeutic approaches to better control blood pressure may be useful in improving cardiovascular outcomes. The prevalence of obstructive sleep apnea (OSA) is very high among patients with RH. Continuous positive airway pressure (CPAP) has been shown to be an effective treatment for reducing blood pressure in patients with RH. Nevertheless, the long-term effect of CPAP treatment on cardiovascular outcomes has not been explored. The main objective of the SARAH study is to assess the impact of OSA and its treatment on cardiovascular outcomes (morbidity and mortality) in patients with RH. This study is a multi-center, prospective, observational cohort study. A total of 1371 patients with RH will be enrolled in the study and followed once a year for five years. At inclusion, ambulatory blood pressure monitoring (ABPM) and a sleep study will be performed in all subjects. Socio-demographic, clinical and cardiovascular variables will be collected at baseline and follow-up. Subsequently, subjects with OSA will be managed according to local standard practice. Based on the OSA diagnosis and its treatment, three cohorts of subjects with RH will be defined: non-OSA, treated OSA and non-treated OSA. This study will contribute to elucidating the long-term impact of OSA treatments on blood pressure control and cardiovascular outcomes in patients with RH. These results will contribute to improve the cardiovascular prognosis of patients with RH. Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Mapping the audit traces of interdisciplinary collaboration: bridging and blending between choreography and cognitive science.

PubMed

Barnard, Philip; deLahunta, Scott

2017-01-01

Two long-term sci-art research projects are described and positioned in the broader conceptual landscape of interdisciplinary collaboration. Both projects were aimed at understanding and augmenting choreographic decision-making and both were grounded in research conducted within a leading contemporary dance company. In each case, the work drew upon methods and theory from the cognitive sciences, and both had a direct impact on the way in which the company made new work. In the synthesis presented here the concept of an audit trace is introduced. Audit traces identify how specific classes of knowledge are used and transformed not only within the arts or sciences but also when arts practice is informed by science or when arts practice informs science.

Theory of electron-impact ionization of atoms

NASA Astrophysics Data System (ADS)

Kadyrov, A. S.; Mukhamedzhanov, A. M.; Stelbovics, A. T.; Bray, I.

2004-12-01

The existing formulations of electron-impact ionization of a hydrogenic target suffer from a number of formal problems including an ambiguous and phase-divergent definition of the ionization amplitude. An alternative formulation of the theory is given. An integral representation for the ionization amplitude which is free of ambiguity and divergence problems is derived and is shown to have four alternative, but equivalent, forms well suited for practical calculations. The extension to amplitudes of all possible scattering processes taking place in an arbitrary three-body system follows. A well-defined conventional post form of the breakup amplitude valid for arbitrary potentials including the long-range Coulomb interaction is given. Practical approaches are based on partial-wave expansions, so the formulation is also recast in terms of partial waves and partial-wave expansions of the asymptotic wave functions are presented. In particular, expansions of the asymptotic forms of the total scattering wave function, developed from both the initial and the final state, for electron-impact ionization of hydrogen are given. Finally, the utility of the present formulation is demonstrated on some well-known model problems.

Long-term impact of wildfire on soils exposed to different fire severities. A case study in Cadiretes Massif (NE Iberian Peninsula).

PubMed

Francos, Marcos; Úbeda, Xavier; Pereira, Paulo; Alcañiz, Meritxell

2018-02-15

Wildfires affect ecosystems depending on the fire regime. Long-term studies are needed to understand the ecological role played by fire, especially as regards its impact on soils. The aim of this study is to monitor the long-term effects (18years) of a wildfire on soil properties in two areas affected by low and high fire severity regimes. The properties studied were total nitrogen (TN), total carbon (TC), C/N ratio, soil organic matter (SOM) and extractable calcium (Ca), magnesium (Mg), sodium (Na) and potassium (K). The study was carried out in three phases: short- (immediately after the wildfire), medium- (seven years after the wildfire) and long-term (18years after the wildfire). The results showed that in both fire regimes TN decreased with time, TC and SOM were significantly lower in the burned plots than they were in the control in the medium- and long-terms. C/N ratio was significantly lower at short-term in low wildfire severity area. Extractable Ca and Mg were significantly higher in control plot than in the burned plots in the medium-term. In the long-term, extractable Ca and Mg were significantly lower in the area exposed to a high severity burning. No differences were identified in the case of extractable Na between plots on any of the sampling dates, while extractable K was significantly higher in the plot exposed to low wildfire than it was in the control. Some restoration measures may be required after the wildfire, especially in areas affected by high severity burning, to avoid the long-term impacts on the essential soil nutrients of TC, SOM, extractable Ca and Mg. This long-term nutrient depletion is attributable to vegetation removal, erosion, leaching and post-fire vegetation consumption. Soils clearly need more time to recover from wildfire disturbance, especially in areas affected by high severity fire regimes. Copyright © 2017 Elsevier B.V. All rights reserved.

Following the funding trail: Financing, nurses and teamwork in Australian general practice

PubMed Central

2011-01-01

Background Across the globe the emphasis on roles and responsibilities of primary care teams is under scrutiny. This paper begins with a review of general practice financing in Australia, and how nurses are currently funded. We then examine the influence on funding structures on the role of the nurse. We set out three dilemmas for policy-makers in this area: lack of an evidence base for incentives, possible untoward impacts on interdisciplinary functioning, and the substitution/enhancement debate. Methods This three year, multimethod study undertook rapid appraisal of 25 general practices and year-long studies in seven practices where a change was introduced to the role of the nurse. Data collected included interviews with nurses (n = 36), doctors (n = 24), and managers (n = 22), structured observation of the practice nurse (51 hours of observation), and detailed case studies of the change process in the seven year-long studies. Results Despite specific fee-for-service funding being available, only 6% of nurse activities generated such a fee. Yet the influence of the funding was to focus nurse activity on areas that they perceived were peripheral to their roles within the practice. Conclusions Interprofessional relationships and organisational climate in general practices are highly influential in terms of nursing role and the ability of practices to respond to and utilise funding mechanisms. These factors need to be considered, and the development of optimal teamwork supported in the design and implementation of further initiatives that financially support nursing in general practice. PMID:21329506

Surveillance of life-long antibiotics: a review of antibiotic prescribing practices in an Australian Healthcare Network.

PubMed

Lau, Jillian S Y; Kiss, Christopher; Roberts, Erika; Horne, Kylie; Korman, Tony M; Woolley, Ian

2017-01-18

The rise of antimicrobial use in the twentieth century has significantly reduced morbidity due to infection, however it has also brought with it the rise of increasing resistance. Some patients are on prolonged, if not "life-long" course of antibiotics. The reasons for this are varied, and include non-infectious indications. We aimed to study the characteristics of this potential source of antibiotic resistance, by exploring the antibiotic dispensing practices and describing the population of patients on long-term antibiotic therapy. A retrospective cross-sectional study of antibiotic dispensing records was performed at a large university hospital-based healthcare network in Melbourne, Australia. Outpatient prescriptions were extracted from the hospital pharmacy database over a 6 month period in 2014. Medical records of these patients were reviewed to determine the indication for prescription, including microbiology, the intended duration, and the prescribing unit. A descriptive analysis was performed on this data. 66,127 dispensing episodes were reviewed. 202 patients were found to have been prescribed 1 or more antibiotics with an intended duration of 1 year or longer. 69/202 (34%) of these patients were prescribed prolonged antibiotics for primary prophylaxis in the setting of immunosuppression. 43/202 (21%) patients were prescribed long-term suppressive antibiotics for infections of thought incurable (e.g. vascular graft infections), and 34/43 (79%) were prescribed by Infectious Diseases doctors. 66/202 (33%) patients with cystic fibrosis were prescribed prolonged courses of macrolides or fluoroquinolones, by respiratory physicians. There was great heterogeneity noted in indications for prolonged antibiotic courses, as well as antibiotic agents utilised. Our study found that that continuous antibiotic therapy represented only a small proportion of overall antibiotic prescribing at our health network. Prolonged courses of antibiotics were used mainly to suppress infections thought incurable, but also as primary and secondary prophylaxis and as anti-inflammatory agents. More research is needed to understand the impact of long-term antibiotic consumption on both patients and microbial ecology.

The impact of inter-annual variability of annual cycle on long-term persistence of surface air temperature in long historical records

NASA Astrophysics Data System (ADS)

Deng, Qimin; Nian, Da; Fu, Zuntao

2018-02-01

Previous studies in the literature show that the annual cycle of surface air temperature (SAT) is changing in both amplitude and phase, and the SAT departures from the annual cycle are long-term correlated. However, the classical definition of temperature anomalies is based on the assumption that the annual cycle is constant, which contradicts the fact of changing annual cycle. How to quantify the impact of the changing annual cycle on the long-term correlation of temperature anomaly variability still remains open. In this paper, a recently developed data adaptive analysis tool, the nonlinear mode decomposition (NMD), is used to extract and remove time-varying annual cycle to reach the new defined temperature anomalies in which time-dependent amplitude of annual cycle has been considered. By means of detrended fluctuation analysis, the impact induced by inter-annual variability from the time-dependent amplitude of annual cycle has been quantified on the estimation of long-term correlation of long historical temperature anomalies in Europe. The results show that the classical climatology annual cycle is supposed to lack inter-annual fluctuation which will lead to a maximum artificial deviation centering around 600 days. This maximum artificial deviation is crucial to defining the scaling range and estimating the long-term persistence exponent accurately. Selecting different scaling range could lead to an overestimation or underestimation of the long-term persistence exponent. By using NMD method to extract the inter-annual fluctuations of annual cycle, this artificial crossover can be weakened to extend a wider scaling range with fewer uncertainties.

Transition from Long Day Care to Kindergarten: Continuity or Not?

ERIC Educational Resources Information Center

Barblett, Lennie; Barratt-Pugh, Caroline; Kilgallon, Pam; Maloney, Carmel

2011-01-01

Transition practices that ensure continuity between early childhood settings have been shown to be important in assisting children's short-term and long-term growth and development (Vogler, Cravello & Woodhead, 2008). In Western Australia many young children move from and between long day care (LDC) settings to kindergarten. In that state,…

Modelling the economics and efficacy of early adoption of preventative practices for managing trunk diseases

USDA-ARS?s Scientific Manuscript database

Trunk diseases pose one of the most significant threats to vineyard longevity, since the introduction of Phylloxera. Research on resistant germplasm and detection tools will help in the long term. In the short term, we aim to promote preventative practices. Experimental trials show three practices t...

Delegation in Long-term Care: Scope of practice or job description?

PubMed

Corazzini, Kirsten N; Anderson, Ruth A; Rapp, Carla Gene; Mueller, Christine; McConnell, Eleanor S; Lekan, Deborah

2010-05-31

This study is a qualitative, descriptive study of how registered nurses (RNs) (N=33) in leadership roles in institutionalized long-term care settings delegate care, including their strategies and processes for delegating care, and their perceptions of barriers to effective delegation and potential benefits of delegation. Findings indicate two key approaches to delegation, including the "follow the job description" approach, emphasizing adherence to facility-level roles and job descriptions, and the "consider the scope of practice" approach, emphasizing consideration of multiple aspects of scope of practice and licensure, and the context of care. While the former resulted in more clarity and certainty for the RN, the latter facilitated a focus on quality of resident care outcomes as linked to the delegation process. Barriers to effective delegation were comparable among RNs using either approach to delegation, and almost all RNs could describe benefits of delegation for long-term care.

Simulation of long-term influence from technical systems on permafrost with various short-scale and hourly operation modes in Arctic region

NASA Astrophysics Data System (ADS)

Vaganova, N. A.

2017-12-01

Technogenic and climatic influences have a significant impact on the degradation of permafrost. Long-term forecasts of such changes during long-time periods have to be taken into account in the oil and gas and construction industries in view to development the Arctic and Subarctic regions. There are considered constantly operating technical systems (for example, oil and gas wells) that affect changes in permafrost, as well as the technical systems that have a short-term impact on permafrost (for example, flare systems for emergency flaring of associated gas). The second type of technical systems is rather complex for simulation, since it is required to reserve both short and long-scales in computations with variable time steps describing the complex technological processes. The main attention is paid to the simulation of long-term influence on the permafrost from the second type of the technical systems.

Influence on bacterial communities under the condition of organic manure substituting nitrogen fertilizer in a 36-year field experiment of Chinese Mollisols

NASA Astrophysics Data System (ADS)

Ma, M.; Jiang, X.; Li, J.

2016-12-01

In recent years, the black soil of northeastern China has been degenerated over time owing to intensive farming practices and inappropriate uses of fertilizer. The objective of this research was to evaluate the impacts of long-term organic manure substituting inorganic nitrogen fertilizer on bacterial communities in Chinese Mollisols. Four treatments were sampled as follows, CK (without fertilizer), PK (inorganic fertilizers PK), NPK (inorganic fertilizers NPK) and MPK (inorganic fertilizers PK with manure). Quantitative PCR analysis of microbial community size and Illumina platform-based analysis of the V4 16S rRNA gene region were followed. The results showed, long term MPK application had no significant effect on soil pH, while NPK and PK application decreased it significantly. Soil OM showed the same trend with soil pH. Compared with CK, NPK treatment decreased gene copy numbers, whereas PK and MPK treatments increased them with a significant difference for MPK (P<0.05). There was no difference on ACE between samples, but long term NPK application significantly decreased CHAO and Shannon index. When comes to bacterial community, all samples were dominated by phyla Proteobacteria, which were represented by 29.59 to 35.73% of the sequences, followed by Acidobacteria (13.23-16.39%), Actinobacteria (9.26-10.83%), Verrucomicrobia (8.62-9.92%) and Planctomycetes (7.03-8.04%). Long term fertilization regimes had a significantly effect on bacterial β-diversity with the bacterial communities. Compared to the other treatments, long term application of NPK changed the bacterial communities conspicuously. Soil pH (F=8.6, P=0.002) and the concentration of OM (F=2.2, P=0.008) were the two most important contributors to the variation in bacterial communities. Our findings suggested that, long-term inorganic fertilizer regimes reduced the biodiversity and abundance of bacteria, and inorganic fertilizer plus manure increased microbial diversity and improved microbial composition.

Effects of Child Abuse and Neglect on Adult Survivors

ERIC Educational Resources Information Center

Johnson, Emmanuel Janagan; James, Christine

2016-01-01

Child abuse has profound immediate and long-term effects on a child's development. The long-term impact of abuse of a child can be seen in higher rates of psychiatric disorders, increased rates of substance abuse and relationship difficulties [Springer, K. W., Sheridan, J., Kuo, D., & Carnes, M. (2003). "The long-term health outcomes of…

The Climate Disruption Challenge for Water Security in a Growing World

NASA Astrophysics Data System (ADS)

Paxton, L. J.; Nix, M.; Ihde, A.; MacDonald, L. H.; Parker, C.; Schaefer, R. K.; Weiss, M.; Babin, S. M.; Swartz, W. H.; Schloman, J.

2012-12-01

Climate disruption, the increasingly large and erratic departures of weather and climate from the benign conditions of the last one hundred years, is the greatest challenge to the long-term stability of world governments. Population growth, food and water security, energy supplies, and economic factors are, to some degree, within the control of governance and policy and all of these are impacted by climate disruption. Climate disruption, on the other hand, is not amenable to direct modification on the short timescales that commonly dictate governmental policy and human response. Global average temperatures will continue to increase even if there were immediate, profound changes in emission scenarios. Policy makers are faced with the very practical and immediate problem of determining what can one reasonably do to ameliorate the impact of climate disruption. The issue from a policy viewpoint is: how does one make effective policy when faced with a situation in which there are varied viewpoints in competition. How does one establish a consensus for action? What information "speaks" to policy makers? Water security is one such issue and provides an important, immediate, and tangible device to use when we examine how one can determine what policies can be effectively pursued. The Global Assimilation of Information for Action (GAIA) project creates a support environment to address the impact of climate disruption on global, national, regional, and/or local interests. The basic research community is concerned with the scientific aspects of predicting climate change in terms of environmental parameters such as rainfall, temperature and humidity while decision makers must deal with planning for a world that may be very different from the one we have grown accustomed to. Decision makers must deal with the long-term impacts on public health, agriculture, economic productivity, security, extreme weather, etc in an environment that has come to focus on short-term issues. To complicate matters, the information available from the climate studies community is couched in terms of model projections with "uncertainties" and a choice of emission scenarios that are often expressed in terms of the results of computer simulations and model output. GAIA develops actionable information and explores the interactions of policy and practice. Part of this framework is the development of "games". These realistic games include the elements of both agent-based and role simulation games in which subject matter experts interact in a realistic scenario to explore courses of action and their outcomes based on realistic, projected environments. We will present examples of some of the past work done at APL and examples of collaborative or competitive games that could be used to explore climate disruption in terms of social, political, and economic impacts. These games provide immediate, "tactile" experience of the implications of a choice of policy. In this talk we will suggest how this tool can be applied to problems like the Colorado River Basin or the Brahmaputra.

Trusting early learners with critical professional activities through emergency medical technician certification.

PubMed

Brenner, Judith; Bird, Jeffrey; Ginzburg, Samara B; Kwiatkowski, Thomas; Papasodero, Vincent; Rennie, William; Schlegel, Elisabeth; Ten Cate, Olle; Willey, Joanne M

2018-03-08

Two dominant themes face medical education: developing integrated curricula and improving the undergraduate medical education (UME) to graduate medical education (GME) transition. An innovative solution to both of these challenges at the Zucker School of Medicine has been the application of the cognitive apprenticeship framework in requiring emergency medical technician (EMT) certification during the first course in medical school as the core on which to build an integrated curriculum and provide entrustable clinical skills. Beginning with the Class of 2011, student feedback about the short-term impact of the experience was collected annually. In addition, perceptions of near graduates and alumni were surveyed in 2017 to explore the long-term impact of the experience. Theme analysis was conducted via inductive coding. Both first-year and more experienced learners report the value of the EMT curriculum as an integrated component of the first course of medical school. Reported positive long-term impacts included the first-hand observation of social determinants of health and interprofessionalism. Negative comments by early learners focused on course logistics, whereas older learners recalled the variability of clinical experiences during ambulance runs. The integration of the EMT curriculum as a core component of the first course serves multiple purposes: 1) it provides the foundation of a spiral learning approach; 2) it contextualizes the basic sciences within clinical practice; 3) it provides opportunities for students to engage in authentic clinical activities under the guidance of mentors; 4) it introduces students to the interdisciplinary nature of medicine; and 5) it serves as the first entrustable professional activity (EPA) for our students.

Self-perceived long-term transfer of learning after postpartum hemorrhage simulation training.

PubMed

de Melo, Brena Carvalho Pinto; Rodrigues Falbo, Ana; Sorensen, Jette Led; van Merriënboer, Jeroen J G; van der Vleuten, Cees

2018-05-01

To explore long-term transfer (application of acquired knowledge and skills on the job) after postpartum hemorrhage simulation training based on either instructional design (ID) principles or conventional best practice. In this qualitative study, semi-structured interviews with obstetrics and gynecology healthcare practitioners were conducted between August 7 and September 26, 2015, in Recife, Brazil. The participants were randomly selected from each of two postpartum hemorrhage simulations attended 2 years earlier (one ID and one conventional best practice). Thematic analysis was used to explore (1) residents' perceptions of long-term transfer of learning, (2) ID elements influencing the perceived long-term transfer, and (3) differences in the participants' perceptions according to the type of simulation attended. There were 12 interview participants. After either simulation format, residents perceived long-term transfer effects. Training design factors influencing transfer were, in their opinion, related to trainees' characteristics, simulation design, and workplace environment. Trainees who participated in the ID-based simulation perceived better communication skills and better overall situational awareness: "I didn't do that before." All residents perceived long-term transfer after simulation training for postpartum hemorrhage. Those who attended the ID format additionally perceived improvements in communication skills and situational awareness, which are fundamental factors in the management of postpartum hemorrhage. © 2018 International Federation of Gynecology and Obstetrics.

Long-term Academic and Career Impacts of Undergraduate Research: Diverse Pathways to Geoscience Careers Following a Summer Atmospheric Science Research Internship

NASA Astrophysics Data System (ADS)

Trott, C. D.; Sample McMeeking, L. B.; Boyd, K.; Bowker, C.

2015-12-01

Research experiences for undergraduates (REU) have been shown to support the success of STEM undergraduates through improving their research skills, ability to synthesize knowledge, and personal and professional development, all while socializing them into the nature of science. REUs are further intended to support STEM career choice and professional advancement, and have thus played a key role in diversity efforts. Recruiting and retaining diverse students in STEM through REUs is of particular importance in the geosciences, where women and ethnic minorities continue to be significantly underrepresented. However, few studies have examined the long-term impacts of these REUs on students' academic and career trajectories. Further, those that do exist primarily study the experiences of current graduate students, scientists, and faculty members—that is, those who have already persisted—which overlooks the multiple academic and career paths REU students might follow and may preclude a thorough examination of REUs' diversity impacts. In this long-term retrospective study of the academic and career impacts of a REU program at a large Western U.S. research university, we interviewed 17 former REU participants on their expectations prior to their REU participation, their experiences during the REU, the immediate outcomes from the experience, and its long-term impacts on their academic and career choices. To address gaps in the existing literature on REU impacts, we purposively sampled students who have taken a variety of educational and career paths, including those not engaged in science research. Despite varied trajectories, the majority of the students we interviewed have persisted in the geosciences and attest to the REU's profound impact on their career-related opportunities and choices. This presentation describes students' diverse STEM pathways and discusses how students' REU expectations, experiences, and immediate outcomes continued to make an impact long-term.

Identifying predictive factors for long-term complications following button battery impactions: A case series and literature review.

PubMed

Eliason, Michael J; Melzer, Jonathan M; Winters, Jessica R; Gallagher, Thomas Q

2016-08-01

To complement a case series review of button battery impactions managed at our single military tertiary care center with a thorough literature review of laboratory research and clinical cases to develop a protocol to optimize patient care. Specifically, to identify predictive factors of long-term complications which can be used by the pediatric otolaryngologist to guide patient management after button battery impactions. A retrospective review of the Department of Defense's electronic medical record systems was conducted to identify patients with button battery ingestions and then characterize their treatment course. A thorough literature review complemented the lessons learned to identify potentially predictive clinical measures for long-term complications. Eight patients were identified as being treated for button battery impaction in the aerodigestive tract with two sustaining long-term complications. The median age of the patients treated was 33 months old and the median estimated time of impaction in the aerodigestive tract prior to removal was 10.5 h. Time of impaction, anatomic direction of the battery's negative pole, and identifying specific battery parameters were identified as factors that may be employed to predict sequelae. Based on case reviews, advancements in battery manufacturing, and laboratory research, there are distinct clinical factors that should be assessed at the time of initial therapy to guide follow-up management to minimize potential catastrophic sequelae of button battery ingestion. Published by Elsevier Ireland Ltd.

Isolationism and the Assault on the Possibility of Shared Truths

ERIC Educational Resources Information Center

Wagner, Paul A.

2011-01-01

Sociologists began defining the term "culture" long ago in order to serve the specific research interests of practicing scientists. The definitions served scientists' purpose well. The term culture became popular beyond even the discipline of sociology. For example, there is a normative sense of the term that serves practical pedagogical purposes…

1. Exterior view of LongTerm Hydrazine Silo (T28E), looking southeast. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Exterior view of Long-Term Hydrazine Silo (T-28E), looking southeast. The structure was designed to assess long-term environmental impacts on storage of the Titan's fuel (hydrazine). The low-lying building to the immediate right of the silo is the Fuel Purification Structure (T-28E), constructed during the late 1960s to purify hydrazine for long-term hardware requirements for satellites and space expedition vehicles associated with the Titan III. - Air Force Plant PJKS, Systems Integration Laboratory, Long-Term Hydrazine Silo, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

Long-term impact of pesticides use on vineyard

NASA Astrophysics Data System (ADS)

Sabatier, Pierre; Poulenard, Jérôme; Fanget, Bernard; Reyss, Jean-Louis; Develle, Anne-Lise; Ployon, Estelle; Wilhelm, Bruno; Naffrechoux, Emmanuel; Dorioz, Jean-Marcel; Montuelle, Bernard; Arnaud, Fabien

2014-05-01

Worldwide increase of pesticides uses in agriculture has been growing over the past decades but their long-term fate and effects on environment and ecosystem are poorly understood. Here, we present a retro-observation approach based on lake sediment record to monitor micropollutants and to evaluate the long term impact of pesticides treatments on a vineyard catchment in Savoie (France). In this study, we combined sedimentological and geochemical analyses to reconstruct the recent history of wine practices. The sediment sequence chronology, based on short-live radionuclides (210Pb/137Cs), provides a well constrain continuous age-depth relationship covering to the last century. Over this period, we reconstruct the succession of fungicides, insecticides and herbicides in relation to the appearance of new chemical substances and the banning of old ones. The first use of fungicide began at the end of the 19th century with the Bordeaux mixture (Cu). After the World War II, we observed an intensification of fungicides treatment against mildew, powdery mildew, Botrytis fungi and black rot with specific molecules succession. Insecticides used in vineyard treatment against tetranychid and eriophyid mites were observed since 1940 with a main increase in 1970. Dicofol, Bromopropylate, Bifenthrin succeed to DDT banning in 1972, but a secondary source of DDT appeared at the early of 90's. The first herbicides use was observed between 1960 and 1970 with the presence of Triazine metabolite (pre-emergence herbicide) and high value of AMPA (Glyphosate metabolite, Roundup®), used as post-emergence herbicide, were found since 1990. Two sedimentation rate increases in 1973 and 1994 could be directly assigned to wine practices. In early 70's, heavy farm machinery associated to the first application of pre-emergence herbicide, induced a first increase of soil erosion. In early 90's, post-emergence herbicide (Roundup®) treatment had a stronger impact on soil erosion with a huge contaminated sediment export. This latter, associated with high AMPA flux, is synchronous to the re-emergence of banned pesticides with the new source of DDT and its aerobic metabolites (DDE) probably stocked in vineyard soil. Over the last years, the decrease of pesticides concentration may be probably related to French and European policies against micropollutant substances in agriculture.

Long-term impacts of manure amendments on carbon and greenhouse gas dynamics of rangelands.

PubMed

Owen, Justine J; Parton, William J; Silver, Whendee L

2015-12-01

Livestock manure is applied to rangelands as an organic fertilizer to stimulate forage production, but the long-term impacts of this practice on soil carbon (C) and greenhouse gas (GHG) dynamics are poorly known. We collected soil samples from manured and nonmanured fields on commercial dairies and found that manure amendments increased soil C stocks by 19.0 ± 7.3 Mg C ha(-1) and N stocks by 1.94 ± 0.63 Mg N ha(-1) compared to nonmanured fields (0-20 cm depth). Long-term historical (1700-present) and future (present-2100) impacts of management on soil C and N dynamics, net primary productivity (NPP), and GHG emissions were modeled with DayCent. Modeled total soil C and N stocks increased with the onset of dairying. Nitrous oxide (N2 O) emissions also increased by ~2 kg N2 O-N ha(-1)  yr(-1) . These emissions were proportional to total N additions and offset 75-100% of soil C sequestration. All fields were small net methane (CH4 ) sinks, averaging -4.7 ± 1.2 kg CH4 -C ha(-1)  yr(-1) . Overall, manured fields were net GHG sinks between 1954 and 2011 (-0.74 ± 0.73 Mg CO2 e ha(-1)  yr(-1) , CO2 e are carbon dioxide equivalents), whereas nonmanured fields varied around zero. Future soil C pools stabilized 40-60 years faster in manured fields than nonmanured fields, at which point manured fields were significantly larger sources than nonmanured fields (1.45 ± 0.52 Mg CO2 e ha(-1)  yr(-1) and 0.51 ± 0.60 Mg CO2 e ha(-1)  yr(-1) , respectively). Modeling also revealed a large background loss of soil C from the passive soil pool associated with the shift from perennial to annual grasses, equivalent to 29.4 ± 1.47 Tg CO2 e in California between 1820 and 2011. Manure applications increased NPP and soil C storage, but plant community changes and GHG emissions decreased, and eventually eliminated, the net climate benefit of this practice. © 2015 John Wiley & Sons Ltd.

Informed Consent to Research in Long-Term Care Settings

PubMed Central

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

2010-01-01

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

Research- and Practice-Based Nutrition Education and Cooking Workshops in Pediatric Oncology: Protocol for Implementation and Development of Curriculum

PubMed Central

Chaput, Cynthia; Beaulieu-Gagnon, Sabrina; Bélanger, Véronique; Drouin, Simon; Bertout, Laurence; Lafrance, Lucie; Olivier, Cinthia; Robitaille, Marthe; Laverdière, Caroline; Sinnett, Daniel; Marquis, Marie

2018-01-01

Background Progresses in childhood cancer treatment, diagnosis, and management have resulted in childhood cancer survival rates of over 80%. However, this therapeutic success comes with a heavy price: two-thirds of childhood cancer survivors will be affected by further complications, including cardiovascular and metabolic diseases. Adequate nutrition during cancer treatment is essential to ensure the child’s optimal development, improve tolerance to treatments, and can contribute to lower the risk of developing cardiometabolic diseases. Side effects of cancer treatments can negatively impact children’s nutritional intake and eating behaviors. Involving the families of childhood cancer patients in educational workshops could be a promising avenue to promote healthy eating during and after cancer treatment. Objective The objectives of this study were to develop, validate, and implement a family-based nutrition education and cooking workshop curriculum in a pediatric oncology setting that addresses the nutritional issues encountered during treatments while promoting the adoption of healthy eating habits for the prevention of long-term cardiometabolic effects. Methods The workshops were developed and validated following an 8-step iterative process, including a review of the literature and consultations with a steering committee. An evaluation tool was also developed. A nonrandomized study protocol was elaborated to implement the workshops and measure their impact. The themes of the 6 research- and practice-based lessons are as follows: meal fortification during cancer treatment, changes in taste during cancer therapy and their impact on children, adapting diet to eating-related side effects of treatments, nutritional support during cancer treatment, Mediterranean diet and health, and planning quick and economic meals. The validation process included consultations with the institution’s clinical nutrition professionals. Self-administered post questionnaires were developed according to the content of each workshop to measure short-term outcomes, namely, participants’ perception of knowledge acquisition, behavioral intention, and satisfaction. Medium-term outcomes that will be evaluated are participants’ anthropometric profile, quality of the diet, and circulating biomarkers of metabolic health. Results The project was funded in 2016 and enrollment will be completed in 2021. Data analysis is currently under way and the first results are expected to be submitted for publication in 2019. Conclusions This research- and practice-based nutrition education and cooking demonstration curriculum could be a valuable complement to a multidisciplinary lifestyle intervention for the prevention of long-term cardiometabolic complications in childhood cancer. PMID:29317383

Field-scale monitoring of the long-term impact and sustainability of drainage water reuse on the west side of California’s San Joaquin Valley

USDA-ARS?s Scientific Manuscript database

Diminishing freshwater resources have brought attention to the reuse of degraded water as a potential water resource rather than as a disposal problem. Drainage water from tile-drained, irrigated agricultural land is degraded water that is often in large supply, but the long-term impact and sustain...

Findings vs. Interpretation in "The Long-Term Impacts of Teachers" by Chetty et al.

ERIC Educational Resources Information Center

Adler, Moshe

2013-01-01

The authors of the study "The Long-Term Impact of Teachers" claim that their study shows that increases in teacher value-added lead to significant and lasting increases in test scores and significant increases in income that will last throughout adulthood. Instead, I show that these claims are false because they are contradicted by the…

Long-term effects on distribution of forest biomass following different harvesting levels in the northern Rocky Mountains

Treesearch

Woongsoon Jang; Christopher R. Keyes; Deborah S. Page-Dumroese

2015-01-01

With increasing public demand for more intensive biomass utilization from forests, the concerns over adverse impacts on productivity by nutrient depletion are increasing. We remeasured the 1974 site of the Forest Residues Utilization Research and Development in northwestern Montana to investigate long-term impacts of intensive biomass utilization on aspects of site...

Impact of Infection Prevention and Control Initiatives on Acute Respiratory Infections in a Pediatric Long-Term Care Facility

PubMed Central

Murray, Meghan T.; Jackson, Olivia; Cohen, Bevin; Hutcheon, Gordon; Saiman, Lisa; Larson, Elaine; Neu, Natalie

2016-01-01

We evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly. PMID:27053088

Framing the Future. Re-framing the Future: A Report on the Long-Term Impacts of Framing the Future.

ERIC Educational Resources Information Center

Mitchell, John

Australia's Framing the Future (FTF) project was designed to develop a model of staff development to support implementation of the National Training Framework (NTF). A survey of FTF project managers found these long-term impacts: implementation of training packages and other aspects of NTF, new forms of collaboration between industry and training…

The Long-Term Economic Impact of in Utero and Postnatal Exposure to Malaria

ERIC Educational Resources Information Center

Barreca, Alan I.

2010-01-01

I use an instrumental-variables identification strategy and historical data from the United States to estimate the long-term economic impact of in utero and postnatal exposure to malaria. My research design matches adults in the 1960 Decennial Census to the malaria death rate in their respective state and year of birth. To address potential…

Managing Environmental Stress: An Evaluation of Environmental Management of the Long Point Sandy Barrier, Lake Erie, Canada.

PubMed

Kreutzwiser; Gabriel

2000-01-01

/ This paper assesses the extent to which key geomorphic components, processes, and stresses have been reflected in the management of a coastal sandy barrier environment. The management policies and practices of selected agencies responsible for Long Point, a World Biosphere Reserve along Lake Erie, Canada, were evaluated for consistency with these principles of environmental management for sandy barriers: maintaining natural stresses essential to sandy barrier development and maintenance;protecting sediment sources, transfers, and storage; recognizing spatial variability and cyclicity of natural stresses, such as barrier overwash events; and accepting and planning for long-term evolutionary changes in the sandy barrier environment. Generally, management policies and practices have not respected the dynamic and sensitive environment of Long Point because of limited mandates of the agencies involved, inconsistent policies, and failure to apply or enforce existing policies. This is particularly evident with local municipalities and less so for the Canadian Wildlife Service, the federal agency responsible for managing National Wildlife Areas at the point. In the developed areas of Long Point, landward sediment transfers and sediment storage in dunes have been impacted by cottage development, shore protection, and maintenance of roads and parking lots. Additionally, agencies responsible for managing Long Point have no jurisdiction over sediment sources as far as 95 km away. Evolutionary change of sandy barriers poses the greatest challenge to environmental managers.

Towards a practical Johnson noise thermometer for long-term measurements in harsh environments

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

Greenen, Adam; Pearce, Jonathan; Cruickshank, David

The impact of mechanical and chemical changes in conventional sensors such as thermocouples and resistance thermometers can be avoided by instead using temperature sensors based on fundamental thermometry. A prime example of this is Johnson noise thermometry, which is based on measurement of the fluctuations in the voltage of a resistor arising from thermal motion of charge carriers - i.e. the 'Johnson noise'. A Johnson noise thermometer never needs calibration and is insensitive to the condition of the sensor material. It is therefore ideally suited to long-term temperature measurements in harsh environments, such as nuclear reactor coolant circuits, in-pile measurements,more » nuclear waste management and storage, and severe accident monitoring. There have been a number of previous attempts to develop a Johnson noise thermometer for the nuclear industry, but none have reached commercial exploitation because of technical problems in practical implementation. The main challenge is to extract the tiny Johnson noise signal from ambient electrical noise influences, both from the internal amplification electronics, and from external electrical noise sources. Recent advances in electronics technology and digital signal processing techniques have opened up new possibilities for developing a viable, practical Johnson noise thermometer. We describe a project funded by the UK Technology Strategy Board (now Innovate UK) 'Developing the nuclear supply chain' call, currently underway, to develop a practical Johnson noise thermometer that makes use of innovative electronics for ultralow noise amplification and signal processing. The new electronics technology has the potential to help overcome the problems encountered with previous attempts at constructing a practical Johnson noise thermometer. An outline of the new developments is presented, together with an overview of the current status of the project. (authors)« less

On becoming a coach: a pilot intervention study with managers in long-term care.

PubMed

Cummings, Greta; Mallidou, Anastasia A; Masaoud, Elmabrok; Kumbamu, Ashok; Schalm, Corinne; Spence Laschinger, Heather K; Estabrooks, Carole A

2014-01-01

Health care leaders have called for the development of communication and leadership skills to improve manager-employee relationships, employee job satisfaction, quality care, and work environments. The aim of the study reported here was to pilot how a 2-day coaching workshop ("Coaching for Impressive CARE") conducted as a leadership development strategy influenced frontline care managers' coaching practices in residential long-term care (LTC) settings. We had four objectives: (a) to identify managers' perceptions of their role as a coach of employee performance in LTC facilities, (b) to understand managers' intentions to coach employee performance, (c) to examine opportunities and factors that contributed to or challenged implementation of workshop coaching skills in daily leadership/management practice, and (d) to examine managers' reports of using coaching practices and employee responses after the workshop. We used an exploratory/descriptive design involving pre-/post-workshop surveys, e-mail reminders, and focus groups to examine participation of 21 LTC managers in a 2-day coaching workshop and their use of coaching practices in the workplace. Focus group findings provided examples of how participants used their coaching skills in practice (e.g., communicating empathy) and how staff responded. Factors contributing to and challenging implementation of these coaching skills in the workplace were identified. Attitudes and intentions to be a coach increased significantly, and some coaching skills were used more frequently after the workshop, specifically planning for performance change with employees. The coaching workshop was feasible to implement, well received by participants, influenced their willingness to become coaches, and had some noted impact on their use of coaching behaviors in the workplace. Coaching skills by managers to improve staff performance with residents in LTC facilities can be learned.

[Combined effects of benzene and chromium on navigation learning and long-term spatial memory in rats].

PubMed

Tikhonov, V V; Ermolina, E V; Miroshnichenko, I V

2009-01-01

The impact of long-term intake of drinking water containing the high level of chromium and benzene or their mixture on navigation learning and long-term spatial memory was studied in a Morris water maze. The chronic neurotoxic effect of benzene was characterized by worse long-term memory, which upon its exposure in combination with chromium remained unchanged and failed to block the realization of a positive effect of chromium on the mechanism of navigation learning.

Exterior view of north and east exterior walls of LongTerm ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Exterior view of north and east exterior walls of Long-Term Oxidizer Silo (T-28B), looking south. Silo was designed to assess long-term environmental impacts on storage of the Titan II's oxidizer (nitrogen tetroxide). The shorter Oxidizer Conditioning Structure (T-28D) is located behind and to the immediate left of T-28B - Air Force Plant PJKS, Systems Integration Laboratory, Long-Term Oxidizer Silo, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

[Public spending on health and population health in Algeria: an econometric analysis].

PubMed

Messaili, Moussa; Kaïd Tlilane, Nouara

2017-07-10

Objective: The objective of this study was to estimate the impact of public spending on health, among other determinants of health, on the health of the population in Algeria, using life expectancy (men and women) and infant mortality rates as indicators of health status. Methods: We conducted a longitudinal study over the period from 1974 to 2010 using the ARDL (Autoregressive Distributed Lags) approach to co-integration to estimate the short-term and long-term relationship. Results: Public spending on health has a positive, but not statistically significant impact, in the long and short term, on life expectancy (men and women). However, public spending significantly reduces the infant mortality rate. The long-term impact of the number of hospital beds is significant for the life expectancy of men, but not for women and infant mortality, but is significant for all indicators in the short-term relationship. The most important variables in improving the health of the population are real GDP per capita and fertility rate.

Gender-related differences in general practice preferences: longitudinal evidence from the Netherlands 1982-2001.

PubMed

Mayorova, Tanja; Stevens, Fred; Scherpbier, Albert; van der Velden, Lud; van der Zee, Jouke

2005-04-01

The proportion of female doctors is increasing. Yet, there is little evidence that demonstrates changing career preferences over a long period, nor do we know the long-term impact of changing male-female ratios in medicine. We explored this within the GP profession. By means of a longitudinal cohort study (postal questionnaires) among all graduated GPs in the Netherlands between 1982 and 2001 we explored trends in career preferences and investigated whether practice preferences of men and women differ over the years. Preference of becoming a GP has significantly decreased among men. GPs prefer group practice more than solo practice. Female doctors were more likely to prefer a small practice and to associate. Men prefer to take over an established practice. Main reasons to abstain from practicing as a GP for men were having found another job or not having found a practice according to their preferences. Main reasons for women were having decided for another job and family life. We conclude that male and female GPs select differently on practice setting. Preferences change through the years but tend to converge. Gender differences are likely due to the circumstance that career choices for men are more influenced by fluctuating labour markets, while female choices are more based on family circumstances. We expect that as more women will become a GP the demand for small group practices will increase. Also, as many female GPs abstain from practicing after having finished a vocational GP training program it will be essential to create work facilities to keep them available for the GP labour market.

How Maryland increased infection prevention and control activity in long-term care facilities, 2003-2008.

PubMed

Roup, Brenda J; Scaletta, Joseph M

2011-05-01

In January 2003, the Maryland Department of Health and Mental Hygiene (DHMH) assessed the state of infection prevention and control (IPC) resources and practices in all long-term care facilities (LTC) in the state. Only 8.1% of facilities that responded employed a trained IPC professional (IP) who managed the facility IPC program. Between 2003 and 2008, the DHMH partnered with long-term care industry trade associations and spearheaded regulatory, educational, and financial initiatives to improve this situation. In January 2008, all LTC facilities in the state were resurveyed to determine the impact of these initiatives on IPC activities. The 2008 survey indicated that 44% of LTC facilities used a trained IP who managed the IPC program, a 5-fold increase from 2003. Unpublished DHMH outbreak data indicated that LTC facilities with a trained IP recognized and reported outbreaks to the local health department 2 days sooner than facilities without a trained IP, resulting in fewer cases of disease. Multiple initiatives with concerned stakeholders and LTC partners over the course of 5 years resulted in increased numbers of LTC facilities with trained IPs who recognized and responded to outbreaks sooner than facilities without trained IPs. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Long-term ecosystem monitoring and assessment of the Detroit River and Western Lake Erie.

PubMed

Hartig, J H; Zarull, M A; Ciborowski, J J H; Gannon, J E; Wilke, E; Norwood, G; Vincent, A N

2009-11-01

Over 35 years of US and Canadian pollution prevention and control efforts have led to substantial improvements in environmental quality of the Detroit River and western Lake Erie. However, the available information also shows that much remains to be done. Improvements in environmental quality have resulted in significant ecological recovery, including increasing populations of bald eagles (Haliaeetus leucocephalus), peregrine falcons (Falco columbarius), lake sturgeon (Acipenser fulvescens), lake whitefish (Coregonus clupeaformis), walleye (Sander vitreus), and burrowing mayflies (Hexagenia spp.). Although this recovery is remarkable, many challenges remain, including population growth, transportation expansion, and land use changes; nonpoint source pollution; toxic substances contamination; habitat loss and degradation; introduction of exotic species; and greenhouse gases and global warming. Research/monitoring must be sustained for effective management. Priority research and monitoring needs include: demonstrating and quantifying cause-effect relationships; establishing quantitative endpoints and desired future states; determining cumulative impacts and how indicators relate; improving modeling and prediction; prioritizing geographic areas for protection and restoration; and fostering long-term monitoring for adaptive management. Key management agencies, universities, and environmental and conservation organizations should pool resources and undertake comprehensive and integrative assessments of the health of the Detroit River and western Lake Erie at least every 5 years to practice adaptive management for long-term sustainability.

Parenting a child with chronic illness as they transition into adulthood: A systematic review and thematic synthesis of parents' experiences.

PubMed

Heath, Gemma; Farre, Albert; Shaw, Karen

2017-01-01

To understand how parents view and experience their role as their child with a long-term physical health condition transitions to adulthood and adult healthcare services. Five databases were systematically searched for qualitative articles examining parents' views and experiences of their child's healthcare transition. Papers were quality assessed and thematically synthesised. Thirty-two papers from six countries, spanning a 17-year period were included. Long-term conditions were diverse. Findings indicated that parents view their child's progression toward self-care as an incremental process which they seek to facilitate through up-skilling them in self-management practices. Parental perceptions of their child's readiness, wellness, competence and long-term condition impacted on the child' progression to healthcare autonomy. A lack of transitional healthcare and differences between paediatric and adult services served as barriers to effective transition. Parents were required to adjust their role, responsibilities and behaviour to support their child's growing independence. Parents can be key facilitators of their child's healthcare transition, supporting them to become experts in their own condition and care. To do so, they require clarification on their role and support from service providers. Interventions are needed which address the transitional care needs of parents as well as young people. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Obesity in pregnancy: implications for the mother and lifelong health of the child. A consensus statement.

PubMed

Poston, Lucilla; Harthoorn, Lucien F; Van Der Beek, Eline M

2011-02-01

Obesity among pregnant women is becoming one of the most important women's health issues. Obesity is associated with increased risk of almost all pregnancy complications: gestational hypertension, preeclampsia, gestational diabetes mellitus, delivery of large-for-GA infants, and higher incidence of congenital defects all occur more frequently than in women with a normal BMI. Evidence shows that a child of an obese mother may suffer from exposure to a suboptimal in utero environment and that early life adversities may extend into adulthood. In September 2009, ILSI Europe convened a workshop with multidisciplinary expertise to review practices and science base of health and nutrition of obese pregnant women, with focus on the long-term health of the child. The consensus viewpoint of the workshop identified gaps and gave recommendations for future research on gestational weight gain, gestational diabetes, and research methodologies. The evidence available on short- and long-term health impact for mother and child currently favors actions directed at controlling prepregnancy weight and preventing obesity in women of reproductive ages. More randomized controlled trials are needed to evaluate the effects of nutritional and behavioral interventions in pregnancy outcomes. Moreover, suggestions that maternal obesity may transfer obesity risk to child through non-Mendelian (e.g. epigenetic) mechanisms require more long-term investigation.

Geoethical issues in long-term assessment of geohazards and related mitigation policies

NASA Astrophysics Data System (ADS)

Tinti, Stefano; Armigliato, Alberto

2015-04-01

Long-term assessment of large-impact and relatively (or very) infrequent geohazards like earthquakes, tsunamis and volcanic eruptions is nowadays a common practice for geoscientists and many groups have been and are involved in producing global and regional hazard maps in response of an increasing demand of the society. Though the societal needs are the basic motivations for such studies, often this aspect is not pondered enough and a lack of communication between geoscientists and the society might be a serious limit to the effective exploitation of the hazard assessment products and to the development of adequate mitigation policies. This paper is an analysis of the role of geoscientists in the process of the production of long-term assessments of dangerous natural phenomena (such as mapping of seismic, tsunami and volcanic hazards), with special emphasis given to the role of communicators and disseminators (with respect to the general public, to authorities, to restricted specialized audiences…), but also of providers of active support to the planners who should be given key elements for making decision. Geoethics imposes geoscientists to take clear and full responsibilities on the products resulting from their assessments, but also to be aware that these products are valuable insofar they are scientifically sound, known, understandable, and utilizable by a wide universe of users.

Follow-up Medical Care After Cancer Treatment

MedlinePlus

... long-term effects, and to study health-related quality of life and behaviors in long-term survivors. Healthcare Delivery ... perceptions, knowledge, and practices of primary care and oncology specialist physicians about follow-up care of adult cancer survivors after treatment. ... for Childhood Cancer Survivors ...

Psychological Distress, Anxiety, and Depression of Cancer-Affected BRCA1/2 Mutation Carriers: a Systematic Review.

PubMed

Ringwald, Johanna; Wochnowski, Christina; Bosse, Kristin; Giel, Katrin Elisabeth; Schäffeler, Norbert; Zipfel, Stephan; Teufel, Martin

2016-10-01

Understanding the intermediate- and long-term psychological consequences of genetic testing for cancer patients has led to encouraging research, but a clear consensus of the psychosocial impact and clinical routine for cancer-affected BRCA1 and BRCA2 mutation carriers is still missing. We performed a systematic review of intermediate- and long-term studies investigating the psychological impact like psychological distress, anxiety, and depression in cancer-affected BRCA mutation carriers compared to unaffected mutation carriers. This review included the screening of 1243 studies. Eight intermediate- and long-term studies focusing on distress, anxiety, and depression symptoms among cancer-affected mutation carriers at least six months after the disclosure of genetic testing results were included. Studies reported a great variety of designs, methods, and patient outcomes. We found evidence indicating that cancer-affected mutation carriers experienced a negative effect in relation to psychological well-being in terms of an increase in symptoms of distress, anxiety, and depression in the first months after test disclosure. In the intermediate- and long-term, no significant clinical relevant symptoms occurred. However, none of the included studies used specific measurements, which can clearly identify psychological burdens of cancer-affected mutation carriers. We concluded that current well-implemented distress screening instruments are not sufficient for precisely identifying the psychological burden of genetic testing. Therefore, future studies should implement coping strategies, specific personality structures, the impact of genetic testing, supportive care needs and disease management behaviour to clearly screen for the possible intermediate- and long-term psychological impact of a positive test disclosure.

The impact of cancer and quality of life among long-term survivors of breast cancer in Austria.

PubMed

Bouskill, Kathryn; Kramer, Michael

2016-11-01

This study explores the relationship between the perceived impact of cancer among long-term breast cancer survivors, sociodemographic and clinical variables, and mental and physical health-related quality of life outcomes in Austria. One hundred and fifty-two long-term survivors of breast cancer (on average 13 years after initial diagnosis) completed three mailed surveys, including the Short Form-36 (SF-36), the Impact of Cancer (version 2) to assess the perceived positive and negative aspects of cancer survivorship, and a general sociodemographic and clinical questionnaire. Linear regression models were constructed to determine the effects of the perceived positive and negative impact of cancer on mental and physical health-related quality of life. Respondents reported a physical health status that centered on population norms for Austria, but scored lower on mental health status. After controlling for age, chemotherapy, exercise, and BMI, the positive impact of cancer was associated with improved physical functioning (p = 0.0014) and the negative impact of cancer was associated with poorer physical functioning (p < 0.0001). After controlling for age, marital status, the belief in emotional distress as a cause of cancer, and high stress levels, the negative impact of cancer was associated with poorer mental functioning (p < 0.0001). Higher perceived positive impact of cancer was not associated with improved mental functioning. Long-term survivors of breast cancer in Austria perceive both positive and negative impacts of breast cancer. These perceptions, in particular the negative impact of cancer, appear to influence, or are potentially influenced by, physical and mental health-related quality of life.

Training Program for Practical Engineering Design through the Collaboration with Regional Companies

NASA Astrophysics Data System (ADS)

Gofuku, Akio; Tabata, Nobuhisa; Tomita, Eiji; Funabiki, Nobuo

An education program to bring up engineering design capabilities through long-term internship by the collaboration with regional companies has been put in practice for five years. The program is composed of two types of long-term internships and several lectures for patent systems and engineering ethics. This paper describes the outline of the program, educational effects, and our experiences. The program was improved into two educational programs in 2011. The one is a special course to educate engineers and scientists who can lead the technologies of their domains. The other is a long-term internship program for master students in engineering divisions of graduate school. This paper also describes the current activities of the latter program.

Windows into the forest: extending long-term small-watershed research

Treesearch

Sally Duncan

2004-01-01

Interactions among forests, forestry, and water remain a critical aspect of Forest Service land stewardship. Small, experimental watershed studies managed by Forest Service Research and Development have a long history of advancing science and management and have resulted in a rich collection of long-term data. Early work addressed effects of forestry practices in...

Historical and projected climate in the Northern Rockies Region [Chapter 3

Treesearch

Linda A. Joyce; Marian Talbert; Darrin Sharp; Jeffrey Morisette; John Stevenson

2018-01-01

Climate influences the ecosystem services we obtain from forest and rangelands. Climate is described by the long-term characteristics of precipitation, temperature, wind, snowfall, and other measures of weather that occur over a long period in a particular place, and is typically expressed as long-term average conditions. Resource management practices are implemented...

The Impact of Public Hospital Closure on Medical and Residency Education: Implications and Recommendations

PubMed Central

Walker, Kara Odom; Calmes, Daphne; Hanna, Nancy; Baker, Richard

2010-01-01

Background Challenges around safety-net hospital closure have impacted medical student and resident exposure to urban public healthcare sites that may influence their future practice choices. Objective To assess the impact of the closure of a public safety-net teaching hospital for the clinical medical education of Charles Drew University medical students and residents. Method Retrospective cohort study of medical students’ and residents’ and clinical placement into safety-net experiences after the closure of the primary teaching hospital. Results The hospital closure impacted both medical student and residency training experiences. Only 71% (17/24) of medical student rotations and 13% (23/180) of residents were maintained at public safety-net clinical sittings. The closure of the public safety-net hospital resulted in the loss of 36% of residency training spots sponsored by historically black medical schools in the United States and an even larger negative impact on the number of physicians training in underserved urban areas of Los Angeles County. Conclusion While the medical educational program changes undertaken in the wake of hospital closure have negatively affected the immediate clinical educational experiences of medical students and residents, it remains to be seen whether the training site location changes will alter their long-term preferences in specialty choice and practice location. PMID:19110905

The impact of public hospital closure on medical and residency education: implications and recommendations.

PubMed

Walker, Kara Odom; Calmes, Daphne; Hanna, Nancy; Baker, Richard

2008-12-01

Challenges around safety-net hospital closure have impacted medical student and resident exposure to urban public healthcare sites that may influence their future practice choices. To assess the impact of the closure of a public safety-net teaching hospital for the clinical medical education of Charles Drew University medical students and residents. Retrospective cohort study of medical students' and residents' and clinical placement into safety-net experiences after the closure of the primary teaching hospital. The hospital closure impacted both medical student and residency training experiences. Only 71% (17/24) of medical student rotations and 13% (23/180) of residents were maintained at public safety-net clinical sittings. The closure of the public safety-net hospital resulted in the loss of 36% of residency training spots sponsored by historically black medical schools in the United States and an even larger negative impact on the number of physicians training in underserved urban areas of Los Angeles County. While the medical educational program changes undertaken in the wake of hospital closure have negatively affected the immediate clinical educational experiences of medical students and residents, it remains to be seen whether the training site location changes will alter their long-term preferences in specialty choice and practice location.

Long-Term Engagement in Authentic Research with NASA (LEARN): Innovative Practices Suggested By a New Model for Teacher Research Experiences

NASA Astrophysics Data System (ADS)

Pippin, M. R.; Joseph, J. D.; Yang, M. M.; Omar, A. H.; Crecelius, S.; Harte, T.; Lewis, P. M., Jr.; Taylor, J.; Bujosa, R.; Moulton, C.; Haggard, C. S.; Hyater-Adams, S.; Kollmeyer, R.; Weisman, A.

2014-12-01

NASA's LEARN Project is an innovative program that provides long-term immersion in the practice of atmospheric science for middle and high school in-service teachers. Working alongside NASA scientists and using authentic NASA Science Mission Directorate research data, teachers develop individual research topics of interest during two weeks in the summer while on-site at NASA Langley. With continued, intensive mentoring by NASA scientists, the teachers further develop their research throughout the academic year through virtual group meetings and data team meetings mirroring scientific collaborations. At the end of the first year, LEARN teachers present scientific posters. The LEARN experience has had such an impact that multiple teachers from the first two cohorts have elected to continue their research. The LEARN project evaluation has provided insights into particularly effective elements of this new approach. Findings indicate that teachers' perceptions of the scientific enterprise have changed, and that LEARN provided substantial resources to help them take real-world research to their students. This presentation will focus on key factors from LEARN's implementation that inform best practices for the incorporation of authentic scientific research into teacher professional development experiences. We suggest that these factors should be considered in the development of other such experiences, including: (1) The involvement of a single scientist as both the project leader/manager and the project scientist, to ensure that the project can meet teachers' needs. (2) An emphasis on framing and approaching scientific research questions, so that teachers can learn to evaluate the feasibility of studies based on scope, scale, and availability of data. (3) Long term, ongoing relationships where teachers and scientists work as collaborators, beyond the workshop "mold." (4) A focus on meeting the needs of individual teachers, whether their needs relate to elements of research and analysis, or to their tight professional schedules. (5) Above all, flexibility and patience. LEARN builds relationships with teachers slowly, over a long period of time. In the middle, life often intervenes. LEARN has emphasized that teachers' success is more important than deadlines or following a rigid protocol.

Climate change, water rights, and water supply: The case of irrigated agriculture in Idaho

NASA Astrophysics Data System (ADS)

Xu, Wenchao; Lowe, Scott E.; Adams, Richard M.

2014-12-01

We conduct a hedonic analysis to estimate the response of agricultural land use to water supply information under the Prior Appropriation Doctrine by using Idaho as a case study. Our analysis includes long-term climate (weather) trends and water supply conditions as well as seasonal water supply forecasts. A farm-level panel data set, which accounts for the priority effects of water rights and controls for diversified crop mixes and rotation practices, is used. Our results indicate that farmers respond to the long-term surface and ground water conditions as well as to the seasonal water supply variations. Climate change-induced variations in climate and water supply conditions could lead to substantial damages to irrigated agriculture. We project substantial losses (up to 32%) of the average crop revenue for major agricultural areas under future climate scenarios in Idaho. Finally, farmers demonstrate significantly varied responses given their water rights priorities, which imply that the distributional impact of climate change is sensitive to institutions such as the Prior Appropriation Doctrine.

A method to preserve trends in quantile mapping bias correction of climate modeled temperature

NASA Astrophysics Data System (ADS)

Grillakis, Manolis G.; Koutroulis, Aristeidis G.; Daliakopoulos, Ioannis N.; Tsanis, Ioannis K.

2017-09-01

Bias correction of climate variables is a standard practice in climate change impact (CCI) studies. Various methodologies have been developed within the framework of quantile mapping. However, it is well known that quantile mapping may significantly modify the long-term statistics due to the time dependency of the temperature bias. Here, a method to overcome this issue without compromising the day-to-day correction statistics is presented. The methodology separates the modeled temperature signal into a normalized and a residual component relative to the modeled reference period climatology, in order to adjust the biases only for the former and preserve the signal of the later. The results show that this method allows for the preservation of the originally modeled long-term signal in the mean, the standard deviation and higher and lower percentiles of temperature. To illustrate the improvements, the methodology is tested on daily time series obtained from five Euro CORDEX regional climate models (RCMs).

Global Warming: Discussion for EOS Science Writers Workshop

NASA Technical Reports Server (NTRS)

Hansen, James E

1999-01-01

The existence of global warming this century is no longer an issue of scientific debate. But there are many important questions about the nature and causes of long-term climate change, th roles of nature and human-made climate forcings and unforced (chaotic) climate variability, the practical impacts of climate change, and what, if anything, should be done to reduce global warming, Global warming is not a uniform increase of temperature, but rather involves at complex geographically varying climate change. Understanding of global warming will require improved observations of climate change itself and the forcing factors that can lead to climate change. The NASA Terra mission and other NASA Earth Science missions will provide key measurement of climate change and climate forcings. The strategy to develop an understanding of the causes and predictability of long-term climate change must be based on combination of observations with models and analysis. The upcoming NASA missions will make important contributions to the required observations.

Long-term impacts of prescribed fire on stand structure, growth, mortality, and individual tree vigor in Pinus resinosa forests

Treesearch

Sawyer S. Scherer; Anthony W. D' Amato; Christel C. Kern; Brian J. Palik; Matthew B. Russell

2016-01-01

Prescribed fire is increasingly being viewed as a valuable tool for mitigating the ecological consequences of long-term fire suppression within fire-adapted forest ecosystems. While the use of burning treatments in northern temperate conifer forests has at times received considerable attention, the long-term (>10 years) effects on forest structure and...

Site productivity and diversity of the Middle Mountain long-term soil productivity study, West Virginia: Pre-experimental site characterization

Treesearch

Mary Beth Adams

2018-01-01

To better understand the impacts of a changing environment and interactions with forest management options for forest resources, including soil, large long-term experiments are required. Such experiments require careful documentation of reference or pre-experimental conditions. This publication describes the Middle Mountain Long-term Soil Productivity (LTSP) Study,...

Community Impact Report. Executive Summary, Fall 2000.

ERIC Educational Resources Information Center

Hodge, Valerie

This summary details Bellevue Community College's (BCC's) (Washington) short-term and long-term community impacts. Short-term community impacts include: (1) 34,994 students were educated and trained at BCC; (2) BCC employed over 2,272 people, 53% of whom lived in the BCC service area; (3) BCC total revenue was $62,966,226; (4) 28.6% of the total…

Management of long-term conditions in a prison setting.

PubMed

Perry, J

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

A systematic review of non-pharmacological interventions to improve nighttime sleep among residents of long-term care settings.

PubMed

Capezuti, Elizabeth; Sagha Zadeh, Rana; Pain, Kevin; Basara, Aleksa; Jiang, Nancy Ziyan; Krieger, Ana C

2018-06-18

Disturbances in sleep and circadian rhythms are common among residents of long-term care facilities. In this systematic review, we aim to identify and evaluate the literature documenting the outcomes associated with non-pharmacological interventions to improve nighttime sleep among long-term care residents. The Preferred Reporting Items for Systematic Reviews guided searches of five databases (MEDLINE, Embase, CINAHL, Scopus, and Cochrane Library) for articles reporting results of experimental or quasi-experimental studies conducted in long-term care settings (nursing homes, assisted-living facilities, or group homes) in which nighttime sleep was subjectively or objectively measured as a primary outcome. We categorized each intervention by its intended use and how it was administered. Of the 54 included studies evaluating the effects of 25 different non-pharmacological interventions, more than half employed a randomized controlled trial design (n = 30); the others used a pre-post design with (n = 11) or without (n = 13) a comparison group. The majority of randomized controlled trials were at low risk for most types of bias, and most other studies met the standard quality criteria. The interventions were categorized as environmental interventions (n = 14), complementary health practices (n = 12), social/physical stimulation (n = 11), clinical care practices (n = 3), or mind-body practices (n = 3). Although there was no clear pattern of positive findings, three interventions had the most promising results: increased daytime light exposure, nighttime use of melatonin, and acupressure. Non-pharmacological interventions have the potential to improve sleep for residents of long-term care facilities. Further research is needed to better standardize such interventions and provide clear implementation guidelines using cost-effective practices.

Health insurance for all long-term care workers: estimated costs and coverage impacts in Minnesota and recommendations for States.

PubMed

Wright, Bernadette; Gruman, Cindy; Alecxih, Lisa; Knatterud, Larhae

2012-01-01

A major barrier to building a strong workforce to meet the growing need for long-care is lack of affordable health benefits. This study projects impacts of funding health coverage for all long-term care workers in Minnesota. Under the most cost effective model plan design, enrollment in employer-sponsored coverage would increase 73% to 100% for individual coverage and 26% to 42% for family coverage. Total monthly costs would be $698/worker in the commercial market or $634/worker through a new dedicated risk pool. Based on our findings and past research, the authors present recommendations for structuring and implementing a long-term care worker health insurance initiative.

Part-time, e-learning interprofessional pain management education for the primary and community care setting.

PubMed

Jenkins, M Sue; Bean, W Geinor; Luke, Karl

2014-02-01

Chronic pain is a long-term condition, which has a major impact on patients, carers and the health service. Despite the Chief Medical Officer setting chronic pain and its management as a national priority in 2008, the utilisation of health services by patients with long-term conditions is increasing, people with pain-related problems are not seen early enough and pain-related attendances to accident and emergency departments is increasing. Early assessment with appropriate evidence-based intervention and early recognition of when to refer to specialist and specialised services is key to addressing the growing numbers suffering with chronic pain. Pain education is recommended in many guidelines, as part of the process to address pain in these issues. Cardiff University validated an e-learning, master's level pain management module for healthcare professionals working in primary and community care. The learning outcomes revolve around robust early assessment and management of chronic pain in primary and community care and the knowledge when to refer on. The module focuses on the biopsychosocial aspects of pain and its management, using a blog as an online case study assessment for learners to demonstrate their knowledge, understanding and application to practice. The module has resulted in learners developing evidence-based recommendations, for pain management in clinical practice.

Effects of meditation practice on spontaneous eyeblink rate.

PubMed

Kruis, Ayla; Slagter, Heleen A; Bachhuber, David R W; Davidson, Richard J; Lutz, Antoine

2016-05-01

A rapidly growing body of research suggests that meditation can change brain and cognitive functioning. Yet little is known about the neurochemical mechanisms underlying meditation-related changes in cognition. Here, we investigated the effects of meditation on spontaneous eyeblink rates (sEBR), a noninvasive peripheral correlate of striatal dopamine activity. Previous studies have shown a relationship between sEBR and cognitive functions such as mind wandering, cognitive flexibility, and attention-functions that are also affected by meditation. We therefore expected that long-term meditation practice would alter eyeblink activity. To test this, we recorded baseline sEBR and intereyeblink intervals (IEBI) in long-term meditators (LTM) and meditation-naive participants (MNP). We found that LTM not only blinked less frequently, but also showed a different eyeblink pattern than MNP. This pattern had good to high degree of consistency over three time points. Moreover, we examined the effects of an 8-week course of mindfulness-based stress reduction on sEBR and IEBI, compared to an active control group and a waitlist control group. No effect of short-term meditation practice was found. Finally, we investigated whether different types of meditation differentially alter eyeblink activity by measuring sEBR and IEBI after a full day of two kinds of meditation practices in the LTM. No effect of meditation type was found. Taken together, these findings may suggest either that individual difference in dopaminergic neurotransmission is a self-selection factor for meditation practice, or that long-term, but not short-term meditation practice induces stable changes in baseline striatal dopaminergic functioning. © 2016 Society for Psychophysiological Research.

Effects of Meditation Practice on Spontaneous Eye Blink Rate

PubMed Central

Kruis, Ayla; Slagter, Heleen A.; Bachhuber, David R.W.; Davidson, Richard J.; Lutz, Antoine

2016-01-01

A rapidly growing body of research suggests that meditation can change brain and cognitive functioning. Yet little is known about the neurochemical mechanisms underlying meditation-related changes in cognition. Here we investigated the effects of meditation on spontaneous Eye Blink Rates (sEBR), a non-invasive peripheral correlate of striatal dopamine activity. Previous studies have shown a relationship between sEBR and cognitive functions such as mind-wandering, cognitive flexibility, and attention–functions that are also affected by meditation. We therefore expected that long-term meditation practice would alter eye-blink activity. To test this, we recorded baseline sEBR and Inter Eye-Blink Intervals (IEBI) in long-term meditators (LTM) and meditation naive participants (MNP). We found that LTM not only blinked less frequently, but also showed a different eye-blink pattern than MNP. This pattern had good to high degree of consistency over three time points. Moreover, we examined the effects of an 8 week-course of Mindfulness Based Stress Reduction (MBSR) on sEBR and IEBI, compared to an active control group and a waitlist-control group. No effect of short-term meditation practice was found. Finally, we investigated whether different types of meditation differentially alter eye blink activity by measuring sEBR and IEBI after a full day of two kinds of meditation practices in the LTM. No effect of meditation type was found. Taken together, these findings may suggest either that individual difference in dopaminergic neurotransmission is a self-selection factor for meditation practice, or that long-term, but not short-term meditation practice induces stable changes in baseline striatal dopaminergic functioning. PMID:26871460

Improving client-centered brain injury rehabilitation through research-based theater.

PubMed

Kontos, Pia C; Miller, Karen-Lee; Gilbert, Julie E; Mitchell, Gail J; Colantonio, Angela; Keightley, Michelle L; Cott, Cheryl

2012-12-01

Traumatic brain injury often results in physical, behavioral, and cognitive impairments perceived by health care practitioners to limit or exclude clients' full participation in treatment decision making. We used qualitative methods to evaluate the short- and long-term impact of "After the Crash: A Play About Brain Injury," a research-based drama designed to teach client-centered care principles to brain injury rehabilitation staff. We conducted interviews and observations with staff of two inpatient neurorehabilitation units in Ontario, Canada. Findings demonstrate the effectiveness of the play in influencing practice through the avoidance of medical jargon to improve clients' understanding and participation in treatment; newfound appreciation for clients' needs for emotional expression and sexual intimacy; increased involvement of family caregivers; and avoidance of staff discussions as if clients were unaware. These findings suggest that research-based drama can effect reflexivity, empathy, and practice change to facilitate a client-centered culture of practice in brain injury rehabilitation.

Long-term impact of clearcutting, deer browsing, and defoliation on stand development in a Pennsylvania mixed-oak forest

Treesearch

Aaron D. Stottlemyer

2014-01-01

The long-term impacts of even-age forest management and excessive browsing by white-tailed deer (Odocoileus virginianus) on regeneration are unknown for hardwood forests in the eastern United States. In 1965, Gene Wood, a graduate student at Pennsylvania State University, initiated a study in a mixed-oak forest in central Pennsylvania to examine...

Long-term fish monitoring in large rivers: Utility of “benchmarking” across basins

USGS Publications Warehouse

Ward, David L.; Casper, Andrew F.; Counihan, Timothy D.; Bayer, Jennifer M.; Waite, Ian R.; Kosovich, John J.; Chapman, Colin; Irwin, Elise R.; Sauer, Jennifer S.; Ickes, Brian; McKerrow, Alexa

2017-01-01

In business, benchmarking is a widely used practice of comparing your own business processes to those of other comparable companies and incorporating identified best practices to improve performance. Biologists and resource managers designing and conducting monitoring programs for fish in large river systems tend to focus on single river basins or segments of large rivers, missing opportunities to learn from those conducting fish monitoring in other rivers. We briefly examine five long-term fish monitoring programs in large rivers in the United States (Colorado, Columbia, Mississippi, Illinois, and Tallapoosa rivers) and identify opportunities for learning across programs by detailing best monitoring practices and why these practices were chosen. Although monitoring objectives, methods, and program maturity differ between each river system, examples from these five case studies illustrate the important role that long-term monitoring programs play in interpreting temporal and spatial shifts in fish populations for both established objectives and newly emerging questions. We suggest that deliberate efforts to develop a broader collaborative network through benchmarking will facilitate sharing of ideas and development of more effective monitoring programs.

33 CFR 332.7 - Management.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

33 CFR 332.7 - Management.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

33 CFR 332.7 - Management.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

40 CFR 230.97 - Management.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

33 CFR 332.7 - Management.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

40 CFR 230.97 - Management.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

40 CFR 230.97 - Management.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

40 CFR 230.97 - Management.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

The Psychometricization of Sigfluence.

ERIC Educational Resources Information Center

Loase, John Frederick

The English language lacks a word that means long-term interpersonal influence of one person toward another. This failing likely conditions people to be superficial in their thinking, and consequently in their behavior. A new term, sigfluence, has been coined to define positive, long-term, significant, impactful, interpersonal influence. One of…

Management training in long-term care.

PubMed

Evashwick, Connie

2002-01-01

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

Examining the short-term impacts of diverse management practices on plant phenology and carbon fluxes of Old World bluestems pasture

USDA-ARS?s Scientific Manuscript database

Burning, grazing, and baling (hay harvesting) are common management practices for tallgrass pasture. To develop and adopt sustainable management practices, it is essential to better understand and quantify the impacts of management practices on plant phenology and carbon fluxes. In this study, we co...

Creature comforts: personal communities, pets and the work of managing a long-term condition.

PubMed

Brooks, Helen L; Rogers, Anne; Kapadia, Dharmi; Pilgrim, Jack; Reeves, David; Vassilev, Ivaylo

2013-06-01

To explore in the context of peoples' personal social networks, the contribution that pets make to 'the work' associated with the management of long-term conditions. Mixed methods survey with nested parallel qualitative study; 300 participants were drawn from diabetes and chronic heart disease registers of General Practices across Greater Manchester in the North West of England. Notions of 'work' were used to describe the illness and everyday activities associated with chronic illness. Nineteen percent of participants identified at least one pet within their network. Pets contributed mostly to managing emotions (emotional work), to enhancing a sense of self identity (biographical work) and to a lesser extent practical tasks (everyday work). There were indicators that pets mediated relationships for people living with a long-term condition through very weak ties with others in domestic and community settings. The findings suggest that pets have unique qualities and are not simply substitutes for human relationships in long-term condition management. The study has potential implications for furthering a social contextual analysis of chronic illness, the understanding of relationships, and the meaning and the role of companion animals in long-term condition management.

Creature comforts: personal communities, pets and the work of managing a long-term condition

PubMed Central

Brooks, Helen L; Rogers, Anne; Kapadia, Dharmi; Pilgrim, Jack; Reeves, David; Vassilev, Ivaylo

2013-01-01

Objectives: To explore in the context of peoples’ personal social networks, the contribution that pets make to ‘the work’ associated with the management of long-term conditions. Method: Mixed methods survey with nested parallel qualitative study; 300 participants were drawn from diabetes and chronic heart disease registers of General Practices across Greater Manchester in the North West of England. Notions of ‘work’ were used to describe the illness and everyday activities associated with chronic illness. Results: Nineteen percent of participants identified at least one pet within their network. Pets contributed mostly to managing emotions (emotional work), to enhancing a sense of self identity (biographical work) and to a lesser extent practical tasks (everyday work). There were indicators that pets mediated relationships for people living with a long-term condition through very weak ties with others in domestic and community settings. Conclusion: The findings suggest that pets have unique qualities and are not simply substitutes for human relationships in long-term condition management. The study has potential implications for furthering a social contextual analysis of chronic illness, the understanding of relationships, and the meaning and the role of companion animals in long-term condition management. PMID:22777565

Responses of Crop Water Use Efficiency to Climate Change and Agronomic Measures in the Semiarid Area of Northern China

PubMed Central

Zhang, Jingting; Ren, Wei; An, Pingli; Pan, Zhihua; Wang, Liwei; Dong, Zhiqiang; He, Di; Yang, Jia; Pan, Shufen; Tian, Hanqin

2015-01-01

It has long been concerned how crop water use efficiency (WUE) responds to climate change. Most of existing researches have emphasized the impact of single climate factor but have paid less attention to the effect of developed agronomic measures on crop WUE. Based on the long-term field observations/experiments data, we investigated the changing responses of crop WUE to climate variables (temperature and precipitation) and agronomic practices (fertilization and cropping patterns) in the semi-arid area of northern China (SAC) during two periods, 1983–1999 and 2000–2010 (drier and warmer). Our results suggest that crop WUE was an intrinsical system sensitive to climate change and agronomic measures. Crops tend to reach the maximum WUE (WUEmax) in warm-dry environment while reach the stable minimum WUE (WUEmin) in warm-wet environment, with a difference between WUEmax and WUEmin ranging from 29.0%-55.5%. Changes in temperature and precipitation in the past three decades jointly enhanced crop WUE by 8.1%-30.6%. Elevated fertilizer and rotation cropping would increase crop WUE by 5.6–11.0% and 19.5–92.9%, respectively. These results indicate crop has the resilience by adjusting WUE, which is not only able to respond to subsequent periods of favorable water balance but also to tolerate the drought stress, and reasonable agronomic practices could enhance this resilience. However, this capacity would break down under impact of climate changes and unconscionable agronomic practices (e.g. excessive N/P/K fertilizer or traditional continuous cropping). Based on the findings in this study, a conceptual crop WUE model is constructed to indicate the threshold of crop resilience, which could help the farmer develop appropriate strategies in adapting the adverse impacts of climate warming. PMID:26336098

Responses of Crop Water Use Efficiency to Climate Change and Agronomic Measures in the Semiarid Area of Northern China.

PubMed

Zhang, Jingting; Ren, Wei; An, Pingli; Pan, Zhihua; Wang, Liwei; Dong, Zhiqiang; He, Di; Yang, Jia; Pan, Shufen; Tian, Hanqin

2015-01-01

It has long been concerned how crop water use efficiency (WUE) responds to climate change. Most of existing researches have emphasized the impact of single climate factor but have paid less attention to the effect of developed agronomic measures on crop WUE. Based on the long-term field observations/experiments data, we investigated the changing responses of crop WUE to climate variables (temperature and precipitation) and agronomic practices (fertilization and cropping patterns) in the semi-arid area of northern China (SAC) during two periods, 1983-1999 and 2000-2010 (drier and warmer). Our results suggest that crop WUE was an intrinsical system sensitive to climate change and agronomic measures. Crops tend to reach the maximum WUE (WUEmax) in warm-dry environment while reach the stable minimum WUE (WUEmin) in warm-wet environment, with a difference between WUEmax and WUEmin ranging from 29.0%-55.5%. Changes in temperature and precipitation in the past three decades jointly enhanced crop WUE by 8.1%-30.6%. Elevated fertilizer and rotation cropping would increase crop WUE by 5.6-11.0% and 19.5-92.9%, respectively. These results indicate crop has the resilience by adjusting WUE, which is not only able to respond to subsequent periods of favorable water balance but also to tolerate the drought stress, and reasonable agronomic practices could enhance this resilience. However, this capacity would break down under impact of climate changes and unconscionable agronomic practices (e.g. excessive N/P/K fertilizer or traditional continuous cropping). Based on the findings in this study, a conceptual crop WUE model is constructed to indicate the threshold of crop resilience, which could help the farmer develop appropriate strategies in adapting the adverse impacts of climate warming.

Exploration of Lower Frequency EEG Dynamics and Cortical Alpha Asymmetry in Long-term Rajyoga Meditators

PubMed Central

Sharma, Kanishka; Chandra, Sushil; Dubey, Ashok Kumar

2018-01-01

Background: Rajyoga meditation is taught by Prajapita Brahmakumaris World Spiritual University (Brahmakumaris) and has been followed by more than one million followers across the globe. However, rare studies were conducted on physiological aspects of rajyoga meditation using electroencephalography (EEG). Band power and cortical asymmetry were not studied with Rajyoga meditators. Aims: This study aims to investigate the effect of regular meditation practice on EEG brain dynamics in low-frequency bands of long-term Rajyoga meditators. Settings and Design: Subjects were matched for age in both groups. Lower frequency EEG bands were analyzed in resting and during meditation. Materials and Methods: Twenty-one male long-term meditators (LTMs) and same number of controls were selected to participate in study as par inclusion criteria. Semi high-density EEG was recorded before and during meditation in LTM group and resting in control group. The main outcome of the study was spectral power of alpha and theta bands and cortical (hemispherical) asymmetry calculated using band power. Statistical Analysis: One-way ANOVA was performed to find the significant difference between EEG spectral properties of groups. Pearson's Chi-square test was used to find difference among demographics data. Results: Results reveal high-band power in alpha and theta spectra in meditators. Cortical asymmetry calculated through EEG power was also found to be high in frontal as well as parietal channels. However, no correlation was seen between the experience of meditation (years, hours) practice and EEG indices. Conclusion: Overall findings indicate contribution of smaller frequencies (alpha and theta) while maintaining meditative experience. This suggests a positive impact of meditation on frontal and parietal areas of brain, involved in the processes of regulation of selective and sustained attention as well as provide evidence about their involvement in emotion and cognitive processing. PMID:29343928

Analyzing and modelling the effect of long-term fertilizer management on crop yield and soil organic carbon in China.

PubMed

Zhang, Jie; Balkovič, Juraj; Azevedo, Ligia B; Skalský, Rastislav; Bouwman, Alexander F; Xu, Guang; Wang, Jinzhou; Xu, Minggang; Yu, Chaoqing

2018-06-15

This study analyzes the influence of various fertilizer management practices on crop yield and soil organic carbon (SOC) based on the long-term field observations and modelling. Data covering 11 years from 8 long-term field trials were included, representing a range of typical soil, climate, and agro-ecosystems in China. The process-based model EPIC (Environmental Policy Integrated Climate model) was used to simulate the response of crop yield and SOC to various fertilization regimes. The results showed that the yield and SOC under additional manure application treatment were the highest while the yield under control treatment was the lowest (30%-50% of NPK yield) at all sites. The SOC in northern sites appeared more dynamic than that in southern sites. The variance partitioning analysis (VPA) showed more variance of crop yield could be explained by the fertilization factor (42%), including synthetic nitrogen (N), phosphorus (P), potassium (K) fertilizers, and fertilizer NPK combined with manure. The interactive influence of soil (total N, P, K, and available N, P, K) and climate factors (mean annual temperature and precipitation) determine the largest part of the SOC variance (32%). EPIC performs well in simulating both the dynamics of crop yield (NRMSE = 32% and 31% for yield calibration and validation) and SOC (NRMSE = 13% and 19% for SOC calibration and validation) under diverse fertilization practices in China. EPIC can assist in predicting the impacts of different fertilization regimes on crop growth and soil carbon dynamics, and contribute to the optimization of fertilizer management for different areas in China. Copyright © 2018. Published by Elsevier B.V.

Recreational music-making: a cost-effective group interdisciplinary strategy for reducing burnout and improving mood states in long-term care workers.

PubMed

Bittman, Barry; Bruhn, Karl T; Stevens, Christine; Westengard, James; Umbach, Paul O

2003-01-01

This controlled, prospective, randomized study examined the clinical and potential economic impact of a 6-session Recreational Music-making (RMM) protocol on burnout and mood dimensions, as well as on Total Mood Disturbance (TMD) in an interdisciplinary group of long-term care workers. A total of 112 employees participated in a 6-session RMM protocol focusing on building support, communication, and interdisciplinary respect utilizing group drumming and keyboard accompaniment. Changes in burnout and mood dimensions were assessed with the Maslach Burnout Inventory and the Profile of Mood States respectively. Cost savings were projected by an independent consulting firm, which developed an economic impact model. Statistically-significant reductions of multiple burnout and mood dimensions, as well as TMD scores, were noted. Economic-impact analysis projected cost savings of $89,100 for a single typical 100-bed facility, with total annual potential savings to the long-term care industry of $1.46 billion. A cost-effective, 6-session RMM protocol reduces burnout and mood dimensions, as well as TMD, in long-term care workers.

Evaluation of the Permanence of Land Use Change Induced by Payments for Environmental Services in Quindío, Colombia.

PubMed

Pagiola, Stefano; Honey-Rosés, Jordi; Freire-González, Jaume

2016-01-01

The effectiveness of conservation interventions such as Payments for Environmental Services (PES) is often evaluated--if it is evaluated at all--only at the completion of the intervention. Since gains achieved by the intervention may be lost after it ends, even apparently successful interventions may not result in long-term conservation benefits, a problem known as that of permanence. This paper uses a unique dataset to examine the permanence of land use change induced by a short-term, asset-building PES program implemented in Quindío, Colombia, between 2003 and 2008. This the first PES program to have a control group for comparison. Under this program, PES had been found to have a positive and highly significant impact on land use. To assess the long-term permanence of these changes, both PES recipients and control households were re-surveyed in 2011, four years after the last payment was made. We find that the land use changes that had been induced by PES were broadly sustained in intervening years, with minor differences across specific practices and sub-groups of participants, indicating that these changes were in fact permanent. The patterns of change in the period after the PES program was completed also help better understand the reasons for the program's success. These results suggest that, at least in the case of productive land uses such as silvopastoral practices under conditions such as those at the study site, asset-building PES programs can be effective at encouraging land owners to adopt environmentally-beneficial land management practices and that the benefits will persist after payments cease.

Bellevue Community College Community Impact Report, Fall 2002.

ERIC Educational Resources Information Center

Bellevue Community Coll., WA.

This document presents data pertaining to the impact of Bellevue Community College (BCC), Washington, on the surrounding community. The study examines both short- and long-term impacts of BCC on the larger community. Short-term impacts include the revenue and expenditures for which BCC is responsible, which for 2001-02 totaled $86,431,309. During…

The greenhouse gas intensity and potential biofuel production capacity of maize stover harvest in the US Midwest

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

Jones, Curtis D.; Zhang, Xuesong; Reddy, Ashwan D.

Agricultural residues are important sources of feedstock for a cellulosic biofuels industry that is being developed to reduce greenhouse gas emissions and improve energy independence. While the US Midwest has been recognized as key to providing maize stover for meeting near-term cellulosic biofuel production goals, there is uncertainty that such feedstocks can produce biofuels that meet federal cellulosic standards. Here, we conducted extensive site-level calibration of the Environmental Policy Integrated Climate (EPIC) terrestrial ecosystems model and applied the model at high spatial resolution across the US Midwest to improve estimates of the maximum production potential and greenhouse gas emissions expectedmore » from continuous maize residue-derived biofuels. A comparison of methodologies for calculating the soil carbon impacts of residue harvesting demonstrates the large impact of study duration, depth of soil considered, and inclusion of litter carbon in soil carbon change calculations on the estimated greenhouse gas intensity of maize stover-derived biofuels. Using the most representative methodology for assessing long-term residue harvesting impacts, we estimate that only 5.3 billion liters per year (bly) of ethanol, or 8.7% of the near-term US cellulosic biofuel demand, could be met under common no-till farming practices. However, appreciably more feedstock becomes available at modestly higher emissions levels, with potential for 89.0 bly of ethanol production meeting US advanced biofuel standards. Adjustments to management practices, such as adding cover crops to no-till management, will be required to produce sufficient quantities of residue meeting the greenhouse gas emission reduction standard for cellulosic biofuels. Considering the rapid increase in residue availability with modest relaxations in GHG reduction level, it is expected that management practices with modest benefits to soil carbon would allow considerable expansion of potential cellulosic biofuel production.« less

[Ergonomics in dental practice. Prevention of physical and mental overload].

PubMed

Plasschaert, A J

1999-02-01

In this article two important issues in dental ergonomics are discussed: physical and mental stress. It is important for a dentist to stay aware of the balance between on one hand short term profit against various forms of stress, and on the other hand long term negative effects. Possible problems are described without going in more deeply into theoretical backgrounds. Practical suggestions for action are given for the dentist who wants to work with pleasure and in good health over a long period of time.

Long-term personality data collection in support of spaceflight and analogue research.

PubMed

Musson, David M; Helmreich, Robert L

2005-06-01

This is a review of past and present research into personality and performance at the University of Texas (UT) Human Factors Research Project. Specifically, personality trait data collected from astronauts, pilots, Antarctic personnel, and other groups over a 15-yr period is discussed with particular emphasis on research in space and space analogue environments. The UT Human Factors Research Project conducts studies in personality and group dynamics in aviation, space, and medicine. Current studies include personality determinants of professional cultures, team effectiveness in both medicine and aviation, and personality predictors of long-term astronaut performance. The Project also studies the design and effectiveness of behavioral strategies used to minimize error and maximize team performance in safety-critical work settings. A multi-year personality and performance dataset presents many opportunities for research, including long-term and follow-up studies of human performance, analyses of trends in recruiting and attrition, and the ability to adapt research design to operational changes and methodological advances. Special problems posed by such long-duration projects include issues of confidentiality and security, as well as practical limitations imposed by current peer-review and short-term funding practices. Practical considerations for ongoing dataset management include consistency of assessment instruments over time, variations in data acquisition from one year to the next, and dealing with changes in theory and practice that occur over the life of the project. A fundamental change in how research into human performance is funded would be required to ensure the ongoing development of such long-duration research databases.

Land use change impacts on floods at the catchment scale: Challenges and opportunities for future research

NASA Astrophysics Data System (ADS)

Rogger, M.; Agnoletti, M.; Alaoui, A.; Bathurst, J. C.; Bodner, G.; Borga, M.; Chaplot, V.; Gallart, F.; Glatzel, G.; Hall, J.; Holden, J.; Holko, L.; Horn, R.; Kiss, A.; Kohnová, S.; Leitinger, G.; Lennartz, B.; Parajka, J.; Perdigão, R.; Peth, S.; Plavcová, L.; Quinton, J. N.; Robinson, M.; Salinas, J. L.; Santoro, A.; Szolgay, J.; Tron, S.; van den Akker, J. J. H.; Viglione, A.; Blöschl, G.

2017-07-01

Research gaps in understanding flood changes at the catchment scale caused by changes in forest management, agricultural practices, artificial drainage, and terracing are identified. Potential strategies in addressing these gaps are proposed, such as complex systems approaches to link processes across time scales, long-term experiments on physical-chemical-biological process interactions, and a focus on connectivity and patterns across spatial scales. It is suggested that these strategies will stimulate new research that coherently addresses the issues across hydrology, soil and agricultural sciences, forest engineering, forest ecology, and geomorphology.

Refrigeration Playbook. Heat Reclaim; Optimizing Heat Rejection and Refrigeration Heat Reclaim for Supermarket Energy Conservation

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

Reis, Chuck; Nelson, Eric; Armer, James

The purpose of this playbook and accompanying spreadsheets is to generalize the detailed CBP analysis and to put tools in the hands of experienced refrigeration designers to evaluate multiple applications of refrigeration waste heat reclaim across the United States. Supermarkets with large portfolios of similar buildings can use these tools to assess the impact of large-scale implementation of heat reclaim systems. In addition, the playbook provides best practices for implementing heat reclaim systems to achieve the best long-term performance possible. It includes guidance on operations and maintenance as well as measurement and verification.

Evidence-based perianesthesia care: accelerated postoperative recovery programs.

PubMed

Pasero, Chris; Belden, Jan

2006-06-01

Prolonged stress response after surgery can cause numerous adverse effects, including gastrointestinal dysfunction, muscle wasting, impaired cognition, and cardiopulmonary, infectious, and thromboembolic complications. These events can delay hospital discharge, extend convalescence, and negatively impact long-term prognosis. Recent advances in perioperative management practices have allowed better control of the stress response and improved outcomes for patients undergoing surgery. At the center of the current focus on improved outcomes are evidence-based fast-track surgical techniques and what is commonly referred to as "accelerated postoperative recovery programs." These programs require a multidisciplinary, coordinated effort, and nurses are essential to their successful implementation.

Who Is at Greatest Risk of Adverse Long-Term Outcomes? The Finnish from a Boy to a Man Study

ERIC Educational Resources Information Center

Sourander, Andre; Jensen, Peter; Davies, Mark; Niemela, Solja; Elonheimo, Henrik; Ristkari, Terja; Helenius, Hans; Sillanmaki, Lauri; Piha, Jorma; Kumpulainen, Kirsti; Tamminen, Tuula; Moilanen, Irma; Almqvist, Fredrik

2007-01-01

Objective: To study associations between comorbid psychopathology and long-term outcomes in a large birth cohort sample from age 8 to early adulthood. Method: The sample included long-term outcome data on 2,556 Finnish boys born in 1981. The aim was to study the impact of early childhood psychopathology types (externalizing versus internalizing…

Space environmental considerations for a long-term cryogenic storage vessel

NASA Technical Reports Server (NTRS)

Nakanishi, Shigeo

1987-01-01

Information is given on the kind of protection that is needed against impact and perforation of a long-term cryogenic storage vessel in space by meteoroids and space debris. The long-term effects of the space environment on thermal control surfaces and coatings, and the question of whether the insulation and thermal control surfaces should be encased in a vacuum jacket shell are discussed.

Improving long-term care provision: towards demand-based care by means of modularity

PubMed Central

2010-01-01

Background As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Methods Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. Conclusion The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further enable demand-based provision of long-term care by means of modularity. PMID:20858256

Improving long-term care provision: towards demand-based care by means of modularity.

PubMed

de Blok, Carolien; Luijkx, Katrien; Meijboom, Bert; Schols, Jos

2010-09-21

As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further enable demand-based provision of long-term care by means of modularity.

Antibiotic treatment of exacerbations of COPD in general practice: long-term impact on health-related quality of life

PubMed Central

Miravitlles, Marc; Llor, Carles; Molina, Jesús; Naberan, Karlos; Cots, Josep M; Ros, Fernando

2010-01-01

Objective: To investigate the impact of exacerbations in health-related quality of life (HRQL) of patients with COPD and to compare the effect of treatment of COPD exacerbations with moxifloxacin (400 mg/day for 5 days) and amoxicillin/clavulanate (500/125 mg 3 times a day for 10 days) on HRQL. Methods: 229 outpatients with stable COPD (mean age 68.2 years; mean FEV1 % predicted 49.3%) participated in a prospective, observational study of 2 years’ duration. The St George’s Respiratory Questionnaire (SGRQ) was completed at baseline and every 6 months thereafter. Results: COPD exacerbations (mean 2.7 episodes/patient) occurred in 136 patients (124 patients received the study medications [amoxicillin/clavulanate 54, moxifloxacin 70]). Differences between baseline and the final visit were higher for moxifloxacin compared with amoxicillin/clavulanate for total SGRQ score (−2.60 [13.1] vs 4.21 [16.2], P = 0.05) and “Symptoms” subscale (−5.64 [16.7] vs 8.27 [21], P = 0.02). The same findings were observed in patients with two or more exacerbations. Conclusions: In COPD outpatients, treatment of exacerbations with moxifloxacin had a more favorable long-term effect on quality of life than amoxicillin/clavulanate. PMID:20368907

Aging of Dissolved Copper and Copper-based Nanoparticles in Five Different Soils: Short-term Kinetics vs. Long-term Fate

EPA Science Inventory

With the growing availability and use of copper-based nanomaterials (Cu-NMs), there is increasing concern regarding their release and potential impact on the environment. In this study, the short term (≤5 d) aging profile and the long-term (135 d) speciation of dissolved Cu, cop...

Short-term pain for long-term gain: seagrass communities increase short-term extremes and long-term offset of CO2 under future ocean acidification

EPA Science Inventory

The impacts of ocean acidification in nearshore estuarine environments remain poorly characterized, despite these areas being some of the most ecologically, economically, and culturally important habitats in the global ocean. Here, we quantify how rising atmospheric CO2 from 1765...

40 CFR 439.52 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2011 CFR

2011-07-01

... day, must reflect not less than 74 percent reduction in the long-term average daily COD load of the... required to attain a limitation for COD that is less than the equivalent of 220 mg/L. (d) The long-term... of NPDES permit limitations regulating discharges subject to this subpart, calculation of the long...

40 CFR 439.52 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2010 CFR

2010-07-01

... day, must reflect not less than 74 percent reduction in the long-term average daily COD load of the... required to attain a limitation for COD that is less than the equivalent of 220 mg/L. (d) The long-term... of NPDES permit limitations regulating discharges subject to this subpart, calculation of the long...

Resident Characteristics Related to the Lack of Morning Care Provision in Long-Term Care

ERIC Educational Resources Information Center

Simmons, Sandra F.; Durkin, Daniel W.; Rahman, Anna N.; Choi, Leena; Beuscher, Linda; Schnelle, John F.

2013-01-01

Purpose: The purpose of this study was to examine usual long-term care (LTC) practices related to 3 aspects of morning care and determine if there were resident characteristics related to the lack of care. Design and Methods: Participants were 169 long-stay residents in 4 community LTC facilities who required staff assistance with either transfer…

Developing nursing practice through work-based learning.

PubMed

Clarke, David J; Copeland, Lisa

2003-12-01

Developing nursing practice in any area demands skills, knowledge, support and a long term commitment to the achievement of best practice. It is easy to become overwhelmed by the competing demands for client care and service delivery. It is not always easy to see how good ideas, clinical concerns and professionally led objectives, can be realised in practice. Ongoing professional development activities, including formal educational programmes can contribute to individual staff members' ability to take on practice development projects. Too often however, educational programmes are seen as making little real difference to clinical practice. Work-based learning, a relatively new approach in higher education in the United Kingdom, presents opportunities for Universities and healthcare providers to work in partnership to realise the shared aims of developing nursing practice. Specific examples, drawn from the personal experiences of one of the authors, will examine the contribution of a work-based learning approach to integrating learning and developing practice in the field of cancer care. The work-based learning approach can bring about tangible benefits for patients, practitioners and organisations, but only if the organisational and contextual factors which impact on practice and its development are properly considered and managed through effective partnerships.

Effectiveness of Career Counseling: A One-Year Follow-Up

ERIC Educational Resources Information Center

Perdrix, Sophie; Stauffer, Sarah; Masdonati, Jonas; Massoudi, Koorosh; Rossier, Jerome

2012-01-01

The short-term effectiveness of career counseling is well supported in the literature. However, the long-term impact is often overlooked. This study quantitatively investigated the long-term stability of the positive effects gained through the career counseling process and qualitatively observed participants' levels of career project…

Consequences of the Chernobyl accident for the natural and human environments

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

Dreicer, M.; Aarkog, A.; Alexakhin, R.

1996-07-01

In the ten years since the Chernobyl accident, an enormous amount of work has been done to assess the consequences to the natural and human environment. Although it is difficult to summarize such a large and varied field, some general conclusions can be drawn. This background paper includes the main findings concerning the direct impacts of radiation on the flora and fauna; the general advances of knowledge in the cycling of radionuclides in natural, seminatural and agricultural environments; some evaluation of countermeasures that were used; and a summary of the human radiation doses resulting from the environmental contamination. although openmore » questions still remain, it can be concluded that: (1) at high radiation levels, the natural environment has shown short term impacts but any significant long term impacts remain to be seen; (2) effective countermeasures can be taken to reduce the transfer of contamination from the environment to humans but these are highly site specific and must be evaluated in terms of practicality as well as population does reduction; (3) the majority of the doses have already been received by the human population. If agricultural countermeasures are appropriately taken, the main source of future doses will be the gathering of food and recreational activities in natural and seminatural ecosystems.« less

Ecology, ethics, and professional environmental practice: The Yucca Mountain, Nevada, project as a case study

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

Malone, C.R.

1995-09-01

The US Department of Energy (DOE) is proposing to develop a geologic repository for disposing of high-level nuclear waste at Yucca Mountain, Nevada. In this commentary, the ecology program for the DOE`s Yucca Mountain Project is discussed from the perspective of state-of-the-art ecosystem analysis, environmental ethics, and standards of professional practice. Specifically at issue is the need by the Yucca Mountain ecology program to adopt an ecosystem approach that encompasses the current strategy based on population biology and community ecology alone. The premise here is that an ecosystem approach is essential for assessing the long-term potential environmental impacts at Yuccamore » Mountain in light of the thermal effects expected to be associated with heat from radioactive decay.« less

Mapping the audit traces of interdisciplinary collaboration: bridging and blending between choreography and cognitive science

PubMed Central

Barnard, Philip; deLahunta, Scott

2017-01-01

ABSTRACT Two long-term sci–art research projects are described and positioned in the broader conceptual landscape of interdisciplinary collaboration. Both projects were aimed at understanding and augmenting choreographic decision-making and both were grounded in research conducted within a leading contemporary dance company. In each case, the work drew upon methods and theory from the cognitive sciences, and both had a direct impact on the way in which the company made new work. In the synthesis presented here the concept of an audit trace is introduced. Audit traces identify how specific classes of knowledge are used and transformed not only within the arts or sciences but also when arts practice is informed by science or when arts practice informs science. PMID:29308084

Achalasia: Outcome in children.

PubMed

Meyer, Anell; Catto-Smith, Anthony; Crameri, Joe; Simpson, Di; Alex, George; Hardikar, Winita; Cameron, Donald; Oliver, Mark

2017-02-01

Oesophageal achalasia is well-recognized but relatively rare in children, occasionally appearing as the "triple A" syndrome (with adrenal insufficiency and alacrima). Treatment modalities, as in adult practice, are not curative, often needing further interventions and spurring the search for better management. The outcome for syndromic variants is unknown. We sought to define the efficacy of treatments for children with achalasia with and without triple A syndrome. We conducted a retrospective analysis of presentation and outcomes for 42 children with achalasia presenting over three decades to a major pediatric referral center. Long term impact of the diagnosis was assessed by questionnaire. We identified 42 children including six with triple A syndrome. The median overall age at diagnosis was 10.8 years and median follow-up 1593 days. Initial Heller myotomy in 17 required further interventions in 11 (65%), while initial treatment with botulinum toxin (n = 20) was ultimately followed by myotomy in 17 (85%). Ten out of 35 patients who underwent myotomy required a repeat myotomy (29%). Patients with triple A syndrome developed symptoms earlier, but had delayed diagnosis, were more underweight at diagnosis and at last follow up. Questionnaire results suggested a significant long term deleterious impact on the quality of life of children and their families. Many children with achalasia relapse after initial treatment, undergoing multiple, different procedures, despite which symptoms persist and impact on quality of life. Symptoms develop earlier in patients with triple A syndrome, but the diagnosis is delayed and this has substantial nutritional impact. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Gray matter volume is associated with rate of subsequent skill learning after a long term training intervention

PubMed Central

Sampaio-Baptista, Cassandra; Scholz, Jan; Jenkinson, Mark; Thomas, Adam G.; Filippini, Nicola; Smit, Gabrielle; Douaud, Gwenaëlle; Johansen-Berg, Heidi

2014-01-01

The ability to predict learning performance from brain imaging data has implications for selecting individuals for training or rehabilitation interventions. Here, we used structural MRI to test whether baseline variations in gray matter (GM) volume correlated with subsequent performance after a long-term training of a complex whole-body task. 44 naïve participants were scanned before undertaking daily juggling practice for 6 weeks, following either a high intensity or a low intensity training regime. To assess performance across the training period participants' practice sessions were filmed. Greater GM volume in medial occipito-parietal areas at baseline correlated with steeper learning slopes. We also tested whether practice time or performance outcomes modulated the degree of structural brain change detected between the baseline scan and additional scans performed immediately after training and following a further 4 weeks without training. Participants with better performance had higher increases in GM volume during the period following training (i.e., between scans 2 and 3) in dorsal parietal cortex and M1. When contrasting brain changes between the practice intensity groups, we did not find any straightforward effects of practice time though practice modulated the relationship between performance and GM volume change in dorsolateral prefrontal cortex. These results suggest that practice time and performance modulate the degree of structural brain change evoked by long-term training regimes. PMID:24680712

A workflow for reproducing mean benthic gas fluxes

NASA Astrophysics Data System (ADS)

Fulweiler, Robinson W.; Emery, Hollie E.; Maguire, Timothy J.

2016-08-01

Long-term data sets provide unique opportunities to examine temporal variability of key ecosystem processes. The need for such data sets is becoming increasingly important as we try to quantify the impact of human activities across various scales and in some cases, as we try to determine the success of management interventions. Unfortunately, long-term benthic flux data sets for coastal ecosystems are rare and curating them is a challenge. If we wish to make our data available to others now and into the future, however, then we need to provide mechanisms that allow others to understand our methods, access the data, reproduce the results, and see updates as they become available. Here we use techniques, learned through the EarthCube Ontosoft Geoscience Paper of the Future project, to develop best practices to allow us to share a long-term data set of directly measured net sediment N2 fluxes and sediment oxygen demand at two sites in Narragansett Bay, Rhode Island (USA). This technical report describes the process we used, the challenges we faced, and the steps we will take in the future to ensure transparency and reproducibility. By developing these data and software sharing tools we hope to help disseminate well-curated data with provenance as well as products from these data, so that the community can better assess how this temperate estuary has changed over time. We also hope to provide a data sharing model for others to follow so that long-term estuarine data are more easily shared and not lost over time.

Tile drainage phosphorus loss with long-term consistent cropping systems and fertilization.

PubMed

Zhang, T Q; Tan, C S; Zheng, Z M; Drury, C F

2015-03-01

Phosphorus (P) loss in tile drainage water may vary with agricultural practices, and the impacts are often hard to detect with short-term studies. We evaluated the effects of long-term (≥43 yr) cropping systems (continuous corn [CC], corn-oats-alfalfa-alfalfa rotation [CR], and continuous grass [CS]) and fertilization (fertilization [F] vs. no-fertilization [NF]) on P loss in tile drainage water from a clay loam soil over a 4-yr period. Compared with NF, long-term fertilization increased concentrations and losses of dissolved reactive P (DRP), dissolved unreactive P (DURP), and total P (TP) in tile drainage water, with the increments following the order: CS > CR > CC. Dissolved P (dissolved reactive P [DRP] and dissolved unreactive P [DURP]) was the dominant P form in drainage outflow, accounting for 72% of TP loss under F-CS, whereas particulate P (PP) was the major form of TP loss under F-CC (72%), F-CR (62%), NF-CS (66%), NF-CC (74%), and NF-CR (72%). Dissolved unreactive P played nearly equal roles as DRP in P losses in tile drainage water. Stepwise regression analysis showed that the concentration of P (DRP, DURP, and PP) in tile drainage flow, rather than event flow volume, was the most important factor contributing to P loss in tile drainage water, although event flow volume was more important in PP loss than in dissolved P loss. Continuous grass significantly increased P loss by increasing P concentration and flow volume of tile drainage water, especially under the fertilization treatment. Long-term grasslands may become a significant P source in tile-drained systems when they receive regular P addition. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Enabling Long-Term Oceanographic Research: Changing Data Practices, Information Management Strategies and Informatics

NASA Astrophysics Data System (ADS)

Baker, K. S.; Chandler, C. L.

2008-12-01

Data management and informatics research are in a state of change in terms of data practices, information strategies, and roles. New ways of thinking about data and data management can facilitate interdisciplinary global ocean science. To meet contemporary expectations for local data use and reuse by a variety of audiences, collaborative strategies involving diverse teams of information professionals are developing. Such changes are fostering the growth of information infrastructures that support multi-scale sampling, data integration, and nascent networks of data repositories. In this retrospective, two examples of oceanographic projects incorporating data management in partnership with long-term science programs are reviewed: the Palmer Station Long-Term Ecological Research program (Palmer LTER) and the United States Joint Global Ocean Flux Study (US JGOFS). Lessons learned - short-term and long-term - from a decade of data management within these two communities will be presented. A conceptual framework called Ocean Informatics provides one example for managing the complexities inherent to sharing oceanographic data. Elements are discussed that address the economies-of-scale as well as the complexities-of-scale pertinent to a broad vision of information management and scientific research.

Impacts of dwarf mistletoe on the physiology of host Tsuga heterophylla trees as recorded in tree-ring C and O stable isotopes

Treesearch

D. E. Marias; F. C. Meinzer; D. R. Woodruff; D. C. Shaw; S. L. Voelker; Steven W. Oak; William J. Otrosina; William D. Smith; Kamal J.K. Gandhi

2014-01-01

Dwarf mistletoes, obligate, parasitic plants with diminutive aerial shoots, have long-term effects on host tree water relations, hydraulic architecture and photosynthetic gas exchange and can eventually induce tree death. To investigate the long-term (1886–2010) impacts of dwarf mistletoe on the growth and gas exchange characteristics of host western hemlock, we...

Home Start Followup Study: A Study of Long-Term Impact of Home Start on Program Participants. Final Report.

ERIC Educational Resources Information Center

Bache, William; And Others

This Home Start followup study was designed to determine the long-term impact of Home Start on program participants in sixteen states within the USA. Home Start was a three-year demonstration program which provided Head Start-type comprehensive services to young children (3- to 5-year-olds) and their families in their homes. In Chapter 1…

Impact of Infection Prevention and Control Initiatives on Acute Respiratory Infections in a Pediatric Long-Term Care Facility.

PubMed

Murray, Meghan T; Jackson, Olivia; Cohen, Bevin; Hutcheon, Gordon; Saiman, Lisa; Larson, Elaine; Neu, Natalie

2016-07-01

We evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly. Infect Control Hosp Epidemiol 2016;37:859-862.

Defining terms for proactive management of resistance to Bt crops and pesticides.

PubMed

Tabashnik, Bruce E; Mota-Sanchez, David; Whalon, Mark E; Hollingworth, Robert M; Carrière, Yves

2014-04-01

Evolution of pest resistance to pesticides is an urgent global problem with resistance recorded in at least 954 species of pests, including 546 arthropods, 218 weeds, and 190 plant pathogens. To facilitate understanding and management of resistance, we provide definitions of 50 key terms related to resistance. We confirm the broad, long-standing definition of resistance, which is a genetically based decrease in susceptibility to a pesticide, and the definition of "field-evolved resistance," which is a genetically based decrease in susceptibility to a pesticide in a population caused by exposure to the pesticide in the field. The impact of field-evolved resistance on pest control can vary from none to severe. We define "practical resistance" as field-evolved resistance that reduces pesticide efficacy and has practical consequences for pest control. Recognizing that resistance is not "all or none" and that intermediate levels of resistance can have a continuum of effects on pest control, we describe five categories of field-evolved resistance and use them to classify 13 cases of field-evolved resistance to five Bacillus thuringiensis (Bt) toxins in transgenic corn and cotton based on monitoring data from five continents for nine major pest species. We urge researchers to publish and analyze their resistance monitoring data in conjunction with data on management practices to accelerate progress in determining which actions will be most useful in response to specific data on the magnitude, distribution, and impact of resistance.

Effects of Successive Harvests on Soil Nutrient Stocks in Established Tropical Plantation Forests

NASA Astrophysics Data System (ADS)

Mendoza, L.; McMahon, D.; Jackson, R. B.

2017-12-01

Large-scale plantation forests in tropical regions alter biogeochemical processes, raising concerns about the long-term sustainability of this land use. Current commercial practices result in nutrient export with removed biomass that may not be balanced by fertilizer application. Consequent changes in a landscape's nutrient distributions can affect the growth of future plantations or other vegetation. Prior studies have reported changes in soil chemical and physical properties when plantation forests replace pastures or native vegetation, but few have examined the impacts of multiple harvest cycles following plantation establishment. This study analyzed macronutrient and carbon content of soil samples from the world's most productive plantation forests, in southeastern Brazil, to understand the long-term effects of plantation forests on soil nutrient stocks and soil fertility. Soil was collected from Eucalyptus plantation sites and adjacent vegetation in 2004 and again in 2016, after at least one full cycle of harvesting and replanting. We found that within surface soil (0-10 cm) Mg and N did not change significantly and C, P, K and Ca concentrations generally increased, but to varying extents within individual management units. This trend of increasing nutrient concentrations suggests that additional harvests do not result in cumulative nutrient depletion. However, large changes in Ca and K concentrations in individual plantation units indicate that added fertilizer does not consistently accumulate in the surface soil. Analysis of deeper soil layers and comparison to unfertilized vegetation will help to determine the fate of fertilizers and native soil nutrients in repeatedly harvested plantations. These results address the necessity of long-term investigation of nutrient changes to better understand and determine the impacts of different types of land use in the tropics.

Physician Perspectives on Long-Term Relationships and Friendships with Patients: A National Assessment.

PubMed

Hines, Harrison G; Avila, Cynthia J; Rudakevych, Tanya M; Curlin, Farr A; Yoon, John D

2017-11-01

Shifts in the healthcare environment have introduced challenges to the long-term continuity of the doctor-patient relationship. This study examines whether certain demographic or religious characteristics of physicians are associated with maintaining long-term relationships (LTRs) and/or friendships with their patients and describes physicians' opinions regarding the influence of such patient relationships on health outcomes. In 2011, survey responses were obtained from 1289 US physicians from various specialties. Physicians answered 8 items that assessed their opinions regarding their friendships, sense of meaningfulness, and experience in LTRs. The χ 2 test was used to examine bivariate associations between each demographic characteristic and physician responses to the importance of LTRs. The survey included 2 questions about the duration of physician practice and the number of patients seen in a typical week, 4 questions about perceived meaningfulness and friendship in the doctor-patient relationship, and 2 questions about the doctor-patient relationship setting. The adjusted survey response rate was 69% (1289/1863), 43% of physicians indicated that many or most of their patient relationships are LTRs, and 13.7% indicated they consider many or most of their patients to be friends. Just fewer than half of physicians (45.1%) perceive LTRs to have a great impact on clinical outcomes, 64.8% believe that LTRs contribute to patient trust, and 52.2% believe that LTRs are more likely to cause a patient to follow a physician's medical recommendations. This study presents a representative picture of US physicians' perceptions regarding relationships with patients. Physicians generally perceive LTRs to have a positive impact on patients' clinical outcomes, although the majority of physicians report they have few or no such relationships.

Social Determinants of Maternal Health in Afghanistan: A Review

PubMed Central

Najafizada, Said Ahmad Maisam; Bourgeault, Ivy Lynn; Labonté, Ronald

2017-01-01

Introduction: Afghanistan has a high maternal mortality rate of 400 per 100,000 live births. Although direct causes of maternal morbidity and mortality in Afghanistan include hemorrhage, obstructed labor, infection, high blood pressure, and unsafe abortion, the high burden of diseases responsible for maternal mortality arises in large part due to social determinants of health. The focus of this literature review is to examine the impact of various social determinants of health on maternal health in Afghanistan, filling an important gap in the existing literature. Methods: This narrative review was conducted using Arksey and O’Malley’s framework of (1) defining the question, (2) searching the literature, (3) assessing the studies, (4) synthesizing selected evidence in context, and (5) summarizing potential programmatic implication of the context. We searched Medline, CABI global health database, and Google Scholar for relevant publications. Results: A total of 38 articles/reports were included in this review. We found that social determinants such as maternal education, sociocultural practices, and social infrastructure have a significant impact on maternal health. Health care may be the immediate determinant, but it is influenced by other determinants that must be addressed in order to alleviate the burden on health care, as well as to achieve long-term reduction in maternal mortality. Conclusion: Because of the importance of social factors for maternal health outcomes, committed involvement of multiple government sectors (i.e. education, labor and social affairs, information and culture, transport and rural development among others, alongside health care) is the long-term solution to the maternal health problems in Afghanistan. National and international organizations’ long-term commitment to social investment such as education, local economy, cultural change, and social infrastructure is recommended for Afghanstan and globally. PMID:29138735

Development and Testing of a Simple Calibration Technique for Long-Term Hydrological Impact Assessment (L-THIA) Model

NASA Astrophysics Data System (ADS)

Muthukrishnan, S.; Harbor, J.

2001-12-01

Hydrological studies are significant part of every engineering, developmental project and geological studies done to assess and understand the interactions between the hydrology and the environment. Such studies are generally conducted before the beginning of the project as well as after the project is completed, such that a comprehensive analysis can be done on the impact of such projects on the local and regional hydrology of the area. A good understanding of the chain of relationships that form the hydro-eco-biological and environmental cycle can be of immense help in maintaining the natural balance as we work towards exploration and exploitation of the natural resources as well as urbanization of undeveloped land. Rainfall-Runoff modeling techniques have been of great use here for decades since they provide fast and efficient means of analyzing vast amount of data that is gathered. Though process based, detailed models are better than the simple models, the later ones are used more often due to their simplicity, ease of use, and easy availability of data needed to run them. The Curve Number (CN) method developed by the United States Department of Agriculture (USDA) is one of the most widely used hydrologic modeling tools in the US, and has earned worldwide acceptance as a practical method for evaluating the effects of land use changes on the hydrology of an area. The Long-Term Hydrological Impact Assessment (L-THIA) model is a basic, CN-based, user-oriented model that has gained popularity amongst watershed planners because of its reliance on readily available data, and because the model is easy to use (http://www.ecn.purdue.edu/runoff) and produces results geared to the general information needs of planners. The L-THIA model was initially developed to study the relative long-term hydrologic impacts of different land use (past/current/future) scenarios, and it has been successful in meeting this goal. However, one of the weaknesses of L-THIA, as well as other models that focus strictly on surface runoff, is that many users are interested in predictions of runoff that match observations of flow in streams and rivers. To make L-THIA more useful for the planners and engineers alike, a simple, long-term calibration method based on linear regression of L-THIA predicted and observed surface runoff has been developed and tested here. The results from Little Eagle Creek (LEC) in Indiana show that such calibrations are successful and valuable. This method can be used to calibrate other simple rainfall-runoff models too.

A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment

PubMed Central

2012-01-01

Background In childhood, attention deficit/hyperactivity disorder (ADHD) is characterized by age-inappropriate levels of inattentiveness/disorganization, hyperactivity/impulsiveness, or a combination thereof. Although the criteria for ADHD are well defined, the long-term consequences in adults and children need to be more comprehensively understood and quantified. We conducted a systematic review evaluating the long-term outcomes (defined as 2 years or more) of ADHD with the goal of identifying long-term outcomes and the impact that any treatment (pharmacological, non-pharmacological, or multimodal) has on ADHD long-term outcomes. Methods Studies were identified using predefined search criteria and 12 databases. Studies included were peer-reviewed, primary studies of ADHD long-term outcomes published between January 1980 to December 2010. Inclusion was agreed on by two independent researchers on review of abstracts or full text. Published statistical comparison of outcome results were summarized as poorer than, similar to, or improved versus comparators, and quantified as percentage comparisons of these categories. Results Outcomes from 351 studies were grouped into 9 major categories: academic, antisocial behavior, driving, non-medicinal drug use/addictive behavior, obesity, occupation, services use, self-esteem, and social function outcomes. The following broad trends emerged: (1) without treatment, people with ADHD had poorer long-term outcomes in all categories compared with people without ADHD, and (2) treatment for ADHD improved long-term outcomes compared with untreated ADHD, although not usually to normal levels. Only English-language papers were searched and databases may have omitted relevant studies. Conclusions This systematic review provides a synthesis of studies of ADHD long-term outcomes. Current treatments may reduce the negative impact that untreated ADHD has on life functioning, but does not usually 'normalize' the recipients. PMID:22947230

DNA from lake sediments reveals long-term ecosystem changes after a biological invasion.

PubMed

Ficetola, Gentile Francesco; Poulenard, Jérôme; Sabatier, Pierre; Messager, Erwan; Gielly, Ludovic; Leloup, Anouk; Etienne, David; Bakke, Jostein; Malet, Emmanuel; Fanget, Bernard; Støren, Eivind; Reyss, Jean-Louis; Taberlet, Pierre; Arnaud, Fabien

2018-05-01

What are the long-term consequences of invasive species? After invasion, how long do ecosystems require to reach a new equilibrium? Answering these questions requires long-term, high-resolution data that are vanishingly rare. We combined the analysis of environmental DNA extracted from a lake sediment core, coprophilous fungi, and sedimentological analyses to reconstruct 600 years of ecosystem dynamics on a sub-Antarctic island and to identify the impact of invasive rabbits. Plant communities remained stable from AD 1400 until the 1940s, when the DNA of invasive rabbits was detected in sediments. Rabbit detection corresponded to abrupt changes of plant communities, with a continuous decline of a dominant plant species. Furthermore, erosion rate abruptly increased with rabbit abundance. Rabbit impacts were very fast and were stronger than the effects of climate change during the 20th century. Lake sediments can allow an integrated temporal analysis of ecosystems, revealing the impact of invasive species over time and improving our understanding of underlying mechanisms.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

PubMed

Olsen, Nina Rydland; Bradley, Peter; Espehaug, Birgitte; Nortvedt, Monica Wammen; Lygren, Hildegunn; Frisk, Bente; Bjordal, Jan Magnus

2015-01-01

Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students. We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations. In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p < 0.001) and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2), p = 0.002), but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1), p = 0.574). Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only. A multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs' abilities to apply EBP knowledge and skills when supervising students.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study

PubMed Central

Olsen, Nina Rydland; Bradley, Peter; Espehaug, Birgitte; Nortvedt, Monica Wammen; Lygren, Hildegunn; Frisk, Bente; Bjordal, Jan Magnus

2015-01-01

Background and Purpose Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students. Methods We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations. Results In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p<0.001) and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2), p = 0.002), but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1), p = 0.574). Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only. Conclusions A multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs’ abilities to apply EBP knowledge and skills when supervising students. PMID:25894559

Partnered Research Experiences for Junior Faculty at Minority-Serving Institutions Enhance Professional Success

PubMed Central

Campbell, Andrew G.; Leibowitz, Michael J.; Murray, Sandra A.; Burgess, David; Denetclaw, Wilfred F.; Carrero-Martinez, Franklin A.; Asai, David J.

2013-01-01

Scientific workforce diversity is critical to ensuring the realization of our national research goals and minority-serving institutions play a vital role in preparing undergraduate students for science careers. This paper summarizes the outcomes of supporting career training and research practices by faculty from teaching-intensive, minority-serving institutions. Support of these faculty members is predicted to lead to: 1) increases in the numbers of refereed publications, 2) increases in federal grant funding, and 3) a positive impact on professional activities and curricular practices at their home institutions that support student training. The results presented show increased productivity is evident as early as 1 yr following completion of the program, with participants being more independently productive than their matched peers in key areas that serve as measures of academic success. These outcomes are consistent with the goals of the Visiting Professorship Program to enhance scientific practices impacting undergraduate student training. Furthermore, the outcomes demonstrate the benefits of training support for research activities at minority-serving institutions that can lead to increased engagement of students from diverse backgrounds. The practices and results presented demonstrate a successful generalizable approach for stimulating junior faculty development and can serve as a basis for long-term faculty career development strategies that support scientific workforce diversity. PMID:24006388

Partnered research experiences for junior faculty at minority-serving institutions enhance professional success.

PubMed

Campbell, Andrew G; Leibowitz, Michael J; Murray, Sandra A; Burgess, David; Denetclaw, Wilfred F; Carrero-Martinez, Franklin A; Asai, David J

2013-01-01

Scientific workforce diversity is critical to ensuring the realization of our national research goals and minority-serving institutions play a vital role in preparing undergraduate students for science careers. This paper summarizes the outcomes of supporting career training and research practices by faculty from teaching-intensive, minority-serving institutions. Support of these faculty members is predicted to lead to: 1) increases in the numbers of refereed publications, 2) increases in federal grant funding, and 3) a positive impact on professional activities and curricular practices at their home institutions that support student training. The results presented show increased productivity is evident as early as 1 yr following completion of the program, with participants being more independently productive than their matched peers in key areas that serve as measures of academic success. These outcomes are consistent with the goals of the Visiting Professorship Program to enhance scientific practices impacting undergraduate student training. Furthermore, the outcomes demonstrate the benefits of training support for research activities at minority-serving institutions that can lead to increased engagement of students from diverse backgrounds. The practices and results presented demonstrate a successful generalizable approach for stimulating junior faculty development and can serve as a basis for long-term faculty career development strategies that support scientific workforce diversity.

Impact of organisational characteristics on turnover intention among care workers in nursing homes in Korea: a structural equation model.

PubMed

Ha, Jong Goon; Man Kim, Ji; Hwang, Won Ju; Lee, Sang Gyu

2014-09-01

The aim of the present study was to analyse the impact of organisational characteristics on the turnover intention of care workers working at nursing homes in Korea. Study participants included 504 care workers working at 14 nursing homes in Korea. The variables measured were: high-performance work practices, consisting of five subfactors (official training, employment stability, autonomy, employee participation and group-based payment); organisational commitment, consisting of three subfactors (affective, normative and continuance commitment); organisational support; and turnover intention. The inter-relationship between high-performance work practices, organisational support, organisational commitment and turnover intention and the fit of the hypothetical model were analysed using structural equation modelling. According to our analysis, high-performance work practices not only had a direct effect on turnover intention, but also an indirect effect by mediating organisational support and commitment. The factor having the largest direct influence on turnover intention was organisational commitment. The results of the present study suggest that to improve health conditions for frail elderly patients at nursing homes, as well as the efficiency of nursing homes through the continuance of nursing service and enhancement of quality of service, long-term care facilities should reduce the turnover intention of care workers by increasing their organisational commitment by actively implementing high-performance work practices.

The Relationship between Staff Religiosity and Attitudes toward Elderly Sexuality.

ERIC Educational Resources Information Center

Walker, Bonnie L.

The relationship between religiosity and the knowledge, attitudes, and practices of long-term care staff related to elderly sexuality was investigated. Participants were 127 long-term care staff recruited at 8 sites in Oklahoma, Michigan, Virginia, California, and Maryland. Participants' positions included nurses, housekeepers, administrators, and…

The long-term problems of contaminated land: Sources, impacts and countermeasures

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

Baes, C.F. III

1986-11-01

This report examines the various sources of radiological land contamination; its extent; its impacts on man, agriculture, and the environment; countermeasures for mitigating exposures; radiological standards; alternatives for achieving land decontamination and cleanup; and possible alternatives for utilizing the land. The major potential sources of extensive long-term land contamination with radionuclides, in order of decreasing extent, are nuclear war, detonation of a single nuclear weapon (e.g., a terrorist act), serious reactor accidents, and nonfission nuclear weapons accidents that disperse the nuclear fuels (termed ''broken arrows'').

Uterine artery embolization for treatment of leiomyomata: long-term outcomes from the FIBROID Registry.

PubMed

Goodwin, Scott C; Spies, James B; Worthington-Kirsch, Robert; Peterson, Eric; Pron, Gaylene; Li, Shuang; Myers, Evan R

2008-01-01

To assess long-term clinical outcomes of uterine artery embolization across a wide variety of practice settings in a large patient cohort. The Fibroid Registry for Outcomes Data (FIBROID) for Uterine Embolization was a 3-year, single-arm, prospective, multi-center longitudinal study of the short- and long-term outcomes of uterine artery embolization for leiomyomata. Two thousand one hundred twelve patients with symptomatic leiomyomata were eligible for long-term follow-up at 27 sites representing a geographically diverse set of practices, including academic centers, community hospitals, and closed-panel health maintenance organizations. At 36 months after treatment, 1,916 patients remained in the study, and of these, 1,278 patients completed the survey. The primary measures of outcome were the symptom and health-related quality-of-life scores from the Uterine Fibroid Symptom and Quality of Life questionnaire. Mean symptom scores improved 41.41 points (P<.001), and the quality of life scores improved 41.47 points (P<.001), both moving into the normal range for this questionnaire. The improvements were independent of practice setting. During the 3 years of the study, Kaplan-Meier estimates of hysterectomy, myomectomy, or repeat uterine artery embolization were 9.79%, 2.82%, and 1.83% of the patients, respectively. Uterine artery embolization results in a durable improvement in quality of life. These results are achievable when the procedure is performed in any experienced community or academic interventional radiology practice. III.

Prevention of venous thromboembolism: practice patterns in 17 geographically diverse long term care facilities in the United States: part 1 of 2 (an AMDA Foundation project).

PubMed

Dharmarajan, T S; Nanda, Aman; Agarwal, Bikash; Agnihotri, Parag; Doxsie, G L; Gokula, Murthy; Javaheri, Ashkan; Kanagala, M; Lebelt, Anna S; Madireddy, Prasuna; Mahapatra, Sourya; Murakonda, P; Muthavarapu, S Ram Rao; Patel, Mennakshi; Patterson, Christopher; Soch, Kathleen; Troncales, Anna; Yaokim, Kamal; Kroft, Robin; Norkus, Edward P

2012-03-01

Current guidelines recommend antithrombotic prophylaxis for venous thromboembolism (VTE) using risk assessment, factoring contraindications. This report represents a summary of current practice patterns to prevent VTE in long term care as Phase 1 of a 3-phase educational intervention study. PHASE 1 Participants were 376 new admissions/readmissions (77 ± 12 [SD] years; 67% female) from 17 geographically diverse long term care facilities (3260 total beds). The process describes current VTE prophylaxis (VTE-P) practices; a companion article describes the educational intervention (Phase 2) and outcome (Phase 3). Phase 1 data were collected on use of nonpharmacological measures and antithrombotic drugs for VTE-P between July and September 2009. Indications for VTE-P were evident in 85% of new admissions, of which two-thirds received VTE-P. Contraindications for anticoagulation were observed in 54.8% of admissions, including quality of life or patient/caregiver wishes. Logistic regression analysis predicted no relationship between any indication for or any contraindication to VTE-P and use of VTE-P, suggesting an inadequate understanding of current clinical practice guidelines. Residents of long term care have significant comorbidity that poses risk for VTE; although many received VTE-P, contraindications were common, warranting individualized considerations. The likelihood of VTE-P was greatest following orthopedic surgery, severe trauma, and medical illness. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Integrated modeling of long-term vegetation and hydrologic dynamics in Rocky Mountain watersheds

Treesearch

Robert Steven Ahl

2007-01-01

Changes in forest structure resulting from natural disturbances, or managed treatments, can have negative and long lasting impacts on water resources. To facilitate integrated management of forest and water resources, a System for Long-Term Integrated Management Modeling (SLIMM) was developed. By combining two spatially explicit, continuous time models, vegetation...

Long-Term Administration of Conjugated Estrogen and Bazedoxifene Decreased Murine Fecal β-Glucuronidase Activity Without Impacting Overall Microbiome Community.

PubMed

Chen, Karen Lee Ann; Liu, Xiaoji; Zhao, Yiru Chen; Hieronymi, Kadriye; Rossi, Gianluigi; Auvil, Loretta Sue; Welge, Michael; Bushell, Colleen; Smith, Rebecca Lee; Carlson, Kathryn E; Kim, Sung Hoon; Katzenellenbogen, John A; Miller, Michael Joseph; Madak-Erdogan, Zeynep

2018-05-25

Conjugated estrogens (CE) and Bazedoxifene (BZA) combination is used to alleviate menopause-associated symptoms in women. CE+BZA undergo first-pass-metabolism in the liver and deconjugation by gut microbiome via β-glucuronidase (GUS) enzyme inside the distal gut. To date, the impact of long-term exposure to CE+BZA on the gut microbiome or GUS activity has not been examined. Our study using an ovariectomized mouse model showed that CE+BZA administration did not affect the overall cecal or fecal microbiome community except that it decreased the abundance of Akkermansia, which was identified as a fecal biomarker correlated with weight gain. The fecal GUS activity was reduced significantly and was positively correlated with the abundance of Lactobacillaceae in the fecal microbiome. We further confirmed in Escherichia coli K12 and Lactobacillus gasseri ADH that Tamoxifen-, 4-hydroxy-Tamoxifen- and Estradiol-Glucuronides competed for GUS activity. Our study for the first time demonstrated that long-term estrogen supplementation directly modulated gut microbial GUS activity. Our findings implicate that long-term estrogen supplementation impacts composition of gut microbiota and microbial activity, which affects estrogen metabolism in the gut. Thus, it is possible to manipulate such activity to improve the efficacy and safety of long-term administered estrogens for postmenopausal women or breast cancer patients.

User-fee-removal improves equity of children's health care utilization and reduces families' financial burden: evidence from Jamaica.

PubMed

Li, Zhihui; Li, Mingqiang; Fink, Günther; Bourne, Paul; Bärnighausen, Till; Atun, Rifat

2017-06-01

The impact of user-fee policies on the equity of health care utilization and households' financial burdens has remained largely unexplored in Latin American and the Caribbean, as well as in upper-middle-income countries. This paper assesses the short- and long-term impacts of Jamaica's user-fee-removal for children in 2007. This study utilizes 14 rounds of data from the Jamaica Survey of Living Conditions (JSLC) for the periods 1996 to 2012. JSLC is a national household survey, which collects data on health care utilization and among other purposes for planning. Interrupted time series (ITS) analysis was used to examine the immediate impact of the user-fee-removal policy on children's health care utilization and households' financial burdens, as well as the impact in the medium- to long-term. Immediately following the implementation of user-fee-removal, the odds of seeking for health care if the children fell ill in the past 4 weeks increased by 97% (odds ratio 2.0, 95% confidence interval (CI) 1.1 to 3.5, P  = 0.018). In the short-term (2007-2008), health care utilization increased at a faster rate among children not in poverty than children in poverty; while this gap narrowed after 2008. There was minimal difference in health care utilization across wealth groups in the medium- to long-term. The household's financial burden (health expenditure as a share of household's non-food expenditures) reduced by 6 percentage points (95% CI: -11 to -1, P  = 0.020) right after the policy was implemented and kept at a low level. The difference in financial burden between children in poverty and children not in poverty shrunk rapidly after 2007 and remained small in subsequent years. User-fee-removal had a positive impact on promoting health care utilization among children and reducing their household health expenditures in Jamaica. The short-term and the medium- to long-term results have different indications: In the short-term, the policy deteriorated the equity of access to health care for children, while the equity status improved fast in the medium- to long-term.

Evaluating health care interventions in the European Union.

PubMed

McDaid, David; Cookson, Richard

2003-02-01

This paper examines the current state of evaluations of health care interventions in the European Union, from the identification and commissioning of research through to its impact on policy and practice. Material is drawn from a survey conducted for the ASTEC project as well as a review of literature. Although the use of evaluative research has increased substantially in the last decade, both the pace of change and preferred research methodologies employed differ markedly. Much research still concentrates on issues of safety, efficacy and effectiveness, although there is evidence of an increasing emphasis on cost-effectiveness. Many countries are beginning to introduce systems linking economic evaluation to the decision-making process, while networks for the exchange of information continue to evolve. Research capacity in the public sector, although improving, is uneven, in part due to the uncertainty over long term career prospects and competition from industry. Capacity building measures should in particular ensure that dissemination expertise is strengthened, and that more emphasis is placed on developing receptor capacity within different stakeholder groups. Linking knowledge production to changes in practice remains a key challenge. Further research on implementation and impact assessment is required, to help demonstrate the value of evaluations on both policy and practice.

[Guidelines for complementary feeding in healthy infants].

PubMed

Romero-Velarde, Enrique; Villalpando-Carrión, Salvador; Pérez-Lizaur, Ana Berta; Iracheta-Gerez, Ma de la Luz; Alonso-Rivera, Carlos Gilberto; López-Navarrete, Gloria Elena; García-Contreras, Andrea; Ochoa-Ortiz, Erika; Zarate-Mondragón, Flora; López-Pérez, Gerardo Tiburcio; Chávez-Palencia, Clío; Guajardo-Jáquez, Manuel; Vázquez-Ortiz, Salvador; Pinzón-Navarro, Beatriz Adriana; Torres-Duarte, Karely Noemy; Vidal-Guzmán, José Domingo; Michel-Gómez, Pedro Luis; López-Contreras, Iris Nallely; Arroyo-Cruz, Liliana Verenice; Almada-Velasco, Pamela; Saltigeral-Simental, Patricia; Ríos-Aguirre, Alejandro; Domínguez-Pineda, Lorena; Rodríguez-González, Perla; Crabtree-Ramírez, Úrsula; Hernández-Rosiles, Vanessa; Pinacho-Velázquez, José Luis

A proper nutrition during the first two years of life is critical to reach the full potential of every human being; now, this period is recognized as a critical window for promoting optimal growth, development, and good health. Therefore, adequate feeding at this stage of life has an impact on health, nutritional status, growth and development of children; not only in the short term, but in the medium and long term. This paper provides recommendations on complementary feeding (CF) presented as questions or statements that are important for those who take care for children during this stage of life. For example: When to start complementary feedings: 4 or 6 months of age?; Exposure to potentially allergenic foods; Introduction of sweetened beverages; Use of artificial sweeteners and light products; Food introduction sequence; Food consistency changes according to neurological maturation; Number of days to test acceptance and tolerance to new foods; Amounts for each meal; Inadequate complementary feeding practices; Myths and realities of complementary feeding; Developmental milestones; Practice of "Baby Led Weaning" and practice of vegetarianism. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

The application of simple metrics in the assessment of glycaemic variability.

PubMed

Monnier, L; Colette, C; Owens, D R

2018-03-06

The assessment of glycaemic variability (GV) remains a subject of debate with many indices proposed to represent either short- (acute glucose fluctuations) or long-term GV (variations of HbA 1c ). For the assessment of short-term within-day GV, the coefficient of variation for glucose (%CV) defined as the standard deviation adjusted on the 24-h mean glucose concentration is easy to perform and with a threshold of 36%, recently adopted by the international consensus on use of continuous glucose monitoring, separating stable from labile glycaemic states. More complex metrics such as the Low Blood Glucose Index (LBGI) or High Blood Glucose Index (HBGI) allow the risk of hypo or hyperglycaemic episodes, respectively to be assessed although in clinical practice its application is limited due to the need for more complex computation. This also applies to other indices of short-term intraday GV including the mean amplitude of glycemic excursions (MAGE), Shlichtkrull's M-value and CONGA. GV is important clinically as exaggerated glucose fluctuations are associated with an enhanced risk of adverse cardiovascular outcomes due primarily to hypoglycaemia. In contrast, there is at present no compelling evidence that elevated short-term GV is an independent risk factor of microvascular complications of diabetes. Concerning long-term GV there are numerous studies supporting its association with an enhanced risk of cardiovascular events. However, this association raises the question as to whether the impact of long-term variability is not simply the consequence of repeated exposure to short-term GV or ambient chronic hyperglycaemia. The renewed emphasis on glucose monitoring with the introduction of continuous glucose monitoring technologies can benefit from the introduction and application of simple metrics for describing GV along with supporting recommendations. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Effects of Transport at Weaning on the Behavior, Physiology and Performance of Pigs

PubMed Central

Sutherland, Mhairi A.; Backus, Brittany L.; McGlone, John J.

2014-01-01

Simple Summary Pigs are commonly transported to separate production facilities at weaning to reduce disease transfer, enhance productivity and to improve overall operational efficiency. A review of the scientific literature suggests that these animals experience stress due to concurrent weaning and transport; however, gaps in the knowledge include the short and long term health and welfare implications of transporting pigs at weaning. Pig welfare and the efficiency of the swine industry may improve if science-based recommendations were in place. Abstract Transport of pigs to separate production facilities at the time of weaning is a common practice, primarily performed to reduce vertical transfer of disease and enhance production and overall farm efficiency. During transport, pigs are exposed to numerous stressors in conjunction with the stress experienced as a result of weaning. In this review, the behavioral and physiological response of pigs experiencing weaning and transport simultaneously will be described, including the effects of space allowance, season and transport duration. Based on the scientific literature, the gaps in the knowledge regarding potential welfare issues are discussed. Changes in behavior and physiology suggest that weaned pigs may experience stress due to transport. Space allowance, season and duration are aspects of transport that can have a marked impact on these responses. To date, the literature regarding the effects of transport on weaned pigs has primarily focused on the short term stress response and little is known about the effects of concurrent weaning and transport on other aspects of pig welfare including morbidity and mortality rates. Greater understanding of the short and long term consequences of transport on weaned pig welfare particularly in relation to factors such as trip duration, provision of feed and water, and best handling practices would benefit the swine industry. Furthermore, the development of guidelines and recommendations to enhance the short and long term welfare of weaned pigs in relation to transport are needed. PMID:26479005

Theory and Practice in Determining the Long-Term Spatial Productivity of Drylands: A California Blue Oak Case Study

NASA Astrophysics Data System (ADS)

Washington-Allen, R. A.; Therrell, M. D.; Emanuel, R. E.

2007-12-01

Herbivory, fire, and climatic events such as El Niño-Southern Oscillation (ENSO) and La Niña have been shown to have proximal and evolutionary effects on the dynamics of Dryland fauna, flora, and soils. However, spatially-explicit historical impacts of these climatic events on Dryland ecosystems is not known. Consequently, this paper has the purpose of presenting the theory and practical application for estimating the historical spatial impacts of these climatic events. We hypothesize that if remotely-sensed vegetation indices (VI) are correlated to historical tree ring data and also to functional ecosystem processes, specifically gross primary productivity (GPP) and net ecosystem production (NEP) as measured by eddy covariance flux towers, then VIs can be used to spatially and temporally distribute GPP and NEP within the species- or community-specific land cover extent over the length of the tree ring record of selected Dryland ecosystems. Secondly, the Shuttle Radar Topography Mission (SRTM) digital terrain model (DTM) data has been used to estimate tree height and in conjuction with plant allometric equations: biomass and standing carbon in various forest ecosystems. Tree height data in relation to tree ring age data and fire history can be used to reconstruct the spatial distribution of savanna demographic age structure, predict standing carbon and thus provide a complementary and independent dataset for comparison to DTMs from Multiangle Imaging Spectroradiometer (MISR), Interferometric Synthetic Aperture Radar (IFSAR), and Moderate Resolution Imaging Spectroradiometer (MODIS) derived GPP spatial maps. We developed a database consisting of a dendrochronology record, SRTM data, globa fre history data, Long term Data Record Advanced Very High Resolution Radiometer Normalized Difference Vegetation Index (LTDR AVHRR NDVI, 1981 - 2003), contemporary gridded climate data, National Land Cover Data (NLCD), and short term eddy covariance flux tower data for the California Blue Oak woodland ecosystem to estimate both regional aboveground productivity and past disturbance history relative climate, particularly droughts, for the last 500 years.

Modeling Impacts of Alternative Practices on Net Global Warming Potential and Greenhouse Gas Intensity from Rice–Wheat Annual Rotation in China

PubMed Central

Wang, Jinyang; Zhang, Xiaolin; Liu, Yinglie; Pan, Xiaojian; Liu, Pingli; Chen, Zhaozhi; Huang, Taiqing; Xiong, Zhengqin

2012-01-01

Background Evaluating the net exchange of greenhouse gas (GHG) emissions in conjunction with soil carbon sequestration may give a comprehensive insight on the role of agricultural production in global warming. Materials and Methods Measured data of methane (CH4) and nitrous oxide (N2O) were utilized to test the applicability of the Denitrification and Decomposition (DNDC) model to a winter wheat – single rice rotation system in southern China. Six alternative scenarios were simulated against the baseline scenario to evaluate their long-term (45-year) impacts on net global warming potential (GWP) and greenhouse gas intensity (GHGI). Principal Results The simulated cumulative CH4 emissions fell within the statistical deviation ranges of the field data, with the exception of N2O emissions during rice-growing season and both gases from the control treatment. Sensitivity tests showed that both CH4 and N2O emissions were significantly affected by changes in both environmental factors and management practices. Compared with the baseline scenario, the long-term simulation had the following results: (1) high straw return and manure amendment scenarios greatly increased CH4 emissions, while other scenarios had similar CH4 emissions, (2) high inorganic N fertilizer increased N2O emissions while manure amendment and reduced inorganic N fertilizer scenarios decreased N2O emissions, (3) the mean annual soil organic carbon sequestration rates (SOCSR) under manure amendment, high straw return, and no-tillage scenarios averaged 0.20 t C ha−1 yr−1, being greater than other scenarios, and (4) the reduced inorganic N fertilizer scenario produced the least N loss from the system, while all the scenarios produced comparable grain yields. Conclusions In terms of net GWP and GHGI for the comprehensive assessment of climate change and crop production, reduced inorganic N fertilizer scenario followed by no-tillage scenario would be advocated for this specified cropping system. PMID:23029173

Long-Term Recovery of Life in the Chicxulub Crater

NASA Astrophysics Data System (ADS)

Lowery, C.; Jones, H.; Bralower, T. J.; Smit, J.; Rodriguez-Tovar, F. J.; Whalen, M. T.; Owens, J. D.; Expedition 364 Science Party, I. I.

2017-12-01

The Chicxulub Crater on the Yucatán Peninsula of Mexico was formed by the impact of an asteroid 66 Ma that caused the extinction of 75% of genera on Earth. Immediately following the impact, the decimated ecosystem began the long process of recovery, both in terms of primary productivity and species diversity. This well-documented process was heterogeneous across the world ocean, but until the present time it has been inaccessible at ground zero of the impact. IODP/ICDP Exp. 364 recovered 9.5 m of pelagic limestone spanning the entire Paleocene, including a continuous section spanning the first 5 myr following the impact. The Chicxulub Crater is the largest known marine impact crater on Earth, and the recovery of the ecosystem presented here is the first such record of long-term primary succession in the sterile zone of a large impact crater. Planktic and benthic foraminifera, calcareous nannoplankton, calcispheres, bioturbation, and geochemical proxies all indicate that export productivity in the Chicxulub Crater recovered rapidly (within 30 kyr) following the impact. Recovery in terms of diversity and species abundance took much longer, and varied between groups. Planktic foraminifera quickly diversified, with all common Paleocene tropical/subtropical species appearing roughly when expected. Trace fossils appear rapidly after the event, with a progressive recovery through the lowermost Paleocene. Calcareous nannoplankton took much longer to recover, and disaster taxa like Braarudosphaera dominated the assemblage well into the late Paleocene. Paleoecology and geochemistry relate these trends to oceanographic conditions within the Chicxulub Crater. Planktic foraminifera from known depth habitats, including Morozovellids, Acarininids, Chiloguembelinids, and Subbotinids, track changes in the water column structure and paleoredox conditions within the crater. Diverse and abundant macro- and microbenthic organisms indicate food availability and good oxygen conditions on the seafloor. The latest Paleocene, just prior to the onset of the PETM, is characterized by a typical and diverse assemblage of foraminifera and calcareous nannoplankton; a normal open-marine assemblage with no trace of long-term negative effects from the impact.

Using Simulation to Compare 4 Categories of Intervention for Reducing Cardiovascular Disease Risks

PubMed Central

Homer, Jack; Trogdon, Justin; Wile, Kristina; Orenstein, Diane

2014-01-01

The Prevention Impacts Simulation Model (PRISM) projects the multiyear impacts of 22 different interventions aimed at reducing risk of cardiovascular disease. We grouped these into 4 categories: clinical, behavioral support, health promotion and access, and taxes and regulation. We simulated impacts for the United States overall and also for a less-advantaged county with a higher death rate. Of the 4 categories of intervention, taxes and regulation reduce costs the most in the short term (through 2020) and long term (through 2040) and reduce deaths the most in the long term; they are second to clinical interventions in reducing deaths in the short term. All 4 categories combined were required to bring costs and deaths in the less-advantaged county down to the national level. PMID:24832142

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

PubMed

Wang, Chia-Hui; Kuo, Nai-Wen

2006-06-01

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

Trade-offs and spatial dependency of rice production and environmental consequences at community level in Southeastern China

NASA Astrophysics Data System (ADS)

Xu, Hui; Liu, Zhong; Wang, Lihua; Wan, Haibo; Jing, Changwei; Jiang, Jingang; Wu, Jiaping; Qi, Jiaguo

2018-02-01

Over the past three decades, farmers in China have increasingly used fertilizers to increase paddy rice production. While this approach has eased the rising demand for food, it is unclear whether it pays off in the long-run when costs associated with environmental consequences are considered. Using two case studies in Zhejiang Province, China, this paper analyzed field-based rice yields, fertilizer inputs, nitrogen leaching and greenhouse emissions and their socioeconomic values of different farm practices. The objective was to assess the trade-offs among economic gains from increased yield and environmental consequences of different paddy rice management practices. The results indicated short-term economic gains to farmers outweigh the environmental cost concerns. However, considering the lasting environmental effects, there is a significant imbalance toward a conservative farming practice. The results further indicated that synergies can be achieved if precision management practices are adopted. It was also indicated that a large spatial variation exists in yields and environmental impacts, suggesting ‘one-size fits all’ policies will likely be ineffective in reducing environmental impacts. Although only two case studies were demonstrated in this study, the approach may be generalized to other geographic regions to help guide paddy farmers in similar climatic and land use environments such as those in the subtropical regions of Southeast Asia, to achieve synergic environment practices.

A Systematic Review of Mindfulness Intervention for Individuals with Developmental Disabilities: Long-Term Practice and Long Lasting Effects

ERIC Educational Resources Information Center

Hwang, Yoon-Suk; Kearney, Patrick

2013-01-01

Can individuals with developmental disabilities learn mindfulness? If so, with what result? A systematic literature review identified 12 studies that taught mindfulness practice to individuals with mild to severe developmental disabilities, demonstrating that mindfulness intervention could significantly reduce the behavioural and/or psychological…

Monitoring regional groundwater extraction: the problem.

PubMed

Bredehoeft, J D

2011-01-01

As hydraulic disturbances (signals) are propagated through a groundwater system two things happen: (1) the higher frequencies in the disturbance are filtered out by the physics of the system and (2) the disturbance takes time to propagate through the system. The filtering and time delays depend on the aquifer diffusivity. This means, for example, if one is observing a water table aquifer at some distance from where annual recharge is occurring, only the long-term average effect of the recharge will be transmitted to the observation point--the system filters out annual variations. These facts have profound impacts on what is feasible to monitor. For example, if one is concerned about the impact of pumping on a spring in a water table aquifer, where the pumping is more than 20 miles or so from the spring, there will be a long delay before the pumping impacts the spring and there will be an equally long delay before a long-term reduction in the pumping regime will restore the spring. The filtering by lower diffusivity groundwater systems makes it impossible to discriminate between the impacts of several major pumpers in the system and/or long-term climate changes. © 2011, The Author(s). Ground Water © 2011, National Ground Water Association.

Integrated Assessment of Prevention and Restoration Actions to Combat Desertification

NASA Astrophysics Data System (ADS)

Bautista, S.; Orr, B. J.; Vallejo, R.

2009-12-01

Recent advances in desertification and land degradation research have provided valuable conceptual and analytical frameworks, degradation indicators, assessment tools and surveillance systems with respect to desertification drivers, processes, and impacts. These findings, together with stakeholders’ perceptions and local/regional knowledge, have helped to define and propose measures and strategies to combat land degradation. However, integrated and comprehensive assessment and evaluation of prevention and restoration strategies and techniques to combat desertification is still lacking, and knowledge on the feasibility and cost-effectiveness of the proposed strategies over a wide range of environmental and socio-economic conditions is very scarce. To address this challenge, we have launched a multinational project (PRACTICE - Prevention and Restoration Actions to Combat Desertification. An Integrated Assessment), funded by the European Commission, in order to link S & T advances and traditional knowledge on prevention and restoration practices to combat desertification with sound implementation, learning and adaptive management, knowledge sharing, and dissemination of best practices. The key activities for pursuing this goal are (1) to establish a platform and information system of long-term monitoring sites for assessing sustainable management and actions to combat desertification, (2) to define an integrated protocol for the assessment of these actions, and (3) to link project assessment and evaluation with training and education, adaptive management, and knowledge sharing and dissemination through a participatory approach involving scientists, managers, technicians, financial officers, and members of the public who are/were impacted by the desertification control projects. Monitoring sites are distributed in the Mediterranean Europe (Greece, Italy, Spain, and Portugal), Africa (Morocco, Namibia, South Africa), Middle East (Israel), China, and South and North America (Chile, Mexico, and USA). PRACTICE integrated assessment protocol (IAPro) assumes the mutual human-environment interactions in land-use/cover change at multiple scales, and therefore adopts an integrated approach, which simultaneously considers both biophysical and socio-economic attributes, for assessing actions to combat desertification. IAPro mostly relies on critical slow variables and particularly exploits long-term monitoring data. Integration of biophysical and socio-economic assessment indicators and stakeholder preferences is based on a participatory multi-criteria decision making process. The process is iterative and provides a framework for knowledge exchange and a path to consensus building.

The Resilience of Groundwater Remediation System in Response to Changing Conditions

NASA Astrophysics Data System (ADS)

Hou, D.

2016-12-01

Anthropogenic activities have caused the contamination of groundwater resources at many locations. In an effort to protect human health and prevent further spreading of groundwater contamination, remediation systems have been or will be built at hundreds of thousands of sites. While the short term effectiveness has been the focus of past research and practice, the long-term effectiveness is increasingly scrutinized. When assessing the long-term effectiveness of groundwater remediation systems, it is important to examine how existing remediation systems respond to changing geophysical (e.g. climate change) and social (e.g. improved living standard and changing development needs) conditions. The resilience of remediation strategies, or their potential to adapt to future changes, is a critical sustainability consideration. We intend to examine the resilience of groundwater remediation systems in response to changing conditions. Among others, we explore the effects of sea level rise and changing hydroclimatic conditions on the life cycle impact of phytoremediation and bioremediation systems. The study was conducted in the San Francisco Bay area, where thousands of contaminated sites are located in an area that may be affected by sea level rise and changing hydroclimatic conditions.

Nurses' Knowledge, Perception, and Self-Confidence Regarding Evidence-Based Antibiotic Use in the Long-Term Care Setting.

PubMed

Hale, LaDonna S; Votaw, Lindsey L; Mayer, Janell E; Sobota, Kristen F

2017-11-01

Describe knowledge, perceptions, and self-confidence of nurses in the long-term care setting before and after online antibiotic stewardship education, and assess effectiveness and satisfaction with the education. Pre-/postsurvey. Three long-term care facilities, Topeka, Kansas. Convenience sample of 140 licensed practical and registered nurses. Nurses viewed a 12-minute online module developed by long-term care consultant pharmacists. The module discussed risks of antibiotic use and the Loeb minimum criteria for initiation of antibiotics in long-term care residents for urinary and respiratory tract infections and explored other conditions contributing to suspicion of these infections. Knowledge, perceptions, and self-confidence were measured using a 5-point Likert-scale survey modified from the Minnesota Department of Health taken before and after the module. Response rate was 45% (63/140) pre-education and 41% (57/140) post-education. Nurses had high baseline self-confidence (mean 4.2 to 4.5/5.0) and pre/post scores did not change significantly. Statistically significant improvements in knowledge and perceptions were seen in 15 of the 33 indices related to assumptions regarding antibiotic use, risks, and indicators of urinary and respiratory bacterial infections. Nurses rated the education as high quality (95%), applicable to practice (95%), and felt very likely to change practice (91%). Although baseline self-confidence was high, key misperceptions were identified, indicating that nurses may not be aware of their knowledge deficits or misperceptions. This low-cost, 12-minute, online education was highly valued and effectively improved nurses' knowledge and perceptions.

Effects of poverty on academic failure and delinquency in boys: a change and process model approach.

PubMed

Pagani, L; Boulerice, B; Vitaro, F; Tremblay, R E

1999-11-01

Using data from the Montreal Longitudinal-Experimental Study, we examined the impact of poverty (and its correlate, family configuration status) on academic placement and self-reported delinquency in boys at age 16. We then investigated whether the relation between family economic hardship and antisocial behaviour is direct or indirect by considering the value of parenting practices and academic failure as process variables in the model. Data included official records, and parent, teacher, and self-reports. The temporal intensity of poverty was classified into five categories: never-poor; always-poor; poor-earlier; poor-later; and transitory-poverty. Family configuration status was classified by both temporal characteristics and number of marital transitions: intact-family; short-term-single; long-term-single; short-term-remarried; long-term-remarried; and multiple-marital-transitions. Results revealed that when maternal education and early childhood behaviour were controlled, poverty had an effect on both academic failure and extreme delinquency. This effect was independent of family configuration status. Although they both significantly predicted extreme delinquency on their own, academic failure and parental supervision did not mediate the relationship between poverty and delinquency. Divorce increased the risk of theft and fighting at age 16, regardless of financial hardship. Parental supervision only helped explain the effects of divorce on boys' fighting.

Evolution of double white dwarf binaries undergoing direct-impact accretion: Implications for gravitational wave astronomy

NASA Astrophysics Data System (ADS)

Kremer, Kyle; Breivik, Katelyn; Larson, Shane L.; Kalogera, Vassiliki

2017-01-01

For close double white dwarf binaries, the mass-transfer phenomenon known as direct-impact accretion (when the mass transfer stream impacts the accretor directly rather than forming a disc) may play a pivotal role in the long-term evolution of the systems. In this analysis, we explore the long-term evolution of white dwarf binaries accreting through direct-impact and explore implications of such systems to gravitational wave astronomy. We cover a broad range of parameter space which includes initial component masses and the strength of tidal coupling, and show that these systems, which lie firmly within the LISA frequency range, show strong negative chirps which can last as long as several million years. Detections of double white dwarf systems in the direct-impact phase by detectors such as LISA would provide astronomers with unique ways of probing the physics governing close compact object binaries.

The High-Skilled VET Practitioner: Interim Findings from the Evaluation of the Long-Term Impacts of the Framing the Future Projects in 1999-2000.

ERIC Educational Resources Information Center

Mitchell, John; Wood, Sarah; Young, Susan

Research was conducted in 2000-01 on the long-term impacts of the 200 projects funded by Australia's Framing the Future in 1999 and of the 250 conducted in 2000. Two main research methodologies (case study investigations and a survey) were used for the study. Case study investigations were conducted with the Deaf Education Network in Sydney; South…

The Long-term Impacts of Earthquakes on Economic Growth

NASA Astrophysics Data System (ADS)

Lackner, S.

2016-12-01

The social science literature has so far not reached a consensus on whether and how earthquakes actually impact economic growth in the long-run. Several hypotheses have been suggested and some even argue for a positive impact. A general weakness in the literature, however, is the predominant use of inadequate measures for the exogenous natural hazard of an earthquake. The most common problems are the lack of individual event size (e.g. earthquake dummy or number of events), the use of magnitude instead of a measure for surface shaking, and endogeneity issues when traditional qualitative intensity scales or actual impact data is used. Here we use peak ground acceleration (PGA) as the ground motion intensity measure and investigate the impacts of earthquake shaking on long-run economic growth. We construct a data set from USGS ShakeMaps that can be considered the universe of global relevant earthquake ground shaking from 1973 to 2014. This data set is then combined with World Bank GDP data to conduct a regression analysis. Furthermore, the impacts of PGA on different industries and other economic variables such as employment and education are also investigated. This will on one hand help to identify the mechanism of how earthquakes impact long-run growth and also show potential impacts on other welfare indicators that are not captured by GDP. This is the first application of global earthquake shaking data to investigate long-term earthquake impacts.

Great Apes and Biodiversity Offset Projects in Africa: The Case for National Offset Strategies

PubMed Central

Kormos, Rebecca; Kormos, Cyril F.; Humle, Tatyana; Lanjouw, Annette; Rainer, Helga; Victurine, Ray; Mittermeier, Russell A.; Diallo, Mamadou S.; Rylands, Anthony B.; Williamson, Elizabeth A.

2014-01-01

The development and private sectors are increasingly considering “biodiversity offsets” as a strategy to compensate for their negative impacts on biodiversity, including impacts on great apes and their habitats in Africa. In the absence of national offset policies in sub-Saharan Africa, offset design and implementation are guided by company internal standards, lending bank standards or international best practice principles. We examine four projects in Africa that are seeking to compensate for their negative impacts on great ape populations. Our assessment of these projects reveals that not all apply or implement best practices, and that there is little standardization in the methods used to measure losses and gains in species numbers. Even if they were to follow currently accepted best-practice principles, we find that these actions may still fail to contribute to conservation objectives over the long term. We advocate for an alternative approach in which biodiversity offset and compensation projects are designed and implemented as part of a National Offset Strategy that (1) takes into account the cumulative impacts of development in individual countries, (2) identifies priority offset sites, (3) promotes aggregated offsets, and (4) integrates biodiversity offset and compensation projects with national biodiversity conservation objectives. We also propose supplementary principles necessary for biodiversity offsets to contribute to great ape conservation in Africa. Caution should still be exercised, however, with regard to offsets until further field-based evidence of their effectiveness is available. PMID:25372894