Comprehensive Truck Size and Weight (TS&W) Study. Phase 1-synthesis, working paper 6 : traffic operations and truck size and weight regulations

DOT National Transportation Integrated Search

2012-04-01

This report presents the Exogenous Factors Test Plan for the national evaluation of the Los Angeles County Congestion Reduction Demonstration (LAC CRD) under the United States Department of Transportation (U.S. DOT) Congestion Reduction Demonstration...

38 CFR 51.120 - Quality of care.

Code of Federal Regulations, 2010 CFR

2010-07-01

... as much normal bowel function as possible. (f) Range of motion. Based on the comprehensive assessment... without a limited range of motion does not experience reduction in range of motion unless the resident's clinical condition demonstrates that a reduction in range of motion is unavoidable; and (2) A resident with...

38 CFR 51.120 - Quality of care.

Code of Federal Regulations, 2011 CFR

2011-07-01

... as much normal bowel function as possible. (f) Range of motion. Based on the comprehensive assessment... without a limited range of motion does not experience reduction in range of motion unless the resident's clinical condition demonstrates that a reduction in range of motion is unavoidable; and (2) A resident with...

What does the 2°C target imply for a global climate agreement in 2020? The limits study on Durban Platform scenarios

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

KRIEGLER, ELMAR; TAVONI, MASSIMO; ABOUMAHBOUB, TINO

This paper provides a novel and comprehensive model-based assessment of possible outcomes of the Durban Platform negotiations with a focus on emissions reduction requirements, the consistency with the 2°C target and global economic impacts. The Durban Platform scenarios investigated in the LIMITS study — all assuming the implementation of comprehensive global emission reductions after 2020, but assuming different 2020 emission reduction levels as well as different long-term concentration targets — exhibit a probability of exceeding the 2°C limit of 22–41% when reaching 450 (450–480) ppm CO 2e, and 35–59% when reaching 500 (480–520) ppm CO 2e in 2100. Forcing andmore » temperature show a peak and decline pattern for both targets. Consistency of the resulting temperature trajectory with the 2°C target is a societal choice, and may be based on the maximum exceedance probability at the time of the peak and the long run exceedance probability, e.g., in the year 2100. The challenges of implementing a long-term target after a period of fragmented near-term climate policy can be significant as reflected in steep reductions of emissions intensity and transitional and long-term economic impacts. In particular, the challenges of adopting the target are significantly higher in 2030 than in 2020, both in terms of required emissions intensity decline rates and economic impacts. Finally, we conclude that an agreement on comprehensive emissions reductions to be implemented from 2020 onwards has particular significance for meeting long-term climate policy objectives.« less

Response to Intervention and the Identification of Specific Learning Disabilities: Why We Need Comprehensive Evaluations as Part of the Process

ERIC Educational Resources Information Center

Ofiesh, Nicole

2006-01-01

The purpose of this article is to underscore why we need to maintain the presence of comprehensive evaluations in the identification of students with specific learning disabilities (SLDs). Response to intervention (RTI) models hold great hope for early instruction, and the reduction of the overrepresentation of students in special education who…

Weight Reduction Diets. New Horizons in Nutrition.

ERIC Educational Resources Information Center

Arnold, Justine; Grogan, Jane, Ed.

This instructional handbook is one of a series of ten packets designed to form a comprehensive course in nutrition for secondary students. The focus of this booklet is on weight reduction diets and, in particular, those diets emphasizing reduced intake of carbohydrates. It contains a page of teaching suggestions, a pre-test for the students, and…

TRACI THE TOOL FOR THE REDUCTION AND ASSESSMENT OF CHEMICAL AND OTHER ENVIRONMENTAL IMPACTS - VERSION 2 CHANGES

EPA Science Inventory

The Tool for the Reduction and Assessment of Chemical and other environmental Impacts (TRACI) was developed to allow the quantification of environmental impacts for a variety of impact categories which are necessary for a comprehensive impact assessment. See Figure 1. TRACI is c...

76 FR 73622 - Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) or Superfund...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-29

... of Possible Funding Reductions Please describe the effects, if any, of a 10% and 20% reduction in... and Liability Act (CERCLA) or Superfund, Section 128(a); Notice of Grant Funding Guidance for State... provides guidance on eligibility for funding, use of funding, grant mechanisms and process for awarding...

Comprehensive Truck Size and Weight (TS&W) Study. Phase 1-synthesis, working paper 9 : the effects of TS&W regulations on truck travel and mode share

DOT National Transportation Integrated Search

2012-04-01

This report presents the Transit System Data Test Plan for the national evaluation of the Los Angeles Congestion Reduction Demonstration (Metro ExpressLanes) under the United States Department of Transportation (U.S. DOT) Congestion Reduction Demonst...

Woody biomass pretreatment for cellulosic ethanol production : technology and energy consumption evaluation

Treesearch

Junyong Zhu; X.J. Pan

2010-01-01

This review presents a comprehensive discussion of the key technical issues in woody biomass pretreatment: barriers to efficient cellulose saccharification, pretreatment energy consumption, in particular energy consumed for wood-size reduction, and criteria to evaluate the performance of a pretreatment. A post-chemical pretreatment size-reduction approach is proposed...

Evaluating Treatment and Generalization Patterns of Two Theoretically Motivated Sentence Comprehension Therapies.

PubMed

Des Roches, Carrie A; Vallila-Rohter, Sofia; Villard, Sarah; Tripodis, Yorghos; Caplan, David; Kiran, Swathi

2016-12-01

The current study examined treatment outcomes and generalization patterns following 2 sentence comprehension therapies: object manipulation (OM) and sentence-to-picture matching (SPM). Findings were interpreted within the framework of specific deficit and resource reduction accounts, which were extended in order to examine the nature of generalization following treatment of sentence comprehension deficits in aphasia. Forty-eight individuals with aphasia were enrolled in 1 of 8 potential treatment assignments that varied by task (OM, SPM), complexity of trained sentences (complex, simple), and syntactic movement (noun phrase, wh-movement). Comprehension of trained and untrained sentences was probed before and after treatment using stimuli that differed from the treatment stimuli. Linear mixed-model analyses demonstrated that, although both OM and SPM treatments were effective, OM resulted in greater improvement than SPM. Analyses of covariance revealed main effects of complexity in generalization; generalization from complex to simple linguistically related sentences was observed both across task and across movement. Results are consistent with the complexity account of treatment efficacy, as generalization effects were consistently observed from complex to simpler structures. Furthermore, results provide support for resource reduction accounts that suggest that generalization can extend across linguistic boundaries, such as across movement type.

Translations on USSR Science and Technology, Physical Sciences and Technology, Number 49.

DTIC Science & Technology

1978-09-20

significant reduction in the times and now a reduction in the cost of the work), and data from the surveys of the incomes of families of workers...computer equipment, it provides comprehensive elaboration of the accounting and statistical material with a reduction in the cost of the work, and...themselves, while actively developing under conditons of space flight? We have already written about hydrogenous bacteria (TEKHNIKA — MOLODEZHI, No 4

Association of Indoor Smoke-Free Air Laws with Hospital Admissions for Acute Myocardial Infarction and Stroke in Three States

PubMed Central

Loomis, Brett R.; Juster, Harlan R.

2012-01-01

Objective. To examine whether comprehensive smoke-free air laws enacted in Florida, New York, and Oregon are associated with reductions in hospital admissions for acute myocardial infarction (AMI) and stroke. Methods. Analyzed trends in county-level, age-adjusted, hospital admission rates for AMI and stroke from 1990 to 2006 (quarterly) for Florida, 1995 to 2006 (monthly) for New York, and 1998 to 2006 (monthly) for Oregon to identify any association between admission rates and passage of comprehensive smoke-free air laws. Interrupted time series analysis was used to adjust for the effects of preexisting moderate local-level laws, seasonal variation in hospital admissions, differences across counties, and a secular time trend. Results. More than 3 years after passage of statewide comprehensive smoke-free air laws, rates of hospitalization for AMI were reduced by 18.4% (95% CI: 8.8–28.0%) in Florida and 15.5% (95% CI: 11.0–20.1%) in New York. Rates of hospitalization for stroke were reduced by 18.1% (95% CI: 9.3–30.0%) in Florida. The few local comprehensive laws in Oregon were not associated with reductions in AMI or stroke statewide. Conclusion. Comprehensive smoke-free air laws are an effective policy tool for reducing the burden of AMI and stroke. PMID:22778759

Climate Leadership Award for Organizational Leadership

EPA Pesticide Factsheets

Apply to the Climate Leadership Award for Organizational Leadership, which publicly recognizes organizations for their comprehensive greenhouse gas inventories and aggressive emissions reduction goals.

Compressed Speech: Potential Application for Air Force Technical Training. Final Report, August 73-November 73.

ERIC Educational Resources Information Center

Dailey, K. Anne

Time-compressed speech (also called compressed speech, speeded speech, or accelerated speech) is an extension of the normal recording procedure for reproducing the spoken word. Compressed speech can be used to achieve dramatic reductions in listening time without significant loss in comprehension. The implications of such temporal reductions in…

Reduction of secondhand tobacco smoke in public places following national smoke-free legislation in Uruguay.

PubMed

Blanco-Marquizo, Adriana; Goja, Beatriz; Peruga, Armando; Jones, Miranda R; Yuan, Jie; Samet, Jonathan M; Breysse, Patrick N; Navas-Acien, Ana

2010-06-01

Smoke-free legislation eliminating tobacco smoke in all indoor public places and workplaces is the international standard to protect all people from exposure to secondhand smoke. Uruguay was the first country in the Americas and the first middle-income country in the world to enact a comprehensive smoke-free national legislation in March 2006. To compare air nicotine concentrations measured in indoor public places and workplaces in Montevideo, Uruguay before (November 2002) and after (July 2007) the implementation of the national legislation. Air nicotine concentrations were measured for 7-14 days using the same protocol in schools, a hospital, a local government building, an airport and restaurants and bars. A total of 100 and 103 nicotine samples were available in 2002 and 2007, respectively. Median (IQR) air nicotine concentrations in the study samples were 0.75 (0.2-1.54) microg/m(3) in 2002 compared to 0.07 (0.0-0.20) microg/m(3) in 2007. The overall nicotine reduction comparing locations sampled in 2007 to those sampled in 2002 was 91% (95% CI 85% to 94%) after adjustment for differences in room volume and ventilation. The greatest nicotine reduction was observed in schools (97% reduction), followed by the airport (94% reduction), the hospital (89% reduction), the local government building (86% reduction) and restaurants/bars (81% reduction). Exposure to secondhand smoke has decreased greatly in indoor public places and workplaces in Montevideo, Uruguay, after the implementation of a comprehensive national smoke-free legislation. These findings suggest that it is possible to successfully implement smoke-free legislations in low and middle-income countries.

Why people stereotype affects how they stereotype: the differential influence of comprehension goals and self-enhancement goals on stereotyping.

PubMed

van den Bos, Arne; Stapel, Diederik A

2009-01-01

In four studies, the authors examined the hypothesis that the way people stereotype is determined by the motives that instigate it. Study 1 measured and demonstrated the effectiveness of a commonly used priming technique to manipulate comprehension and self-enhancement goals. Study 2 demonstrated that why people stereotype determines how they stereotype: When a comprehension goal was salient, positive as well as negative stereotypes were applied, whereas a salient self-enhancement goal led to the application of negative but not positive stereotypes. Study 3 replicated these effects with different stereotypes. Study 4 replicated these effects and gave more insight in the consequences of goal fulfillment on stereotyping. Results indicated the fulfillment of a salient self-enhancement or comprehension goal led to the reduction of stereotyping. These effects were goal specific: Fulfillment of a self-enhancement goal decreased enhancement-driven but not comprehension-driven stereotyping; fulfillment of a comprehension goal decreased comprehension-driven but not enhancement-driven stereotyping.

The Differential Effects of Social Media Sites for Promoting Cancer Risk Reduction.

PubMed

Lauckner, Carolyn; Whitten, Pamela

2016-09-01

Social media are potentially valuable tools for disseminating cancer education messages, but the differential effects of various sites on persuasive outcomes are unknown. In an effort to inform future health promotion, this research tested the effects of Facebook, YouTube, Twitter, and blogs for delivering a cancer risk reduction message. Using an experimental design, participants were randomly placed in several conditions that delivered the same message but with different forms of social media. Effects on comprehension and attitudes were examined, as they are important variables in the behavior change process. YouTube led to higher comprehension and stronger attitudes toward cancer risk reduction than Twitter, but there were no differences between other sites. Additionally, YouTube led to stronger attitudes toward cancer risk reduction as compared to Facebook, but not any other sites. These results demonstrate that, even if the message is kept constant, the form of social media used to deliver content can have an effect on persuasive outcomes. More research is needed to determine the mechanisms behind the differences found, however. Altogether, this line of research is valuable for any individuals seeking to use social media for health promotion purposes and could have direct implications for the development of cancer risk reduction campaigns.

Comprehensive Group Therapy of Obesity and Its Impact on Selected Anthropometric and Postural Parameters.

PubMed

Horák, Stanislav; Sovová, Eliška; Pastucha, Dalibor; Konečný, Petr; Radová, Lenka; Calabová, Naděžda; Janoutová, Jana; Janout, Vladimír

2017-12-01

Obesity is a multifactorial disease. This non-infectious epidemic has reached pandemic proportions in the 21 century. Posture is a dynamic process referring to an active maintenance of body movement segments against the action of external forces. The aim of the study was to investigate the effect of comprehensive group therapy for obese persons on selected anthropometric and postural parameters. The study comprised 53 females with a mean age of 44.5 years (range 29–65 years, standard deviation 9.42 years, median 44 years), who completed a controlled weight loss programme. At the beginning and at the end of the programme, anthropometric parameters (Body Mass Index (BMI), weight and waist circumference) were measured and the posturography tests Limits of Stability (LOS) and Motor Control Test (MCT) were performed using the NeuroCom's SMART EquiTest system. The data were statistically analyzed using R software at a level of significance of 0.05. There were positive changes after the controlled weight loss programme in anthropometric parameters (BMI reduction, with p<0.001; waist circumference reduction, with p<0.001; and weight loss, with p<0.001), postural stability with statistically significant (p<0.05) improvements in both postural activity (LOS test parameters) and reactions (MCT parameters). The study showed a statistically significant effect of comprehensive group therapy for obesity in terms of reductions in waist circumference, body weight and BMI, and thus the overall reduction of both cardiovascular and metabolic risks, as well as improved postural skills (activity and reactions). Copyright© by the National Institute of Public Health, Prague 2017

Microenterprise Development Interventions for Sexual Risk Reduction: A Systematic Review

PubMed Central

Lee, Ramon; Thirumurthy, Harsha; Muessig, Kathryn E.; Tucker, Joseph D.

2013-01-01

Comprehensive interventions that address both individual and structural determinants associated with HIV/STI risk are gaining increasing attention over the past decade. Microenterprise development offers an appealing model for HIV prevention by addressing poverty and gender equality. This study systematically reviewed the effects of microenterprise development interventions on HIV/STI incidence and sexual risk behaviors. Microenterprise development was defined as developing small business capacity among individuals to alleviate poverty. Seven eligible research studies representing five interventions were identified and included in this review. All of the studies targeted women, and three focused on sex workers. None measured biomarker outcomes. All three sex worker studies showed significant reduction in sexual risk behaviors when compared to the control group. Non-sex worker studies showed limited changes in sexual risk behavior. This review indicates the potential utility of microenterprise development in HIV risk reduction programs. More research is needed to determine how microenterprise development can be effectively incorporated in comprehensive HIV control strategies. PMID:23963497

Microenterprise development interventions for sexual risk reduction: a systematic review.

PubMed

Cui, Rosa R; Lee, Ramon; Thirumurthy, Harsha; Muessig, Kathryn E; Tucker, Joseph D

2013-11-01

Comprehensive interventions that address both individual and structural determinants associated with HIV/STI risk are gaining increasing attention over the past decade. Microenterprise development offers an appealing model for HIV prevention by addressing poverty and gender equality. This study systematically reviewed the effects of microenterprise development interventions on HIV/STI incidence and sexual risk behaviors. Microenterprise development was defined as developing small business capacity among individuals to alleviate poverty. Seven eligible research studies representing five interventions were identified and included in this review. All of the studies targeted women, and three focused on sex workers. None measured biomarker outcomes. All three sex worker studies showed significant reduction in sexual risk behaviors when compared to the control group. Non-sex worker studies showed limited changes in sexual risk behavior. This review indicates the potential utility of microenterprise development in HIV risk reduction programs. More research is needed to determine how microenterprise development can be effectively incorporated in comprehensive HIV control strategies.

[Clinical laboratory approaches to parodontitis treatment optimization].

PubMed

Soboleva, L A; Shul'diakov, A A; Oseeva, A O; Aleksandrova, E A

2010-01-01

In order to determine cycloferon liniment clinical-pathogenetic efficacy in comprehensive parodontitis therapy examination and treatment of 80 patients was done. It was determined that the cycloferon liniment use in comprehensive treatment of patients with parodontitis let to reduce infectious load in parodontal pockets and local inflammation intensity, to normalize the secretory immunoglobulin level and immune status indices that provided speed up of healing process and reduction relapse frequency.

A Summary of Research on Energy Saving and Emission Reduction of Transportation

NASA Astrophysics Data System (ADS)

Cheng, Dongxiang; Wu, Lufen

2017-12-01

Road transport is an important part of transportation, and road in the field of energy-saving emission reduction is a very important industry. According to the existing problems of road energy saving and emission reduction, this paper elaborates the domestic and international research on energy saving and emission reduction from three aspects: road network optimization, pavement material and pavement maintenance. Road network optimization may be overlooked, and the research content is still relatively preliminary; pavement materials mainly from the asphalt pavement temperature mixed asphalt technology research; pavement maintenance technology development is relatively comprehensive.

Evaluating Treatment and Generalization Patterns of Two Theoretically Motivated Sentence Comprehension Therapies

PubMed Central

Des Roches, Carrie A.; Vallila-Rohter, Sofia; Villard, Sarah; Tripodis, Yorghos; Caplan, David

2016-01-01

Purpose The current study examined treatment outcomes and generalization patterns following 2 sentence comprehension therapies: object manipulation (OM) and sentence-to-picture matching (SPM). Findings were interpreted within the framework of specific deficit and resource reduction accounts, which were extended in order to examine the nature of generalization following treatment of sentence comprehension deficits in aphasia. Method Forty-eight individuals with aphasia were enrolled in 1 of 8 potential treatment assignments that varied by task (OM, SPM), complexity of trained sentences (complex, simple), and syntactic movement (noun phrase, wh-movement). Comprehension of trained and untrained sentences was probed before and after treatment using stimuli that differed from the treatment stimuli. Results Linear mixed-model analyses demonstrated that, although both OM and SPM treatments were effective, OM resulted in greater improvement than SPM. Analyses of covariance revealed main effects of complexity in generalization; generalization from complex to simple linguistically related sentences was observed both across task and across movement. Conclusions Results are consistent with the complexity account of treatment efficacy, as generalization effects were consistently observed from complex to simpler structures. Furthermore, results provide support for resource reduction accounts that suggest that generalization can extend across linguistic boundaries, such as across movement type. PMID:27997950

The Impact of California's Class Size Reduction Initiative on Student Achievement: Detailed Findings from Eight School Districts.

ERIC Educational Resources Information Center

Mitchell, Douglas E.; Mitchell, Ross E.

This report presents a comprehensive preliminary analysis of how California's Class Size Reduction (CSR) initiative has impacted student achievement during the first 2 years of implementation. The analysis is based on complete student, classroom, and teacher records from 26,126 students in 1,174 classrooms from 83 schools in 8 Southern California…

Effect of systematic review of medication by general practitioner on drug consumption among nursing-home residents.

PubMed

Khunti, K; Kinsella, B

2000-09-01

nursing-home patients usually have many medical problems and often take many drugs. They are therefore at risk from drug side effects and interactions. to evaluate the impact of a visit by a general practitioner and a comprehensive repeat prescribing review on the consumption of inappropriate drugs in nursing homes. two general practitioners made one comprehensive visit to four randomly selected nursing homes. In each home we discussed all patients in detail with a senior member of staff. We reviewed the prescribing record of each patient and stopped items if we considered them inappropriately prescribed or unnecessary. repeat prescriptions were altered in 65% of patients: 51% had an item stopped and 26% had an item changed to a cheaper alternative or the dose reduced. There was a reduction in the mean number of repeat prescriptions prescribed. a single visit by a general practitioner to a nursing home and a comprehensive repeat prescribing review can lead to a reduction in the number of items prescribed and to substantial savings for the health service. Further rigorous, cost-effectiveness studies are needed.

Honduras: Political and Economic Situation and U.S. Relations

DTIC Science & Technology

2006-10-13

2006.6 Amid the country’s hurricane reconstruction efforts, Honduras signed a poverty reduction and growth facility ( PRGF ) agreement with the International...macroeconomic discipline and to develop a comprehensive poverty reduction strategy. In February 2004, Honduras signed a three-year PRGF agreement...IMF Executive Board Completes Third Program and Financing Assurances Reviews under Honduras’ PRGF Arrangement,” Press Release No. 05/280, Dec. 16, 2005

Energy saving and consumption reducing evaluation of thermal power plant

NASA Astrophysics Data System (ADS)

Tan, Xiu; Han, Miaomiao

2018-03-01

At present, energy saving and consumption reduction require energy saving and consumption reduction measures for thermal power plant, establishing an evaluation system for energy conservation and consumption reduction is instructive for the whole energy saving work of thermal power plant. By analysing the existing evaluation system of energy conservation and consumption reduction, this paper points out that in addition to the technical indicators of power plant, market activities should also be introduced in the evaluation of energy saving and consumption reduction in power plant. Ttherefore, a new evaluation index of energy saving and consumption reduction is set up and the example power plant is calculated in this paper. Rresults show that after introducing the new evaluation index of energy saving and consumption reduction, the energy saving effect of the power plant can be judged more comprehensively, so as to better guide the work of energy saving and consumption reduction in power plant.

Improvement of metabolism among obese breast cancer survivors in differing weight loss regimens.

PubMed

Jen, K-L Catherine; Djuric, Zora; DiLaura, Nora M; Buison, Anne; Redd, Jennifer N; Maranci, Vera; Hryniuk, William M

2004-02-01

To compare the efficacy of different weight loss regimens on body weight loss and metabolic improvement in breast cancer survivors. Forty-eight obese breast cancer survivors were randomly divided into four groups and were followed for 1 year: 1) the Control group (subjects did not receive specific nutrition counseling); 2) the Weight Watchers group (subjects were given free coupons to attend weekly Weight Watchers meetings); 3) the Individualized group (a registered dietitian provided one-on-one nutritional counseling); and 4) the Comprehensive group (subjects received individualized dietary counseling and free coupons for the weekly Weight Watchers meetings). At baseline and 3-, 6-, and 12-month data collection visits, a fasting blood sample was obtained for assays. A three-day dietary record was kept during the week before these visits and dietary intake was analyzed. Subjects in the three intervention groups lost weight (Control: 1.1 +/- 1.7 kg; Weight Watchers: -2.7 +/- 2.1 kg; Individualized: -8.0 +/- 1.9 kg; Comprehensive: -9.5 +/- 2.7 kg) and percentage body fat, but only the Individualized and Comprehensive groups had significant losses. Subjects in the Comprehensive group showed the most improvement in cholesterol levels and had reductions in blood leptin levels. Because insulin resistance and high blood leptin levels are associated with breast cancer, losing weight to improve these parameters may reduce the risk of recurrence. Only subjects in the Comprehensive group showed significant reductions in body weight and fat, energy intake, and leptin levels. For breast cancer survivors, different weight loss strategies should be considered to assist them in losing weight.

Executive Order 13514: Federal Leadership in Environmental, Energy, and Economic Performance; Comprehensive Federal Fleet Management Handbook (Book)

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

Daley, R.; Ahdieh, N.; Bentley, J.

2014-01-01

A comprehensive Federal Fleet Management Handbook that builds upon the "Guidance for Federal Agencies on E.O. 13514 Section 12-Federal Fleet Management" and provides information to help fleet managers select optimal greenhouse gas and petroleum reduction strategies for each location, meeting or exceeding related fleet requirements, acquiring vehicles to support these strategies while minimizing fleet size and vehicle miles traveled, and refining strategies based on agency performance.

Fall risk assessment and prevention.

PubMed

Kline, Nancy E; Davis, Mary Elizabeth; Thom, Bridgette

2011-02-01

Patient falls are a common cause of morbidity and are the leading cause of injury deaths in adults age 65 years and older. Injuries sustained as result of falls in a cancer hospital are often severe, regardless of patient age, due to the nature of the underlying cancer. Falls are a nursing-sensitive indicator and nurses are in a unique position to assess, design, implement, and evaluate programs for fall risk reduction. We analyzed our nursing processes related to falls and fall prevention in conjunction with an evidence-based review, a research study to improve our fall risk-assessment process, and development of a comprehensive fall-reduction program. This article outlines how our institution developed a fall risk assessment for the oncology patient population, and utilized this assessment in a comprehensive nursing approach to fall prevention in both inpatient and outpatient settings.

Breast Cancer Risk Reduction, Version 2.2015.

PubMed

Bevers, Therese B; Ward, John H; Arun, Banu K; Colditz, Graham A; Cowan, Kenneth H; Daly, Mary B; Garber, Judy E; Gemignani, Mary L; Gradishar, William J; Jordan, Judith A; Korde, Larissa A; Kounalakis, Nicole; Krontiras, Helen; Kumar, Shicha; Kurian, Allison; Laronga, Christine; Layman, Rachel M; Loftus, Loretta S; Mahoney, Martin C; Merajver, Sofia D; Meszoely, Ingrid M; Mortimer, Joanne; Newman, Lisa; Pritchard, Elizabeth; Pruthi, Sandhya; Seewaldt, Victoria; Specht, Michelle C; Visvanathan, Kala; Wallace, Anne; Bergman, Mary Ann; Kumar, Rashmi

2015-07-01

Breast cancer is the most frequently diagnosed malignancy in women in the United States and is second only to lung cancer as a cause of cancer death. To assist women who are at increased risk of developing breast cancer and their physicians in the application of individualized strategies to reduce breast cancer risk, NCCN has developed these guidelines for breast cancer risk reduction. Copyright © 2015 by the National Comprehensive Cancer Network.

Rotorcraft In-Plane Noise Reduction Using Active/Passive Approaches with Induced Vibration Tracking

NASA Astrophysics Data System (ADS)

Chia, Miang Hwee

A comprehensive study of the use of active and passive approaches for in-plane noise reduction, including the vibrations induced during noise reduction, was conducted on a hingeless rotor configuration resembling the MBB BO-105 rotor. First, a parametric study was performed to examine the effects of rotor blade stiffness on the vibration and noise reduction performance of a 20%c plain trailing edge flap and a 1.5%c sliding microflap. This was accomplished using a comprehensive code AVINOR (for Active VIbration and NOise Reduction). A two-dimensional unsteady reduced order aerodynamic model (ROM), using the Rational Function Approximation approach and CFD-based oscillatory aerodynamic load data, was used in the comprehensive code. The study identified a hingeless blade configuration with torsional frequency of 3.17/rev as an optimum configuration for studying vibration and noise reduction using on-blade control devices such as flaps or microflaps. Subsequently, a new suite of computational tools capable of predicting in-plane low frequency sound pressure level (LFSPL) rotorcraft noise and its control was developed, replacing the acoustic module WOPWOP in AVINOR with a new acoustic module HELINOIR (for HELIcopter NOIse Reduction), which overcomes certain limitations associated with WOPWOP. The new suite, consisting of the AVINOR/HELINOIR combination, was used to study active flaps, as well as microflaps operating in closed-loop mode for in-plane noise reduction. An alternative passive in-plane noise reduction approach using modification to the blade tip in the 10%R outboard region was also studied. The new suite consisting of the AVINOR/HELINOIR combination based on a compact aeroacoustic model was validated by comparing with wind tunnel test results, and subsequently verified by comparing with computational results. For active control, the in-plane noise reduction obtained with a single 20%c plain trailing edge flap during level flight at a moderate advance ratio was examined. Different configurations of far-field and near-field feedback microphone locations were examined to develop a fundamental understanding of the feedback microphone locations on the noise reduction process A near-field microphone located on the tip of a nose boom was found to produce a LFSPL reduction of up to 6dB. However, this noise reduction was accompanied by an out-of-plane noise increase of 18dB and 60% increase in vertical hub shear. For passive control, three tip geometries having sweep, dihedral, and anhedral, were considered. The tip dihedral reduced LFSPL by up to 2dB without a vibratory load penalty. However, this was accompanied by an increase in the mid frequency sound pressure levels (MFSPL). The tip sweep and tip anhedral produced an increase in in-plane LFSPL below the horizon. A comparison of the active and passive approaches indicated that active approaches implemented by a plain flap with a feedback microphone located on the nose boom is superior to the passive control approaches. However, there is a general trade-off between LFSPL reduction, MFSPL generation and vibratory hub loads induced by noise control.

A process for quantifying aesthetic and functional breast surgery: I. Quantifying optimal nipple position and vertical and horizontal skin excess for mastopexy and breast reduction.

PubMed

Tebbetts, John B

2013-07-01

This article defines a comprehensive process using quantified parameters for objective decision making, operative planning, technique selection, and outcomes analysis in mastopexy and breast reduction, and defines quantified parameters for nipple position and vertical and horizontal skin excess. Future submissions will detail application of the processes for skin envelope design and address composite, three-dimensional parenchyma modification options. Breast base width was used to define a proportional, desired nipple-to-inframammary fold distance for optimal aesthetics. Vertical and horizontal skin excess were measured, documented, and used for technique selection and skin envelope design in mastopexy and breast reduction. This method was applied in 124 consecutive mastopexy and 122 consecutive breast reduction cases. Average follow-up was 4.6 years (range, 6 to 14 years). No changes were made to the basic algorithm of the defined process during the study period. No patient required nipple repositioning. Complications included excessive lower pole restretch (4 percent), periareolar scar hypertrophy (0.8 percent), hematoma (1.2 percent), and areola shape irregularities (1.6 percent). Delayed healing at the junction of vertical and horizontal scars occurred in two of 124 reduction patients (1.6 percent), neither of whom required revision. The overall reoperation rate was 6.5 percent (16 of 246). This study defines the first steps of a comprehensive process for using objectively defined parameters that surgeons can apply to skin envelope design for mastopexy and breast reduction. The method can be used in conjunction with, or in lieu of, other described methods to determine nipple position.

Effects of an intervention in active strategies for text comprehension and recall.

PubMed

Elosúa, M Rosa; García-Madruga, Juan A; Gutiérrez, Francisco; Luque, Juan Luis; Gárate, Milagros

2002-11-01

The aim of this study was to investigate the effects of an intervention program to promote active text-processing strategies (main-idea identification and summarization) at two developmental levels (12- and 16-year-olds). The independent variables were training condition (experimental and control) and school level (7th and 10th grades). Several measures were taken as dependent variables: reading span, reading time, construction of macrostructure, and structural recall. The hypothesis claimed that training would increase comprehension and recall significantly. Furthermore, as a result of the training program, a reduction in developmental differences in the experimental groups at posttest was also expected. Results supported the predictions, showing a significant improvement in the experimental groups' reading comprehension and recall. These results are discussed in terms of the importance of active and self-controlled strategies for text comprehension and recall.

31 CFR 561.803 - Consultations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Consultations. In implementing sections 104 and 104A of the Comprehensive Iran Sanctions, Accountability, and Divestment Act of 2010 (Pub. L. 111-195) (22 U.S.C. 8501-8551), as amended by the Iran Threat Reduction and...

31 CFR 561.803 - Consultations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Consultations. In implementing sections 104 and 104A of the Comprehensive Iran Sanctions, Accountability, and Divestment Act of 2010 (Pub. L. 111-195) (22 U.S.C. 8501-8551), as amended by the Iran Threat Reduction and...

Comprehensive nutrition and lifestyle education improves weight loss and physical activity in Hispanic Americans following gastric bypass surgery: a randomized controlled trial.

PubMed

Nijamkin, Monica Petasne; Campa, Adriana; Sosa, Jorge; Baum, Marianna; Himburg, Susan; Johnson, Paulette

2012-03-01

As morbid obesity increasingly affects Hispanic Americans, the incidence of bariatric procedures among this population is rising. Despite this, prospective research on the effects of comprehensive postoperative education-centered interventions on weight loss and physical activity focused on Hispanic Americans is lacking. To examine whether a comprehensive nutrition education and behavior modification intervention improves weight loss and physical activity in Hispanic Americans with obesity following Roux-en-Y gastric bypass surgery (RYGB). A prospective randomized-controlled trial was conducted between November 2008 and April 2010. At 6 months following RYGB, 144 Hispanic Americans with obesity were randomly assigned to a comprehensive nutrition and lifestyle educational intervention (n=72) or a noncomprehensive approach (comparison group n=72). Those in the comprehensive group received education sessions every other week for 6 weeks in small groups and frequent contact with a registered dietitian. Those in the comparison group received brief, printed healthy lifestyle guidelines. Patients were reassessed at 12 months following surgery. Main outcome measures were excess weight loss and physical activity changes over time. Statistical analyses used t test, ?(2) test, Wilcoxon signed rank, Mann-Whitney U test, and intent-to-treat analysis, significance P<0.05. Participants (mean age 44.5 ± 13.5 years) were mainly Cuban-born women (83.3%). Mean preoperative excess weight and body mass index (calculated as kg/m(2)) were 72.20 ± 27.81 kg and 49.26 ± 9.06, respectively. At 12 months following surgery, both groups lost weight significantly, but comprehensive group participants experienced greater excess weight loss (80% vs 64% from preoperative excess weight; P<0.001) and greater body mass index reduction (6.48 ± 4.37 vs 3.63 ± 3.41; P<0.001) than comparison group participants. Comprehensive group participants were significantly more involved in physical activity (+14 min/wk vs ?4 min/wk; P<0.001) than comparison group participants. Mean protein intake was significantly lower in the comparison group than that in the comprehensive group (P<0.024). Findings support the importance of comprehensive nutrition education for achieving more effective weight reduction in Hispanic Americans following RYGB. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

The Future of Data Reduction at UKIRT

NASA Astrophysics Data System (ADS)

Economou, F.; Bridger, A.; Wright, G. S.; Rees, N. P.; Jenness, T.

The Observatory Reduction and Acquisition Control (ORAC) project is a comprehensive re-implementation of all existing instrument user interfaces and data handling software involved at the United Kingdom Infrared Telescope (UKIRT). This paper addresses the design of the data reduction part of the system. Our main aim is to provide data reduction facilities for the new generation of UKIRT instruments of a similar standard to our current software packages, which have enjoyed success because of their science-driven approach. Additionally we wish to use modern software techniques in order to produce a system that is portable, flexible and extensible so as to have modest maintenance requirements, both in the medium and the longer term.

A model for evaluating academic research centers: Case study of the Asian/Pacific Islander Youth Violence Prevention Center.

PubMed

Nishimura, Stephanie T; Hishinuma, Earl S; Goebert, Deborah A; Onoye, Jane M M; Sugimoto-Matsuda, Jeanelle J

2018-02-01

To provide one model for evaluating academic research centers, given their vital role in addressing public health issues. A theoretical framework is described for a comprehensive evaluation plan for research centers. This framework is applied to one specific center by describing the center's Logic Model and Evaluation Plan, including a sample of the center's activities. Formative and summative evaluation information is summarized. In addition, a summary of outcomes is provided: improved practice and policy; reduction of risk factors and increase in protective factors; reduction of interpersonal youth violence in the community; and national prototype for prevention of interpersonal youth violence. Research centers are important mechanisms to advance science and improve people's quality of life. Because of their more infrastructure-intensive and comprehensive approach, they also require substantial resources for success, and thus, also require careful accountability. It is therefore important to comprehensively evaluate these centers. As provided herein, a more systematic and structured approach utilizing logic models, an evaluation plan, and successful processes can provide research centers with a functionally useful method in their evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Primary Hemostatic Capacity of Whole Blood: A Comprehensive Analysis of Pathogen Reduction and Refrigeration Effects Over Time

DTIC Science & Technology

2013-01-01

reduction and refrigeration is intriguing and suggests that PRT WB may complement the beneficial effects of the antifibrinolytic, tranexamic acid in...and ABBREVIATIONS: aPTT = activated partial thromboplastin time; ASPI = arachidonic acid agonist; COL = collagen; GPIba = glycoprotein Ib alpha; K...riboflavin and ultraviolet (UV) light to damage the nucleic acids of white blood cells (WBCs), parasites, bacteria, and viruses, is being consid- ered

What is Climate Leadership: Examples and Lessons Learned in Organizational Leadership Webinar

EPA Pesticide Factsheets

Organizations discuss creating comprehensive GHG inventories and aggressive emissions reduction goals, as well as leadership in their internal response to climate change, through engaging partners and addressing climate risk in their enterprise strategies.

What is Climate Leadership: Examples and Lessons Learned in Supply Chain Management Webinar

EPA Pesticide Factsheets

Organizations that have developed comprehensive greenhouse gas inventories and aggressive emissions reduction goals discuss their strategies for managing greenhouse gases in their organizational supply chains and use of EPA Supply Chain resources.

A comprehensive plan for helicopter drag reduction

NASA Technical Reports Server (NTRS)

Williams, R. M.; Montana, P. S.

1975-01-01

Current helicopters have parasite drag levels 6 to 10 times as great as fixed wing aircraft. The commensurate poor cruise efficiency results in a substantial degradation of potential mission capability. The paper traces the origins of helicopter drag and shows that the problem (primarily due to bluff body flow separation) can be solved by the adoption of a comprehensive research and development plan. This plan, known as the Fuselage Design Methodology, comprises both nonaerodynamic and aerodynamic aspects. The aerodynamics are discussed in detail and experimental and analytical programs are described which will lead to a solution of the bluff body problem. Some recent results of work conducted at the Naval Ship Research and Development Center (NSRDC) are presented to illustrate these programs. It is concluded that a 75-per cent reduction of helicopter drag is possible by the full implementation of the Fuselage Design Methodology.

Italy SimSmoke: the effect of tobacco control policies on smoking prevalence and smoking attributable deaths in Italy

PubMed Central

2012-01-01

Background While Italy has implemented some tobacco control policies over the last few decades, which resulted in a decreased smoking prevalence, there is still considerable scope to strengthen tobacco control policies consistent with the World Health Organization (WHO) policy guidelines. The present study aims to evaluate the effect of past and project the effect of future tobacco control policies on smoking prevalence and associated premature mortality in Italy. Methods To assess, individually and in combination, the effect of seven types of policies, we used the SimSmoke simulation model of tobacco control policy. The model uses population, smoking rates and tobacco control policy data for Italy. Results Significant reductions of smoking prevalence and premature mortality can be achieved through tobacco price increases, high intensity media campaigns, comprehensive cessation treatment program, strong health warnings, stricter smoke-free air regulations and advertising bans, and youth access laws. With a comprehensive approach, the smoking prevalence can be decreased by as much as 12% soon after the policies are in place, increasing to a 30% reduction in the next twenty years and a 34% reduction by 30 years in 2040. Without effective tobacco control policies, a total of almost 300 thousand lives will be prematurely lost due to smoking by the year 2040. Conclusion Besides presenting the benefits of a comprehensive tobacco control strategy, the model helps identify information gaps in surveillance and evaluation schemes that will promote the effectiveness of future tobacco control policy in Italy. PMID:22931428

Health behaviour change of people living with HIV after a comprehensive community-based HIV stigma reduction intervention in North-West Province in South Africa.

PubMed

Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael

2014-01-01

Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large.

Health behaviour change of people living with HIV after a comprehensive community-based HIV stigma reduction intervention in North-West Province in South Africa

PubMed Central

Chidrawi, H. Christa; Greeff, Minrie; Temane, Q. Michael

2014-01-01

Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large. PMID:25495580

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

Wiser, Ryan; Barbose, Galen; Heeter, Jenny

This analysis is the first-ever comprehensive assessment of the benefits and impacts of state renewable portfolio standards (RPSs). This joint National Renewable Energy Laboratory-Lawrence Berkeley National Laboratory project provides a retrospective analysis of RPS program benefits and impacts, including greenhouse gas emissions reductions, air pollution emission reductions, water use reductions, gross jobs and economic development impacts, wholesale electricity price reduction impacts, and natural gas price reduction impacts. Wherever possible, benefits and impacts are quantified in monetary terms. The paper will inform state policymakers, RPS program administrators, industry, and others about the costs and benefits of state RPS programs. In particular,more » the work seeks to inform decision-making surrounding ongoing legislative proposals to scale back, freeze, or expand existing RPS programs, as well as future discussions about increasing RPS targets or otherwise increasing renewable energy associated with Clean Power Plan compliance or other emission-reduction goals.« less

Retrospective Analysis of the Benefits and Impacts of U.S. Renewable Portfolio Standards

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

Wiser, Ryan; Barbose, Galen; Heeter, Jenny

This analysis is the first-ever comprehensive assessment of the benefits and impacts of state renewable portfolio standards (RPSs). This joint National Renewable Energy Laboratory-Lawrence Berkeley National Laboratory project provides a retrospective analysis of RPS program benefits and impacts, including greenhouse gas emissions reductions, air pollution emission reductions, water use reductions, gross jobs and economic development impacts, wholesale electricity price reduction impacts, and natural gas price reduction impacts. Wherever possible, benefits and impacts are quantified in monetary terms. The paper will inform state policymakers, RPS program administrators, industry, and others about the costs and benefits of state RPS programs. In particular,more » the work seeks to inform decision-making surrounding ongoing legislative proposals to scale back, freeze, or expand existing RPS programs, as well as future discussions about increasing RPS targets or otherwise increasing renewable energy associated with Clean Power Plan compliance or other emission-reduction goals.« less

Emissions versus climate change

EPA Science Inventory

Climate change is likely to offset some of the improvements in air quality expected from reductions in pollutant emissions. A comprehensive analysis of future air quality over North America suggests that, on balance, the air will still be cleaner in coming decades.

Study of Technological Improvements in Automobile Fuel Consumption : Volume 2. Comprehensive Discussion.

DOT National Transportation Integrated Search

1974-12-01

A study was conducted to determine the potential reduction in automotive fuel consumption based on the use of innovative systems and improved components. Technological areas investigated were: spark ignited engines with and without turbocharging, ele...

Understanding Pacific Highway commercial vehicle operations to support emissions reduction programs

DOT National Transportation Integrated Search

2011-02-01

In an effort to recommend regionally comprehensive border management solutions that will simultaneously reduce cost to carriers, and air emissions, UW researchers will work with the International Mobility and Trade Corridor Project (IMTC), a cross-bo...

Reduction of Subjective and Objective System Complexity

NASA Technical Reports Server (NTRS)

Watson, Michael D.

2015-01-01

Occam's razor is often used in science to define the minimum criteria to establish a physical or philosophical idea or relationship. Albert Einstein is attributed the saying "everything should be made as simple as possible, but not simpler". These heuristic ideas are based on a belief that there is a minimum state or set of states for a given system or phenomena. In looking at system complexity, these heuristics point us to an idea that complexity can be reduced to a minimum. How then, do we approach a reduction in complexity? Complexity has been described as a subjective concept and an objective measure of a system. Subjective complexity is based on human cognitive comprehension of the functions and inter relationships of a system. Subjective complexity is defined by the ability to fully comprehend the system. Simplifying complexity, in a subjective sense, is thus gaining a deeper understanding of the system. As Apple's Jonathon Ive has stated," It's not just minimalism or the absence of clutter. It involves digging through the depth of complexity. To be truly simple, you have to go really deep". Simplicity is not the absence of complexity but a deeper understanding of complexity. Subjective complexity, based on this human comprehension, cannot then be discerned from the sociological concept of ignorance. The inability to comprehend a system can be either a lack of knowledge, an inability to understand the intricacies of a system, or both. Reduction in this sense is based purely on a cognitive ability to understand the system and no system then may be truly complex. From this view, education and experience seem to be the keys to reduction or eliminating complexity. Objective complexity, is the measure of the systems functions and interrelationships which exist independent of human comprehension. Jonathon Ive's statement does not say that complexity is removed, only that the complexity is understood. From this standpoint, reduction of complexity can be approached in finding the optimal or 'best balance' of the system functions and interrelationships. This is achievable following von Bertalanffy's approach of describing systems as a set of equations representing both the system functions and the system interrelationships. Reduction is found based on an objective function defining the system output given variations in the system inputs and the system operating environment. By minimizing the objective function with respect to these inputs and environments, a reduced system can be found. Thus, a reduction of the system complexity is feasible.

[Evaluation on cost-effectiveness of snail control project by environmental modification in hilly regions].

PubMed

Li, Shui-Ming; Chen, Shi-Jun; Wu, Xiao-Jun; Chen, Xi-Qing; Zhang, Rong-Ping; Zhang, Jian-Rong

2011-02-01

To evaluate the cost-effectiveness of the snail control project by environmental modification in order to provide the evidence for quickly interrupting the transmission of schistosomiasis in hilly regions. Field investigations were carried out. The changes of the snail habitat areas were compared before and after the snail control project. The direct costs of the snail control were calculated. The reduction rates of snail area and snail density were regarded as the evaluation indexes of the effectiveness. The costs for reduction of 1% of snail area and 1% of snail density were used as the unit for cost-effectiveness analysis. After the 15 projects were implemented, there were no snails in 12 areas. The reduction rates of snail areas were 72.22% to 100%. The reduction rates of the snail area and density were both 100% in the areas with digging new ditches to fill up the old ones and building reservoirs. The total cost of 15 projects was 1 450 800 Yuan. The average cost per unit was 0.56 Yuan/m2. After the snail control project by digging new ditches to fill up the old ones was implemented, the costs of snail area and density decreased by one unit were 300 -700 Yuan, by building reservoirs, the costs were 600 -2 600 Yuan, by building fishpond, the costs were 1 200 - 1 500 Yuan, by watershed comprehensive measures, the costs were 900 - 2 700 Yuan. The cost of digging new ditches to fill up the old ones was significantly lower than that of building reservoirs or watershed comprehensive measures, but there was no significant difference between building reservoirs and watershed comprehensive measures. In hilly regions, the implementation of snail control project by environmental modification combined with construction of water conservancy is effective, and the cost-effectiveness of the snail control with digging new ditches to fill up the old ones is excellent.

[Energy Conservation and Emissions Reduction Benefits Analysis for Battery Electric Buses Based on Travel Services].

PubMed

Lin, Xiao-dan; Tian, Liang; Lü, Bin; Yang, Jian-xin

2015-09-01

Battery Electric Bus (BEB) has become one of prior options of urban buses for its "zero emission" during the driving stage. However, the environmental performance of electric buses is affected by multi-factors from the point of whole life cycle. In practice, carrying capacity of BEB and power generation structures can both implement evident effects on the energy consumption and pollutants emission of BEB. Therefore, take the above factors into consideration, in this article, Life Cycle Assessment is employed to evaluate the energy conservation and emissions reduction benefits of BEB. Results indicate that, travel service is more reasonable as the functional unit, rather than mileage, since the carrying capacity of BEB is 15% lower than the diesel buses. Moreover, compared with diesel buses, the energy conservation and emissions reduction benefits of battery electric buses are all different due to different regional power structures. Specifically, the energy benefits are 7. 84%, 11. 91%, 26. 90%, 11. 15%, 19. 55% and 20. 31% respectively in Huabei, Huadong, Huazhong, Dongbei, Xibei and Nanfang power structure. From the point of comprehensive emissions reduction benefits, there is no benefit in Huabei power structure, as it depends heavily on coal. But in other areas, the comprehensive emissions reduction benefits of BEB are separately 3. 46%, 26. 81%, 1. 17%, 13. 74% and 17. 48% in Huadong, Huazhong, Dongbei, Xibei and Nanfang. Therefore, it suggests that, enlargement of carrying capacity should be taken as the most prior technology innovation direction for BEB, and the grids power structure should be taken into consideration when the development of BEB is in planning.

Reduction in hospitalisations and emergency department visits for frail patients with heart failure: Results of the UMIPIC healthcare programme.

PubMed

Cerqueiro, J M; González-Franco, A; Montero-Pérez-Barquero, M; Llácer, P; Conde, A; Dávila, M F; Carrera, M; Serrado, A; Suárez, I; Pérez-Silvestre, J; Satué, J A; Arévalo-Lorido, J C; Rodríguez, A; Herrero, A; Jordana, R; Manzano, L

2016-01-01

Heart failure (HF) is a disease with high morbidity and mortality. We evaluated the usefulness of the Comprehensive Management Units for Patients with HF (Unidades de Manejo Integral para Pacientes con IC [UMIPIC]) programme. We analysed the patient data from the UMIPIC programme, which was recorded in the HF registry (RICA) of the Spanish Society of Internal Medicine. We compared emergency department visits and hospitalisations for any cause and for HF during the year prior to inclusion in the programme against those that occurred during the subsequent follow-up year, using the chi-squared test. A total of 258 patients (mean age, 80years; 51.9% women) were included in the study. During the previous year, there were 693 hospitalisations for all causes and 174 hospitalisations during the follow-up (75% reduction, P<.001). There were 613 hospitalisations for HF during the previous year and 92 during the follow-up (85% reduction, P<.001); 655 vs. 302 in terms of emergency department visits for any cause (53.9% reduction, P<.001); and 440 vs. 120 for emergency department visits for HF (72% reduction, P<.001). There were no significant differences in the number of hospitalisations or emergency department visits for causes other than HF. The UMIPIC programme based on the comprehensive care of elderly patients with HF and comorbidity reduces the rate of hospital readmissions and emergency department visits during the first year of follow-up. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Comprehensive Truck Size and Weight Study : volume 2 : issues and background

DOT National Transportation Integrated Search

2014-01-01

Connected vehicle wireless data communications can enable safety applications that may reduce injuries and fatalities suffered on our roads and highways, as well as enabling reductions in traffic congestion and impacts on the environment. As a critic...

77 FR 34951 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

... National Healthy Worksite Program--New--National Center for Chronic Disease Prevention and Health Promotion...), a comprehensive workplace health promotion program to address physical activity, nutrition, and... of participating NHWP worksites; to describe implementation and costs of workplace health promotion...

Control and monitoring of Salmonella in egg-laying chickens

USDA-ARS?s Scientific Manuscript database

Contaminated eggs have been internationally significant sources for the transmission of Salmonella infection to humans for several decades. Both the public and private sectors have invested substantial resources in comprehensive risk reduction and monitoring programs for Salmonella in commercial egg...

Microbiology of Shell Egg Production in the United States

USDA-ARS?s Scientific Manuscript database

A significant proportion of human illnesses caused by Salmonella are linked to the consumption of contaminated eggs. Substantial government and industry resources have been committed to comprehensive Salmonella testing and risk reduction programs for commercial egg-laying flocks. The implementation ...

Cardiovascular Events Following Smoke-Free Legislations: An Updated Systematic Review and Meta-Analysis

PubMed Central

Jones, Miranda R.; Barnoya, Joaquin; Stranges, Saverio; Losonczy, Lia; Navas-Acien, Ana

2014-01-01

Background Legislations banning smoking in indoor public places and workplaces are being implemented worldwide to protect the population from secondhand smoke exposure. Several studies have reported reductions in hospitalizations for acute coronary events following the enactment of smoke-free laws. Objective We set out to conduct a systematic review and meta-analysis of epidemiologic studies examining how legislations that ban smoking in indoor public places impact the risk of acute coronary events. Methods We searched MEDLINE, EMBASE, and relevant bibliographies including previous systematic reviews for studies that evaluated changes in acute coronary events, following implementation of smoke-free legislations. Studies were identified through December 2013. We pooled relative risk (RR) estimates for acute coronary events comparing post- vs. pre-legislation using inverse-variance weighted random-effects models. Results Thirty-one studies providing estimates for 47 locations were included. The legislations were implemented between 1991 and 2010. Following the enactment of smoke-free legislations, there was a 12 % reduction in hospitalizations for acute coronary events (pooled RR: 0.88, 95 % CI: 0.85–0.90). Reductions were 14 % in locations that implemented comprehensive legislations compared to an 8 % reduction in locations that only had partial restrictions. In locations with reductions in smoking prevalence post-legislation above the mean (2.1 % reduction) there was a 14 % reduction in events compared to 10 % in locations below the mean. The RRs for acute coronary events associated with enacting smoke-free legislation were 0.87 vs. 0.89 in locations with smoking prevalence pre-legislation above and below the mean (23.1 %), and 0.87 vs. 0.89 in studies from the Americas vs. other regions. Conclusion The implementation of smoke-free legislations was related to reductions in acute coronary event hospitalizations in most populations evaluated. Benefits are greater in locations with comprehensive legislations and with greater reduction in smoking prevalence post-legislation. These cardiovascular benefits reinforce the urgent need to enact and enforce smoke-free legislations that protect all citizens around the world from exposure to tobacco smoke in public places. PMID:25328861

Antipsychotic-induced weight gain: a comprehensive research synthesis.

PubMed

Allison, D B; Mentore, J L; Heo, M; Chandler, L P; Cappelleri, J C; Infante, M C; Weiden, P J

1999-11-01

The purpose of this study was to estimate and compare the effects of antipsychotics-both the newer ones and the conventional ones-on body weight. A comprehensive literature search identified 81 English- and non-English-language articles that included data on weight change in antipsychotic-treated patients. For each agent, a meta-analysis and random effects metaregression estimated the weight change after 10 weeks of treatment at a standard dose. A comprehensive narrative review was also conducted on all articles that did not yield quantitative information but did yield important qualitative information. Placebo was associated with a mean weight reduction of 0.74 kg. Among conventional agents, mean weight change ranged from a reduction of 0.39 kg with molindone to an increase of 3.19 kg with thioridazine. Among newer antipsychotic agents, mean increases were as follows: clozapine, 4.45 kg; olanzapine, 4.15 kg; sertindole, 2.92 kg; risperidone, 2.10 kg; and ziprasidone, 0.04 kg. Insufficient data were available to evaluate quetiapine at 10 weeks. Both conventional and newer antipsychotics are associated with weight gain. Among the newer agents, clozapine appears to have the greatest potential to induce weight gain, and ziprasidone the least. The differences among newer agents may affect compliance with medication and health risk.

Skeletal heterochrony is associated with the anatomical specializations of snakes among squamate reptiles.

PubMed

Werneburg, Ingmar; Sánchez-Villagra, Marcelo R

2015-01-01

Snakes possess a derived anatomy, characterized by limb reduction and reorganization of the skull and internal organs. To understand the origin of snakes from an ontogenetic point of view, we conducted comprehensive investigations on the timing of skeletal elements, based on published and new data, and reconstructed the evolution of the ossification sequence among squamates. We included for the first time Varanus, a critical taxon in phylogenetic context. There is comprehensive delay in the onset of ossification of most skeletal elements in snakes when compared to reference developmental events through evolution. We hypothesize that progressing deceleration accompanied limb reduction and reorganization of the snake skull. Molecular and morphological studies have suggested close relationship of snakes to either amphisbaenians, scincids, geckos, iguanids, or varanids. Likewise, alternative hypotheses on habitat for stem snakes have been postulated. Our comprehensive heterochrony analyses detected developmental shifts in ossification for each hypothesis of snake origin. Moreover, we show that reconstruction of ancestral developmental sequences is a valuable tool to understand ontogenetic mechanisms associated with major evolutionary changes and test homology hypotheses. The "supratemporal" of snakes could be homolog to squamosal of other squamates, which starts ossification early to become relatively large in snakes. © 2014 The Author(s). Evolution © 2014 The Society for the Study of Evolution.

Tobacco Smoke Pollution in Hospitality Venues Before and After Passage of Statewide Smoke-Free Legislation.

PubMed

Buettner-Schmidt, Kelly; Boursaw, Blake; Lobo, Marie L; Travers, Mark J

2017-03-01

In 2012, North Dakota enacted a comprehensive statewide law prohibiting smoking in enclosed public places. Disparities in tobacco control exist in rural areas. This study's objective was to determine the extent to which the passage of a comprehensive, statewide, smoke-free law in a predominantly rural state influenced tobacco smoke pollution in rural and nonrural venues. A longitudinal cohort design study comparing the levels of tobacco smoke pollution before and after passage of the statewide smoke-free law was conducted in 64 restaurants and bars statewide in North Dakota. Particulate matter with a median aerodynamic diameter of <2.5 μm (a valid atmospheric marker of tobacco smoke pollution) was assessed. A significant 83% reduction in tobacco smoke pollution levels occurred after passage of the law. Significant reductions in tobacco smoke pollution levels occurred in each of the rural categories; however, no difference by rurality was noted in the analysis after passage of the law, in contrast to the study before passage. To our knowledge, this was the largest, single, rural postlaw study globally. A comprehensive statewide smoke-free law implemented in North Dakota dramatically decreased the level of tobacco smoke pollution in bars and restaurants. © 2016 The Authors. Public Health Nursing Published by Wiley Periodicals, Inc.

Fermentation and Hydrogen Metabolism Affect Uranium Reduction by Clostridia

DOE PAGES

Gao, Weimin; Francis, Arokiasamy J.

2013-01-01

Previously, it has been shown that not only is uranium reduction under fermentation condition common among clostridia species, but also the strains differed in the extent of their capability and the pH of the culture significantly affected uranium(VI) reduction. In this study, using HPLC and GC techniques, metabolic properties of those clostridial strains active in uranium reduction under fermentation conditions have been characterized and their effects on capability variance of uranium reduction discussed. Then, the relationship between hydrogen metabolism and uranium reduction has been further explored and the important role played by hydrogenase in uranium(VI) and iron(III) reduction by clostridiamore » demonstrated. When hydrogen was provided as the headspace gas, uranium(VI) reduction occurred in the presence of whole cells of clostridia. This is in contrast to that of nitrogen as the headspace gas. Without clostridia cells, hydrogen alone could not result in uranium(VI) reduction. In alignment with this observation, it was also found that either copper(II) addition or iron depletion in the medium could compromise uranium reduction by clostridia. In the end, a comprehensive model was proposed to explain uranium reduction by clostridia and its relationship to the overall metabolism especially hydrogen (H 2 ) production.« less

16 CFR 1000.25 - Office of Hazard Identification and Reduction.

Code of Federal Regulations, 2014 CFR

2014-01-01

... has line authority over the Directorates for Epidemiology and Health Sciences, Economic Analysis, Engineering Sciences, and Laboratory Sciences. The Office develops strategies for and implements the agency's... social impacts of projects are comprehensively and objectively presented to the Commission for decision. ...

16 CFR 1000.25 - Office of Hazard Identification and Reduction.

Code of Federal Regulations, 2011 CFR

2011-01-01

... has line authority over the Directorates for Epidemiology and Health Sciences, Economic Analysis, Engineering Sciences, and Laboratory Sciences. The Office develops strategies for and implements the agency's... social impacts of projects are comprehensively and objectively presented to the Commission for decision. ...

16 CFR 1000.25 - Office of Hazard Identification and Reduction.

Code of Federal Regulations, 2012 CFR

2012-01-01

... has line authority over the Directorates for Epidemiology and Health Sciences, Economic Analysis, Engineering Sciences, and Laboratory Sciences. The Office develops strategies for and implements the agency's... social impacts of projects are comprehensively and objectively presented to the Commission for decision. ...

16 CFR 1000.25 - Office of Hazard Identification and Reduction.

Code of Federal Regulations, 2010 CFR

2010-01-01

... has line authority over the Directorates for Epidemiology and Health Sciences, Economic Analysis, Engineering Sciences, and Laboratory Sciences. The Office develops strategies for and implements the agency's... social impacts of projects are comprehensively and objectively presented to the Commission for decision. ...

Listing Waters Impaired by Atmospheric Mercury: Voluntary Subcategory 5m for States with Comprehensive Mercury Reduction Programs

EPA Pesticide Factsheets

The document presents information regarding a voluntary approach for listing waters impaired by mercury predominantly from atmospheric sources pursuant to Clean Water Act Section 303(d), also known as “subcategory 5m.”

Liquid Rocket Engine Testing

NASA Technical Reports Server (NTRS)

Rahman, Shamim

2005-01-01

Comprehensive Liquid Rocket Engine testing is essential to risk reduction for Space Flight. Test capability represents significant national investments in expertise and infrastructure. Historical experience underpins current test capabilities. Test facilities continually seek proactive alignment with national space development goals and objectives including government and commercial sectors.

NASA aerodynamics program

NASA Technical Reports Server (NTRS)

Holmes, Bruce J.; Schairer, Edward; Hicks, Gary; Wander, Stephen; Blankson, Isiaiah; Rose, Raymond; Olson, Lawrence; Unger, George

1990-01-01

Presented here is a comprehensive review of the following aerodynamics elements: computational methods and applications, computational fluid dynamics (CFD) validation, transition and turbulence physics, numerical aerodynamic simulation, drag reduction, test techniques and instrumentation, configuration aerodynamics, aeroacoustics, aerothermodynamics, hypersonics, subsonic transport/commuter aviation, fighter/attack aircraft and rotorcraft.

The two levels of care for diabetes in a developing country: Mechanisms for improved intermediate health outcomes.

PubMed

Vitale, Rebecca J; Pillai, Pradeep B; Krishnan, Gopika; Jothydev, Sunitha; Kesavadev, Jothydev

2016-01-01

India has over 70 million citizens with diabetes, the second-most of any country worldwide. Disparities in learning skills, resources, education, and physician practices make it difficult to practically implement the diabetes management guidelines recommended by international scientific organizations. In its guidelines, the International Diabetes Federation advocates for three different levels of care based on availability of resources. This study investigates the differences in intermediate health outcomes between two diabetes care programs: one a comprehensive diabetes centre, the other a limited care setting. The comprehensive centre offers telemedicine and periodic diabetes education, empowering patients and providing 24-hour advice on lifestyle modifications, diet, and exercise. All patients of this centre practice self-monitoring of blood glucose. The subjects in the limited care setting receive minimal investigations and periodic physical follow-ups, and few patients have access to home glucose monitoring. The results showed that HbA1c (7.62 vs. 8.58, p=0.003), cholesterol (134.4 vs. 173.4, p<0.001), and diastolic blood pressure (72.9 vs. 77.0, p=0.016) were significantly lower in patients receiving comprehensive care, while the reductions in systolic blood pressure (134.6 vs. 138.7, p=0.202) did not achieve statistical significance. These reductions, which remained significant after correcting for confounding factors, could be attributed to more aggressive treatment regimens in the comprehensive care centre, as well as the real-time, frequent communication with medical professionals in the telemedicine program. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

ERP evidence for memory and predictive mechanisms in word-to-text integration

PubMed Central

Stafura, Joseph Z.; Rickles, Benjamin; Perfetti, Charles A.

2016-01-01

During reading, word-to-text integration processes proceed quickly and incrementally through both prospective (predictive) and retrospective (memory) processes. Across a sentence boundary, where prediction may be less functional, memorial processes may be especially important. We tested predictive and memory mechanisms with event-related potentials (ERPs) recorded on the first content word across a sentence boundary by manipulating the direction of association between this word and one from the preceding sentence. For comparison with this text comprehension (TC) task, we tested these same word pairs in a word meaning judgment (MJ) task. In both tasks we found reduced N400 amplitudes over central scalp electrodes when the two words were either forward-associated (FA) or backward-associated (BA), relative to task-specific baseline conditions. In the MJ task, FA pairs produced a greater reduction in the N400 reduction than BA pairs over right parietal areas. However, in the TC task, BA pairs produced a greater N400 reduction than FA pairs over left parietal electrodes. A temporal principal component analysis of TC and MJ data showed a component reflecting the central N400. Additional components from TC data reflected FA-BA differences during early (N200) and late (parietal N400 and LPC) phases of processing. Comprehension skill predicted association effects in the MJ task, especially FA, and the BA central N400 effects in the TC task. The results demonstrate that, beyond N400 indicators of prediction effects, ERPs reflect the role of memory processes in word-to-text integration across sentences, part of a dynamic interplay between anticipatory and memorial processes that support comprehension. PMID:27110578

Screening analysis and selection of emission reduction concepts for intermittent combustion aircraft engines

NASA Technical Reports Server (NTRS)

Rezy, B. J.; Meyers, J. E.; Tucker, J. R.; Stuckas, S. J.

1976-01-01

An analysis was conducted to screen, evaluate, and select three engine exhaust emission reduction concepts from a group of 14 candidate alternatives. A comprehensive literature search was conducted to survey the emission reduction technology state-of-the-art and establish contact with firms working on intermittent combustion engine development and pollution reduction problems. Concept development, advantages, disadvantages, and expected emission reduction responses are stated. A set of cost effectiveness criteria was developed, appraised for relative importance, and traded off against each concept so that its merit could be determined. A decision model was used to aid the evaluators in managing the criteria, making consistent judgements, calculating merit scores, and ranking the concepts. An Improved Fuel Injection System, Improved Cooling Combustion Chamber, and a Variable Timing Ignition System were recommended to NASA for approval and further concept development. An alternate concept, Air Injection, was also recommended.

16 CFR § 1000.25 - Office of Hazard Identification and Reduction.

Code of Federal Regulations, 2013 CFR

2013-01-01

... has line authority over the Directorates for Epidemiology and Health Sciences, Economic Analysis, Engineering Sciences, and Laboratory Sciences. The Office develops strategies for and implements the agency's... social impacts of projects are comprehensively and objectively presented to the Commission for decision. ...

The effect of heat acclimation on sweat microminerals: Artifact of surface contamination

USDA-ARS?s Scientific Manuscript database

Heat acclimation (HA) reportedly conveys conservation in sweat micromineral concentrations when sampled from arm sweat, but time course is unknown. The observation that comprehensive cleaning of the skin surface negates sweat micromineral reductions during prolonged sweating raises the question of w...

Potential Crash Reduction Benefits of Safety Improvement Projects Part A : Shoulder Rumble Strips

DOT National Transportation Integrated Search

2012-06-01

This research provides a comprehensive evaluation of the safety benefits of shoulder rumble strips in rural highways in Idaho. The effectiveness of shoulder rumble strips in reducing the number and severity of run-off-the-road (ROR) crashes was exami...

Potential Crash Reduction Benefits of Safety Improvement Projects - Part A : Shoulder Rumble Strips

DOT National Transportation Integrated Search

2012-06-01

This research provides a comprehensive evaluation of the safety benefits of shoulder rumble strips in rural highways in Idaho. The effectiveness of shoulder rumble strips in reducing the number and severity of run-off-the-road (ROR) crashes was exami...

Introduction to Sustainable Urban Engineering - National Perspective - Measuring the Magnitude of the Problem

EPA Science Inventory

This seminar will present previous work on the Tool for the Reduction and Assessment and of Chemical and other environmental Impacts (TRACI) along with interim research on the quantification of land use modifications for comprehensive impact assessment. Various research options ...

Effects of synthetic air entraining agents on compressive strength of Portland cement concrete : mechanism of interaction and remediation strategy

DOT National Transportation Integrated Search

1999-07-01

This document reports the results of a comprehensive study pertaining to the determination of causes and mechanisms resulting in a reduction strength in concrete mixtures containing synthetic air entraining admixtures. The study involved experimentat...

A Successful Model for a Comprehensive Patient Flow Management Center at an Academic Health System.

PubMed

Lovett, Paris B; Illg, Megan L; Sweeney, Brian E

2016-05-01

This article reports on an innovative approach to managing patient flow at a multicampus academic health system, integrating multiple services into a single, centralized Patient Flow Management Center that manages supply and demand for inpatient services across the system. Control of bed management was centralized across 3 campuses and key services were integrated, including bed management, case management, environmental services, patient transport, ambulance and helicopter dispatch, and transfer center. A single technology platform was introduced, as was providing round-the-clock patient placement by critical care nurses, and adding medical directors. Daily bed meetings with nurse managers and charge nurses drive action plans. This article reports immediate improvements in the first year of operations in emergency department walkouts, emergency department boarding, ambulance diversion, growth in transfer volume, reduction in lost transfers, reduction in time to bed assignment, and bed turnover time. The authors believe theirs is the first institution to integrate services and centralize bed management so comprehensively. © The Author(s) 2014.

Decreasing scoring errors on Wechsler Scale Vocabulary, Comprehension, and Similarities subtests: a preliminary study.

PubMed

Linger, Michele L; Ray, Glen E; Zachar, Peter; Underhill, Andrea T; LoBello, Steven G

2007-10-01

Studies of graduate students learning to administer the Wechsler scales have generally shown that training is not associated with the development of scoring proficiency. Many studies report on the reduction of aggregated administration and scoring errors, a strategy that does not highlight the reduction of errors on subtests identified as most prone to error. This study evaluated the development of scoring proficiency specifically on the Wechsler (WISC-IV and WAIS-III) Vocabulary, Comprehension, and Similarities subtests during training by comparing a set of 'early test administrations' to 'later test administrations.' Twelve graduate students enrolled in an intelligence-testing course participated in the study. Scoring errors (e.g., incorrect point assignment) were evaluated on the students' actual practice administration test protocols. Errors on all three subtests declined significantly when scoring errors on 'early' sets of Wechsler scales were compared to those made on 'later' sets. However, correcting these subtest scoring errors did not cause significant changes in subtest scaled scores. Implications for clinical instruction and future research are discussed.

Implementation of a referral to discharge glycemic control initiative for reduction of surgical site infections in gynecologic oncology patients.

PubMed

Hopkins, Laura; Brown-Broderick, Jennifer; Hearn, James; Malcolm, Janine; Chan, James; Hicks-Boucher, Wendy; De Sousa, Filomena; Walker, Mark C; Gagné, Sylvain

2017-08-01

To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II'). Key components of this quality of care initiative included pre-operative HbA1c measurement with special triage for patients meeting criteria for diabetes or pre-diabetes, standardization of available intraoperative insulin choices, rigorous pre-op/intra-op/post-op glucose monitoring with control targets set to maintain BG ≤10mmol/L (180mg/dL) and communication/notification with primary care providers. Effectiveness was evaluated against a similar control group of patients ('Group I') undergoing surgery in 2014 prior to implementation of this initiative. We studied a total of 462 patients. Subjects in the screened (Group II) and comparison (Group I) groups were of similar age (avg. 61.0, 60.0years; p=0.422) and BMI (avg. 31.1, 32.3kg/m 2 ; p=0.257). Descriptive statistics served to compare surgical site infection (SSI) rates and other characteristics across groups. Women undergoing surgery prior to implementation of this algorithm (n=165) had an infection rate of 14.6%. Group II (n=297) showed an over 2-fold reduction in SSI compared to Group I [5.7%; p=0.001, adjRR: 0.45, 95% CI: (0.25, 0.81)]. Additionally, approximately 19% of Group II patients were newly diagnosed with either prediabetes (HbA1C 6.0-6.4) or diabetes (HbA1C≥6.5) and were referred to family or internal medicine for appropriate management. Implementation of a comprehensive multidisciplinary glycemic control initiative can lead to a significant reduction in surgical site infections in addition to early identification of an important health condition in the gynecologic oncology patient population. Copyright © 2017 Elsevier Inc. All rights reserved.

Reviews on current carbon emission reduction technologies and projects and their feasibilities on ships

NASA Astrophysics Data System (ADS)

Wang, Haibin; Zhou, Peilin; Wang, Zhongcheng

2017-06-01

Concern about global climate change is growing, and many projects and researchers are committed to reducing greenhouse gases from all possible sources. International Maritime (IMO) has set a target of 20% CO2 reduction from shipping by 2020 and also presented a series of carbon emission reduction methods, which are known as Energy Efficiency Design Index (EEDI) and Energy Efficiency Operation Indicator (EEOI). Reviews on carbon emission reduction from all industries indicate that, Carbon Capture and Storage (CCS) is an excellent solution to global warming. In this paper, a comprehensive literature review of EEDI and EEOI and CCS is conducted and involves reviewing current policies, introducing common technologies, and considering their feasibilities for marine activities, mainly shipping. Current projects are also presented in this paper, thereby illustrating that carbon emission reduction has been the subject of attention from all over the world. Two case ship studies indicate the economic feasibility of carbon emission reduction and provide a guide for CCS system application and practical installation on ships.

Determinants of underage college student drinking: implications for four major alcohol reduction strategies.

PubMed

Paek, Hye-Jin; Hove, Thomas

2012-01-01

Guided by the assumptions of the social ecological model and the social marketing approach, this study provides a simultaneous and comprehensive assessment of 4 major alcohol reduction strategies for college campuses: school education programs, social norms campaigns, alcohol counter-marketing, and alcohol control policies. Analysis of nationally representative secondary survey data among 5,472 underage students reveals that alcohol marketing seems to be the most formidable risk factor for underage drinking, followed by perceived drinking norms (injunctive norm) and lax policy enforcement. This analysis suggests that, to make social norms campaigns and alcohol control policies more effective, alcohol reduction strategies should be developed to counter the powerful influence of alcohol marketing and promotions.

ANALYSIS AND REDUCTION OF LANDSAT DATA FOR USE IN A HIGH PLAINS GROUND-WATER FLOW MODEL.

USGS Publications Warehouse

Thelin, Gail; Gaydas, Leonard; Donovan, Walter; Mladinich, Carol

1984-01-01

Data obtained from 59 Landsat scenes were used to estimate the areal extent of irrigated agriculture over the High Plains region of the United States for a ground-water flow model. This model provides information on current trends in the amount and distribution of water used for irrigation. The analysis and reduction process required that each Landsat scene be ratioed, interpreted, and aggregated. Data reduction by aggregation was an efficient technique for handling the volume of data analyzed. This process bypassed problems inherent in geometrically correcting and mosaicking the data at pixel resolution and combined the individual Landsat classification into one comprehensive data set.

Dynamically Tuned Blade Pitch Links for Vibration Reduction

NASA Technical Reports Server (NTRS)

Milgram, Judah; Chopra, Inderjit; Kottapalli, Sesi

1994-01-01

A passive vibration reduction device in which the conventional main rotor blade pitch link is replaced by a spring/damper element is investigated using a comprehensive rotorcraft analysis code. A case study is conducted for a modern articulated helicopter main rotor. Correlation of vibratory pitch link loads with wind tunnel test data is satisfactory for lower harmonics. Inclusion of unsteady aerodynamics had little effect on the correlation. In the absence of pushrod damping, reduction in pushrod stiffness from the baseline value had an adverse effect on vibratory hub loads in forward flight. However, pushrod damping in combination with reduced pushrod stiffness resulted in modest improvements in fixed and rotating system hub loads.

Dramatic reduction of void swelling by helium in ion-irradiated high purity α-iron

DOE PAGES

Bhattacharya, Arunodaya; Meslin, Estelle; Henry, Jean; ...

2018-04-11

Effect of helium on void swelling was studied in high-purity α-iron, irradiated using energetic self-ions to 157 displacements per atom (dpa) at 773 K, with and without helium co-implantation up to 17 atomic parts-per-million (appm) He/dpa. Helium is known to enhance cavity formation in metals in irradiation environments, leading to early void swelling onset. In this study, microstructure characterization by transmission electron microscopy revealed compelling evidence of dramatic swelling reduction by helium co-implantation, achieved primarily by cavity size reduction. In conclusion, a comprehensive understanding of helium induced cavity microstructure development is discussed using sink strength ratios of dislocations and cavities.

The Global Fund to Fight AIDS, Tuberculosis and Malaria's investments in harm reduction through the rounds-based funding model (2002-2014).

PubMed

Bridge, Jamie; Hunter, Benjamin M; Albers, Eliot; Cook, Catherine; Guarinieri, Mauro; Lazarus, Jeffrey V; MacAllister, Jack; McLean, Susie; Wolfe, Daniel

2016-01-01

Harm reduction is an evidence-based, effective response to HIV transmission and other harms faced by people who inject drugs, and is explicitly supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. In spite of this, people who inject drugs continue to have poor and inequitable access to these services and face widespread stigma and discrimination. In 2013, the Global Fund launched a new funding model-signalling the end of the previous rounds-based model that had operated since its founding in 2002. This study updates previous analyses to assess Global Fund investments in harm reduction interventions for the duration of the rounds-based model, from 2002 to 2014. Global Fund HIV and TB/HIV grant documents from 2002 to 2014 were reviewed to identify grants that contained activities for people who inject drugs. Data were collected from detailed grant budgets, and relevant budget lines were recorded and analysed to determine the resources allocated to different interventions that were specifically targeted at people who inject drugs. 151 grants for 58 countries, plus one regional proposal, contained activities targeting people who inject drugs-for a total investment of US$ 620 million. Two-thirds of this budgeted amount was for interventions in the "comprehensive package" defined by the United Nations. 91% of the identified amount was for Eastern Europe and Asia. This study represents an updated, comprehensive assessment of Global Fund investments in harm reduction from its founding (2002) until the start of the new funding model (2014). It also highlights the overall shortfall of harm reduction funding, with the estimated global need being US$ 2.3 billion for harm reduction in 2015 alone. Using this baseline, the Global Fund must carefully monitor its new funding model and ensure that investments in harm reduction are maintained or scaled-up. There are widespread concerns regarding the withdrawal from middle-income countries where harm reduction remains essential and unfunded through other sources: for example, 15% of the identified investments were for countries which are now ineligible for Global Fund support. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Endovascular aneurysm repair delivery redesign leads to quality improvement and cost reduction.

PubMed

Warner, Courtney J; Horvath, Alexander J; Powell, Richard J; Columbo, Jesse A; Walsh, Teri R; Goodney, Philip P; Walsh, Daniel B; Stone, David H

2015-08-01

Endovascular aneurysm repair (EVAR) is now a mainstay of therapy for abdominal aortic aneurysm, although it remains associated with significant expense. We performed a comprehensive analysis of EVAR delivery at an academic medical center to identify targets for quality improvement and cost reduction in light of impending health care reform. All infrarenal EVARs performed from April 2011 to March 2012 were identified (N = 127). Procedures were included if they met standard commercial instructions for use guidelines, used a single manufacturer, and were billed to Medicare diagnosis-related group 238 (n = 49). By use of DMAIC (define, measure, analyze, improve, and control) quality improvement methodology (define, measure, analyze, improve, control), targets for EVAR quality improvement were identified and high-yield changes were implemented. Procedure technical costs were calculated before and after process redesign. Perioperative services and clinic visits were identified as targets for quality improvement efforts and cost reduction. Mean technical costs before the intervention were $31,672, with endograft implants accounting for 52%. Pricing redesign in collaboration with hospital purchasing reduced mean EVAR technical costs to $28,607, a 10% reduction in overall cost, with endograft implants now accounting for 46%. Perioperative implementation of instrument tray redesign reduced instrument use by 32% (184 vs 132 instruments), saving $50,000 annually. Unnecessary clinic visits were reduced by 39% (1.6 vs 1.1 clinic visits per patient) through implementation of a preclinic imaging protocol. There was no difference in mean length of stay after the intervention. Comprehensive EVAR delivery redesign leads to cost reduction and waste elimination while preserving quality. Future efforts to achieve more competitive and transparent device pricing will make EVAR more cost neutral and enhance its financial sustainability for health care systems. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Endovascular aneurysm repair delivery redesign leads to quality improvement and cost reduction

PubMed Central

Warner, Courtney J.; Horvath, Alexander J.; Powell, Richard J.; Columbo, Jesse A.; Walsh, Teri R.; Goodney, Philip P.; Walsh, Daniel B.; Stone, David H.

2017-01-01

Objective Endovascular aneurysm repair (EVAR) is now a mainstay of therapy for abdominal aortic aneurysm, although it remains associated with significant expense. We performed a comprehensive analysis of EVAR delivery at an academic medical center to identify targets for quality improvement and cost reduction in light of impending health care reform. Methods All infrarenal EVARs performed from April 2011 to March 2012 were identified (N = 127). Procedures were included if they met standard commercial instructions for use guidelines, used a single manufacturer, and were billed to Medicare diagnosis-related group 238 (n = 49). By use of DMAIC (define, measure, analyze, improve, and control) quality improvement methodology (define, measure, analyze, improve, control), targets for EVAR quality improvement were identified and high-yield changes were implemented. Procedure technical costs were calculated before and after process redesign. Results Perioperative services and clinic visits were identified as targets for quality improvement efforts and cost reduction. Mean technical costs before the intervention were $31,672, with endograft implants accounting for 52%. Pricing redesign in collaboration with hospital purchasing reduced mean EVAR technical costs to $28,607, a 10% reduction in overall cost, with endograft implants now accounting for 46%. Perioperative implementation of instrument tray redesign reduced instrument use by 32% (184 vs 132 instruments), saving $50,000 annually. Unnecessary clinic visits were reduced by 39% (1.6 vs 1.1 clinic visits per patient) through implementation of a preclinic imaging protocol. There was no difference in mean length of stay after the intervention. Conclusions Comprehensive EVAR delivery redesign leads to cost reduction and waste elimination while preserving quality. Future efforts to achieve more competitive and transparent device pricing will make EVAR more cost neutral and enhance its financial sustainability for health care systems. PMID:25935271

HETEROGENEITY OF SYSTEMIC INFLAMMATORY RESPONSES TO PERIODONTAL THERAPY

PubMed Central

Behle, Jan H.; Sedaghatfar, Michael H.; Demmer, Ryan T.; Wolf, Dana L.; Celenti, Romanita; Kebschull, Moritz; Belusko, Paul B.; Herrera-Abreu, Miriam; Lalla, Evanthia; Papapanou, Panos N.

2009-01-01

Aims We investigated the effect of comprehensive periodontal therapy on the levels of multiple systemic inflammatory biomarkers. Methods Thirty patients with severe periodontitis received comprehensive periodontal therapy within a 6-week period. Blood samples were obtained at: one week pre- therapy (T1), therapy initiation (T2), treatment completion (T3), and 4 weeks thereafter (T4). We assessed plasma concentrations of 19 biomarkers using multiplex assays, and serum IgG antibodies to periodontal bacteria using checkerboard immunoblotting. At T2 and T4, dental plaque samples were analyzed using checkerboard hybridizations. Results At T3, PAI-1, sE-selectin, sVCAM-1, MMP-9, myeloperoxidase, and a composite Summary Inflammatory Score (SIS) were significantly reduced. However, only sE-selectin, sICAM, and serum amyloid P sustained a reduction at T4. Responses were highly variable: analyses of SIS slopes between baseline and T4 showed that approximately 1/3 and 1/4 of the patients experienced marked reduction and pronounced increase in systemic inflammation, respectively, while the remainder were seemingly unchanged. Changes in inflammatory markers correlated poorly with clinical, microbiological and serological markers of periodontitis. Conclusions Periodontal therapy resulted in an overall reduction of systemic inflammation, but the responses were inconsistent across subjects and largely not sustainable. The determinants of this substantial heterogeneity need to be explored further. PMID:19426174

Cervical cancer burden and prevention strategies: Asia Oceania perspective.

PubMed

Garland, Suzanne M; Bhatla, Neerja; Ngan, Hextan Y S

2012-09-01

The Asia Oceania region contributes to more than 50% of cervical cancer cases worldwide. Yet cervical cancer is one of few cancers that can be prevented through comprehensive screening for precancerous lesions, with their subsequent treatment. Screening with cervical cytology, a very old technology, has reduced cervical cancer mortality and incidence when applied in comprehensive programs with high coverage and high quality assurance. However, of those countries within this region that have set up such programs, many have been opportunistic, had poor coverage, or inadequate treatment facilities for lesions found. Consequently, they have not seen large reductions in cancer incidence or mortality. Some have therefore adopted visual inspection by acetic acid (VIA) and Lugol's iodine (VILI) or human papillomavirus (HPV) DNA assays for screening. With two safe, immunogenic and efficacious prophylactic vaccines licensed, the way forward to reduction of cervical cancer to becoming uncommon is within reach. Where governments have supported high coverage public-health vaccination programs, reductions in disease burden with shortest incubation (genital warts, high-grade abnormalities) are already being reported. One of the biggest impediments is the cost of vaccines that are affordable to resource-poor countries. Other challenges include, infrastructure for delivery of vaccines, plus general acceptance of vaccination by the community. ©2012 AACR

NLC Mechanical

Science.gov Websites

group depend on the project phase and the maturity of the NLC design. Currently the NLC project is in design approaches that will enable cost estimates, schedules, risk assessment and risk reduction availability are utilized in generating and selecting among design alternatives. A more comprehensive version

78 FR 20110 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

... Project Science to Practice: Developing and Testing a Marketing Strategy for Preventing Alcohol-related... marketing strategy for The Safer Campuses and Communities intervention, a comprehensive, community-based... the spring and fall semester of the 2012-2013 academic years, and will constitute a marketing strategy...

Adapting a Comprehensive Approach to African American Women's Sexual Risk Taking.

ERIC Educational Resources Information Center

Wyatt, Gail E.; Tucker, M. Belinda; Romero, Gloria J.; Carmona, Jennifer Vargas; Newcomb, Michael D.; Wayment, Heidi A.; Loeb, Tamra Burns; Solis, Beatriz M.; Mitchell-Kernan, Claudia

1997-01-01

Examined factors predicting the context of HIV-related sexual behaviors in African American women. Surveys investigated demographics; sexual history, behavior, attitudes, risk, and communication; drug use; contraception; and risk reduction efforts since Magic Johnson's HIV disclosure. Demographics, sexual communication, and past sexual experiences…

Microbiological Consequences of Different Housing Systems for Laying Hens: Field and Experimental Infection Studies

USDA-ARS?s Scientific Manuscript database

A significant proportion of human illnesses caused by Salmonella are linked to the consumption of contaminated eggs. In response, substantial government and private industry resources are committed to comprehensive Salmonella testing and risk reduction programs for commercial egg-laying flocks. Envi...

38 CFR 52.120 - Quality of care.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (f) Range of motion. Based on the comprehensive assessment of a participant, the program management must ensure that— (1) A participant who enters the program without a limited range of motion does not experience reduction in range of motion unless the participant's clinical condition demonstrates that a...

38 CFR 52.120 - Quality of care.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... (f) Range of motion. Based on the comprehensive assessment of a participant, the program management must ensure that— (1) A participant who enters the program without a limited range of motion does not experience reduction in range of motion unless the participant's clinical condition demonstrates that a...

SIMULTANEOUS WATER CONSERVATION/RECYCLING/REUSE AND WASTE REDUCTION IN SEMICONDUCTOR MANUFACTURING

EPA Science Inventory

The project was devoted to two separate arms of research.  The overall goals of this research was to reduce the water use in the semi-conductor industry through a comprehensive program to reduce water usage in manufacturing processes, to investigate opportunitie...

Does Guiding Toward Task-Relevant Information Help Improve Graph Processing and Graph Comprehension of Individuals with Low or High Numeracy? An Eye-Tracker Experiment.

PubMed

Keller, Carmen; Junghans, Alex

2017-11-01

Individuals with low numeracy have difficulties with understanding complex graphs. Combining the information-processing approach to numeracy with graph comprehension and information-reduction theories, we examined whether high numerates' better comprehension might be explained by their closer attention to task-relevant graphical elements, from which they would expect numerical information to understand the graph. Furthermore, we investigated whether participants could be trained in improving their attention to task-relevant information and graph comprehension. In an eye-tracker experiment ( N = 110) involving a sample from the general population, we presented participants with 2 hypothetical scenarios (stomach cancer, leukemia) showing survival curves for 2 treatments. In the training condition, participants received written instructions on how to read the graph. In the control condition, participants received another text. We tracked participants' eye movements while they answered 9 knowledge questions. The sum constituted graph comprehension. We analyzed visual attention to task-relevant graphical elements by using relative fixation durations and relative fixation counts. The mediation analysis revealed a significant ( P < 0.05) indirect effect of numeracy on graph comprehension through visual attention to task-relevant information, which did not differ between the 2 conditions. Training had a significant main effect on visual attention ( P < 0.05) but not on graph comprehension ( P < 0.07). Individuals with high numeracy have better graph comprehension due to their greater attention to task-relevant graphical elements than individuals with low numeracy. With appropriate instructions, both groups can be trained to improve their graph-processing efficiency. Future research should examine (e.g., motivational) mediators between visual attention and graph comprehension to develop appropriate instructions that also result in higher graph comprehension.

Changing Conspiracy Beliefs through Rationality and Ridiculing.

PubMed

Orosz, Gábor; Krekó, Péter; Paskuj, Benedek; Tóth-Király, István; Bőthe, Beáta; Roland-Lévy, Christine

2016-01-01

Conspiracy theory (CT) beliefs can be harmful. How is it possible to reduce them effectively? Three reduction strategies were tested in an online experiment using general and well-known CT beliefs on a comprehensive randomly assigned Hungarian sample ( N = 813): exposing rational counter CT arguments, ridiculing those who hold CT beliefs, and empathizing with the targets of CT beliefs. Several relevant individual differences were measured. Rational and ridiculing arguments were effective in reducing CT, whereas empathizing with the targets of CTs had no effect. Individual differences played no role in CT reduction, but the perceived intelligence and competence of the individual who conveyed the CT belief-reduction information contributed to the success of the CT belief reduction. Rational arguments targeting the link between the object of belief and its characteristics appear to be an effective tool in fighting conspiracy theory beliefs.

Impact of a Web-based worksite health promotion program on absenteeism.

PubMed

Niessen, Maurice A J; Kraaijenhagen, Roderik A; Dijkgraaf, Marcel G W; Van Pelt, Danielle; Van Kalken, Coen K; Peek, Niels

2012-04-01

To evaluate the effect of participation in a comprehensive, Web-based worksite health promotion program on absenteeism. Study population consists of Dutch workers employed at a large financial services company. Linear regression was used to assess the impact of program attendance on the difference between baseline and follow-up absenteeism rates, controlling for gender, age, job level, years of employment, and noncompletion of the program. Data from 20,797 individuals were analyzed; 3826 individuals enrolled in the program during the study period. A 20.3% reduction in absenteeism was shown among program attendees compared with nonparticipants during a median follow-up period of 23.3 months. Participating in the worksite health promotion program led to an immediate reduction in absenteeism. Improved psychological well-being, increased exercise, and weight reduction are possible pathways toward this reduction.

The efficacy of different models of smoke-free laws in reducing exposure to second-hand smoke: a multi-country comparison.

PubMed

Ward, Mark; Currie, Laura M; Kabir, Zubair; Clancy, Luke

2013-05-01

Exposure to second-hand tobacco smoke is a serious public health concern and while all EU Member States have enacted some form of regulation aimed at limiting exposure, the scope of these regulations vary widely and many countries have failed to enact comprehensive legislation creating smoke-free workplaces and indoor public places. To gauge the effectiveness of different smoke-free models we compared fine particles from second-hand smoke in hospitality venues before and after the implementation of smoking bans in France, Greece, Ireland, Italy, Portugal, Turkey, and Scotland. Data on PM2.5 fine particle concentration levels were recorded in 338 hospitality venues across these countries before and after the implementation of smoke-free legislation. Changes in mean PM2.5 concentrations during the period from pre- to post-legislation were then compared across countries. While a reduction in PM2.5 was observed in all countries, those who had enacted and enforced more fully comprehensive smoke-free legislation experienced the greatest reduction in second-hand tobacco smoke. Comprehensive smoke-free laws are more effective than partial laws in reducing exposure to second-hand tobacco smoke. Also, any law, regardless of scope must be actively enforced in order to have the desired impact. There is continued need for surveillance of smoke-free efforts in all countries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Community-based comprehensive intervention for people with schizophrenia in Guangzhou, China: Effects on clinical symptoms, social functioning, internalized stigma and discrimination.

PubMed

Li, Jie; Huang, Yuan-Guang; Ran, Mao-Sheng; Fan, Yu; Chen, Wen; Evans-Lacko, Sara; Thornicroft, Graham

2018-04-01

Comprehensive interventions including components of stigma and discrimination reduction in schizophrenia in low- and middle-income countries (LMICs) are lacking. We developed a community-based comprehensive intervention to evaluate its effects on clinical symptoms, social functioning, internalized stigma and discrimination among patients with schizophrenia. A randomized controlled trial including an intervention group (n = 169) and a control group (n = 158) was performed. The intervention group received comprehensive intervention (strategies against stigma and discrimination, psycho-education, social skills training and cognitive behavioral therapy) and the control group received face to face interview. Both lasted for nine months. Participants were measured at baseline, 6 months and 9 months using the Internalized Stigma of Mental Illness scale (ISMI), Discrimination and Stigma Scale (DISC-12), Global Assessment of Functioning (GAF), Schizophrenia Quality of Life Scale (SQLS), Self-Esteem Scale (SES), Brief Psychiatric Rating Scale (BPRS) and PANSS negative scale (PANSS-N). Insight and medication compliance were evaluated by senior psychiatrists. Data were analyzed by descriptive statistics, t-test, chi-square test or Fisher's exact test. Linear Mixed Models were used to show intervention effectiveness on scales. General Linear Mixed Models with multinomial logistic link function were used to assess the effectiveness on medication compliance and insight. We found a significant reduction on anticipated discrimination, BPRS and PANSS-N total scores, and an elevation on overcoming stigma and GAF in the intervention group after 9 months. These suggested the intervention may be effective in reducing anticipated discrimination, increasing skills overcoming stigma as well as improving clinical symptoms and social functioning in Chinese patients with schizophrenia. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

[Effect of comprehensive control in demonstration plots of parasitic diseases in Guizhou Province].

PubMed

Ai-Ya, Zhu; An-Mei, Li; Guang-Chu, Lin; Jian-Jun, Xu; Liang-Xian, Sun

2011-10-01

To evaluate the effect of comprehensive control in demonstration plots of parasitic diseases in Guizhou Province. The data of parasitic disease control in demonstration plots from 2006 to 2009 were collected and analyzed, including deworming, water and latrines renovation, health education, survey on infections in crowd, etc. After 3 years comprehensive control, the infection rates of soil-transmitted nematodes among people reduced from 30.25% to 8.37%, with the reduction rate of 72.32%. The infection rates of Ascaris lumbricoides, hookworm and Trichuris trichiura reduced from 26.88%, 2.86% and 4.13% to 7.43%, 0.09% and 1.13%, respectively. The awareness rate of health knowledge among residents increased from 44.18% to 93.64%, with an increasing rate of 111.94%. The coverage rate of non-hazardous sanitary latrines was 81.29%. The beneficial rate of the water renovation reached 96.31%. The comprehensive control strategies mainly based on health education and infectious source control correspond to the reality of rural parasitic disease control nowadays. The comprehensive control model integrating government leadership, department cooperation and social concern is useful for parasitic disease control and should be popularized.

Physical and Chemical Processes in Flames

DTIC Science & Technology

2010-02-15

Results: Use of comprehensively validated reduced chemical kinetic mechanism allows realistic description of methane oxidation chemistry with NOx ...PERFORMING ORGANIZATION REPORT NUMBER Department of Mechanical and Aerospace Engineering Princeton University Princeton, NJ 08544... mechanism reduction; skeletal mechanism ; CO/H2 oxidation; ethylene oxidation; heptane oxidation; directed relation graph; high-pressure combustion

Teaching and Maintaining Behavior Management Skills in the Nursing Home.

ERIC Educational Resources Information Center

Burgio, Louis D.; Stevens, Alan; Burgio, Kathryn L.; Roth, David L.; Paul, Penelope; Gerstle, John

2002-01-01

Examines the efficacy of a comprehensive behavior management skills training program for improving certified nursing assistants' (CNAs) skill performance in the nursing home. Results reveal improvement in five out of seven communication skills. Although CNAs showed a reduction in the use of ineffective behavior management strategies, they did not…

The Cost-Effectiveness of NBPTS Teacher Certification

ERIC Educational Resources Information Center

Yeh, Stuart S.

2010-01-01

A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of…

Environmental Policy--a Priority for Schools in the '90s.

ERIC Educational Resources Information Center

Ehrhardt, Cathryn

1989-01-01

A transformation of public attitudes on the environment has resulted in more stringent standards on almost all school programs for hazardous waste management, air quality, groundwater, and emergency planning and response. A comprehensive environmental risk reduction and management policy should highlight the potential for environmental risks in…

Corporate Financial Assistance for Child Care. The Conference Board Research Bulletin No. 177.

ERIC Educational Resources Information Center

Friedman, Dana

Described are four different corporate initiatives that help employees pay for work-related child care expenses: vouchers, discounts, flexible benefit programs and comprehensive cafeteria plans, and flexible spending accounts with salary reduction. Several other options, such as corporate contributions to community programs, subsidizing on-site…

Comprehensive Truck Size and Weight (TS&W) Study. Phase 1-synthesis, working paper 8 : logistics and truck size and weight regulations

DOT National Transportation Integrated Search

2012-04-01

This report presents the Safety Data Test Plan for the national evaluation of the Los Angeles County Congestion Reduction Demonstration (CRD) under the United States Department of Transportation (U.S. DOT) Urban Partnership Agreement (UPA) Program. T...

The Mobility Assistance Program. A Comprehensive Evaluation Report.

ERIC Educational Resources Information Center

Hicks, Laurabeth H.

The Mobility Assistance Program (MAP) was established to assist U.S. Department of Education employees affected by the reduction in force (RIF). MAP's mission was to provide career transition and outplacement job search assistance to RIF-affected employees. It provided these services: job search, personnel support, training, and professional…

Reduction of Adolescent Drug Abuse Through Post-Hypnotic Cue Association

ERIC Educational Resources Information Center

Martin, Roger D.

1974-01-01

Six adolescents, all females, who were involved in a variety of drug misuse were self-referrals for treatment. Treatment consisted of an initial comprehensive psychological examination, three intensive sessions of hypnosis and a procedure to develop cue association in situations where the girls felt tense. Results were favorable. (Author)

The National Drug Control Strategy, 1997.

ERIC Educational Resources Information Center

Office of National Drug Control Policy, Washington, DC.

This federal document offers a comprehensive approach to reduce demand for illegal drugs and decrease their availability. Supported by statistical tables and graphs, the summary is divided into six sections. "The Purpose and Nature of the Strategy" outlines a 10-year plan for drug interdiction and reduction and identifies the elements of…

Managing Conflict: 50 Strategies for School Leaders

ERIC Educational Resources Information Center

Edmonson, Stacey; Combs, Julie; Harris, Sandra

2008-01-01

This book offers 50 easy-to-read strategies for managing conflicts in your school involving students, parents, and teachers. Individually, these strategies provide specific insights into conflict resolution, reduction, and management. As a whole, the 50 strategies provide a comprehensive method to lead constructive change in your school. With…

Cardiovascular Risk Reduction. The Problems Facing the School Age Population.

ERIC Educational Resources Information Center

Moller, James H.

1982-01-01

A comprehensive health education program stressing the development of sound health habits should be offered to all students from kindergarten through twelfth grade. Such programs could help to prevent the development of cardiovascular disease by educating students of current practices that add to the risk of disease. (CJ)

Toward a Dependable Peace: A Proposal for an Appropriate Security System.

ERIC Educational Resources Information Center

Johansen, Robert C.

This booklet proposes that citizens and governments think imaginatively about national and international security and take action for comprehensive arms reductions. The document is presented in eight chapters. Chapter I reports that global insecurity exists despite continuous arms control negotiations since World War II. Chapter II discusses…

Written Disclosure Treatment for Posttraumatic Stress Disorder in Substance Use Disorder Inpatients

ERIC Educational Resources Information Center

Bragdon, Rodney A.; Lombardo, Thomas W.

2012-01-01

Comprehensive exposure-based approaches to treating posttraumatic stress disorder (PTSD) are effective, but they are time intensive and not widely used because of factors such as client noncompliance and fears of iatrogenic effects. Exposure by writing disclosure (WD), modeled after Pennebaker's brief stress-reduction procedure, may circumvent…

Characteristics of School Buildings in the U.S.

ERIC Educational Resources Information Center

Chmelynski, Harry J.; Leovic, Kelly W.

The Environmental Protection Agency's (EPA's) Radon Mitigation Branch (RMB) conducts research and development on the reduction of indoor radon levels. Finding that there was no comprehensive database on the physical characteristics of the nations's school buildings (with information specific to radon-mitigation research), the RMB conducted a study…

A COMPREHENSIVE APPROACH TO IDENTIFY AND QUANTIFY FUNDAMENTAL PARAMETERS THAT INFLUENCE METAL LEACHING CHEMISTRY IN LANDFILLS SYSTEMS (PRESENTATION)

EPA Science Inventory

Various anthropogenic activities generate hazardous solid wastes that are affluent in heavy metals, which can cause significant damage to the environment and human health. Heavy metals/metalloids can exist in multiple oxidation states, and can undergo oxidation or reduction when ...

A COMPREHENSIVE APPROACH TO IDENTIFY AND QUANTIFY FUNDAMENTAL PARAMETERS THAT INFLUENCE METAL LEACHING CHEMISTRY IN LANDFILLS SYSTEMS (ABSTRACT)

EPA Science Inventory

Various anthropogenic activities generate hazardous solid wastes that are affluent in heavy metals, which can cause significant damage to the environment and human health. Heavy metals/metalloids can exist in multiple oxidation states, and can undergo oxidation or reduction when ...

Comprehensive Truck Size and Weight (TS&W) Study. Phase 1-synthesis, working paper 10 : enforcement and truck size and weight regulations

DOT National Transportation Integrated Search

2012-04-01

This report presents the Content Analysis Test Plan for the national evaluation of the Los Angeles County Congestion Reduction Demonstration (CRD) under the United States Department of Transportation (U.S. DOT) Urban Partnership Agreement (UPA) Progr...

Abstinence education.

PubMed

Zeiler, Alean

2014-11-01

The American College of Pediatricians strongly endorses abstinence-until-marriage sex education and recommends adoption by all school systems in lieu of "comprehensive sex education." This position is based on "the public health principle of primary prevention-risk avoidance in lieu of risk reduction," upholding the "human right to the highest attainable standard of health" (Freedman 1995).

Colorado Children's Budget 2005

ERIC Educational Resources Information Center

Colorado Children's Campaign, 2005

2005-01-01

The Children's Budget is a comprehensive report on funding for children's services in Colorado. This report provides a six- year funding history for more than 50 programs funded with state, local, and federal dollars. The Colorado Children's Budget analyzes reductions in programs and services during the economic downturn. The data in the…

Applying multi-criteria decision-making to improve the waste reduction policy in Taiwan.

PubMed

Su, Jun-Pin; Hung, Ming-Lung; Chao, Chia-Wei; Ma, Hwong-wen

2010-01-01

Over the past two decades, the waste reduction problem has been a major issue in environmental protection. Both recycling and waste reduction policies have become increasingly important. As the complexity of decision-making has increased, it has become evident that more factors must be considered in the development and implementation of policies aimed at resource recycling and waste reduction. There are many studies focused on waste management excluding waste reduction. This study paid more attention to waste reduction. Social, economic, and management aspects of waste treatment policies were considered in this study. Further, a life-cycle assessment model was applied as an evaluation system for the environmental aspect. Results of both quantitative and qualitative analyses on the social, economic, and management aspects were integrated via the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method into the comprehensive decision-making support system of multi-criteria decision-making (MCDM). A case study evaluating the waste reduction policy in Taoyuan County is presented to demonstrate the feasibility of this model. In the case study, reinforcement of MSW sorting was shown to be the best practice. The model in this study can be applied to other cities faced with the waste reduction problems.

The SCUBA map reduction cookbook

NASA Astrophysics Data System (ADS)

Sandell, G.; Jessop, N.; Jenness, T.

This cookbook tells you how to reduce and analyze maps obtained with SCUBA using the off-line SCUBA reduction package, SURF, and the Starlink KAPPA, Figaro, GAIA and CONVERT applications. The easiest way of using these packages is to run-up ORAC-DR, a general purpose pipeline for reducing data from any telescope. A set of data reduction recipes are available to ORAC-DR for use when working with scuba maps, these recipes utilize the SURF and KAPPA packages. This cookbook makes no attempts to explain why and how, for that there is a comprehensive Starlink User Note 216 which properly documents all the software tasks in SURF, which should be consulted for those who need to know details of a task, or how the task really works.

Restricted Boltzmann machines based oversampling and semi-supervised learning for false positive reduction in breast CAD.

PubMed

Cao, Peng; Liu, Xiaoli; Bao, Hang; Yang, Jinzhu; Zhao, Dazhe

2015-01-01

The false-positive reduction (FPR) is a crucial step in the computer aided detection system for the breast. The issues of imbalanced data distribution and the limitation of labeled samples complicate the classification procedure. To overcome these challenges, we propose oversampling and semi-supervised learning methods based on the restricted Boltzmann machines (RBMs) to solve the classification of imbalanced data with a few labeled samples. To evaluate the proposed method, we conducted a comprehensive performance study and compared its results with the commonly used techniques. Experiments on benchmark dataset of DDSM demonstrate the effectiveness of the RBMs based oversampling and semi-supervised learning method in terms of geometric mean (G-mean) for false positive reduction in Breast CAD.

Carrier air wing mishap reduction using a human factors classification system and risk management.

PubMed

Belland, Kxis M; Olsen, Cara; Lawry, Russell

2010-11-01

In 1998, the Navy's center of excellence for advanced air wing combat operations, namely the Naval Strike and Air Warfare Center (NSAWC), had a spike in Class A flight mishaps. The spike triggered an intense review of prior mishaps and current mishap-reduction practices using the Human Factors Analysis and Classification System (HFACS). The review resulted in NSAWC instituting a comprehensive multifactorial mishap reduction plan applying Operational Risk Management (ORM) precepts. This is a nonrandomized investigational study with use of a historical comparison population. The Class A mishap rate per flight hour covering 10 yr prior to the mishap reduction efforts was estimated and compared to the Class A mishap rate per flight hour for the 10 yr after implementation using Poisson regression. Combined Fleet and NSAWC data shows a 27% reduction in mishap rate, but the 21% reduction in the Fleet alone was not statistically significant. The mishap reduction at NSAWC was statistically significant with an 84% reduction. Fallon carrier air wing mishap rates post-ORM mishap reduction efforts are approaching those seen in the Fleet, but are still elevated overall (3.7 vs. 2.4). The incidence rate ratio was 80% lower at Fallon than the rest of the Fleet, indicating a significantly greater reduction in NSAWC air wing mishaps and suggests focused aviation mishap reduction efforts in similar circumstances could result in similar reductions.

Tobacco Town: Computational Modeling of Policy Options to Reduce Tobacco Retailer Density.

PubMed

Luke, Douglas A; Hammond, Ross A; Combs, Todd; Sorg, Amy; Kasman, Matt; Mack-Crane, Austen; Ribisl, Kurt M; Henriksen, Lisa

2017-05-01

To identify the behavioral mechanisms and effects of tobacco control policies designed to reduce tobacco retailer density. We developed the Tobacco Town agent-based simulation model to examine 4 types of retailer reduction policies: (1) random retailer reduction, (2) restriction by type of retailer, (3) limiting proximity of retailers to schools, and (4) limiting proximity of retailers to each other. The model examined the effects of these policies alone and in combination across 4 different types of towns, defined by 2 levels of population density (urban vs suburban) and 2 levels of income (higher vs lower). Model results indicated that reduction of retailer density has the potential to decrease accessibility of tobacco products by driving up search and purchase costs. Policy effects varied by town type: proximity policies worked better in dense, urban towns whereas retailer type and random retailer reduction worked better in less-dense, suburban settings. Comprehensive retailer density reduction policies have excellent potential to reduce the public health burden of tobacco use in communities.

Helicopter Non-Unique Trim Strategies for Blade-Vortex Interaction (BVI) Noise Reduction

NASA Technical Reports Server (NTRS)

Malpica, Carlos; Greenwood, Eric; Sim, Ben W.

2016-01-01

An acoustics parametric analysis of the effect of fuselage drag and pitching moment on the Blade-Vortex Interaction (BVI) noise radiated by a medium lift helicopter (S-70UH-60) in a descending flight condition was conducted. The comprehensive analysis CAMRAD II was used for the calculation of vehicle trim, wake geometry and integrated air loads on the blade. The acoustics prediction code PSU-WOPWOP was used for calculating acoustic pressure signatures for a hemispherical grid centered at the hub. This paper revisits the concept of the X-force controller for BVI noise reduction, and investigates its effectiveness on an S-70 helicopter. The analysis showed that further BVI noise reductions were achievable by controlling the fuselage pitching moment. Reductions in excess of 6 dB of the peak BVI noise radiated towards the ground were demonstrated by compounding the effect of airframe drag and pitching moment simultaneously.

The anterior temporal lobes support residual comprehension in Wernicke’s aphasia

PubMed Central

Robson, Holly; Zahn, Roland; Keidel, James L.; Binney, Richard J.; Sage, Karen; Lambon Ralph, Matthew A.

2014-01-01

Wernicke’s aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory–verbal comprehension is significantly impaired in Wernicke’s aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke’s aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke’s aphasia and 12 control participants performed semantic animate–inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke’s aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke’s aphasia group displayed an ‘over-activation’ in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke’s aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions. PMID:24519979

The anterior temporal lobes support residual comprehension in Wernicke's aphasia.

PubMed

Robson, Holly; Zahn, Roland; Keidel, James L; Binney, Richard J; Sage, Karen; Lambon Ralph, Matthew A

2014-03-01

Wernicke's aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke's aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke's aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke's aphasia and 12 control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke's aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke's aphasia group displayed an 'over-activation' in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke's aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions.

Streamlining Workflow for Endovascular Mechanical Thrombectomy: Lessons Learned from a Comprehensive Stroke Center.

PubMed

Wang, Hongjin; Thevathasan, Arthur; Dowling, Richard; Bush, Steven; Mitchell, Peter; Yan, Bernard

2017-08-01

Recently, 5 randomized controlled trials confirmed the superiority of endovascular mechanical thrombectomy (EMT) to intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. The implication is that our health systems would witness an increasing number of patients treated with EMT. However, in-hospital delays, leading to increased time to reperfusion, are associated with poor clinical outcomes. This review outlines the in-hospital workflow of the treatment of acute ischemic stroke at a comprehensive stroke center and the lessons learned in reduction of in-hospital delays. The in-hospital workflow for acute ischemic stroke was described from prehospital notification to femoral arterial puncture in preparation for EMT. Systematic review of literature was also performed with PubMed. The implementation of workflow streamlining could result in reduction of in-hospital time delays for patients who were eligible for EMT. In particular, time-critical measures, including prehospital notification, the transfer of patients from door to computed tomography (CT) room, initiation of intravenous thrombolysis in the CT room, and the mobilization of neurointervention team in parallel with thrombolysis, all contributed to reduction in time delays. We have identified issues resulting in in-hospital time delays and have reported possible solutions to improve workflow efficiencies. We believe that these measures may help stroke centers initiate an EMT service for eligible patients. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Methodological and hermeneutic reduction - a study of Finnish multiple-birth families.

PubMed

Heinonen, Kristiina

2015-07-01

To describe reduction as a method in methodological and hermeneutic reduction and the hermeneutic circle using van Manen's principles, with the empirical example of the lifeworlds of multiple-birth families in Finland. Reduction involves several levels that can be distinguished for their methodological usefulness. Researchers can use reduction in different ways and dimensions for their methodological needs. Open interviews with public health nurses, family care workers and parents of twins. The systematic literature and knowledge review shows there were no articles on multiple-birth families that used van Manen's method. This paper presents reduction as a method that uses the hermeneutic circle. The lifeworlds of multiple-birth families consist of three core themes: 'A state of constant vigilance'; 'Ensuring that they can continue to cope'; and 'Opportunities to share with other people'. Reduction allows us to perform deep phenomenological-hermeneutic research and understand people's lifeworlds. It helps to keep research stages separate but also enables a consolidated view. Social care and healthcare professionals have to hear parents' voices better to comprehensively understand their situation; they also need further tools and training to be able to empower parents of twins. The many variations in adapting reduction mean its use can be very complex and confusing. This paper adds to the discussion of phenomenology, hermeneutic study and reduction.

Behavioral Health in Developmental Disabilities: A Comprehensive Program of Nutrition, Exercise, and Weight Reduction

ERIC Educational Resources Information Center

Fleming, Richard K.; Stokes, Elise A.; Curtin, Carol; Bandini, Linda G.; Gleason, James; Scampini, Renee; Maslin, Melissa C. T.; Hamad, Charles

2008-01-01

We review the literature on the prevalence and conditions resulting in overweight and obesity in people with intellectual disability (ID), followed by obesity treatment research with typically developing children and adaptations for children with ID. In addition to proposing directions for future research and practice, we report a comprehensive…

Reducing Class Size: What Do We Know?

ERIC Educational Resources Information Center

Bascia, Nina

2010-01-01

This report provides an overview of findings from the research on primary class size reduction as a strategy to improve student learning. Its purpose is to provide a comprehensive and balanced picture of a very popular educational reform strategy that has often been seen as a "quick fix" for improving students' opportunities to learn in…

INFLUENCE OF PH AND OXIDATION-REDUCTION (EH) POTENTIAL ON THE DISSOLUTION OF MERCURY-CONTAINING MINE WASTES FROM THE SULFUR BANK MERCURY MINE

EPA Science Inventory

Mine waste rock and roaster tailings were collected from the Sulfur Bank Mercury Mine (SBMM) located in Clearlake Oaks, California. The site has been under investigation as a Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) site. Characterization an...

Sound Diffraction Around Movable Partitions in Teaching Spaces. Education Building Report 1.

ERIC Educational Resources Information Center

Choudhury, N. K. D.

This study concerns the diffraction of sound around flexible partitions used in teaching spaces. It includes a comprehensive study of the acoustical conditions in several school buildings in India, Malaysia, Singapore, and Sri Lanka. The noise reduction properties of some typical partitions the minimum height of the partition between two teaching…

Perceived Personal and Social Competence: Development of Valid and Reliable Measures

ERIC Educational Resources Information Center

Fetro, Joyce V.; Rhodes, Darson L.; Hey, David W.

2010-01-01

During the last 20 years, youth programming has shifted from risk reduction to youth development. While numerous instruments exist to measure selected individual characteristics/competencies among youth, a comprehensive instrument to measure four constructs of personal and social skills could not be identified. The purpose of this study was to…

A Model for the Inclusion of a Physical Fitness and Health Promotion Component in a Chemical Abuse Treatment Program.

ERIC Educational Resources Information Center

Fridinger, Fred; Dehart, Beverly

1993-01-01

Describes treatment program at Charter Hospital in Fort Worth, Texas, which incorporates comprehensive medical examination, fitness and nutritional screenings, and appropriate exercise activities into alcohol and other substance abuse treatment. Notes that educational sessions are offered on health fitness, risk reduction, stress management,…

Fuel mapping for the future

Treesearch

C.W. Woodall; G.R. Holden; J.S. Vissage

2004-01-01

The large wildland fires that raged during the 2000 and 2002 fire seasons highlighted the need for a nationwide strategic assessment of forest fuels. The lack of a nationally consistent and comprehensive inventory of forest fuels has hindered large-scale assessments- essential for effective fuel hazard management and monitoring reduction treatments. Data from the USDA...

Proceedings: Conference on Computers in Chemical Education and Research, Dekalb, Illinois, 19-23 July 1971.

ERIC Educational Resources Information Center

1971

Computers have effected a comprehensive transformation of chemistry. Computers have greatly enhanced the chemist's ability to do model building, simulations, data refinement and reduction, analysis of data in terms of models, on-line data logging, automated control of experiments, quantum chemistry and statistical and mechanical calculations, and…

Connecticut Professional School Counselors: College and Career Counseling Services and Smaller Ratios Benefit Students

ERIC Educational Resources Information Center

Lapan, Richard T.; Whitcomb, Sara A.; Aleman, Nancy M.

2012-01-01

Results connect the implementation of the college and career counseling components of a comprehensive school counseling program and lower student-to-school-counselor ratios to a reduction in suspension rates and disciplinary incidents for Connecticut high school students. Principal ratings of college and career counseling services provided in…

75 FR 32749 - Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-09

... provisions of the Paperwork Reduction Act (44 U.S.C. Chapter 35). A shortened comment period of one week is... response rates require a 2 month field period, and analysis and summary of data requires a month time... Comprehensive Review Working Group, Crystal Mall 2, 1801 S. Bell St., Suite 409, Arlington, VA; or call (703...

Economic mitigation challenges: how further delay closes the door for achieving climate targets

NASA Astrophysics Data System (ADS)

Luderer, Gunnar; Pietzcker, Robert C.; Bertram, Christoph; Kriegler, Elmar; Meinshausen, Malte; Edenhofer, Ottmar

2013-09-01

While the international community aims to limit global warming to below 2 ° C to prevent dangerous climate change, little progress has been made towards a global climate agreement to implement the emissions reductions required to reach this target. We use an integrated energy-economy-climate modeling system to examine how a further delay of cooperative action and technology availability affect climate mitigation challenges. With comprehensive emissions reductions starting after 2015 and full technology availability we estimate that maximum 21st century warming may still be limited below 2 ° C with a likely probability and at moderate economic impacts. Achievable temperature targets rise by up to ˜0.4 ° C if the implementation of comprehensive climate policies is delayed by another 15 years, chiefly because of transitional economic impacts. If carbon capture and storage (CCS) is unavailable, the lower limit of achievable targets rises by up to ˜0.3 ° C. Our results show that progress in international climate negotiations within this decade is imperative to keep the 2 ° C target within reach.

Environmental assessment of NH3 injection for an industrial package boiler. Volume 2. Data supplement. Final report, January 1983-January 1984

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

Castaldini, C.; DeRosier, R.; Waterland, L.R.

1986-02-01

The report discusses emission results from comprehensive flue-gas sampling of a gas- and oil-fired industrial boiler equipped with Exxon's Thermal DeNOx Ammonia Injection Process for NOx reduction. Comprehensive emission measurements included continuous monitoring of flue gas emissions; source assessment sampling system (SASS) tests; EPA Method 5/17 for solid and condensible particulate emissions and ammonia emissions; controlled condensation system for SO2 and SO3; and N2O emission sampling. Ammonia injection at a NH3/NO molar ratio of 2.52 gave a NOx reduction of 41% from an uncontrolled level of 234 ppm to a controlled level of 137 ppm. NH3 emissions increased from 11more » ppm for the baseline to an average of 430 ppm for ammonia injection. Nitrous oxide, N2O, was reduced 68% from a 50 ppm baseline level to a 17 ppm controlled level. Total particulate emissions increased by an order of magnitude from a baseline of 17.7 ng/J to a controlled level of 182 ng/J.« less

Reducing alcohol consumption among university students: recruitment and program design strategies based on Social Marketing Theory.

PubMed

Black, D R; Smith, M A

1994-09-01

Recruitment of program participants and development of appealing comprehensive alcohol abuse prevention programs is an exigent priority for university campuses due to the serious physical and emotional consequences related to alcohol consumption. A sample of 67 students from a large midwestern university completed a survey based on Social Marketing Theory (SMT) which was developed to improve recruitment and enhance the design of comprehensive alcohol abuse prevention programs. The results indicate that recruitment may be optimized by providing a flexible, convenient, low-cost program that encourages friends' participation, communicates alcohol-related risks and offers university credit or refund as participation incentives. The design of alcohol abuse prevention programs may be enhanced by emphasizing the positive outcomes of reducing alcohol consumption, improving the quality and quantity of alternatives to the social atmosphere connected with drinking, and soliciting respected opinion leaders (physicians and parents) to communicate alcohol reduction messages. This project is a first initiative to 'fill the gap' in the social marketing research literature by providing formative information pertinent to recruitment and design of alcohol reduction programs specifically for college students.

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

Bhattacharya, Arunodaya; Meslin, Estelle; Henry, Jean

Effect of helium on void swelling was studied in high-purity α-iron, irradiated using energetic self-ions to 157 displacements per atom (dpa) at 773 K, with and without helium co-implantation up to 17 atomic parts-per-million (appm) He/dpa. Helium is known to enhance cavity formation in metals in irradiation environments, leading to early void swelling onset. In this study, microstructure characterization by transmission electron microscopy revealed compelling evidence of dramatic swelling reduction by helium co-implantation, achieved primarily by cavity size reduction. In conclusion, a comprehensive understanding of helium induced cavity microstructure development is discussed using sink strength ratios of dislocations and cavities.

Experimental and theoretical sound transmission. [reduction of interior noise in aircraft

NASA Technical Reports Server (NTRS)

Roskam, J.; Muirhead, V. U.; Smith, H. W.; Durenberger, D. W.

1978-01-01

The capabilities of the Kansas University- Flight Research Center for investigating panel sound transmission as a step toward the reduction of interior noise in general aviation aircraft were discussed. Data obtained on panels with holes, on honeycomb panels, and on various panel treatments at normal incidence were documented. The design of equipment for panel transmission loss tests at nonnormal (slanted) sound incidence was described. A comprehensive theory-based prediction method was developed and shows good agreement with experimental observations of the stiffness controlled, the region, the resonance controlled region, and the mass-law region of panel vibration.

Comprehensive long-term management program for asthma: effect on outcomes in adult African-Americans.

PubMed

Kelso, T M; Abou-Shala, N; Heilker, G M; Arheart, K L; Portner, T S; Self, T H

1996-06-01

To determine if a comprehensive long-term management program, emphasizing inhaled corticosteroids and patient education, would improve outcomes in adult African-American asthmatics a nonrandomized control trial with a 2-year intervention was performed in a university-based clinic. Inclusion criteria consisted of (> or = 5) emergency department (ED) visits or hospitalizations (> or = 2) during the previous 2 years. Intervention patients were volunteers; a comparable control group was identified via chart review at hospitals within the same area and time period as the intervention patients. Individualized doses of beclomethasone with a spacer, inhaled albuterol "as needed," and crisis prednisone were the primary therapies. Environmental control, peak flow monitoring, and a partnership with the patient were emphasized. Detailed patient education was an integral part of management. Control patients received usual care from local physicians. ED visits and hospitalizations for 2 years before and 2 years during the intervention period were compared. Quality of life (QOL) measurements were made at baseline and every 6 months in the intervention group. Study group (n = 21) had a significant reduction in ED visits (2.3 +/- 0.2 pre-intervention versus 0.6 +/- 0.2 post-intervention; P = 0.0001). Control group (n = 18) did not have a significant change in ED visits during the 2-year post-intervention period (2.6 +/- 0.2 pre-intervention versus 2.0 +/- 0.2 post-intervention; P = 0.11). Both groups had significant reductions in hospitalizations, but the study group had a greater reduction. Sixty-two percent of study patients had complete elimination of ED visits and hospitalizations, whereas no control patients had total elimination of the need for institutional acute care. QOL in the study patients revealed significant improvements for most parameters. A comprehensive long-term management program emphasizing inhaled corticosteroids combined with other state-of-the-art management, including intensive patient education, improves outcomes in adult African-American asthmatics.

Stress, stress reduction, and hypertension in African Americans: an updated review.

PubMed

Barnes, V; Schneider, R; Alexander, C; Staggers, F

1997-07-01

This is a comprehensive and integrative review of multiple factors underlying the greater prevalence of hypertension in African Americans compared with whites. Evidence linking stress with hypertension and cardiovascular disease in African Americans is reviewed. A survey of mechanisms of hypertension in African Americans and existing behavioral strategies for the treatment of hypertension is presented. Given that the excess of hypertension may be mediated in part by behavioral factors operating through biological mechanisms, a case is presented for behavioral stress reduction measures. This review of stress reduction techniques especially the Transcendental Mediation program for the treatment of hypertension in African Americans highlights current issues facing the field. New information is provided to help direct future nonpharmacological research and practice in hypertension to prevent morbidity and premature mortality in this underserved population.

[Study on the effectiveness of implementation: the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

PubMed

Zhang, J; Jin, R R; Li, J J; Li, J L; Su, X W; Deng, G J; Ma, S; Zhao, J; Wang, Y P; Bian, F; Qu, Y M; Shen, Z Z; Jiang, Y; Liu, Y L

2018-04-10

Objective: To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods: Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December, 2016 in order to conduct on process and outcome evaluation of the above mentioned objective. In the meantime, case study was also conducted. Results: All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country, with health education and health promotion, surveillance and safeguard measures in particular. A government-led and inter-sector coordination and communication mechanism had been well established, with more than 16 non-health departments actively involved. 28.7% of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases. Among the residents, 72.1% of them consumed vegetables and 53.6% consumed fruits daily, with another 86.9% walked at least 10 minutes per day. Over 70% of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers, and above 50% of them were under standardized management. Residents, living in the National Demonstration Areas under higher ranking of implementation scores, were more likely to be aware of relevant knowledge on chronic disease control and prevention ( OR =6.591, 95% CI : 5.188-8.373), salt reduction ( OR =1.352, 95% CI : 1.151-1.589), oil reduction ( OR =1.477, 95% CI : 1.249-1.746) and recommendation on physical activities ( OR =1.975, 95% CI : 1.623- 2.403). Conclusion: The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases, and thus become an important 'carrier' for chronic disease prevention and control programs in China.

Effects of vegetation cover of natural grassland on runoff and sediment yield in loess hilly region of China.

PubMed

Zhao, Xining; Chen, Xiaoli; Huang, Jun; Wu, Pute; Helmers, Matthew J

2014-02-01

The effects of vegetation cover (VC) on runoff and sediment yield were investigated from rainfall simulation experiments in the Loess Plateau of China. Five VCs from 0% to 80% and three different rainfall intensities (I₂.₀, ₁.₅, ₀.₇₅) were implemented. The results indicated that runoff and sediment yields in slopes were significantly affected by I and VC, and when the VC amounted to 40% there occurred obvious benefits of runoff and sediment reductions and then amplitude decreased with the increase of VC. The runoff reduction benefits at I₁.₅ and I₀.₇₅ were much greater than that at I₂.₀, while the sediment reduction benefits had no significant difference among different rainfall intensities. At I₂.₀, the natural grassland slopes with high VC exhibited the characteristics of high runoff but low sediment production. There existed a power function relationship between cumulative runoff and sediment yield. The increase in cumulative sediment yield was less than the increase in cumulative runoff with increasing VC, and the sediment reduction benefit was greater than runoff reduction on natural grassland slopes. The ratio of runoff reduction to sediment reduction can be used as a comprehensive index for assessing the benefits of runoff and sediment reduction in natural grassland. © 2013 Society of Chemical Industry.

Development of a Comprehensive Community Nitrogen Oxide Emissions Reduction Toolkit (CCNERT)

NASA Astrophysics Data System (ADS)

Sung, Yong Hoon

The main objective of this study is to research and develop a simplified tool to estimate energy use in a community and its associated effects on air pollution. This tool is intended to predict the impacts of selected energy conservation options and efficiency programs on emission reduction. It is intended to help local government and their residents understand and manage information collection and the procedures to be used. This study presents a broad overview of the community-wide energy use and NOx emissions inventory process. It also presents various simplified procedures to estimate each sector's energy use. In an effort to better understand community-wide energy use and its associated NOx emissions, the City of College Station, Texas, was selected as a case study community for this research. While one community might successfully reduce the production of NOx emissions by adopting electricity efficiency programs in its buildings, another community might be equally successful by changing the mix of fuel sources used to generate electricity, which is consumed by the community. In yet a third community low NOx automobiles may be mandated. Unfortunately, the impact and cost of one strategy over another changes over time as major sources of pollution are reduced. Therefore, this research proposes to help community planners answer these questions and to assist local communities with their NOx emission reduction plans by developing a Comprehensive Community NOx Emissions Reduction Toolkit (CCNERT). The proposed simplified tool could have a substantial impact on reducing NOx emission by providing decision-makers with a preliminary understanding about the impacts of various energy efficiency programs on emissions reductions. To help decision makers, this study has addressed these issues by providing a general framework for examining how a community's non-renewable energy use leads to NOx emissions, by quantifying each end-user's energy usage and its associated NOx emissions, and by evaluating the environmental benefits of various types of energy saving options.

Impact of comprehensive cardiovascular risk reduction programme on risk factor clustering associated with elevated blood pressure in an Indian industrial population.

PubMed

Jeemon, Panniyammakal; Prabhakaran, Dorairaj; Goenka, Shifalika; Ramakrishnan, Lakshmy; Padmanabhan, Sandosh; Huffman, Mark; Joshi, Prashant; Sivasankaran, Sivasubramonian; Mohan, B V M; Ahmed, F; Ramanathan, Meera; Ahuja, R; Sinha, Nakul; Thankappan, K R; Reddy, K S

2012-04-01

Cardiovascular risk factors clustering associated with blood pressure (BP) has not been studied in the Indian population. This study was aimed at assessing the clustering effect of cardiovascular risk factors with suboptimal BP in Indian population as also the impact of risk reduction interventions. Data from 10543 individuals collected in a nation-wide surveillance programme in India were analysed. The burden of risk factors clustering with blood pressure and coronary heart disease (CHD) was assessed. The impact of a risk reduction programmme on risk factors clustering was prospectively studied in a sub-group. Mean age of participants was 40.9 ± 11.0 yr. A significant linear increase in number of risk factors with increasing blood pressure, irrespective of stratifying using different risk factor thresholds was observed. While hypertension occurred in isolation in 2.6 per cent of the total population, co-existence of hypertension and >3 risk factors was observed in 12.3 per cent population. A comprehensive risk reduction programme significantly reduced the mean number of additional risk factors in the intervention population across the blood pressure groups, while it continued to be high in the control arm without interventions (both within group and between group P<0.001). The proportion of 'low risk phenotype' increased from 13.4 to 19.9 per cent in the intervention population and it was decreased from 27.8 to 10.6 per cent in the control population (P<0.001). The proportion of individuals with hypertension and three more risk factors decreased from 10.6 to 4.7 per cent in the intervention arm while it was increased from 13.3 to 17.8 per cent in the control arm (P<0.001). Our findings showed that cardiovascular risk factors clustered together with elevated blood pressure and a risk reduction programme significantly reduced the risk factors burden.

Assessment on the Benefits from Energy Structure Optimization and Coal-fired Emission Control in Beijing: 1998-2013

NASA Astrophysics Data System (ADS)

Zong, Y.; He, K.; Zhang, Q.; Hong, C.

2016-12-01

Coal has long been an important energy type of Beijing's energy consumption. Since 1998, to improve urban air quality, Beijing has vigorously promoted the structure optimization of energy consumption. Primary measures included the implementation of strict emission standards for coal-fired power plant boilers, subsidized replacement and after-treatment retrofit of coal-fired boilers, the mandatory application of low-sulfur coal, and the accelerated use of natural gas, imported electricity and other clean energy. This work attempts to assess the emission reduction benefits on measures of three sectors, including replacing with clean energy and application of end-of-pipe control technologies in power plants, comprehensive control on coal-fired boilers and residential heating renovation. This study employs the model of Multi-resolution Emission Inventory for China (MEIC) to quantify emission reductions from upfront measures. These control measures have effectively reduced local emissions of major air pollutants in Beijing. The total emissions of PM2.5, PM10, SO2 and NOX from power plants in Beijing are estimated to have reduced 14.5 kt, 23.7 kt, 45.0 kt and 7.6 kt from 1998 to 2013, representing reductions of 86%, 87%, 85% and 16%, respectively. Totally, 14.3 kt, 24.0 kt, 136 kt and 48.7kt of PM2.5, PM10, SO2 and NOX emissions have been mitigated due to the comprehensive control measures on coal-fired boilers from 1998 to 2013. Residential heating renovation projects by replacing coal with electricity in Beijing's conventional old house areas contribute to emission reductions of 630 t, 870 t, 2070 t and 790 t for PM2.5, PM10, SO2 and NOX, respectively.

Research to Support California Greenhouse Gas Reduction Programs

NASA Astrophysics Data System (ADS)

Croes, B. E.; Charrier-Klobas, J. G.; Chen, Y.; Duren, R. M.; Falk, M.; Franco, G.; Gallagher, G.; Huang, A.; Kuwayama, T.; Motallebi, N.; Vijayan, A.; Whetstone, J. R.

2016-12-01

Since the passage of the California Global Warming Solutions Act in 2006, California state agencies have developed comprehensive programs to reduce both long-lived and short-lived climate pollutants. California is already close to achieving its goal of reducing greenhouse (GHG) emissions to 1990 levels by 2020, about a 30% reduction from business as usual. In addition, California has developed strategies to reduce GHG emissions another 40% by 2030, which will put the State on a path to meeting its 2050 goal of an 80% reduction. To support these emission reduction goals, the California Air Resources Board (CARB) and the California Energy Commission have partnered with NASA's Carbon Monitoring System (CMS) program on a comprehensive research program to identify and quantify the various GHG emission source sectors in the state. These include California-specific emission studies and inventories for carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) emission sources; a Statewide GHG Monitoring Network for these pollutants integrated with the Los Angeles Megacities Carbon Project funded by several federal agencies; efforts to verify emission inventories using inversion modeling and other techniques; mobile measurement platforms and flux chambers to measure local and source-specific emissions; and a large-scale statewide methane survey using a tiered monitoring and measurement program, which will include satellite, airborne, and ground-level measurements of the various regions and source sectors in the State. In addition, there are parallel activities focused on black carbon (BC) and fluorinated gases (F-gases) by CARB. This presentation will provide an overview of results from inventory, monitoring, data analysis, and other research efforts on Statewide, regional, and local sources of GHG emissions in California.

76 FR 26682 - Study on Protection of Certain Railroad Risk Reduction Data From Discovery or Use in Litigation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-09

... public relations campaigns but instead serious, comprehensive, and in-depth analyses. In other words... and request for public comment. SUMMARY: In accordance with section 109 of the Rail Safety Improvement Act of 2008 (RSIA), FRA is soliciting public comment on the issue of whether it is in the public...

Abstinence education*

PubMed Central

Zeiler, Alean

2014-01-01

The American College of Pediatricians strongly endorses abstinence-until-marriage sex education and recommends adoption by all school systems in lieu of “comprehensive sex education.” This position is based on “the public health principle of primary prevention—risk avoidance in lieu of risk reduction,” upholding the “human right to the highest attainable standard of health” (Freedman 1995). PMID:25473134

An Assessment of Prison-Based Drug Treatment; Texas' In-Prison Therapeutic Community Program.

ERIC Educational Resources Information Center

Knight, Kevin; Simpson, D. Dwayne; Chatham, Lois R.; Camacho, L. Mabel

1997-01-01

Provides an overview of a comprehensive, prison-based treatment assessment, including a six-month follow-up study. Results show that 80% of the inmates referred to the program graduated. Graduates demonstrated marked reductions in criminal and drug-use activity and had lower relapse and recidivism rates when compared to other parolees. (RJM)

Poverty Diagnostics Using Poor Data: Strengthening the Evidence Base for Pro-Poor Policy Making in Lesotho

ERIC Educational Resources Information Center

May, Julian; Roberts, Benjamin

2005-01-01

Increasingly national statistical agencies are being called upon to provide high quality data on a regular basis, to be used by governments for evidence-based policy development. Poverty Reduction Strategy Papers (PRSPs) give impetus to this, and bring a prerequisite for comprehensive "poverty diagnosis." Often the data that are required…

Self streamlining wind tunnel: Low speed testing and transonic test section design

NASA Technical Reports Server (NTRS)

Wolf, S. W. D.; Goodyer, M. J.

1977-01-01

Comprehensive aerodynamic data on an airfoil section were obtained through a wide range of angles of attack, both stalled and unstalled. Data were gathered using a self streamlining wind tunnel and were compared to results obtained on the same section in a conventional wind tunnel. The reduction of wall interference through streamline was demonstrated.

Transportation. Teacher's Guide and Student Guide. Net Energy Unit. Draft.

ERIC Educational Resources Information Center

Treagust, David F.

This module is intended to increase the students' comprehension of costs, in terms of money and in energy, involved in various modes of transportation. Four main inquiries are covered in the module: (1) money saved by car pooling to school; (2) reductions in fuel consumption possible without car pooling; (3) comparisons of inter-city and urban…

A Review of Multicomponent Interventions to Prevent and Control Tobacco Use among College Students

ERIC Educational Resources Information Center

Rodgers, Kirsten C.

2012-01-01

Objective: Multicomponent tobacco control programs have been implemented at the state and community levels and have led to a reduction in tobacco use. The purpose was to review the public health research literature on tobacco prevention and control programs on college campuses and derive evidence-based implications for comprehensive program…

Discovering Social Inequality: Dutch Educational Research in the Post-War Era

ERIC Educational Resources Information Center

Bakker, Nelleke; Amsing, Hilda T. A.

2012-01-01

Between the 1940s and 1960s across Western Europe a spirit of reform along comprehensive lines manifested itself in secondary education, aiming at a reduction of the existing social inequality of educational chances. These reforms are said to be rooted in new policies and in new approaches in educational studies. This article explores the…

A framework for projecting the potential statewide vehicle miles traveled (VMT) reduction from state-level strategies in California : a National Center for Sustainable Transportation white paper.

DOT National Transportation Integrated Search

2017-03-01

The California Global Warming Solutions Act of 2006 (Assembly Bill 32) created a : comprehensive, multi-year program to reduce greenhouse gas (GHG) emissions in the state to : 80% below 1990 levels by 2050. With the recent passage of Senate Bill 32, ...

A Comprehensive Investigation of Visibility Problems on Highways: Developing Real Time Monitoring and Prediction System for Reduced Visibility and Understanding Traffic and Human Factors Implications

DOT National Transportation Integrated Search

2015-10-01

Visibility is one of the most important impacts weather can have on road systems; weather-related visibility reduction is most often due to fog. Florida is among the top-rated states in the United States with regards to traffic safety problems result...

Causes of maternal mortality decline in Matlab, Bangladesh.

PubMed

Chowdhury, Mahbub Elahi; Ahmed, Anisuddin; Kalim, Nahid; Koblinsky, Marge

2009-04-01

Bangladesh is distinct among developing countries in achieving a low maternal mortality ratio (MMR) of 322 per 100,000 livebirths despite the very low use of skilled care at delivery (13% nationally). This variation has also been observed in Matlab, a rural area in Bangladesh, where longitudinal data on maternal mortality are available since the mid-1970s. The current study investigated the possible causes of the maternal mortality decline in Matlab. The study analyzed 769 maternal deaths and 215,779 pregnancy records from the Health and Demographic Surveillance System (HDSS) and other sources of safe motherhood data in the ICDDR,B and government service areas in Matlab during 1976-2005. The major interventions that took place in both the areas since the early 1980s were the family-planning programme plus safe menstrual regulation services and safe motherhood interventions (midwives for normal delivery in the ICDDR,B service area from the late 1980s and equal access to comprehensive emergency obstetric care [EmOC] in public facilities for women from both the areas). National programmes for social development and empowerment of women through education and microcredit programmes were implemented in both the areas. The quantitative findings were supplemented by a qualitative study by interviewing local community care providers for their change in practices for maternal healthcare over time. After the introduction of the safe motherhood programme, reduction in maternal mortality was higher in the ICDDR,B service area (68.6%) than in the government service area (50.4%) during 1986-1989 and 2001-2005. Reduction in the number of maternal deaths due to the fertility decline was higher in the government service area (30%) than in the ICDDR,B service area (23%) during 1979-2005. In each area, there has been substantial reduction in abortion-related mortality--86.7% and 78.3%--in the ICDDR,B and government service areas respectively. Education of women was a strong predictor of the maternal mortality decline in both the areas. Possible explanations for the maternal mortality decline in Matlab are: better access to comprehensive EmOC services, reduction in the total fertility rate, and improved education of women. To achieve the Millenium Development Goal 5 targets, policies that bring further improved comprehensive EmOC, strengthened family-planning services, and expanded education of females are essential.

Causes of Maternal Mortality Decline in Matlab, Bangladesh

PubMed Central

Ahmed, Anisuddin; Kalim, Nahid; Koblinsky, Marge

2009-01-01

Bangladesh is distinct among developing countries in achieving a low maternal mortality ratio (MMR) of 322 per 100,000 livebirths despite the very low use of skilled care at delivery (13% nationally). This variation has also been observed in Matlab, a rural area in Bangladesh, where longitudinal data on maternal mortality are available since the mid-1970s. The current study investigated the possible causes of the maternal mortality decline in Matlab. The study analyzed 769 maternal deaths and 215,779 pregnancy records from the Health and Demographic Surveillance System (HDSS) and other sources of safe motherhood data in the ICDDR,B and government service areas in Matlab during 1976-2005. The major interventions that took place in both the areas since the early 1980s were the family-planning programme plus safe menstrual regulation services and safe motherhood interventions (midwives for normal delivery in the ICDDR,B service area from the late 1980s and equal access to comprehensive emergency obstetric care [EmOC] in public facilities for women from both the areas). National programmes for social development and empowerment of women through education and microcredit programmes were implemented in both the areas. The quantitative findings were supplemented by a qualitative study by interviewing local community care providers for their change in practices for maternal healthcare over time. After the introduction of the safe motherhood programme, reduction in maternal mortality was higher in the ICDDR,B service area (68.6%) than in the government service area (50.4%) during 1986-1989 and 2001-2005. Reduction in the number of maternal deaths due to the fertility decline was higher in the government service area (30%) than in the ICDDR,B service area (23%) during 1979-2005. In each area, there has been substantial reduction in abortion-related mortality—86.7% and 78.3%—in the ICDDR,B and government service areas respectively. Education of women was a strong predictor of the maternal mortality decline in both the areas. Possible explanations for the maternal mortality decline in Matlab are: better access to comprehensive EmOC services, reduction in the total fertility rate, and improved education of women. To achieve the Millenium Development Goal 5 targets, policies that bring further improved comprehensive EmOC, strengthened family-planning services, and expanded education of females are essential. PMID:19489410

Tobacco Town: Computational Modeling of Policy Options to Reduce Tobacco Retailer Density

PubMed Central

Luke, Douglas A.; Hammond, Ross A.; Combs, Todd; Sorg, Amy; Kasman, Matt; Mack-Crane, Austen; Ribisl, Kurt M.; Henriksen, Lisa

2017-01-01

Objectives To identify the behavioral mechanisms and effects of tobacco control policies designed to reduce tobacco retailer density. Methods We developed the Tobacco Town agent-based simulation model to examine 4 types of retailer reduction policies: (1) random retailer reduction, (2) restriction by type of retailer, (3) limiting proximity of retailers to schools, and (4) limiting proximity of retailers to each other. The model examined the effects of these policies alone and in combination across 4 different types of towns, defined by 2 levels of population density (urban vs suburban) and 2 levels of income (higher vs lower). Results Model results indicated that reduction of retailer density has the potential to decrease accessibility of tobacco products by driving up search and purchase costs. Policy effects varied by town type: proximity policies worked better in dense, urban towns whereas retailer type and random retailer reduction worked better in less-dense, suburban settings. Conclusions Comprehensive retailer density reduction policies have excellent potential to reduce the public health burden of tobacco use in communities. PMID:28398792

Advances in Photocatalytic CO₂ Reduction with Water: A Review.

PubMed

Nahar, Samsun; Zain, M F M; Kadhum, Abdul Amir H; Hasan, Hassimi Abu; Hasan, Md Riad

2017-06-08

In recent years, the increasing level of CO₂ in the atmosphere has not only contributed to global warming but has also triggered considerable interest in photocatalytic reduction of CO₂. The reduction of CO₂ with H₂O using sunlight is an innovative way to solve the current growing environmental challenges. This paper reviews the basic principles of photocatalysis and photocatalytic CO₂ reduction, discusses the measures of the photocatalytic efficiency and summarizes current advances in the exploration of this technology using different types of semiconductor photocatalysts, such as TiO₂ and modified TiO₂, layered-perovskite Ag/ALa₄Ti₄O 15 (A = Ca, Ba, Sr), ferroelectric LiNbO₃, and plasmonic photocatalysts. Visible light harvesting, novel plasmonic photocatalysts offer potential solutions for some of the main drawbacks in this reduction process. Effective plasmonic photocatalysts that have shown reduction activities towards CO₂ with H₂O are highlighted here. Although this technology is still at an embryonic stage, further studies with standard theoretical and comprehensive format are suggested to develop photocatalysts with high production rates and selectivity. Based on the collected results, the immense prospects and opportunities that exist in this technique are also reviewed here.

Between a rock and a hard place: Prescription opioid restrictions in the time of fentanyl and other street drug adulterants.

PubMed

Cheng, Tessa; DeBeck, Kora

2017-09-14

Non-medical prescription opioid use (NMPOU) has increased alarmingly across Canada and resulted in strict prescribing restrictions on opioids. Despite a clear need to reduce opioid prescriptions in response to this crisis, few other policies have been implemented and this singular focus is incongruent with the known characteristics of substance use disorders, negative effects of supply reduction policies, and realities of pain management. Given the recent rise of fentanyl and other dangerous adulterants in street drugs, this commentary argues that a comprehensive response to NMPOU that includes improvements to addiction management and harm-reduction services is urgently needed.

Neurovascular structures of the mandibular angle and condyle: a comprehensive anatomical review.

PubMed

Yang, Hun-Mu; Won, Sung-Yoon; Kim, Hee-Jin; Hu, Kyung-Seok

2015-11-01

Various surgical interventions including esthetic surgery, salivary gland excision, and open reduction of fracture have been performed in the area around the mandibular angle and condyle. This study aimed to comprehensively review the anatomy of the neurovascular structures on the angle and condyle with recent anatomic and clinical research. We provide detailed information about the branching and distributing patterns of the neurovascular structures at the mandibular angle and condyle, with reported data of measurements and proportions from previous anatomical and clinical research. Our report should serve to help practitioners gain a better understanding of the area in order or reduce potential complications during local procedures. Reckless manipulation during mandibular angle reduction could mutilate arterial branches, not only from the facial artery, but also from the external carotid artery. The transverse facial artery and superficial temporal artery could be damaged during approach and incision in the condylar area. The marginal mandibular branch of the facial nerve can be easily damaged during submandibular gland excision or facial rejuvenation treatment. The main trunk of the facial nerve and its upper and lower distinct divisions have been damaged during parotidectomy, rhytidectomy, and open reductions of condylar fractures. By revisiting the information in the present study, surgeons will be able to more accurately prevent procedure-related complications, such as iatrogenic vascular accidents on the mandibular angle and condyle, complete and partial facial palsy, gustatory sweating (Frey syndrome), and traumatic neuroma after parotidectomy.

Reduction of State Victim Compensation Disparities in Disadvantaged Crime Victims Through Active Outreach and Assistance: A Randomized Trial

PubMed Central

Alvidrez, Jennifer; Shumway, Martha; Boccellari, Alicia; Green, Jon Dean; Kelly, Vanessa; Merrill, Gregory

2008-01-01

Objectives. We examined whether providing active outreach and assistance to crime victims as part of comprehensive psychosocial services reduced disparities in access to state compensation funds. Methods. We analyzed data from a randomized trial of injured crime victims (N = 541) and compared outcomes from comprehensive psychosocial services with usual community care. We examined the impact of outreach and assistance on disparities in applying for victim compensation by testing for interactions between victim characteristics and treatment condition in logistic regression analyses. Results. Victims receiving comprehensive services were much more likely to apply for victim compensation than were victims receiving usual care. Comprehensive services decreased disparities associated with younger age, lower levels of education, and homelessness. Conclusions. State-level victim compensation funds are available to help individuals recover physically, psychologically, and financially from crime victimization. However, few crime victims apply for victim compensation, and there are particularly low application rates among young, male, ethnic minority, and physical assault victims. Active outreach and assistance can address disparities in access to victim compensation funds for disadvantaged populations and should be offered more widely to victims of violent crime. PMID:18382004

Stress, stress reduction, and hypertension in African Americans: an updated review.

PubMed Central

Barnes, V.; Schneider, R.; Alexander, C.; Staggers, F.

1997-01-01

This is a comprehensive and integrative review of multiple factors underlying the greater prevalence of hypertension in African Americans compared with whites. Evidence linking stress with hypertension and cardiovascular disease in African Americans is reviewed. A survey of mechanisms of hypertension in African Americans and existing behavioral strategies for the treatment of hypertension is presented. Given that the excess of hypertension may be mediated in part by behavioral factors operating through biological mechanisms, a case is presented for behavioral stress reduction measures. This review of stress reduction techniques especially the Transcendental Mediation program for the treatment of hypertension in African Americans highlights current issues facing the field. New information is provided to help direct future nonpharmacological research and practice in hypertension to prevent morbidity and premature mortality in this underserved population. PMID:9220696

Cost of photovoltaic energy systems as determined by balance-of-system costs

NASA Technical Reports Server (NTRS)

Rosenblum, L.

1978-01-01

The effect of the balance-of-system (BOS), i.e., the total system less the modules, on photo-voltaic energy system costs is discussed for multikilowatt, flat-plate systems. Present BOS costs are in the range of 10 to 16 dollars per peak watt (1978 dollars). BOS costs represent approximately 50% of total system cost. The possibility of future BOS cost reduction is examined. It is concluded that, given the nature of BOS costs and the lack of comprehensive national effort focussed on cost reduction, it is unlikely that BOS costs will decline greatly in the next several years. This prognosis is contrasted with the expectations of the Department of Energy National Photovoltaic Program goals and pending legislation in the Congress which require a BOS cost reduction of an order of magnitude or more by the mid-1980s.

Levels of reduction in van Manen's phenomenological hermeneutic method: an empirical example.

PubMed

Heinonen, Kristiina

2015-05-01

To describe reduction as a method using van Manen's phenomenological hermeneutic research approach. Reduction involves several levels that can be distinguished for their methodological usefulness. Researchers can use reduction in different ways and dimensions for their methodological needs. A study of Finnish multiple-birth families in which open interviews (n=38) were conducted with public health nurses, family care workers and parents of twins. A systematic literature and knowledge review showed there were no articles on multiple-birth families that used van Manen's method. Discussion The phenomena of the 'lifeworlds' of multiple-birth families consist of three core essential themes as told by parents: 'a state of constant vigilance', 'ensuring that they can continue to cope' and 'opportunities to share with other people'. Reduction provides the opportunity to carry out in-depth phenomenological hermeneutic research and understand people's lives. It helps to keep research stages separate but also enables a consolidated view. Social care and healthcare professionals have to hear parents' voices better to comprehensively understand their situation; they need further tools and training to be able to empower parents of twins. This paper adds an empirical example to the discussion of phenomenology, hermeneutic study and reduction as a method. It opens up reduction for researchers to exploit.

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

Zhang, Ping; Van Nostrand, Joy D.; He, Zhili

Cr(VI) is a widespread environmental contaminant that is highly toxic and soluble. Previous work indicated that a one-time amendment of polylactate hydrogen-release compound (HRC) reduced groundwater Cr(VI) concentrations for >3.5 years at a contaminated aquifer; however, microbial communities responsible for Cr(VI) reduction are poorly understood. Here in this study, we hypothesized that HRC amendment would significantly change the composition and structure of groundwater microbial communities, and that the abundance of key functional genes involved in HRC degradation and electron acceptor reduction would increase long-term in response to this slowly degrading, complex substrate. To test these hypotheses, groundwater microbial communities weremore » monitored after HRC amendment for >1 year using a comprehensive functional gene microarray. The results showed that the overall functional composition and structure of groundwater microbial communities underwent sequential shifts after HRC amendment. Particularly, the abundance of functional genes involved in acetate oxidation, denitrification, dissimilatory nitrate reduction, metal reduction, and sulfate reduction significantly increased. The overall community dynamics was significantly correlated with changes in groundwater concentrations of microbial biomass, acetate, NO 3 -, Cr(VI), Fe(II) and SO 4 2-. Finally, our results suggest that HRC amendment primarily stimulated key functional processes associated with HRC degradation and reduction of multiple electron acceptors in the aquifer toward long-term Cr(VI) reduction.« less

The development of a model of culturally responsive science and mathematics teaching

NASA Astrophysics Data System (ADS)

Hernandez, Cecilia M.; Morales, Amanda R.; Shroyer, M. Gail

2013-12-01

This qualitative theoretical study was conducted in response to the current need for an inclusive and comprehensive model to guide the preparation and assessment of teacher candidates for culturally responsive teaching. The process of developing a model of culturally responsive teaching involved three steps: a comprehensive review of the literature; a synthesis of the literature into thematic categories to capture the dispositions and behaviors of culturally responsive teaching; and the piloting of these thematic categories with teacher candidates to validate the usefulness of the categories and to generate specific exemplars of behavior to represent each category. The model of culturally responsive teaching contains five thematic categories: (1) content integration, (2) facilitating knowledge construction, (3) prejudice reduction, (4) social justice, and (5) academic development. The current model is a promising tool for comprehensively defining culturally responsive teaching in the context of teacher education as well as to guide curriculum and assessment changes aimed to increase candidates' culturally responsive knowledge and skills in science and mathematics teaching.

Balancing Accession and Retention. Cost and Productivity Tradeoffs.

DTIC Science & Technology

1983-03-01

Alternative ...’ i :. :- : . - :’: .-- . .:. . ,. , . -.- - - i . . . , . . -. - - .- - - . ’ ’:- LIST OF TABLES Page I Rating groups...for bonus payments and second-term pay are more than offset by reductions in recruiting and training costs and first-term pay. Alternatively , holding...discounted value using a 10 percent discount rate. Costs for AFEES processing and training are taken from the Navy Comprehensive Compensation and Supply

AN EXPERIMENT IN BASIC AIRBORNE ELECTRONICS TRAINING, PART IV-- EFFECT OF REDUCTION IN TRAINING TIME ON FLEET PERFORMANCE. FINAL REPORT.

ERIC Educational Resources Information Center

BALDWIN, ROBERT O.; AND OTHERS

THREE PRECEDING REPORTS PRESENTED THE EFFECTS OF SHORTENING TRAINING TIME IN AVIONICS FUNDAMENTALS AND AVIATION ELECTRONICS TECHNICIAN (RADAR) TRAINING UPON THE FINAL COMPREHENSIVE EXAMINATION IN THESE COURSES AND UPON PERFORMANCE IN A SUBSEQUENT EQUIPMENT COURSE. THIS REPORT COMPARES THE ON THE JOB PERFORMANCE OF GRADUATES FROM FOUR GROUPS…

How We Hear What Is Hardly There: Mechanisms Underlying Compensation for /t/-Reduction in Speech Comprehension

ERIC Educational Resources Information Center

Mitterer, Holger; Yoneyama, Kiyoko; Ernestus, Mirjam

2008-01-01

In four experiments, we investigated how listeners compensate for reduced /t/ in Dutch. Mitterer and Ernestus [Mitterer, H., & Ernestus, M. (2006). "Listeners recover /t/s that speakers lenite: evidence from /t/-lenition in Dutch." "Journal of Phonetics," 34, 73-103] showed that listeners are biased to perceive a /t/ more easily after /s/ than…

Project F. A. S. T.: Facilitating Academic Study Techniques for Handicapped Children. Volume 2. Final Report.

ERIC Educational Resources Information Center

Martin, Clessen J.

Volume 2, the appendix to the final report of Project FAST, consists of prose selections used to study the effects of text reduction techniques on the comprehension and recall of written materials among visually handicapped and hearing impaired subjects. Each selection is presented in various versions such as 10 percent subjective deleted, 20…

Parallel In Situ Screening of Remediation Strategies for Improved Decision Making, Remedial Design, and Cost Savings

DTIC Science & Technology

2012-11-01

vitamin B12. Additionally, a reductant reacts directly with hexavalent chromium to reduce it to the trivalent state. SRS®-M provides a readily...experiments ......................................................................... 27 Figure 8. Hexavalent chromium detected in ISMA effluent post in situ...ground surface cis-DCE cis-dichloroethene CERCLA Comprehensive Environmental Response, Compensation, and Liability Act Cr(VI) hexavalent chromium

Temporomandibular joint dislocation

PubMed Central

Sharma, Naresh Kumar; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal; Singh, Shreya

2015-01-01

Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation. PMID:26668447

Hospital Admissions for Acute Myocardial Infarction, Angina, Stroke, and Asthma After Implementation of Arizona's Comprehensive Statewide Smoking Ban

PubMed Central

Walsh, Michele E.

2011-01-01

Objectives. We examined the impact of Arizona's May 2007 comprehensive statewide smoking ban on hospital admissions for diagnoses for which there is evidence of a causal relationship with secondhand smoke (SHS) exposure (acute myocardial infarction [AMI], angina, stroke, and asthma). Methods. We compared monthly hospital admissions from January 2004 through May 2008 for these primary diagnoses and 4 diagnoses not associated with SHS (appendicitis, kidney stones, acute cholecystitis, and ulcers) for Arizona counties with preexisting county or municipal smoking bans and counties with no previous bans. We attributed reductions in admissions to the statewide ban if they occurred only in diagnoses associated with SHS and if they were larger in counties with no previous bans. We analyzed the data with Poisson regressions, controlling for seasonality and admissions trends. We also estimated cost savings. Results. Statistically significant reductions in hospital admissions were seen for AMI, angina, stroke, and asthma in counties with no previous bans over what was seen in counties with previous bans. No ban variable coefficients were statistically significant for diagnoses not associated with SHS. Conclusions. Arizona's statewide smoking ban decreased hospital admissions for AMI, stroke, asthma, and angina. PMID:20466955

Boundary layer drag reduction research hypotheses derived from bio-inspired surface and recent advanced applications.

PubMed

Luo, Yuehao; Yuan, Lu; Li, Jianhua; Wang, Jianshe

2015-12-01

Nature has supplied the inexhaustible resources for mankind, and at the same time, it has also progressively developed into the school for scientists and engineers. Through more than four billions years of rigorous and stringent evolution, different creatures in nature gradually exhibit their own special and fascinating biological functional surfaces. For example, sharkskin has the potential drag-reducing effect in turbulence, lotus leaf possesses the self-cleaning and anti-foiling function, gecko feet have the controllable super-adhesion surfaces, the flexible skin of dolphin can accelerate its swimming velocity. Great profits of applying biological functional surfaces in daily life, industry, transportation and agriculture have been achieved so far, and much attention from all over the world has been attracted and focused on this field. In this overview, the bio-inspired drag-reducing mechanism derived from sharkskin is explained and explored comprehensively from different aspects, and then the main applications in different fluid engineering are demonstrated in brief. This overview will inevitably improve the comprehension of the drag reduction mechanism of sharkskin surface and better understand the recent applications in fluid engineering. Copyright © 2015 Elsevier Ltd. All rights reserved.

Developing "Personality" Taxonomies: Metatheoretical and Methodological Rationales Underlying Selection Approaches, Methods of Data Generation and Reduction Principles.

PubMed

Uher, Jana

2015-12-01

Taxonomic "personality" models are widely used in research and applied fields. This article applies the Transdisciplinary Philosophy-of-Science Paradigm for Research on Individuals (TPS-Paradigm) to scrutinise the three methodological steps that are required for developing comprehensive "personality" taxonomies: 1) the approaches used to select the phenomena and events to be studied, 2) the methods used to generate data about the selected phenomena and events and 3) the reduction principles used to extract the "most important" individual-specific variations for constructing "personality" taxonomies. Analyses of some currently popular taxonomies reveal frequent mismatches between the researchers' explicit and implicit metatheories about "personality" and the abilities of previous methodologies to capture the particular kinds of phenomena toward which they are targeted. Serious deficiencies that preclude scientific quantifications are identified in standardised questionnaires, psychology's established standard method of investigation. These mismatches and deficiencies derive from the lack of an explicit formulation and critical reflection on the philosophical and metatheoretical assumptions being made by scientists and from the established practice of radically matching the methodological tools to researchers' preconceived ideas and to pre-existing statistical theories rather than to the particular phenomena and individuals under study. These findings raise serious doubts about the ability of previous taxonomies to appropriately and comprehensively reflect the phenomena towards which they are targeted and the structures of individual-specificity occurring in them. The article elaborates and illustrates with empirical examples methodological principles that allow researchers to appropriately meet the metatheoretical requirements and that are suitable for comprehensively exploring individuals' "personality".

A physical workload index to evaluate a safe resident handling program for nursing home personnel.

PubMed

Kurowski, Alicia; Buchholz, Bryan; Punnett, Laura

2014-06-01

The aim of this study was to obtain a comprehensive analysis of the physical workload of clinical staff in long-term care facilities, before and after a safe resident handling program (SRHP). Ergonomic exposures of health care workers include manual handling of patients and many non-neutral postures. A comprehensive assessment requires the integration of loads from these varied exposures into a single metric. The Postures, Activities, Tools, and Handling observational protocol, customized for health care, was used for direct observations of ergonomic exposures in clinical jobs at 12 nursing homes before the SRHP and 3, 12, 24, and 36 months afterward. Average compressive forces on the spine were estimated for observed combinations of body postures and manual handling and then weighted by frequencies of observed time for the combination. These values were summed to obtain a biomechanical index for nursing assistants and nurses across observation periods. The physical workload index (PWI) was much higher for nursing assistants than for nurses and decreased more after 3 years (-24% versus -2.5%). Specifically during resident handling, the PWI for nursing assistants decreased by 41% of baseline value. Spinal loading was higher for nursing assistants than for nurses in long-term care centers. Both job groups experienced reductions in physical loading from the SRHP, especially the nursing assistants and especially while resident handling. The PWI facilitates a comprehensive investigation of physical loading from both manual handling and non-neutral postures. It can be used in any work setting to identify high-risk tasks and determine whether reductions in one exposure are offset by increases in another.

A comprehensive review of the SLMTA literature part 2: Measuring success.

PubMed

Luman, Elizabeth T; Yao, Katy; Nkengasong, John N

2014-01-01

Since its introduction in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has been implemented in 617 laboratories in 47 countries. We completed a systematic review of the published literature on SLMTA. The review consists of two companion papers; this article examines quantitative evidence presented in the publications along with a meta-analysis of selected results. We identified 28 published articles with data from SLMTA implementation. The SLMTA programme was evaluated through audits based on a standard checklist, which is divided into 12 sections corresponding to the 12 Quality System Essentials (QSEs). Several basic service delivery indicators reported by programmes were also examined. Results for various components of the programme were reviewed and summarised; a meta-analysis of QSE results grouped by the three stages of the quality cycle was conducted for 126 laboratories in 12 countries. Global programme data show improved quality in SLMTA laboratories in every country, with average improvements on audit scores of 25 percentage points. Meta-analysis identified Improvement Management as the weakest stage, with internal audit (8%) and occurrence management (16%) showing the lowest scores. Studies documented 19% - 95% reductions in turn-around times, 69% - 93% reductions in specimen rejection rates, 76% - 81% increases in clinician satisfaction rates, 67% - 85% improvements in external quality assessment results, 50% - 66% decreases in nonconformities and 67% increases in staff punctuality. The wide array of results reported provides a comprehensive picture of the SLMTA programme overall, suggesting a substantive impact on provision of quality laboratory services and patient care. These comprehensive results establish a solid data-driven foundation for program improvement and further expansion.

The effect of tobacco control policies on smoking prevalence and smoking-attributable deaths. Findings from the Netherlands SimSmoke Tobacco Control Policy Simulation Model.

PubMed

Nagelhout, Gera E; Levy, David T; Blackman, Kenneth; Currie, Laura; Clancy, Luke; Willemsen, Marc C

2012-02-01

To develop a simulation model projecting the effect of tobacco control policies in the Netherlands on smoking prevalence and smoking-attributable deaths. Netherlands SimSmoke-an adapted version of the SimSmoke simulation model of tobacco control policy-uses population, smoking rates and tobacco control policy data for the Netherlands to predict the effect of seven types of policies: taxes, smoke-free legislation, mass media, advertising bans, health warnings, cessation treatment and youth access policies. Outcome measures were smoking prevalence and smoking-attributable deaths. With a comprehensive set of policies, as recommended by MPOWER, smoking prevalence can be decreased by as much as 21% in the first year, increasing to a 35% reduction in the next 20 years and almost 40% by 30 years. By 2040, 7706 deaths can be averted in that year alone with the stronger set of policies. Without effective tobacco control policies, almost a million lives will be lost to tobacco-related diseases between 2011 and 2040. Of those, 145,000 can be saved with a comprehensive tobacco control package. Smoking prevalence and smoking-attributable deaths in the Netherlands can be reduced substantially through tax increases, smoke-free legislation, high-intensity media campaigns, stronger advertising bans and health warnings, comprehensive cessation treatment and youth access laws. The implementation of these FCTC/MPOWER recommended policies could be expected to show similar or even larger relative reductions in smoking prevalence in other countries which currently have weak policies. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy?

PubMed

Hyseni, Lirije; Elliot-Green, Alex; Lloyd-Williams, Ffion; Kypridemos, Chris; O'Flaherty, Martin; McGill, Rory; Orton, Lois; Bromley, Helen; Cappuccio, Francesco P; Capewell, Simon

2017-01-01

Non-communicable disease (NCD) prevention strategies now prioritise four major risk factors: food, tobacco, alcohol and physical activity. Dietary salt intake remains much higher than recommended, increasing blood pressure, cardiovascular disease and stomach cancer. Substantial reductions in salt intake are therefore urgently needed. However, the debate continues about the most effective approaches. To inform future prevention programmes, we systematically reviewed the evidence on the effectiveness of possible salt reduction interventions. We further compared "downstream, agentic" approaches targeting individuals with "upstream, structural" policy-based population strategies. We searched six electronic databases (CDSR, CRD, MEDLINE, SCI, SCOPUS and the Campbell Library) using a pre-piloted search strategy focussing on the effectiveness of population interventions to reduce salt intake. Retrieved papers were independently screened, appraised and graded for quality by two researchers. To facilitate comparisons between the interventions, the extracted data were categorised using nine stages along the agentic/structural continuum, from "downstream": dietary counselling (for individuals, worksites or communities), through media campaigns, nutrition labelling, voluntary and mandatory reformulation, to the most "upstream" regulatory and fiscal interventions, and comprehensive strategies involving multiple components. After screening 2,526 candidate papers, 70 were included in this systematic review (49 empirical studies and 21 modelling studies). Some papers described several interventions. Quality was variable. Multi-component strategies involving both upstream and downstream interventions, generally achieved the biggest reductions in salt consumption across an entire population, most notably 4g/day in Finland and Japan, 3g/day in Turkey and 1.3g/day recently in the UK. Mandatory reformulation alone could achieve a reduction of approximately 1.45g/day (three separate studies), followed by voluntary reformulation (-0.8g/day), school interventions (-0.7g/day), short term dietary advice (-0.6g/day) and nutrition labelling (-0.4g/day), but each with a wide range. Tax and community based counselling could, each typically reduce salt intake by 0.3g/day, whilst even smaller population benefits were derived from health education media campaigns (-0.1g/day). Worksite interventions achieved an increase in intake (+0.5g/day), however, with a very wide range. Long term dietary advice could achieve a -2g/day reduction under optimal research trial conditions; however, smaller reductions might be anticipated in unselected individuals. Comprehensive strategies involving multiple components (reformulation, food labelling and media campaigns) and "upstream" population-wide policies such as mandatory reformulation generally appear to achieve larger reductions in population-wide salt consumption than "downstream", individually focussed interventions. This 'effectiveness hierarchy' might deserve greater emphasis in future NCD prevention strategies.

Moving from Outsider to Insider: Peer Status and Partnerships between Electricity Utilities and Residential Consumers

PubMed Central

Morris, Peter; Buys, Laurie; Vine, Desley

2014-01-01

An electricity demand reduction project based on comprehensive residential consumer engagement was established within an Australian community in 2008. By 2011, both the peak demand and grid supplied electricity consumption had decreased to below pre-intervention levels. This case study research explored the relationship developed between the utility, community and individual consumer from the residential customer perspective through qualitative research of 22 residential households. It is proposed that an energy utility can be highly successful at peak demand reduction by becoming a community member and a peer to residential consumers and developing the necessary trust, access, influence and partnership required to create the responsive environment to change. A peer-community approach could provide policymakers with a pathway for implementing pro-environmental behaviour for low carbon communities, as well as peak demand reduction, thereby addressing government emission targets while limiting the cost of living increases from infrastructure expenditure. PMID:24979234

Moving from outsider to insider: peer status and partnerships between electricity utilities and residential consumers.

PubMed

Morris, Peter; Buys, Laurie; Vine, Desley

2014-01-01

An electricity demand reduction project based on comprehensive residential consumer engagement was established within an Australian community in 2008. By 2011, both the peak demand and grid supplied electricity consumption had decreased to below pre-intervention levels. This case study research explored the relationship developed between the utility, community and individual consumer from the residential customer perspective through qualitative research of 22 residential households. It is proposed that an energy utility can be highly successful at peak demand reduction by becoming a community member and a peer to residential consumers and developing the necessary trust, access, influence and partnership required to create the responsive environment to change. A peer-community approach could provide policymakers with a pathway for implementing pro-environmental behaviour for low carbon communities, as well as peak demand reduction, thereby addressing government emission targets while limiting the cost of living increases from infrastructure expenditure.

Heavy Class Helicopter Fuselage Model Drag Reduction by Active Flow Control Systems

NASA Astrophysics Data System (ADS)

De Gregorio, F.

2017-08-01

A comprehensive experimental investigation of helicopter blunt fuselage drag reduction using active flow control is being carried out within the European Clean Sky program. The objective is to demonstrate the capability of several active flow technologies to decrease fuselage drag by alleviating the flow separation occurring in the rear area of some helicopters. The work is performed on a simplified blunt fuselage at model-scale. Two different flow control actuators are considered for evaluation: steady blowing, unsteady blowing (or pulsed jets). Laboratory tests of each individual actuator are first performed to assess their performance and properties. The fuselage model is then equipped with these actuators distributed in 3 slots located on the ramp bottom edge. This paper addresses the promising results obtained during the wind-tunnel campaign, since significant drag reductions are achieved for a wide range of fuselage angles of attack and yaw angles without detriment of the other aerodynamic characteristics.

Advanced air revitalization system modeling and testing

NASA Technical Reports Server (NTRS)

Dall-Baumann, Liese; Jeng, Frank; Christian, Steve; Edeer, Marybeth; Lin, Chin

1990-01-01

To support manned lunar and Martian exploration, an extensive evaluation of air revitalization subsystems (ARS) is being conducted. The major operations under study include carbon dioxide removal and reduction; oxygen and nitrogen production, storage, and distribution; humidity and temperature control; and trace contaminant control. A comprehensive analysis program based on a generalized block flow model was developed to facilitate the evaluation of various processes and their interaction. ASPEN PLUS was used in modelling carbon dioxide removal and reduction. Several life support test stands were developed to test new and existing technologies for their potential applicability in space. The goal was to identify processes which use compact, lightweight equipment and maximize the recovery of oxygen and water. The carbon dioxide removal test stands include solid amine/vacuum desorption (SAVD), regenerative silver oxide chemisorption, and electrochemical carbon dioxide concentration (EDC). Membrane-based carbon dioxide removal and humidity control, catalytic reduction of carbon dioxide, and catalytic oxidation of trace contaminants were also investigated.

Maximizing your Process Improvement ROI through Harmonization

DTIC Science & Technology

2008-03-01

ISO 12207 ) provide comprehensive guidance on what system and software engineering processes are needed. The frameworks of Six Sigma provide specific...reductions. Their veloci-Q Enterprise integrated system, includes ISO 9001, CMM, P-CMM, TL9000, British Standard 7799, and Six Sigma. They estimate a 30...at their discretion. And, they chose to blend process maturity models and ISO standards to support their objective regarding the establishment of

Ecological consequences of alternative fuel reduction treatments in seasonally dry forests: the national fire and fire surrogate study

Treesearch

J.D. McIver; C.J. Fettig

2010-01-01

This special issue of Forest Science features the national Fire and Fire Surrogate study (FFS), a niultisite, multivariate research project that evaluates the ecological consequences of prescribed fire and its mechanical surrogates in seasonally dry forests of the United States. The need for a comprehensive national FFS study stemmed from concern that information on...

Science You Can Use Bulletin: Revisiting disturbance: A new guide for keeping dry mixed conifer forests healthy through fuel management

Treesearch

Sue Miller; Theresa Jain; Mike A. Battaglia; Han-Sup Han; Russell T. Graham; Christopher R. Keyes; Jeremy S. Fried; Jonathan E. Sandquist

2014-01-01

Planning for hazardous fuels reduction can be challenging, given that land managers must balance multiple resource objectives. To help managers with planning and implementing fuel treatments, the Rocky Mountain Research Station, with support from the Joint Fire Science Program, has published A Comprehensive Guide to Fuel Management Practices for Dry Mixed Conifer...

Relative Utility of Selected Software Requirement Metrics

DTIC Science & Technology

1991-12-01

testing . They can also help in deciding if and how to use complexity reduction techniques. In summary, requirement metrics can be useful because they...answer items in a test instrument. In order to differentiate between misinterpretation and comprehension, the measurement technique must be able to...effectively test a requirement, it is verifiable. Ramamoorthy and others have proposed requirements complexity metrics that can be used to infer the

Recent Developments in U.S. Engine Noise Reduction Research

NASA Technical Reports Server (NTRS)

Bridges, James; Envia, Edmane; Huff, Dennis

2001-01-01

Aircraft engine noise research in the United States has made considerable progress over the past 10 years for both subsonic and supersonic flight applications. The Advanced Subsonic Technology (AST) Noise Reduction Program started in 1994 and will be completed in 2001 without major changes to program plans and funding levels. As a result, significant progress has been made toward the goal of reducing engine source noise by 6 EPNdB (Effective Perceived Noise level in decibels). This paper will summarize some of the significant accomplishments from the subsonic engine noise research performed over the past 10 years. The review is by no means comprehensive and only represents a sample of major accomplishments.

Airframe self-noise: Four years of research. [aircraft noise reduction for commercial aircraft

NASA Technical Reports Server (NTRS)

Hardin, J. C.

1976-01-01

A critical assessment of the state of the art in airframe self-noise is presented. Full-scale data on the intensity, spectra and directivity of this noise source are evaluated in the light of the comprehensive theory developed by Ffowcs-Williams and Hawkins. Vibration of panels on commercial aircraft is identified as a possible additional source of airframe noise. The present understanding and methods for prediction of other component sources - airfoils, struts, and cavities - are discussed, and areas for further research as well as potential methods for airframe noise reduction are identified. Finally, the various experimental methods which have been developed for airframe noise research are discussed and sample results are presented.

AstroNavigation: Freely-available Online Instruction for Performing a Sight Reduction

NASA Astrophysics Data System (ADS)

Gessner Stewart, Susan; Grundstrom, Erika; Caudel, Dave

2015-08-01

A reliable method of obtaining your geographic location from observations of celestial bodies is globally available. This online learning module, developed through a collaboration between Vanderbilt University and the U.S. Naval Observatory, serves to address the need for freely-available comprehensive instruction in celestial navigation online. Specifically targeted are the steps of preforming a sight reduction to obtain a terrestrial position using this technique. Difficult concepts such as plotting on a navigational chart and the complexities of using navigation publications are facilitated through this online content delivery, rooted in effective course design principles. There is good potential in using celestial navigation as a tool for stimulating interest in astronomy given its resourcefulness and accessibility.

Safety evaluation methodology for advanced coal extraction systems

NASA Technical Reports Server (NTRS)

Zimmerman, W. F.

1981-01-01

Qualitative and quantitative evaluation methods for coal extraction systems were developed. The analysis examines the soundness of the design, whether or not the major hazards have been eliminated or reduced, and how the reduction would be accomplished. The quantitative methodology establishes the approximate impact of hazards on injury levels. The results are weighted by peculiar geological elements, specialized safety training, peculiar mine environmental aspects, and reductions in labor force. The outcome is compared with injury level requirements based on similar, safer industries to get a measure of the new system's success in reducing injuries. This approach provides a more detailed and comprehensive analysis of hazards and their effects than existing safety analyses.

Research on effect of China’s energy saving policy of phase-out incandescent lamps

NASA Astrophysics Data System (ADS)

Ding, Qing; Zhao, Yuejin; Liang, Xiuying; Lin, Ling

2017-11-01

China’s energy saving policy of phase-out of incandescent lamps have been introduced and a comprehensive evaluation framework has been put forward. The impact of the implementation of the policy on manufacturing enterprises and places of sale, lighting industry and domestic and foreign markets, as well as the effect of energy conservation and emission reduction have been analyzed from micro, meso and macro layers. The research results show that, under the guidance of the policy, the orderly product mix transformation has been seen in incandescent lamp manufacturing enterprises, incandescent lamps gradually exit the Chinese mainstream lighting product market, and the energy conservation and emission reduction effect is remarkable.

Mechanism of sodium chloride in promoting reduction of high-magnesium low-nickel oxide ore

PubMed Central

Zhou, Shiwei; Wei, Yonggang; Li, Bo; Wang, Hua; Ma, Baozhong; Wang, Chengyan

2016-01-01

Sodium chloride has been proved that it is an effective promoter for the reduction of high-magnesium, low-nickel oxide ore. The aim of current work is to clarify the promotion behavior of sodium chloride in the roasting reduction process. The influence of moisture on the reduction of ore in the presence of sodium chloride is studied to get clear comprehension of promotion process. In the presence of moisture, the HCl is produced by pyrohydrolysis of sodium chloride for chlorinating nickel and iron oxides, moreover, interactions between metallic oxides and sodium chloride are also a way for chlorination at high temperature (>802 °C); subsequently, the metal chloride would be reduced by reductant. In the absence of moisture, the magnetic separation results show that the recoveries of iron and nickel have a significant increase; moreover, olivine structure would be destroyed gradually with the increase of roasting temperature in the action of sodium chloride, and the sodium chloride existed in high-magnesium, low-nickel oxide ore could make the NiO isolate from NiO-bearing minerals. The NiO reacts with Fe2O3 at high temperature to form NiFe2O4, which is conductive to the formation of Ni-Fe alloy during the reduction process. PMID:27374991

Mechanism of sodium chloride in promoting reduction of high-magnesium low-nickel oxide ore.

PubMed

Zhou, Shiwei; Wei, Yonggang; Li, Bo; Wang, Hua; Ma, Baozhong; Wang, Chengyan

2016-07-04

Sodium chloride has been proved that it is an effective promoter for the reduction of high-magnesium, low-nickel oxide ore. The aim of current work is to clarify the promotion behavior of sodium chloride in the roasting reduction process. The influence of moisture on the reduction of ore in the presence of sodium chloride is studied to get clear comprehension of promotion process. In the presence of moisture, the HCl is produced by pyrohydrolysis of sodium chloride for chlorinating nickel and iron oxides, moreover, interactions between metallic oxides and sodium chloride are also a way for chlorination at high temperature (>802 °C); subsequently, the metal chloride would be reduced by reductant. In the absence of moisture, the magnetic separation results show that the recoveries of iron and nickel have a significant increase; moreover, olivine structure would be destroyed gradually with the increase of roasting temperature in the action of sodium chloride, and the sodium chloride existed in high-magnesium, low-nickel oxide ore could make the NiO isolate from NiO-bearing minerals. The NiO reacts with Fe2O3 at high temperature to form NiFe2O4, which is conductive to the formation of Ni-Fe alloy during the reduction process.

Advances in Photocatalytic CO2 Reduction with Water: A Review

PubMed Central

Nahar, Samsun; Zain, M. F. M.; Kadhum, Abdul Amir H.; Hasan, Hassimi Abu; Hasan, Md. Riad

2017-01-01

In recent years, the increasing level of CO2 in the atmosphere has not only contributed to global warming but has also triggered considerable interest in photocatalytic reduction of CO2. The reduction of CO2 with H2O using sunlight is an innovative way to solve the current growing environmental challenges. This paper reviews the basic principles of photocatalysis and photocatalytic CO2 reduction, discusses the measures of the photocatalytic efficiency and summarizes current advances in the exploration of this technology using different types of semiconductor photocatalysts, such as TiO2 and modified TiO2, layered-perovskite Ag/ALa4Ti4O15 (A = Ca, Ba, Sr), ferroelectric LiNbO3, and plasmonic photocatalysts. Visible light harvesting, novel plasmonic photocatalysts offer potential solutions for some of the main drawbacks in this reduction process. Effective plasmonic photocatalysts that have shown reduction activities towards CO2 with H2O are highlighted here. Although this technology is still at an embryonic stage, further studies with standard theoretical and comprehensive format are suggested to develop photocatalysts with high production rates and selectivity. Based on the collected results, the immense prospects and opportunities that exist in this technique are also reviewed here. PMID:28772988

Unpacking commercial sector opposition to European smoke-free policy: lack of unity, ‘fear of association’ and harm reduction debates

PubMed Central

Weishaar, Heide; Amos, Amanda; Collin, Jeff

2016-01-01

Objective Tobacco companies have made extensive efforts to build alliances against comprehensive smoke-free legislation. This article analyses the interaction between actors who opposed the development of the European Council Recommendation on smoke-free environments. Methods Drawing on data from 200 policy documents and 32 semistructured interviews and using qualitative textual analysis and organisational network analysis, opponents’ positions on, and responses to, the policy initiative, strategies to oppose the policy, and efforts to build alliances were investigated. Results The non-binding nature of the policy, scientific evidence and clear political will to adopt EU-wide measures combined to limit the intensity of commercial sector opposition to the comprehensive EU smoke-free policy. Most tobacco companies, led by the Confederation of European Community Cigarette Manufacturers (CECCM), voiced reservations against the proposal, criticised the policy process and fought flanking measures on product regulation. However, some companies focused on instigating harm reduction debates. These divergent approaches and the reluctance of other commercial actors to demonstrate solidarity with the tobacco sector prevented the establishment of a cohesive commercial sector alliance. Conclusions The comparatively limited opposition to EU smoke-free policy contrasts with previous accounts of tobacco industry resistance to tobacco control. While context-specific factors can partially explain these differences, the paper indicates that the sector's diminished credibility and lack of unity hampered political engagement and alliance building. Industry efforts to emphasise the benefits of smokeless tobacco during smoke-free policy debates highlight the potential of harm reduction as a gateway for tobacco companies to re-enter the political arena. PMID:26055268

Impact of tobacco control policies on adolescent smoking: findings from the Global Youth Tobacco Survey in Taiwan.

PubMed

Huang, Song-Lih; Lin, I-Feng; Chen, Chuan-Yu; Tsai, Tzu-I

2013-10-01

To assess the impact of a set of comprehensive tobacco control policies implemented in Taiwan in 2009, including extensive smoke-free policy, advertisement ban, pictorial warning and price increase, on adolescent smoking prevalence. Five waves of cross-sectional surveys. Taiwan, 2004-11. Nationally representative sample of junior high schools aged 13-15 years, in a biennial survey, total sample size 101,100. Core questionnaire of the Global Youth Tobacco Survey, including ever smoking, 30-day smoking and number of cigarettes smoked. The magnitude of prevalence change before and after the 2009 policy implementation was quantified by adjusted odds ratios estimated by piecewise logistic regression models. The 30-day smoking prevalence demonstrated an upward trend [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.02-1.10] between 2004 and 2008. Significant decline in 30-day smoking prevalence after the 2009 law implementation was observed (OR = 0.84, 95% CI = 0.71-0.99). Those living in non-city areas demonstrated a greater magnitude of change. In addition to changes in prevalence, we observed some delay in the age starting smoking, reduction in smokers who smoke fewer than one cigarette per day, and decrease in smokers who did not buy cigarettes. The decline in smoking prevalence was contributed primarily by the reduction in experimenters. The comprehensive tobacco control programme introduced in Taiwan in 2009 was associated with a reduction in adolescent smoking, particularly among those in earlier stages of smoking and those who resided in non-city areas. © 2013 Society for the Study of Addiction.

A strategy for selecting sexual partners believed to pose little/no risks for HIV: serosorting and its implications for HIV transmission.

PubMed

Eaton, Lisa A; Kalichman, Seth C; O'Connell, Daniel A; Karchner, William D

2009-10-01

A common HIV/AIDS risk reduction strategy among men who have sex with men (MSM) is to limit their unprotected sex partners to those who are of the same HIV status, a practice referred to as serosorting. Decisions to serosort for HIV risk reduction are based on personal impressions and beliefs, and there is limited guidance offered on this community derived strategy from public health services. This paper reviews research on serosorting for HIV risk reduction and offers an evidence-based approach to serosorting guidance. Following a comprehensive electronic and manual literature search, we reviewed 51 studies relating to the implications of serosorting. Studies showed that HIV negative MSM who select partners based on HIV status are inadvertently placing themselves at risk for HIV. Infrequent HIV testing, lack of HIV status disclosure, co-occurring sexually transmitted infections, and acute HIV infection impede the potential protective benefits of serosorting. Public health messages should continue to encourage reductions in numbers of sexual partners and increases in condom use. Risk reduction messages should also highlight the limitations of relying on one's own and partner's HIV status in making sexual risk decisions.

Reduction of capsule endoscopy reading times by unsupervised image mining.

PubMed

Iakovidis, D K; Tsevas, S; Polydorou, A

2010-09-01

The screening of the small intestine has become painless and easy with wireless capsule endoscopy (WCE) that is a revolutionary, relatively non-invasive imaging technique performed by a wireless swallowable endoscopic capsule transmitting thousands of video frames per examination. The average time required for the visual inspection of a full 8-h WCE video ranges from 45 to 120min, depending on the experience of the examiner. In this paper, we propose a novel approach to WCE reading time reduction by unsupervised mining of video frames. The proposed methodology is based on a data reduction algorithm which is applied according to a novel scheme for the extraction of representative video frames from a full length WCE video. It can be used either as a video summarization or as a video bookmarking tool, providing the comparative advantage of being general, unbounded by the finiteness of a training set. The number of frames extracted is controlled by a parameter that can be tuned automatically. Comprehensive experiments on real WCE videos indicate that a significant reduction in the reading times is feasible. In the case of the WCE videos used this reduction reached 85% without any loss of abnormalities.

ANP system activity predicts variability of fat mass reduction and insulin sensitivity during weight loss.

PubMed

Brachs, Maria; Wiegand, Susanna; Leupelt, Verena; Ernert, Andrea; Kintscher, Ulrich; Jumpertz von Schwarzenberg, Reiner; Decker, Anne-Marie; Bobbert, Thomas; Hübner, Norbert; Chen, Wei; Krude, Heiko; Spranger, Joachim; Mai, Knut

2016-06-01

In weight loss trials, a considerable inter-individual variability in reduction of fat mass and changes of insulin resistance is observed, even under standardized study conditions. The underlying mechanisms are not well understood. Given the metabolic properties of the atrial natriuretic peptide (ANP) system, we hypothesized that ANP signaling might be involved in this phenomenon by changes of ANP secretion or receptor balance. Therefore, we investigated the impact of systemic, adipose and myocellular ANP system on metabolic and anthropometric improvements during weight loss. We comprehensively investigated 143 subjects (31 male, 112 female) before and after a 3 month-standardized weight loss program. The time course of BMI, fat mass, insulin sensitivity, circulating mid-regional proANP (MR-proANP) levels as well as adipose and myocellular natriuretic receptor A (NPR-A) and C (NPR-C) mRNA expression were investigated. BMI decreased by -12.6±3.7%. This was accompanied by a remarkable decrease of adipose NPR-C expression (1005.0±488.4 vs. 556.7±465.6; p<0.001) as well as a tendency towards increased adipose NPR-A expression (4644.7±946.8 vs. 4877.6±869.8; p=0.051). Weight loss induced changes in NPR-C (ΔNPR-C) was linked to relative reduction of total fat mass (ΔFM) (r=0.281; p<0.05), reduction of BMI (r=0.277; p<0.01), and increase of free fatty acids (ΔFFA) (r=-0.258; p<0.05). Basal NPR-C expression and weight loss induced ΔNPR-C independently explained 22.7% of ΔFM. In addition, ΔMR-proANP was independently associated with improvement of insulin sensitivity (standardized ß=0.246, p<0.01). ANP receptor expression predicted the degree of weight loss induced fat mass reduction. Our comprehensive human data support that peripheral ANP signalling is involved in control of adipose tissue plasticity and function during weight loss. (Funded by the Deutsche Forschungsgemeinschaft (KFO281/2), the Berlin Institute of Health (BIH) and the German Centre for Cardiovascular Research (DZHK/BMBF); ClinicalTrials.gov number: NCT00850629). Copyright © 2016 Elsevier Inc. All rights reserved.

Effectiveness of comprehensive fixed appliance treatment used with the Forsus Fatigue Resistant Device in Class II patients.

PubMed

Franchi, Lorenzo; Alvetro, Lisa; Giuntini, Veronica; Masucci, Caterina; Defraia, Efisio; Baccetti, Tiziano

2011-07-01

To assess the dental, skeletal, and soft tissue effects of comprehensive fixed appliance treatment combined with the Forsus Fatigue Resistant Device (FRD) in Class II patients. Thirty-two Class II patients (mean age 12.7 ± 1.2 years) were treated consecutively with the FRD protocol and compared with a matched sample of 27 untreated Class II subjects (mean age 12.8 ± 1.3 years). Lateral cephalograms were taken before therapy and at the completion of comprehensive therapy. The mean duration of comprehensive treatment was 2.4 ± 0.4 years. Statistical comparisons were carried out with the Student's t-test (P < .05). The success rate was 87.5%. The FRD group showed a significant restraint in the sagittal skeletal position of the maxilla (also at the soft tissue level), a significant increase in mandibular length, and a significant improvement in maxillo-mandibular sagittal skeletal relationships. The treated group exhibited a significant reduction in overjet and a significant increase in molar relationship. The lower incisors were significantly proclined and intruded, while the lower first molars moved significantly in a mesial and vertical direction. The FRD protocol is effective in correcting Class II malocclusion with a combination of skeletal (mainly maxillary) and dentoalveolar (mainly mandibular) modifications.

Mechanisms underlying syntactic comprehension deficits in vascular aphasia: new evidence from self-paced listening.

PubMed

Caplan, David; Michaud, Jennifer; Hufford, Rebecca

2015-01-01

Sixty-one people with aphasia (pwa) and 41 matched controls were tested for the ability to understand sentences that required the ability to process particular syntactic elements and assign particular syntactic structures. Participants paced themselves word-by-word through 20 examples of 11 spoken sentence types and indicated which of two pictures corresponded to the meaning of each sentence. Sentences were developed in pairs such that comprehension of the experimental version of a pair required an aspect of syntactic processing not required in the corresponding baseline sentence. The need for the syntactic operations required only in the experimental version was triggered at a "critical word" in the experimental sentence. Listening times for critical words in experimental sentences were compared to those for corresponding words in the corresponding baseline sentences. The results were consistent with several models of syntactic comprehension deficits in pwa: resource reduction, slowed lexical and/or syntactic processing, abnormal susceptibility to interference from thematic roles generated non-syntactically. They suggest that a previously unidentified disturbance limiting the duration of parsing and interpretation may lead to these deficits, and that this mechanism may lead to structure-specific deficits in pwa. The results thus point to more than one mechanism underlying syntactic comprehension disorders both across and within pwa.

Place and Policy: Secondhand Smoke Exposure in Bars and Restaurants.

PubMed

Buettner-Schmidt, Kelly; Boursaw, Blake; Lobo, Marie L

2018-06-04

Rural populations have been identified as having tobacco use disparities, with contributing factors including less demand for policy change than in urban areas, resulting in higher age-adjusted death rates related to tobacco use. In 2012, the rural state of North Dakota enacted a statewide comprehensive law requiring all bars and restaurants to be smoke-free. The purpose of this longitudinal study, performed in three phases, was to assess the continued effects of a statewide comprehensive smoke-free law in a primarily rural state, using a stratified random sample. Particulate matter and compliance indicators were assessed in restaurants and bars 21 months after enactment of the comprehensive law. Results were compared with the findings from the Phase 1 and Phase 2 samples, in which venues were assessed before passage of the law and approximately 3 months after enactment, respectively. The comprehensive, statewide, smoke-free law led to immediate, sustained, and substantial reductions in secondhand smoke and eliminated previous significant disparities in secondhand smoke exposure in rural communities. Although indoor smoke-free compliance with the law was generally high, compliance in required outdoor smoke-free areas was low. Compliance with signage requirements, both indoors and outdoors, was low. The comprehensive statewide smoke-free law created a just distribution of smoke-free laws statewide, resulting in increased protection of rural populations from secondhand smoke. Targeted public health interventions to address compliance may reduce secondhand smoke levels in outlier venues that continue to have high levels of secondhand smoke.

A comprehensive review of the SLMTA literature part 2: Measuring success

PubMed Central

Yao, Katy; Nkengasong, John N.

2014-01-01

Background Since its introduction in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has been implemented in 617 laboratories in 47 countries. Objective We completed a systematic review of the published literature on SLMTA. The review consists of two companion papers; this article examines quantitative evidence presented in the publications along with a meta-analysis of selected results. Methods We identified 28 published articles with data from SLMTA implementation. The SLMTA programme was evaluated through audits based on a standard checklist, which is divided into 12 sections corresponding to the 12 Quality System Essentials (QSEs). Several basic service delivery indicators reported by programmes were also examined. Results for various components of the programme were reviewed and summarised; a meta-analysis of QSE results grouped by the three stages of the quality cycle was conducted for 126 laboratories in 12 countries. Results Global programme data show improved quality in SLMTA laboratories in every country, with average improvements on audit scores of 25 percentage points. Meta-analysis identified Improvement Management as the weakest stage, with internal audit (8%) and occurrence management (16%) showing the lowest scores. Studies documented 19% – 95% reductions in turn-around times, 69% – 93% reductions in specimen rejection rates, 76% – 81% increases in clinician satisfaction rates, 67% – 85% improvements in external quality assessment results, 50% – 66% decreases in nonconformities and 67% increases in staff punctuality. Conclusions The wide array of results reported provides a comprehensive picture of the SLMTA programme overall, suggesting a substantive impact on provision of quality laboratory services and patient care. These comprehensive results establish a solid data-driven foundation for program improvement and further expansion. PMID:29043201

Enhancing Cardiac Rehabilitation With Stress Management Training: A Randomized Clinical Efficacy Trial

PubMed Central

Blumenthal, James A.; Sherwood, Andrew; Smith, Patrick J.; Watkins, Lana; Mabe, Stephanie; Kraus, William E.; Ingle, Krista; Miller, Paula; Hinderliter, Alan

2016-01-01

Background Cardiac rehabilitation (CR) is the standard of care for patients with coronary heart disease (CHD). Despite considerable epidemiologic evidence that high stress is associated with worse health outcomes, stress management training (SMT) is not included routinely as a component of CR. Methods and Results 151 outpatients with CHD aged 36 to 84 years were randomized to 12-weeks of comprehensive CR or comprehensive CR combined with SMT (CR+SMT), with assessments of stress and CHD biomarkers obtained before and after treatment. A matched sample of CR-eligible patients who did not receive CR comprised a No-CR comparison group. All participants were followed for up to 5.3 years (median = 3.2 years) for clinical events. Patients randomized to CR+SMT exhibited greater reductions in composite stress levels compared with those randomized to CR alone (P = 0.022), an effect that was driven primarily by improvements in anxiety, distress, and perceived stress. Both CR groups achieved significant, and comparable, improvements in CHD biomarkers. Participants in the CR+SMT group exhibited lower rates of clinical events compared with CR alone (18% vs. 33%, HR = 0.49 [0.25, 0.95], P = 0.035) and both CR groups had lower event rates compared to the No-CR group (47%, HR = 0.44 [0.27, 0.71], P < .001). Conclusions CR enhanced by SMT produced significant reductions in stress and greater improvements in medical outcomes compared with standard CR. Our findings indicate that SMT may provide incremental benefit when combined with comprehensive CR and suggest that SMT should be incorporated routinely into CR. Clinical Trial Registration Information www.Clinicaltrials.gov. Identifier: NCT00981253. PMID:27045127

Development and Clinical Assessment of a Comprehensive Product for Pigmentation Control in Multiple Ethnic Populations.

PubMed

Makino, Elizabeth T; Kadoya, Kuniko; Sigler, Monya L; Hino, Peter D; Mehta, Rahul C

2016-12-01

Pigmentary changes in people of different ethnic origins are controlled by slight variations in key biological pathways leading to different outcomes from the same treatment. It is important to develop and test products for desired outcomes in varying ethnic populations. To develop a comprehensive product (LYT2) that affects all major biological pathways controlling pigmentation and test for clinical efficacy and safety in different ethnic populations. A thorough analysis of biological pathways was used to identify ingredient combinations for LYT2 that provided optimal melanin reduction in a 3-D skin model. Expression of four key genes for melanogenesis, TYR, TYRP-1, DCT, and MITF was analyzed by qPCR. Clinical study was conducted to compare the efficacy and tolerability of LYT2 against 4% hydroquinone (HQ). Average melanin suppression by LYT2 in 7 independent experiments was 45%. All four key genes show significant down- regulation of expression. LYT2 provided statistically significant reductions in mean overall hyperpigmentation grades as early as week 2 compared to baseline, with continued significant improvements through week 12 in all ethnic groups tested. We have successfully combined management of 6 categories of pathways related to melanogenesis: melanocyte activation, melanosome development, melanin production, melanin distribution, keratinocyte turnover, and barrier function to create a comprehensive HQ-free product. The outcome clearly shows greater pigmentation control with LYT2 compared to other HQ-free products in skin tissue models and earlier control in clinical studies compared to 4% HQ. Clinical study shows pigmentation control benefits of LYT2 in people of Caucasian, Hispanic, and African ethnic origins. J Drugs Dermatol. 2016;15(12):1562-1570.

Waste reduction plan for The Oak Ridge National Laboratory

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

Schultz, R.M.

1990-04-01

The Oak Ridge National Laboratory (ORNL) is a multipurpose Research and Development (R D) facility. These R D activities generate numerous small waste streams. Waste minimization is defined as any action that minimizes the volume or toxicity of waste by avoiding its generation or recycling. This is accomplished by material substitution, changes to processes, or recycling wastes for reuse. Waste reduction is defined as waste minimization plus treatment which results in volume or toxicity reduction. The ORNL Waste Reduction Program will include both waste minimization and waste reduction efforts. Federal regulations, DOE policies and guidelines, increased costs and liabilities associatedmore » with the management of wastes, limited disposal options and facility capacities, and public consciousness have been motivating factors for implementing comprehensive waste reduction programs. DOE Order 5820.2A, Section 3.c.2.4 requires DOE facilities to establish an auditable waste reduction program for all LLW generators. In addition, it further states that any new facilities, or changes to existing facilities, incorporate waste minimization into design considerations. A more recent DOE Order, 3400.1, Section 4.b, requires the preparation of a waste reduction program plan which must be reviewed annually and updated every three years. Implementation of a waste minimization program for hazardous and radioactive mixed wastes is sited in DOE Order 5400.3, Section 7.d.5. This document has been prepared to address these requirements. 6 refs., 1 fig., 2 tabs.« less

Research on potential user identification model for electric energy substitution

NASA Astrophysics Data System (ADS)

Xia, Huaijian; Chen, Meiling; Lin, Haiying; Yang, Shuo; Miao, Bo; Zhu, Xinzhi

2018-01-01

The implementation of energy substitution plays an important role in promoting the development of energy conservation and emission reduction in china. Energy service management platform of alternative energy users based on the data in the enterprise production value, product output, coal and other energy consumption as a potential evaluation index, using principal component analysis model to simplify the formation of characteristic index, comprehensive index contains the original variables, and using fuzzy clustering model for the same industry user’s flexible classification. The comprehensive index number and user clustering classification based on constructed particle optimization neural network classification model based on the user, user can replace electric potential prediction. The results of an example show that the model can effectively predict the potential of users’ energy potential.

A Comprehensive Approach to Risk Reduction for Asian and Pacific Islander American Women With HIV/AIDS.

PubMed

Sabato, Todd M

2014-07-01

As HIV incidence rises globally, Asian and Pacific Islander communities are increasingly affected. While often overlooked, Asian and Pacific Islander American women have shown the greatest percentage increase in HIV diagnosis rates. The development of a multilevel and multistrategy approach to HIV/AIDS education, prevention, and treatment among Asian and Pacific Islander females requires health care providers to identify personal and cultural barriers to prevention and treatment and implement culturally sensitive and specific measures. The purpose of this article is to illuminate barriers to HIV-related prevention, treatment, and care among Asian and Pacific Islander American females and provide practical application-based suggestions for providers, which may enhance Asian and Pacific Islander female inclusion in comprehensive HIV prevention. © The Author(s) 2014.

Rapid Assessment of Age-Related Differences in Standing Balance

PubMed Central

Kalisch, Tobias; Kattenstroth, Jan-Christoph; Noth, Sebastian; Tegenthoff, Martin; Dinse, Hubert R.

2011-01-01

As life expectancy continues to rise, in the future there will be an increasing number of older people prone to falling. Accordingly, there is an urgent need for comprehensive testing of older individuals to collect data and to identify possible risk factors for falling. Here we use a low-cost force platform to rapidly assess deficits in balance under various conditions. We tested 21 healthy older adults and 24 young adults during static stance, unidirectional and rotational displacement of their centre of pressure (COP). We found an age-related increase in postural sway during quiet standing and a reduction of maximal COP displacement in unidirectional and rotational displacement tests. Our data show that even low-cost computerized assessment tools allow for the comprehensive testing of balance performance in older subjects. PMID:21629742

Automating OSIRIS Data Reduction for the Keck Observatory Archive

NASA Astrophysics Data System (ADS)

Holt, J.; Tran, H. D.; Goodrich, R.; Berriman, G. B.; Gelino, C. R.; KOA Team

2014-05-01

By the end of 2013, the Keck Observatory Archive (KOA) will serve data from all active instruments on the Keck Telescopes. OSIRIS (OH-Suppressing Infra-Red Imaging Spectrograph), the last active instrument to be archived in KOA, has been in use behind the (AO) system at Keck since February 2005. It uses an array of tiny lenslets to simultaneously produce spectra at up to 4096 locations. Due to the complicated nature of the OSIRIS raw data, the OSIRIS team developed a comprehensive data reduction program. This data reduction system has an online mode for quick real-time reductions, which are used primarily for basic data visualization and quality assessment done at the telescope while observing. The offline version of the data reduction system includes an expanded reduction method list, does more iterations for a better construction of the data cubes, and is used to produce publication-quality products. It can also use reconstruction matrices that are developed after the observations were taken, and are more refined. The KOA team is currently utilizing the standard offline reduction mode to produce quick-look browse products for the raw data. Users of the offline data reduction system generally use a graphical user interface to manually setup the reduction parameters. However, in order to reduce and serve the 200,000 science files on disk, all of the reduction parameters and steps need to be fully automated. This pipeline will also be used to automatically produce quick-look browse products for future OSIRIS data after each night's observations. Here we discuss the complexities of OSIRIS data, the reduction system in place, methods for automating the system, performance using virtualization, and progress made to date in generating the KOA products.

Automating OSIRIS Data Reduction for the Keck Observatory Archive

NASA Astrophysics Data System (ADS)

Tran, Hien D.; Holt, J.; Goodrich, R. W.; Lyke, J. E.; Gelino, C. R.; Berriman, G. B.; KOA Team

2014-01-01

Since the end of 2013, the Keck Observatory Archive (KOA) has served data from all active instruments on the Keck Telescopes. OSIRIS (OH-Suppressing Infra-Red Imaging Spectrograph), the last active instrument to be archived in KOA, has been in use behind the adaptive optics (AO) system at Keck since February 2005. It uses an array of tiny lenslets to simultaneously produce spectra at up to 4096 locations. Due to the complicated nature of the OSIRIS raw data, the OSIRIS team developed a comprehensive data reduction program. This data reduction system has an online mode for quick real-time reductions which are used primarily for basic data visualization and quality assessment done at the telescope while observing. The offline version of the data reduction system includes an expanded reduction method list, does more iterations for a better construction of the data cubes, and is used to produce publication-quality products. It can also use reconstruction matrices that are developed after the observations were taken, and are more refined. The KOA team is currently utilizing the standard offline reduction mode to produce quick-look browse products for the raw data. Users of the offline data reduction system generally use a graphical user interface to manually setup the reduction parameters. However, in order to reduce and serve the ~200,000 science files on disk, all of the reduction parameters and steps need to be fully automated. This pipeline will also be used to automatically produce quick-look browse products for future OSIRIS data after each night's observations. Here we discuss the complexities of OSIRIS data, the reduction system in place, methods for automating the system, performance using virtualization, and progress made to date in generating the KOA products.

Reducing the risk of public health emergencies for the world’s largest mass gathering

PubMed Central

Sun, Xiaodong; Keim, Mark; He, Yongchao; Mahany, Mollie; Yuan, Zheng'an

2013-01-01

Mass Gatherings and Public Health   Mass gatherings are highly visible events with the potential for serious health and political consequences if not managed carefully and effectively.1-4 Mass gatherings have been reported to have significant impact upon public health systems throughout the world.5-10 International mass gathering events, such as those associated with the Olympic Games, often carry high political significance and have a historical risk for terrorist attacks.2 Mass gatherings ranging from the subnational level to international the level have also been associated with outbreaks and subsequent spread of communicable diseases. These events have included outbreaks of foodborne shigellosis occurring at an outdoor music festival in the United States.5,6 The annual Hajj pilgrimage in Saudi Arabia has been plagued by public health threats such as fires, stampedes and an outbreak of meningitis.7,9 Influenza outbreaks were also reported during the 2008 World Youth Day mass gathering in Australia.10 Local, provincial and national public health and medical agencies are frequently involved before, during and after a major event. Therefore, disaster risk reduction is a key element for the effective management of mass gatherings. Disaster Risk Reduction Throughout the world, the overall approach to emergencies and disasters has recently shifted from post-impact activities (i.e., ad hoc relief and reconstruction) to a more systematic and comprehensive process of risk management.11 Disaster risk management includes pre-impact disaster risk reduction (i.e., prevention, preparedness and mitigation) as well as post-impact response and recovery).12 While planners may not always have the ability to prevent health hazards from occurring at mass gathering events, the health sector can play an important role in preventing the public health impact of such hazards. This manuscript describes a comprehensive approach for disaster risk reduction as implemented by those entities responsible for health security associated with the 2010 Shanghai World Exposition (Shanghai Expo). PMID:28228984

NAD(P)H:Flavin Mononucleotide Oxidoreductase Inactivation during 2,4,6-Trinitrotoluene Reduction

PubMed Central

Riefler, R. Guy; Smets, Barth F.

2002-01-01

Bacteria readily transform 2,4,6-trinitrotoluene (TNT), a contaminant frequently found at military bases and munitions production facilities, by reduction of the nitro group substituents. In this work, the kinetics of nitroreduction were investigated by using a model nitroreductase, NAD(P)H:flavin mononucleotide (FMN) oxidoreductase. Under mediation by NAD(P)H:FMN oxidoreductase, TNT rapidly reacted with NADH to form 2-hydroxylamino-4,6-dinitrotoluene and 4-hydroxylamino-2,6-dinitrotoluene, whereas 2-amino-4,6-dinitrotoluene and 4-amino-2,6-dinitrotoluene were not produced. Progressive loss of activity was observed during TNT reduction, indicating inactivation of the enzyme during transformation. It is likely that a nitrosodinitrotoluene intermediate reacted with the NAD(P)H:FMN oxidoreductase, leading to enzyme inactivation. A half-maximum constant with respect to NADH, KN, of 394 μM was measured, indicating possible NADH limitation under typical cellular conditions. A mathematical model that describes the inactivation process and NADH limitation provided a good fit to TNT reduction profiles. This work represents the first step in developing a comprehensive enzyme level understanding of nitroarene biotransformation. PMID:11916686

Hospital charges associated with motorcycle crash factors: a quantile regression analysis.

PubMed

Olsen, Cody S; Thomas, Andrea M; Cook, Lawrence J

2014-08-01

Previous studies of motorcycle crash (MC) related hospital charges use trauma registries and hospital records, and do not adjust for the number of motorcyclists not requiring medical attention. This may lead to conservative estimates of helmet use effectiveness. MC records were probabilistically linked with emergency department and hospital records to obtain total hospital charges. Missing data were imputed. Multivariable quantile regression estimated reductions in hospital charges associated with helmet use and other crash factors. Motorcycle helmets were associated with reduced median hospital charges of $256 (42% reduction) and reduced 98th percentile of $32,390 (33% reduction). After adjusting for other factors, helmets were associated with reductions in charges in all upper percentiles studied. Quantile regression models described homogenous and heterogeneous associations between other crash factors and charges. Quantile regression comprehensively describes associations between crash factors and hospital charges. Helmet use among motorcyclists is associated with decreased hospital charges. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Parameter dependence of ELM loss reduction by magnetic perturbations at low pedestal density and collisionality in ASDEX upgrade

NASA Astrophysics Data System (ADS)

Leuthold, N.; Suttrop, W.; Fischer, R.; Kappatou, A.; Kirk, A.; McDermott, R.; Mlynek, A.; Valovič, M.; Willensdorfer, M.; the ASDEX Upgrade Team; the EUROfusion MST1 Team

2017-05-01

ELM mitigation by magnetic perturbations is studied at low pedestal collisionalities down to ITER-like values ({ν }{e,{PED}}* =0.1) in ASDEX Upgrade. A comprehensive database of ELM energy losses for varying plasma density, heating power, edge safety factor and magnetic perturbation structure has been assembled to investigate parameter dependencies of ELM mitigation. It is found that magnetic perturbations with a toroidal mode number n = 2 can reduce the ELM energy loss normalized to the energy stored in the plasma pedestal from about 30% to less than 5%, i.e. by a factor of six, below an electron pedestal collisionality of {ν }{e,{PED}}* =0.4. At this level of ELM mitigation a significant reduction of the pedestal pressure and, therefore, global plasma confinement occurs. This pedestal pressure reduction is mostly due to a reduction of plasma density, the so-called ‘pump-out’ effect. Refueling by neutral beams and in particular by pellet injection is possible and can re-establish confinement, however, the ELM energy loss increases as well with increasing density.

Comparing Binaural Pre-processing Strategies I: Instrumental Evaluation.

PubMed

Baumgärtel, Regina M; Krawczyk-Becker, Martin; Marquardt, Daniel; Völker, Christoph; Hu, Hongmei; Herzke, Tobias; Coleman, Graham; Adiloğlu, Kamil; Ernst, Stephan M A; Gerkmann, Timo; Doclo, Simon; Kollmeier, Birger; Hohmann, Volker; Dietz, Mathias

2015-12-30

In a collaborative research project, several monaural and binaural noise reduction algorithms have been comprehensively evaluated. In this article, eight selected noise reduction algorithms were assessed using instrumental measures, with a focus on the instrumental evaluation of speech intelligibility. Four distinct, reverberant scenarios were created to reflect everyday listening situations: a stationary speech-shaped noise, a multitalker babble noise, a single interfering talker, and a realistic cafeteria noise. Three instrumental measures were employed to assess predicted speech intelligibility and predicted sound quality: the intelligibility-weighted signal-to-noise ratio, the short-time objective intelligibility measure, and the perceptual evaluation of speech quality. The results show substantial improvements in predicted speech intelligibility as well as sound quality for the proposed algorithms. The evaluated coherence-based noise reduction algorithm was able to provide improvements in predicted audio signal quality. For the tested single-channel noise reduction algorithm, improvements in intelligibility-weighted signal-to-noise ratio were observed in all but the nonstationary cafeteria ambient noise scenario. Binaural minimum variance distortionless response beamforming algorithms performed particularly well in all noise scenarios. © The Author(s) 2015.

The Wild Wild West: A Framework to Integrate mHealth Software Applications and Wearables to Support Physical Activity Assessment, Counseling and Interventions for Cardiovascular Disease Risk Reduction

PubMed Central

Lobelo, Felipe; Kelli, Heval M.; Tejedor, Sheri Chernetsky; Pratt, Michael; McConnell, Michael V.; Martin, Seth S.; Welk, Gregory J.

2017-01-01

Physical activity (PA) interventions constitute a critical component of cardiovascular disease (CVD) risk reduction programs. Objective mobile health (mHealth) software applications (apps) and wearable activity monitors (WAMs) can advance both assessment and integration of PA counseling in clinical settings and support community-based PA interventions. The use of mHealth technology for CVD risk reduction is promising, but integration into routine clinical care and population health management has proven challenging. The increasing diversity of available technologies and the lack of a comprehensive guiding framework are key barriers for standardizing data collection and integration. This paper reviews the validity, utility and feasibility of implementing mHealth technology in clinical settings and proposes an organizational framework to support PA assessment, counseling and referrals to community resources for CVD risk reduction interventions. This integration framework can be adapted to different clinical population needs. It should also be refined as technologies and regulations advance under an evolving health care system landscape in the United States and globally. PMID:26923067

Comparing Binaural Pre-processing Strategies I

PubMed Central

Krawczyk-Becker, Martin; Marquardt, Daniel; Völker, Christoph; Hu, Hongmei; Herzke, Tobias; Coleman, Graham; Adiloğlu, Kamil; Ernst, Stephan M. A.; Gerkmann, Timo; Doclo, Simon; Kollmeier, Birger; Hohmann, Volker; Dietz, Mathias

2015-01-01

In a collaborative research project, several monaural and binaural noise reduction algorithms have been comprehensively evaluated. In this article, eight selected noise reduction algorithms were assessed using instrumental measures, with a focus on the instrumental evaluation of speech intelligibility. Four distinct, reverberant scenarios were created to reflect everyday listening situations: a stationary speech-shaped noise, a multitalker babble noise, a single interfering talker, and a realistic cafeteria noise. Three instrumental measures were employed to assess predicted speech intelligibility and predicted sound quality: the intelligibility-weighted signal-to-noise ratio, the short-time objective intelligibility measure, and the perceptual evaluation of speech quality. The results show substantial improvements in predicted speech intelligibility as well as sound quality for the proposed algorithms. The evaluated coherence-based noise reduction algorithm was able to provide improvements in predicted audio signal quality. For the tested single-channel noise reduction algorithm, improvements in intelligibility-weighted signal-to-noise ratio were observed in all but the nonstationary cafeteria ambient noise scenario. Binaural minimum variance distortionless response beamforming algorithms performed particularly well in all noise scenarios. PMID:26721920

The Wild Wild West: A Framework to Integrate mHealth Software Applications and Wearables to Support Physical Activity Assessment, Counseling and Interventions for Cardiovascular Disease Risk Reduction.

PubMed

Lobelo, Felipe; Kelli, Heval M; Tejedor, Sheri Chernetsky; Pratt, Michael; McConnell, Michael V; Martin, Seth S; Welk, Gregory J

2016-01-01

Physical activity (PA) interventions constitute a critical component of cardiovascular disease (CVD) risk reduction programs. Objective mobile health (mHealth) software applications (apps) and wearable activity monitors (WAMs) can advance both assessment and integration of PA counseling in clinical settings and support community-based PA interventions. The use of mHealth technology for CVD risk reduction is promising, but integration into routine clinical care and population health management has proven challenging. The increasing diversity of available technologies and the lack of a comprehensive guiding framework are key barriers for standardizing data collection and integration. This paper reviews the validity, utility and feasibility of implementing mHealth technology in clinical settings and proposes an organizational framework to support PA assessment, counseling and referrals to community resources for CVD risk reduction interventions. This integration framework can be adapted to different clinical population needs. It should also be refined as technologies and regulations advance under an evolving health care system landscape in the United States and globally. Copyright © 2016 Elsevier Inc. All rights reserved.

A Study to Ascertain the Feasibility of Joint Efforts to Establish a Comprehensive Health Care Delivery System Utilizing Hill-Burton Constructed Hospital,

DTIC Science & Technology

1978-12-15

Utilization Review Procedures ................ 22 Reduced Philanthropy ......................... 22 Lack of Incentives ........................... 23 Reductions...challenges are made on hospitals in the form of status of technology, elite physician compliments, and increased specialization of labor which ccnstantly...construction are now marginally subsidized by philanthropy . Third party reimbursement is now the dominant source of hospital revenue with cost based formula

Federal Debt and Interests Costs

DTIC Science & Technology

1993-05-01

relatively small amount of bond to Argentina as part of a comprehensive debt issued directly to foreign governments in debt reduction agreement with commercial...their investments because of an economic crisis needs of the private sector, propped up interest or as part of a coordinated political action. U.S...Zero-Coupon Bonds. Similar to savings and loan crisis . Because REFCORP is the foreign zero-coupon bonds described above technically private, the money

Cognitive and Psychological Issues in Emphysema

PubMed Central

Kozora, Elizabeth; Emery, Charles; Kaplan, Robert M.; Wamboldt, Fredrick S.; Zhang, Lening; Make, Barry J.

2008-01-01

Various psychological and cognitive difficulties have been documented in patients with emphysema. The aim of this article is to review prior literature on the prevalence of these difficulties in emphysema, as well as identify specific studies demonstrating improvement in these areas after therapy. Traditional therapies such as continuous and intermittent oxygen therapy and comprehensive pulmonary rehabilitation are reviewed. In general, these studies demonstrate reductions in symptoms of depression and anxiety as well as specific improvements in complex attention and verbal fluency. In a more recent study, patients with emphysema who underwent lung volume reduction surgery (LVRS) demonstrated improved psychomotor speed, verbal memory, and naming skills at 6 months compared with patients with emphysema who were in comprehensive rehabilitation only. The patients with emphysema who had LVRS also demonstrated greater decline in depressive symptoms compared with the rehabilitation patients at 6 months. There were no associations between improved neuropsychological tests and changes in depression, exercise tests, pulmonary function, oxygenation, or quality of life scores, and thus the mechanism of behavioral improvement identified in the patients who underwent LVRS remained unclear. Overall, studies suggest that psychological and cognitive improvements occur subsequent to a variety of medical and behavioral treatment therapeutic approaches, and that LVRS appears to have an advantage for some patients with emphysema. PMID:18453371

Is the "alcopops" tax working? Probably yes but there is a bigger picture.

PubMed

Skov, Steven J; Chikritzhs, Tanya N; Kypri, Kypros; Miller, Peter G; Hall, Wayne D; Daube, Michael M; Moodie, A Rob

2011-07-18

The Australian Government's decision to raise taxes on ready-to-drink spirit-based beverages (RTDs; "alcopops") in 2008 caused great controversy. Interest groups have selectively cited evidence to support their points of view. The alcohol industry cited Victorian data from the Australian Secondary Students' Alcohol and Drug Survey (ASSADS) as evidence that the tax had failed, but closer examination of the data suggests that fewer students are drinking, and fewer are drinking at risky or high-risk levels. Excise data from the first full year after the tax came into effect showed a more than 30% reduction in RTD sales and a 1.5% reduction in total pure alcohol sold in Australia. Although understanding the impact of the alcopops tax will require critical analysis of a range of evidence, sales and ASSADS data suggest that the tax has resulted in reduced consumption of RTDs and total alcohol. The most effective and cost-effective measures for reducing consumption and harm are a comprehensive graduated volumetric alcohol taxation system, a minimum price per standard drink, and special measures for particular products that may cause disproportionate harm. While welcoming the alcopops tax, public health advocates have consistently argued for a comprehensive package of reform that covers pricing, availability and promotion of alcohol, as well as education and treatment services.

Impact of an Individual Mandate and Other Health Reforms on Dependent Coverage for Adolescents and Young Adults.

PubMed

Wisk, Lauren E; Finkelstein, Jonathan A; Toomey, Sara L; Sawicki, Gregory S; Schuster, Mark A; Galbraith, Alison A

2018-06-01

To determine the effect of state-level dependent coverage expansion (DCE) with and without other state health reforms on exit from dependent coverage for adolescents and young adults (AYA). Administrative longitudinal data for 131,542 privately insured AYA in Massachusetts (DCE with other reforms) versus Maine and New Hampshire (DCE without other reforms) across three periods: prereform (1/00-12/06), poststate reform (1/07-9/10), and postfederal reform (10/10-12/12). A difference-in-differences estimator was used to determine the rate of exit from dependent coverage, age at exit from dependent coverage, and re-uptake of dependent coverage among AYA in states with comprehensive reforms versus DCE only. Implementation of DCE with other reforms was significantly associated with a 23 percent reduction in exit from dependent coverage among AYA compared to the reduction observed for DCE alone. Additionally, comprehensive reforms were associated with over two additional years of dependent coverage for the average AYA and a 33 percent increase in the odds of regaining dependent coverage after a prior loss. Findings suggest that an individual mandate and other reforms may enhance the effect of DCE in preventing loss of coverage among AYA. © Health Research and Educational Trust.

Managing carbon emissions in China through building energy efficiency.

PubMed

Li, Jun; Colombier, Michel

2009-06-01

This paper attempts to analyse the role of building energy efficiency (BEE) in China in addressing climate change mitigation. It provides an analysis of the current situation and future prospects for the adoption of BEE technologies in Chinese cities. It outlines the economic and institutional barriers to large-scale deployment of the sustainable, low-carbon, and even carbon-free construction techniques. Based on a comprehensive overview of energy demand characteristics and development trends driven by economic and demographic growth, different policy tools for cost-effective CO(2) emission reduction in the Chinese construction sector are described. We propose a comprehensive approach combining building design and construction, and the urban planning and building material industries, in order to drastically improve BEE during this period of rapid urban development. A coherent institutional framework needs to be established to ensure the implementation of efficiency policies. Regulatory and incentive options should be integrated into the policy portfolios of BEE to minimise the efficiency gap and to realise sizeable carbon emissions cuts in the next decades. We analyse in detail several policies and instruments, and formulate relevant policy proposals fostering low-carbon construction technology in China. Specifically, Our analysis shows that improving building energy efficiency can generate considerable carbon emissions reduction credits with competitive price under the CDM framework.

Impact of a comprehensive law on the prevalence of tobacco consumption in Spain: evaluation of different scenarios.

PubMed

Raña, P; Pérez-Ríos, M; Santiago-Pérez, M I; Crujeiras, R M

2016-09-01

Since 2011, smoking legislation was hardened in Spain, banning tobacco consumption in all hospitality venues. Law 42/2010 was the first comprehensive tobacco control policy enacted in Spain. The aim of this paper is to evaluate the effect that this intervention has had in reducing the prevalence of tobacco consumption, setting up three scenarios on the basis of different theoretical levels of effect of the law. A predictive model based on Markov Chains was developed to distinguish the effect of tobacco control policies in different scenarios. The model developed uses population, smoking rates and smoking characteristics from a non-transmissible disease surveillance system developed in Galicia (namely SICRI). Results show that tobacco control policies hardly affect the predicted trend in a temporal frame of 10 years, with relative reduction in the predicted male smoking prevalence of 20.4% with no intervention, reaching a reduction of 26.1% under the maximum effect of the policies. In the global population the effects of the law in the predicted prevalence have been barely perceived. For people under 25 years of age, interventions have had an important and positive effect, which proves that policies affecting this age group should be hardened. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Comprehensive primary health care under neo-liberalism in Australia.

PubMed

Baum, Fran; Freeman, Toby; Sanders, David; Labonté, Ronald; Lawless, Angela; Javanparast, Sara

2016-11-01

This paper applies a critical analysis of the impact of neo-liberal driven management reform to examine changes in Australian primary health care (PHC) services over five years. The implementation of comprehensive approaches to primary health care (PHC) in seven services: five state-managed and two non-government organisations (NGOs) was tracked from 2009 to 2014. Two questions are addressed: 1) How did the ability of Australian PHC services to implement comprehensive PHC change over the period 2009-2014? 2) To what extent is the ability of the PHC services to implement comprehensive PHC shaped by neo-liberal health sector reform processes? The study reports on detailed tracking and observations of the changes and in-depth interviews with 63 health service managers and practitioners, and regional and central health executives. The documented changes were: in the state-managed services (although not the NGOs) less comprehensive service coverage and more focus on clinical services and integration with hospitals and much less development activity including community development, advocacy, intersectoral collaboration and attention to the social determinants. These changes were found to be associated with practices typical of neo-liberal health sector reform: considerable uncertainty, more directive managerial control, budget reductions and competitive tendering and an emphasis on outputs rather than health outcomes. We conclude that a focus on clinical service provision, while highly compatible with neo-liberal reforms, will not on its own produce the shifts in population disease patterns that would be required to reduce demand for health services and promote health. Comprehensive PHC is much better suited to that task. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Six steps to a successful dose-reduction strategy

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

Bennett, M.

1995-03-01

The increased importance of demonstrating achievement of the ALARA principle has helped produce a proliferation of dose-reduction ideas. Across a company there may be many dose-reduction items being pursued in a variety of areas. However, companies have a limited amount of resource and, therefore, to ensure funding is directed to those items which will produce the most benefit and that all areas apply a common policy, requires the presence of a dose-reduction strategy. Six steps were identified in formulating the dose-reduction strategy for Rolls-Royce and Associates (RRA): (1) collating the ideas; (2) quantitatively evaluating them on a common basis; (3)more » prioritizing the ideas in terms of cost benefit, (4) implementation of the highest priority items; (5) monitoring their success; (6) periodically reviewing the strategy. Inherent in producing the dose-reduction strategy has been a comprehensive dose database and the RRA-developed dose management computer code DOMAIN, which allows prediction of dose rates and dose. The database enabled high task dose items to be identified, assisted in evaluating dose benefits, and monitored dose trends once items had been implemented. The DOMAIN code was used both in quantifying some of the project dose benefits and its results, such as dose contours, used in some of the dose-reduction items themselves. In all, over fifty dose-reduction items were evaluated in the strategy process and the items which will give greatest benefit are being implemented. The strategy has been successful in giving renewed impetus and direction to dose-reduction management.« less

A Comprehensive Prevention Approach to Reducing Assault Offenses and Assault Injuries Among Youth

PubMed Central

Heinze, Justin E.; Reischl, Thomas M.; Bai, Mengqiao; Roche, Jessica S.; Morrel-Samuels, Susan; Cunningham, Rebecca M.; Zimmerman, Marc A.

2018-01-01

Since 2011, the CDC-funded Michigan Youth Violence Prevention Center (MI-YVPC), working with community partners, has implemented a comprehensive prevention approach to reducing youth violence in Flint, MI, based on public health principles. MI-YVPC employed an intervention strategy that capitalizes on existing community resources and application of evidence-based programs using a social-ecological approach to change. We evaluated the combined effect of six programs in reducing assaults and injury among 10–24 year olds in the intervention area relative to a matched comparison community. We used generalized linear mixed models to examine change in the intervention area counts of reported assault offenses and assault injury presentation relative to the comparison area over a period six years prior- and two and a half years post-intervention. Results indicated that youth victimization and assault injuries fell in the intervention area subsequent to the initiation of the interventions and that these reductions were sustained over time. Our evaluation demonstrated that a comprehensive multi-level approach can be effective for reducing youth violence and injury. PMID:26572898

Listening comprehension across the adult lifespan.

PubMed

Sommers, Mitchell S; Hale, Sandra; Myerson, Joel; Rose, Nathan; Tye-Murray, Nancy; Spehar, Brent

2011-01-01

Although age-related declines in perceiving spoken language are well established, the primary focus of research has been on perception of phonemes, words, and sentences. In contrast, relatively few investigations have been directed at establishing the effects of age on the comprehension of extended spoken passages. Moreover, most previous work has used extreme-group designs in which the performance of a group of young adults is contrasted with that of a group of older adults and little if any information is available regarding changes in listening comprehension across the adult lifespan. Accordingly, the goals of the current investigation were to determine whether there are age differences in listening comprehension across the adult lifespan and, if so, whether similar trajectories are observed for age-related changes in auditory sensitivity and listening comprehension. This study used a cross-sectional lifespan design in which approximately 60 individuals in each of 7 decades, from age 20 to 89 yr (a total of 433 participants), were tested on three different measures of listening comprehension. In addition, we obtained measures of auditory sensitivity from all participants. Changes in auditory sensitivity across the adult lifespan exhibited the progressive high-frequency loss typical of age-related hearing impairment. Performance on the listening comprehension measures, however, demonstrated a very different pattern, with scores on all measures remaining relatively stable until age 65 to 70 yr, after which significant declines were observed. Follow-up analyses indicated that this same general pattern was observed across three different types of passages (lectures, interviews, and narratives) and three different question types (information, integration, and inference). Multiple regression analyses indicated that low-frequency pure-tone average was the single largest contributor to age-related variance in listening comprehension for individuals older than 65 yr, but that age accounted for significant variance even after controlling for auditory sensitivity. Results suggest that age-related reductions in auditory sensitivity account for a sizable portion of individual variance in listening comprehension that was observed across the adult lifespan. Other potential contributors including a possible role for age-related declines in perceptual and cognitive abilities are discussed. Clinically, the results suggest that amplification is likely to improve listening comprehension but that increased audibility alone may not be sufficient to maintain listening comprehension beyond age 65 and 70 yr. Additional research will be needed to identify potential target abilities for training or other rehabilitation procedures that could supplement sensory aids to provide additional improvements in listening comprehension.

Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy?

PubMed Central

Hyseni, Lirije; Elliot-Green, Alex; Lloyd-Williams, Ffion; Kypridemos, Chris; O’Flaherty, Martin; McGill, Rory; Orton, Lois; Bromley, Helen; Cappuccio, Francesco P.; Capewell, Simon

2017-01-01

Background Non-communicable disease (NCD) prevention strategies now prioritise four major risk factors: food, tobacco, alcohol and physical activity. Dietary salt intake remains much higher than recommended, increasing blood pressure, cardiovascular disease and stomach cancer. Substantial reductions in salt intake are therefore urgently needed. However, the debate continues about the most effective approaches. To inform future prevention programmes, we systematically reviewed the evidence on the effectiveness of possible salt reduction interventions. We further compared “downstream, agentic” approaches targeting individuals with “upstream, structural” policy-based population strategies. Methods We searched six electronic databases (CDSR, CRD, MEDLINE, SCI, SCOPUS and the Campbell Library) using a pre-piloted search strategy focussing on the effectiveness of population interventions to reduce salt intake. Retrieved papers were independently screened, appraised and graded for quality by two researchers. To facilitate comparisons between the interventions, the extracted data were categorised using nine stages along the agentic/structural continuum, from “downstream”: dietary counselling (for individuals, worksites or communities), through media campaigns, nutrition labelling, voluntary and mandatory reformulation, to the most “upstream” regulatory and fiscal interventions, and comprehensive strategies involving multiple components. Results After screening 2,526 candidate papers, 70 were included in this systematic review (49 empirical studies and 21 modelling studies). Some papers described several interventions. Quality was variable. Multi-component strategies involving both upstream and downstream interventions, generally achieved the biggest reductions in salt consumption across an entire population, most notably 4g/day in Finland and Japan, 3g/day in Turkey and 1.3g/day recently in the UK. Mandatory reformulation alone could achieve a reduction of approximately 1.45g/day (three separate studies), followed by voluntary reformulation (-0.8g/day), school interventions (-0.7g/day), short term dietary advice (-0.6g/day) and nutrition labelling (-0.4g/day), but each with a wide range. Tax and community based counselling could, each typically reduce salt intake by 0.3g/day, whilst even smaller population benefits were derived from health education media campaigns (-0.1g/day). Worksite interventions achieved an increase in intake (+0.5g/day), however, with a very wide range. Long term dietary advice could achieve a -2g/day reduction under optimal research trial conditions; however, smaller reductions might be anticipated in unselected individuals. Conclusions Comprehensive strategies involving multiple components (reformulation, food labelling and media campaigns) and “upstream” population-wide policies such as mandatory reformulation generally appear to achieve larger reductions in population-wide salt consumption than “downstream”, individually focussed interventions. This ‘effectiveness hierarchy’ might deserve greater emphasis in future NCD prevention strategies. PMID:28542317

[Dynamic magnetotherapy use in comprehensive treatment phlegmons of maxillofacial region and mandible fractures].

PubMed

Lepilin, A V; Raĭgorodckiĭ, Iu M; Nozdrachev, V G; Erokina, N L

2007-01-01

145 patients (60 with phlegmons of submandibular and submental regions, 85--with fractures of mandible) were observed and treated with the use of moving pulse magnetic field (MPMF) produced by special apparatus (AMO-ATOS-E, , Saratov-city), 60 patients with the same pathology were treated by traditional physical methods and served as control. Use of MPMF led to quicker patient recovery: quicker reduction (if compared with traditional physical methods of treatment) of oedema and soft tissue inflammatory infiltration, quicker relief from inflammatory reaction (according to data of cytokinin profile), improvement of tissue blood supply in the region of fractures in patients with mandible fractures. As the result--we had shortening treatment terms of such patients and complication number reduction.

Energy taxation as a policy instrument to reduce CO{sub 2} emissions: A net benefit analysis

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

Boyd, R.; Krutilla, K.; Viscusi, W.K.

1995-07-01

This study evaluates the costs and benefits of energy taxation as a policy instrument to conserve energy and reduce CO{sub 2} emissions. The study combines economic cost estimates generated with a CGE model and monetary estimates of environmental damages in a comprehensive cost/benefit framework. We find that optimal CO{sub 2} emissions reductions range from 5 to 38%, depending on different assumptions about energy substitution elasticities and environmental damages. CO{sub 2} emissions reductions of between 8 and 64% can be attained at no additional welfare cost relative to a policy of not undertaking any action to control CO{sub 2} emissions. 33more » refs., 7 figs., 8 tabs.« less

Scale-up of a comprehensive harm reduction programme for people injecting opioids: lessons from north-eastern India

PubMed Central

Lalmuanpuii, Melody; Biangtung, Langkham; Mishra, Ritu Kumar; Reeve, Matthew J; Tzudier, Sentimoa; Singh, Angom L; Sinate, Rebecca

2013-01-01

Abstract Problem Harm reduction packages for people who inject illicit drugs, including those infected with human immunodeficiency virus (HIV), are cost-effective but have not been scaled up globally. In the north-eastern Indian states of Manipur and Nagaland, the epidemic of HIV infection is driven by the injection of illicit drugs, especially opioids. These states needed to scale up harm reduction programmes but faced difficulty doing so. Approach In 2004, the Bill & Melinda Gates Foundation funded Project ORCHID to scale up a harm reduction programme in Manipur and Nagaland. Local setting In 2003, an estimated 10 000 and 16 000 people were injecting drugs in Manipur and Nagaland, respectively. The prevalence of HIV infection among people injecting drugs was 24.5% in Manipur and 8.4% in Nagaland. Relevant changes By 2012, the harm reduction programme had been scaled up to an average of 9011 monthly contacts outside clinics (80% of target); an average of 1709 monthly clinic visits (15% of target, well above the 5% monthly goal) and an average monthly distribution of needles and syringes of 16 each per programme participant. Opioid agonist maintenance treatment coverage was 13.7% and retention 6 months after enrolment was 63%. Antiretroviral treatment coverage for HIV-positive participants was 81%. Lessons learnt A harm reduction model consisting of community-owned, locally relevant innovations and business approaches can result in good harm reduction programme scale-up and influence harm reduction policy. Project ORCHID has influenced national harm reduction policy in India and contributed to the development of harm reduction guidelines. PMID:23599555

Harm reduction principles for healthcare settings.

PubMed

Hawk, Mary; Coulter, Robert W S; Egan, James E; Fisk, Stuart; Reuel Friedman, M; Tula, Monique; Kinsky, Suzanne

2017-10-24

Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of their disclosure of negative health behaviors, given that health behaviors are not binary or linear but operate along a continuum based on a variety of individual and social determinants.

Reduction in childhood malnutrition in Vietnam from 1990 to 2004.

PubMed

Khan, Nguyen Cong; Tuyen, Le Danh; Ngoc, Tran Xuan; Duong, Phan Hoai; Khoi, Ha Huy

2007-01-01

Reduction in childhood malnutrition in Vietnam between 1990 and 2004 was assessed using data from 5 national surveys. The prevalence of malnutrition, including stunting, declined significantly for underweight from 45% in 1990 to 26.6% in 2004. While the average reduction was 1.3% per year in the period from 1990 to 2000, it was 1.8% per year in the period from 2000 to 2004. The prevalence of stunting declined from 56.5% in 1990 to 30.7% in 2004, with an average reduction of 2% per year in the period from 1990 to 2000 and 1.5% per year in the period from 2000 to 2004. There were clear differences in the decrease in malnutrition prevalence between urban, rural and mountainous areas, the reduction being highest in the urban regions and lowest in the mountainous areas. Regression analysis showed that the nutrition status of the child is positively related to better household living conditions and to the educational level of the father, but not the mother. Stunting is higher in children whose parents are farmers and higher in households with more children. Stunting prevalence is lower in households with safe water access and hygienic toilets. In future , the dramatic reduction is childhood malnutrition as seen in the period 1990 to 2004 might not continue. More comprehensive apptoaches will be needed to lower childhood malnutrition in Vietnam further.

Toxics Use Reduction in the Home: Lessons Learned from Household Exposure Studies

PubMed Central

Dunagan, Sarah C.; Dodson, Robin E.; Rudel, Ruthann A.; Brody, Julia G.

2010-01-01

Workers and fence-line communities have been the first to benefit from the substantial reductions in toxic chemical use and byproducts in industrial production resulting from the Massachusetts Toxics Use Reduction Act (TURA). As TURA motivates reformulation of products as well as retooling of production processes, benefits could extend more broadly to large-scale reductions in everyday exposures for the general population. Household exposure studies, including those conducted by Silent Spring Institute, show that people are exposed to complex mixtures of indoor toxics from building materials and a myriad of consumer products. Pollutants in homes are likely to have multiple health effects because many are classified as endocrine disrupting compounds (EDCs), with the ability to interfere with the body's hormone system. Product-related EDCs measured in homes include phthalates, halogenated flame retardants, and alkylphenols. Silent Spring Institute's chemical analysis of personal care and cleaning products confirms many are potential sources of EDCs, highlighting the need for a more comprehensive toxics use reduction (TUR) approach to reduce those exposures. Toxics use reduction targeted at EDCs in consumer products has the potential to substantially reduce occupational and residential exposures. The lessons that have emerged from household exposure research can inform improved chemicals management policies at the state and national levels, leading to safer products and widespread health and environmental benefits. PMID:21516227

Dynamics of microbial community composition and function during in-situ bioremediation of a uranium-contaminated aquifer

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

Nostrand, J.D. Van; Wu, L.; Wu, W.M.

2010-08-15

A pilot-scale system was established to examine the feasibility of in situ U(VI) immobilization at a highly contaminated aquifer (U.S. DOE Integrated Field Research Challenge site, Oak Ridge, TN). Ethanol was injected intermittently as an electron donor to stimulate microbial U(VI) reduction, and U(VI) concentrations fell to below the Environmental Protection Agency drinking water standard (0.03 mg liter{sup -1}). Microbial communities from three monitoring wells were examined during active U(VI) reduction and maintenance phases with GeoChip, a high-density, comprehensive functional gene array. The overall microbial community structure exhibited a considerable shift over the remediation phases examined. GeoChip-based analysis revealed thatmore » Fe(III)-reducing bacterial (FeRB), nitrate-reducing bacterial (NRB), and sulfate-reducing bacterial (SRB) functional populations reached their highest levels during the active U(VI) reduction phase (days 137 to 370), in which denitrification and Fe(III) and sulfate reduction occurred sequentially. A gradual decrease in these functional populations occurred when reduction reactions stabilized, suggesting that these functional populations could play an important role in both active U(VI) reduction and maintenance of the stability of reduced U(IV). These results suggest that addition of electron donors stimulated the microbial community to create biogeochemical conditions favorable to U(VI) reduction and prevent the reduced U(IV) from reoxidation and that functional FeRB, SRB, and NRB populations within this system played key roles in this process.« less

Dynamics of Microbial Community Composition and Function during In Situ Bioremediation of a Uranium-Contaminated Aquifer▿‡

PubMed Central

Van Nostrand, Joy D.; Wu, Liyou; Wu, Wei-Min; Huang, Zhijian; Gentry, Terry J.; Deng, Ye; Carley, Jack; Carroll, Sue; He, Zhili; Gu, Baohua; Luo, Jian; Criddle, Craig S.; Watson, David B.; Jardine, Philip M.; Marsh, Terence L.; Tiedje, James M.; Hazen, Terry C.; Zhou, Jizhong

2011-01-01

A pilot-scale system was established to examine the feasibility of in situ U(VI) immobilization at a highly contaminated aquifer (U.S. DOE Integrated Field Research Challenge site, Oak Ridge, TN). Ethanol was injected intermittently as an electron donor to stimulate microbial U(VI) reduction, and U(VI) concentrations fell to below the Environmental Protection Agency drinking water standard (0.03 mg liter−1). Microbial communities from three monitoring wells were examined during active U(VI) reduction and maintenance phases with GeoChip, a high-density, comprehensive functional gene array. The overall microbial community structure exhibited a considerable shift over the remediation phases examined. GeoChip-based analysis revealed that Fe(III)-reducing bacterial (FeRB), nitrate-reducing bacterial (NRB), and sulfate-reducing bacterial (SRB) functional populations reached their highest levels during the active U(VI) reduction phase (days 137 to 370), in which denitrification and Fe(III) and sulfate reduction occurred sequentially. A gradual decrease in these functional populations occurred when reduction reactions stabilized, suggesting that these functional populations could play an important role in both active U(VI) reduction and maintenance of the stability of reduced U(IV). These results suggest that addition of electron donors stimulated the microbial community to create biogeochemical conditions favorable to U(VI) reduction and prevent the reduced U(IV) from reoxidation and that functional FeRB, SRB, and NRB populations within this system played key roles in this process. PMID:21498771

Sustained reduction in antibiotic consumption in a South African public sector hospital; Four year outcomes from the Groote Schuur Hospital antibiotic stewardship program.

PubMed

Boyles, T H; Naicker, V; Rawoot, N; Raubenheimer, P J; Eick, B; Mendelson, M

2017-01-30

Overuse of antibiotics has driven global bacterial resistance to the extent that we have entered a post-antibiotic era, where infections that were once easily treatable are now becoming untreatable. Efforts to control consumption have focused on antibiotic stewardship programmes (ASPs), aimed at optimising use. To report antibiotic consumption and cost over 4 years from a public hospital ASP in South Africa (SA). A comprehensive ASP comprising online education, a dedicated antibiotic prescription chart and weekly dedicated ward rounds was introduced at Groote Schuur Hospital, Cape Town, in 2012. Electronic records were used to collect data on volume and cost of antibiotics and related laboratory tests, and to determine inpatient mortality and 30-day readmission rates. These data were compared with a control period before the intervention. Total antibiotic consumption fell from 1 046 defined daily doses/1 000 patient days in 2011 (control period) to 868 by 2013 and remained at similar levels for the next 2 years. This was driven by reductions in intravenous antibiotic use, particularly ceftriaxone. Inflation-adjusted cost savings on antibiotics were ZAR3.2 million over 4 years. Laboratory tests increased over the same period with a total increased cost of ZAR0.4 million. There was no significant change in mortality or 30-day readmission rates. The effects of a comprehensive ASP on medical inpatients at a public sector hospital in SA were durable over 4 years, leading to a reduction in total antibiotic consumption without adverse effect. When increased laboratory costs were offset there was a net cost saving of ZAR2.8 million.

Evaluating oxidation-reduction properties of dissolved organic matter from Chinese milk vetch (Astragalus sinicus L.): a comprehensive multi-parametric study.

PubMed

Liu, Yong; Lou, Jun; Li, Fang-Bai; Xu, Jian-Ming; Yu, Xiong-Sheng; Zhu, Li-An; Wang, Feng

2014-08-01

Green manuring is a common practice in replenishment of soil organic matter and nutrients in rice paddy field. Owing to the complex interplay of multiple factors, the oxidation--reduction (redox) properties of dissolved organic matter (DOM) from green manure crops are presently not fully understood. In this study, a variety of surrogate parameters were used to evaluate the redox capacity and redox state of DOM derived from Chinese milk vetch (CMV, Astragalus sinicus L.) via microbial decomposition under continuously flooded (CF) and non-flooded (NF) conditions. Additionally, the correlation between the surrogate parameters of CMV-DOM and the kinetic parameters of relevant redox reactions was evaluated in a soil-water system containing CMV-DOM. Results showed that the redox properties of CMV-DOM were substantially different between the fresh and decomposed CMV-DOM treatments. Determination of the surrogate parameters via ultraviolet-visible/Fourier transform infrared absorption spectroscopy and gel permeation chromatography generally provided high-quality data for predicting the redox capacity of CMV-DOM, while the surrogate parameters determined by elemental analysis were suitable for predicting the redox state of CMV-DOM. Depending on the redox capacity and redox state of various moieties/components, NF-decomposed CMV-DOM could easily accelerate soil reduction by shuttling electrons to iron oxides, because it contained more reversible redox-active functional groups (e.g. quinone and hydroquinone pairs) than CF-decomposed CMV-DOM. This work demonstrates that a single index cannot interpret complex changes in multiple factors that jointly determine the redox reactivity of CMV-DOM. Thus, a multi-parametric study is needed for providing comprehensive information on the redox properties of green manure DOM.

Unpacking commercial sector opposition to European smoke-free policy: lack of unity, 'fear of association' and harm reduction debates.

PubMed

Weishaar, Heide; Amos, Amanda; Collin, Jeff

2016-07-01

Tobacco companies have made extensive efforts to build alliances against comprehensive smoke-free legislation. This article analyses the interaction between actors who opposed the development of the European Council Recommendation on smoke-free environments. Drawing on data from 200 policy documents and 32 semistructured interviews and using qualitative textual analysis and organisational network analysis, opponents' positions on, and responses to, the policy initiative, strategies to oppose the policy, and efforts to build alliances were investigated. The non-binding nature of the policy, scientific evidence and clear political will to adopt EU-wide measures combined to limit the intensity of commercial sector opposition to the comprehensive EU smoke-free policy. Most tobacco companies, led by the Confederation of European Community Cigarette Manufacturers (CECCM), voiced reservations against the proposal, criticised the policy process and fought flanking measures on product regulation. However, some companies focused on instigating harm reduction debates. These divergent approaches and the reluctance of other commercial actors to demonstrate solidarity with the tobacco sector prevented the establishment of a cohesive commercial sector alliance. The comparatively limited opposition to EU smoke-free policy contrasts with previous accounts of tobacco industry resistance to tobacco control. While context-specific factors can partially explain these differences, the paper indicates that the sector's diminished credibility and lack of unity hampered political engagement and alliance building. Industry efforts to emphasise the benefits of smokeless tobacco during smoke-free policy debates highlight the potential of harm reduction as a gateway for tobacco companies to re-enter the political arena. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Development of Comprehensive Reduced Kinetic Models for Supersonic Reacting Shear Layer Simulations

NASA Technical Reports Server (NTRS)

Zambon, A. C.; Chelliah, H. K.; Drummond, J. P.

2006-01-01

Large-scale simulations of multi-dimensional unsteady turbulent reacting flows with detailed chemistry and transport can be computationally extremely intensive even on distributed computing architectures. With the development of suitable reduced chemical kinetic models, the number of scalar variables to be integrated can be decreased, leading to a significant reduction in the computational time required for the simulation with limited loss of accuracy in the results. A general MATLAB-based automated mechanism reduction procedure is presented to reduce any complex starting mechanism (detailed or skeletal) with minimal human intervention. Based on the application of the quasi steady-state (QSS) approximation for certain chemical species and on the elimination of the fast reaction rates in the mechanism, several comprehensive reduced models, capable of handling different fuels such as C2H4, CH4 and H2, have been developed and thoroughly tested for several combustion problems (ignition, propagation and extinction) and physical conditions (reactant compositions, temperatures, and pressures). A key feature of the present reduction procedure is the explicit solution of the concentrations of the QSS species, needed for the evaluation of the elementary reaction rates. In contrast, previous approaches relied on an implicit solution due to the strong coupling between QSS species, requiring computationally expensive inner iterations. A novel algorithm, based on the definition of a QSS species coupling matrix, is presented to (i) introduce appropriate truncations to the QSS algebraic relations and (ii) identify the optimal sequence for the explicit solution of the concentration of the QSS species. With the automatic generation of the relevant source code, the resulting reduced models can be readily implemented into numerical codes.

Applying Systems Thinking to Law Enforcement Safety: Recommendation for a Comprehensive Safety Management Framework

DTIC Science & Technology

2015-12-01

Occupational Injuries COPS Community Oriented Policing Services CRM Crew Resource Management DA Department of the Army FEMA Federal Emergency...establishes composite risk management ( CRM ), also known as crew resource management, “as the Army’s principal risk reduction methodology and assures...regulatory and statutory compliance.”106 CRM , also utilized by other branches within the military and by the aviation industry, is intended “to minimize

Experimental investigation of shock-cell noise reduction for single-stream nozzles in simulated flight, comprehensive data report. Volume 3: Shadowgraph photos and facility description

NASA Technical Reports Server (NTRS)

Yamamoto, K.; Brausch, J. F.; Janardan, B. A.; Hoerst, D. J.; Price, A. O.; Knott, P. R.

1984-01-01

A total of 142 shadowgraph photographs were taken on 43 different plumes that were distributed over the six nozzle configurations using the 9.5 inch diameter collimated light beam of the shadowgraph setup. Aerodynamic flow conditions of the shadowgraph test points, the location and identification of each of the photographs, and copies of the pictures are presented.

Evaluation of Treatment Technologies for Wastewater from Insensitive Munitions Production. Phase 1: Technology Down-Selection

DTIC Science & Technology

2013-11-01

the AOP reactor according to the target process formulation. Gases were vented to a GAC vessel. ERDC/EL TR-13-20 94 10.2.2 Results and Discussion...destructive and filtration methods such as biological treatment (destructive), chemical reduction (destructive), reverse osmosis (RO)/nano- filtration ... filtration ), and advanced oxidation processes (destructive). A comprehensive evaluation of alternatives relies on a detailed list of criteria, allowing for

Comprehensive treatment of three patients with comorbid OCPD and ADHD.

PubMed

Josephson, Stephen C; Hollander, Eric; Sumner, Jennifer

2007-05-01

Three patients were seen in an outpatient setting with work difficulties involving disorganization and task completion. They were evaluated and found to have significant symptoms of both attention-deficit/hyperactivity disorder, inattentive subtype and obsessive-compulsive personality disorder and were then treated with a creative combined behavioral and medication treatment, which emphasized the use of external aides (eg, paraprofessionals). Significant symptom reduction was observed as a result of this combined intervention.

The Effects of Signal Erosion and Core Genome Reduction on the Identification of Diagnostic Markers

DTIC Science & Technology

2016-09-20

31 diagnostics for the identification of bacterial pathogens. To do this effectively, 32 genomics databases must be comprehensive to identify the...diverse B. 118 pseudomallei/mallei strains were sequenced, assembled, and deposited in public 119 databases (Supplemental Table 1); these genomes were...combined with 160 B. 120 pseudomallei/mallei genome assemblies already in public databases . Most of the 121 genomes (n=779) in this study were

Dissociations and Associations of Performance in Syntactic Comprehension in Aphasia and their Implications for the Nature of Aphasic Deficits

PubMed Central

Caplan, David; Michaud, Jennifer; Hufford, Rebecca

2013-01-01

Sixty one pwa were tested on syntactic comprehension in three tasks: sentence-picture matching, sentence-picture matching with auditory moving window presentation, and object manipulation. There were significant correlations of performances on sentences across tasks. First factors in unrotated factor analyses accounted for most of the variance on which all sentence types loaded in each task. Dissociations in performance between sentence types that differed minimally in their syntactic structures were not consistent across tasks. These results replicate previous results with smaller samples and provide important validation of basic aspects of aphasic performance in this area of language processing. They point to the role of a reduction in processing resources and of the interaction of task demands and parsing and interpretive abilities in the genesis of patient performance. PMID:24061104

Monitoring the Sodium Content of Restaurant Foods: Public Health Challenges and Opportunities

PubMed Central

Cogswell, Mary E.; Gunn, Janelle P.; Curtis, Christine J.; Rhodes, Donna; Hoy, Kathy; Pehrsson, Pamela; Nickle, Melissa; Merritt, Robert

2013-01-01

We reviewed methods of studies assessing restaurant foods’ sodium content and nutrition databases. We systematically searched the 1964–2012 literature and manually examined references in selected articles and studies. Twenty-six (5.2%) of the 499 articles we found met the inclusion criteria and were abstracted. Five were conducted nationally. Sodium content determination methods included laboratory analysis (n = 15), point-of-purchase nutrition information or restaurants’ Web sites (n = 8), and menu analysis with a nutrient database (n = 3). There is no comprehensive data system that provides all information needed to monitor changes in sodium or other nutrients among restaurant foods. Combining information from different sources and methods may help inform a comprehensive system to monitor sodium content reduction efforts in the US food supply and to develop future strategies. PMID:23865701

Development and validation of a ten-item questionnaire with explanatory illustrations to assess upper extremity disorders: favorable effect of illustrations in the item reduction process.

PubMed

Kurimoto, Shigeru; Suzuki, Mikako; Yamamoto, Michiro; Okui, Nobuyuki; Imaeda, Toshihiko; Hirata, Hitoshi

2011-11-01

The purpose of this study is to develop a short and valid measure for upper extremity disorders and to assess the effect of attached illustrations in item reduction of a self-administered disability questionnaire while retaining psychometric properties. A validated questionnaire used to assess upper extremity disorders, the Hand20, was reduced to ten items using two item-reduction techniques. The psychometric properties of the abbreviated form, the Hand10, were evaluated on an independent sample that was used for the shortening process. Validity, reliability, and responsiveness of the Hand10 were retained in the item reduction process. It was possible that the use of explanatory illustrations attached to the Hand10 helped with its reproducibility. The illustrations for the Hand10 promoted text comprehension and motivation to answer the items. These changes resulted in high acceptability; more than 99.3% of patients, including 98.5% of elderly patients, could complete the Hand10 properly. The illustrations had favorable effects on the item reduction process and made it possible to retain precision of the instrument. The Hand10 is a reliable and valid instrument for individual-level applications with the advantage of being compact and broadly applicable, even in elderly individuals.

Cost-effectiveness analysis of salt reduction policies to reduce coronary heart disease in Syria, 2010-2020.

PubMed

Wilcox, Meredith L; Mason, Helen; Fouad, Fouad M; Rastam, Samer; al Ali, Radwan; Page, Timothy F; Capewell, Simon; O'Flaherty, Martin; Maziak, Wasim

2015-01-01

This study presents a cost-effectiveness analysis of salt reduction policies to lower coronary heart disease in Syria. Costs and benefits of a health promotion campaign about salt reduction (HP); labeling of salt content on packaged foods (L); reformulation of salt content within packaged foods (R); and combinations of the three were estimated over a 10-year time frame. Policies were deemed cost-effective if their cost-effectiveness ratios were below the region's established threshold of $38,997 purchasing power parity (PPP). Sensitivity analysis was conducted to account for the uncertainty in the reduction of salt intake. HP, L, and R+HP+L were cost-saving using the best estimates. The remaining policies were cost-effective (CERs: R=$5,453 PPP/LYG; R+HP=$2,201 PPP/LYG; R+L=$2,125 PPP/LYG). R+HP+L provided the largest benefit with net savings using the best and maximum estimates, while R+L was cost-effective with the lowest marginal cost using the minimum estimates. This study demonstrated that all policies were cost-saving or cost effective, with the combination of reformulation plus labeling and a comprehensive policy involving all three approaches being the most promising salt reduction strategies to reduce CHD mortality in Syria.

Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials.

PubMed

Ellis, Graham; Whitehead, Martin A; Robinson, David; O'Neill, Desmond; Langhorne, Peter

2011-10-27

To evaluate the effectiveness of comprehensive geriatric assessment in hospital for older adults admitted as an emergency. We searched the EPOC Register, Cochrane's Controlled Trials Register, the Database of Abstracts of Reviews of Effects (DARE), Medline, Embase, CINAHL, AARP Ageline, and handsearched high yield journals. Randomised controlled trials of comprehensive geriatric assessment (whether by mobile teams or in designated wards) compared with usual care. Comprehensive geriatric assessment is a multidimensional interdisciplinary diagnostic process used to determine the medical, psychological, and functional capabilities of a frail elderly person to develop a coordinated and integrated plan for treatment and long term follow-up. Three independent reviewers assessed eligibility and trial quality and extracted published data. Two additional reviewers moderated. Twenty two trials evaluating 10,315 participants in six countries were identified. For the primary outcome "living at home," patients who underwent comprehensive geriatric assessment were more likely to be alive and in their own homes at the end of scheduled follow-up (odds ratio 1.16 (95% confidence interval 1.05 to 1.28; P = 0.003; number needed to treat 33) at a median follow-up of 12 months versus 1.25 (1.11 to 1.42; P < 0.001; number needed to treat 17) at a median follow-up of six months) compared with patients who received general medical care. In addition, patients were less likely to be living in residential care (0.78, 0.69 to 0.88; P < 0.001). Subgroup interaction suggested differences between the subgroups "wards" and "teams" in favour of wards. Patients were also less likely to die or experience deterioration (0.76, 0.64 to 0.90; P = 0.001) and were more likely to experience improved cognition (standardised mean difference 0.08, 0.01 to 0.15; P = 0.02) in the comprehensive geriatric assessment group. Comprehensive geriatric assessment increases patients' likelihood of being alive and in their own homes after an emergency admission to hospital. This seems to be especially true for trials of wards designated for comprehensive geriatric assessment and is associated with a potential cost reduction compared with general medical care.

The impact of aircraft noise exposure on South African children's reading comprehension: the moderating effect of home language.

PubMed

Seabi, Joseph; Cockcroft, Kate; Goldschagg, Paul; Greyling, Mike

2012-01-01

Given the limited studies conducted within the African continent, the purpose of this study was to investigate the impact of chronic aircraft noise exposure and the moderating effect of home language on the learners' reading comprehension. The sample comprised 437 (52%) senior primary learners exposed to high levels of aircraft noise (Experimental group) and 337 (48%) learners residing in a quieter area (Control group). Of these, 151 learners in the Experimental group spoke English as a first language (EFL) and 162 spoke English as a second language (ESL). In the Control group, the numbers were similarly divided (EFL n = 191; ESL n = 156). A univariate General Linear Model was used to investigate the effects of aircraft noise exposure and language on reading comprehension, while observing for the possible impact of intellectual ability, gender, and socioeconomic status on the results. A significant difference was observed between ESL and EFL learners in favor of the latter (F 1,419 = 21.95, P =.000). In addition a substantial and significant interaction effect was found between the experimental and control groups for the two language groups. For the EFL speakers there was a strong reduction in reading comprehension in the aircraft noise group. By contrast this difference was not significant for the ESL speakers. Implications of the findings and suggestions for further research are made in the article.

Significant reduction of repeat teen pregnancy in a comprehensive young parent program.

PubMed

Omar, H A; Fowler, A; McClanahan, K K

2008-10-01

To describe a comprehensive, multidisciplinary approach to teen mothers and their children that significantly reduces repeat pregnancies. Retrospective review of repeat teen pregnancy data. Young Parent Program (YPP) at a university-based health center. 1386 teen mothers between the ages of 11 and 19 who participated in the YPP for at least three years. Comprehensive Care: for both teen mother and her baby, including prenatal and postnatal care, preventive care, reproductive services, mental health, and acute care visits. Family counseling and similar services were also provided to siblings of the teen. CONTINUITY OF CARE: Patients are seen by the same staff and attending physicians on each visit. The treatment team includes physicians, nurses, social worker, nutritionist, and psychologist, all of whom are available to provide care at each visit. Flexible hours: Including evening clinic to allow teens to attend school or work during the day. Financial incentive: Patients with no insurance are given free contraceptives and a "no charge" clinic visit. Extensive contraceptive counseling is provided prior to start of contraceptive use and at every clinic visit. Routine telephone and/or mail reminders of appointments Rate of repeat teen pregnancy. Only 11(.79%) had repeat pregnancies. Older youth appeared more likely to repeat a pregnancy. Comprehensive intervention for teen mothers can be very successful in reducing repeat teen pregnancy in those teens who participate consistently in the program over a period of years.

Effectiveness of a Comprehensive Stress Management Program to Reduce Work-Related Stress in a Medium-Sized Enterprise

PubMed Central

2014-01-01

Objectives To assess the effectiveness of a comprehensive workplace stress management program consisting of participatory action-oriented training (PAOT) and individual management. Methods A comprehensive workplace stress management program was conducted in a medium-sized enterprise. The baseline survey was conducted in September 2011, using the Korean Occupational Stress Scale (KOSS) and Worker’s Stress Response Inventory (WSRI). After implementing both organizational and individual level interventions, the follow up evaluation was conducted in November 2011. Results Most of the workers participated in the organizational level PAOT and made Team-based improvement plans. Based on the stress survey, 24 workers were interviewed by a researcher. After the organizational and individual level interventions, there was a reduction of several adverse psychosocial factors and stress responses. In the case of blue-collar workers, psychosocial factors such as the physical environment, job demands, organizational system, lack of rewards, and occupational climate were significantly improved; in the case of white-collar workers, the occupational climate was improved. Conclusions In light of these results, we concluded that the comprehensive stress management program was effective in reducing work-related stress in a short-term period. A persistent long-term follow up is necessary to determine whether the observed effects are maintained over time. Both team-based improvement activities and individual interviews have to be sustainable and complementary to each other under the long-term plan. PMID:24524591

Strategies to Reduce Dietary Sodium Intake

PubMed Central

Cobb, Laura K; Appel, Lawrence J; Anderson, Cheryl A.M.

2013-01-01

Opinion Excess sodium intake has an important, if not predominant, role in the pathogenesis of elevated blood pressure, one of the most important modifiable determinants of cardiovascular disease (CVD). In the United States, almost 80% of sodium in the diet comes from packaged and restaurant foods. Given the current food environment, educational efforts such as clinician counseling are useful, but a comprehensive public health approach is necessary to achieve meaningful reductions in sodium intake. A successful approach includes several key strategies, which together will both promote positive decisions by individuals and change the context in which they make those decisions. The strategies include: (1) public education, (2) individual dietary counseling, (3) food labeling, (4) coordinated, voluntary industry sodium reduction, (5) government and private sector food procurement policies, and (6) FDA regulations, as recommended by the Institute of Medicine, to modify sodium’s generally regarded as safe (GRAS) status. Population-wide reduction in sodium intake has the potential to substantially reduce the public burden of preventable CVD and reduce health care costs. PMID:22580974

Event-related potential evidence for the processing efficiency theory.

PubMed

Murray, N P; Janelle, C M

2007-01-15

The purpose of this study was to examine the central tenets of the processing efficiency theory using psychophysiological measures of attention and effort. Twenty-eight participants were divided equally into either a high or low trait anxiety group. They were then required to perform a simulated driving task while responding to one of four target light-emitting diodes. Cortical activity and dual task performance were recorded under two conditions -- baseline and competition -- with cognitive anxiety being elevated in the competitive session by an instructional set. Although driving speed was similar across sessions, a reduction in P3 amplitude to cue onset in the light detection task occurred for both groups during the competitive session, suggesting a reduction in processing efficiency as participants became more state anxious. Our findings provide more comprehensive and mechanistic evidence for processing efficiency theory, and confirm that increases in cognitive anxiety can result in a reduction of processing efficiency with little change in performance effectiveness.

Estimating the Return on Investment From a Health Risk Management Program Offered to Small Colorado-Based Employers

PubMed Central

Goetzel, Ron Z.; Tabrizi, Maryam; Henke, Rachel Mosher; Benevent, Richele; Brockbank, Claire v. S.; Stinson, Kaylan; Trotter, Margo; Newman, Lee S.

2015-01-01

Objective To determine whether changes in health risks for workers in small businesses can produce medical and productivity cost savings. Methods A 1-year pre- and posttest study tracked changes in 10 modifiable health risks for 2458 workers at 121 Colorado businesses that participated in a comprehensive worksite health promotion program. Risk reductions were entered into a return-on-investment (ROI) simulation model. Results Reductions were recorded in 10 risk factors examined, including obesity (−2.0%), poor eating habits (−5.8%), poor physical activity (−6.5%), tobacco use (−1.3%), high alcohol consumption (−1.7%), high stress (−3.5%), depression (−2.3%), high blood pressure (−0.3%), high total cholesterol (−0.9%), and high blood glucose (−0.2%). The ROI model estimated medical and productivity savings of $2.03 for every $1.00 invested. Conclusions Pooled data suggest that small businesses can realize a positive ROI from effective risk reduction programs. PMID:24806569

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

Erhart, Steven C.; Spencer, Charles G.

The accomplishments to date and the long-range planning of the Y-12 Energy Management and Sustainability and Stewardship programs support the U.S. Department of Energy (DOE) and the National Nuclear Security Administration (NNSA) vision for a commitment to energy effi ciency and sustainability and to achievement of the Guiding Principles. Specifi cally, the Y-12 vision is to support the Environment, Safety and Health Policy and the DOE Strategic Sustainability Performance Plan (SSPP), while promoting overall sustainability and reduction of greenhouse gas (GHG) emissions. The mission of the Y-12 Energy Management program is to incorporate energy-efficient technologies site-wide and to position Y-12more » to meet NNSA energy requirement needs through 2025 and beyond. This plan addresses: Greenhouse Gas Reduction and Comprehensive Greenhouse Gas Inventory; Buildings, ESPC Initiative Schedule, and Regional and Local Planning; Fleet Management; Water Use Efficiency and Management; Pollution Prevention and Waste Reduction; Sustainable Acquisition; Electronic Stewardship and Data Centers; Renewable Energy; Climate Change; and Budget and Funding.« less

Barriers for progress in salt reduction in the general population. An international study.

PubMed

Newson, R S; Elmadfa, I; Biro, Gy; Cheng, Y; Prakash, V; Rust, P; Barna, M; Lion, R; Meijer, G W; Neufingerl, N; Szabolcs, I; van Zweden, R; Yang, Y; Feunekes, G I J

2013-12-01

Salt reduction is important for reducing hypertension and the risk of cardiovascular events, nevertheless worldwide salt intakes are above recommendations. Consequently strategies to reduce intake are required, however these require an understanding of salt intake behaviours to be effective. As limited information is available on this, an international study was conducted to derive knowledge on salt intake and associated behaviours in the general population. An online cohort was recruited consisting of a representative sample from Germany, Austria, United States of America, Hungary, India, China, South Africa, and Brazil (n=6987; aged 18-65 years; age and gender stratified). Participants completed a comprehensive web-based questionnaire on salt intake and associated behaviours. While salt reduction was seen to be healthy and important, over one third of participants were not interested in salt reduction and the majority were unaware of recommendations. Salt intake was largely underestimated and people were unaware of the main dietary sources of salt. Participants saw themselves as mainly responsible for their salt intake, but also acknowledged the roles of others. Additionally, they wanted to learn more about why salt was bad for health and what the main sources in the diet were. As such, strategies to reduce salt intake must raise interest in engaging in salt reduction through improving understanding of intake levels and dietary sources of salt. Moreover, while some aspects of salt reduction can be globally implemented, local tailoring is required to match level of interest in salt reduction. These findings provide unique insights into issues surrounding salt reduction and should be used to develop effective salt reduction strategies and/or policies. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Harm reduction and “Clean” community: can Viet Nam have both?

PubMed Central

2012-01-01

The findings of our research show that while police play multiple roles in the fight against drug-related crime, they often perceived their tasks – especially preventing and controlling drug use on the one hand, and supporting harm reduction on the other – as contradictory, and this creates tensions in their work and relations with their communities. Although they are leaders and implementers of harm reduction, not all police know about it, and some remain skeptical or perceive it as contradictory to their main task of fighting drugs. Methadone treatment is seen by some as in competition with their main task of coordinating conventional drug treatment in the rehabilitation center. The history of drug use and the evolution of discourses on drug use in Viet Nam have created these conflicting pressures on police, and thus created contradictory expectations and led to different views and attitudes of police regarding various harm reduction measures. This might aid understanding why, despite the comprehensive and progressive policies on HIV/AIDS and harm reduction in Viet Nam, it is not easy for police to actively and effectively support and be involved in harm reduction at the ground level. To promote the wider acceptance of harm reduction the concept of community safety must be expanded to include community health; harm reduction must be integrated into the “new society” movement; and laws and policies need further revision to reduce contradiction between current drug laws and HIV laws. Harm reduction guidelines for police and other actors need to be disseminated and supported, embodying better ways of working between sectors, and all sectors in the partnership require support for building capacity to contribute to the overall goal. PMID:22769430

First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents.

PubMed

Letourneau, Elizabeth J; McCart, Michael R; Sheidow, Ashli J; Mauro, Pia M

2017-01-01

There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N=45) or usual services (US; N=60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

Are Cultural Values and Beliefs Included in U.S. Based HIV Interventions?

PubMed Central

Wyatt, Gail E.; Williams, John K.; Gupta, Arpana; Malebranche, Dominique

2013-01-01

Objective To determine the extent to which current U.S. based HIV/AIDS prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. Method A comprehensive literature review was conducted to determine which published HIV/AIDS prevention and risk reduction interventions incorporated aspects of cultural beliefs. Results This review of 166 HIV prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. Conclusion HIV interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual’s risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. PMID:21884721

First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents

PubMed Central

Letourneau, Elizabeth J.; McCart, Michael R.; Sheidow, Ashli J.; Mauro, Pia M.

2016-01-01

There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N = 45) or usual services (US; N = 60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. PMID:27629581

Manipulation of nasal fractures with local anaesthetic: a 'how to do it' with online video tutorial.

PubMed

Repanos, Costa; Anderson, Daniel; Earnshaw, James; Mitchell, David; Coman, William

2010-06-01

Nasal fractures are the most common facial fractures and displaced fractures may cause considerable cosmetic concern. Traditionally, displaced nasal fractures have been manipulated under general anaesthesia (GA) performed within 2 weeks of the injury. Despite evidence for the benefit of local anaesthesia (LA), nasal fractures are still most commonly reduced under GA. We have presented a method of reduction of simple nasal fractures under LA in an outpatient setting. This has the advantage of being painless, simple to attempt and cost-effective. If reduction is inadequate then a general anaesthetic reduction is still possible. A recent comprehensive systematic review of all the available evidence did not show any significant difference (in terms of cosmesis, pain or nasal obstruction) between using LA and GA methods and highlighted the evidence base to support LA. We describe our method of assessment and treatment of displaced nasal fractures and provide an online tutorial (http://sciencestage.com/v/22194/local-anaesthetic-nasal-fracture-reduction.html). It is important to keep in mind that any concerns should be referred to an otolaryngology specialist for further management and that practitioners attempting this technique should first receive training from an otolaryngologist.

Harm reduction programmes in the Asia--Pacific Region.

PubMed

Reid, Gary; Devaney, Madonna L; Baldwin, Simon

2008-01-01

This paper reports on the public health intervention of harm reduction to address drug use issues in the Asia-Pacific region. It is based on the report 'Situational analysis of illicit drug issues and responses in Asia and the Pacific', commissioned by the Australian National Council on Drugs Asia Pacific Drug Issues Committee. A comprehensive desk-based review based on published and unpublished literature and key informant data. Drug use in the Asia--Pacific region is widespread, resulting in serious adverse health consequences. Needle and syringe programmes are found in some parts of Asia, but not in the six Pacific Island countries reviewed. Outreach and peer education programmes are implemented, but overall appear minor in size and scope. Substitution therapy programmes appear to be entering a new era of acceptance in some parts of Asia. Primary health care specifically for drug users overall is limited. Harm reduction programmes in the Asia--Pacific region are either small in scale or do not exist. Most programmes lack the technical capacity, human resources and a limited scope of operations to respond effectively to the needs of drug users. Governments in this region should be encouraged to endorse evidence-based harm reduction programmes.

[Ecological security of wastewater treatment processes: a review].

PubMed

Yang, Sai; Hua, Tao

2013-05-01

Though the regular indicators of wastewater after treatment can meet the discharge requirements and reuse standards, it doesn't mean the effluent is harmless. From the sustainable point of view, to ensure the ecological and human security, comprehensive toxicity should be considered when discharge standards are set up. In order to improve the ecological security of wastewater treatment processes, toxicity reduction should be considered when selecting and optimizing the treatment processes. This paper reviewed the researches on the ecological security of wastewater treatment processes, with the focus on the purposes of various treatment processes, including the processes for special wastewater treatment, wastewater reuse, and for the safety of receiving waters. Conventional biological treatment combined with advanced oxidation technologies can enhance the toxicity reduction on the base of pollutants removal, which is worthy of further study. For the process aimed at wastewater reuse, the integration of different process units can complement the advantages of both conventional pollutants removal and toxicity reduction. For the process aimed at ecological security of receiving waters, the emphasis should be put on the toxicity reduction optimization of process parameters and process unit selection. Some suggestions for the problems in the current research and future research directions were put forward.

Addressing excess risk of overdose among recently incarcerated people in the USA: harm reduction interventions in correctional settings.

PubMed

Brinkley-Rubinstein, Lauren; Cloud, David H; Davis, Chelsea; Zaller, Nickolas; Delany-Brumsey, Ayesha; Pope, Leah; Martino, Sarah; Bouvier, Benjamin; Rich, Josiah

2017-03-13

Purpose The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population. Design/methodology/approach Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs. Federal, state, and local plans commonly lack corrections as an ingredient in combating overdose. Harm reduction strategies are vital for reducing the risk of overdose in the post-release community. Findings Therefore, the authors recommend that the following be implemented in correctional settings: expansion of overdose education and naloxone programs; establishment of comprehensive medication assisted treatment programs as standard of care; development of corrections-specific overdose risk assessment tools; and increased collaboration between corrections entities and community-based organizations. Originality/value In this policy brief the authors provide recommendations for implementing harm reduction approaches in criminal justice settings. Adoption of these strategies could reduce the number of overdoses among those with recent criminal justice involvement.

Impact of smoke-free legislation on perinatal and infant mortality: a national quasi-experimental study

PubMed Central

Been, Jasper V; Mackay, Daniel F; Millett, Christopher; Pell, Jill P; van Schayck, Onno CP; Sheikh, Aziz

2015-01-01

Smoke-free legislation is associated with improved early-life outcomes; however its impact on perinatal survival is unclear. We linked individual-level data with death certificates for all registered singletons births in England (1995–2011). We used interrupted time series logistic regression analysis to study changes in key adverse perinatal events following the July 2007 national, comprehensive smoke-free legislation. We studied 52,163 stillbirths and 10,238,950 live-births. Smoke-free legislation was associated with an immediate 7.8% (95%CI 3.5–11.8; p < 0.001) reduction in stillbirth, a 3.9% (95%CI 2.6–5.1; p < 0.001) reduction in low birth weight, and a 7.6% (95%CI 3.4–11.7; p = 0.001) reduction in neonatal mortality. No significant impact on SIDS was observed. Using a counterfactual scenario, we estimated that in the first four years following smoke-free legislation, 991 stillbirths, 5,470 cases of low birth weight, and 430 neonatal deaths were prevented. In conclusion, smoke-free legislation in England was associated with clinically important reductions in severe adverse perinatal outcomes. PMID:26268789

[Parodontitis immunotropic therapy in patients with chronic viral and bacterial infections].

PubMed

Soboleva, L A; Siakin, R R; Blinnikova, E N; Shul'diakov, A A; Pichugina, L M

2010-01-01

80 patients with chronic hepatitis and brucellosis were examined in order to determine the efficacy of cycloferon liniment in parodontitis treatment. It was established that the use of local cycloferon form in comprehensive treatment of parodontitis helped to speed up recovery process and to reduce the frequency of disease relapses. Normalization of lipid peroxidation and antioxidant defense processes indices with reduction of infectious loading of parodontal pockets fluid and normalization of local cytokines' status was noted.

Guinea: Background and Relations with the United States

DTIC Science & Technology

2010-03-22

wounded, by stray bullets.20 After a week of unrest, Conté met with mutiny leaders, and the government agreed to pay salary arrears of $1,100 to each...period. IDA also provides grants to countries at risk of debt distress. 117 The HIPC Initiative is a comprehensive approach to debt reduction for...track. Reaching the HIPC “completion point” would grant Guinea an estimated relief of $2.2 billion and reduce debt service by approximately $100

Guinea: Background and Relations with the United States

DTIC Science & Technology

2010-07-19

salary arrears of $1,100 to each soldier, sack the defense minister, and grant promotions to junior officers, ending the uprising.15 In mid-June 2008...Service 17 printing large amounts of new currency in 2009), and the freezing of some foreign aid.75 Guinea’s external debt burden—$3.1 billion in...period. IDA also provides grants to countries at risk of debt distress. 100 The HIPC Initiative is a comprehensive approach to debt reduction for

POLAR/CEPPAD Data Analysis

NASA Technical Reports Server (NTRS)

Baker, D. N.; Hoffman, R. (Technical Monitor)

2001-01-01

This final report provides a final report on a NASA sponsored project involving data reduction and scientific analysis related to the Comprehensive Energetic Particle Pitch Angle Distribution (CEPPAD) experiment of POLAR. Dr. D.N. Baker, the chief scientist, has focused primarily on the calibration of CEPPAD sensors and the interpretation of data from the sensors which has led to discoveries regarding storm-substorm relationships in the earth's magnetosphere. The report contains approximately 190 bibliographic references to the activities of Baker and others involved.

Army Posture Statement: A Statement on the Posture of the United States Army 2011

DTIC Science & Technology

2011-03-02

Program Temporary End Strength Increase ( TESI ) Drawdown Plan Theater Support and Aviation Reset Transferability of GI Bill Benefits to Family Members...we described the Army as “out of balance” and put in place a four year plan to restore balance to a point where we could meet the demands on our...Component Readiness1* F. Army Force Generation (ARFORGEN)* G. Reset* H. Army Campaign Plan for Health Promotion & Risk Reduction* I. Comprehensive

Healthy Schools-Healthy Kids: a controlled evaluation of a comprehensive universal eating disorder prevention program.

PubMed

McVey, Gail; Tweed, Stacey; Blackmore, Elizabeth

2007-06-01

This study was a controlled evaluation of a comprehensive school-based universal prevention program involving male and female students, parents, teachers, school administrators and local public health professionals. A total of 982 male and female Grades 6 and 7 middle school students (and 91 teachers/school administrators) completed self-report surveys at baseline on measures of body satisfaction, internalization of media ideals, size acceptance, disordered eating, weight-based teasing, weight loss and muscle-gaining behaviours, and perceptions of school climate (teachers only). Eighty-four percent of the students repeated the surveys immediately following the 8-month school-wide intervention and 71% again 6 months later. Repeated measures ANCOVAs revealed that participation in the Healthy Schools-Healthy Kids (HS-HK) program had a positive influence by reducing the internalization of media ideals among male and female students and by reducing disordered eating among female students. The program was also associated with reductions in weight-loss behaviours among the students, although this effect was lost by the 6-month follow-up. When the intervention students were sub-divided into low versus high-risk groups, the high-risk group appeared to benefit most from the intervention with significant reductions in internalization of media ideals, greater body satisfaction, and reduced disordered eating over time. There were no intervention effects for teachers. Challenges of engaging teachers in prevention are discussed.

Comprehensively Characterizing the Thioredoxin Interactome In Vivo Highlights the Central Role Played by This Ubiquitous Oxidoreductase in Redox Control*

PubMed Central

Arts, Isabelle S.; Vertommen, Didier; Baldin, Francesca; Laloux, Géraldine; Collet, Jean-François

2016-01-01

Thioredoxin (Trx) is a ubiquitous oxidoreductase maintaining protein-bound cysteine residues in the reduced thiol state. Here, we combined a well-established method to trap Trx substrates with the power of bacterial genetics to comprehensively characterize the in vivo Trx redox interactome in the model bacterium Escherichia coli. Using strains engineered to optimize trapping, we report the identification of a total 268 Trx substrates, including 201 that had never been reported to depend on Trx for reduction. The newly identified Trx substrates are involved in a variety of cellular processes, ranging from energy metabolism to amino acid synthesis and transcription. The interaction between Trx and two of its newly identified substrates, a protein required for the import of most carbohydrates, PtsI, and the bacterial actin homolog MreB was studied in detail. We provide direct evidence that PtsI and MreB contain cysteine residues that are susceptible to oxidation and that participate in the formation of an intermolecular disulfide with Trx. By considerably expanding the number of Trx targets, our work highlights the role played by this major oxidoreductase in a variety of cellular processes. Moreover, as the dependence on Trx for reduction is often conserved across species, it also provides insightful information on the interactome of Trx in organisms other than E. coli. PMID:27081212

Comprehensive Utilization of Iron and Phosphorus from High-Phosphorus Refractory Iron Ore

NASA Astrophysics Data System (ADS)

Sun, Yongsheng; Zhang, Qi; Han, Yuexin; Gao, Peng; Li, Guofeng

2018-02-01

An innovative process of coal-based reduction followed by magnetic separation and dephosphorization was developed to simultaneously recover iron and phosphorus from one typical high-phosphorus refractory iron ore. The experimental results showed that the iron minerals in iron ore were reduced to metallic iron during the coal-based reduction and the phosphorus was enriched in the metallic iron phase. The CaO-SiO2-FeO-Al2O3 slag system was used in the dephosphorization of metallic iron. A hot metal of 99.17% Fe and 0.10% P was produced with Fe recovery of 84.41%. Meanwhile, a dephosphorization slag of 5.72% P was obtained with P recovery of 67.23%. The contents of impurities in hot metal were very low, and it could be used as feedstock for steelmaking after a secondary refining. Phosphorus in the dephosphorization slag mainly existed in the form of a 5CaO·P2O5·SiO2 solid solution where the P2O5 content is 13.10%. At a slag particle size of 20.7 μm (90% passing), 94.54% of the P2O5 could be solubilized in citric acid, indicating the slag met the feedstock requirements in phosphate fertilizer production. Consequently, the proposed process achieved simultaneous Fe and P recovery, paving the way to comprehensive utilization of high-phosphorus refractory iron ore.

Multi-Hazard Interactions in Guatemala

NASA Astrophysics Data System (ADS)

Gill, Joel; Malamud, Bruce D.

2017-04-01

In this paper, we combine physical and social science approaches to develop a multi-scale regional framework for natural hazard interactions in Guatemala. The identification and characterisation of natural hazard interactions is an important input for comprehensive multi-hazard approaches to disaster risk reduction at a regional level. We use five transdisciplinary evidence sources to organise and populate our framework: (i) internationally-accessible literature; (ii) civil protection bulletins; (iii) field observations; (iv) stakeholder interviews (hazard and civil protection professionals); and (v) stakeholder workshop results. These five evidence sources are synthesised to determine an appropriate natural hazard classification scheme for Guatemala (6 hazard groups, 19 hazard types, and 37 hazard sub-types). For a national spatial extent (Guatemala), we construct and populate a "21×21" hazard interaction matrix, identifying 49 possible interactions between 21 hazard types. For a sub-national spatial extent (Southern Highlands, Guatemala), we construct and populate a "33×33" hazard interaction matrix, identifying 112 possible interactions between 33 hazard sub-types. Evidence sources are also used to constrain anthropogenic processes that could trigger natural hazards in Guatemala, and characterise possible networks of natural hazard interactions (cascades). The outcomes of this approach are among the most comprehensive interaction frameworks for national and sub-national spatial scales in the published literature. These can be used to support disaster risk reduction and civil protection professionals in better understanding natural hazards and potential disasters at a regional scale.

Alterations in zebrafish development induced by simvastatin: Comprehensive morphological and physiological study, focusing on muscle

PubMed Central

Campos, Laise M; Rios, Eduardo A; Guapyassu, Livia; Midlej, Victor; Atella, Georgia C; Herculano-Houzel, Suzana; Benchimol, Marlene; Mermelstein, Claudia

2016-01-01

The cholesterol synthesis inhibitor simvastatin, which is used to treat cardiovascular diseases, has severe collateral effects. We decided to comprehensively study the effects of simvastatin in zebrafish development and in myogenesis, because zebrafish has been used as a model to human diseases, due to its handling easiness, the optical clarity of its embryos, and the availability of physiological and structural methodologies. Furthermore, muscle is an important target of the drug. We used several simvastatin concentrations at different zebrafish developmental stages and studied survival rate, morphology, and physiology of the embryos. Our results show that high levels of simvastatin induce structural damage whereas low doses induce minor structural changes, impaired movements, and reduced heart beating. Morphological alterations include changes in embryo and somite size and septa shape. Physiological changes include movement reduction and slower heartbeat. These effects could be reversed by the addition of exogenous cholesterol. Moreover, we quantified the total cell number during zebrafish development and demonstrated a large reduction in cell number after statin treatment. Since we could classify the alterations induced by simvastatin in three distinct phenotypes, we speculate that simvastatin acts through more than one mechanism and could affect both cell replication and/or cell death and muscle function. Our data can contribute to the understanding of the molecular and cellular basis of the mechanisms of action of simvastatin. PMID:27444151

Alterations in zebrafish development induced by simvastatin: Comprehensive morphological and physiological study, focusing on muscle.

PubMed

Campos, Laise M; Rios, Eduardo A; Guapyassu, Livia; Midlej, Victor; Atella, Georgia C; Herculano-Houzel, Suzana; Benchimol, Marlene; Mermelstein, Claudia; Costa, Manoel L

2016-11-01

The cholesterol synthesis inhibitor simvastatin, which is used to treat cardiovascular diseases, has severe collateral effects. We decided to comprehensively study the effects of simvastatin in zebrafish development and in myogenesis, because zebrafish has been used as a model to human diseases, due to its handling easiness, the optical clarity of its embryos, and the availability of physiological and structural methodologies. Furthermore, muscle is an important target of the drug. We used several simvastatin concentrations at different zebrafish developmental stages and studied survival rate, morphology, and physiology of the embryos. Our results show that high levels of simvastatin induce structural damage whereas low doses induce minor structural changes, impaired movements, and reduced heart beating. Morphological alterations include changes in embryo and somite size and septa shape. Physiological changes include movement reduction and slower heartbeat. These effects could be reversed by the addition of exogenous cholesterol. Moreover, we quantified the total cell number during zebrafish development and demonstrated a large reduction in cell number after statin treatment. Since we could classify the alterations induced by simvastatin in three distinct phenotypes, we speculate that simvastatin acts through more than one mechanism and could affect both cell replication and/or cell death and muscle function. Our data can contribute to the understanding of the molecular and cellular basis of the mechanisms of action of simvastatin. © 2016 by the Society for Experimental Biology and Medicine.

The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review

PubMed Central

2016-01-01

Background Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. Objective The aim of this paper was to perform a comprehensive literature review on nurses’ quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Methods Using publications from 2004–2014, contributing factors to American and Canadian nurses’ QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Results Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses’ quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. Conclusions This review’s findings support the importance of QWL as an indicator of nurses’ broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system. PMID:27734769

The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review.

PubMed

Nowrouzi, Behdin; Giddens, Emilia; Gohar, Basem; Schoenenberger, Sandrine; Bautista, Mary Christine; Casole, Jennifer

2016-10-01

Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. The aim of this paper was to perform a comprehensive literature review on nurses' quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Using publications from 2004-2014, contributing factors to American and Canadian nurses' QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses' quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. This review's findings support the importance of QWL as an indicator of nurses' broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system.

The use of multimedia consent programs for surgical procedures: a systematic review.

PubMed

Nehme, Jean; El-Khani, Ussamah; Chow, Andre; Hakky, Sherif; Ahmed, Ahmed R; Purkayastha, Sanjay

2013-02-01

To compare multimedia and standard consent, in respect to patient comprehension, anxiety, and satisfaction, for various surgical/interventional procedures. Electronic searches of PubMed, MEDLINE, Ovid, Embase, and Google Scholar were performed. Relevant articles were assessed by 2 independent reviewers. Comparative (randomized and nonrandomized control trials) studies of multimedia and standard consent for a variety of surgical/interventional procedures were included. Studies had to report on at least one of the outcome measures. Studies were reviewed by 2 independent investigators. The first investigator extracted all relevant data, and consensus of each extraction was performed by a second investigator to verify the data. Overall, this review suggests that the use of multimedia as an adjunct to conventional consent appears to improve patient comprehension. Multimedia leads to high patient satisfaction in terms of feasibility, ease of use, and availability of information. There is no conclusive evidence demonstrating a significant reduction in preoperative anxiety.

Dissociations and associations of performance in syntactic comprehension in aphasia and their implications for the nature of aphasic deficits.

PubMed

Caplan, David; Michaud, Jennifer; Hufford, Rebecca

2013-10-01

Sixty-one pwa were tested on syntactic comprehension in three tasks: sentence-picture matching, sentence-picture matching with auditory moving window presentation, and object manipulation. There were significant correlations of performances on sentences across tasks. First factors on which all sentence types loaded in unrotated factor analyses accounted for most of the variance in each task. Dissociations in performance between sentence types that differed minimally in their syntactic structures were not consistent across tasks. These results replicate previous results with smaller samples and provide important validation of basic aspects of aphasic performance in this area of language processing. They point to the role of a reduction in processing resources and of the interaction of task demands and parsing and interpretive abilities in the genesis of patient performance. Copyright © 2013 Elsevier Inc. All rights reserved.

Tobacco Smoke Exposure in Non-smoking Hospitality Workers Before and After a State Smoking Ban

PubMed Central

Jensen, Joni A.; Schillo, Barbara A.; Moilanen, Molly M.; Lindgren, Bruce R.; Murphy, Sharon; Carmella, Steven; Hecht, Stephen S.; Hatsukami, Dorothy K.

2010-01-01

Secondhand smoke exposure is estimated to account for 3000 cancer deaths per year. While several countries and states in the U.S. have passed comprehensive smoke-free laws to protect all employees, a significant number of workers are still not protected. The purpose of this study was to determine the effects of passing a comprehensive smoking ban that included bars and restaurants on biomarkers of nicotine and carcinogen exposure. The urines of non-smoking employees (N=24) of bars and restaurants that allowed smoking prior to the smoke-free law were analyzed before and after the law was passed in Minnesota. The results showed significant reductions in both total cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) (free plus glucuronidated) after the ban was instituted. These results provide further support for the importance of protecting employees working in all venues. PMID:20354127

Tobacco smoke exposure in nonsmoking hospitality workers before and after a state smoking ban.

PubMed

Jensen, Joni A; Schillo, Barbara A; Moilanen, Molly M; Lindgren, Bruce R; Murphy, Sharon; Carmella, Steven; Hecht, Stephen S; Hatsukami, Dorothy K

2010-04-01

Secondhand smoke exposure is estimated to account for 3,000 cancer deaths per year. Although several countries and states in the United States have passed comprehensive smoke-free laws to protect all employees, a significant number of workers are still not protected. The purpose of this study was to determine the effects of passing a comprehensive smoking ban that included bars and restaurants on biomarkers of nicotine and carcinogen exposure. The urines of nonsmoking employees (n = 24) of bars and restaurants that allowed smoking before the smoke-free law were analyzed before and after the law was passed in Minnesota. The results showed significant reductions in both total cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (free plus glucuronidated) after the ban was instituted. These results provide further support for the importance of protecting employees working in all venues.

Improvements in chronic diseases with a comprehensive natural medicine approach: a review and case series.

PubMed

Nader, T; Rothenberg, S; Averbach, R; Charles, B; Fields, J Z; Schneider, R H

2000-01-01

Approximately 40% of the US population report using complementary and alternative medicine, including Maharishi Vedic Medicine (MVM), a traditional, comprehensive system of natural medicine, for relief from chronic and other disorders. Although many reports suggest health benefits from individual MVM techniques, reports on integrated holistic approaches are rare. This case series, designed to investigate the effectiveness of an integrated, multimodality MVM program in an ideal clinical setting, describes the outcomes in four patients: one with sarcoidosis; one with Parkinson's disease; a third with renal hypertension; and a fourth with diabetes/essential hypertension/anxiety disorder. Standard symptom reports and objective markers of disease were evaluated before, during, and after the treatment period. Results suggested substantial improvements as indicated by reductions in major signs, symptoms, and use of conventional medications in the four patients during the 3-week in-residence treatment phase and continuing through the home follow-up program.

Improvements in Chronic Diseases With a Comprehensive Natural Medicine Approach: A Review and Case Series

PubMed Central

Nader, Tony; Rothenberg, Stuart; Averbach, Richard; Charles, Barry; Fields, Jeremy Z.; Schneider, Robert H.

2008-01-01

Approximately 40% of the US population report using complementary and alternative medicine, including Maharishi Vedic Medicine (MVM), a traditional, comprehensive system of natural medicine, for relief from chronic and other disorders. Although many reports suggest health benefits from individual MVM techniques, reports on integrated holistic approaches are rare. This case series, designed to investigate the effectiveness of an integrated, multi-modality MVM program in an ideal clinical setting, describes the outcomes in four patients: one with sarcoidosis; one with Parkinson’s disease; a third with renal hypertension; and a fourth with diabetes/essential hypertension/anxiety disorder. Standard symptom reports and objective markers of disease were evaluated before, during, and after the treatment period. Results suggested substantial improvements as indicated by reductions in major signs, symptoms, and use of conventional medications in the four patients during the 3-week in-residence treatment phase and continuing through the home follow-up program. PMID:10971882

Temporomandibular disorders. Part 2: conservative management

PubMed Central

Shaffer, Stephen M; Brismée, Jean-Michel; Sizer, Phillip S; Courtney, Carol A

2014-01-01

Appropriate management of temporomandibular disorders (TMD) requires an understanding of the underlying dysfunction associated with the temporomandibular joint (TMJ) and surrounding structures. A comprehensive examination process, as described in part 1 of this series, can reveal underlying clinical findings that assist in the delivery of comprehensive physical therapy services for patients with TMD. Part 2 of this series focuses on management strategies for TMD. Physical therapy is the preferred conservative management approach for TMD. Physical therapists are professionally well-positioned to step into the void and provide clinical services for patients with TMD. Clinicians should utilize examination findings to design rehabilitation programs that focus on addressing patient-specific impairments. Potentially appropriate plan of care components include joint and soft tissue mobilization, trigger point dry needling, friction massage, therapeutic exercise, patient education, modalities, and outside referral. Management options should address both symptom reduction and oral function. Satisfactory results can often be achieved when management focuses on patient-specific clinical variables. PMID:24976744

Comprehensive national database of tree effects on air quality and human health in the United States.

PubMed

Hirabayashi, Satoshi; Nowak, David J

2016-08-01

Trees remove air pollutants through dry deposition processes depending upon forest structure, meteorology, and air quality that vary across space and time. Employing nationally available forest, weather, air pollution and human population data for 2010, computer simulations were performed for deciduous and evergreen trees with varying leaf area index for rural and urban areas in every county in the conterminous United States. The results populated a national database of annual air pollutant removal, concentration changes, and reductions in adverse health incidences and costs for NO2, O3, PM2.5 and SO2. The developed database enabled a first order approximation of air quality and associated human health benefits provided by trees with any forest configurations anywhere in the conterminous United States over time. Comprehensive national database of tree effects on air quality and human health in the United States was developed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Low-level laser therapy for fat layer reduction: a comprehensive review.

PubMed

Avci, Pinar; Nyame, Theodore T; Gupta, Gaurav K; Sadasivam, Magesh; Hamblin, Michael R

2013-08-01

Low-level laser (light) therapy (LLLT) is a noninvasive, nonthermal approach to disorders requiring reduction of pain and inflammation and stimulation of healing and tissue regeneration. Within the last decade, LLLT started being investigated as an adjuvant to liposuction, for noninvasive body contouring, reduction of cellulite, and improvement of blood lipid profile. LLLT may also aid autologous fat transfer procedures by enhancing the viability of adipocytes. However the underlying mechanism of actions for such effects still seems to be unclear. It is important, therefore, to understand the potential efficacy and proposed mechanism of actions of this new procedure for fat reduction. A review of the literature associated with applications of LLLT related to fat layer reduction was performed to evaluate the findings from pre-clinical and clinical studies with respect to the mechanism of action, efficacy, and safety. The studies as of today suggest that LLLT has a potential to be used in fat and cellulite reduction as well as in improvement of blood lipid profile without any significant side effects. One of the main proposed mechanism of actions is based upon production of transient pores in adipocytes, allowing lipids to leak out. Another is through activation of the complement cascade which could cause induction of adipocyte apoptosis and subsequent release of lipids. Although the present studies have demonstrated safety and efficacy of LLLT in fat layer reduction, studies demonstrating the efficacy of LLLT as a stand-alone procedure are still inadequate. Moreover, further studies are necessary to identify the mechanism of action. Copyright © 2013 Wiley Periodicals, Inc.

Global Fund investments in harm reduction from 2002 to 2009.

PubMed

Bridge, Jamie; Hunter, Benjamin M; Atun, Rifat; Lazarus, Jeffrey V

2012-07-01

Injecting drug use has been documented in 158 countries and is a major contributor to HIV epidemics. People who inject drugs have poor and inequitable access to HIV services. The Global Fund to Fight AIDS, Tuberculosis and Malaria is the leading multilateral donor for HIV programmes and encourages applicants to include harm reduction interventions in their proposals. This study is the first detailed analysis of Global Fund investments in harm reduction interventions. The full list of more than 1000 Global Fund grants was analysed to identify HIV grants that contain activities for people who inject drugs. Data were collected from the detailed budgets agreed between the Global Fund and grant recipients. Relevant budget lines were recorded and analysed in terms of the resources allocated to different interventions. 120 grants from 55 countries and territories contained activities for people who inject drugs worth a total of US$ 361 million, increasing to US$ 430 million after projections were made for grants that had yet to enter their final phase of funding. Two-thirds of the budgeted US$ 361 million was allocated to core harm reduction activities as defined by the United Nations. Thirty-nine of the 55 countries were in Eastern Europe and Asia. Only three countries with generalised HIV epidemics had grants that included harm reduction activities. This study represents the most comprehensive assessment of Global Fund investments in harm reduction. This funding, while substantial, falls short of the estimated needs. Investments in harm reduction must increase if HIV transmission among people who inject drugs is to be halved by 2015. Copyright © 2012 Elsevier B.V. All rights reserved.

Low-Level Laser Therapy for Fat Layer Reduction: A Comprehensive Review

PubMed Central

Avci, Pinar; Nyame, Theodore T.; Gupta, Gaurav K.; Sadasivam, Magesh; Hamblin, Michael R.

2013-01-01

Background and Objective Low-level laser (light) therapy (LLLT) is a noninvasive, nonthermal approach to disorders requiring reduction of pain and inflammation and stimulation of healing and tissue regeneration. Within the last decade, LLLT started being investigated as an adjuvant to liposuction, for noninvasive body contouring, reduction of cellulite, and improvement of blood lipid profile. LLLT may also aid autologous fat transfer procedures by enhancing the viability of adipocytes. However the underlying mechanism of actions for such effects still seems to be unclear. It is important, therefore, to understand the potential efficacy and proposed mechanism of actions of this new procedure for fat reduction. Materials and Methods A review of the literature associated with applications of LLLT related to fat layer reduction was performed to evaluate the findings from pre-clinical and clinical studies with respect to the mechanism of action, efficacy, and safety. Results The studies as of today suggest that LLLT has a potential to be used in fat and cellulite reduction as well as in improvement of blood lipid profile without any significant side effects. One of the main proposed mechanism of actions is based upon production of transient pores in adipocytes, allowing lipids to leak out. Another is through activation of the complement cascade which could cause induction of adipocyte apoptosis and subsequent release of lipids. Conclusion Although the present studies have demonstrated safety and efficacy of LLLT in fat layer reduction, studies demonstrating the efficacy of LLLT as a stand-alone procedure are still inadequate. Moreover, further studies are necessary to identify the mechanism of action. PMID:23749426

Haptic computer-assisted patient-specific preoperative planning for orthopedic fractures surgery.

PubMed

Kovler, I; Joskowicz, L; Weil, Y A; Khoury, A; Kronman, A; Mosheiff, R; Liebergall, M; Salavarrieta, J

2015-10-01

The aim of orthopedic trauma surgery is to restore the anatomy and function of displaced bone fragments to support osteosynthesis. For complex cases, including pelvic bone and multi-fragment femoral neck and distal radius fractures, preoperative planning with a CT scan is indicated. The planning consists of (1) fracture reduction-determining the locations and anatomical sites of origin of the fractured bone fragments and (2) fracture fixation-selecting and placing fixation screws and plates. The current bone fragment manipulation, hardware selection, and positioning processes based on 2D slices and a computer mouse are time-consuming and require a technician. We present a novel 3D haptic-based system for patient-specific preoperative planning of orthopedic fracture surgery based on CT scans. The system provides the surgeon with an interactive, intuitive, and comprehensive, planning tool that supports fracture reduction and fixation. Its unique features include: (1) two-hand haptic manipulation of 3D bone fragments and fixation hardware models; (2) 3D stereoscopic visualization and multiple viewing modes; (3) ligaments and pivot motion constraints to facilitate fracture reduction; (4) semiautomatic and automatic fracture reduction modes; and (5) interactive custom fixation plate creation to fit the bone morphology. We evaluate our system with two experimental studies: (1) accuracy and repeatability of manual fracture reduction and (2) accuracy of our automatic virtual bone fracture reduction method. The surgeons achieved a mean accuracy of less than 1 mm for the manual reduction and 1.8 mm (std [Formula: see text] 1.1 mm) for the automatic reduction. 3D haptic-based patient-specific preoperative planning of orthopedic fracture surgery from CT scans is useful and accurate and may have significant advantages for evaluating and planning complex fractures surgery.

Differential sensitivity to regional-scale drought in six central US grasslands.

PubMed

Knapp, Alan K; Carroll, Charles J W; Denton, Elsie M; La Pierre, Kimberly J; Collins, Scott L; Smith, Melinda D

2015-04-01

Terrestrial ecosystems often vary dramatically in their responses to drought, but the reasons for this are unclear. With climate change forecasts for more frequent and extensive drought in the future, a more complete understanding of the mechanisms that determine differential ecosystem sensitivity to drought is needed. In 2012, the Central US experienced the fourth largest drought in a century, with a regional-scale 40% reduction in growing season precipitation affecting ecosystems ranging from desert grassland to mesic tallgrass prairie. This provided an opportunity to assess ecosystem sensitivity to a drought of common magnitude in six native grasslands. We tested the prediction that drought sensitivity is inversely related to mean annual precipitation (MAP) by quantifying reductions in aboveground net primary production (ANPP). Long-term ANPP data available for each site (mean length = 16 years) were used as a baseline for calculating reductions in ANPP, and drought sensitivity was estimated as the reduction in ANPP per millimeter reduction in precipitation. Arid grasslands were the most sensitive to drought, but drought responses and sensitivity varied by more than twofold among the six grasslands, despite all sites experiencing 40% reductions in growing season precipitation. Although drought sensitivity generally decreased with increasing MAP as predicted, there was evidence that the identity and traits of the dominant species, as well as plant functional diversity, influenced sensitivity. A more comprehensive understanding of the mechanisms leading to differences in drought sensitivity will require multi-site manipulative experiments designed to assess both biotic and abiotic determinants of ecosystem sensitivity.

Reduction and Simultaneous Removal of 99 Tc and Cr by Fe(OH) 2 (s) Mineral Transformation

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

Saslow, Sarah A.; Um, Wooyong; Pearce, Carolyn I.

Technetium (Tc) remains a priority remediation concern due to persistent challenges, including rapid re-oxidation of immobilized Tc, and competing contaminants, e.g. Cr(VI), that inhibit targeted Tc reduction and incorporation into stable mineral phases. Here Fe(OH) 2(s) is investigated as a comprehensive solution for overcoming these challenges, by serving as both the reductant, (Fe(II)), and immobilization agent to form Tc-incorporated magnetite (Fe 3O 4). Trace metal analysis suggests removal of Tc(VII) and Cr(VI) from solution occurs simultaneously; however, complete removal and reduction of Cr(VI) is achieved earlier than the removal/reduction of co-mingled Tc(VII). Bulk oxidation state analysis of the magnetite solidmore » phase by XANES confirms that the majority of Tc is Tc(IV), which is corroborated by XPS. Furthermore, EXAFS results show successful Tc(IV) incorporation into magnetite octahedral sites without additional substitution of Cr or Tc into neighboring Fe octahedral sites. XPS analysis of Cr confirms reduction to Cr(III) and the formation of a Cr-incorporated spinel, Cr2O 3, and Cr(OH)3 phases. Spinel (modeled as Fe 3O 4), goethite, and feroxyhyte are detected in all reacted solid phase samples analyzed by XRD, where Tc(IV) incorporation has little effect on the spinel lattice structure. In the presence of Cr(III) a spinel phase along the magnetite-chromite (Fe 3O 4-FeCr 2O 4) solid-solution line is formed.« less

Model-based Analysis of Mixed Uranium(VI) Reduction by Biotic and Abiotic Pathways During in Situ Bioremediation

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

Zhao, Jiao; Scheibe, Timothy D.; Mahadevan, Radhakrishnan

2013-10-24

Uranium bioremediation has emerged as a potential strategy of cleanup of radionuclear contamination worldwide. An integrated geochemical & microbial community model is a promising approach to predict and provide insights into the bioremediation of a complicated natural subsurface. In this study, an integrated column-scale model of uranium bioremediation was developed, taking into account long-term interactions between biotic and abiotic processes. It is also combined with a comprehensive thermodynamic analysis to track the fate and cycling of biogenic species. As compared with other bioremediation models, the model increases the resolution of the connection of microbial community to geochemistry and establishes directmore » quantitative correlation between overall community evolution and geochemical variation, thereby accurately predicting the community dynamics under different sedimentary conditions. The thermodynamic analysis examined a recently identified homogeneous reduction of U(VI) by Fe(II) under dynamic sedimentary conditions across time and space. It shows that the biogenic Fe(II) from Geobacter metabolism can be removed rapidly by the biogenic sulphide from sulfate reducer metabolism, hence constituting one of the reasons that make the abiotic U(VI) reduction thermodynamically infeasible in the subsurface. Further analysis indicates that much higher influent concentrations of both Fe(II) and U(VI) than normal are required to for abiotic U(VI) reduction to be thermodynamically feasible, suggesting that the abiotic reduction cannot be an alternative to the biotic reduction in the remediation of uranium contaminated groundwater.« less

The electrochemical reduction processes of solid compounds in high temperature molten salts.

PubMed

Xiao, Wei; Wang, Dihua

2014-05-21

Solid electrode processes fall in the central focus of electrochemistry due to their broad-based applications in electrochemical energy storage/conversion devices, sensors and electrochemical preparation. The electrolytic production of metals, alloys, semiconductors and oxides via the electrochemical reduction of solid compounds (especially solid oxides) in high temperature molten salts has been well demonstrated to be an effective and environmentally friendly process for refractory metal extraction, functional materials preparation as well as spent fuel reprocessing. The (electro)chemical reduction of solid compounds under cathodic polarizations generally accompanies a variety of changes at the cathode/melt electrochemical interface which result in diverse electrolytic products with different compositions, morphologies and microstructures. This report summarizes various (electro)chemical reactions taking place at the compound cathode/melt interface during the electrochemical reduction of solid compounds in molten salts, which mainly include: (1) the direct electro-deoxidation of solid oxides; (2) the deposition of the active metal together with the electrochemical reduction of solid oxides; (3) the electro-inclusion of cations from molten salts; (4) the dissolution-electrodeposition process, and (5) the electron hopping process and carbon deposition with the utilization of carbon-based anodes. The implications of the forenamed cathodic reactions on the energy efficiency, chemical compositions and microstructures of the electrolytic products are also discussed. We hope that a comprehensive understanding of the cathodic processes during the electrochemical reduction of solid compounds in molten salts could form a basis for developing a clean, energy efficient and affordable production process for advanced/engineering materials.

Adolescent views on comprehensive health risk assessment and counseling: assessing gender differences.

PubMed

Kadivar, Hajar; Thompson, Lindsay; Wegman, Martin; Chisholm, TaJuana; Khan, Maryum; Eddleton, Katie; Muszynski, Michael; Shenkman, Elizabeth

2014-07-01

Adolescence is an important time for the detection of health risk behaviors and factors with subsequent counseling and intervention. Limited research has examined adolescent perceptions of comprehensive health risk assessments (HRAs) and counseling with an assessment of gender differences. Participants were identified using Florida's Medicaid and State Children's Health Insurance Program databases. A total of 35 low-income, racially/ethnically diverse adolescents (ages 14-18 years) participated in eight focus groups stratified by gender. Adolescents completed an internet-based, tablet-administered, comprehensive HRA and then participated in a semi-structured interview. Discussions were recorded, transcribed, and analyzed using a multi-step, team-based approach applying grounded theory to determine major themes. Male adolescents desired less parental involvement, had less understanding of the protections of clinical confidentiality and the need for comprehensive HRA, and placed greater emphasis on the importance of professional appearance. In contrast, more females valued face-to-face interactions and stressed the importance of concern from the health risk assessor. Overall, adolescents placed importance on their relationship with the health risk assessor, and on valuing trust, confidentiality, and nonjudgmental care. Adolescents preferred to complete HRAs in clinical, private, and professional settings, and reported that tablet technology supported their confidentially in completing the HRA. Furthermore, they stressed the importance of autonomy and learning about the health risk outcomes for risk reduction. Gender differences exist in adolescent perceptions of comprehensive HRAs. Adolescent perceptions of HRAs support their use in confidential primary care settings using modalities that emphasize nonjudgmental, private care, and the use of communication techniques that respect adolescents' autonomy to change health risks. Copyright © 2014. Published by Elsevier Inc.

Lower risk of progression from prediabetes to diabetes with health checkup with lifestyle education: Japan Ningen Dock study.

PubMed

Okada, R; Tsushita, K; Wakai, K; Ishizaka, Y; Kato, K; Wada, T; Watanabe, K

2017-08-01

To investigate whether the progression from prediabetes to diabetes is lower among those who undertake Ningen Dock (comprehensive health checkups with lifestyle education and doctor's consultation) than those who undertake basic mandatory occupational health checkups. Subjects aged 30-69 years with complete annual data from 2008 to 2012 for either Ningen Dock or basic health checkups were enrolled. Subjects with prediabetes (fasting plasma glucose 100-125 mg/dl or HbA1c 5.7-6.4%) at baseline were selected (14,928 in the comprehensive group and 10,433 in the basic group). The incidence of diabetes (fasting plasma glucose ≥ 126 mg/dl, HbA1c ≥ 6.5% or taking glucose-lowering drugs) and the reduction of risk factors were compared. After 4 years, 3226 cases of diabetes occurred among 25,361 subjects with prediabetes. The incidence of diabetes was lower in the comprehensive group than the basic group (2.9 vs. 3.8 cases/100 person-years, hazard ratio 0.75, 95% confidence interval 0.68-0.81 after adjustment). Moreover, more overweight subjects controlled their body mass index (16.2% vs. 13.2%) and more began a daily exercise habit (11.8% vs. 8.5%) in the comprehensive group than in the basic group. The incidence of diabetes was lower in subjects who could control their weight or start daily exercise at year 1 in the comprehensive group. Progression from prediabetes to diabetes was significantly lower in subjects undertaking a comprehensive health checkup with lifestyle education. Lifestyle education at health checkup for people with prediabetes might prevent progression to diabetes by reducing modifiable risk factors. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Clinical and cost outcomes of multifactorial, cardiovascular risk management interventions in worksites: a comprehensive review and analysis.

PubMed

Pelletier, K R

1997-12-01

This paper is a critical review of the clinical and cost outcome evaluation studies of multifactorial, comprehensive, cardiovascular risk management programs in worksites. A comprehensive international literature search conducted under the auspices of the National Heart, Lung and Blood Institute identified 17 articles based on 12 studies that examined the clinical outcomes of multifactorial, comprehensive programs. These articles were identified through MEDLINE, manual searches of recent journals, and through direct inquiries to worksite health promotion researchers. All studies were conducted between 1978 and 1995, with 1978 being the date of the first citation of a methodologically rigorous evaluation. Of the 12 research studies, only 8 utilized the worksite as both the unit of assignment and as the unit of analysis. None of the studies analyzed adequately for cost effectiveness. Given this limitation, this review briefly considers the relevant worksite research that has demonstrated cost outcomes. Worksite-based, multifactorial cardiovascular intervention programs reviewed for this article varied widely in the comprehensiveness, intensity, and duration of both the interventions and evaluations. Results from randomized trials suggest that providing opportunities for individualized, cardiovascular risk reduction counseling for high-risk employees within the context of comprehensive programming may be the critical component of an effective worksite intervention. Despite the many limitations of the current methodologies of the 12 studies, the majority of the research to date indicates the following: (1) favorable clinical and cost outcomes; (2) that more recent and more rigorously designed research tends to support rather than refute earlier and less rigorously designed studies; and (3) that rather than interpreting the methodological flaws and diversity as inherently negative, one may consider it as indicative of a robust phenomena evident in many types of worksites, with diverse employees, differing interventions, and varying degrees of methodological sophistication. Results of these studies reviewed provide both cautious optimism about the effectiveness of these worksite programs and insights regarding the essential components and characteristics of successful programs.

Informing Comprehensive HIV Prevention: A Situational Analysis of the HIV Prevention and Care Context, North West Province South Africa

PubMed Central

Lippman, Sheri A.; Treves-Kagan, Sarah; Gilvydis, Jennifer M.; Naidoo, Evasen; Khumalo-Sakutukwa, Gertrude; Darbes, Lynae; Raphela, Elsie; Ntswane, Lebogang; Barnhart, Scott

2014-01-01

Objective Building a successful combination prevention program requires understanding the community’s local epidemiological profile, the social community norms that shape vulnerability to HIV and access to care, and the available community resources. We carried out a situational analysis in order to shape a comprehensive HIV prevention program that address local barriers to care at multiple contextual levels in the North West Province of South Africa. Method The situational analysis was conducted in two sub-districts in 2012 and guided by an adaptation of WHO’s Strategic Approach, a predominantly qualitative method, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. Analysis began during fieldwork with nightly discussions of findings and continued with coding original textual data from the fieldwork notebooks and a select number of recorded interviews. Results We conducted over 200 individual and group interviews and gleaned four principal social barriers to HIV prevention and care, including: HIV fatalism, traditional gender norms, HIV-related stigma, and challenges with communication around HIV, all of which fuel the HIV epidemic. At the different levels of response needed to stem the epidemic, we found evidence of national policies and programs that are mitigating the social risk factors but little community-based responses that address social risk factors to HIV. Conclusions Understanding social and structural barriers to care helped shape our comprehensive HIV prevention program, which address the four ‘themes’ identified into each component of the program. Activities are underway to engage communities, offer community-based testing in high transmission areas, community stigma reduction, and a positive health, dignity and prevention program for stigma reduction and improve communication skills. The situational analysis process successfully shaped key programmatic decisions and cultivated a deeper collaboration with local stakeholders to support program implementation. PMID:25028976

Informing comprehensive HIV prevention: a situational analysis of the HIV prevention and care context, North West Province South Africa.

PubMed

Lippman, Sheri A; Treves-Kagan, Sarah; Gilvydis, Jennifer M; Naidoo, Evasen; Khumalo-Sakutukwa, Gertrude; Darbes, Lynae; Raphela, Elsie; Ntswane, Lebogang; Barnhart, Scott

2014-01-01

Building a successful combination prevention program requires understanding the community's local epidemiological profile, the social community norms that shape vulnerability to HIV and access to care, and the available community resources. We carried out a situational analysis in order to shape a comprehensive HIV prevention program that address local barriers to care at multiple contextual levels in the North West Province of South Africa. The situational analysis was conducted in two sub-districts in 2012 and guided by an adaptation of WHO's Strategic Approach, a predominantly qualitative method, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. Analysis began during fieldwork with nightly discussions of findings and continued with coding original textual data from the fieldwork notebooks and a select number of recorded interviews. We conducted over 200 individual and group interviews and gleaned four principal social barriers to HIV prevention and care, including: HIV fatalism, traditional gender norms, HIV-related stigma, and challenges with communication around HIV, all of which fuel the HIV epidemic. At the different levels of response needed to stem the epidemic, we found evidence of national policies and programs that are mitigating the social risk factors but little community-based responses that address social risk factors to HIV. Understanding social and structural barriers to care helped shape our comprehensive HIV prevention program, which address the four 'themes' identified into each component of the program. Activities are underway to engage communities, offer community-based testing in high transmission areas, community stigma reduction, and a positive health, dignity and prevention program for stigma reduction and improve communication skills. The situational analysis process successfully shaped key programmatic decisions and cultivated a deeper collaboration with local stakeholders to support program implementation.

Physiotherapy Commenced Within the First Four Weeks Post-Spinal Surgery Is Safe and Effective: A Systematic Review and Meta-Analysis.

PubMed

Snowdon, Megan; Peiris, Casey L

2016-02-01

To determine whether physiotherapy commenced within the first 4 weeks post-spinal surgery is safe and effective. Electronic databases CINAHL, MEDLINE, AMED, PubMed, Embase, and PEDro were searched from the earliest date possible through May 2015. An additional trial was identified through reference list scanning. Controlled trials evaluating comprehensive physiotherapy rehabilitation commenced within 4 weeks postoperatively compared with a control group receiving no physiotherapy, standard postoperative care, rest, less active physiotherapy, or sham physiotherapy after spinal surgery of a musculoskeletal etiology. Two reviewers independently applied inclusion and exclusion criteria, with disagreements discussed until consensus could be reached. Searching identified 3162 potentially relevant articles, of which 4 trials with 250 participants met the inclusion criteria. Data were extracted using a predefined data extraction form. Methodological quality of trials was assessed independently by 2 reviewers using the Downs and Black checklist. Pooled analyses were performed using a random-effects model with inverse variance methods to calculate risk differences and 95% confidence intervals (CIs) (dichotomous outcomes), and standardized mean differences (SMDs) and 95% CIs (continuous outcomes). When compared with no or sham physiotherapy, early comprehensive physiotherapy did not increase the risk of adverse events (risk difference, -.01; 95% CI, -.07 to .05; I(2)=0%). In addition, there is moderate-quality evidence demonstrating a reduction in pain by a moderate and significant amount at 12 weeks (SMD=-.38; 95% CI, -.66 to -.10; I(2)=0%) and at 12+ months (SMD=-.30; 95% CI, -.59 to -.02; I(2)=0%). Early comprehensive physiotherapy commenced within the first 4 weeks post-spinal surgery does not increase the potential for an adverse event and leads to a moderate, statistically significant reduction in pain when compared with a control group. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effect of Exercise Training on Cardiac Biomarkers in At-Risk Populations: A Systematic Review.

PubMed

Glenney, Susan Sullivan; Brockemer, Derrick Paul; Ng, Andy C; Smolewski, Michael A; Smolgovskiy, Vladimir M; Lepley, Adam S

2017-12-01

Studies have demonstrated beneficial effects of exercise on cardiovascular disease biomarkers for healthy individuals; however, a comprehensive review regarding the effect of exercise on cardiovascular disease biomarkers in at-risk populations is lacking. A literature search was performed to identify studies meeting the following criteria: randomized controlled study, participants with pathology/activity limitations, biomarker outcome (total cholesterol, high-density lipoprotein, low-density lipoprotein, C-reactive protein, insulin, triglycerides, or glucose), and exercise intervention. Means and standard deviations from each biomarker were used to calculate standardized Cohen's d effect sizes with 95% confidence intervals. In total, 37 articles were included. The majority (44/57; 77%) of data points demonstrated moderate to strong effects for the reduction in total cholesterol, triglycerides, and low-density lipoprotein, and elevation in high-density lipoprotein following exercise. The majority of data points demonstrated strong effects for reductions in blood glucose (24/30; 80%) and insulin (23/24; 96%) levels following exercise intervention. Evidence is heterogeneous regarding the influence of exercise on cardiovascular disease biomarkers in at-risk patients, which does not allow a definitive conclusion. Favorable effects include reductions in triglycerides, total cholesterol, low-density lipoprotein, glucose, and insulin, and elevation in high-density lipoprotein following exercise intervention. The strongest evidence indicates that exercise is favorable for the reduction in glucose and cholesterol levels among obese patients, and reduction of insulin regardless of population.

A review on photocatalytic CO2 reduction using perovskite oxide nanomaterials

NASA Astrophysics Data System (ADS)

Zeng, Sheng; Kar, Piyush; Thakur, Ujwal Kumar; Shankar, Karthik

2018-02-01

As the search for efficient catalysts for CO2 photoreduction continues, nanostructured perovskite oxides have emerged as a class of high-performance photocatalytic materials. The perovskite oxide candidates for CO2 photoreduction are primarily nanostructured forms of titanates, niobates, tantalates and cobaltates. These materials form the focus of this review article because they are much sought-after due to their nontoxic nature, adequate chemical stability, and tunable crystal structures, bandgaps and surface energies. As compared to conventional semiconductors and nanomaterial catalysts, nanostructured perovskite oxides also exhibit an extended optical-absorption edge, longer charge carrier lifetimes, and favorable band-alignment with respect to reduction potential of activated CO2 and reduction products of the same. While CO2 reduction product yields of several hundred μmol-1 h-1 are observed with many types of perovskite oxide nanomaterials in stand-alone forms, yield of such quantities are not common with semiconductor nanomaterials of other types. In this review, we present current state-of-the-art synthesis methods to form perovskite oxide nanomaterials, and procedures to engineer their bandgaps. This review also presents a comprehensive summary and discussion on crystal structures, defect distribution, morphologies and electronic properties of the perovskite oxides, and correlation of these properties to CO2 photoreduction performance. This review offers researchers key insights for developing advanced perovskite oxides in order to further improve the yields of CO2 reduction products.

TEM Cell Testing of Cable Noise Reduction Techniques from 2 MHz to 200 MHz -- Part 2

NASA Technical Reports Server (NTRS)

Bradley, Arthur T.; Evans, William C.; Reed, Joshua L.; Shimp, Samuel K., III; Fitzpatrick, Fred D.

2008-01-01

This paper presents empirical results of cable noise reduction techniques as demonstrated in a TEM cell operating with radiated fields from 2 - 200 MHz. It is the second part of a two-paper series. The first paper discussed cable types and shield connections. In this second paper, the effects of load and source resistances and chassis connections are examined. For each topic, well established theories are compared to data from a real-world physical system. Finally, recommendations for minimizing cable susceptibility (and thus cable emissions) are presented. There are numerous papers and textbooks that present theoretical analyses of cable noise reduction techniques. However, empirical data is often targeted to low frequencies (e.g. <50 KHz) or high frequencies (>100 MHz). Additionally, a comprehensive study showing the relative effects of various noise reduction techniques is needed. These include the use of dedicated return wires, twisted wiring, cable shielding, shield connections, changing load or source impedances, and implementing load- or source-to-chassis isolation. We have created an experimental setup that emulates a real-world electrical system, while still allowing us to independently vary a host of parameters. The goal of the experiment was to determine the relative effectiveness of various noise reduction techniques when the cable is in the presence of radiated emissions from 2 MHz to 200 MHz.

[Harm reduction interventions in drug users: current situation and recommendations].

PubMed

Bosque-Prous, Marina; Brugal, María Teresa

2016-11-01

Harm reduction encompasses interventions, programmes and policies that seek to reduce the negative consequences of the consumption of both legal and illegal drugs on the individual and public health. Harm reduction looks to mitigate the harm suffered by drug users through drug use monitoring and prevention, and promotes initiatives that respect and protect the human rights of this population. The harm reduction policies that have proven effective and efficient are: opioid substitution maintenance therapy (methadone); needle and syringe exchange programmes; supervised drug consumption rooms; and overdose prevention through peer-based naloxone distribution. In order to be effective, these policies must have comprehensive coverage and be implemented in areas where the target population is prevalent. Resident-based opposition to the implementation of these policies is known as the NIMBY (Not In My Back Yard) phenomenon, which is characterised by being against the implementation of new measures in a particular place, but does not question their usefulness. Given that any NIMBY phenomenon is a complex social, cultural and political phenomenon, it is important to conduct a thorough analysis of the situation prior to implementing any of these measures. Harm reduction policies must be extended to other substances such as alcohol and tobacco, as well as to other conditions beyond infectious/contagious diseases and overdose. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Online drug user-led harm reduction in Hungary: a review of “Daath”

PubMed Central

2013-01-01

Harm reduction has been increasingly finding its way into public drug policies and healthcare practices worldwide, with successful intervention measures justifiably focussing on the highest-risk groups, such as injecting drug users. However, there are also other types of drug users in need for harm reduction, even though they pose less, low, or no public health risk. Occasionally, drug users may autonomously organise themselves into groups to provide advocacy, harm reduction, and peer-help services, sometimes online. The http://www.daath.hu website has been operated since 2001 by the “Hungarian Psychedelic Community”, an unorganised drug user group with a special interest in hallucinogenic and related substances. As of today, the website serves about 1200 visitors daily, and the online community comprises of more than 8000 registered members. The Daath community is driven by a strong commitment to the policy of harm reduction in the form of various peer-help activities that aim to expand harm reduction without promoting drug use. Our review comprehensively summarises Daath’s user-led harm reduction services and activities from the last ten years, firstly outlining the history and growth phases of Daath, along with its self-set guidelines and policies. Online services (such as a discussion board, and an Ecstasy pill database) and offline activities (such as Ecstasy pill field testing, and a documentary film about psychedelics) are described. In order to extend its harm reduction services and activities in the future, Daath has several social, commercial, and legislative challenges to face. Starting with a need to realign its focus, outlooks for the upcoming operation of Daath are pondered. Future trends in harm reduction, such as separating harm-decreasing from benefit-increasing, are also discussed. We aim to share these innovative harm reduction measures and good practices in order to be critically assessed, and – if found useful – adapted and applied elsewhere. PMID:24088321

[Pain and opioid dependency as multilevel network phenomenon : Theoretical and metatheoretical aspects].

PubMed

Tretter, F

2016-08-01

Methodological reflections on pain research and pain therapy focussing on addiction risks are addressed in this article. Starting from the incompleteness of objectification of the purely subjectively fully understandable phenomena of pain and addiction, the relevance of a comprehensive general psychology is underlined. It is shown that that reduction of pain and addiction to a mainly focally arguing neurobiology is only possible if both disciplines have a systemic concept of pain and addiction. With this aim, parallelized conceptual network models are presented.

Capturing CO2 from Coal-Fired Power Plants: Challenges for a Comprehensive Strategy

DTIC Science & Technology

2008-08-15

efficient flue gas desulfurization (FGD) or selective catalytic reduction (SCR) devices (or none), requiring either upgrading of existing FGD and SCR...saturated flue Figure 6. CO2 Price Projections CRS-16 42 Donald Shattuck, et al., A History of Flue Gas Desulfurization (FGD) — The Early Years, UE Technical...available in both the eastern and western parts of the United States, or by the use of emerging flue gas desulfurization (FGD) devices.46 At the time

Heavy Duty Roots Expander Heat Energy Recovery (HD-REHER)

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

Subramanian, Swami

2015-10-01

Eaton Corporation proposed a comprehensive project to develop and demonstrate advanced component technology that will reduce the cost of implementing Organic Rankine Cycle (ORC) Waste Heat Recovery (WHR) systems to Heavy-Duty Diesel engines, making adaptation of this fuel efficiency improving technology more commercially attractive to end-users in the next 5 to 10 year time period. Accelerated adaptation and implementation of new fuel efficiency technology into service is critical for reduction of fuel used in the commercial vehicle segment.

Study on the Potential Development of Rainwater Utilization in the Hilly City of Southern China

NASA Astrophysics Data System (ADS)

Fu, Xiaoran; Liu, Jiahong; Shao, Weiwei; Zhang, Haixing

2017-12-01

Aimed at the current flood problems and the contradiction between supply and demand of water resources in the southern cities of China, the comprehensive utilization of Urban Rainwater Resources (URRs) is a significant solution. At present, the research on the comprehensive utilization system of urban rainwater resources in China is still immature, especially the lack of a comprehensive method for the comprehensive utilization of the rainwater and flood resources in the south. Based on the current mode for utilization of URRs at home and abroad, Fenghuang County in Hunan Province was taken as a case of study, which is a typical mountainous city in the southern China. And the potential development of URRs was simulated and evaluated with a comparison of before and after the exploitation and utilization of URRs in this paper. The reduction effect of flood and waterlogging on the ancient city area is analyzed from SWMM. The simulation results show that the potential of exploitation and utilization of URRs in Fenghuang county is remarkable under the mode of exploitation and utilization which is given priority to flood prevention and control, and the annual development potential is 4.865×105 m3. The rainwater utilization measures of flood control effect is obvious with this mode, and the relevant research results can provide theoretical and technical support for enhancing urban water security capability, water conservation capacity, and disaster mitigation of urban flood.

Harm reduction and law enforcement in Vietnam: influences on street policing

PubMed Central

2012-01-01

Background and rationale The HIV epidemic in Vietnam has from its start been concentrated among injecting drug users. Vietnam instituted the 2006 HIV/AIDS Law which includes comprehensive harm reduction measures, but these are unevenly accepted and inadequately implemented. Ward police are a major determinant of risk for IDUs, required to participate in drug control practices (especially meeting quotas for detention centres) which impede support for harm reduction. We studied influences on ward level police regarding harm reduction in Hanoi to learn how to better target education and structural change. Methods After document review, we interviewed informants from government, NGOs, INGOs, multilateral agencies, and police, using semi-structured guides. Topics covered included perceptions of harm reduction and the police role in drug law enforcement, and harm reduction training and advocacy among police. Results Police perceive conflicting responsibilities, but overwhelmingly see their responsibility as enforcing drug laws, identifying and knowing drug users, and selecting those for compulsory detention. Harm reduction training was very patchy, ward police not being seen as important to it; and understanding of harm reduction was limited, tending to reflect drug control priorities. Justification for methadone was as much crime prevention as HIV prevention. Competing pressures on ward police create much anxiety, with performance measures based around drug control; recourse to detention resolves competing pressures more safely. There is much recognition of the importance of discretion, and much use of it to maintain good social order. Policy dissemination approaches within the law enforcement sector were inconsistent, with little communication about harm reduction programs or approaches, and an unfounded assumption that training at senior levels would naturally reach to the street. Discussion Ward police have not been systematically included in harm reduction advocacy or training strategies to support or operationalise legalised harm reduction interventions. The practices of street police challenge harm reduction policies, entirely understandably given the competing pressures on them. For harm reduction to be effective in Vietnam, it is essential that the ambiguities and contradictions between laws to control HIV and to control drugs be resolved for the street-level police. PMID:22769590

Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials

PubMed Central

Whitehead, Martin A; Robinson, David; O’Neill, Desmond; Langhorne, Peter

2011-01-01

Objective To evaluate the effectiveness of comprehensive geriatric assessment in hospital for older adults admitted as an emergency. Search strategy We searched the EPOC Register, Cochrane’s Controlled Trials Register, the Database of Abstracts of Reviews of Effects (DARE), Medline, Embase, CINAHL, AARP Ageline, and handsearched high yield journals. Selection criteria Randomised controlled trials of comprehensive geriatric assessment (whether by mobile teams or in designated wards) compared with usual care. Comprehensive geriatric assessment is a multidimensional interdisciplinary diagnostic process used to determine the medical, psychological, and functional capabilities of a frail elderly person to develop a coordinated and integrated plan for treatment and long term follow-up. Data collection and analysis Three independent reviewers assessed eligibility and trial quality and extracted published data. Two additional reviewers moderated. Results Twenty two trials evaluating 10 315 participants in six countries were identified. For the primary outcome “living at home,” patients who underwent comprehensive geriatric assessment were more likely to be alive and in their own homes at the end of scheduled follow-up (odds ratio 1.16 (95% confidence interval 1.05 to 1.28; P=0.003; number needed to treat 33) at a median follow-up of 12 months versus 1.25 (1.11 to 1.42; P<0.001; number needed to treat 17) at a median follow-up of six months) compared with patients who received general medical care. In addition, patients were less likely to be living in residential care (0.78, 0.69 to 0.88; P<0.001). Subgroup interaction suggested differences between the subgroups “wards” and “teams” in favour of wards. Patients were also less likely to die or experience deterioration (0.76, 0.64 to 0.90; P=0.001) and were more likely to experience improved cognition (standardised mean difference 0.08, 0.01 to 0.15; P=0.02) in the comprehensive geriatric assessment group. Conclusions Comprehensive geriatric assessment increases patients’ likelihood of being alive and in their own homes after an emergency admission to hospital. This seems to be especially true for trials of wards designated for comprehensive geriatric assessment and is associated with a potential cost reduction compared with general medical care. PMID:22034146

Photoreduction of Graphene Oxide and Photochemical Synthesis of Graphene-Metal Nanoparticle Hybrids by Ketyl Radicals.

PubMed

Mangadlao, Joey Dacula; Cao, Pengfei; Choi, Diana; Advincula, Rigoberto C

2017-07-26

The photoreduction of graphene oxide (GO) using ketyl radicals is demonstrated for the first time. The use of photochemical reduction through ketyl radicals generated by I-2959 or (1-[4-(2-hydroxyethoxy)phenyl]-2-hydroxy-2-methyl-1-propan-1-one) is interesting because it affords spatial and temporal control of the reduction process. Graphene-metal nanoparticle hybrids of Ag, Au, and Pd were also photochemically fabricated in a one-pot procedure. Comprehensive spectroscopic and imaging techniques were carried out to fully characterize the materials. The nanoparticle hybrids showed promising action for the catalytic degradation of model environmental pollutants, namely, 4-nitrophenol, Rose Bengal, and Methyl Orange. The process described can be extended to polymer nanocomposites that can be photopatterned and could be potentially extended to fabricating plastic electronic devices.

Heterogeneous electrochemical CO2 reduction using nonmetallic carbon-based catalysts: current status and future challenges

NASA Astrophysics Data System (ADS)

Ma, Tao; Fan, Qun; Tao, Hengcong; Han, Zishan; Jia, Mingwen; Gao, Yunnan; Ma, Wangjing; Sun, Zhenyu

2017-11-01

Electrochemical CO2 reduction (ECR) offers an important pathway for renewable energy storage and fuels production. It still remains a challenge in designing highly selective, energy-efficient, robust, and cost-effective electrocatalysts to facilitate this kinetically slow process. Metal-free carbon-based materials have features of low cost, good electrical conductivity, renewability, diverse structure, and tunability in surface chemistry. In particular, surface functionalization of carbon materials, for example by doping with heteroatoms, enables access to unique active site architectures for CO2 adsorption and activation, leading to interesting catalytic performances in ECR. We aim to provide a comprehensive review of this category of metal-free catalysts for ECR, providing discussions and/or comparisons among different nonmetallic catalysts, and also possible origin of catalytic activity. Fundamentals and some future challenges are also described.

A comparative study of the tail ion distribution with reduced Fokker-Planck models

NASA Astrophysics Data System (ADS)

McDevitt, C. J.; Tang, Xian-Zhu; Guo, Zehua; Berk, H. L.

2014-03-01

A series of reduced models are used to study the fast ion tail in the vicinity of a transition layer between plasmas at disparate temperatures and densities, which is typical of the gas and pusher interface in inertial confinement fusion targets. Emphasis is placed on utilizing progressively more comprehensive models in order to identify the essential physics for computing the fast ion tail at energies comparable to the Gamow peak. The resulting fast ion tail distribution is subsequently used to compute the fusion reactivity as a function of collisionality and temperature. While a significant reduction of the fusion reactivity in the hot spot compared to the nominal Maxwellian case is present, this reduction is found to be partially recovered by an increase of the fusion reactivity in the neighboring cold region.

Rethinking impact evaluation and carbon reduction analysis on electric bus vehicles in China

NASA Astrophysics Data System (ADS)

Li, Zhenyu; Li, Chao; Liao, Kai; Yin, Zhifang

2018-02-01

New energy bus vehicles (NEBVs) are expanding in China, but they have some problems such as technology, high cost and safety etc., thus NEBVs should be comprehensively evaluated from costs, technologies, environment, and based on the evaluation results, some changes should be improved. This paper firstly analyses the current status of both vehicle development and existing policies, identifies the main characteristics and the main problems in term of the economic, standard, policy, etc., by scenario analysis, forecasts the future growth from now to 2030 and calculates the emission reduction in low level scenario and high level scenario. In 2020 and 2030, 6 million and 24 million ton of CO2 emission will be reduced respectively. Finally, the paper makes a conclusion of Chinese experiences and gives some measures for the future development.

The effects of anticipated funding changes on maternal and child health projects: a case study of uncertainty.

PubMed

Schlesinger, E R; Skoner, M M; Trooskin, E D; Markel, J R; North, A F

1976-04-01

A questionnaire survey of Title V special projects--Maternal and Infant Care (M&I), Comprehensive Care for Children and Youth (C&Y), Neonatal Intensive Care and Children's Dental Care--indicated that the anticipated change from federal project grants to state formula grants caused anxiety among project directors, low morale and high turnover in project staff, difficulty in filling staff positions, and anticipation of service reductions. These effects were much more prevalent and severe in projects which could realistically be expected to suffer budget cuts as a result of the shift in funding method. Despite the widespread anxiety, low morale and adverse effects reported by program directors, there was no reduction in the number of patients served, the scope of services offered, or the number of staff employed.

Eliminating waste in US health care.

PubMed

Berwick, Donald M; Hackbarth, Andrew D

2012-04-11

The need is urgent to bring US health care costs into a sustainable range for both public and private payers. Commonly, programs to contain costs use cuts, such as reductions in payment levels, benefit structures, and eligibility. A less harmful strategy would reduce waste, not value-added care. The opportunity is immense. In just 6 categories of waste--overtreatment, failures of care coordination, failures in execution of care processes, administrative complexity, pricing failures, and fraud and abuse--the sum of the lowest available estimates exceeds 20% of total health care expenditures. The actual total may be far greater. The savings potentially achievable from systematic, comprehensive, and cooperative pursuit of even a fractional reduction in waste are far higher than from more direct and blunter cuts in care and coverage. The potential economic dislocations, however, are severe and require mitigation through careful transition strategies.

Mesoporous silica nanoparticle supported PdIr bimetal catalyst for selective hydrogenation, and the significant promotional effect of Ir

NASA Astrophysics Data System (ADS)

Yang, Hui; Huang, Chao; Yang, Fan; Yang, Xu; Du, Li; Liao, Shijun

2015-12-01

A mesoporous silica nanoparticle (MSN) supported bimetal catalyst, PdIr/MSN, was prepared by a facile impregnation and hydrogen reduction method. The strong promotional effect of Ir was observed and thoroughly investigated. At the optimal molar ratio of Ir to Pd (NIr/NPd = 0.1), the activity of PdIr0.1/MSN was up to eight times and 28 times higher than that of monometallic Pd/MSN and Ir/MSN, respectively. The catalysts were characterized comprehensively by X-ray diffraction, transmission electron microscopy, X-ray photoelectron spectroscopy, and hydrogen temperature programmed reduction, which revealed that the promotional effect of Ir may be due to the enhanced dispersion of active components on the MSN, and to the intensified Pd-Ir electronic interaction caused by the addition of Ir.

Theoretical Investigations into Defected Graphene for Electrochemical Reduction of CO 2

DOE PAGES

Siahrostami, Samira; Jiang, Kun; Karamad, Mohammadreza; ...

2017-10-10

Here, despite numerous experimental efforts that have been dedicated to studying carbon-based materials for electrochemical reduction of CO 2, a rationalization of the associated trends in the intrinsic activity of different active motifs has so far been elusive. In the present work, we employ density functional theory calculations to examine a variety of different active sites in N-doped graphene to give a comprehensive outline of the trends in activity. We find that adsorption energies of COOH* and CO* do not follow the linear scaling relationships observed for the pure transition metals, and this unique scaling is rationalized through differences inmore » electronic structure between transition metals and defected graphene. This finding rationalizes most of the experimental observations on the carbon-based materials which present promising catalysts for the two-electron reduction of CO 2 to CO. With this simple thermodynamic analysis, we identify several active sites that are expected to exhibit a comparable or even better activity to the state-of-the-art gold catalyst, and several configurations are suggested to be selective for CO 2RR over HER.« less

Role of Colgate Total toothpaste in helping control plaque and gingivitis.

PubMed

Rover, Jo-Ann; Leu-Wai-See, Petal

2014-06-01

To assess the anti-plaque and anti-gingivitis effects of a dentifrice containing 0.3% triclosan, 2% copolymer and 0.243% (1,100 ppm) sodium fluoride in subjects with moderate plaque-induced gingivitis. This was a single center, monadic study. Subjects had at least 20 teeth remaining in the functional dentition, excluding third molars. Following a baseline examination for plaque, gingival inflammation and bleeding, 75 qualified healthy adult males and females, ages 18-70 were selected to participate in the study. Dental prophylaxis was performed and subjects were provided with two tubes of toothpaste (Colgate Total) and a soft-bristle toothbrush (Colgate Wave Toothbrush). The subjects were instructed to brush twice daily using a modified Bass brushing technique. At the end of the 6- to 8-week period subjects returned for collection of clinical and subjective data. 75 subjects completed the study. Both clinical and subjective reductions were significant. The results showed statistically significant reductions in plaque index, gingival inflammation and bleeding on probing. The overall conclusion was that Colgate Total was a comprehensive dentifrice that produced a significant reduction in gingivitis, plaque, and bleeding.

Dietary salt intake and risk of gastric cancer.

PubMed

D'Elia, Lanfranco; Galletti, Ferruccio; Strazzullo, Pasquale

2014-01-01

Humans began to use large amounts of salt for the main purpose of food preservation approximately 5,000 years ago and, although since then advanced technologies have been developed allowing drastic reduction in the use of salt for food storage, excess dietary salt intake remains very common. Gastric cancer is a common neoplasia, and dietary factors, including salt consumption, are considered relevant to its causation. A number of experimental studies supported the cocarcinogenic effect of salt through synergic action with Helicobacter pylori infection, in addition to some independent effects such as increase in the rate of cell proliferation and of endogenous mutations. Many epidemiological studies analyzed the relationship between excess salt intake and risk of gastric cancer. Both cross-sectional and prospective studies indicated a possibly dose-dependent positive association. In particular, a comprehensive meta-analysis of longitudinal studies detected a strong adverse effect of total salt intake and salt-rich foods on the risk of gastric cancer in the general population. Altogether, the epidemiological, clinical, and experimental evidence supports the possibility of a substantial reduction in the rates of gastric cancer through progressive reduction in population salt intake.

Investigations of surface coatings to reduce memory effect in plastic scintillator detectors used for radioxenon detection

NASA Astrophysics Data System (ADS)

Bläckberg, L.; Fay, A.; Jõgi, I.; Biegalski, S.; Boman, M.; Elmgren, K.; Fritioff, T.; Johansson, A.; Mårtensson, L.; Nielsen, F.; Ringbom, A.; Rooth, M.; Sjöstrand, H.; Klintenberg, M.

2011-11-01

In this work Al2O3 and SiO2 coatings are tested as Xe diffusion barriers on plastic scintillator substrates. The motivation is improved beta-gamma coincidence detection systems, used to measure atmospheric radioxenon within the verification regime of the Comprehensive Nuclear-Test-Ban Treaty. One major drawback with the current setup of these systems is that the radioxenon tends to diffuse into the plastic scintillator material responsible for the beta detection, resulting in an unwanted memory effect. Here, coatings with thicknesses between 20 and 900 nm have been deposited onto plastic scintillators, and investigated using two different experimental techniques. The results show that all tested coatings reduce the Xe diffusion into the plastic. The reduction is observed to increase with coating thickness for both coating materials. The 425 nm Al2O3 coating is the most successful one, presenting a diffusion reduction of a factor 100, compared to uncoated plastic. In terms of memory effect reduction this coating is thus a viable solution to the problem in question.

Reduction of aflatoxin B1 to aflatoxicol: a comprehensive DFT study provides clues to its toxicity.

PubMed

Karabulut, Sedat; Paytakov, Guvanchmyrat; Leszczynski, Jerzy

2014-12-01

Aflatoxicol (AFL) is one of most the important metabolites of aflatoxin B1 (AFB1). AFL can be formed through enzymatic or synthetic reduction of AFB1. Various experimental and theoretical studies have been focused on the AFB1 due to its high toxicity and carcinogenicity. The selective reduction of AFB1 carbonyls, molecular structure of AFL and its effect on toxicity has been studied here by the density functional theory (DFT) method. Although the toxicity of AFL is 18 times lower than that of AFB1, it has been concluded that both molecular structures have similar potency to form an exo-epoxide (AFEP) analogue which can bind to DNA. Calculations revealed that only one of the three possible tautomers of AFL is stable, both in the gas phase and water. The electronic properties of aflatoxicol are calculated as similar to aflatoxin B1 and this may be an explanation of similar carcinogenicity and toxicity of these compounds, which has been proved by experimental results. © 2014 Society of Chemical Industry.

High-throughput microarray mapping of cell wall polymers in roots and tubers during the viscosity-reducing process.

PubMed

Huang, Yuhong; Willats, William G; Lange, Lene; Jin, Yanling; Fang, Yang; Salmeán, Armando A; Pedersen, Henriette L; Busk, Peter Kamp; Zhao, Hai

2016-01-01

Viscosity reduction has a great impact on the efficiency of ethanol production when using roots and tubers as feedstock. Plant cell wall-degrading enzymes have been successfully applied to overcome the challenges posed by high viscosity. However, the changes in cell wall polymers during the viscosity-reducing process are poorly characterized. Comprehensive microarray polymer profiling, which is a high-throughput microarray, was used for the first time to map changes in the cell wall polymers of sweet potato (Ipomoea batatas), cassava (Manihot esculenta), and Canna edulis Ker. over the entire viscosity-reducing process. The results indicated that the composition of cell wall polymers among these three roots and tubers was markedly different. The gel-like matrix and glycoprotein network in the C. edulis Ker. cell wall caused difficulty in viscosity reduction. The obvious viscosity reduction of the sweet potato and the cassava was attributed to the degradation of homogalacturonan and the released 1,4-β-d-galactan and 1,5-α-l-arabinan. © 2015 International Union of Biochemistry and Molecular Biology, Inc.

Effects of fucoidan from Fucus vesiculosus in reducing symptoms of osteoarthritis: a randomized placebo-controlled trial

PubMed Central

Myers, Stephen P; Mulder, Ann M; Baker, Don G; Robinson, Shelley R; Rolfe, Margaret I; Brooks, Lyndon; Fitton, J Helen

2016-01-01

Purpose Preliminary investigation of a fucoidan with demonstrated reduction in the symptoms of osteoarthritis (OA) of the hip and knee. Patients and methods A double-blind randomized controlled trial was carried out to determine the safety and efficacy of a 300 mg dose of a Fucus vesiculosus extract (85% fucoidan) over a 12-week period in a population (n=122) with mild-to-moderate OA of the hip and knee as measured by the validated instrument “Comprehensive Osteoarthritis Test.” Safety was measured by assessing cholesterol, liver function, renal function, and hematopoietic function, and closely monitoring adverse events. Result Ninety-six participants completed the study. The reduction in symptoms of OA was not significantly different from the placebo response. There were no changes in the blood measurements that were of any clinical significance during the course of the study. Conclusion The F. vesiculosus fucoidan extract was safe and well tolerated. At a dose of 300 mg, the extract showed no difference in reduction of OA symptoms from the placebo. PMID:27307702

Communicating Treatment Risk Reduction to People With Low Numeracy Skills: A Cross-Cultural Comparison

PubMed Central

2009-01-01

Objectives. We sought to address denominator neglect (i.e. the focus on the number of treated and nontreated patients who died, without sufficiently considering the overall numbers of patients) in estimates of treatment risk reduction, and analyzed whether icon arrays aid comprehension. Methods. We performed a survey of probabilistic, national samples in the United States and Germany in July and August of 2008. Participants received scenarios involving equally effective treatments but differing in the overall number of treated and nontreated patients. In some conditions, the number who received a treatment equaled the number who did not; in others the number was smaller or larger. Some participants received icon arrays. Results. Participants—particularly those with low numeracy skills—showed denominator neglect in treatment risk reduction perceptions. Icon arrays were an effective method for eliminating denominator neglect. We found cross-cultural differences that are important in light of the countries' different medical systems. Conclusions. Problems understanding numerical information often reside not in the mind but in the problem's representation. These findings suggest suitable ways to communicate quantitative medical data. PMID:19833983

Changes in neurotic personality profile associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders.

PubMed

Rodziński, Paweł; Rutkowski, Krzysztof; Sobański, Jerzy A; Mielimąka, Michał; Murzyn, Agnieszka; Cyranka, Katarzyna; Dembińska, Edyta; Grządziel, Karolina; Klasa, Katarzyna; Müldner-Nieckowski, Łukasz; Smiatek-Mazgaj, Bogna

2015-01-01

Analysis of associations between changes in neurotic personality profile and reductionof suicidal ideation (SI) - or lack of such reduction - defined as its elimination or reduction of its intensity in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men treated due to neurotic, behavioral or personality disorders in a day hospital between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. Patients who improved in terms of SI obtained significantly greater reduction of global neurotic personality disintegration (neuroticism) than others (p<0.0005 in women and p=0.015 in men). Associations were found between improvement in terms of SI and greater reduction of many neurotic personality traits (p<0.05) in both genders: Negative self-esteem, Impulsiveness, Sense of alienation, Demobilization, Difficulties in emotional relations, Lack of vitality, Sense of lack of control, Sense of guilt, Difficulties in interpersonal relations, Sense of being in danger, Exaltation, Ponderings; and only in women: Feeling of being dependent on the Environment, Asthenia, Difficulties with decision making, Conviction of own resourcelessness in life, Deficit in internal locus of control and Imagination. indulging in fiction. The results confirm effectiveness of intensive psychotherapy as a treatment method that leads to comprehensive improvement encompassing reduction of neurotic personality disorders (neuroticism) and of majority of neurotic personality traits, as well as SI reduction. The revealed associations weigh in favor of hypothesis on neuroticism as SI predisposing factor in patients with neurotic, behavioral and personality disorders.

Optimization of heat and relative humidity conditions to reduce Escherichia coli O157:H7 contamination and maximize the germination of radish seeds.

PubMed

Song, M K; Kim, H W; Rhee, M S

2016-06-01

We previously reported that a combination of heat and relative humidity (RH) had a marked bactericidal effect on Escherichia coli O157:H7 on radish seeds. Here, response surface methodology with a Box-Behnken design was used to build a model to predict reductions in E. coli O157:H7 populations based on three independent variables: heating temperature (55 °C, 60 °C, or 65 °C), RH (40%, 60%, and 80%), and holding time (8, 15, or 22 h). Optimum treatment conditions were selected using a desirability function. The predictive model for microbial reduction had a high regression coefficient (R(2) = 0.97), and the accuracy of the model was verified using validation data (R(2) = 0.95). Among the three variables examined, heating temperature (P < 0.0001) and RH (P = 0.004) were the most significant in terms of bacterial reduction and seed germination, respectively. The optimum conditions for microbial reduction (6.6 log reduction) determined by ridge analysis were as follows: 64.5 °C and 63.2% RH for 17.7 h. However, when both microbial reduction and germination rate were taken into consideration, the desirability function yielded optimal conditions of 65 °C and 40% RH for 8 h (6.6 log reduction in the bacterial population; 94.4% of seeds germinated). This study provides comprehensive data that improve our understanding of the effects of heating temperature, RH, and holding time on the E. coli O157:H7 population on radish seeds. Radish seeds can be exposed to these conditions before sprouting, which greatly increases the microbiological safety of the products. Copyright © 2015 Elsevier Ltd. All rights reserved.

Relative risk reduction is useful metric to standardize effect size for public heath interventions for translational research.

PubMed

Mirzazadeh, Ali; Malekinejad, Mohsen; Kahn, James G

2015-03-01

Heterogeneity of effect measures in intervention studies undermines the use of evidence to inform policy. Our objective was to develop a comprehensive algorithm to convert all types of effect measures to one standard metric, relative risk reduction (RRR). This work was conducted to facilitate synthesis of published intervention effects for our epidemic modeling of the health impact of human immunodeficiency virus [HIV testing and counseling (HTC)]. We designed and implemented an algorithm to transform varied effect measures to RRR, representing the proportionate reduction in undesirable outcomes. Our extraction of 55 HTC studies identified 473 effect measures representing unique combinations of intervention-outcome-population characteristics, using five outcome metrics: pre-post proportion (70.6%), odds ratio (14.0%), mean difference (10.2%), risk ratio (4.4%), and RRR (0.9%). Outcomes were expressed as both desirable (29.5%, eg, consistent condom use) and undesirable (70.5%, eg, inconsistent condom use). Using four examples, we demonstrate our algorithm for converting varied effect measures to RRR and provide the conceptual basis for advantages of RRR over other metrics. Our review of the literature suggests that RRR, an easily understood and useful metric to convey risk reduction associated with an intervention, is underused by original and review studies. Copyright © 2015 Elsevier Inc. All rights reserved.

Design and optimization of a noise reduction system for infrasonic measurements using elements with low acoustic impedance.

PubMed

Alcoverro, Benoit; Le Pichon, Alexis

2005-04-01

The implementation of the infrasound network of the International Monitoring System (IMS) for the enforcement of the Comprehensive Nuclear-Test-Ban Treaty (CTBT) increases the effort in the design of suitable noise reducer systems. In this paper we present a new design consisting of low impedance elements. The dimensioning and the optimization of this discrete mechanical system are based on numerical simulations, including a complete electroacoustical modeling and a realistic wind-noise model. The frequency response and the noise reduction obtained for a given wind speed are compared to statistical noise measurements in the [0.02-4] Hz frequency band. The effects of the constructive parameters-the length of the pipes, inner diameters, summing volume, and number of air inlets-are investigated through a parametric study. The studied system consists of 32 air inlets distributed along an overall diameter of 16 m. Its frequency response is flat up to 4 Hz. For a 2 m/s wind speed, the maximal noise reduction obtained is 15 dB between 0.5 and 4 Hz. At lower frequencies, the noise reduction is improved by the use of a system of larger diameter. The main drawback is the high-frequency limitation introduced by acoustical resonances inside the pipes.

The Healthy Eating Agenda in Australia. Is Salt a Priority for Manufacturers?

PubMed Central

Nichols, Tyler; Yam, Chrystal

2017-01-01

Many nation states have endorsed and acted on the World Health Organization’s target of a 30% reduction in global salt consumption by 2025. In Australia, new government-led voluntary measures were initiated in 2009, consisting of public–private partnerships, front-of-pack labelling, and food reformulation targets (which include reduced salt). How Australia’s private sector has responded to this healthy eating agenda has been investigated in a limited way, particularly with regards to manufacturers which produce processed foods considered significant sources of sodium. In this study we asked: have Australia’s largest food manufacturers made “…positive (nutrition) changes to their product portfolios” as disclosed in their public policies, priorities, and communications? And, is salt reduction a priority for processed food manufacturers? A systematic search and critical content-analysis of grey literature published by food manufacturers was conducted. The results suggest half of the sample publically describe some salt reduction activities but the scale and efficacy of these changes is unclear from the available literature. The Australian Government’s Healthy Food Partnership could capitalise on current documented activities in salt reduction, and implement a more comprehensive healthy eating agenda moving forward. In light of the increasing rates of hypertension, population salt consumption and diet-related disease, more could be done. PMID:28809812

Are cultural values and beliefs included in U.S. based HIV interventions?

PubMed

Wyatt, Gail E; Williams, John K; Gupta, Arpana; Malebranche, Dominique

2012-11-01

To determine the extent to which current United States based human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. A comprehensive literature review was conducted to determine which published human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions incorporated aspects of cultural beliefs. This review of 166 human immunodeficiency virus (HIV) prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. human immunodeficiency virus (HIV) interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual's risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. Copyright © 2011. Published by Elsevier Inc.

Calibrating a tensor magnetic gradiometer using spin data

USGS Publications Warehouse

Bracken, Robert E.; Smith, David V.; Brown, Philip J.

2005-01-01

Scalar magnetic data are often acquired to discern characteristics of geologic source materials and buried objects. It is evident that a great deal can be done with scalar data, but there are significant advantages to direct measurement of the magnetic gradient tensor in applications with nearby sources, such as unexploded ordnance (UXO). To explore these advantages, we adapted a prototype tensor magnetic gradiometer system (TMGS) and successfully implemented a data-reduction procedure. One of several critical reduction issues is the precise determination of a large group of calibration coefficients for the sensors and sensor array. To resolve these coefficients, we devised a spin calibration method, after similar methods of calibrating space-based magnetometers (Snare, 2001). The spin calibration procedure consists of three parts: (1) collecting data by slowly revolving the sensor array in the Earth?s magnetic field, (2) deriving a comprehensive set of coefficients from the spin data, and (3) applying the coefficients to the survey data. To show that the TMGS functions as a tensor gradiometer, we conducted an experimental survey that verified that the reduction procedure was effective (Bracken and Brown, in press). Therefore, because it was an integral part of the reduction, it can be concluded that the spin calibration was correctly formulated with acceptably small errors.

Evaluation of char combustion models: measurement and analysis of variability in char particle size and density

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

Maloney, Daniel J; Monazam, Esmail R; Casleton, Kent H

Char samples representing a range of combustion conditions and extents of burnout were obtained from a well-characterized laminar flow combustion experiment. Individual particles from the parent coal and char samples were characterized to determine distributions in particle volume, mass, and density at different extent of burnout. The data were then compared with predictions from a comprehensive char combustion model referred to as the char burnout kinetics model (CBK). The data clearly reflect the particle- to-particle heterogeneity of the parent coal and show a significant broadening in the size and density distributions of the chars resulting from both devolatilization and combustion.more » Data for chars prepared in a lower oxygen content environment (6% oxygen by vol.) are consistent with zone II type combustion behavior where most of the combustion is occurring near the particle surface. At higher oxygen contents (12% by vol.), the data show indications of more burning occurring in the particle interior. The CBK model does a good job of predicting the general nature of the development of size and density distributions during burning but the input distribution of particle size and density is critical to obtaining good predictions. A significant reduction in particle size was observed to occur as a result of devolatilization. For comprehensive combustion models to provide accurate predictions, this size reduction phenomenon needs to be included in devolatilization models so that representative char distributions are carried through the calculations.« less

Word-to-text integration: ERP evidence for semantic and orthographic effects in Chinese.

PubMed

Chen, Lin; Fang, Xiaoping; Perfetti, Charles A

2017-05-01

Although writing systems affect reading at the level of word identification, one expects writing system to have minimal effects on comprehension processes. We tested this assumption by recording ERPs while native Chinese speakers read short texts for comprehension in the word-to-text integration (WTI) paradigm to compare with studies of English using this paradigm. Of interest was the ERP on a 2-character word that began the second sentence of the text, with the first sentence varied to manipulate co-reference with the critical word in the second sentence. A paraphrase condition in which the critical word meaning was coreferential with a word in the first sentence showed a reduced N400 reduction. Consistent with results in English, this N400 effect suggests immediate integration of a Chinese 2-character word with the meaning of the text. Chinese allows an additional test of a morpheme effect when one character of a two-character word is repeated across the sentence boundary, thus having both orthographic and meaning overlap. This shared morpheme condition showed no effect during the timeframe when orthographic effects are observed (e.g. N200), nor did it show an N400 effect. However, character repetition did produce an N400 reduction on parietal sites regardless it represented the same morpheme or a different one. The results indicate that the WTI integration effect is general across writing systems at the meaning level, but that the orthographic form nonetheless has an effect, and is specifically functional in Chinese reading.

Environmental assessment of NH/sub 3/ injection for an industrial package boiler. Volume 1. Technical results. Final report, January 1983-January 1984

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

Castaldini, C.; DeRosier, R.; Waterland, L.R.

1986-02-01

The report discusses emission results from comprehensive flue gas sampling of a gas- and oil-fired industrial boiler equipped with Exxon's Thermal DeNO/sub x/ Ammonia Injection Process for NO/sub x/ reduction. Comprehensive emission measurements included continuous monitoring of flue gas emissions; source assessment sampling system (SASS) tests; EPA Method 5/17 for solid and condensible particulate emissions and ammonia emissions; controlled condensation system for SO/sub 2/ and SO/sub 3/; and N/sub 2/O emission sampling. Ammonia injection at a NH/sub 3//NO molar ratio of 2.52 gave a NO/sub x/ reduction of 41% from an uncontrolled level of 234 ppm to a controlled levelmore » of 137 ppm. NH/sub 3/ emissions increased from 11 ppm for the baseline to an average of 430 ppm for ammonia injection. Nitrous oxide, N/sub 2/O was reduced 68% from a 50 ppm baseline level to a 17 ppm controlled level. Total particulate emissions increased by an order of magnitude from a baseline of 17.7 ng/J to a controlled level of 182 ng/J. The increase is in part attributed to formation of ammonia sulfate and bisulfate from residual ammonia and SO/sub x/. Total organic emissions were at a moderate level and showed a relative concentration in the nonvolatile category. Organic emissions of CO and trace inorganic elements were not significantly affected by ammonia injection.« less

Successes and challenges of the millennium development goals in Ethiopia: lessons for the sustainable development goals.

PubMed

Assefa, Yibeltal; Damme, Wim Van; Williams, Owain D; Hill, Peter S

2017-01-01

We analysed the performance of Ethiopia in achieving the health-related millennium development goals (MDGs) with the aim of acquiring lessons for the sustainable development goals (SDGs). Ethiopia achieved most of the health MDGs: a 67% reduction in under-five mortality, a 71% decline in maternal mortality ratio, a 90% decline in new HIV infections, a decrease in malaria-related deaths by 73% and a more than 50% decline in mortality due to tuberculosis. We argue that these achievements are due to implementation of a mix of comprehensive strategies within the health system and across other sectors of the government. Scaling up of interventions by disease control programmes (including the health extension programme) and strengthening of the health system have played important roles towards the achievements. These health gains could not have been realised without progress in the other MDGs: poverty reduction, education, access to safe drinking-water and peace and stability of the country. However, the gains were not equitable, with differences between urban and rural areas, among regions and socioeconomic strata. Ethiopia's remarkable success in meeting most of the targets of the health-related MDGs could be explained by its comprehensive and multisectoral approach for health development. The inequity gap remains a challenge that achieving the health-related SDGs requires the country to implement strategies, which specifically target more marginal populations and geographic areas. This also needs peace and stability, without which it is almost impossible to improve health.

Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs.

PubMed

Goodman, Patrick; Agnew, Michelle; McCaffrey, Marie; Paul, Gillian; Clancy, Luke

2007-04-15

Environmental tobacco smoke (ETS) causes disease in nonsmokers. Workplace bans on smoking are interventions to reduce exposure to ETS to try to prevent harmful health effects. On March 29, 2004, the Irish government introduced the first national comprehensive legislation banning smoking in all workplaces, including bars and restaurants. This study examines the impact of this legislation on air quality in pubs and on respiratory health effects in bar workers in Dublin. Exposure study. Concentrations of particulate matter 2.5 microm or smaller (PM(2.5)) and particulate matter 10 microm or smaller (PM(10)) in 42 pubs were measured and compared before and after the ban. Benzene concentrations were also measured in 26 of the pubs. Health effects study. Eighty-one barmen volunteered to have full pulmonary function studies, exhaled breath carbon monoxide, and salivary cotinine levels performed before the ban and repeated 1 year after the ban. They also completed questionnaires on exposure to ETS and respiratory symptoms on both occasions. Exposure study. There was an 83% reduction in PM(2.5) and an 80.2% reduction in benzene concentration in the bars. Health effects study. There was a 79% reduction in exhaled breath carbon monoxide and an 81% reduction in salivary cotinine. There were statistically significant improvements in measured pulmonary function tests and significant reductions in self-reported symptoms and exposure levels in nonsmoking barmen volunteers after the ban. A total workplace smoking ban results in a significant reduction in air pollution in pubs and an improvement in respiratory health in barmen.

Cost-Benefit Analysis of Green Infrastructures on Community Stormwater Reduction and Utilization: A Case of Beijing, China.

PubMed

Liu, Wen; Chen, Weiping; Feng, Qi; Peng, Chi; Kang, Peng

2016-12-01

Cost-benefit analysis is demanded for guiding the plan, design and construction of green infrastructure practices in rapidly urbanized regions. We developed a framework to calculate the costs and benefits of different green infrastructures on stormwater reduction and utilization. A typical community of 54,783 m 2 in Beijing was selected for case study. For the four designed green infrastructure scenarios (green space depression, porous brick pavement, storage pond, and their combination), the average annual costs of green infrastructure facilities are ranged from 40.54 to 110.31 thousand yuan, and the average of the cost per m 3 stormwater reduction and utilization is 4.61 yuan. The total average annual benefits of stormwater reduction and utilization by green infrastructures of the community are ranged from 63.24 to 250.15 thousand yuan, and the benefit per m 3 stormwater reduction and utilization is ranged from 5.78 to 11.14 yuan. The average ratio of average annual benefit to cost of four green infrastructure facilities is 1.91. The integrated facilities had the highest economic feasibility with a benefit to cost ratio of 2.27, and followed by the storage pond construction with a benefit to cost ratio of 2.14. The results suggested that while the stormwater reduction and utilization by green infrastructures had higher construction and maintenance costs, their comprehensive benefits including source water replacements benefits, environmental benefits and avoided cost benefits are potentially interesting. The green infrastructure practices should be promoted for sustainable management of urban stormwater.

Smoking-related microRNAs and mRNAs in human peripheral blood mononuclear cells

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

Su, Ming-Wei

Teenager smoking is of great importance in public health. Functional roles of microRNAs have been documented in smoke-induced gene expression changes, but comprehensive mechanisms of microRNA-mRNA regulation and benefits remained poorly understood. We conducted the Teenager Smoking Reduction Trial (TSRT) to investigate the causal association between active smoking reduction and whole-genome microRNA and mRNA expression changes in human peripheral blood mononuclear cells (PBMC). A total of 12 teenagers with a substantial reduction in smoke quantity and a decrease in urine cotinine/creatinine ratio were enrolled in genomic analyses. In Gene Set Enrichment Analysis (GSEA) and Ingenuity Pathway Analysis (IPA), differentially expressedmore » genes altered by smoke reduction were mainly associated with glucocorticoid receptor signaling pathway. The integrative analysis of microRNA and mRNA found eleven differentially expressed microRNAs negatively correlated with predicted target genes. CD83 molecule regulated by miR-4498 in human PBMC, was critical for the canonical pathway of communication between innate and adaptive immune cells. Our data demonstrated that microRNAs could regulate immune responses in human PBMC after habitual smokers quit smoking and support the potential translational value of microRNAs in regulating disease-relevant gene expression caused by tobacco smoke. - Highlights: • We conducted a smoke reduction trial program and investigated the causal relationship between smoke and gene regulation. • MicroRNA and mRNA expression changes were examined in human PBMC. • MicroRNAs are important in regulating disease-causal genes after tobacco smoke reduction.« less

Communication about melanoma and risk reduction after melanoma diagnosis.

PubMed

Rodríguez, Vivian M; Berwick, Marianne; Hay, Jennifer L

2017-12-01

Melanoma patients are advised to perform regular risk-reduction practices, including sun protection as well as skin self-examinations (SSEs) and physician-led examinations. Melanoma-specific communication regarding family risk and screening may promote such behaviors. To this end, associations between patients' melanoma-specific communication and risk reduction were examined. Melanoma patients (N = 169) drawn from a population-based cancer registry reported their current risk-reduction practices, perceived risk of future melanoma, and communication with physicians and relatives about melanoma risk and screening. Patients were, on average, 56 years old and 6.7 years' post diagnosis; 51% were male, 93% reported "fair/very fair" skin color, 75% completed at least some college, and 22% reported a family history of melanoma. Patients reported varying levels of regular (always/nearly always) sun protection: sunscreen use (79%), shade seeking (60%), hat use (54%), and long-sleeve shirt use (30%). Only 28% performed thorough SSE regularly, whereas 92% reported undergoing physician-led skin examinations within the past year. Participants who were female, younger, and had a higher perceived risk of future melanoma were more likely to report past communication. In adjusted analyses, communication remained uniquely associated with increased sunscreen use and SSE. Encouraging melanoma patients to have a more active role in discussions concerning melanoma risk and screening with relatives and physicians alike may be a useful strategy to promote 2 key risk-reduction practices post melanoma diagnosis and treatment. Future research is needed to identify additional strategies to improve comprehensive risk reduction in long-term melanoma patients. Copyright © 2016 John Wiley & Sons, Ltd.

Sensory and Physical Effects of Sugar Reduction in a Caramel Coating System.

PubMed

Mayhew, Emily J; Schmidt, Shelly J; Lee, Soo-Yeun

2017-08-01

Sugar reduction in processed foods is a pressing and complex problem, as sugars contribute important sensory and physical properties to foods. Composed of sugars and lipids, caramel coating systems, like the coating in caramel popcorns, exemplify this challenge. In order to probe the feasibility and consequences of sugar reduction, both sensory and physical properties were measured for 3 types of caramel coating systems. Four commonly used sugar alcohols, isomalt, maltitol, mannitol, and sorbitol, with different thermal properties and relative sweetness values were chosen to replace sugar in the caramel coating systems at 25% and 50% sugar reduction levels. Full sugar (control) and reduced sugar caramel coating samples were prepared in duplicate. Ten trained panelists participated in a 6-wk descriptive analysis panel to define and quantify the intensity of important sensory characteristics. All 24 sensory terms generated by the panel differed significantly across caramel type and sugar replacer. Thermal properties were measured through differential scanning calorimetry, and textural properties were measured through texture profile analysis. Replacement of sugar with sugar alcohols was found to decrease the glass transition temperature and systematically alter the hardness and resilience of caramel samples. Principal component analysis of sensory and physical data revealed that caramel coating type dictates caramel aroma, aroma by mouth, taste, and aftertaste, while sugar replacer and replacement level dictate texture. This research represents the first comprehensive study of the effects of sugar reduction in a caramel coating system and suggests successful strategies for sugar reduction and key parameters to control in reduced sugar systems. © 2017 Institute of Food Technologists®.

Study of Pellets and Lumps as Raw Materials in Silicon Production from Quartz and Silicon Carbide

NASA Astrophysics Data System (ADS)

Dal Martello, E.; Tranell, G.; Gaal, S.; Raaness, O. S.; Tang, K.; Arnberg, L.

2011-10-01

The use of high-purity carbon and quartz raw materials reduces the need for comprehensive refining steps after the silicon has been produced carbothermically in the electric reduction furnace. The current work aims at comparing the reaction mechanisms and kinetics occurring in the inner part of the reduction furnace when pellets or lumpy charge is used, as well as the effect of the raw material mix. Laboratory-scale carbothermic reduction experiments have been carried out in an induction furnace. High-purity silicon carbide and two different high-purity hydrothermal quartzes were charged as raw materials at different molar ratios. The charge was in the form of lumps (size, 2-5 mm) or as powder (size, 10-20 μm), mixed and agglomerated as pellets (size, 1-3 mm) and reacted at 2273 K (2000 °C). The thermal properties of the quartzes were measured also by heating a small piece of quartz in CO atmosphere. The investigated quartzes have different reactivity in reducing atmosphere. The carbothermal reduction experiments show differences in the reacted charge between pellets and lumps as charge material. Solid-gas reactions take place from the inside of the pellets porosity, whereas reactions in lumps occur topochemically. Silicon in pellets is produced mainly in the rim zone. Larger volumes of silicon have been found when using lumpy charge. More SiO is produced when using pellets than for lumpy SiO2 for the same molar ratio and heating conditions. The two SiC polytypes used in the carbothermal reduction experiments as carbon reductants presented different reactivity.

Overview of California's Efforts to Understand and Reduce Methane Sources

NASA Astrophysics Data System (ADS)

Croes, B. E.; Chen, Y.; Duren, R. M.; Falk, M.; Franco, G.; Herner, J.; Ingram, W.; Kuwayama, T.; McCarthy, R.; Scheehle, E.; Vijayan, A.

2016-12-01

Methane is an important short-lived climate pollutant (SLCP) and also has significant health implications as a tropospheric ozone precursor. As part of a comprehensive effort to reduce greenhouse gas (GHG) emissions overall by 40% from 1990 levels by 2030, California has proposed an SLCP Strategy that includes a 40% reduction of methane emissions from 2013 levels by 2030, with goals to reduce oil and gas related emissions and capture methane emissions from dairy operations and organic waste. A recent analysis of satellite data found a large methane "hot spot" over the Central Valley in California, likely the second largest over the entire U.S. In light of this finding, the California legislature passed Assembly Bill 1496 in 2015, which requires the California Air Resources Board (CARB) to undertake measurements to understand the sources of methane hot spots, evaluate life-cycle emissions from natural gas imported into California, and update relevant policies and programs. There is growing evidence in the recent scientific literature suggesting that a small fraction of methane sources within a category emit disproportionately higher emissions than their counterparts, usually referred to as "super emitters". As such, controlling these sources may provide a lower cost opportunity for methane reductions needed to meet near- and long-term climate goals. In order to achieve a comprehensive understanding of sources contributing to "hot spots", CARB, the California Energy Commission, and NASA's Jet Propulsion Laboratory are implementing a large-scale statewide methane survey using a tiered monitoring and measurement program, which will include airborne and ground-level measurements of the various regions and source sectors in the State. This presentation will discuss research and program implementation efforts to evaluate and mitigate methane super emitters and hot spots. These efforts are expected to improve our understanding of methane emission source distributions, improve the estimate of the overall magnitude of anthropogenic methane emissions in California, and inform and improve the effectiveness of methane reduction policies and programs.

Black Carbon, Dust and Organic Matter at South Cascade Glacier in Washington State, USA: A Comprehensive Characterization of Temporal (1865-2014) and Spatial Variability

NASA Astrophysics Data System (ADS)

Kaspari, S.; Pittenger, D.; Swick, M.; Skiles, M.; Perez, A.; Sethi, H.; Sevier, E.

2017-12-01

Rising temperatures are a widely recognized cause of glacial retreat in Washington, however light absorbing aerosols (LAA, including black carbon (BC), dust and organic matter) can also contribute to increased melt by reducing snow albedo. We present updated results of BC and dust variability at South Cascade (SOCAS) glacier spanning 1865-1994 using a 158 m ice core. Peak BC deposition occurred between 1940-1958, when median BC concentrations were 25 times higher than background levels. Post 1958 BC concentrations decrease, followed by an increase post 1980 associated with melt consolidation and/or trans-Pacific aerosol transport. Dust deposition at SOCAS is dominated by local sources. Albedo reductions from LAA are dominated by dust deposition, except during high BC deposition events from wildfires, and during the 1940-1958 period when BC contributes equally to albedo reductions. Results from a 2014 field campaign that included collection of 3 shallow ice cores, surface snow, and snow albedo measurements allow the 1865-1994 ice core record to be extended toward present, and spatial variability in LAA to be characterized. Snow albedo transects were measured using a spectrometer. BC concentrations were measured using a Single Particle Soot Photometer (SP2). Gravimetric filtration was used to determine the total LAA, and a thermal gravimetric technique was used to partition the LAA between dust and organic matter. The organic matter was partitioned into organic and elemental carbon using a thermal optical method. These methods allow LAA abundances be measured, but to partition the contribution of the LAA to albedo reductions requires characterization of LAA optical properties. This was accomplished using a Hyperspectral Imaging Microscope Spectrometer method that allows particle reflectance to be measured at 138 nm2 pixel resolution. By combining these methods, we provide a comprehensive characterization of spatial and temporal LAA variability at SOCAS.

Healthy Start: a comprehensive health education program for preschool children.

PubMed

Williams, C L; Squillace, M M; Bollella, M C; Brotanek, J; Campanaro, L; D'Agostino, C; Pfau, J; Sprance, L; Strobino, B A; Spark, A; Boccio, L

1998-01-01

Healthy Start is a 3-year demonstration and education research project designed to evaluate the effectiveness of a multidimensional cardiovascular (CV) risk reduction intervention in preschool centers over a 3-year period of time. Two primary interventions are employed. The first is the preschool food service intervention program designed to reduce the total fat in preschool meals and snacks to less than 30% of calories and reduce the saturated fat to less than 10% of calories. The second major intervention is a comprehensive preschool health education curriculum, focused heavily on nutrition. Effectiveness of the intervention will be determined through evaluation of changes in dietary intake of preschool children at school meals and snacks, especially with respect to intake of total and saturated fat. Evaluation of the education component will include assessment of program implementation by teachers, assessment of changes in nutrition knowledge by preschool children, and assessment of changes in home meals that children consume (total and saturated fat content). Blood cholesterol will be evaluated semiannually to evaluate changes that may be due to modification of dietary intake. Growth and body fatness will also be assessed. While substantial efforts have targeted CV risk reduction and health education for elementary school children, similar efforts aimed at preschool children have been lacking. The rationale for beginning CV risk reduction programs for preschool children is based upon the premise that risk factors for heart disease are prevalent by 3 years of age and tend to track over time, most commonly hypercholesterolemia and obesity, both related to nutrition. Since the behavioral antecedents for nutritional risk factors begin to be established very early in life, it is important to develop and evaluate new educational initiatives such as Healthy Start, aimed at the primary prevention of cardiovascular risk factors in preschool children. The purpose of this publication is to describe the rationale and methods for the Healthy Start project.

A Multigene Test Could Cost-Effectively Help Extend Life Expectancy for Women at Risk of Hereditary Breast Cancer.

PubMed

Li, Yonghong; Arellano, Andre R; Bare, Lance A; Bender, Richard A; Strom, Charles M; Devlin, James J

2017-04-01

The National Comprehensive Cancer Network recommends that women who carry gene variants that confer substantial risk for breast cancer consider risk-reduction strategies, that is, enhanced surveillance (breast magnetic resonance imaging and mammography) or prophylactic surgery. Pathogenic variants can be detected in women with a family history of breast or ovarian cancer syndromes by multigene panel testing. To investigate whether using a seven-gene test to identify women who should consider risk-reduction strategies could cost-effectively increase life expectancy. We estimated effectiveness and lifetime costs from a payer perspective for two strategies in two hypothetical cohorts of women (40-year-old and 50-year-old cohorts) who meet the National Comprehensive Cancer Network-defined family history criteria for multigene testing. The two strategies were the usual test strategy for variants in BRCA1 and BRCA2 and the seven-gene test strategy for variants in BRCA1, BRCA2, TP53, PTEN, CDH1, STK11, and PALB2. Women found to have a pathogenic variant were assumed to undergo either prophylactic surgery or enhanced surveillance. The incremental cost-effectiveness ratio for the seven-gene test strategy compared with the BRCA1/2 test strategy was $42,067 per life-year gained or $69,920 per quality-adjusted life-year gained for the 50-year-old cohort and $23,734 per life-year gained or $48,328 per quality-adjusted life-year gained for the 40-year-old cohort. In probabilistic sensitivity analysis, the seven-gene test strategy cost less than $100,000 per life-year gained in 95.7% of the trials for the 50-year-old cohort. Testing seven breast cancer-associated genes, followed by risk-reduction management, could cost-effectively improve life expectancy for women at risk of hereditary breast cancer. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Development of self-compressing BLSOM for comprehensive analysis of big sequence data.

PubMed

Kikuchi, Akihito; Ikemura, Toshimichi; Abe, Takashi

2015-01-01

With the remarkable increase in genomic sequence data from various organisms, novel tools are needed for comprehensive analyses of available big sequence data. We previously developed a Batch-Learning Self-Organizing Map (BLSOM), which can cluster genomic fragment sequences according to phylotype solely dependent on oligonucleotide composition and applied to genome and metagenomic studies. BLSOM is suitable for high-performance parallel-computing and can analyze big data simultaneously, but a large-scale BLSOM needs a large computational resource. We have developed Self-Compressing BLSOM (SC-BLSOM) for reduction of computation time, which allows us to carry out comprehensive analysis of big sequence data without the use of high-performance supercomputers. The strategy of SC-BLSOM is to hierarchically construct BLSOMs according to data class, such as phylotype. The first-layer BLSOM was constructed with each of the divided input data pieces that represents the data subclass, such as phylotype division, resulting in compression of the number of data pieces. The second BLSOM was constructed with a total of weight vectors obtained in the first-layer BLSOMs. We compared SC-BLSOM with the conventional BLSOM by analyzing bacterial genome sequences. SC-BLSOM could be constructed faster than BLSOM and cluster the sequences according to phylotype with high accuracy, showing the method's suitability for efficient knowledge discovery from big sequence data.

A Structured Transfer of Care Process Reduces Perioperative Complications in Cardiac Surgery Patients.

PubMed

Hall, Michael; Robertson, Jamie; Merkel, Matthias; Aziz, Michael; Hutchens, Michael

2017-08-01

Serious complications are common during the intensive care of postoperative cardiac surgery patients. Some of these complications may be influenced by communication during the process of handover of care from the operating room to the intensive care unit (ICU) team. A structured transfer of care process may reduce the rate of communication errors and perioperative complications. We hypothesized that a collaborative, comprehensive, structured handover of care from the intraoperative team to the ICU team would reduce a specific set of postoperative complications. We tested this hypothesis by developing and introducing a comprehensive multidisciplinary transfer of care process. We measured patient outcomes before and after the intervention using a linkage between 2 care databases: an Anesthesia Information Management System and a critical care complication registry database. There were 1127 total postoperative cardiac surgery admissions during the study period, 550 before and 577 after the intervention. There was no statistical difference between overall complications before and after the intervention (P = .154). However, there was a statistically significant reduction in preventable complications after the intervention (P = .023). The main finding of this investigation is that the introduction of a collaborative, comprehensive transfer of care process from the operating room to the ICU was associated with patients suffering fewer preventable complications.

Toward a comprehensive areal model of earthquake-induced landslides

USGS Publications Warehouse

Miles, S.B.; Keefer, D.K.

2009-01-01

This paper provides a review of regional-scale modeling of earthquake-induced landslide hazard with respect to the needs for disaster risk reduction and sustainable development. Based on this review, it sets out important research themes and suggests computing with words (CW), a methodology that includes fuzzy logic systems, as a fruitful modeling methodology for addressing many of these research themes. A range of research, reviewed here, has been conducted applying CW to various aspects of earthquake-induced landslide hazard zonation, but none facilitate comprehensive modeling of all types of earthquake-induced landslides. A new comprehensive areal model of earthquake-induced landslides (CAMEL) is introduced here that was developed using fuzzy logic systems. CAMEL provides an integrated framework for modeling all types of earthquake-induced landslides using geographic information systems. CAMEL is designed to facilitate quantitative and qualitative representation of terrain conditions and knowledge about these conditions on the likely areal concentration of each landslide type. CAMEL is highly modifiable and adaptable; new knowledge can be easily added, while existing knowledge can be changed to better match local knowledge and conditions. As such, CAMEL should not be viewed as a complete alternative to other earthquake-induced landslide models. CAMEL provides an open framework for incorporating other models, such as Newmark's displacement method, together with previously incompatible empirical and local knowledge. ?? 2009 ASCE.

Exploring the adequacy of smoking cessation support for pregnant and postpartum women

PubMed Central

2013-01-01

Background Smoking in pregnancy exemplifies the relationship between tobacco use and health inequalities. While difficulty reaching and engaging this population in cessation support is often highlighted in the literature, there is limited research that explores the factors that shape the provision and use of support by this subpopulation. Using Ontario, Canada, as a case study, this study examines how the use of cessation support by women is encouraged or discouraged by cessation policy, programming and practice; how geographical and sociocultural factors influence provision and uptake of support; and how barriers and challenges can be addressed through a comprehensive approach. Methods Semi-structured, in-depth interviews with key informants (31) and pregnant or postpartum women (29) were conducted to examine the cessation needs of this subpopulation, barriers to the provision and uptake of cessation support and directions for policy, service provision and programming. Results Key barriers included: the absence of a provincial cessation strategy and funding, capacity and engagement/accessibility issues. Geographical features presented additional challenges to provision/uptake, as did the absence of resources tailored to Aboriginal women and adolescents. Key informants recommended a comprehensive cessation strategy to facilitate coordination of cessation resources provincially and locally and elucidated the need for capacity building within tobacco control and within reproductive, child and maternal health. Participants also highlighted the need to further develop tobacco control policies and target the social determinants of health through poverty reduction, housing and education support. The provision of incentives, transportation, childcare and meals/snacks; adoption of woman-centred, harm-reduction and stigma reduction approaches; and promotion of programs through a variety of local venues were recommended by participants to address engagement and accessibility issues. Conclusions The current cessation system in Ontario is not equipped to adequately reduce smoking among pregnant and postpartum women. A comprehensive, multi-sector strategy designed to provide tailored and sustainable support through different system entry points is needed. A cultural shift in practice is also necessary to eliminate mixed messaging, strengthen practice and encourage open channels of communication about smoking between women and their providers. The study highlights the need to address smoking among women in a more holistic manner and for capacity building strategies that focus on strengthening providers’ competency and confidence in practice. Future research should explore: capacity building strategies, especially among rural and remote communities; the smoking and cessation experiences of different subpopulations of pregnant and postpartum women; the effectiveness of tailored strategies; and interventions that address smoking among partners and other family members. PMID:23672201

Laser and Light Treatments for Hair Reduction in Fitzpatrick Skin Types IV-VI: A Comprehensive Review of the Literature.

PubMed

Fayne, Rachel A; Perper, Marina; Eber, Ariel E; Aldahan, Adam S; Nouri, Keyvan

2018-04-01

Unwanted facial and body hair presents as a common finding in many patients, such as females with hirsutism. With advances in laser and light technology, a clinically significant reduction in hair can be achieved in patients with light skin. However, in patients with darker skin, Fitzpatrick skin types (FST) IV-VI, the higher melanin content of the skin interferes with the proposed mechanism of laser-induced selective photothermolysis, which is to target the melanin in the hair follicle to cause permanent destruction of hair bulge stem cells. Many prospective and retrospective studies have been conducted with laser and light hair-removal devices, but most exclude patients with darkly pigmented skin, considering them a high-risk group for unwanted side effects, including pigmentation changes, blisters, and crust formation. We reviewed the published literature to obtain studies that focused on hair reduction for darker skin types. The existing literature for this patient population identifies longer wavelengths as a key element of the treatment protocol and indicates neodymium-doped yttrium aluminum garnet (Nd:YAG), diode, alexandrite, and ruby lasers as well as certain intense pulsed light sources for safe hair reduction with minimal side effects in patients with FST IV-VI, so long as energy settings and wavelengths are appropriate. Based on the findings in this review, safe and effective hair reduction for patients with FST IV-VI is achievable under proper treatment protocols and energy settings.

Smoking Patterns in Oregon Youth: Effects of Funding and Defunding of a Comprehensive State Tobacco Control Program

PubMed Central

Pizacani, Barbara A.; Dent, Clyde W.; Maher, Julie E.; Rohde, Kristen; Stark, Michael J.; Biglan, Anthony; Thompson, Jill

2014-01-01

Purpose Comprehensive tobacco control programs have included school-based prevention programs as a key strategy to reach adolescents. Unfortunately, these programs have undergone extensive budget reductions in recent years. In 2003, funding for the Oregon Tobacco Prevention and Education Program was reduced by about 70%, and the school component was entirely defunded. To assess the effects of program funding and subsequent defunding on smoking prevalence within targeted Oregon schools, we compared the change in 30-day smoking prevalence between grades 8 and 11 in school districts in two periods: namely, during funding and after funding was eliminated. Methods We used annual school-based survey data for grades 8 and 11 to describe district-level changes in smoking prevalence in five age cohorts: two during the funding period and three after defunding. Each cohort was comprised of districts whose 8th-graders completed the survey and participated again 3 years later. Using mixed models, we compared the change in 30-day adjusted smoking prevalence among cohorts in funded districts, defunded districts, and districts that never received funding. Results Smoking prevalence growth was significantly higher among cohorts from the defunded period than for cohorts from the funded period (p = .04) and was not significantly different from schools that were never-funded (p = .79). Conclusions In Oregon, funding a school component of a comprehensive tobacco control strategy was associated with depressed uptake of smoking. Gains were quickly lost upon program defunding. School programs are an important strategy if they are long term, comprehensive, and reinforced in the larger environment. PMID:19237108

The impact of medication synchronization on quality care criteria in an independent community pharmacy.

PubMed

Hinson, Jessica L; Garofoli, Gretchen K; Elswick, Betsy M

To determine the impact of a comprehensive medication synchronization program in an independent community pharmacy by (1) evaluating changes in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and (2) examining the change in monthly prescription volume. Independent community pharmacy in Morgantown, WV. Waterfront Family Pharmacy is a single-location independent community pharmacy located in Morgantown, WV. The pharmacy consists of four full-time pharmacists and is the primary practice site for one community pharmacy PGY-1 resident. The pharmacy provides a variety of clinical services, including vaccine administration, medication therapy management, and diabetes education services. In September 2014, Waterfront Family Pharmacy started a comprehensive medication synchronization program. Change in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and change in monthly prescription volume. At the end of 6 months there was improvement in all targeted EQuIPP scores. There was a 7% improvement in proportion of days covered (PDC) for cholesterol-reducing agents, a 9.5% improvement in PDC for oral glycemic agents, a 1.2% improvement in PDC for renin-angiotensin system antagonists, and a 1.8% reduction in the use of high-risk medications in the elderly. There was also an average increase in monthly prescription volume of 4.8% over the first 6 months after the implementation of the comprehensive medication synchronization program. The implementation of a comprehensive medication synchronization program in an independent community pharmacy may result in benefits including improved EQuIPP scores and increased prescription volume. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Individual Differences in Sentence Comprehension: A Functional Magnetic Resonance Imaging Investigation of Syntactic and Lexical Processing Demands

PubMed Central

Prat, Chantel S.; Keller, Timothy A.; Just, Marcel Adam

2008-01-01

Language comprehension is neurally underpinned by a network of collaborating cortical processing centers; individual differences in comprehension must be related to some set of this network’s properties. This study investigated the neural bases of individual differences during sentence comprehension by examining the network’s response to two variations in processing demands: reading sentences containing words of high versus low lexical frequency and having simpler versus more complex syntax. In a functional magnetic resonance imaging study, readers who were independently identified as having high or low working memory capacity for language exhibited three differentiating properties of their language network, namely, neural efficiency, adaptability, and synchronization. First, greater efficiency (defined as a reduction in activation associated with improved performance) was manifested as less activation in the bilateral middle frontal and right lingual gyri in high-capacity readers. Second, increased adaptability was indexed by larger lexical frequency effects in high-capacity readers across bilateral middle frontal, bilateral inferior occipital, and right temporal regions. Third, greater synchronization was observed in high-capacity readers between left temporal and left inferior frontal, left parietal, and right occipital regions. Synchronization interacted with adaptability, such that functional connectivity remained constant or increased with increasing lexical and syntactic demands in high-capacity readers, whereas low-capacity readers either showed no reliable differentiation or a decrease in functional connectivity with increasing demands. These results are among the first to relate multiple cortical network properties to individual differences in reading capacity and suggest a more general framework for understanding the relation between neural function and individual differences in cognitive performance. PMID:17892384

Individual differences in sentence comprehension: a functional magnetic resonance imaging investigation of syntactic and lexical processing demands.

PubMed

Prat, Chantel S; Keller, Timothy A; Just, Marcel Adam

2007-12-01

Language comprehension is neurally underpinned by a network of collaborating cortical processing centers; individual differences in comprehension must be related to some set of this network's properties. This study investigated the neural bases of individual differences during sentence comprehension by examining the network's response to two variations in processing demands: reading sentences containing words of high versus low lexical frequency and having simpler versus more complex syntax. In a functional magnetic resonance imaging study, readers who were independently identified as having high or low working memory capacity for language exhibited three differentiating properties of their language network, namely, neural efficiency, adaptability, and synchronization. First, greater efficiency (defined as a reduction in activation associated with improved performance) was manifested as less activation in the bilateral middle frontal and right lingual gyri in high-capacity readers. Second, increased adaptability was indexed by larger lexical frequency effects in high-capacity readers across bilateral middle frontal, bilateral inferior occipital, and right temporal regions. Third, greater synchronization was observed in high-capacity readers between left temporal and left inferior frontal, left parietal, and right occipital regions. Synchronization interacted with adaptability, such that functional connectivity remained constant or increased with increasing lexical and syntactic demands in high-capacity readers, whereas low-capacity readers either showed no reliable differentiation or a decrease in functional connectivity with increasing demands. These results are among the first to relate multiple cortical network properties to individual differences in reading capacity and suggest a more general framework for understanding the relation between neural function and individual differences in cognitive performance.

Symmetry Analysis and Exact Solutions of the 2D Unsteady Incompressible Boundary-Layer Equations

NASA Astrophysics Data System (ADS)

Han, Zhong; Chen, Yong

2017-01-01

To find intrinsically different symmetry reductions and inequivalent group invariant solutions of the 2D unsteady incompressible boundary-layer equations, a two-dimensional optimal system is constructed which attributed to the classification of the corresponding Lie subalgebras. The comprehensiveness and inequivalence of the optimal system are shown clearly under different values of invariants. Then by virtue of the optimal system obtained, the boundary-layer equations are directly reduced to a system of ordinary differential equations (ODEs) by only one step. It has been shown that not only do we recover many of the known results but also find some new reductions and explicit solutions, which may be previously unknown. Supported by the Global Change Research Program of China under Grant No. 2015CB953904, National Natural Science Foundation of China under Grant Nos. 11275072, 11435005, 11675054, and Shanghai Collaborative Innovation Center of Trustworthy Software for Internet of Things under Grant No. ZF1213

Decomposition of CO2 Emission Factors in Baoding

NASA Astrophysics Data System (ADS)

Li, Wei; Wang, xuyang; Zhang, Hongzhi

2018-01-01

Baoding, as one of the first “five provinces and eight cities” low carbon pilot cities, undertakes an important task and mission. The urgent task is to explore a peak route and emission reduction path suitable for Baoding’s own development, so as to provide reference for the construction of low-carbon pilot cities. At present, the carbon emissions of Baoding city and its subordinate districts and counties are not clear, and the carbon emissions, change trends and emission characteristics of various industries have not been systematically studied. This lead researcherscan not carry out further attribution analysis, the prediction of future emissions trends and put forward specific measures to reduce emissions are impossible.If the government can not accurately and comprehensively understand the problems faced in the construction and development of low-carbon cities, it is difficult to fundamentally put forward effective emission reduction policies and measures.

Impact of Health Insurance on Health Care Treatment and Cost in Vietnam: A Health Capability Approach to Financial Protection

PubMed Central

Nguyen, Kim Thuy; Khuat, Oanh Thi Hai; Pham, Duc Cuong; Khuat, Giang Thi Hong

2012-01-01

We applied an alternative conceptual framework for analyzing health insurance and financial protection grounded in the health capability paradigm. Through an original survey of 706 households in Dai Dong, Vietnam, we examined the impact of Vietnamese health insurance schemes on inpatient and outpatient health care access, costs, and health outcomes using bivariate and multivariable regression analyses. Insured respondents had lower outpatient and inpatient treatment costs and longer hospital stays but fewer days of missed work or school than the uninsured. Insurance reform reduced household vulnerability to high health care costs through direct reduction of medical costs and indirect reduction of income lost to illness. However, from a normative perspective, out-of-pocket costs are still too high, and accessibility issues persist; a comprehensive insurance package and additional health system reforms are needed. PMID:22698046

Modified magnetism within the coherence volume of superconducting Fe1+δSexTe1-x

NASA Astrophysics Data System (ADS)

Leiner, J.; Thampy, V.; Christianson, A. D.; Abernathy, D. L.; Stone, M. B.; Lumsden, M. D.; Sefat, A. S.; Sales, B. C.; Hu, Jin; Mao, Zhiqiang; Bao, Wei; Broholm, C.

2014-09-01

Neutron scattering is used to probe magnetic interactions as superconductivity develops in optimally doped Fe1+δSexTe1-x. Applying the first moment sum rule to comprehensive neutron scattering data, we extract the change in magnetic exchange energy Δ [JR -R'] in the superconducting state referenced to the normal state. Oscillatory changes are observed for Fe-Fe displacements |ΔR |<ξ, where ξ =1.3(1) nm is the superconducting coherence length. Dominated by a large reduction in the second nearest neighbor exchange energy [-1.2(2) meV/Fe], the overall reduction in magnetic interaction energy is Δ=-0.31(9) meV/Fe. Comparison to the superconducting condensation energy ΔESC=-0.013(1) meV/Fe, which we extract from specific heat data, suggests the modified magnetism we probe drives superconductivity in Fe1+δSexTe1-x.

Economic assessment of single-walled carbon nanotube processes

NASA Astrophysics Data System (ADS)

Isaacs, J. A.; Tanwani, A.; Healy, M. L.; Dahlben, L. J.

2010-02-01

The carbon nanotube market is steadily growing and projected to reach 1.9 billion by 2010. This study examines the economics of manufacturing single-walled carbon nanotubes (SWNT) using process-based cost models developed for arc, CVD, and HiPco processes. Using assumed input parameters, manufacturing costs are calculated for 1 g SWNT for arc, CVD, and HiPco, totaling 1,906, 1,706, and 485, respectively. For each SWNT process, the synthesis and filtration steps showed the highest costs, with direct labor as a primary cost driver. Reductions in production costs are calculated for increased working hours per day and for increased synthesis reaction yield (SRY) in each process. The process-based cost models offer a means for exploring opportunities for cost reductions, and provide a structured system for comparisons among alternative SWNT manufacturing processes. Further, the models can be used to comprehensively evaluate additional scenarios on the economics of environmental, health, and safety best manufacturing practices.

The comprehensive study and the reduction of contact resistivity on the n-InGaAs M-I-S contact system with different inserted insulators

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

Liao, M.-H., E-mail: mhliaoa@ntu.edu.tw; Lien, C.

2015-05-15

Five different kinds of insulators including BaTiO{sub 3}, TiO{sub 2}, Al{sub 2}O{sub 3}, CdO and ZnO on the n-type InGaAs metal-insulator-semiconductor (M-I-S) ohmic contact structure are studied. The effect for the dielectric constant (ε) of inserted insulator and the conduction band offset (CBO) between an insulator and semiconductor substrate is analyzed by a unified M-I-S contact model. Based on the theoretical model and experimental data, we demonstrates that the inserted ZnO insulator with the high electron affinity and the low CBO (∼0.1 eV) to the InGaAs substrate results in ∼10 times contact resistivity reduction, even the ε of ZnO ismore » not pretty high (∼10)« less

Reduction of Thoroughbred racing fatalities at New York Racing Association racetracks using a multi-disciplinary mortality review process.

PubMed

Palmer, Scott E; McDonough, Sean P; Mohammed, Hussni O

2017-07-01

Between January 1, 2013 and December 31, 2015, findings of a New York State Gaming Commission-Cornell University postmortem examination program were utilized in a multi-disciplinary mortality review process to review 129 racing fatalities at Thoroughbred racetracks operated by the New York Racing Association (NYRA). Musculoskeletal fractures comprised 79% of the fatalities; cardiopulmonary conditions accounted for 12% of the fatalities. Other causes of death included gastrointestinal (3%), respiratory (5%), and central nervous system (2%) conditions. Fetlock failure represented 50% of the musculoskeletal fatalities. The general distribution of these findings was very similar to that reported by the California Animal Health and Food Safety Laboratory System during the same period. These findings, used in conjunction with a comprehensive mortality review process and regulatory reform, have contributed to a significant reduction of the incidence of Thoroughbred racing fatalities at NYRA racetracks during the period of this review.

Hormones and ethics: Understanding the biological basis of unethical conduct.

PubMed

Lee, Jooa Julia; Gino, Francesca; Jin, Ellie Shuo; Rice, Leslie K; Josephs, Robert A

2015-10-01

Globally, fraud has been rising sharply over the last decade, with current estimates placing financial losses at greater than $3.7 trillion annually. Unfortunately, fraud prevention has been stymied by lack of a clear and comprehensive understanding of its underlying causes and mechanisms. In this paper, we focus on an important but neglected topic--the biological antecedents and consequences of unethical conduct--using salivary collection of hormones (testosterone and cortisol). We hypothesized that preperformance cortisol levels would interact with preperformance levels of testosterone to regulate cheating behavior in 2 studies. Further, based on the previously untested cheating-as-stress-reduction hypothesis, we predicted a dose-response relationship between cheating and reductions in cortisol and negative affect. Taken together, this research marks the first foray into the possibility that endocrine-system activity plays an important role in the regulation of unethical behavior. (c) 2015 APA, all rights reserved).

The diffusion and impact of clean indoor air laws.

PubMed

Eriksen, Michael P; Cerak, Rebecca L

2008-01-01

Over the past quarter century, primarily as a result of scientific discovery, citizen advocacy, and legislative action, comprehensive clean indoor air laws have spread rapidly throughout the world. Laws that establish completely smoke-free indoor environments have many relative advantages including being low cost, safe, effective, and easy to implement. The diffusion of these laws has been associated with a dramatic and rapid reduction in population levels of serum cotinine among nonsmokers and has also contributed to a reduction in overall cigarette consumption among smokers, with no adverse economic impact, except to the tobacco industry. Currently, nearly half of the U.S. population lives in jurisdictions with some combination of completely smoke-free workplaces, restaurants, or bars. The diffusion of clean indoor air laws is spreading rapidly throughout the world, stimulated by the first global health treaty, the Framework Convention on Tobacco Control.

Ionic Graphitization of Ultrathin Films of Ionic Compounds.

PubMed

Kvashnin, A G; Pashkin, E Y; Yakobson, B I; Sorokin, P B

2016-07-21

On the basis of ab initio density functional calculations, we performed a comprehensive investigation of the general graphitization tendency in rocksalt-type structures. In this paper, we determine the critical slab thickness for a range of ionic cubic crystal systems, below which a spontaneous conversion from a cubic to a layered graphitic-like structure occurs. This conversion is driven by surface energy reduction. Using only fundamental parameters of the compounds such as the Allen electronegativity and ionic radius of the metal atom, we also develop an analytical relation to estimate the critical number of layers.

Experimental investigation of shock-cell noise reduction for single-stream nozzles in simulated flight, comprehensive data report. Volume 2: Laser velocimeter data

NASA Technical Reports Server (NTRS)

Yamamoto, K.; Brausch, J. F.; Janardan, B. A.; Hoerst, D. J.; Price, A. O.; Knott, P. R.

1984-01-01

Mean velocity (axial component) and turbulent velocity (axial component) measurements for thirty one selected flow conditions of six models were performed employing the Laser Doppler Velocimeter Aerodynamic conditions which define the test points are given. Tabulations which explain the scope of mean velocity traverses and turbulence histogram measurements are also presented. The actual LV position, the type of traverse, and measured mean and turbulent velocities along copies of the LV mean velocity traces are contained.

The cost-effectiveness of NBPTS teacher certification.

PubMed

Yeh, Stuart S

2010-06-01

A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of value-added statistical methods to identify effective teachers, and the implementation of systems where student performance in math and reading is rapidly assessed 2-5 times per week. The most cost-effective approach, rapid assessment, is three magnitudes as cost-effective as Board certification.

Carbon Nanomaterials in Direct Liquid Fuel Cells.

PubMed

Du, Huayun; Zhao, Cindy Xinxin; Lin, Jing; Guo, Jiang; Wang, Bin; Hu, Zhen; Shao, Qian; Pan, Duo; Wujcik, Evan K; Guo, Zhanhu

2018-04-19

Fuel cells have attracted more attentions due to many advantages they can provide, including high energy efficiency and low environmental burden. To form a stable, low cost and efficient catalyst, we presented here the state of the art of electrocatalyst fabrication approaches, involving carbon nanotubes and their multifunctional nanocomposites incorporated with noble metals, such as Pt, Pd, Au, their binary and ternary systems. Both fuel oxidation reactions and oxygen reduction reactions were emphasized with comprehensive examples and future prospects. © 2018 The Chemical Society of Japan & Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

The Effects of Signal Erosion and Core Genome Reduction on the Identification of Diagnostic Markers

PubMed Central

Sahl, Jason W.; Vazquez, Adam J.; Hall, Carina M.; Busch, Joseph D.; Tuanyok, Apichai; Mayo, Mark; Schupp, James M.; Lummis, Madeline; Pearson, Talima; Shippy, Kenzie; Allender, Christopher J.; Theobald, Vanessa; Hutcheson, Alex; Korlach, Jonas; LiPuma, John J.; Ladner, Jason; Lovett, Sean; Koroleva, Galina; Palacios, Gustavo; Limmathurotsakul, Direk; Wuthiekanun, Vanaporn; Wongsuwan, Gumphol; Currie, Bart J.

2016-01-01

ABSTRACT Whole-genome sequence (WGS) data are commonly used to design diagnostic targets for the identification of bacterial pathogens. To do this effectively, genomics databases must be comprehensive to identify the strict core genome that is specific to the target pathogen. As additional genomes are analyzed, the core genome size is reduced and there is erosion of the target-specific regions due to commonality with related species, potentially resulting in the identification of false positives and/or false negatives. PMID:27651357

Airframe noise: A design and operating problem

NASA Technical Reports Server (NTRS)

Hardin, J. C.

1976-01-01

A critical assessment of the state of the art in airframe noise is presented. Full-scale data on the intensity, spectra, and directivity of this noise source are evaluated in light of the comprehensive theory developed by Ffowcs Williams and Hawkings. Vibration of panels on the aircraft is identified as a possible additional source of airframe noise. The present understanding and methods for prediction of other component sources - airfoils, struts, and cavities - are discussed. Operating problems associated with airframe noise as well as potential design methods for airframe noise reduction are identified.

Simulation of fluidized bed coal combustors

NASA Technical Reports Server (NTRS)

Rajan, R.

1979-01-01

The many deficiencies of previous work on simulation of fluidized bed combustion (FBC) processes are presented. An attempt is made to reduce these deficiencies, and to formulate a comprehensive FBC model taking into account the following elements: (1) devolatilization of coal and the subsequent combustion of volatiles and residual char; (2) sulfur dioxide capture by limestone; (3) NOx release and reduction of NOx by char; (4) attrition and elutriation of char and limestone; (5) bubble hydrodynamics; (6) solids mixing; (7) heat transfer between gas and solid, and solid and heat exchange surfaces; and (8) freeboard reactions.

Principles of a clean operating room environment.

PubMed

Howard, James L; Hanssen, Arlen D

2007-10-01

Optimizing the operating room environment is necessary to minimize the prevalence of arthroplasty infection. Reduction of bacterial contamination in the operating room should be a primary focus of all members of the operating room team. However, in recent years, there has been a decline in the emphasis of the basic principles of antisepsis in many operating rooms. The purpose of this review is to highlight important considerations for optimizing the operating room environment. These principles should be actively promoted by orthopedic surgeons in their operating rooms as part of a comprehensive approach to minimizing arthroplasty infection.

Tax-deferred annuity plans: meeting the IRS audit challenge.

PubMed

Schussler, M

1997-01-01

A growing number of nonprofit organizations are being fined for violations of IRS regulations following IRS audits of their tax-deferred annuity (TDA) plans. To ensure that their organizations can withstand the scrutiny of an IRS audit, TDA plan administrators must ensure that plans meet IRS regulations and be prepared for IRS audits. Documentation--particularly of the TDA plan itself, and procedures related to salary reduction programs, compensation limits, excess deferrals and other excess contributions, loans, and distributions--must be comprehensive and in compliance with IRS regulations.

Improved chest expansion in idiopathic scoliosis after intensive, multiple-modality, nonsurgical treatment in an adult.

PubMed

Hawes, M C; Brooks, W J

2001-08-01

This case report documents a substantial increase in chest wall expansion in a middle-aged woman with stable right thoracic spinal curvature due to idiopathic scoliosis. Treatment involved intensive psychological and mobilization therapies, including comprehensive manipulative medicine treatments and daily manual traction. Over an 8-year period, a 6-cm increase in resting chest circumference (in the absence of weight gain) and a 7.5-cm increase in chest expansion were correlated with a substantial reduction of incidence of respiratory infections.

Aqueous Hydricity of Late Metal Catalysts as a Continuum Tuned by Ligands and the Medium.

PubMed

Pitman, Catherine L; Brereton, Kelsey R; Miller, Alexander J M

2016-02-24

Aqueous hydride transfer is a fundamental step in emerging alternative energy transformations such as H2 evolution and CO2 reduction. "Hydricity," the hydride donor ability of a species, is a key metric for understanding transition metal hydride reactivity, but comprehensive studies of aqueous hydricity are scarce. An extensive and self-consistent aqueous hydricity scale is constructed for a family of Ru and Ir hydrides that are key intermediates in aqueous catalysis. A reference hydricity is determined using redox potentiometry and spectrophotometric titration for a particularly water-soluble species. Then, relative hydricity values for a range of species are measured using hydride transfer equilibria, taking advantage of expedient new synthetic procedures for Ru and Ir hydrides. This large collection of hydricity values provides the most comprehensive picture so far of how ligands impact hydricity in water. Strikingly, we also find that hydricity can be viewed as a continuum in water: the free energy of hydride transfer changes with pH, buffer composition, and salts present in solution.

The Healthy LifeWorks Project: a pilot study of the economic analysis of a comprehensive workplace wellness program in a Canadian government department.

PubMed

Makrides, Lydia; Smith, Steven; Allt, Jane; Farquharson, Jane; Szpilfogel, Claudine; Curwin, Sandra; Veinot, Paula; Wang, Feifei; Edington, Dee

2011-07-01

To examine the relationship between health risks and absenteeism and drug costs vis-a-vis comprehensive workplace wellness. Eleven health risks, and change in drug claims, short-term and general illness calculated across four risk change groups. Wellness score examined using Wilcoxon test and regression model for cost change. The results showed 31% at risk; 9 of 11 risks associated with higher drug costs. Employees moving from low to high risk showed highest relative increase (81%) in drug costs; moving from high to low had lowest (24%). Low-high had highest increase in absenteeism costs (160%). With each risk increase, absenteeism costs increased by $CDN248 per year (P < 0.05) with average decrease of 0.07 risk factors and savings $CDN6979 per year. Both high-risk reduction and low-risk maintenance are important to contain drug costs. Only low-risk maintenance also avoids absenteeism costs associated with high risks.

Cancer survivorship: a new challenge in comprehensive cancer control.

PubMed

Pollack, Lori A; Greer, Greta E; Rowland, Julia H; Miller, Andy; Doneski, Donna; Coughlin, Steven S; Stovall, Ellen; Ulman, Doug

2005-10-01

Cancer survivors are a growing population in the United States because of earlier cancer diagnosis, the aging of society, and more effective risk reduction and treatment. Concerns about the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families are increasingly being recognized and addressed by public, private, and non-profit organizations. The purpose of this paper is to discuss how survivorship fits within the framework of comprehensive cancer control. We summarize three national reports on cancer survivorship and highlight how various organizations and programs are striving to address the needs of cancer survivors through public health planning, including the challenges these groups face and the gaps in knowledge and available services. As cancer survivorship issues are being recognized, many organizations have objectives and programs to address concerns of those diagnosed with cancer. However, better coordination and dissemination may decrease overlap and increase the reach of efforts and there is limited evidence for the effectiveness and impact of these efforts.

Pulp fiction - The volunteer concept (or how not to site additional LLRW disposal capacity)

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

Burton, D.A.

1995-12-31

Experiences of compacts and of individual states throughout the nation indicate that low-level radioactive waste disposal siting processes, based from the beginning upon the volunteer concept are fraught with problems. Most apparent among these problems is that the volunteer concept does not lead to scientifically and technically based siting endeavors. Ten years have passed since the Amendments Act of 1985, and no compact or state has been - successful in providing for new LLRW disposal capacity. That failure can be traced in part to the reliance upon the volunteer concept in siting attempts. If success is to be achieved, themore » future direction for LLRW management must focus on three areas: first, a comprehensive evaluation of all LLRW management options, including reduction of waste generated and on-site storage; secondly, a comprehensive evaluation of the current as well as projected waste stream, to determine the amount of disposal capacity actually needed; and, finally, sound scientifically and technically based siting processes.« less

Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options—a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference

PubMed Central

Kirchhof, Paulus; Lip, Gregory Y.H.; Van Gelder, Isabelle C.; Bax, Jeroen; Hylek, Elaine; Kaab, Stefan; Schotten, Ulrich; Wegscheider, Karl; Boriani, Giuseppe; Brandes, Axel; Ezekowitz, Michael; Diener, Hans; Haegeli, Laurent; Heidbuchel, Hein; Lane, Deirdre; Mont, Luis; Willems, Stephan; Dorian, Paul; Aunes-Jansson, Maria; Blomstrom-Lundqvist, Carina; Borentain, Maria; Breitenstein, Stefanie; Brueckmann, Martina; Cater, Nilo; Clemens, Andreas; Dobrev, Dobromir; Dubner, Sergio; Edvardsson, Nils G.; Friberg, Leif; Goette, Andreas; Gulizia, Michele; Hatala, Robert; Horwood, Jenny; Szumowski, Lukas; Kappenberger, Lukas; Kautzner, Josef; Leute, Angelika; Lobban, Trudie; Meyer, Ralf; Millerhagen, Jay; Morgan, John; Muenzel, Felix; Nabauer, Michael; Baertels, Christoph; Oeff, Michael; Paar, Dieter; Polifka, Juergen; Ravens, Ursula; Rosin, Ludger; Stegink, W.; Steinbeck, Gerhard; Vardas, Panos; Vincent, Alphons; Walter, Maureen; Breithardt, Günter; Camm, A. John

2012-01-01

While management of atrial fibrillation (AF) patients is improved by guideline-conform application of anticoagulant therapy, rate control, rhythm control, and therapy of accompanying heart disease, the morbidity and mortality associated with AF remain unacceptably high. This paper describes the proceedings of the 3rd Atrial Fibrillation NETwork (AFNET)/European Heart Rhythm Association (EHRA) consensus conference that convened over 60 scientists and representatives from industry to jointly discuss emerging therapeutic and diagnostic improvements to achieve better management of AF patients. The paper covers four chapters: (i) risk factors and risk markers for AF; (ii) pathophysiological classification of AF; (iii) relevance of monitored AF duration for AF-related outcomes; and (iv) perspectives and needs for implementing better antithrombotic therapy. Relevant published literature for each section is covered, and suggestions for the improvement of management in each area are put forward. Combined, the propositions formulate a perspective to implement comprehensive management in AF. PMID:21791573

Improving tsunami resiliency: California's Tsunami Policy Working Group

USGS Publications Warehouse

Real, Charles R.; Johnson, Laurie; Jones, Lucile M.; Ross, Stephanie L.; Kontar, Y.A.; Santiago-Fandiño, V.; Takahashi, T.

2014-01-01

California has established a Tsunami Policy Working Group to facilitate development of policy recommendations for tsunami hazard mitigation. The Tsunami Policy Working Group brings together government and industry specialists from diverse fields including tsunami, seismic, and flood hazards, local and regional planning, structural engineering, natural hazard policy, and coastal engineering. The group is acting on findings from two parallel efforts: The USGS SAFRR Tsunami Scenario project, a comprehensive impact analysis of a large credible tsunami originating from an M 9.1 earthquake in the Aleutian Islands Subduction Zone striking California’s coastline, and the State’s Tsunami Preparedness and Hazard Mitigation Program. The unique dual-track approach provides a comprehensive assessment of vulnerability and risk within which the policy group can identify gaps and issues in current tsunami hazard mitigation and risk reduction, make recommendations that will help eliminate these impediments, and provide advice that will assist development and implementation of effective tsunami hazard risk communication products to improve community resiliency.

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

The U.S. Department of Energy (DOE) and U.S. General Services Administration (GSA) are issuing comprehensive guidance on the federal fleet requirements of Executive Order (E.O.) 13693, Planning for Federal Sustainability in the Next Decade (E.O. 13693), to help federal agencies subject to the executive order develop an overall approach for reducing total fleet greenhouse gas (GHG) emissions and fleet-wide per-mile GHG emissions, and ensure the approach helps these agencies meet their requirements. Three key GHG emissions reduction strategies - right-sizing fleets to mission, increasing fleet fuel efficiency, and displacing petroleum with alternative fuel use - are essential to meeting themore » requirements and are discussed further in this document. This guidance document is intended to help agency Chief Sustainability Officers (CSOs) and headquarters fleet managers craft tailored executable plans that achieve the purpose of E.O. 13693. The guidance will assist agencies in completing the first phase of a comprehensive fleet management framework by identifying the strategies each agency will then implement to meet or exceed its requirements.« less

Language and Speech in Autism.

PubMed

Gernsbacher, Morton Ann; Morson, Emily M; Grace, Elizabeth J

2016-01-01

Autism is a developmental disability characterized by atypical social interaction, interests or body movements, and communication. Our review examines the empirical status of three communication phenomena believed to be unique to autism: pronoun reversal (using the pronoun you when the pronoun I is intended, and vice versa), echolalia (repeating what someone has said), and a reduced or even reversed production-comprehension lag (a reduction or reversal of the well-established finding that speakers produce less sophisticated language than they can comprehend). Each of these three phenomena has been claimed to be unique to autism; therefore, each has been proposed to be diagnostic of autism, and each has been interpreted in autism-centric ways (psychoanalytic interpretations of pronoun reversal, behaviorist interpretations of echolalia, and clinical lore about the production-comprehension lag). However, as our review demonstrates, none of these three phenomena is in fact unique to autism; none can or should serve as diagnostic of autism, and all call into question unwarranted assumptions about autistic persons and their language development and use.

Language and Speech in Autism

PubMed Central

Gernsbacher, Morton Ann; Morson, Emily M.; Grace, Elizabeth J.

2017-01-01

Autism is a developmental disability characterized by atypical social interaction, interests or body movements, and communication. Our review examines the empirical status of three communication phenomena believed to be unique to autism: pronoun reversal (using the pronoun you when the pronoun I is intended, and vice versa), echolalia (repeating what someone has said), and a reduced or even reversed production-comprehension lag (a reduction or reversal of the well-established finding that speakers produce less sophisticated language than they can comprehend). Each of these three phenomena has been claimed to be unique to autism; therefore, each has been proposed to be diagnostic of autism, and each has been interpreted in autism-centric ways (psychoanalytic interpretations of pronoun reversal, behaviorist interpretations of echolalia, and clinical lore about the production-comprehension lag). However, as our review demonstrates, none of these three phenomena is in fact unique to autism; none can or should serve as diagnostic of autism, and all call into question unwarranted assumptions about autistic persons and their language development and use. PMID:28127576

The VOICES/VOCES success story: effective strategies for training, technical assistance and community-based organization implementation.

PubMed

Hamdallah, Myriam; Vargo, Sue; Herrera, Jennifer

2006-08-01

The Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) project successfully disseminated VOICES/VOCES, a brief video-based HIV risk reduction intervention targeting African American and Latino heterosexual men and women at risk for HIV infection. Elements of the dissemination strategy included a comprehensive and user-friendly intervention kit, comprising (a) an implementationmanual and othermaterials necessary for conducting the intervention (b) a Training of Facilitators (TOF) curriculum used to teach agency staff how to implement the EBI in their setting, (c) a network of expert trainers who attend a training institute to become adept at using the TOF curriculum to train facilitators, (d) a comprehensive training coordination center to plan and deliver TOF trainings, (e) proactive technical assistance to trainers, and (f) post-TOF technical assistance for local implementers. This article reports on those strategies and a local CBO's successful participation in DEBI, resulting implementation of VOICES/VOCES, with unique approaches to adaptation and tailoring.

Hypertension in Russia: Changes Observed After 4 Years of a Comprehensive Health System Improvement Program in the Yaroslavl Region.

PubMed

Mozheyko, Maria; Eregin, Sergey; Danilenko, Natalia; Vigdorchik, Alexey; Tobe, Sheldon W; Campbell, Norman; McLean, Donna; Baskakova, Zhanna; Klimovskaia, Ilnaz; Ramanathan, Krishnan; Hughes, David

2017-02-01

Rates of cardiovascular mortality and morbidity in Russia have been among the highest in Europe. A comprehensive health system improvement program targeting better diagnosis and control of hypertension was undertaken in the Yaroslavl Region of Russia. This initiative was a joint program between clinicians, the Department of Health and Pharmacy of the Yaroslavl Region, and Novartis Pharma LLC. From 2011 to 2014, the blood pressure control rate improved substantially (94% relative improvement), the percentage of patients with a systolic blood pressure ≥180 mm Hg decreased (from 10% to 5%), and there was a reduction in stroke incidence rate from 4.6 to 3.7 per 1000 population. During this same period, significant changes were made to the way hypertension was diagnosed and treated across all regional government polyclinics, and the use of antihypertensive therapies increased. © 2016 The Authors. The Journal of Clinical Hypertension Published by Wiley Periodicals, Inc.

Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis.

PubMed

McNeil, Ryan; Guirguis-Younger, Manal; Dilley, Laura B; Aubry, Tim D; Turnbull, Jeffrey; Hwang, Stephen W

2012-05-17

Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.

Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national irish smoking ban: interrupted time-series analysis.

PubMed

Stallings-Smith, Sericea; Zeka, Ariana; Goodman, Pat; Kabir, Zubair; Clancy, Luke

2013-01-01

Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post-ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages ≥35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76-0.99), a 26% reduction in ischemic heart disease (IHD) (RR: 0.74; 95% CI: 0.63-0.88), a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54-0.85), and a 38% reduction in chronic obstructive pulmonary disease (COPD) (RR: 0.62; 95% CI: 0.46-0.83) mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages ≥65 years, but not in ages 35-64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32-0.70). Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305-4,629) smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, post-ban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular causes, and is the first to demonstrate reductions in cerebrovascular and respiratory causes.

Reductions in Cardiovascular, Cerebrovascular, and Respiratory Mortality following the National Irish Smoking Ban: Interrupted Time-Series Analysis

PubMed Central

Stallings-Smith, Sericea; Zeka, Ariana; Goodman, Pat; Kabir, Zubair; Clancy, Luke

2013-01-01

Background Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post-ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. Methods A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages ≥35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76–0.99), a 26% reduction in ischemic heart disease (IHD) (RR: 0.74; 95% CI: 0.63–0.88), a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54–0.85), and a 38% reduction in chronic obstructive pulmonary disease (COPD) (RR: 0.62; 95% CI: 0.46–0.83) mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages ≥65 years, but not in ages 35–64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32–0.70). Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305–4,629) smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. Conclusions The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, post-ban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular causes, and is the first to demonstrate reductions in cerebrovascular and respiratory causes. PMID:23637964

An overview of monitoring and reduction strategies for health and climate change related emissions in the Middle East and North Africa region

NASA Astrophysics Data System (ADS)

Abbass, Rana Alaa; Kumar, Prashant; El-Gendy, Ahmed

2018-02-01

This review assesses the current state of air pollution in the Middle East and North Africa (MENA) region. Emission types and sources in the region are identified and quantified to understand the monitoring, legislative and reduction needs through a systematic review of available literature. It is found that both health (e.g., particulate matter, PM; and heavy metals) and climate change (e.g., carbon dioxide and methane) emissions are increasing with the time. Regarding health emissions, over 99% of the MENA population is exposed to PM levels that exceed the standards set by the World Health Organization (WHO). The dominant source of climate change emissions is the energy sector contributing ∼38% of CO2 emissions, followed by the transport sector at ∼25%. Numerous studies have been carried out on air pollution in the region, however, there is a lack of comprehensive regional studies that would provide a holistic assessment. Most countries have air quality monitoring systems in place, however, the data is not effectively evaluated to devise pollution reduction strategies. Moreover, comprehensive emission inventories for the individual countries in the region are also lacking. The legislative and regulatory systems in MENA region follow the standards set by international environmental entities such as the WHO and the U.S. Environmental Protection Agency but their effective reinforcement remains a concern. It is concluded that the opportunities for emission reduction and control could be best implemented in the road transportation sector using innovative technologies. One of the potential ways forward is to channel finance flows from fossil fuel subsidies to upgrade road transport with public transportation systems such as buses and trains, as suggested by a 'high shift' scenario for MENA region. Furthermore, emission control programs and technologies are more effective when sponsored and implemented by the private sector; the success of Saudi Aramco in supporting national emission monitoring is one such example. Finally, an energy-pollution-water nexus is assessed for the region as an integrated approach to address its urban issues. The assessment of topic areas covered clearly suggests a need to control the main sources of air pollution to limit its relatively high impact on the human health in the MENA region.

BVI induced vibration and noise alleviation by active and passive approaches

NASA Astrophysics Data System (ADS)

Liu, Li

This dissertation describes the development of a comprehensive aeroelastic/aeroacoustic simulation capability for the modeling of vibration and noise in rotorcraft induced by blade-vortex interaction (BVI). Subsequently this capability is applied to study vibration and noise reduction, using active and passive control approaches. The active approach employed is the actively controlled partial span trailing edge flaps (ACF), implemented in single and dual, servo and plain flap configurations. The passive approach is based on varying the sweep and anhedral on the tip of the rotor. Two different modern helicopters are chosen as the baseline for the implementation of ACF approach, one resembling a four-bladed MBB BO-105 hingeless rotor and the other similar to a five-bladed MD-900 bearingless rotor. The structural model is based on a finite element approach capable of simulating composite helicopter blades with swept tips, and representing multiple load paths at the blade root which is a characteristic of bearingless rotors. An unsteady compressible aerodynamic model based on a rational function approximation (RFA) approach is combined with a free wake analysis which has been enhanced by improving the wake analysis resolution and modeling a dual vortex structure. These enhancements are important for capturing BVI effects. A method for predicting compressible unsteady blade surface pressure distribution on rotor blades has been developed, which is required by the acoustic analysis. A modified version of helicopter noise code WOPWOP with provisions for blade flexibility has been combined with the aeroelastic analysis to predict the BVI noise. Several variants of the higher harmonic control (HHC) algorithm have been applied for the active noise control, as well as the simultaneous vibration and noise control. Active control of BVI noise is accomplished using feedback from an onboard microphone. The simulation has been extensively validated against experimental data and other comprehensive rotorcraft codes, and overall good correlation is obtained. Subsequently, the effectiveness of the ACF approach for vibration and BVI noise reduction has been explored, using the two different helicopter configurations. Vibration reductions of up to 86% and 60% are shown for the hingeless and bearingless rotor, respectively. Noise reductions of up to 6dB and 3dB are also demonstrated for these two configurations. (Abstract shortened by UMI.)

The importance of community consultation and social support in adhering to an obesity reduction program: results from the Healthy Weights Initiative.

PubMed

Lemstra, Mark; Rogers, Marla R

2015-01-01

Few community-based obesity reduction programs have been evaluated. After 153 community consultations, the City of Moose Jaw, SK, Canada, decided to initiate a free comprehensive program. The initiative included 71 letters of support from the Mayor, every family physician, cardiologist, and internist in the city, and every relevant community group including the Heart and Stroke Foundation, the Canadian Cancer Society, and the Public Health Agency of Canada. To promote strong adherence while positively influencing a wide range of physical and mental health variables measured through objective assessment or validated surveys. The only inclusion criterion was that the individuals must be obese adults (body mass index >30 kg/m(2)). Participants were requested to sign up with a "buddy" who was also obese and identify three family members or friends to sign a social support contract. During the initial 12 weeks, each individual received 60 group exercise sessions, 12 group cognitive behavioral therapy sessions, and 12 group dietary sessions with licensed professionals. During the second 12-week period, maintenance therapy included 12 group exercise sessions (24 weeks in total). To date, 243 people have been referred with 229 starting. Among those who started, 183 completed the program (79.9%), while 15 quit for medical reasons and 31 quit for personal reasons. Mean objective reductions included the following: 31.0 lbs of body fat, 3.9% body fat, 2.9 in from the waist, 2.3 in from the hip, blood cholesterol by 0.5 mmol/L, systolic blood pressure by 5.9 mmHg, and diastolic blood pressure by 3.2 mmHg (all P<0.000). There were no changes in blood sugar levels. There was also statistically significant differences in aerobic fitness, self-report health, quality of life measured by Short Form-36, and depressed mood measured by Beck Depression Inventory-II (all P<0.000). Independent risk factors for not completing the program were not having a family member or friend sign a social support contract (odds ratio 2.91, 95% confidence interval 1.01-8.34, P=0.047) and lower education (odds ratio 2.90, 95% confidence interval 1.20-7.03, P=0.018). Comprehensive obesity reduction programs can be effective when there is extensive consultation at the community level and social support at the individual level.

The Effect of Local Smokefree Regulations on Birth Outcomes and Prenatal Smoking.

PubMed

Bartholomew, Karla S; Abouk, Rahi

2016-07-01

Objectives We assessed the impact of varying levels of smokefree regulations on birth outcomes and prenatal smoking. Methods We exploited variations in timing and regulation restrictiveness of West Virginia's county smokefree regulations to assess their impact on birthweight, gestational age, low birthweight, very low birthweight, preterm birth, and prenatal smoking. We conducted regression analysis using state Vital Statistics individual-level data for singletons born to West Virginia residents between 1995-2010 (N = 293,715). Results Only more comprehensive smokefree regulations were associated with statistically significant favorable effects on birth outcomes in the full sample: Comprehensive (workplace/restaurant/bar ban) demonstrated increased birthweight (29 grams, p < 0.05) and gestational age (1.64 days, p < 0.01), as well as reductions in very low birthweight (-0.4 %, p < 0.05) and preterm birth (-1.5 %, p < 0.01); Restrictive (workplace/restaurant ban) demonstrated a small decrease in very low birthweight (-0.2 %, p < 0.05). Among less restrictive regulations: Moderate (workplace ban) was associated with a 23 g (p < 0.01) decrease in birthweight; Limited (partial ban) had no effect. Comprehensive's improvements extended to most maternal groups, and were broadest among mothers 21+ years, non-smokers, and unmarried mothers. Prenatal smoking declined slightly (-1.7 %, p < 0.01) only among married women with Comprehensive. Conclusions Regulation restrictiveness is a determining factor in the impact of smokefree regulations on birth outcomes, with comprehensive smokefree regulations showing promise in improving birth outcomes. Favorable effects on birth outcomes appear to stem from reduced secondhand smoke exposure rather than reduced prenatal smoking prevalence. This study is limited by an inability to measure secondhand smoke exposure and the paucity of data on policy implementation and enforcement.

A randomized controlled trial of interim methadone maintenance.

PubMed

Schwartz, Robert P; Highfield, David A; Jaffe, Jerome H; Brady, Joseph V; Butler, Carol B; Rouse, Charles O; Callaman, Jason M; O'Grady, Kevin E; Battjes, Robert J

2006-01-01

Effective alternatives to long waiting lists for entry into methadone hydrochloride maintenance treatment are needed to reduce the complications of continuing heroin dependence and to increase methadone treatment entry. To compare the effectiveness of interim methadone maintenance with that of the usual waiting list condition in facilitating methadone treatment entry and reducing heroin and cocaine use and criminal behavior. Randomized, controlled, clinical trial using 2 conditions, with treatment assignment on a 3:2 basis to interim maintenance-waiting list control. A methadone treatment program in Baltimore. A total of 319 individuals meeting the criteria for current heroin dependence and methadone maintenance treatment. Participants were randomly assigned to either interim methadone maintenance, consisting of an individually determined methadone dose and emergency counseling only for up to 120 days, or referral to community-based methadone treatment programs. Entry into comprehensive methadone maintenance therapy at 4 months from baseline; self-reported days of heroin use, cocaine use, and criminal behavior; and number of urine drug test results positive for heroin and cocaine at the follow-up interview conducted at time of entry into comprehensive methadone treatment (or at 4 months from baseline for participants who did not enter regular treatment). Significantly more participants assigned to the interim methadone maintenance condition entered comprehensive methadone maintenance treatment by the 120th day from baseline (75.9%) than those assigned to the waiting list control condition (20.8%) (P<.001). Overall, in the past 30 days at follow-up, interim participants reported significantly fewer days of heroin use (P<.001), had a significant reduction in heroin-positive drug test results (P<.001), reported spending less money on drugs (P<.001), and received less illegal income (P<.02) than the waiting list participants. Interim methadone maintenance results in a substantial increase in the likelihood of entry into comprehensive treatment, and is an effective means of reducing heroin use and criminal behavior among opioid-dependent individuals awaiting entry into a comprehensive methadone treatment program.

Dynamic Succession of Groundwater Functional Microbial Communities in Response to Emulsified Vegetable Oil Amendment during Sustained In Situ U(VI) Reduction.

PubMed

Zhang, Ping; Wu, Wei-Min; Van Nostrand, Joy D; Deng, Ye; He, Zhili; Gihring, Thomas; Zhang, Gengxin; Schadt, Chris W; Watson, David; Jardine, Phil; Criddle, Craig S; Brooks, Scott; Marsh, Terence L; Tiedje, James M; Arkin, Adam P; Zhou, Jizhong

2015-06-15

A pilot-scale field experiment demonstrated that a one-time amendment of emulsified vegetable oil (EVO) reduced groundwater U(VI) concentrations for 1 year in a fast-flowing aquifer. However, little is known about how EVO amendment stimulates the functional gene composition, structure, and dynamics of groundwater microbial communities toward prolonged U(VI) reduction. In this study, we hypothesized that EVO amendment would shift the functional gene composition and structure of groundwater microbial communities and stimulate key functional genes/groups involved in EVO biodegradation and reduction of electron acceptors in the aquifer. To test these hypotheses, groundwater microbial communities after EVO amendment were analyzed using a comprehensive functional gene microarray. Our results showed that EVO amendment stimulated sequential shifts in the functional composition and structure of groundwater microbial communities. Particularly, the relative abundance of key functional genes/groups involved in EVO biodegradation and the reduction of NO3 (-), Mn(IV), Fe(III), U(VI), and SO4 (2-) significantly increased, especially during the active U(VI) reduction period. The relative abundance for some of these key functional genes/groups remained elevated over 9 months. Montel tests suggested that the dynamics in the abundance, composition, and structure of these key functional genes/groups were significantly correlated with groundwater concentrations of acetate, NO3 (-), Mn(II), Fe(II), U(VI), and SO4 (2-). Our results suggest that EVO amendment stimulated dynamic succession of key functional microbial communities. This study improves our understanding of the composition, structure, and function changes needed for groundwater microbial communities to sustain a long-term U(VI) reduction. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Dynamic Succession of Groundwater Functional Microbial Communities in Response to Emulsified Vegetable Oil Amendment during Sustained In Situ U(VI) Reduction

PubMed Central

Zhang, Ping; Wu, Wei-Min; Van Nostrand, Joy D.; Deng, Ye; He, Zhili; Gihring, Thomas; Zhang, Gengxin; Schadt, Chris W.; Watson, David; Jardine, Phil; Criddle, Craig S.; Brooks, Scott; Marsh, Terence L.; Tiedje, James M.; Arkin, Adam P.

2015-01-01

A pilot-scale field experiment demonstrated that a one-time amendment of emulsified vegetable oil (EVO) reduced groundwater U(VI) concentrations for 1 year in a fast-flowing aquifer. However, little is known about how EVO amendment stimulates the functional gene composition, structure, and dynamics of groundwater microbial communities toward prolonged U(VI) reduction. In this study, we hypothesized that EVO amendment would shift the functional gene composition and structure of groundwater microbial communities and stimulate key functional genes/groups involved in EVO biodegradation and reduction of electron acceptors in the aquifer. To test these hypotheses, groundwater microbial communities after EVO amendment were analyzed using a comprehensive functional gene microarray. Our results showed that EVO amendment stimulated sequential shifts in the functional composition and structure of groundwater microbial communities. Particularly, the relative abundance of key functional genes/groups involved in EVO biodegradation and the reduction of NO3−, Mn(IV), Fe(III), U(VI), and SO42− significantly increased, especially during the active U(VI) reduction period. The relative abundance for some of these key functional genes/groups remained elevated over 9 months. Montel tests suggested that the dynamics in the abundance, composition, and structure of these key functional genes/groups were significantly correlated with groundwater concentrations of acetate, NO3−, Mn(II), Fe(II), U(VI), and SO42−. Our results suggest that EVO amendment stimulated dynamic succession of key functional microbial communities. This study improves our understanding of the composition, structure, and function changes needed for groundwater microbial communities to sustain a long-term U(VI) reduction. PMID:25862231

Dynamic Succession of Groundwater Functional Microbial Communities in Response to Emulsified Vegetable Oil Amendment during Sustained In Situ U(VI) Reduction

DOE PAGES

Zhang, Ping; Wu, Wei-Min; Van Nostrand, Joy D.; ...

2015-04-10

A pilot-scale field experiment demonstrated that a one-time amendment of emulsified vegetable oil (EVO) reduced groundwater U(VI) concentrations for 1 year in a fast-flowing aquifer. However, little is known about how EVO amendment stimulates the functional gene composition, structure, and dynamics of groundwater microbial communities toward prolonged U(VI) reduction. In this paper, we hypothesized that EVO amendment would shift the functional gene composition and structure of groundwater microbial communities and stimulate key functional genes/groups involved in EVO biodegradation and reduction of electron acceptors in the aquifer. To test these hypotheses, groundwater microbial communities after EVO amendment were analyzed using amore » comprehensive functional gene microarray. Our results showed that EVO amendment stimulated sequential shifts in the functional composition and structure of groundwater microbial communities. Particularly, the relative abundance of key functional genes/groups involved in EVO biodegradation and the reduction of NO 3 -, Mn(IV), Fe(III), U(VI), and SO 4 2- significantly increased, especially during the active U(VI) reduction period. The relative abundance for some of these key functional genes/groups remained elevated over 9 months. Montel tests suggested that the dynamics in the abundance, composition, and structure of these key functional genes/groups were significantly correlated with groundwater concentrations of acetate, NO 3 -, Mn(II), Fe(II), U(VI), and SO 4 2-. Our results suggest that EVO amendment stimulated dynamic succession of key functional microbial communities. Finally, this study improves our understanding of the composition, structure, and function changes needed for groundwater microbial communities to sustain a long-term U(VI) reduction.« less

Dynamic Succession of Groundwater Functional Microbial Communities in Response to Emulsified Vegetable Oil Amendment during Sustained In Situ U(VI) Reduction

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

Zhang, Ping; Wu, Wei-Min; Van Nostrand, Joy D.

A pilot-scale field experiment demonstrated that a one-time amendment of emulsified vegetable oil (EVO) reduced groundwater U(VI) concentrations for 1 year in a fast-flowing aquifer. However, little is known about how EVO amendment stimulates the functional gene composition, structure, and dynamics of groundwater microbial communities toward prolonged U(VI) reduction. In this paper, we hypothesized that EVO amendment would shift the functional gene composition and structure of groundwater microbial communities and stimulate key functional genes/groups involved in EVO biodegradation and reduction of electron acceptors in the aquifer. To test these hypotheses, groundwater microbial communities after EVO amendment were analyzed using amore » comprehensive functional gene microarray. Our results showed that EVO amendment stimulated sequential shifts in the functional composition and structure of groundwater microbial communities. Particularly, the relative abundance of key functional genes/groups involved in EVO biodegradation and the reduction of NO 3 -, Mn(IV), Fe(III), U(VI), and SO 4 2- significantly increased, especially during the active U(VI) reduction period. The relative abundance for some of these key functional genes/groups remained elevated over 9 months. Montel tests suggested that the dynamics in the abundance, composition, and structure of these key functional genes/groups were significantly correlated with groundwater concentrations of acetate, NO 3 -, Mn(II), Fe(II), U(VI), and SO 4 2-. Our results suggest that EVO amendment stimulated dynamic succession of key functional microbial communities. Finally, this study improves our understanding of the composition, structure, and function changes needed for groundwater microbial communities to sustain a long-term U(VI) reduction.« less

Graduated driver licensing programs and fatal crashes of 16-year-old drivers: a national evaluation.

PubMed

Chen, Li-Hui; Baker, Susan P; Li, Guohua

2006-07-01

Implementation of graduated driver licensing programs is associated with reductions in crash rates of young drivers, but graduated driver licensing programs vary in their components. The impact of programs with different components is unknown. The purpose of this work was to determine which graduated driver licensing programs are associated with the greatest reductions in fatal motor vehicle crashes involving 16-year-old drivers. We conducted a retrospective study of all 16-year-old drivers involved in fatal crashes in the United States from 1994 through 2004 using data from the Fatality Analysis Reporting System and the US Census Bureau. We measured incidence rate ratios of fatal motor vehicle crashes involving 16-year-old drivers according to graduated driver licensing programs, adjusted for state and year. Compared with state quarters with no graduated driver licensing program components, reductions of 16% to 21% in fatal crash involvement rates of 16-year-old drivers occurred with programs that included > or = 3-month mandatory waiting period, nighttime driving restriction, and either > or = 30 hours of supervised driving or passenger restriction. Reductions of 18% to 21% occurred in state quarters with programs that included > or = 5 of the 7 components examined. Drivers aged 20 to 24 or 25 to 29 years did not experience significant reductions. Comprehensive graduated driver licensing programs are associated with reductions of approximately 20% in 16-year-old drivers' fatal crash involvement rates. The greatest benefit seems to be associated with programs that include age requirements and > or = 3 months of waiting before the intermediate stage, nighttime driving restriction, and either > or = 30 hours of supervised driving or passenger restriction.

Identification of the inactivating factors and mechanisms exerted on MS2 coliphage in concentrated synthetic urine.

PubMed

Oishi, Wakana; Sano, Daisuke; Decrey, Loic; Kadoya, Syunsuke; Kohn, Tamar; Funamizu, Naoyuki

2017-11-15

Volume reduction (condensation) is a key for the practical usage of human urine as a fertilizer because it enables the saving of storage space and the reduction of transportation cost. However, concentrated urine may carry infectious disease risks resulting from human pathogens frequently present in excreta, though the survival of pathogens in concentrated urine is not well understood. In this study, the inactivation of MS2 coliphage, a surrogate for single-stranded RNA human enteric viruses, in concentrated synthetic urine was investigated. The infectious titer reduction of MS2 coliphage in synthetic urine samples was measured by plaque assay, and the reduction of genome copy number was monitored by reverse transcription-quantitative PCR (RTqPCR). Among chemical-physical conditions such as pH and osmotic pressure, uncharged ammonia was shown to be the predominant factor responsible for MS2 inactivation, independently of urine concentration level. The reduction rate of the viral genome number varied among genome regions, but the comprehensive reduction rate of six genome regions was well correlated with that of the infectious titer of MS2 coliphage. This indicates that genome degradation is the main mechanism driving loss of infectivity, and that RT-qPCR targeting the six genome regions can be used as a culture-independent assay for monitoring infectivity loss of the coliphage in urine. MS2 inactivation rate constants were well predicted by a model using ion composition and speciation in synthetic urine samples, which suggests that MS2 infectivity loss can be estimated solely based on the solution composition, temperature and pH, without explicitly accounting for effects of osmotic pressure. Copyright © 2017 Elsevier B.V. All rights reserved.

Environmental considerations in the selection of isolation gowns: A life cycle assessment of reusable and disposable alternatives.

PubMed

Vozzola, Eric; Overcash, Michael; Griffing, Evan

2018-04-11

Isolation gowns serve a critical role in infection control by protecting healthcare workers, visitors, and patients from the transfer of microorganisms and body fluids. The decision of whether to use a reusable or disposable garment system is a selection process based on factors including sustainability, barrier effectiveness, cost, and comfort. Environmental sustainability is increasingly being used in the decision-making process. Life cycle assessment is the most comprehensive and widely used tool used to evaluate environmental performance. The environmental impacts of market-representative reusable and disposable isolation gown systems were compared using standard life cycle assessment procedures. The basis of comparison was 1,000 isolation gown uses in a healthcare setting. The scope included the manufacture, use, and end-of-life stages of the gown systems. At the healthcare facility, compared to the disposable gown system, the reusable gown system showed a 28% reduction in energy consumption, a 30% reduction in greenhouse gas emissions, a 41% reduction in blue water consumption, and a 93% reduction in solid waste generation. Selecting reusable garment systems may result in significant environmental benefits compared to selecting disposable garment systems. By selecting reusable isolation gowns, healthcare facilities can add these quantitative benefits directly to their sustainability scorecards. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Relative Risk Reduction as a Metric to Standardize Effect Size for Public Heath Interventions for Translational Research: Methods and Applications

PubMed Central

Mirzazadeh, A; Malekinejad, M; Kahn, JG

2018-01-01

Objective Heterogeneity of effect measures in intervention studies undermines the use of evidence to inform policy. Our objective was to develop a comprehensive algorithm to convert all types of effect measures to one standard metric, relative risk reduction (RRR). Study Design and Setting This work was conducted to facilitate synthesis of published intervention effects for our epidemic modeling of the health impact of HIV Testing and Counseling (HTC). We designed and implemented an algorithm to transform varied effect measures to RRR, representing the proportionate reduction in undesirable outcomes. Results Our extraction of 55 HTC studies identified 473 effect measures representing unique combinations of intervention-outcome-population characteristics, using five outcome metrics: pre-post proportion (70.6%), odds ratio (14.0%), mean difference (10.2%), risk ratio (4.4%), and RRR (0.9%). Outcomes were expressed as both desirable (29.5%, e.g., consistent condom use) and undesirable (70.5% e.g., inconsistent condom use). Using four examples, we demonstrate our algorithm for converting varied effect measures to RRR, and provide the conceptual basis for advantages of RRR over other metrics. Conclusion Our review of the literature suggests that RRR, an easily understood and useful metric to convey risk reduction associated with an intervention, is underutilized by original and review studies. PMID:25726522

Reducing the use of carcinogens: the Massachusetts experience.

PubMed

Jacobs, Molly M; Massey, Rachel I; Tenney, Heather; Harriman, Elizabeth

2014-01-01

Toxics use reduction (TUR) is one part of a comprehensive cancer prevention strategy. TUR emphasizes reducing the use of cancer-causing chemicals by improving manufacturing processes and identifying and adopting safer alternatives. This analysis draws on 20 years of data collected from industries reporting to the Massachusetts Toxics Use Reduction Act (TURA) program to assess trends in the use and release of chemicals associated with cancer. We used a master list of known and suspected carcinogens developed from authoritative sources and a list of carcinogens grouped by their association with 11 cancer sites to analyze trends in use and release of chemicals by industrial facilities reporting to the TURA program from 1990 to 2010. The trend analysis shows that reported use and releases of carcinogens by these Massachusetts companies have decreased dramatically over time. Reported use declined 32% from 1990 to 2010, and reported releases declined 93% from 1991 to 2010 (1991 is when additional industrial sectors, including electric utilities, were phased into the program). Particularly large reductions were achieved in the use of trichloroethylene, perchloroethylene and cadmium and cadmium compounds. The analysis of groups of chemicals associated with specific cancer sites shows similar trends. Important opportunities for further reductions in many carcinogens, including formaldehyde, hexavalent chromium, and a variety of halogenated compounds are identified. Continued work to minimize the use of carcinogens can help to reduce the burden of cancer in Massachusetts and elsewhere.

Modelling Electrical Energy Consumption in Automotive Paint Shop

NASA Astrophysics Data System (ADS)

Oktaviandri, Muchamad; Safiee, Aidil Shafiza Bin

2018-03-01

Industry players are seeking ways to reduce operational cost to sustain in a challenging economic trend. One key aspect is an energy cost reduction. However, implementing energy reduction strategy often struggle with obstructions, which slow down their realization and implementation. Discrete event simulation method is an approach actively discussed in current research trend to overcome such obstructions because of its flexibility and comprehensiveness. Meanwhile, in automotive industry, paint shop is considered the most energy consumer area which is reported consuming about 50%-70% of overall automotive plant consumption. Hence, this project aims at providing a tool to model and simulate energy consumption at paint shop area by conducting a case study at XYZ Company, one of the automotive companies located at Pekan, Pahang. The simulation model was developed using Tecnomatix Plant Simulation software version 13. From the simulation result, the model was accurately within ±5% for energy consumption and ±15% for maximum demand after validation with real system. Two different energy saving scenarios were tested. Scenario 1 was based on production scheduling approach under low demand situation which results energy saving up to 30% on the consumption. Meanwhile scenario 2 was based on substituting high power compressor with the lower power compressor. The results were energy consumption saving of approximately 1.42% and maximum demand reduction about 1.27%. This approach would help managers and engineers to justify worthiness of investment for implementing the reduction strategies.

NO Dioxygenase Activity in Hemoglobins Is Ubiquitous In Vitro, but Limited by Reduction In Vivo

PubMed Central

Smagghe, Benoit J.; Trent, James T.; Hargrove, Mark S.

2008-01-01

Genomics has produced hundreds of new hemoglobin sequences with examples in nearly every living organism. Structural and biochemical characterizations of many recombinant proteins reveal reactions, like oxygen binding and NO dioxygenation, that appear general to the hemoglobin superfamily regardless of whether they are related to physiological function. Despite considerable attention to “hexacoordinate” hemoglobins, which are found in nearly every plant and animal, no clear physiological role(s) has been assigned to them in any species. One popular and relevant hypothesis for their function is protection against NO. Here we have tested a comprehensive representation of hexacoordinate hemoglobins from plants (rice hemoglobin), animals (neuroglobin and cytoglobin), and bacteria (Synechocystis hemoglobin) for their abilities to scavenge NO compared to myoglobin. Our experiments include in vitro comparisons of NO dioxygenation, ferric NO binding, NO-induced reduction, NO scavenging with an artificial reduction system, and the ability to substitute for a known NO scavenger (flavohemoglobin) in E. coli. We conclude that none of these tests reveal any distinguishing predisposition toward a role in NO scavenging for the hxHbs, but that any hemoglobin could likely serve this role in the presence of a mechanism for heme iron re-reduction. Hence, future research to test the role of Hbs in NO scavenging would benefit more from the identification of cognate reductases than from in vitro analysis of NO and O2 binding. PMID:18446211

Bacterial decolorization of textile dyes is an extracellular process requiring a multicomponent electron transfer pathway

PubMed Central

Brigé, Ann; Motte, Bart; Borloo, Jimmy; Buysschaert, Géraldine; Devreese, Bart; Van Beeumen, Jozef J.

2008-01-01

Summary Many studies have reported microorganisms as efficient biocatalysts for colour removal of dye‐containing industrial wastewaters. We present the first comprehensive study to identify all molecular components involved in decolorization by bacterial cells. Mutants from the model organism Shewanella oneidensis MR‐1, generated by random transposon and targeted insertional mutagenesis, were screened for defects in decolorization of an oxazine and diazo dye. We demonstrate that decolorization is an extracellular reduction process requiring a multicomponent electron transfer pathway that consists of cytoplasmic membrane, periplasmic and outer membrane components. The presence of melanin, a redox‐active molecule excreted by S. oneidensis, was shown to enhance the dye reduction rates. Menaquinones and the cytochrome CymA are the crucial cytoplasmic membrane components of the pathway, which then branches off via a network of periplasmic cytochromes to three outer membrane cytochromes. The key proteins of this network are MtrA and OmcB in the periplasm and outer membrane respectively. A model of the complete dye reduction pathway is proposed in which the dye molecules are reduced by the outer membrane cytochromes either directly or indirectly via melanin. PMID:21261820

Research supporting potential modification of the NASA specification for dry heat microbial reduction of spacecraft hardware

NASA Astrophysics Data System (ADS)

Spry, James A.; Beaudet, Robert; Schubert, Wayne

Dry heat microbial reduction (DHMR) is the primary method currently used to reduce the microbial load of spacecraft and component parts to comply with planetary protection re-quirements. However, manufacturing processes often involve heating flight hardware to high temperatures for purposes other than planetary protection DHMR. At present, the specifica-tion in NASA document NPR8020.12, describing the process lethality on B. atrophaeus (ATCC 9372) bacterial spores, does not allow for additional planetary protection bioburden reduction credit for processing outside a narrow temperature, time and humidity window. Our results from a comprehensive multi-year laboratory research effort have generated en-hanced data sets on four aspects of the current specification: time and temperature effects in combination, the effect that humidity has on spore lethality, and the lethality for spores with exceptionally high thermal resistance (so called "hardies"). This paper describes potential modifications to the specification, based on the data set gener-ated in the referenced studies. The proposed modifications are intended to broaden the scope of the current specification while still maintaining confidence in a conservative interpretation of the lethality of the DHMR process on microorganisms.

Biomimetics of [NiFe]-Hydrogenase: Nickel- or Iron-Centered Proton Reduction Catalysis?

PubMed

Tang, Hao; Hall, Michael B

2017-12-13

The [NiFe] hydrogenase (H2ase) has been characterized in the Ni-R state with a hydride bridging between Fe and Ni but displaced toward the Ni. In nearly all of the synthetic Ni-R models reported so far, the hydride ligand is either displaced toward Fe, or terminally bound to Fe. Recently, a structural and functional [NiFe]-H2ase mimic ( Nat. Chem. 2016 , 8 , 1054 - 1060 ) was reported to produce H 2 catalytically via EECC mechanism through a Ni-centered hydride intermediate like the enzyme. Here, a comprehensive DFT study shows a much lower energy route via an E[ECEC] mechanism through an Fe-centered hydride intermediate. Although catalytic H 2 production occurs at the potential corresponding to the complex's second reduction, a third electron is needed to induce the second proton addition from the weak acid. The first two-electron reductions and a proton addition produce a semibridging hydride with a short Fe-H bond like other structured [NiFe]-biomimetics, but this species is not basic enough to add another proton from the weak acid without the third electron. The calculated mechanism provides insight into the origin of this structure in the enzyme.

Solar Concentrator Demonstrator for Lunar Regolith Processing

NASA Technical Reports Server (NTRS)

Fikes, John C.; Howell, Joe T.; Gerrish, Harold P.; Patrick, Stephen L.

2008-01-01

NASA at the Marshall Space Flight Center (MSFC) is building a portable inflatable solar concentrator ground demonstrator for use in testing in-situ resource utilization (ISRU) lunar regolith processing methods. Of primary interest is the production of oxygen as a propellant oxidizer and for life support. There are various processes being proposed for the in-situ reduction of the lunar regolith, the leading processes are hydrogen reduction, carbothermal reduction and vapor phase pyrolysis. The concentrator system being built at MSFC could support demonstrations of all of these processes. The system consists of a light inflatable concentrator that will capture sunlight and focus it onto a receiver inside a vacuum chamber. Inflatable concentrators are good for space based applications due to their low weight and dense packaging at launch. The hexapod design allows the spot size to be increased to reduce the power density if needed for the process being demonstrated. In addition to the hardware development, a comprehensive simulation model is being developed and will be verified and validated using the system hardware. The model will allow for the evaluation of different lunar locations and operational scenarios for the lunar regolith processing with a high confidence in the predicted results.

Biofuel manufacturing from woody biomass: effects of sieve size used in biomass size reduction.

PubMed

Zhang, Meng; Song, Xiaoxu; Deines, T W; Pei, Z J; Wang, Donghai

2012-01-01

Size reduction is the first step for manufacturing biofuels from woody biomass. It is usually performed using milling machines and the particle size is controlled by the size of the sieve installed on a milling machine. There are reported studies about the effects of sieve size on energy consumption in milling of woody biomass. These studies show that energy consumption increased dramatically as sieve size became smaller. However, in these studies, the sugar yield (proportional to biofuel yield) in hydrolysis of the milled woody biomass was not measured. The lack of comprehensive studies about the effects of sieve size on energy consumption in biomass milling and sugar yield in hydrolysis process makes it difficult to decide which sieve size should be selected in order to minimize the energy consumption in size reduction and maximize the sugar yield in hydrolysis. The purpose of this paper is to fill this gap in the literature. In this paper, knife milling of poplar wood was conducted using sieves of three sizes (1, 2, and 4 mm). Results show that, as sieve size increased, energy consumption in knife milling decreased and sugar yield in hydrolysis increased in the tested range of particle sizes.

Target Salt 2025: A Global Overview of National Programs to Encourage the Food Industry to Reduce Salt in Foods

PubMed Central

Webster, Jacqui; Trieu, Kathy; Dunford, Elizabeth; Hawkes, Corinna

2014-01-01

Reducing population salt intake has been identified as a priority intervention to reduce non-communicable diseases. Member States of the World Health Organization have agreed to a global target of a 30% reduction in salt intake by 2025. In countries where most salt consumed is from processed foods, programs to engage the food industry to reduce salt in products are being developed. This paper provides a comprehensive overview of national initiatives to encourage the food industry to reduce salt. A systematic review of the literature was supplemented by key informant questionnaires to inform categorization of the initiatives. Fifty nine food industry salt reduction programs were identified. Thirty eight countries had targets for salt levels in foods and nine countries had introduced legislation for some products. South Africa and Argentina have both introduced legislation limiting salt levels across a broad range of foods. Seventeen countries reported reductions in salt levels in foods—the majority in bread. While these trends represent progress, many countries have yet to initiate work in this area, others are at early stages of implementation and further monitoring is required to assess progress towards achieving the global target. PMID:25195640

Target salt 2025: a global overview of national programs to encourage the food industry to reduce salt in foods.

PubMed

Webster, Jacqui; Trieu, Kathy; Dunford, Elizabeth; Hawkes, Corinna

2014-08-21

Reducing population salt intake has been identified as a priority intervention to reduce non-communicable diseases. Member States of the World Health Organization have agreed to a global target of a 30% reduction in salt intake by 2025. In countries where most salt consumed is from processed foods, programs to engage the food industry to reduce salt in products are being developed. This paper provides a comprehensive overview of national initiatives to encourage the food industry to reduce salt. A systematic review of the literature was supplemented by key informant questionnaires to inform categorization of the initiatives. Fifty nine food industry salt reduction programs were identified. Thirty eight countries had targets for salt levels in foods and nine countries had introduced legislation for some products. South Africa and Argentina have both introduced legislation limiting salt levels across a broad range of foods. Seventeen countries reported reductions in salt levels in foods-the majority in bread. While these trends represent progress, many countries have yet to initiate work in this area, others are at early stages of implementation and further monitoring is required to assess progress towards achieving the global target.

Photometric Characterization of the Reductive Amination Scope of the Imine Reductases from Streptomyces tsukubaensis and Streptomyces ipomoeae.

PubMed

Matzel, Philipp; Krautschick, Lukas; Höhne, Matthias

2017-10-18

Imine reductases (IREDs) have emerged as promising enzymes for the asymmetric synthesis of secondary and tertiary amines starting from carbonyl substrates. Screening the substrate specificity of the reductive amination reaction is usually performed by time-consuming GC analytics. We found two highly active IREDs in our enzyme collection, IR-20 from Streptomyces tsukubaensis and IR-Sip from Streptomyces ipomoeae, that allowed a comprehensive substrate screening with a photometric NADPH assay. We screened 39 carbonyl substrates combined with 17 amines as nucleophiles. Activity data from 663 combinations provided a clear picture about substrate specificity and capabilities in the reductive amination of these enzymes. Besides aliphatic aldehydes, the IREDs accepted various cyclic (C 4 -C 8 ) and acyclic ketones, preferentially with methylamine. IR-Sip also accepted a range of primary and secondary amines as nucleophiles. In biocatalytic reactions, IR-Sip converted (R)-3-methylcyclohexanone with dimethylamine or pyrrolidine with high diastereoselectivity (>94-96 % de). The nucleophile acceptor spectrum depended on the carbonyl substrate employed. The conversion of well-accepted substrates could also be detected if crude lysates were employed as the enzyme source. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Improving diabetes care: Multi-component CArdiovascular Disease Risk Reduction Strategies for People with Diabetes in South Asia - The CARRS Multi-center Translation Trial

PubMed Central

Shah, Seema; Singh, Kavita; Ali, Mohammed K.; Mohan, V.; Kadir, Muhammad Masood; Unnikrishnan, A.G.; Sahay, Rakesh Kumar; Varthakavi, Premlata; Dharmalingam, Mala; Viswanathan, Vijay; Masood, Qamar; Bantwal, Ganapathi; Khadgawat, Rajesh; Desai, Ankush; Sethi, Bipin Kumar; Shivashankar, Roopa; Ajay, Vamadevan S; Reddy, K. Srinath; Narayan, K.M. Venkat; Prabhakaran, Dorairaj; Tandon, Nikhil

2012-01-01

Aims Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in people with diabetes in South Asia. The CARRS translation trial tests the effectiveness, cost-effectiveness, and sustainability of a clinic-based multi-component CVD risk reduction intervention among people with diabetes in India and Pakistan. Methods We randomly assigned 1,146 adults with diabetes recruited from 10 urban clinic sites, to receive usual care by physicians or to receive an integrated multi-component CVD risk reduction intervention. The intervention involves electronic health record management, decision-support prompts to the healthcare team, and the support of a care coordinator to actively facilitate patient and provider adherence to evidence-based guidelines. The primary outcome is a composite of multiple CVD risk factor control (blood glucose and either blood pressure or cholesterol, or all three). Other outcomes include control of the individual CVD risk factors, process and patient-centered measures, cost-effectiveness, and acceptability/feasibility. Conclusion The CARRS translation trial tests a low-cost diabetes care delivery model in urban South Asia to achieve comprehensive cardio-metabolic disease case-management of high-risk patients (clinicaltrials.gov number: NCT01212328). PMID:23084280

Hospital admissions for acute myocardial infarction before and after implementation of a comprehensive smoke-free policy in Uruguay

PubMed Central

Sebrié, Ernesto Marcelo; Sandoya, Edgardo; Hyland, Andrew; Bianco, Eduardo; Glantz, Stanton A; Cummings, K Michael

2012-01-01

Background Stimulated by the WHO Framework Convention on Tobacco Control, many countries in Latin America adopted comprehensive smoke-free policies. In March 2006, Uruguay became the first Latin American country to adopt 100% smoke-free national legislation, which ended smoking in all indoor public places and workplaces, including restaurants and bars. The objective of this study was to evaluate trends in hospital admissions for cardiovascular disease 2 years before and 2 years after the policy was implemented in Uruguay. Methods Reports of hospital admissions for acute myocardial infarction (AMI) (International Classification of Disease-10 I21) from 37 hospitals (79% of all hospital admissions in the country), representing the period 2 years before and 2 years after the adoption of a nationwide smoke-free policy in Uruguay (between 1 March 2004 and 29 February 2008), were reviewed. A time series analysis was undertaken to compare the average monthly number of events of hospital admission for AMI before and after the smoke-free law. Results A total of 7949 hospital admissions for AMI were identified during the 4-year study period. Two years after the smoke-free policy was enacted, hospital admissions for AMI fell by 22%. The same pattern and roughly the same magnitude of reduction in AMI admissions were observed for patients seen in public and private hospitals, men, women and people aged 40–65 years and older than 65 years. Conclusions The national smoke-free policy implemented in Uruguay in 2006 was associated with a significant reduction in hospital admissions for AMI. PMID:22337557

Comprehensive smoke-free policies: a tool for improving preconception health?

PubMed

Klein, Elizabeth G; Liu, Sherry T; Conrey, Elizabeth J

2014-01-01

Lower income women are at higher risk for preconception and prenatal smoking, are less likely to spontaneously quit smoking during pregnancy, and have higher prenatal relapse rates than women in higher income groups. Policies prohibiting tobacco smoking in public places are intended to reduce exposure to secondhand smoke; additionally, since these policies promote a smoke-free norm, there have been associations between smoke-free policies and reduced smoking prevalence. Given the public health burden of smoking, particularly among women who become pregnant, our objective was to assess the impact of smoke-free policies on the odds of preconception smoking among low-income women. We estimated the odds of preconception smoking among low-income women in Ohio between 2002 and 2009 using data from repeated cross-sectional samples of women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A logistic spline regression was applied fitting a knot at the point of enforcement of the Ohio Smoke-free Workplace Act to evaluate whether this policy was associated with changes in the odds of smoking. After adjusting for individual- and environmental-level factors, the Ohio Smoke-free Workplace Act was associated with a small, but statistically significant reduction in the odds of preconception smoking in WIC participants. Comprehensive smoke-free policies prohibiting smoking in public places and workplaces may also be associated with reductions in smoking among low-income women. This type of policy or environmental change strategy may promote a tobacco-free norm and improve preconception health among a population at risk for smoking.

Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis.

PubMed

Ahmad, Mansur; Hollender, Lars; Anderson, Quentin; Kartha, Krishnan; Ohrbach, Richard; Truelove, Edmond L; John, Mike T; Schiffman, Eric L

2009-06-01

As part of the Multisite Research Diagnostic Criteria For Temporomandibular Disorders (RDC/TMD) Validation Project, comprehensive temporomandibular joint diagnostic criteria were developed for image analysis using panoramic radiography, magnetic resonance imaging (MRI), and computerized tomography (CT). Interexaminer reliability was estimated using the kappa (kappa) statistic, and agreement between rater pairs was characterized by overall, positive, and negative percent agreement. Computerized tomography was the reference standard for assessing validity of other imaging modalities for detecting osteoarthritis (OA). For the radiologic diagnosis of OA, reliability of the 3 examiners was poor for panoramic radiography (kappa = 0.16), fair for MRI (kappa = 0.46), and close to the threshold for excellent for CT (kappa = 0.71). Using MRI, reliability was excellent for diagnosing disc displacements (DD) with reduction (kappa = 0.78) and for DD without reduction (kappa = 0.94) and good for effusion (kappa = 0.64). Overall percent agreement for pairwise ratings was >or=82% for all conditions. Positive percent agreement for diagnosing OA was 19% for panoramic radiography, 59% for MRI, and 84% for CT. Using MRI, positive percent agreement for diagnoses of any DD was 95% and of effusion was 81%. Negative percent agreement was >or=88% for all conditions. Compared with CT, panoramic radiography and MRI had poor and marginal sensitivity, respectively, but excellent specificity in detecting OA. Comprehensive image analysis criteria for the RDC/TMD Validation Project were developed, which can reliably be used for assessing OA using CT and for disc position and effusion using MRI.

COACH trial: A randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: Rationale and design

PubMed Central

Allen, Jerilyn K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Bone, Lee; Hill, Martha N; Levine, David M

2011-01-01

Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in urban community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. Methods The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. Results A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. Conclusions This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a community clinic-based intervention is potentially enormous. PMID:21241828

Biology's response to dieting: the impetus for weight regain

PubMed Central

Bergouignan, Audrey; Cornier, Marc-Andre; Jackman, Matthew R.

2011-01-01

Dieting is the most common approach to losing weight for the majority of obese and overweight individuals. Restricting intake leads to weight loss in the short term, but, by itself, dieting has a relatively poor success rate for long-term weight reduction. Most obese people eventually regain the weight they have worked so hard to lose. Weight regain has emerged as one of the most significant obstacles for obesity therapeutics, undoubtedly perpetuating the epidemic of excess weight that now affects more than 60% of U.S. adults. In this review, we summarize the evidence of biology's role in the problem of weight regain. Biology's impact is first placed in context with other pressures known to affect body weight. Then, the biological adaptations to an energy-restricted, low-fat diet that are known to occur in the overweight and obese are reviewed, and an integrative picture of energy homeostasis after long-term weight reduction and during weight regain is presented. Finally, a novel model is proposed to explain the persistence of the “energy depletion” signal during the dynamic metabolic state of weight regain, when traditional adiposity signals no longer reflect stored energy in the periphery. The preponderance of evidence would suggest that the biological response to weight loss involves comprehensive, persistent, and redundant adaptations in energy homeostasis and that these adaptations underlie the high recidivism rate in obesity therapeutics. To be successful in the long term, our strategies for preventing weight regain may need to be just as comprehensive, persistent, and redundant, as the biological adaptations they are attempting to counter. PMID:21677272

Word-to-text integration: ERP evidence for semantic and orthographic effects in Chinese

PubMed Central

Chen, Lin; Fang, Xiaoping; Perfetti, Charles A.

2016-01-01

Although writing systems affect reading at the level of word identification, one expects writing system to have minimal effects on comprehension processes. We tested this assumption by recording ERPs while native Chinese speakers read short texts for comprehension in the word-to-text integration (WTI) paradigm to compare with studies of English using this paradigm. Of interest was the ERP on a 2-character word that began the second sentence of the text, with the first sentence varied to manipulate co-reference with the critical word in the second sentence. A paraphrase condition in which the critical word meaning was coreferential with a word in the first sentence showed a reduced N400 reduction. Consistent with results in English, this N400 effect suggests immediate integration of a Chinese 2-character word with the meaning of the text. Chinese allows an additional test of a morpheme effect when one character of a two-character word is repeated across the sentence boundary, thus having both orthographic and meaning overlap. This shared morpheme condition showed no effect during the timeframe when orthographic effects are observed (e.g. N200), nor did it show an N400 effect. However, character repetition did produce an N400 reduction on parietal sites regardless it represented the same morpheme or a different one. The results indicate that the WTI integration effect is general across writing systems at the meaning level, but that the orthographic form nonetheless has an effect, and is specifically functional in Chinese reading. PMID:28670097

Comprehensive Model for Enhanced Biodegradation of Chlorinated Solvents in Groundwater

NASA Astrophysics Data System (ADS)

Kouznetsova, I.; Gerhard, J. I.; Mao, X.; Robinson, C.; Barry, A. D.; Harkness, M.; Mack, E. E.; Dworatzek, S.

2007-12-01

SABRE (Source Area BioREmediation) is a public/private consortium whose charter is to de-termine if enhanced anaerobic bioremediation can result in effective treatment of chlorinated solvent DNAPL source areas. The focus of this 4-year, $5.7 million research and development project is a field site in the United Kingdom containing TCE DNAPL. A comprehensive numerical model for simulating dehalogenation of chlorinated ethenes has been developed. The model considers the kinetic dissolution of DNAPL and nonaqueous organic amendments, bacterial growth and decay, and the interaction of biological and geochemical reactions that might influence biological activity. The model accounts for inhibitory effects of high chlorin-ated solvent concentrations as well as the link between fermentation and dehalogenation due to dynamic hydrogen concentration (the direct electron donor). In addition to the standard biodegradation pathways, sulphate reduction, mineral dissolution and precipitation kinetics are incorporated. These latter processes influence the soil buffering capacity and thus the net acidity generated. One-dimensional simulations were carried out to reproduce the data from columns packed with site soil and groundwater exhibiting both intermediate (250 mg/L) and near solubility (1100 mg/L) TCE concentrations. The modelling aims were to evaluate the key processes underpinning bioremediation success and provide a tool for investigating field sys-tem sensitivity to site data and design variables. This paper will present the model basis and validation and examine sensitivity to key processes including chlorinated ethene partitioning into soybean oil, sulphate reduction, and geochemical influences such as pH and the role of buffering in highly dechlorinating systems.

COACH trial: a randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: rationale and design.

PubMed

Allen, Jerilyn K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Bone, Lee; Hill, Martha N; Levine, David M

2011-05-01

Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in urban community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a community clinic-based intervention is potentially enormous. Copyright © 2011 Elsevier Inc. All rights reserved.

A comprehensive device modelling of perovskite solar cell with inorganic copper iodide as hole transport material

NASA Astrophysics Data System (ADS)

Zulqarnain Haider, Syed; Anwar, Hafeez; Wang, Mingqing

2018-03-01

Hole transport material (HTM) plays an important role in the efficiency and stability of perovskite solar cells (PSCs). Spiro-MeOTAD, the commonly used HTM, is costly and can be easily degraded by heat and moisture, thus offering hindrance to commercialize PSCs. There is dire need to find an alternate inorganic and stable HTM to exploit PSCs with their maximum capability. In this paper, a comprehensive device simulation is used to study various possible parameters that can influence the performance of perovskite solar cell with CuI as HTM. These include the effect of doping density, defect density and thickness of absorber layer, along with the influence of diffusion length of carriers as well as electron affinity of electron transport layer (ETM) and HTM on the performance of PSCs. In addition, hole mobility and doping density of HTM is also investigated. CuI is a p-type inorganic material with low cost and relatively high stability. It is found that concentration of dopant in absorber layer and HTM, the electron affinity of HTM and ETM affect the performance of solar cell minutely, while cell performance improves greatly with the reduction of defect density. Upon optimization of parameters, power conversion efficiency for this device is found to be 21.32%. The result shows that lead-based PSC with CuI as HTM is an efficient system. Enhancing the stability and reduction of defect density are critical factors for future research. These factors can be improved by better fabrication process and proper encapsulation of solar cell.

Widely-targeted quantitative lipidomics methodology by supercritical fluid chromatography coupled with fast-scanning triple quadrupole mass spectrometry.

PubMed

Takeda, Hiroaki; Izumi, Yoshihiro; Takahashi, Masatomo; Paxton, Thanai; Tamura, Shohei; Koike, Tomonari; Yu, Ying; Kato, Noriko; Nagase, Katsutoshi; Shiomi, Masashi; Bamba, Takeshi

2018-05-03

Lipidomics, the mass spectrometry-based comprehensive analysis of lipids, has attracted attention as an analytical approach to provide novel insight into lipid metabolism and to search for biomarkers. However, an ideal method for both comprehensive and quantitative analysis of lipids has not been fully developed. Herein, we have proposed a practical methodology for widely-targeted quantitative lipidome analysis using supercritical fluid chromatography fast-scanning triple-quadrupole mass spectrometry (SFC/QqQMS) and theoretically calculated a comprehensive lipid multiple reaction monitoring (MRM) library. Lipid classes can be separated by SFC with a normal phase diethylamine-bonded silica column with high-resolution, high-throughput, and good repeatability. Structural isomers of phospholipids can be monitored by mass spectrometric separation with fatty acyl-based MRM transitions. SFC/QqQMS analysis with an internal standard-dilution method offers quantitative information for both lipid class and individual lipid molecular species in the same lipid class. Additionally, data acquired using this method has advantages including reduction of misidentification and acceleration of data analysis. Using the SFC/QqQMS system, alteration of plasma lipid levels in myocardial infarction-prone rabbits to the supplementation of eicosapentaenoic acid was first observed. Our developed SFC/QqQMS method represents a potentially useful tool for in-depth studies focused on complex lipid metabolism and biomarker discovery. Published under license by The American Society for Biochemistry and Molecular Biology, Inc.

A qualitative study exploring patients' experiences of standard care or cardiac rehabilitation post minor stroke and transient ischaemic attack.

PubMed

Hillsdon, Kaye M; Kersten, Paula; Kirk, Hayden J S

2013-09-01

To explore individuals' experiences of receiving either standard care or comprehensive cardiac rehabilitation post minor stroke or transient ischaemic attack. A qualitative study using semi-structured interviews, alongside a randomized controlled trial, exploring the effectiveness of comprehensive cardiac rehabilitation compared with standard care. Interviews were transcribed verbatim and subjected to thematic analysis. Individuals' homes. People who have experienced a minor stroke or transient ischaemic attack and who were partaking in a secondary prevention randomized controlled trial (6-7 months post the event, 17 males, five females; mean age 67 years). Not relevant. Not relevant. Four themes were identified: information delivery, comparing oneself with others, psychological impact, attitudes and actions regarding risk factor reduction. Participants indicated a need for improved information delivery, specific to their own risk factors and lifestyle changes. Many experienced psychological impact as a result of their minor stroke. Participants were found to make two types of social comparison; the comparison of self to another affected by stroke, and the comparison of self to cardiac patients. Comprehensive cardiac rehabilitation was reported to have positive effects on people's motivation to exercise. Following a minor stroke, many individuals do not recall information given or risk factors specific to them. Downward comparison with individuals who have had a cardiovascular event led to some underplaying the significance of their minor stroke.

Reflections on 30+ years of smoking cessation research: from the individual to the world.

PubMed

Lando, Harry A

2006-01-01

This is a personal retrospective in which I describe my career as a smoking cessation researcher and place cessation into an overall perspective of tobacco reduction. I spent approximately the first 15 years focusing primarily upon small group approaches to cessation emphasising relatively intensive behavioural interventions. It became apparent, however, that these types of approaches in isolation, even if broadly disseminated, would have relatively minimal impact on overall tobacco use. In part because I became discouraged with the potential of group programmes to reduce overall smoking prevalence, I began to focus more on population-based studies, especially in the context of 'teachable moments' including pregnancy, hospitalisation, forced abstinence in the military and existing smoking-related disease. I became concerned especially with the fact that there has been relatively little work with hard-core medically compromised smokers. It also became apparent that promoting cessation would be most likely to be effective with a comprehensive evidence-based tobacco reduction strategy including school and community-based prevention programmes, enforcement of ordinances restricting minors' access to tobacco, restrictions on tobacco advertising and promotion, counter advertising and strong smoke-free policies. In recent years I have become very concerned about the overall global tobacco epidemic and the projections of dramatically increasing tobacco morbidity and mortality in developing countries. I am now devoting my primary career emphasis to global tobacco reduction initiatives, including cessation research in India and Indonesia, cessation as part of broader tobacco reduction strategies and networking to increase resources and emphasis devoted to global tobacco reduction.

Meta-analysis: low-dose intake of vitamin E combined with other vitamins or minerals may decrease all-cause mortality.

PubMed

Jiang, Shan; Pan, Zhenyu; Li, Hui; Li, Fenglan; Song, Yanyan; Qiu, Yu

2014-01-01

It has been suggested that vitamin E alone or combined with other vitamins or minerals can prevent oxidative stress and slow oxidative injury-related diseases, such as cardiovascular disease and cancer. A comprehensive search of PubMed/MEDLINE, EMBASE and the Cochrane Library was performed. Relative risk was used as an effect measure to compare the intervention and control groups. A total of 33 trials were included in the meta-analysis. Neither vitamin E intake alone (RR=1.01; 95% CI, 0.97 to 1.04; p=0.77) nor vitamin E intake combined with other agents (RR=0.97; 95% CI, 0.89 to 1.06; p=0.55) was correlated with all-cause mortality. Subgroup analyses revealed that low-dose vitamin E supplementation combined with other agents is associated with a statistically significant reduction in all-cause mortality (RR=0.92; 95% CI, 0.86 to 0.98; p=0.01), and vitamin E intake combined with other agents is associated with a statistically significant reduction in mortality rates among individuals without probable or confirmed diseases (RR=0.92; 95% CI, 0.86 to 0.99; p=0.02). Neither vitamin E intake alone nor combined with other agents is associated with a reduction in all-cause mortality. But a low dose (<400 IU/d) of vitamin E combined with other agents is correlated with a reduction in all-cause mortality, and vitamin E intake combined with other agents is correlated with a reduction in the mortality rate among individuals without probable or confirmed diseases.

Does Reducing the Duration from Symptom Onset to Recanalization Improve the Results of Intracranial Mechanical Thrombectomy in the Elderly?

PubMed Central

KOMATSUBARA, Koichiro; DEMBO, Tomohisa; SATO, Eishi; SASAMORI, Hiroki; TORII, Masataka; SHIOKAWA, Yoshiaki; HIRANO, Teruyuki

2017-01-01

Endovascular recanalization for acute major cerebral artery occlusion is effective within a short time after symptom onset. However, its efficacy in the elderly remains unknown. We assessed the efficacy of our comprehensive stroke center’s reduction of this time in 28 consecutive patients for elderly patients (defined as patients aged ≥75 years) with acute major cerebral artery occlusion treated with intravenous injection of tissue plasminogen activator, followed by thrombus retrieval by endovascular therapy. The patients were divided into groups according to whether they were treated before implementation of the time reduction measure (from January 2012 to May 2014) or after (from June 2014 to May 2015). The onset-to-door, onset-to-needle, onset-to-recanalization (O2R), door-to-image (D2I), door-to-needle (D2N), door-to-puncture (D2P), door-to-recanalization (D2R), and puncture-to-recanalization time intervals were compared between the two groups. There were 14 patients (including 8 elderly patients ≥80 years) before and 14 patients (including 10 elderly patients ≥80 years) after the time reduction measure. The mean duration of each of the following time intervals was significantly reduced after the time reduction measure (P < 0.05). To reduce the O2R time, the D2P time is the first time interval that can be reduced. At our center, conferences were regularly held to raise awareness among staff and make specific changes in the workflow, and overall time reduction was achieved. Similar results were obtained in elderly patients. PMID:28132961

Mechanistic insights into electrochemical reduction of CO2 over Ag using density functional theory and transport models

PubMed Central

Goodpaster, Jason D.; Weber, Adam Z.

2017-01-01

Electrochemical reduction of CO2 using renewable sources of electrical energy holds promise for converting CO2 to fuels and chemicals. Since this process is complex and involves a large number of species and physical phenomena, a comprehensive understanding of the factors controlling product distribution is required. While the most plausible reaction pathway is usually identified from quantum-chemical calculation of the lowest free-energy pathway, this approach can be misleading when coverages of adsorbed species determined for alternative mechanism differ significantly, since elementary reaction rates depend on the product of the rate coefficient and the coverage of species involved in the reaction. Moreover, cathode polarization can influence the kinetics of CO2 reduction. Here, we present a multiscale framework for ab initio simulation of the electrochemical reduction of CO2 over an Ag(110) surface. A continuum model for species transport is combined with a microkinetic model for the cathode reaction dynamics. Free energies of activation for all elementary reactions are determined from density functional theory calculations. Using this approach, three alternative mechanisms for CO2 reduction were examined. The rate-limiting step in each mechanism is **COOH formation at higher negative potentials. However, only via the multiscale simulation was it possible to identify the mechanism that leads to a dependence of the rate of CO formation on the partial pressure of CO2 that is consistent with experiments. Simulations based on this mechanism also describe the dependence of the H2 and CO current densities on cathode voltage that are in strikingly good agreement with experimental observation. PMID:28973926

InMAP: A model for air pollution interventions

DOE PAGES

Tessum, Christopher W.; Hill, Jason D.; Marshall, Julian D.; ...

2017-04-19

Mechanistic air pollution modeling is essential in air quality management, yet the extensive expertise and computational resources required to run most models prevent their use in many situations where their results would be useful. We present InMAP (Intervention Model for Air Pollution), which offers an alternative to comprehensive air quality models for estimating the air pollution health impacts of emission reductions and other potential interventions. InMAP estimates annual-average changes in primary and secondary fine particle (PM2.5) concentrations—the air pollution outcome generally causing the largest monetized health damages–attributable to annual changes in precursor emissions. InMAP leverages pre-processed physical and chemical informationmore » from the output of a state-of-the-science chemical transport model and a variable spatial resolution computational grid to perform simulations that are several orders of magnitude less computationally intensive than comprehensive model simulations. In comparisons we run, InMAP recreates comprehensive model predictions of changes in total PM2.5 concentrations with population-weighted mean fractional bias (MFB) of -17% and population-weighted R2 = 0.90. Although InMAP is not specifically designed to reproduce total observed concentrations, it is able to do so within published air quality model performance criteria for total PM2.5. Potential uses of InMAP include studying exposure, health, and environmental justice impacts of potential shifts in emissions for annual-average PM2.5. InMAP can be trained to run for any spatial and temporal domain given the availability of appropriate simulation output from a comprehensive model. The InMAP model source code and input data are freely available online under an open-source license.« less

InMAP: A model for air pollution interventions

PubMed Central

Hill, Jason D.; Marshall, Julian D.

2017-01-01

Mechanistic air pollution modeling is essential in air quality management, yet the extensive expertise and computational resources required to run most models prevent their use in many situations where their results would be useful. Here, we present InMAP (Intervention Model for Air Pollution), which offers an alternative to comprehensive air quality models for estimating the air pollution health impacts of emission reductions and other potential interventions. InMAP estimates annual-average changes in primary and secondary fine particle (PM2.5) concentrations—the air pollution outcome generally causing the largest monetized health damages–attributable to annual changes in precursor emissions. InMAP leverages pre-processed physical and chemical information from the output of a state-of-the-science chemical transport model and a variable spatial resolution computational grid to perform simulations that are several orders of magnitude less computationally intensive than comprehensive model simulations. In comparisons run here, InMAP recreates comprehensive model predictions of changes in total PM2.5 concentrations with population-weighted mean fractional bias (MFB) of −17% and population-weighted R2 = 0.90. Although InMAP is not specifically designed to reproduce total observed concentrations, it is able to do so within published air quality model performance criteria for total PM2.5. Potential uses of InMAP include studying exposure, health, and environmental justice impacts of potential shifts in emissions for annual-average PM2.5. InMAP can be trained to run for any spatial and temporal domain given the availability of appropriate simulation output from a comprehensive model. The InMAP model source code and input data are freely available online under an open-source license. PMID:28423049

Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: a comprehensive narrative overview of English-language studies.

PubMed

Fischer, Benedikt; Blanken, Peter; Da Silveira, Dartiu; Gallassi, Andrea; Goldner, Elliot M; Rehm, Jürgen; Tyndall, Mark; Wood, Evan

2015-04-01

There are an estimated several million crack-cocaine users globally; use is highest in the Americas. Most crack users are socio-economically marginalized (e.g., homeless), and feature elevated risks for morbidity (e.g., blood-borne viruses), mortality and crime/violence involvement, resulting in extensive burdens. No comprehensive reviews of evidence-based prevention and/or treatment interventions specifically for crack use exist. We conducted a comprehensive narrative overview of English-language studies on the efficacy of secondary prevention and treatment interventions for crack (cocaine) abuse/dependence. Literature searches (1990-2014) using pertinent keywords were conducted in main scientific databases. Titles/abstracts were reviewed for relevance, and full studies were included in the review if involving a primary prevention/treatment intervention study comprising a substantive crack user sample. Intervention outcomes considered included drug use, health risks/status (e.g., HIV or sexual risks) and select social outcome indicators. Targeted (e.g., behavioral/community-based) prevention measures show mixed and short-term effects on crack use/HIV risk outcomes. Material (e.g., safer crack use kit distribution) interventions also document modest efficacy in risk reduction; empirical assessments of environmental (e.g., drug consumption facilities) for crack smokers are not available. Diverse psycho-social treatment (including contingency management) interventions for crack abuse/dependence show some positive but also limited/short-term efficacy, yet likely constitute best currently available treatment options. Ancillary treatments show little effects but are understudied. Despite ample studies, pharmaco-therapeutic/immunotherapy treatment agents have not produced convincing evidence; select agents may hold potential combined with personalized approaches and/or psycho-social strategies. No comprehensively effective 'gold-standard' prevention/treatment interventions for crack abuse exist; concerted research towards improved interventions is urgently needed. Copyright © 2015 Elsevier B.V. All rights reserved.

Impact of 2 Successive Smoking Bans on Hospital Admissions for Cardiovascular Diseases in Spain.

PubMed

Galán, Iñaki; Simón, Lorena; Boldo, Elena; Ortiz, Cristina; Medrano, María José; Fernández-Cuenca, Rafael; Linares, Cristina; Pastor-Barriuso, Roberto

2018-04-16

To evaluate the impact of 2 smoking bans enacted in 2006 (partial ban) and 2011 (comprehensive ban) on hospitalizations for cardiovascular disease in the Spanish adult population. The study was performed in 14 provinces in Spain. Hospital admission records were collected for acute myocardial infarction (AMI), ischemic heart disease (IHD), and cerebrovascular disease (CVD) in patients aged ≥ 18 years from 2003 through 2012. We estimated immediate and 1-year effects with segmented-linear models. The coefficients for each province were combined using random-effects multivariate meta-analysis models. Overall, changes in admission rates immediately following the implementation of the partial ban and 1 year later were -1.8% and +1.2% for AMI, +0.1 and +0.4% for IHD, and +1.0% and +2.8% for CVD (P>.05). After the comprehensive ban, immediate changes were -2.3% for AMI, -2.6% for IHD, and -0.8% for CVD (P>.05), only to return to precomprehensive ban values 1 year later. For patients aged ≥ 65 years of age, immediate changes associated with the comprehensive ban were -5.0%, -3.9%, and -2.3% for AMI, IHD, and CVD, respectively (P<.05). Again, the 1-year changes were not statistically significant. In Spain, smoking bans failed to significantly reduce hospitalizations for AMI, IHD, or CVD among patients ≥ 18 years of age. In the population aged ≥ 65 years, hospital admissions due to these diseases showed significant decreases immediately after the implementation of the comprehensive ban, but these reductions disappeared at the 1-year evaluation. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Effect of in-hospital comprehensive geriatric assessment (CGA) in older people with hip fracture. The protocol of the Trondheim Hip Fracture Trial

PubMed Central

2011-01-01

Background Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT) aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit. Methods/design The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB) at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival. Discussion We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients. Trials registration ClinicalTrials.gov, NCT00667914 PMID:21510886

InMAP: A model for air pollution interventions

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

Tessum, Christopher W.; Hill, Jason D.; Marshall, Julian D.

Mechanistic air pollution modeling is essential in air quality management, yet the extensive expertise and computational resources required to run most models prevent their use in many situations where their results would be useful. We present InMAP (Intervention Model for Air Pollution), which offers an alternative to comprehensive air quality models for estimating the air pollution health impacts of emission reductions and other potential interventions. InMAP estimates annual-average changes in primary and secondary fine particle (PM2.5) concentrations—the air pollution outcome generally causing the largest monetized health damages–attributable to annual changes in precursor emissions. InMAP leverages pre-processed physical and chemical informationmore » from the output of a state-of-the-science chemical transport model and a variable spatial resolution computational grid to perform simulations that are several orders of magnitude less computationally intensive than comprehensive model simulations. In comparisons we run, InMAP recreates comprehensive model predictions of changes in total PM2.5 concentrations with population-weighted mean fractional bias (MFB) of -17% and population-weighted R2 = 0.90. Although InMAP is not specifically designed to reproduce total observed concentrations, it is able to do so within published air quality model performance criteria for total PM2.5. Potential uses of InMAP include studying exposure, health, and environmental justice impacts of potential shifts in emissions for annual-average PM2.5. InMAP can be trained to run for any spatial and temporal domain given the availability of appropriate simulation output from a comprehensive model. The InMAP model source code and input data are freely available online under an open-source license.« less

Comprehensive sector-wide strategies to prevent and control obesity: what are the potential health and broader societal benefits? A case study from Australia.

PubMed

Kite, James; Hector, Debra J; St George, Alexis; Pedisic, Zeljko; Phongsavan, Philayrath; Bauman, Adrian; Mitchell, Jo; Bellew, Bill

2015-09-30

Several countries have recently established multistakeholder strategies to prevent or control overweight and obesity; however, studies have not yet been done on their effectiveness and likely impact. This study's objectives were to (i) explore sector-wide benefits and impacts likely to accrue from implementing an obesity prevention strategy in the Australian state of New South Wales; (ii) discuss the wider implications of the findings for research and practice; and (iii) strengthen the case for sustained implementation of a comprehensive, intersectoral approach. A case study approach, including evidence reviews and illustrative epidemiological models, was used to show potential benefits from meeting selected targets and objectives specified in the strategy. For adults, improved health outcomes potentially include reductions in all-cause mortality, cardiovascular disease, type 2 diabetes, various cancers, osteoarthritis, infant mortality and healthcare costs. Potential benefits beyond the health sector involve disability payments, absenteeism, worker productivity, workplace injuries and insurance claims. For children and adolescents, improved health outcomes potentially include metabolic risk factors, dental health, prehypertension/hypertension, cardiovascular disease risk factors, depression, rates of mortality in hospitalised children, bullying and otitis media. Sector-wide health, social and economic benefits from successful implementation of multisector obesity prevention strategies are likely to be substantial if specified targets are achieved. Epidemiological modelling described in this paper for selected examples provides illustrative rather than comprehensive evidence for potential benefits. Process evaluation of the extent of implementation of these multisectoral strategies, together with the accumulated data on intervention effectiveness, will determine their potential population health benefit. Quantifying the health and social benefits that are likely to accrue if comprehensive sector-wide obesity prevention and control strategies are established can strengthen advocacy for their sustained implementation.

Pediatric CT: implementation of ASIR for substantial radiation dose reduction while maintaining pre-ASIR image noise.

PubMed

Brady, Samuel L; Moore, Bria M; Yee, Brian S; Kaufman, Robert A

2014-01-01

To determine a comprehensive method for the implementation of adaptive statistical iterative reconstruction (ASIR) for maximal radiation dose reduction in pediatric computed tomography (CT) without changing the magnitude of noise in the reconstructed image or the contrast-to-noise ratio (CNR) in the patient. The institutional review board waived the need to obtain informed consent for this HIPAA-compliant quality analysis. Chest and abdominopelvic CT images obtained before ASIR implementation (183 patient examinations; mean patient age, 8.8 years ± 6.2 [standard deviation]; range, 1 month to 27 years) were analyzed for image noise and CNR. These measurements were used in conjunction with noise models derived from anthropomorphic phantoms to establish new beam current-modulated CT parameters to implement 40% ASIR at 120 and 100 kVp without changing noise texture or magnitude. Image noise was assessed in images obtained after ASIR implementation (492 patient examinations; mean patient age, 7.6 years ± 5.4; range, 2 months to 28 years) the same way it was assessed in the pre-ASIR analysis. Dose reduction was determined by comparing size-specific dose estimates in the pre- and post-ASIR patient cohorts. Data were analyzed with paired t tests. With 40% ASIR implementation, the average relative dose reduction for chest CT was 39% (2.7/4.4 mGy), with a maximum reduction of 72% (5.3/18.8 mGy). The average relative dose reduction for abdominopelvic CT was 29% (4.8/6.8 mGy), with a maximum reduction of 64% (7.6/20.9 mGy). Beam current modulation was unnecessary for patients weighing 40 kg or less. The difference between 0% and 40% ASIR noise magnitude was less than 1 HU, with statistically nonsignificant increases in patient CNR at 100 kVp of 8% (15.3/14.2; P = .41) for chest CT and 13% (7.8/6.8; P = .40) for abdominopelvic CT. Radiation dose reduction at pediatric CT was achieved when 40% ASIR was implemented as a dose reduction tool only; no net change to the magnitude of noise in the reconstructed image or the patient CNR occurred. © RSNA, 2013.

The Possibilities of Reducing Food Choice to Improve the Performance of College Foodservices.

PubMed

Mirosa, Miranda; Loh, Joanne; Spence, Heather

2016-07-01

College administrative and management leaders, foodservice personnel, and student residents value social, nutritional, financial, and environmental sustainability in their dining expectations. Menu choice reduction looks promising as a strategy to achieve these goals. However, foodservice research about dominant attitudes across these stakeholders is limited. To identify qualitative views from all stakeholders about choice reduction to ensure that any changes to the meal service are not to the detriment of consumer satisfaction. A comprehensive list of 74 statements representing the spectrum of attitudes surrounding choice was generated by searching a variety of resources, including academic literature and Internet sites, and by conducting semistructured interviews with stakeholders. A final set of 42 statements resulted from researcher scrutiny for optimum balance, clarity, appropriateness, simplicity, and applicability. A new sample of participants was then asked to sort these 42 statements into a normal distribution grid from "strongly disagree" to "strongly agree." A purposive convenience sample of stakeholders (staff n=5 and residents n=4) was used to identify statements about choice reduction. A second sample of stakeholders (staff n=6 and residents n=29) were recruited to sort the final 42 statements. Q methodology analysis techniques were used. This involved conducting a by-person factor analysis, using the centroid factor extraction method because of the permissiveness it allows for data exploration. A varimax factor rotation to enhance interpretability of the results identified shared viewpoints. Three dominant viewpoints toward the possibility of choice reduction in the meal service were identified. Factor 1 was "health driven" (in which healthiness was paramount). Factor 2 was "variety seekers" (in which choice had instrumental value). Factor 3 was "choice lovers" (in which choice had intrinsic value). Although participants could see a number of benefits of choice reduction, strong attitudinal barriers existed toward adopting choice reduction initiatives. These barriers need to be overcome to avoid dissatisfaction with the foodservice should choice reduction measures be implemented. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Investigation of drag and heat reduction induced by a novel combinational lateral jet and spike concept in supersonic flows based on conjugate heat transfer approach

NASA Astrophysics Data System (ADS)

Zhu, Liang; Chen, Xiong; Li, Yingkun; Musa, Omer; Zhou, Changsheng

2018-01-01

When flying at supersonic or hypersonic speeds through the air, the drag and severe heating have a great impact on the vehicles, thus the drag reduction and thermal protection studies have attracted worldwide attention. In the current study, the Reynolds-averaged Navier-Stokes (RANS) equations coupled with the shear stress transport (SST) k - ω turbulence model have been employed to investigate the flow behavior induced by a novel combinational lateral jet and spike concept in supersonic flows. A coupling conjugate heat transfer (CHT) approach has been applied to investigate the thermal protection, which takes the heat transfer of structure into consideration. After the code was validated by the available experimental results and the gird independency analysis was carried out, the influences of the spike length ratio, lateral jet pressure ratio and lateral jet location on the drag and heat reduction performance are analyzed comprehensively. The obtained results show that a remarkable reduction in the drag and heat flux is achieved when a lateral jet is added to the spike. This implies that the combinational lateral jet and spike concept in supersonic flows have a great benefit to the drag and heat reduction. Both the drag and heat reduction decrease with the increase of the lateral jet pressure ratio, and the heat flux is more sensitive to the lateral jet pressure ratio. The lateral jet should not be located in the bottom of the spike in order to realize better drag and heat reduction performance. The drag and heat flux could be reduced by about 45% by reasonable lateral jet location. The drag decreases with the increase of the spike length ratio whereas the heat flux is affected by the spike length ratio just in a certain range.

The epidemiology of closed reduction for simple elbow dislocations and the incidence of early subsequent open reduction.

PubMed

Mayne, Ian P; Wasserstein, David; Modi, Chetan S; Henry, Patrick D G; Mahomed, Nizar; Veillette, Christian

2015-01-01

Simple elbow dislocations are often treated with closed reduction (CR); however, the rate of CR failure and factors that may predict failure have been largely underinvestigated. The objectives of this study were (1) to determine the incidence of elbow dislocations treated by CR in a universal health care system and (2) to identify patient characteristics associated with failed CR, defined as the subsequent need for open reduction. Patients ≥16 years old who underwent elbow CR by a physician between 1994 and 2010 were identified from administrative databases. Concurrent elbow fractures were excluded. The incidence density rate (IDR) of CR per 100,000 eligible person-years among the general population was calculated. Failed CR was defined as subsequent open reduction with or without ligament repair or reconstruction within 90 days. Patient and provider characteristics were modeled in a multivariate logistic regression for failure. The cohort consisted of 4878 patients (median age, 41 years) who underwent CR (IDR, 2.65 per 100,000 person-years), and 75 (1.5%) underwent subsequent open reduction with or without ligament repair or reconstruction (median time, 15 days). Young men (≤20 years) had the highest IDR (7.45 per 100,000 person-years), twice that of young women (P = .005). Patient characteristics associated with failed CR included older age (P = .001), admission to the hospital (P < .0001), >1 attempted CR (P = .001), and new orthopedic consultation in the 4 weeks after the CR (P = .02). Young men are at highest risk for CR for simple elbow dislocations; however, older patients are more likely to require open intervention, as are those with markers of a difficult reduction signifying potentially greater soft tissue damage. A comprehensive understanding of the epidemiology of simple elbow dislocation will aid management decisions. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Markets for Clean Air

NASA Astrophysics Data System (ADS)

Ellerman, A. Denny; Joskow, Paul L.; Schmalensee, Richard; Montero, Juan-Pablo; Bailey, Elizabeth M.

2000-06-01

Markets for Clean Air provides a comprehensive, in-depth description and evaluation of the first three years' experience with the U.S. Acid Rain Program. This environmental control program is the world's first large-scale use of a tradable emission permit system for achieving environmental goals. The book analyzes the behavior and performance of the market for emissions permits, called allowances in the Acid Rain Program, and quantifies emission reductions, compliance costs, and cost savings associated with the trading program. The book also includes chapters on the historical context in which this pioneering program developed and the political economy of allowance allocations.

Cognitive Behavioral Therapy for Anxiety Disorders in Youth

PubMed Central

Seligman, Laura D.; Ollendick, Thomas H.

2011-01-01

Synopsis Cognitive behavioral therapies (CBTs) have been shown to be efficacious for the treatment of anxiety disorders in children and adolescents. Randomized clinical trials indicate that approximately two-thirds of children treated with CBT will be free of their primary diagnosis at posttreatment. Although several CBT treatment packages have been investigated in youth with diverse anxiety disorders, common core components have been identified. A comprehensive assessment, development of a good therapeutic relationship and working alliance, cognitive restructuring, repeated exposure with reduction of avoidance behavior, and skills training comprise the core procedures for the treatment of anxiety disorders in youth. PMID:21440852

Leprosy: a glossary.

PubMed

Virmond, Marcos; Grzybowski, Andrzej; Virmond, Luiza

2015-01-01

Leprosy continues to afflict residents from a number of countries in Africa, South America, and southeast Asia, despite the marked reduction in the number of cases of leprosy worldwide, after the introduction of the multidrug regimens as recommended by the World Health Organization (WHO-MDT). With the increasing immigration of individuals from risk areas to Europe and the United States, knowledge of the basic concepts of leprosy would be helpful to clinicians caring for immigrants in nonendemic areas. We present a comprehensive, updated, and critical glossary of the most relevant terms related to leprosy. Copyright © 2015. Published by Elsevier Inc.

Becoming homeless, being homeless, and resolving homelessness among women.

PubMed

Finfgeld-Connett, Deborah

2010-07-01

The purpose of this investigation was to more comprehensively articulate the experiences of homeless women and make evidence-based inferences regarding optimal social services. This study was conducted using qualitative meta-synthesis methods. As youth, homeless women experience challenging circumstances that leave them ill-prepared to prevent and resolve homelessness in adulthood. Resolution of homelessness occurs in iterative stages: crisis, assessment, and sustained action. To enhance forward progression through these stages, nurses are encouraged to promote empowerment in concordance with the Transtheoretical and Harm Reduction Models. Services that are highly valued include physical and mental health care and child care assistance.

A Comprehensive Robust Adaptive Controller for Gust Load Alleviation

PubMed Central

Quagliotti, Fulvia

2014-01-01

The objective of this paper is the implementation and validation of an adaptive controller for aircraft gust load alleviation. The contribution of this paper is the design of a robust controller that guarantees the reduction of the gust loads, even when the nominal conditions change. Some preliminary results are presented, considering the symmetric aileron deflection as control device. The proposed approach is validated on subsonic transport aircraft for different mass and flight conditions. Moreover, if the controller parameters are tuned for a specific gust model, even if the gust frequency changes, no parameter retuning is required. PMID:24688411

The economic impact of Medicare Part D on congestive heart failure.

PubMed

Dall, Timothy M; Blanchard, Tericke D; Gallo, Paul D; Semilla, April P

2013-05-01

Medicare Part D has had important implications for patient outcomes and treatment costs among beneficiaries with congestive heart failure (CHF). This study finds that improved medication adherence associated with expansion of drug coverage under Part D led to nearly $2.6 billion in reductions in medical expenditures annually among beneficiaries diagnosed with CHF and without prior comprehensive drug coverage, of which over $2.3 billion was savings to Medicare. Further improvements in adherence could potentially save Medicare another $1.9 billion annually, generating upwards of $22.4 billion in federal savings over 10 years.

Multi-Detection Events, Probability Density Functions, and Reduced Location Area

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

Eslinger, Paul W.; Schrom, Brian T.

2016-03-01

Abstract Several efforts have been made in the Comprehensive Nuclear-Test-Ban Treaty (CTBT) community to assess the benefits of combining detections of radionuclides to improve the location estimates available from atmospheric transport modeling (ATM) backtrack calculations. We present a Bayesian estimation approach rather than a simple dilution field of regard approach to allow xenon detections and non-detections to be combined mathematically. This system represents one possible probabilistic approach to radionuclide event formation. Application of this method to a recent interesting radionuclide event shows a substantial reduction in the location uncertainty of that event.

Implementation of occupational health service improvements through application of total quality management processes.

PubMed

Thomas, Elizabeth Anne

2011-06-01

The occupational health services department for a manufacturing division of a high-technology firm was redesigned from an outsourced model, in which most services were provided by an outside clinic vendor, to an in-house service model, in which services were provided by an on-site nurse practitioner. The redesign and implementation, accomplished by a cross-functional team using Total Quality Management processes, resulted in a comprehensive occupational health services department that realized significant cost reduction, increased compliance with regulatory and company requirements, and improved employee satisfaction. Implications of this project for occupational health nurses are discussed.

Reduction of Sleep Deprivation and Fatigue in Mass Transit Rail Operators.

PubMed

Haynes, Ajeenah L

2017-08-01

Sleep and work schedules differ considerably between rail workers and the broader U.S. workforce. Due to extended work hours and night shift schedules, train and engine service workers who operate passenger trains or move freight are most vulnerable to fatigue. This article addresses the need for comprehensive fatigue risk management systems (FRMS) for rail operators. Using a transactional ergonomic perspective, FRMS are discussed with a focus on fatigue education and administrative controls to reduce feelings of tiredness, low motivation, poor concentration, and low physical activity among mass transit rail operators. Recommendations for intervention implementation and evaluation are provided.

[Asthma due to grain dust].

PubMed

Baur, X; Preisser, A; Wegner, R

2003-06-01

The actual literature as well as two case reports described in detail show that grain dust induces asthmatic reactions and ODTS which are obviously not of allergic origin. For diagnosis occupational-type exposure tests are decisive whereas allergological testing usually is not. Endotoxins which are present in the grain dust samples in high concentrations have to be regarded as the major causative components. To avoid irreversible lung function impairment a comprehensive early diagnosis is necessary. Generally, a remarkable reduction of exposure to dust with high levels of airborne endotoxin in agriculture has to be achieved since in many workplaces corresponding exposures are still rather high.

Effectiveness of a transitional home care program in reducing acute hospital utilization: a quasi-experimental study.

PubMed

Low, Lian Leng; Vasanwala, Farhad Fakhrudin; Ng, Lee Beng; Chen, Cynthia; Lee, Kheng Hock; Tan, Shu Yun

2015-03-14

Improving healthcare utilization is essential as health systems around the world grapple with the escalating demands for acute hospital resources. Evidence suggests that transitional care programs are effective to improve utilization of healthcare. However, the evidence for transitional care programs that enhance the home medical care model and provide multi-disciplinary patient-centered care is not well established. We evaluated if a transitional home care program operated by the Singapore General Hospital was effective in reducing acute hospital utilization. We performed a quasi-experimental study using a pre-post design to evaluate the effectiveness of a transitional home care program in reducing hospital admissions and emergency department attendances of medically complex patients enrolled into the program in a tertiary hospital in Singapore. Patients received a comprehensive needs assessment performed by the physician and a nurse case manager in the home setting, followed by an individualized care plan that included medical and nursing care, patient education and coordination of care with hospital specialists and community services. Primary study outcomes were emergency department attendances and hospital admissions to all hospitals. These were extracted from hospital administrative data and national health records. Wilcoxon Signed Ranks Test was used for assess differences in pre and post continuous data. Overall, 262 patients were enrolled into the program and 259 were analyzed. Patients had a 51.6% and 52.8% reduction in hospital admissions in the three-month and six-month post enrollment, respectively. Similarly, a 47.1% and 48.2% reduction was observed for emergency department attendances in the three and six months post enrollment, respectively. The average difference in per patient hospital bed days in the pre- and post-enrollment periods were 12.05 days and 20.03 days at the 3-month and 6-month periods, respectively. Patients enrolled in the transitional home care program had significantly lower acute hospital utilization through the reduction of emergency department attendances and hospital admissions. A comprehensive assessment of patients' medical and social needs in the home setting and formulation of an individualized care plan optimized post-discharge care for medically complex patients.

A comprehensive framework to assess, model, and enhance the human role in conserving energy in commercial buildings

NASA Astrophysics Data System (ADS)

Azar, Elie

Energy conservation and sustainability are subjects of great interest today, especially in the commercial building sector which is witnessing a very high and growing demand for energy. Traditionally, efforts to reduce energy consumption in this sector consisted of researching and developing energy efficient building technologies and systems. On the other hand, recent studies indicate that human actions are major determinants of building energy performance and can lead to excessive energy use even in advanced low-energy buildings. As a result, it is essential to determine if the approach to future energy reduction initiatives should remain solely technology-focused, or if a human-focused approach is also needed to complement advancements in technology and improve building operation and performance. In practice, while technology-focused solutions have been extensively researched, promoted, and adopted in commercial buildings, research efforts on the role of human actions and energy use behaviors in energy conservation remain very limited. This study fills the missing gap in literature by presenting a comprehensive framework to (1) understand and quantify the influence of human actions on building energy performance, (2) model building occupants' energy use behaviors and account for potential changes in these behaviors over time, and (3) test and optimize different human-focused energy reduction interventions to increase their adoption in commercial buildings. Results are significant and prove that human actions have a major role to play in reducing the energy intensity of the commercial building sector. This sheds the light on the need for a shift in how people currently use and control different buildings systems, as this is crucial to ensure efficient building operation and to maximize the return on investment in energy-efficient technologies. Furthermore, this study proposes methods and tools that can be applied on any individual or groups of commercial buildings to evaluate the human impact on their energy performance. This is expected to boost research on the topic and promote the integration of human-focused interventions in large-scale energy reduction initiatives and policies. Finally, this dissertation presents a roadmap for the future challenges to energy conservation and the steps to take towards a more sustainable building sector and society.

Heterogeneous catalytic conversion of CO2: a comprehensive theoretical review.

PubMed

Li, Yawei; Chan, Siew Hwa; Sun, Qiang

2015-05-21

The conversion of CO2 into fuels and useful chemicals has been intensively pursued for renewable, sustainable and green energy. However, due to the negative adiabatic electron affinity (EA) and large ionization potential (IP), the CO2 molecule is chemically inert, thus making the conversion difficult under normal conditions. Novel catalysts, which have high stability, superior efficiency and low cost, are urgently needed to facilitate the conversion. As the first step to design such catalysts, understanding the mechanisms involved in CO2 conversion is absolutely indispensable. In this review, we have summarized the recent theoretical progress in mechanistic studies based on density functional theory, kinetic Monte Carlo simulation, and microkinetics modeling. We focus on reaction channels, intermediate products, the key factors determining the conversion of CO2 in solid-gas interface thermocatalytic reduction and solid-liquid interface electrocatalytic reduction. Furthermore, we have proposed some possible strategies for improving CO2 electrocatalysis and also discussed the challenges in theory, model construction, and future research directions.

A Mixed-Methods Pilot Study of Mindfulness-Based Stress Reduction for HIV-Associated Chronic Pain.

PubMed

George, Mary Catherine; Wongmek, Arada; Kaku, Michelle; Nmashie, Alexandra; Robinson-Papp, Jessica

2017-01-01

Treatment guidelines for chronic pain recommend nonpharmacologic modalities as part of a comprehensive management plan. Chronic pain is common among people living with HIV/AIDS, but there is little data to guide the choice of nonpharmacologic therapies in this complex population. We performed a mixed-methods feasibility study of Mindfulness-Based Stress Reduction (MBSR) versus health education control with 32 inner city, HIV-infected participants. Outcome measures included: the Brief Pain Inventory, Perceived Stress Scale, HIV Symptoms Index, autonomic function testing, and audiotaped focus groups. Post-intervention, participants reported modest improvements in pain measures and perceived stress, but no effect of group assignment was observed. At 3-month follow-up, 79% of MBSR participants were still practicing, and pain intensity was improved, whereas in the control group pain intensity had worsened. Qualitative analysis revealed a strong sense of community in both groups, but only MBSR was perceived as useful for relaxation and pain relief.

Microbial, physical and chemical properties of irrigation water in rice fields of Southern Brazil.

PubMed

Reche, Maria Helena L R; Machado, Vilmar; Saul, Danilo A; Macedo, Vera R M; Marcolin, Elio; Knaak, Neiva; Fiuza, Lidia M

2016-03-01

This paper presents the results of the statistical analysis of microbiological, physical and chemical parameters related to the quality of the water used in rice fields in Southern Brazil. Data were collected during three consecutive crop years, within structure of a comprehensive monitoring program. The indicators used were: potential hydrogen, electrical conductivity, turbidity, nitrogen, phosphorus, potassium, calcium, total and fecal coliforms. Principal Component and Discriminant Analysis showed consistent differences between the water irrigation and drainage, as the temporal variation demonstrated a clear reduction in the concentration of most of the variables analyzed. The pattern of this reduction is not the same in the two regions - that is, the importance of each of the different variables in the observed differentiation is modified in two locations. These results suggested that the variations in the water quality utilized for rice irrigation was influenced by certain specific aspects of each rice region in South Brazilian - such as anthropic action or soil/climate conditions in each hydrographic basin.

The genomic era and serious mental illness: a potential application for psychiatric genetic counseling.

PubMed

Austin, Jehannine C; Honer, William G

2007-02-01

Genetic counseling is an important clinical service that is routinely offered to families affected by genetic disorders or by complex disorders for which genetic testing is available. It is not yet routinely offered to individuals with serious mental illnesses and their families, but recent findings that beliefs about the cause of mental illness can affect an individual's adaptation to the illness suggest that genetic counseling may be a useful intervention for this population. In a genetic counseling session the counselor discusses genetic and environmental contributors to disease pathogenesis; helps individuals explore conceptions, fears, and adaptive strategies; and provides nondirective support for decision making. Expected outcomes may include reductions in fear, stigma, and guilt associated with a psychiatric diagnosis; improvements in adherence to prescribed medications; declines in risk behaviors; and reductions in misconceptions about the illness. The authors endorse a multidisciplinary approach in which a psychiatrist and genetic counselor collaborate to provide comprehensive psychiatric genetic counseling.

The lithium storage performance of electrolytic-carbon from CO2

NASA Astrophysics Data System (ADS)

Tang, Juanjuan; Deng, Bowen; Xu, Fei; Xiao, Wei; Wang, Dihua

2017-02-01

Sustainable and affordable energy resources are urgently demanded to mitigate environmental issues. Herein, carbon materials, prepared by electrochemical reduction of greenhouse gas, CO2, in Li-Na-K carbonate molten salts (electrolytic-carbon), are tested as negative electrode materials for Li-ion batteries. Owing to the small particle size and suitable surface area, the electrolytic-carbon exhibits a high reversible capacity of 798 mAh g-1 (more than two times of graphites' theoretical capacity) at 50 mA g-1 and 266 mAh g-1 with a stable cyclability over 500 cycles at a current density up to 500 mA g-1, as well as remarkable rate performance. Furthermore, a comprehensively study was conducted to investigate the effects of electrolysis temperature and cell voltage on the electrochemical performance of the electrolytic-carbon. These results demonstrate a promising strategy to develop renewable high-performance carbon negative electrode materials for Li-ion batteries by molten salt capture and electrochemical reduction of CO2.

Quantification of Changes for the Milne Ice Shelf, Nunavut, Canada, 1950 -- 2009

NASA Astrophysics Data System (ADS)

Mortimer, Colleen Adel

This study presents a comprehensive overview of the current state of the Milne Ice Shelf and how it has changed over the last 59 years. The 205 +/-1 km2 ice shelf experienced a 28% (82 +/-0.8 km 2) reduction in area between 1950 -- 2009, and a 20% (2.5 +/-0.9km 3 water equivalent (w.e.)) reduction in volume between 1981 -- 2008/2009, suggesting a long-term state of negative mass balance. Comparison of mean annual specific mass balances (up to -0.34 m w.e. yr-1) with surface mass balance measurements for the nearby Ward Hunt Ice Shelf suggest that basal melt is a key contributor to total ice shelf thinning. The development and expansion of new and existing surface cracks, as well as ice-marginal and epishelf lake development, indicate significant ice shelf weakening. Over the next few decades it is likely that the Milne Ice Shelf will continue to deteriorate.

Coordinated Care Organizations: Neonatal and Infant Outcomes in Oregon.

PubMed

Harvey, S Marie; Oakley, Lisa P; Yoon, Jangho; Luck, Jeff

2017-11-01

In 2012, Oregon's Medicaid program implemented a comprehensive accountable care model delivered through coordinated care organizations (CCOs). Because CCOs are expected to improve utilization of services and health outcomes, neonatal and infant outcomes may be important indicators of their impact. Estimating difference-in-differences models, we compared prepost CCO changes in outcomes (e.g., low birth weight, abnormal conditions, 5-minute Apgar score, congenital anomalies, and infant mortality) between Medicaid and non-Medicaid births among 99,924 infants born in Oregon during 2011 and 2013. We further examined differences in the impact of CCOs by ethnicity and rurality. Following CCO implementation the likelihood of low birth weight and abnormal conditions decreased by 0.95% and 1.08%, a reduction of 13.4% and 10.4% compared with the pre-CCO level for Medicaid enrollees, respectively. These reductions could be predictive of lifelong health benefits for infants and lower costs for acute care and are, therefore, important markers of success for the CCO model.