Quantitative Properties of the Macro Supply and Demand Structure for Care Facilities for Elderly in Japan.

PubMed

Nishino, Tatsuya

2017-12-01

As the Asian country with the most aged population, Japan, has been modifying its social welfare system. In 2000, the Japanese social care vision turned towards meeting the elderly's care needs in their own homes with proper formal care services. This study aims to understand the quantitative properties of the macro supply and demand structure for facilities for the elderly who require support or long-term care throughout Japan and present them as index values. Additionally, this study compares the targets for establishing long-term care facilities set by Japan's Ministry of Health, Labor and Welfare for 2025. In 2014, approximately 90% of all the people who were certified as requiring support and long-term care and those receiving preventive long-term care or long-term care services, were 75 years or older. The target increases in the number of established facilities by 2025 (for the 75-years-or-older population) were calculated to be 3.3% for nursing homes; 2.71% for long-term-care health facilities; 1.7% for group living facilities; and, 1.84% for community-based multi-care facilities. It was revealed that the establishment targets for 2025 also increase over current projections with the expected increase of the absolute number of users of group living facilities and community-based multi-care facilities. On the other hand, the establishment target for nursing homes remains almost the same as the current projection, whereas that for long-term-care health facilities decreases. These changes of facility ratios reveal that the Japanese social care system is shifting to realize 'Ageing in Place'. When considering households' tendencies, the target ratios for established facilities are expected to be applied to the other countries in Asia.

Quantitative Properties of the Macro Supply and Demand Structure for Care Facilities for Elderly in Japan

PubMed Central

Nishino, Tatsuya

2017-01-01

As the Asian country with the most aged population, Japan, has been modifying its social welfare system. In 2000, the Japanese social care vision turned towards meeting the elderly’s care needs in their own homes with proper formal care services. This study aims to understand the quantitative properties of the macro supply and demand structure for facilities for the elderly who require support or long-term care throughout Japan and present them as index values. Additionally, this study compares the targets for establishing long-term care facilities set by Japan’s Ministry of Health, Labor and Welfare for 2025. In 2014, approximately 90% of all the people who were certified as requiring support and long-term care and those receiving preventive long-term care or long-term care services, were 75 years or older. The target increases in the number of established facilities by 2025 (for the 75-years-or-older population) were calculated to be 3.3% for nursing homes; 2.71% for long-term-care health facilities; 1.7% for group living facilities; and, 1.84% for community-based multi-care facilities. It was revealed that the establishment targets for 2025 also increase over current projections with the expected increase of the absolute number of users of group living facilities and community-based multi-care facilities. On the other hand, the establishment target for nursing homes remains almost the same as the current projection, whereas that for long-term-care health facilities decreases. These changes of facility ratios reveal that the Japanese social care system is shifting to realize ‘Ageing in Place’. When considering households’ tendencies, the target ratios for established facilities are expected to be applied to the other countries in Asia. PMID:29194405

Advanced long term cryogenic storage systems

NASA Technical Reports Server (NTRS)

Brown, Norman S.

1987-01-01

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

Sustained Innovation Through Shared Capitalism and Democratic Governance

NASA Astrophysics Data System (ADS)

Beyster, M. A.; Blasi, J.; Sibilia, J.; Zebuchen, T.; Bowman, A.

The Foundation for Enterprise Development (FED) explores application of democratic representative governance models and structures for long-term interdisciplinary research, development and education to the concept of an organization that can sustain activity in support of interstellar travel in the 100-year timeframe, as outlined by the 100 Year StarshipTM. This paper titled, Sustained Innovation through Shared Capitalism and Democratic Governance , explores the roots of representative structures and organizations as long-lived success stories throughout history. Research, innovation, organizational structures and associated issues are explored to address the long-term focus required for development, both material and human. Impact investing vehicles are also explored as potential investment structures addressing the long-term horizon required by the organization. This paper provides an illustration, description and philosophical approach of this model as developed by the FED and our collaborators.

NASA Office of Aeronautics and Space Technology Summer Workshop. Volume 11: Life support panel

NASA Technical Reports Server (NTRS)

1975-01-01

Life support technology requirements for long-term space habitation are identified with emphasis on regeneration capabilities and biological life support systems. Other topics discussed include: water recovery, oxygen recovery, waste management recycle, and a man-made closed ecology with selected biological species.

HDAC inhibition modulates hippocampus-dependent long-term memory for object location in a CBP-dependent manner

PubMed Central

Haettig, Jakob; Stefanko, Daniel P.; Multani, Monica L.; Figueroa, Dario X.; McQuown, Susan C.; Wood, Marcelo A.

2011-01-01

Transcription of genes required for long-term memory not only involves transcription factors, but also enzymatic protein complexes that modify chromatin structure. Chromatin-modifying enzymes, such as the histone acetyltransferase (HAT) CREB (cyclic-AMP response element binding) binding protein (CBP), are pivotal for the transcriptional regulation required for long-term memory. Several studies have shown that CBP and histone acetylation are necessary for hippocampus-dependent long-term memory and hippocampal long-term potentiation (LTP). Importantly, every genetically modified Cbp mutant mouse exhibits long-term memory impairments in object recognition. However, the role of the hippocampus in object recognition is controversial. To better understand how chromatin-modifying enzymes modulate long-term memory for object recognition, we first examined the role of the hippocampus in retrieval of long-term memory for object recognition or object location. Muscimol inactivation of the dorsal hippocampus prior to retrieval had no effect on long-term memory for object recognition, but completely blocked long-term memory for object location. This was consistent with experiments showing that muscimol inactivation of the hippocampus had no effect on long-term memory for the object itself, supporting the idea that the hippocampus encodes spatial information about an object (such as location or context), whereas cortical areas (such as the perirhinal or insular cortex) encode information about the object itself. Using location-dependent object recognition tasks that engage the hippocampus, we demonstrate that CBP is essential for the modulation of long-term memory via HDAC inhibition. Together, these results indicate that HDAC inhibition modulates memory in the hippocampus via CBP and that different brain regions utilize different chromatin-modifying enzymes to regulate learning and memory. PMID:21224411

Problems associated with the utilization of algae in bioregenerative life support systems

NASA Technical Reports Server (NTRS)

Averner, M. M.; Karel, M.; Radmer, R.

1984-01-01

A workshop was conducted to identify the potential problems associated with the use of microalgae in biorregenerative life support systems, and to identify algae rlated research issues that must be addressed through space flight experimentation. Major questions to be resolved relate to the choice of algal species for inclusion in a bioregenerative life support system, their long term behavior in the space environment, and the nature of the techniques required for the continuous growth of algae on the scale required. Consideration was given to the problems associated with the conversion of algal biomass into edible components. Specific concerns were addressed and alternative transformation processes identified and compared. The workshop identified the following major areas to be addressed by space flight experimentation: (1) long term culture stability, (2) optimal design of algal growth reactors, and (3) post growth harvesting and processing in the space environment.

The requirement for enhanced CREB1 expression in consolidation of long-term synaptic facilitation and long-term excitability in sensory neurons of Aplysia

PubMed Central

Liu, Rong-Yu; Cleary, Leonard J.; Byrne, John H.

2011-01-01

Accumulating evidence suggests that the transcriptional activator CREB1 is important for serotonin (5-HT)-induced long-term facilitation (LTF) of the sensorimotor synapse in Aplysia. Moreover, creb1 is among the genes activated by CREB1, suggesting a role for this protein beyond the induction phase of LTF. The time course of the requirement for CREB1 synthesis in the consolidation of long-term facilitation was examined using RNA interference (RNAi) techniques in sensorimotor co-cultures. Injection of CREB1 small-interfering RNA (siRNA) immediately or 10 h after 5-HT treatment blocked LTF when measured at 24 h and 48 h after treatment. In contrast, CREB1 siRNA did not block LTF when injected 16 h after 5-HT treatment. These results demonstrate that creb1 expression must be sustained for a relatively long time in order to support the consolidation of LTF. In addition, LTF is also accompanied by a long-term increase in the excitability (LTE) of sensory neurons (SNs). Because LTE was observed in the isolated SN after 5-HT treatment, this long-term change was intrinsic to that element of the circuit. LTE was blocked when CREB1 siRNA was injected into isolated SNs immediately after 5-HT treatment. These data suggest that 5-HT-induced CREB1 synthesis is required for consolidation of both LTF and LTE. PMID:21543617

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

PubMed Central

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

2016-01-01

Background Long-term success of HIV antiretroviral therapy requires near-perfect adherence, maintained throughout one’s lifetime. However, perceptions towards ART and patterns of adherence may change during the life course. We assessed challenges to long-term adherence in adolescents and adults in three regional HIV treatment centers in Uganda. Methods We conducted 24 in-depth interviews and 2 focus group discussions with a total of 33 health-care providers and expert clients (HIV patients on long-term ART who assist with adherence support of fellow patients). Interview topics included experiences with patients on long-term treatment with either declining adherence or persistent poor adherence. Transcribed texts were coded and analyzed based on the social-ecological framework highlighting differences and commonalities between adolescents and adults. Results The overarching themes in adolescents were unstructured treatment holidays, delays in disclosure of HIV status by caretakers, stigma, which was mainly experienced in boarding schools, and diminishing or lack of clinical support. In particular, there was minimal support for early and gradual disclosure for caretakers to the infected children, diminishing clinical support for young adults during transition to adult-based care and declining peer-to-peer support group activities. The predominating theme in adults was challenges with treatment access among temporary economic migrants. Common themes to adults and adolescents were challenges with disclosure in intimate relationships, treatment related factors including side effects, supply of single tablets in place of fixed-dose combined drugs, supply of drug brands with unfavorable taste and missed opportunities for counseling due to shortage of staff. Conclusion Adherence counseling and support should be adapted differently for adolescents and adults and to the emerging life course challenges in long-term treated patients. Programs should also address constraints experienced by temporary economic migrants to ensure continuity of treatment within the host country. PMID:27898736

21 CFR 868.5610 - Membrane lung for long-term pulmonary support.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Membrane lung for long-term pulmonary support. 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5610 Membrane lung for long-term pulmonary support. (a) Identification. A membrane lung for long-term pulmonary support...

21 CFR 868.5610 - Membrane lung for long-term pulmonary support.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Membrane lung for long-term pulmonary support. 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5610 Membrane lung for long-term pulmonary support. (a) Identification. A membrane lung for long-term pulmonary support...

FY04 Advanced Life Support Architecture and Technology Studies: Mid-Year Presentation

NASA Technical Reports Server (NTRS)

Lange, Kevin; Anderson, Molly; Duffield, Bruce; Hanford, Tony; Jeng, Frank

2004-01-01

Long-Term Objective: Identify optimal advanced life support system designs that meet existing and projected requirements for future human spaceflight missions. a) Include failure-tolerance, reliability, and safe-haven requirements. b) Compare designs based on multiple criteria including equivalent system mass (ESM), technology readiness level (TRL), simplicity, commonality, etc. c) Develop and evaluate new, more optimal, architecture concepts and technology applications.

Long-Term Condition Self-Management Support in Online Communities: A Meta-Synthesis of Qualitative Papers.

PubMed

Allen, Chris; Vassilev, Ivaylo; Kennedy, Anne; Rogers, Anne

2016-03-10

Recent years have seen an exponential increase in people with long-term conditions using the Internet for information and support. Prior research has examined support for long-term condition self-management through the provision of illness, everyday, and emotional work in the context of traditional offline communities. However, less is known about how communities hosted in digital spaces contribute through the creation of social ties and the mobilization of an online illness "workforce." The aim was to understand the negotiation of long-term condition illness work in patient online communities and how such work may assist the self-management of long-term conditions in daily life. A systematic search of qualitative papers was undertaken using various online databases for articles published since 2004. A total of 21 papers met the inclusion criteria of using qualitative methods and examined the use of peer-led online communities for those with a long-term condition. A qualitative meta-synthesis was undertaken and the review followed a line of argument synthesis. The main themes identified in relation to the negotiation of self-management support were (1) redressing offline experiential information and knowledge deficits, (2) the influence of modeling and learning behaviors from others on self-management, (3) engagement that validates illness and negates offline frustrations, (4) tie formation and community building, (5) narrative expression and cathartic release, and (6) dissociative anonymity and invisibility. These translated into a line of argument synthesis in which four network mechanisms for self-management support in patient online communities were identified. These were (1) collective knowledge and identification through lived experience; (2) support, information, and engagement through readily accessible gifting relationships; (3) sociability that extends beyond illness; and (4) online disinhibition as a facilitator in the negotiation of self-management support. Social ties forged in online spaces provide the basis for performing relevant self-management work that can improve an individual's illness experience, tackling aspects of self-management that are particularly difficult to meet offline. Membership in online groups can provide those living with a long-term condition with ready access to a self-management support illness workforce and illness and emotional support. The substitutability of offline illness work may be particularly important to those whose access to support offline is either limited or absent. Furthermore, such resources require little negotiation online because information and support is seemingly gifted to the community by its members.

Long-Term Condition Self-Management Support in Online Communities: A Meta-Synthesis of Qualitative Papers

PubMed Central

Vassilev, Ivaylo; Kennedy, Anne; Rogers, Anne

2016-01-01

Background Recent years have seen an exponential increase in people with long-term conditions using the Internet for information and support. Prior research has examined support for long-term condition self-management through the provision of illness, everyday, and emotional work in the context of traditional offline communities. However, less is known about how communities hosted in digital spaces contribute through the creation of social ties and the mobilization of an online illness “workforce.” Objective The aim was to understand the negotiation of long-term condition illness work in patient online communities and how such work may assist the self-management of long-term conditions in daily life. Methods A systematic search of qualitative papers was undertaken using various online databases for articles published since 2004. A total of 21 papers met the inclusion criteria of using qualitative methods and examined the use of peer-led online communities for those with a long-term condition. A qualitative meta-synthesis was undertaken and the review followed a line of argument synthesis. Results The main themes identified in relation to the negotiation of self-management support were (1) redressing offline experiential information and knowledge deficits, (2) the influence of modeling and learning behaviors from others on self-management, (3) engagement that validates illness and negates offline frustrations, (4) tie formation and community building, (5) narrative expression and cathartic release, and (6) dissociative anonymity and invisibility. These translated into a line of argument synthesis in which four network mechanisms for self-management support in patient online communities were identified. These were (1) collective knowledge and identification through lived experience; (2) support, information, and engagement through readily accessible gifting relationships; (3) sociability that extends beyond illness; and (4) online disinhibition as a facilitator in the negotiation of self-management support. Conclusions Social ties forged in online spaces provide the basis for performing relevant self-management work that can improve an individual’s illness experience, tackling aspects of self-management that are particularly difficult to meet offline. Membership in online groups can provide those living with a long-term condition with ready access to a self-management support illness workforce and illness and emotional support. The substitutability of offline illness work may be particularly important to those whose access to support offline is either limited or absent. Furthermore, such resources require little negotiation online because information and support is seemingly gifted to the community by its members. PMID:26965990

Hybrid Fiber/Copper LAN Meets School's 25-Year Networking Requirements.

ERIC Educational Resources Information Center

Petruso, Sam; Humes, Vince

1994-01-01

Describes an innovative new curriculum being implemented at Walnut Creek Middle School (Pennsylvania) and an advanced networked computer environment that supports it now and will also meet future needs. Topics addressed include physical facilities; networking goals, both short-term and long-term; fiber-optic cable versus copper; and future…

Development of a resource model for infection prevention and control programs in acute, long term, and home care settings: conference proceedings of the Infection Prevention and Control Alliance.

PubMed

Morrison, Judith

2004-02-01

There is mounting concern about the impact of health care restructuring on the provision of infection prevention services across the health care continuum. In response to this, Health Canada hosted two meetings of Canadian infection control experts to develop a model upon which the resources required to support an effective, integrated infection prevention and control program across the health care continuum could be based. The final models project the IPCP needs as three full time equivalent infection control professionals/500 beds in acute care hospitals and one full time equivalent infection control professional/150-250 beds in long term care facilities. Non human resource requirements are also described for acute, long term, community, and home care settings.

Long-Term Ecological Monitoring Field Sampling Plan for 2007

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

T. Haney

2007-07-31

This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used t determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007more » investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality.« less

Parenting a child with chronic illness as they transition into adulthood: A systematic review and thematic synthesis of parents' experiences.

PubMed

Heath, Gemma; Farre, Albert; Shaw, Karen

2017-01-01

To understand how parents view and experience their role as their child with a long-term physical health condition transitions to adulthood and adult healthcare services. Five databases were systematically searched for qualitative articles examining parents' views and experiences of their child's healthcare transition. Papers were quality assessed and thematically synthesised. Thirty-two papers from six countries, spanning a 17-year period were included. Long-term conditions were diverse. Findings indicated that parents view their child's progression toward self-care as an incremental process which they seek to facilitate through up-skilling them in self-management practices. Parental perceptions of their child's readiness, wellness, competence and long-term condition impacted on the child' progression to healthcare autonomy. A lack of transitional healthcare and differences between paediatric and adult services served as barriers to effective transition. Parents were required to adjust their role, responsibilities and behaviour to support their child's growing independence. Parents can be key facilitators of their child's healthcare transition, supporting them to become experts in their own condition and care. To do so, they require clarification on their role and support from service providers. Interventions are needed which address the transitional care needs of parents as well as young people. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Visual Decision Support Tool for Supporting Asset Management Performance, Risk, and Cost Analysis (WERF Report INFR5R12)

EPA Science Inventory

Abstract:Managing urban water infrastructures faces the challenge of jointly dealing with assets of diverse types, useful life, cost, ages and condition. Service quality and sustainability require sound long-term planning, well aligned with tactical and operational planning and m...

Beyond post-marketing research and MedWatch: Long-term studies of drug risks.

PubMed

Resnik, David B

2007-10-01

Critics of the drug safety system have discussed many different potential reforms, ranging from mandatory registration of clinical trials to increasing the power of regulatory agencies, but few have discussed one of the most important ways of enhancing safety: increasing the number of long-term studies of medications. Long-term studies of the risks and benefits of drugs can provide useful information for regulators, healthcare professionals, and patients. Government funding agencies should lead the effort to conduct long-term studies of drugs, but private companies should also be required to lend financial support. Because cost-effectiveness is likely to be an important consideration in conducting this research, funding agencies should focus, at first, on drugs that are used to treat common, chronic conditions.

Beyond post-marketing research and MedWatch: Long-term studies of drug risks

PubMed Central

Resnik, David B

2007-01-01

Critics of the drug safety system have discussed many different potential reforms, ranging from mandatory registration of clinical trials to increasing the power of regulatory agencies, but few have discussed one of the most important ways of enhancing safety: increasing the number of long-term studies of medications. Long-term studies of the risks and benefits of drugs can provide useful information for regulators, healthcare professionals, and patients. Government funding agencies should lead the effort to conduct long-term studies of drugs, but private companies should also be required to lend financial support. Because cost-effectiveness is likely to be an important consideration in conducting this research, funding agencies should focus, at first, on drugs that are used to treat common, chronic conditions. PMID:19727333

78 FR 14808 - Notice of Regulatory Waiver Requests Granted for the Fourth Quarter of Calendar Year 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-07

... often refinanced well in advance of the long-term maturity date of the loan due to [[Page 14812... be refinanced. The FHA refinanced mortgage has a 35-year term. Nature of Requirement: To achieve the... favorable terms would preserve needed affordable housing that is strongly supported by both the State of New...

Low-threshold support services for people with dementia within the scope of respite care in Germany - A qualitative study on different stakeholders' perspective.

PubMed

Hochgraeber, Iris; von Kutzleben, Milena; Bartholomeyczik, Sabine; Holle, Bernhard

2017-07-01

Low-threshold support services are provided within the basket of services of German long-term care insurance as a part of respite care to support family carers and people with dementia. This study investigates various stakeholders' (providers, coordinators, volunteers, family carers and people with dementia) perspectives on low-threshold support service regarding its organisation and conceptualisation as well as how stakeholders and users value low-threshold support service using a qualitative approach. Twelve guided interviews and group discussions were conducted with 31 participants. Organisation and conceptualisation are characterised by the lowness of the service thresholds, which is perceived to be quick and simple forms of support with no user requirements. Multiple barriers such as the challenging behaviour of people with dementia and their initial refusal as well as their holding low-threshold support service in low esteem can hinder the utilisation of these services. Low-threshold support service within the scope of the long-term care insurance law can be separated into two types: low-cost (non-professional) services and high-cost services with comprehensive training for 'employed' volunteers (professional). Both types are constantly developing within the landscape of the German long-term care system, and low-threshold support service appears to be adapted to diverse needs. Therefore, it is important to avoid replacing non-professional services with professional services.

Long-term semantic representations moderate the effect of attentional refreshing on episodic memory.

PubMed

Loaiza, Vanessa M; Duperreault, Kayla A; Rhodes, Matthew G; McCabe, David P

2015-02-01

The McCabe effect (McCabe, Journal of Memory and Language 58:480-494, 2008) refers to an advantage in episodic memory (EM) retrieval for memoranda studied in complex span versus simple span tasks, particularly for memoranda presented in earlier serial positions. This finding has been attributed to the necessity to refresh memoranda during complex span tasks that, in turn, promotes content-context binding in working memory (WM). Several frameworks have conceptualized WM as being embedded in long-term memory. Thus, refreshing may be less efficient when memoranda are not well-established in long-term semantic memory (SM). To investigate this, we presented words and nonwords in simple and complex span trials in order to manipulate the long-term semantic representations of the memoranda with the requirement to refresh the memoranda during WM. A recognition test was administered that required participants to make a remember-know decision for each memorandum recognized as old. The results replicated the McCabe effect, but only for words, and the beneficial effect of refreshing opportunities was exclusive to recollection. These results extend previous research by indicating that the predictive relationship between WM refreshing and long-term EM is specific to recollection and, furthermore, moderated by representations in long-term SM. This supports the predictions of WM frameworks that espouse the importance of refreshing in content-context binding, but also those that view WM as being an activated subset of and, therefore, constrained by the contents of long-term memory.

A requirement for memory retrieval during and after long-term extinction learning

PubMed Central

Ouyang, Ming; Thomas, Steven A.

2005-01-01

Current learning theories are based on the idea that learning is driven by the difference between expectations and experience (the delta rule). In extinction, one learns that certain expectations no longer apply. Here, we test the potential validity of the delta rule by manipulating memory retrieval (and thus expectations) during extinction learning. Adrenergic signaling is critical for the time-limited retrieval (but not acquisition or consolidation) of contextual fear. Using genetic and pharmacologic approaches to manipulate adrenergic signaling, we find that long-term extinction requires memory retrieval but not conditioned responding. Identical manipulations of the adrenergic system that do not affect memory retrieval do not alter extinction. The results provide substantial support for the delta rule of learning theory. In addition, the timing over which extinction is sensitive to adrenergic manipulation suggests a model whereby memory retrieval occurs during, and several hours after, extinction learning to consolidate long-term extinction memory. PMID:15947076

Assessment and Mitigation of the Effects of Noise on Habitability in Deep Space Environments: Report on Non-Auditory Effects of Noise

NASA Technical Reports Server (NTRS)

Begault, Durand R.

2018-01-01

This document reviews non-auditory effects of noise relevant to habitable volume requirements in cislunar space. The non-auditory effects of noise in future long-term space habitats are likely to be impactful on team and individual performance, sleep, and cognitive well-being. This report has provided several recommendations for future standards and procedures for long-term space flight habitats, along with recommendations for NASA's Human Research Program in support of DST mission success.

Left heart bypass support with the Rotaflow Centrifugal Pump® as a bridge to decision and recovery in an adult.

PubMed

Kashiwa, Koichi; Nishimura, Takashi; Saito, Aya; Kubo, Hitoshi; Fukaya, Aoi; Tamai, Hisayoshi; Yambe, Tomoyuki; Kyo, Shunei; Ono, Minoru

2012-06-01

Since left heart bypass or biventricular circulatory assist with an extracorporeal centrifugal pump as a bridge to decision or recovery sometimes requires long-time support, the long-term durability of extracorporeal centrifugal pumps is crucial. The Rotaflow Centrifugal Pump(®) (MAQUET Cardiopulmonary AG, Hirrlingen, Germany) is one of the centrifugal pumps available for long-term use in Japan. However, there have been few reports of left heart bypass or biventricular circulatory support over the mid-term. This is a case report of left heart bypass support with the Rotaflow Centrifugal Pump(®) as a bridge to decision and recovery for an adult patient who could not be weaned from cardiopulmonary bypass and percutaneous cardiopulmonary support after cardiac surgery. We could confirm that the patient's consciousness level was normal; however, the patient could not be weaned from the left heart bypass support lasting 1 month. Therefore, the circulatory assist device was switched to the extracorporeal Nipro ventricular assist device (VAD). This time, left heart bypass support could be maintained for 30 days using a single Rotaflow Centrifugal Pump(®). There were no signs of hemolysis during left heart bypass support. The Rotaflow Centrifugal Pump(®) itself may be used as a device for a bridge to decision or recovery before using a VAD in cardiogenic shock patients.

Direct and indirect effects of nutritional status, physical function and cognitive function on activities of daily living in Japanese older adults requiring long-term care.

PubMed

Kamo, Tomohiko; Nishida, Yuusuke

2014-10-01

To identify the direct and indirect effects of nutritional status, physical function, and cognitive function on activities of daily living in Japanese older adults requiring long-term care. In total, 179 participants aged ≥ 65 years who were eligible for long-term care insurance (mean age 85.5 ± 7.8 years) were recruited for this study. Nutritional status (Mini Nutritional Assessment, Short Form) and physical function (Short Physical Performance Battery) were examined. Activities of daily living, cognitive function and frailty were assessed using the Barthel Index, Mini-Mental State Examination and Clinical Frailty Scale, respectively. Path analysis was used to determine relationships between these factors and the activities of daily living. For Japanese older adults requiring long-term care, pathways were modeled for nutritional status, physical function and the activities of daily living. The total effect of nutritional status was 0.516 (P<0.001). The indirect effect of nutritional status through physical function on the activities of daily living was 0.458 (P<0.001). Finally, no significant direct effect of nutritional status on activities of daily living was observed (b=0.058, P=0.258). The present study identified the complex pathway from nutritional status to the activities of daily living through physical function in aged Japanese people requiring long-term care. These findings suggest that maintaining good nutritional status and nutritional support might delay physical function decline, and prolong the activities of daily living. © 2013 Japan Geriatrics Society.

A decision support tool for synchronizing technology advances with strategic mission objectives

NASA Technical Reports Server (NTRS)

Hornstein, Rhoda S.; Willoughby, John K.

1992-01-01

Successful accomplishment of the objectives of many long-range future missions in areas such as space systems, land-use planning, and natural resource management requires significant technology developments. This paper describes the development of a decision-support data-derived tool called MisTec for helping strategic planners to determine technology development alternatives and to synchronize the technology development schedules with the performance schedules of future long-term missions. Special attention is given to the operations, concept, design, and functional capabilities of the MisTec. The MisTec was initially designed for manned Mars mission, but can be adapted to support other high-technology long-range strategic planning situations, making it possible for a mission analyst, planner, or manager to describe a mission scenario, determine the technology alternatives for making the mission achievable, and to plan the R&D activity necessary to achieve the required technology advances.

[Nutritional care of elderly people with chronic alcoholism].

PubMed

Brugerolles, Héléna; Mathy, Fabrice; Emery, Sophie; Hervé, Christian

2014-01-01

The management of elderly people with chronic alcoholism involves several players, including dieticians.Without stigmatisingthe person or apportioning blame, the challenge is to enable them to become a player in their treatment. Long-term support is required.

miR-191 and miR-135 are required for long-lasting spine remodelling associated with synaptic long-term depression

NASA Astrophysics Data System (ADS)

Hu, Zhonghua; Yu, Danni; Gu, Qin-Hua; Yang, Yanqin; Tu, Kang; Zhu, Jun; Li, Zheng

2014-02-01

Activity-dependent modification of dendritic spines, subcellular compartments accommodating postsynaptic specializations in the brain, is an important cellular mechanism for brain development, cognition and synaptic pathology of brain disorders. NMDA receptor-dependent long-term depression (NMDAR-LTD), a prototypic form of synaptic plasticity, is accompanied by prolonged remodelling of spines. The mechanisms underlying long-lasting spine remodelling in NMDAR-LTD, however, are largely unclear. Here we show that LTD induction causes global changes in miRNA transcriptomes affecting many cellular activities. Specifically, we show that expression changes of miR-191 and miR-135 are required for maintenance but not induction of spine restructuring. Moreover, we find that actin depolymerization and AMPA receptor exocytosis are regulated for extended periods of time by miRNAs to support long-lasting spine plasticity. These findings reveal a miRNA-mediated mechanism and a role for AMPA receptor exocytosis in long-lasting spine plasticity, and identify a number of candidate miRNAs involved in LTD.

Workstation Segment Specification for the World-Wide Military Command and Control (WWMCCS) Information System (WIS)

DTIC Science & Technology

1989-07-01

software eventually, and which indicate the general thrust of evolution and growth capabilities required of the workstation segment. These GRAY sections...configuration control over the evolution of the system. (" - The transition from the WWMCCS Standard ADP system to WIS will be gradual and will be...has been designed to support the workstation needs required for most WIS users, and is the workstation that will support the long-term evolution of

Services provided in support of the planetary quarantine requirements

NASA Technical Reports Server (NTRS)

Favero, M. S.

1972-01-01

Results are presented of laboratory experiments conducted on the thermal resistance of naturally occurring airborne spores and microbiological examinations of space hardware using long-term slit samplers and rodac plate and swab-rinse methods of sampling environmental surfaces.

EXTINCTION DEBT OF PROTECTED AREAS IN DEVELOPING LANDSCAPES

EPA Science Inventory

To conserve biological diversity, protected-area networks must be based not only upon current species distributions but also the landscape's long-term capacity to support populations. We used spatially-explicit population models requiring detailed habitat and demographic data to ...

NASA's EOSDIS Near Term Challenges

NASA Technical Reports Server (NTRS)

Behnke, Jeanne

2018-01-01

Given the long-term requirements, and the rapid pace of information technology and changing expectations of the user community, the ESDIS Project has had to evolve EOSDIS continually over the past three decades. However, many challenges remain. One near-term challenge is the enormous quantity of new data that will need to be managed by the EOSDIS. With the upcoming launch of the latest NASA missions coupled with existing operational missions and field campaigns, EOSDIS can expect to handle as much as 50 petabytes of data per year. In perspective, this is twice the size of the current existing archive, which took over 21 years to collect. Another continuing challenge is the disparate requirements of a diverse science community. Maintaining rigorous long-term data preservation, supporting ease of discovery and access, incorporating user feedback, enabling reanalysis/ reprocessing, and agile integration of new data sources, continue to be the Project's objectives.

[Nursing in the framework of long-term care insurance as a basic principle of a specific nursing approach of rehabilitation?].

PubMed

Dangel, Bärbel; Korporal, Johannes

2003-02-01

Activating nursing based on the criteria of the long-term care insurance may be understood as a second specific and nursing approach of rehabilitation beneath medical rehabilitation. Activating nursing is unspecific, characterized by the norms and guidelines of the long-term care insurance, but defined as the general norm of practical nursing. A professional nursing definition for a specific concept is lacking just as funding of nursing science. Adhering to activating nursing as a nursing complement to medical rehabilitation in the framework of long-term care insurance requires professional development and funding. Furthermore, more support of social law is necessary, which depends on professional nursing and nursing science-based indication and the intervention approach. The article develops an approach--based on a study about rehabilitation of people in need for care--and reflects on implementation and acceptance by people in the need of care.

Case management information systems: how to put the pieces together now and beyond year 2000.

PubMed

Matthews, P

1999-01-01

Healthcare organizations must establish the goals and objectives of their case management processes before functional and system requirements can be defined. A gap analysis will identify existing systems that can be used to support case management as well as areas in need of systems support. The gap analysis will also identify short-term tactical projects and long-term strategic initiatives supporting the automation of case management. The projects resulting from the gap analysis must be incorporated into the organization's business and information systems plan and budget to ensure appropriate funding and prioritization.

IDENTIFICATION OF TIME-INTEGRATED SAMPLING AND MEASUREMENT TECHNIQUES TO SUPPORT HUMAN EXPOSURE STUDIES

EPA Science Inventory

Accurate exposure classification tools are required to link exposure with health effects in epidemiological studies. Long-term, time-integrated exposure measures would be desirable to address the problem of developing appropriate residential childhood exposure classifications. ...

Mental and social health in disasters: the Sphere standards and post-tsunami psychosocial interventions in Asia.

PubMed

Henderson, Silja E K; Elsass, Peter; Berliner, Peter

2016-07-01

The primary objective of this paper is to examine and inform the mental health and psychosocial support standards of the 2011 edition of the Sphere Project's Humanitarian Charter and Minimum Standards in Humanitarian Response. This is done through a qualitative analysis of internal evaluation documents, reflecting four long-term humanitarian psychosocial programmes in different countries in post-tsunami Asia. The analysis yielded three overall conclusions. First, the Sphere standards on mental health and psychosocial support generally are highly relevant to long-term psychosocial interventions after disasters such as the Indian Ocean tsunami of 26 December 2004, and their application in such settings may improve the quality of the response. Second, some of the standards in the current Sphere handbook may lack sufficient guidance to ensure the quality of humanitarian response required. Third, the long-term intervention approach poses specific challenges to programming, a problem that could be addressed by including additional guidance in the publication. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Advanced Exploration Systems Water Architecture Study Interim Results

NASA Technical Reports Server (NTRS)

Sargusingh, Miriam J.

2013-01-01

The mission of the Advanced Exploration System (AES) Water Recovery Project (WRP) is to develop advanced water recovery systems that enable NASA human exploration missions beyond low Earth orbit (LEO). The primary objective of the AES WRP is to develop water recovery technologies critical to near-term missions beyond LEO. The secondary objective is to continue to advance mid-readiness-level technologies to support future NASA missions. An effort is being undertaken to establish the architecture for the AES Water Recovery System (WRS) that meets both near- and long-term objectives. The resultant architecture will be used to guide future technical planning, establish a baseline development roadmap for technology infusion, and establish baseline assumptions for integrated ground and on-orbit Environmental Control and Life Support Systems definition. This study is being performed in three phases. Phase I established the scope of the study through definition of the mission requirements and constraints, as well as identifying all possible WRS configurations that meet the mission requirements. Phase II focused on the near-term space exploration objectives by establishing an International Space Station-derived reference schematic for long-duration (>180 day) in-space habitation. Phase III will focus on the long-term space exploration objectives, trading the viable WRS configurations identified in Phase I to identify the ideal exploration WRS. The results of Phases I and II are discussed in this paper.

AES Water Architecture Study Interim Results

NASA Technical Reports Server (NTRS)

Sarguisingh, Miriam J.

2012-01-01

The mission of the Advanced Exploration System (AES) Water Recovery Project (WRP) is to develop advanced water recovery systems in order to enable NASA human exploration missions beyond low earth orbit (LEO). The primary objective of the AES WRP is to develop water recovery technologies critical to near term missions beyond LEO. The secondary objective is to continue to advance mid-readiness level technologies to support future NASA missions. An effort is being undertaken to establish the architecture for the AES Water Recovery System (WRS) that meets both near and long term objectives. The resultant architecture will be used to guide future technical planning, establish a baseline development roadmap for technology infusion, and establish baseline assumptions for integrated ground and on-orbit environmental control and life support systems (ECLSS) definition. This study is being performed in three phases. Phase I of this study established the scope of the study through definition of the mission requirements and constraints, as well as indentifying all possible WRS configurations that meet the mission requirements. Phase II of this study focused on the near term space exploration objectives by establishing an ISS-derived reference schematic for long-duration (>180 day) in-space habitation. Phase III will focus on the long term space exploration objectives, trading the viable WRS configurations identified in Phase I to identify the ideal exploration WRS. The results of Phases I and II are discussed in this paper.

Geographic information system development in the CARETS project

USGS Publications Warehouse

Mitchell, William B.; Fegeas, Robin G.; Fitzpatrick, Katherine A.; Hallam, Cheryl A.

1977-01-01

Experience in the development of a geographic information system to support the CARETS project has confirmed the considerable advantages that may accrue by paralleling the system development with a rational and balanced system production effort which permits the integration of the education and training of users with interim deliverable products to them. Those advantages include support for a long-term staff plan that recognizes substantial staff changes through system development and implementation, a fiscal plan that provides continuity in resources necessary for total system development, and a feedback system which allows the user to communicate his experiences in using the system. Thus far balance between system development and system production has not been achieved because of continuing large-scale spatial data processing requirements coupled with strong and insistent demands from users for immediately deliverable products from the system. That imbalance has refocussed staffing and fiscal plans from long-term system development to short- and near-term production requirements, continuously extends total system development time, and increases the possibility that later system development may reduce the usefulness of current interim products.

Effects of Radiation and Long-Term Thermal Cycling on EPC 1001 Gallium Nitride Transistors

NASA Technical Reports Server (NTRS)

Patterson, Richard L.; Scheick, Leif; Lauenstein, Jean-Marie; Casey, Megan; Hammoud, Ahmad

2012-01-01

Electronics designed for use in NASA space missions are required to work efficiently and reliably under harsh environment conditions. These include radiation, extreme temperatures, and thermal cycling, to name a few. Data obtained on long-term thermal cycling of new un-irradiated and irradiated samples of EPC1001 gallium nitride enhancement-mode transistors are presented. This work was done by a collaborative effort including GRC, GSFC, and support the NASA www.nasa.gov 1 JPL in of Electronic Parts and Packaging (NEPP) Program

Effects of the Extraterrestrial Environment on Plants: Recommendations for Future Space Experiments for the MELiSSA Higher Plant Compartment.

PubMed

Wolff, Silje A; Coelho, Liz H; Karoliussen, Irene; Jost, Ann-Iren Kittang

2014-05-05

Due to logistical challenges, long-term human space exploration missions require a life support system capable of regenerating all the essentials for survival. Higher plants can be utilized to provide a continuous supply of fresh food, atmosphere revitalization, and clean water for humans. Plants can adapt to extreme environments on Earth, and model plants have been shown to grow and develop through a full life cycle in microgravity. However, more knowledge about the long term effects of the extraterrestrial environment on plant growth and development is necessary. The European Space Agency (ESA) has developed the Micro-Ecological Life Support System Alternative (MELiSSA) program to develop a closed regenerative life support system, based on micro-organisms and higher plant processes, with continuous recycling of resources. In this context, a literature review to analyze the impact of the space environments on higher plants, with focus on gravity levels, magnetic fields and radiation, has been performed. This communication presents a roadmap giving directions for future scientific activities within space plant cultivation. The roadmap aims to identify the research activities required before higher plants can be included in regenerative life support systems in space.

Effects of the Extraterrestrial Environment on Plants: Recommendations for Future Space Experiments for the MELiSSA Higher Plant Compartment

PubMed Central

Wolff, Silje A.; Coelho, Liz H.; Karoliussen, Irene; Jost, Ann-Iren Kittang

2014-01-01

Due to logistical challenges, long-term human space exploration missions require a life support system capable of regenerating all the essentials for survival. Higher plants can be utilized to provide a continuous supply of fresh food, atmosphere revitalization, and clean water for humans. Plants can adapt to extreme environments on Earth, and model plants have been shown to grow and develop through a full life cycle in microgravity. However, more knowledge about the long term effects of the extraterrestrial environment on plant growth and development is necessary. The European Space Agency (ESA) has developed the Micro-Ecological Life Support System Alternative (MELiSSA) program to develop a closed regenerative life support system, based on micro-organisms and higher plant processes, with continuous recycling of resources. In this context, a literature review to analyze the impact of the space environments on higher plants, with focus on gravity levels, magnetic fields and radiation, has been performed. This communication presents a roadmap giving directions for future scientific activities within space plant cultivation. The roadmap aims to identify the research activities required before higher plants can be included in regenerative life support systems in space. PMID:25370192

Dendritic sodium spikes are required for long-term potentiation at distal synapses on hippocampal pyramidal neurons

PubMed Central

Kim, Yujin; Hsu, Ching-Lung; Cembrowski, Mark S; Mensh, Brett D; Spruston, Nelson

2015-01-01

Dendritic integration of synaptic inputs mediates rapid neural computation as well as longer-lasting plasticity. Several channel types can mediate dendritically initiated spikes (dSpikes), which may impact information processing and storage across multiple timescales; however, the roles of different channels in the rapid vs long-term effects of dSpikes are unknown. We show here that dSpikes mediated by Nav channels (blocked by a low concentration of TTX) are required for long-term potentiation (LTP) in the distal apical dendrites of hippocampal pyramidal neurons. Furthermore, imaging, simulations, and buffering experiments all support a model whereby fast Nav channel-mediated dSpikes (Na-dSpikes) contribute to LTP induction by promoting large, transient, localized increases in intracellular calcium concentration near the calcium-conducting pores of NMDAR and L-type Cav channels. Thus, in addition to contributing to rapid neural processing, Na-dSpikes are likely to contribute to memory formation via their role in long-lasting synaptic plasticity. DOI: http://dx.doi.org/10.7554/eLife.06414.001 PMID:26247712

Reference Model for an Open Archival Information System

NASA Technical Reports Server (NTRS)

1997-01-01

This document is a technical report for use in developing a consensus on what is required to operate a permanent, or indefinite long-term, archive of digital information. It may be useful as a starting point for a similar document addressing the indefinite long-term preservation of non-digital information. This report establishes a common framework of terms and concepts which comprise an Open Archival Information System (OAIS). It allows existing and future archives to be more meaningfully compared and contrasted. It provides a basis for further standardization of within an archival context and it should promote greater vendor awareness of, and support of , archival requirements. Through the process of normal evolution, it is expected that expansion, deletion, or modification to this document may occur. This report is therefore subject to CCSDS document management and change control procedures.

[An ultra-low power, wearable, long-term ECG monitoring system with mass storage].

PubMed

Liu, Na; Chen, Yingmin; Zhang, Wenzan; Luo, Zhangyuan; Jin, Xun; Ying, Weihai

2012-01-01

In this paper, we described an ultra-low power, wearable ECG system capable of long term monitoring and mass storage. This system is based on micro-chip PIC18F27J13 with consideration of its high level of integration and low power consumption. The communication with the micro-SD card is achieved through SPI bus. Through the USB, it can be connected to the computer for replay and disease diagnosis. Given its low power cost, lithium cells are used to support continuous ECG acquiring and storage for up to 15 days. Meanwhile, the wearable electrodes avoid the pains and possible risks in implanting. Besides, the mini size of the system makes long wearing possible for patients and meets the needs of long-term dynamic monitoring and mass storage requirements.

Mobile Phone and Tablet Apps to Support Young People's Management of Their Physical Long-Term Conditions: A Systematic Review Protocol.

PubMed

Majeed-Ariss, Rabiya; Hall, Andrew G; McDonagh, Janet; Fallon, Deborah; Swallow, Veronica

2015-04-07

The prevalence of long-term or chronic conditions that limit activity and reduce quality of life in young people aged 10-24 years is rising. This group has distinct health care needs and requires tailored support strategies to facilitate increasing personal responsibility for the management of their condition wherever possible, as they mature. Mobile phone and tablet mobile technologies featuring software program apps are already well used by young people for social networking or gaming. They have also been utilized in health care to support personal condition management, using condition-specific and patient-tailored software. Such apps have much potential, and there is an emerging body of literature on their use in a health context making this review timely. The objective of this paper is to develop a systematic review protocol focused on identifying and assessing the effectiveness of mobile phone and tablet apps that support young people's management of their chronic conditions. The search strategy will include a combination of standardized indexed search terms and free-text terms related to the key concepts of young people; long-term conditions and mobile technology. Peer-reviewed journal articles published from 2003 that meet the inclusion and exclusion criteria will be identified through searching the generated hits from 5 bibliographical databases. Two independent reviewers will screen the titles and abstracts to determine which articles focus on testing interventions identified as a mobile phone or tablet apps, and that have been designed and delivered to support the management of long-term conditions in young people aged 10-24 years. Data extraction and quality assessment tools will be used to facilitate consistent analysis and synthesis. It is anticipated that several studies will meet the selection criteria but that these are likely to be heterogeneous in terms of study design, reported outcomes, follow-up times, participants' age, and health condition. Sub-group analyses will be undertaken and where possible meta-analyses will take place. This review will synthesize available knowledge surrounding tablet and mobile phone apps that support management of long term physical health conditions in young people. The findings will be synthesized to determine which elements of the technologies were most effective for this population. This systematic review aims to synthesize existing literature in order to generate findings that will facilitate the development of an app intervention. The review will form the first phase of development and evaluation of a complex intervention as recommended by the United Kingdom Medical Research Council. The knowledge gained from the review will be verified in subsequent phases, which will include primary qualitative work with health professionals and young people with long term conditions as research participants. Young people living with long-term conditions will be involved as co-researchers and consumer advisors in all subsequent phases to develop and evaluate an app to support the management of long-term physical health conditions. PROSPERO International prospective register of systematic reviews: CRD42014015418; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014015418#.VRqCpTpnL8E (Archived by Webcite at http://www.webcitation.org/6XREcWqQY).

Approaches to lunar base life support

NASA Technical Reports Server (NTRS)

Brown, M. F.; Edeen, M. A.

1990-01-01

Various approaches to reliable, low maintenance, low resupply regenerative long-term life support for lunar base application are discussed. The first approach utilizes Space Station Freedom physiochemical systems technology which has closed air and water loops with approximately 99 and 90 percent closure respectively, with minor subsystem changes to the SSF baseline improving the level of water resupply for the water loop. A second approach would be a physiochemical system, including a solid waste processing system and improved air and water loop closure, which would require only food and nitrogen for resupply. A hybrid biological/physiochemical life support system constitutes the third alternative, incorporating some level of food production via plant growth into the life support system. The approaches are described in terms of mass, power, and resupply requirements; and the potential evolution of a small, initial outpost to a large, self-sustaining base is discussed.

Studying frequency processing of the brain to enhance long-term memory and develop a human brain protocol.

PubMed

Friedrich, Wernher; Du, Shengzhi; Balt, Karlien

2015-01-01

The temporal lobe in conjunction with the hippocampus is responsible for memory processing. The gamma wave is involved with this process. To develop a human brain protocol, a better understanding of the relationship between gamma and long-term memory is vital. A more comprehensive understanding of the human brain and specific analogue waves it uses will support the development of a human brain protocol. Fifty-eight participants aged between 6 and 60 years participated in long-term memory experiments. It is envisaged that the brain could be stimulated through binaural beats (sound frequency) at 40 Hz (gamma) to enhance long-term memory capacity. EEG recordings have been transformed to sound and then to an information standard, namely ASCII. Statistical analysis showed a proportional relationship between long-term memory and gamma activity. Results from EEG recordings indicate a pattern. The pattern was obtained through the de-codification of an EEG recording to sound and then to ASCII. Stimulation of gamma should enhance long term memory capacity. More research is required to unlock the human brains' protocol key. This key will enable the processing of information directly to and from human memory via gamma, the hippocampus and the temporal lobe.

75 FR 38913 - Long-Term Gulf Coast Restoration Support Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

... Coast Restoration Support Plan Memorandum for the Heads of Executive Departments and Agencies The oil... must help the Gulf Coast and its people recover from this tragedy. A long-term plan to restore the... to create a plan of Federal support for the long-term economic and environmental restoration of the...

Language and Short-Term Memory: The Role of Perceptual-Motor Affordance

PubMed Central

2014-01-01

The advantage for real words over nonwords in serial recall—the lexicality effect—is typically attributed to support for item-level phonology, either via redintegration, whereby partially degraded short-term traces are “cleaned up” via support from long-term representations of the phonological material or via the more robust temporary activation of long-term lexical phonological knowledge that derives from its combination with established lexical and semantic levels of representation. The much smaller effect of lexicality in serial recognition, where the items are re-presented in the recognition cue, is attributed either to the minimal role for redintegration from long-term memory or to the minimal role for item memory itself in such retrieval conditions. We show that the reduced lexicality effect in serial recognition is not a function of the retrieval conditions, but rather because previous demonstrations have used auditory presentation, and we demonstrate a robust lexicality effect for visual serial recognition in a setting where auditory presentation produces no such effect. Furthermore, this effect is abolished under conditions of articulatory suppression. We argue that linguistic knowledge affects the readiness with which verbal material is segmentally recoded via speech motor processes that support rehearsal and therefore affects tasks that involve recoding. On the other hand, auditory perceptual organization affords sequence matching in the absence of such a requirement for segmental recoding and therefore does not show such effects of linguistic knowledge. PMID:24797440

Language and short-term memory: the role of perceptual-motor affordance.

PubMed

Macken, Bill; Taylor, John C; Jones, Dylan M

2014-09-01

The advantage for real words over nonwords in serial recall--the lexicality effect--is typically attributed to support for item-level phonology, either via redintegration, whereby partially degraded short-term traces are "cleaned up" via support from long-term representations of the phonological material or via the more robust temporary activation of long-term lexical phonological knowledge that derives from its combination with established lexical and semantic levels of representation. The much smaller effect of lexicality in serial recognition, where the items are re-presented in the recognition cue, is attributed either to the minimal role for redintegration from long-term memory or to the minimal role for item memory itself in such retrieval conditions. We show that the reduced lexicality effect in serial recognition is not a function of the retrieval conditions, but rather because previous demonstrations have used auditory presentation, and we demonstrate a robust lexicality effect for visual serial recognition in a setting where auditory presentation produces no such effect. Furthermore, this effect is abolished under conditions of articulatory suppression. We argue that linguistic knowledge affects the readiness with which verbal material is segmentally recoded via speech motor processes that support rehearsal and therefore affects tasks that involve recoding. On the other hand, auditory perceptual organization affords sequence matching in the absence of such a requirement for segmental recoding and therefore does not show such effects of linguistic knowledge.

Implementing the supportive supervision intervention for registered nurses in a long-term care home: a feasibility study.

PubMed

McGilton, Katherine S; Profetto-McGrath, Joanne; Robinson, Angela

2013-11-01

This pilot study was conducted in response to the call in 2009 by the International Association of Gerontology and Geriatrics to focus on effective leadership structures in nursing homes and to develop leadership capacity. Few researchers have evaluated interventions aimed at enhancing the leadership ability of registered nurses in long-term care. The aim of the pilot study was to test the feasibility of a three-part supportive supervisory intervention to improve supervisory skills of registered nurses in long-term care. A repeated measures group design was used. Quantitative data were collected from healthcare aides, licensed practical nurses (i.e., supervised staff), and registered nurses (i.e., supervisors). Focus groups with care managers and supervisors examined perceptions of the intervention. There were nonsignificant changes in both the registered nurse supervisors' job satisfaction and the supervised staff's perception of their supervisors' support. Supervised staff scores indicated an increase in the use of research utilization but did not reflect an increase in job satisfaction. Focus group discussions revealed that the supervisors and care managers perceived the workshop to be valuable; however, the weekly self-reflection, coaching, and mentoring components of the intervention were rare and inconsistent. While the primary outcomes were not influenced by the Supportive Supervision Intervention, further effort is required to understand how best to enhance the supportive supervisory skills of RNs. Examples of how to improve the possibility of a successful intervention are advanced. Effective supervisory skills among registered nurses are crucial for improving the quality of care in long-term care homes. Registered nurses are receptive to interventions that will enhance their roles as supervisors. © 2013 Sigma Theta Tau International.

Supportive care after curative treatment for breast cancer (survivorship care): resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement.

PubMed

Ganz, Patricia A; Yip, Cheng Har; Gralow, Julie R; Distelhorst, Sandra R; Albain, Kathy S; Andersen, Barbara L; Bevilacqua, Jose Luiz B; de Azambuja, Evandro; El Saghir, Nagi S; Kaur, Ranjit; McTiernan, Anne; Partridge, Ann H; Rowland, Julia H; Singh-Carlson, Savitri; Vargo, Mary M; Thompson, Beti; Anderson, Benjamin O

2013-10-01

Breast cancer survivors may experience long-term treatment complications, must live with the risk of cancer recurrence, and often experience psychosocial complications that require supportive care services. In low- and middle-income settings, supportive care services are frequently limited, and program development for survivorship care and long-term follow-up has not been well addressed. As part of the 5th Breast Health Global Initiative (BHGI) Global Summit, an expert panel identified nine key resources recommended for appropriate survivorship care, and developed resource-stratified recommendations to illustrate how health systems can provide supportive care services for breast cancer survivors after curative treatment, using available resources. Key recommendations include health professional education that focuses on the management of physical and psychosocial long-term treatment complications. Patient education can help survivors transition from a provider-intense cancer treatment program to a post-treatment provider partnership and self-management program, and should include: education on recognizing disease recurrence or metastases; management of treatment-related sequelae, and psychosocial complications; and the importance of maintaining a healthy lifestyle. Increasing community awareness of survivorship issues was also identified as an important part of supportive care programs. Other recommendations include screening and management of psychosocial distress; management of long-term treatment-related complications including lymphedema, fatigue, insomnia, pain, and women's health issues; and monitoring survivors for recurrences or development of second primary malignancies. Where possible, breast cancer survivors should implement healthy lifestyle modifications, including physical activity, and maintain a healthy weight. Health professionals should provide well-documented patient care records that can follow a patient as they transition from active treatment to follow-up care. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial

PubMed Central

Roets-Merken, Lieve M; Zuidema, Sytse U; Vernooij-Dassen, Myrra J F J; Teerenstra, Steven; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

2018-01-01

Objective To evaluate the effectiveness of a nurse-supported self-management programme to improve social participation of dual sensory impaired older adults in long-term care homes. Design Cluster randomised controlled trial. Setting Thirty long-term care homes across the Netherlands. Participants Long-term care homes were randomised into intervention clusters (n=17) and control clusters (n=13), involving 89 dual sensory impaired older adults and 56 licensed practical nurses. Intervention Nurse-supported self-management programme. Measurements Effectiveness was evaluated by the primary outcome social participation using a participation scale adapted for visually impaired older adults distinguishing four domains: instrumental activities of daily living, social-cultural activities, high-physical-demand and low-physical-demand leisure activities. A questionnaire assessing hearing-related participation problems was added as supportive outcome. Secondary outcomes were autonomy, control, mood and quality of life and nurses’ job satisfaction. For effectiveness analyses, linear mixed models were used. Sampling and intervention quality were analysed using descriptive statistics. Results Self-management did not affect all four domains of social participation; however. the domain ‘instrumental activities of daily living’ had a significant effect in favour of the intervention group (P=0.04; 95% CI 0.12 to 8.5). Sampling and intervention quality was adequate. Conclusions A nurse-supported self-management programme was effective in empowering the dual sensory impaired older adults to address the domain ‘instrumental activities of daily living’, but no differences were found in addressing the other three participation domains. Self-management showed to be beneficial for managing practical problems, but not for those problems requiring behavioural adaptations of other persons. Trial registration number NCT01217502; Results. PMID:29371264

Reforming long-term care financing through insurance

PubMed Central

Meiners, Mark R.

1988-01-01

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

STAT3 Controls the Long-Term Survival and Phenotype of Repair Schwann Cells during Nerve Regeneration.

PubMed

Benito, Cristina; Davis, Catherine M; Gomez-Sanchez, Jose A; Turmaine, Mark; Meijer, Dies; Poli, Valeria; Mirsky, Rhona; Jessen, Kristjan R

2017-04-19

After nerve injury, Schwann cells convert to a phenotype specialized to promote repair. But during the slow process of axonal regrowth, these repair Schwann cells gradually lose their regeneration-supportive features and eventually die. Although this is a key reason for the frequent regeneration failures in humans, the transcriptional mechanisms that control long-term survival and phenotype of repair cells have not been studied, and the molecular signaling underlying their decline is obscure. We show, in mice, that Schwann cell STAT3 has a dual role. It supports the long-term survival of repair Schwann cells and is required for the maintenance of repair Schwann cell properties. In contrast, STAT3 is less important for the initial generation of repair Schwann cells after injury. In repair Schwann cells, we find that Schwann cell STAT3 activation by Tyr705 phosphorylation is sustained during long-term denervation. STAT3 is required for maintaining autocrine Schwann cell survival signaling, and inactivation of Schwann cell STAT3 results in a striking loss of repair cells from chronically denervated distal stumps. STAT3 inactivation also results in abnormal morphology of repair cells and regeneration tracks, and failure to sustain expression of repair cell markers, including Shh, GDNF, and BDNF. Because Schwann cell development proceeds normally without STAT3, the function of this factor appears restricted to Schwann cells after injury. This identification of transcriptional mechanisms that support long-term survival and differentiation of repair cells will help identify, and eventually correct, the failures that lead to the deterioration of this important cell population. SIGNIFICANCE STATEMENT Although injured peripheral nerves contain repair Schwann cells that provide signals and spatial clues for promoting regeneration, the clinical outcome after nerve damage is frequently poor. A key reason for this is that, during the slow growth of axons through the proximal parts of injured nerves repair, Schwann cells gradually lose regeneration-supporting features and eventually die. Identification of signals that sustain repair cells is therefore an important goal. We have found that in mice the transcription factor STAT3 protects these cells from death and contributes to maintaining the molecular and morphological repair phenotype that promotes axonal regeneration. Defining the molecular mechanisms that maintain repair Schwann cells is an essential step toward developing therapeutic strategies that improve nerve regeneration and functional recovery. Copyright © 2017 Benito, Davis et al.

LifeSat engineering in-house vehicle design

NASA Technical Reports Server (NTRS)

Adkins, A.; Badhwar, G.; Bryant, L.; Caram, J.; Conley, G.; Crull, T.; Cuthbert, P.; Darcy, E.; Delaune, P.; Edeen, M.

1992-01-01

The LifeSat program was initiated to research the effects of microgravity and cosmic radiation on living organisms. The effects of long-term human exposure to free-space radiation fields over a range of gravitational environments has long been recognized as one of the primary design uncertainties for human space exploration. A critical design issue in the radiation biology requirements was the lack of definition of the minimum radiation absorbed dosage required to produce statistically meaningful data. The Phase A study produced a spacecraft conceptual design resembling a Discoverer configuration with a total weight of approximately 2800 pounds that would carry a 525-pound payload module (45 inches in diameter and 36 inches long) and support up to 12 rodents and a general biology module supporting lower life forms for an on-orbit duration of up to 60 days. The phase B conceptual designs focused on gravitational biology requirements and only briefly addressed the design impacts of the shift toward radiobiological science that occurred during the latter half of the Phase B studies.

Enabling science support for better decision-making when responding to chemical spills

USGS Publications Warehouse

Weidhass, Jennifer L.; Dietrich, Andrea M.; DeYonker, Nathan J.; Dupont, R. Ryan; Foreman, William T.; Gallagher, Daniel; Gallagher, Jennifer E. G.; Whelton, Andrew J.; Alexander, William

2016-01-01

Chemical spills and accidents contaminate the environment and disrupt societies and economies around the globe. In the United States there were approximately 172,000 chemical spills that affected US waterbodies from 2004 to 2014. More than 8000 of these spills involved non–petroleum-related chemicals. Traditional emergency responses or incident command structures (ICSs) that respond to chemical spills require coordinated efforts by predominantly government personnel from multiple disciplines, including disaster management, public health, and environmental protection. However, the requirements of emergency response teams for science support might not be met within the traditional ICS. We describe the US ICS as an example of emergency-response approaches to chemical spills and provide examples in which external scientific support from research personnel benefitted the ICS emergency response, focusing primarily on nonpetroleum chemical spills. We then propose immediate, near-term, and long-term activities to support the response to chemical spills, focusing on nonpetroleum chemical spills. Further, we call for science support for spill prevention and near-term spill-incident response and identify longer-term research needs. The development of a formal mechanism for external science support of ICS from governmental and nongovernmental scientists would benefit rapid responders, advance incident- and crisis-response science, and aid society in coping with and recovering from chemical spills.

Noncontact ECG system for unobtrusive long-term monitoring.

PubMed

McDonald, Neil J; Anumula, Harini A; Duff, Eric; Soussou, Walid

2012-01-01

This paper describes measurements made using an ECG system with QUASAR's capacitive bioelectrodes integrated into a pad system that is placed over a chair. QUASAR's capacitive bioelectrode has the property of measuring bioelectric potentials at a small separation from the body. This enables the measurement of ECG signals through fabric, without the removal of clothing or preparation of skin. The ECG was measured through the subject's clothing while the subject sat in the chair without any supporting action from the subject. The ECG pad system is an example of a high compliance system that places minimal requirements upon the subject and, consequently, can be used to generate a long-term record from ECG segments collected on a daily basis, providing valuable information on long-term trends in cardiac health.

Internet Interventions for Long-Term Conditions: Patient and Caregiver Quality Criteria

PubMed Central

Murray, Elizabeth; Stevenson, Fiona; Gore, Charles; Nazareth, Irwin

2006-01-01

Background Interactive health communication applications (IHCAs) that combine high-quality health information with interactive components, such as self-assessment tools, behavior change support, peer support, or decision support, are likely to benefit people with long-term conditions. IHCAs are now largely Web-based and are becoming known as "Internet interventions." Although there are numerous professionally generated criteria to assess health-related websites, to date there has been scant exploration of patient-generated assessment criteria even though patients and professionals use different criteria for assessing the quality of traditional sources of health information. Objective We aimed to determine patients' and caregivers' requirements of IHCAs for long-term conditions as well as their criteria for assessing the quality of different programs. Methods This was a qualitative study with focus groups. Patients and caregivers managing long-term conditions used three (predominantly Web-based) IHCAs relevant to their condition and subsequently discussed the strengths and weaknesses of the different IHCAs in focus groups. Participants in any one focus group all shared the same long-term condition and viewed the same three IHCAs. Patient and caregiver criteria for IHCAs emerged from the data. Results There were 40 patients and caregivers who participated in 10 focus groups. Participants welcomed the potential of Internet interventions but felt that many were not achieving their full potential. Participants generated detailed and specific quality criteria relating to information content, presentation, interactivity, and trustworthiness, which can be used by developers and purchasers of Internet interventions. Conclusions The user-generated quality criteria reported in this paper should help developers and purchasers provide Internet interventions that better meet user needs. PMID:16954123

Cervical cancer survivorship: Long-term quality of life and social support

PubMed Central

Pfaendler, Krista S.; Wenzel, Lari; Mechanic, Mindy B.; Penner, Kristine R.

2015-01-01

Purpose Surgery, radiotherapy and chemotherapy are the mainstays of cervical cancer treatment. Many patients receive multiple treatment modalities, each with its own long-term effects. Given the high 5 year survival rate for cervical cancer patients, evaluation and improvement of long-term quality of life are essential. Methods Pertinent articles were identified through searches of PubMed for literature published from 1993-2014. We summarize quality of life data from long-term follow up studies of cervical cancer patients. We additionally summarize small group interviews of Hispanic and non-Hispanic cervical cancer survivors regarding social support and coping. Findings Data is varied in terms of the long term impact of treatment on quality of life but consistent in suggesting that patients who receive radiotherapy as part of their treatment have the highest risk of increased long term dysfunction of bladder and bowel, as well as sexual dysfunction and psychosocial consequences. Rigorous investigations regarding long-term consequences of treatment modalities are lacking. Implications Continued work to improve treatment outcomes and survival should also include a focus on reducing adverse long-term side effects. Providing supportive care during treatment, and evaluating the effects of supportive care, may reduce the prevalence and magnitude of long-term sequelae of cervical cancer, which will in turn improve quality of life and quality of care. PMID:25592090

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

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

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

2011-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2011-06-01

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

Revising the Lubben Social Network Scale for use in residential long-term care settings.

PubMed

Munn, Jean; Radey, Melissa; Brown, Kristin; Kim, Hyejin

2018-04-19

We revised the Lubben Social Network Scale (LSNS) to develop a measure of social support specific to residential long-term care (LTC) settings, the LSNS-LTC with five domains (i.e., family, friends, residents, volunteers, and staff). The authors modified the LSNS-18 to capture sources of social support specific to LTC, specifically relationships with residents, volunteers, and staff. We piloted the resultant 28-item measure with 64 LTC residents. Fifty-four respondents provided adequate information for analyses that included descriptive statistics and reliability coefficients. Twenty of the items performed well (had correlations >0.3, overall α = 0.85) and were retained. Three items required modification. The five items related to volunteers were eliminated due to extensive (>15%) missing data resulting in a proposed 23-item measure. We identified, and to some degree quantified, supportive relationships within the LTC environment, while developing a self-report tool to measure social support in these settings.

Nutritional support at home and in the community.

PubMed

Puntis, J W

2001-04-01

Technical developments in feeding, together with the growth of support structures in the community has lead to a steady increase in the number of children receiving home enteral tube feeding and home parenteral nutrition. In many cases the adverse nutritional consequences of disease can be ameliorated or prevented, and long term parenteral nutrition represents a life saving intervention. Careful follow up of children receiving home nutritional therapy is necessary to establish the ratio of risks to benefits. A considerable burden is sometimes placed on family or other carers who therefore require adequate training and ongoing support. The respective responsibilities of different agencies relating to funding and support tasks require more clear definition.

45 CFR 144.206 - Reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships... that sells a qualified long-term care insurance policy under a qualified State long-term care insurance...

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-07-16

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

National Aeronautics and Space Administration (NASA) Environmental Control and Life Support (ECLS) Capability Roadmap Development for Exploration

NASA Technical Reports Server (NTRS)

Bagdigian, Robert M.; Carrasquillo, Robyn L.; Metcalf, Jordan; Peterson, Laurie

2012-01-01

NASA is considering a number of future human space exploration mission concepts. Although detailed requirements and vehicle architectures remain mostly undefined, near-term technology investment decisions need to be guided by the anticipated capabilities needed to enable or enhance the mission concepts. This paper describes a roadmap that NASA has formulated to guide the development of Environmental Control and Life Support Systems (ECLSS) capabilities required to enhance the long-term operation of the International Space Station (ISS) and enable beyond-Low Earth Orbit (LEO) human exploration missions. Three generic mission types were defined to serve as a basis for developing a prioritized list of needed capabilities and technologies. Those are 1) a short duration micro gravity mission; 2) a long duration transit microgravity mission; and 3) a long duration surface exploration mission. To organize the effort, ECLSS was categorized into three major functional groups (atmosphere, water, and solid waste management) with each broken down into sub-functions. The ability of existing, flight-proven state-of-the-art (SOA) technologies to meet the functional needs of each of the three mission types was then assessed. When SOA capabilities fell short of meeting the needs, those "gaps" were prioritized in terms of whether or not the corresponding capabilities enable or enhance each of the mission types. The resulting list of enabling and enhancing capability gaps can be used to guide future ECLSS development. A strategy to fulfill those needs over time was then developed in the form of a roadmap. Through execution of this roadmap, the hardware and technologies needed to enable and enhance exploration may be developed in a manner that synergistically benefits the ISS operational capability, supports Multi-Purpose Crew Vehicle (MPCV) development, and sustains long-term technology investments for longer duration missions. This paper summarizes NASA s ECLSS capability roadmap development process, findings, and recommendation

12 CFR 1263.9 - Makes long-term home mortgage loans requirement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Makes long-term home mortgage loans requirement. 1263.9 Section 1263.9 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS MEMBERS OF THE BANKS Eligibility Requirements § 1263.9 Makes long-term home mortgage loans requirement. An...

12 CFR 1263.9 - Makes long-term home mortgage loans requirement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Makes long-term home mortgage loans requirement. 1263.9 Section 1263.9 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS MEMBERS OF THE BANKS Eligibility Requirements § 1263.9 Makes long-term home mortgage loans requirement. An...

NR4A nuclear receptors support memory enhancement by histone deacetylase inhibitors

PubMed Central

Hawk, Joshua D.; Bookout, Angie L.; Poplawski, Shane G.; Bridi, Morgan; Rao, Allison J.; Sulewski, Michael E.; Kroener, Brian T.; Manglesdorf, David J.; Abel, Ted

2012-01-01

The formation of a long-lasting memory requires a transcription-dependent consolidation period that converts a short-term memory into a long-term memory. Nuclear receptors compose a class of transcription factors that regulate diverse biological processes, and several nuclear receptors have been implicated in memory formation. Here, we examined the potential contribution of nuclear receptors to memory consolidation by measuring the expression of all 49 murine nuclear receptors after learning. We identified 13 nuclear receptors with increased expression after learning, including all 3 members of the Nr4a subfamily. These CREB-regulated Nr4a genes encode ligand-independent “orphan” nuclear receptors. We found that blocking NR4A activity in memory-supporting brain regions impaired long-term memory but did not impact short-term memory in mice. Further, expression of Nr4a genes increased following the memory-enhancing effects of histone deacetylase (HDAC) inhibitors. Blocking NR4A signaling interfered with the ability of HDAC inhibitors to enhance memory. These results demonstrate that the Nr4a gene family contributes to memory formation and is a promising target for improving cognitive function. PMID:22996661

Paediatric and congenital cardiac surgery in emerging economies: surgical 'safari' versus educational programmes.

PubMed

Corno, Antonio F

2016-07-01

To attract the interest of all people potentially involved in humanitarian activities in the emerging economies, in particular giving attention to the basic requirements of the organization of paediatric cardiac surgery activities, the requirements for a successful partnership with the local existing organizations and the basic elements of a patient-centred multidisciplinary integrated approach. Unfortunately, for many years, the interventions in the low and middle income countries were largely limited to short-term medical missions, not inappropriately nicknamed 'surgical safari', because of negative general and specific characteristics. The negative aspects and the limits of the short-term medical missions can be overcome only by long-term educational programmes. The most suitable and consistent models of long-term educational programmes have been combined and implemented with the personal experience to offer a proposal for a long-term educational project, with the following steps: (i) site selection; (ii) demographic research; (iii) site assessment; (iv) organization of surgical educational teams; (v) regular frequency of surgical educational missions; (vi) programme evolution and maturation; (vii) educational outreach and interactive support. Potential limits of a long-term educational surgical programme are: (i) financial affordability; (ii) basic legal needs; (iii) legal support; (iv) non-profit indemnification. The success should not be measured by the number of successful operations of any given mission, but by the successful operations that our colleagues perform after we leave. Considering that the children in need outnumber by far the people able to provide care, in this humanitarian medicine there should be plenty of room for cooperation rather than competition. The main goal should be to provide teaching to local staff and implement methods and techniques to support the improvement of the care of the patients in the long run. This review focuses on the organization of paediatric cardiac activities in the emerging economies, but 'the less privileged parts of the world' can be anywhere, not necessarily limited to economic constraints. Lack of diversity because of social, intellectual, educational and professional growth, the last consisting in cultural stagnation, is responsible for the lack of scientific progress and development. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Ultra Reliable Closed Loop Life Support for Long Space Missions

NASA Technical Reports Server (NTRS)

Jones, Harry W.; Ewert, Michael K.

2010-01-01

Spacecraft human life support systems can achieve ultra reliability by providing sufficient spares to replace all failed components. The additional mass of spares for ultra reliability is approximately equal to the original system mass, provided that the original system reliability is not too low. Acceptable reliability can be achieved for the Space Shuttle and Space Station by preventive maintenance and by replacing failed units. However, on-demand maintenance and repair requires a logistics supply chain in place to provide the needed spares. In contrast, a Mars or other long space mission must take along all the needed spares, since resupply is not possible. Long missions must achieve ultra reliability, a very low failure rate per hour, since they will take years rather than weeks and cannot be cut short if a failure occurs. Also, distant missions have a much higher mass launch cost per kilogram than near-Earth missions. Achieving ultra reliable spacecraft life support systems with acceptable mass will require a well-planned and extensive development effort. Analysis must determine the reliability requirement and allocate it to subsystems and components. Ultra reliability requires reducing the intrinsic failure causes, providing spares to replace failed components and having "graceful" failure modes. Technologies, components, and materials must be selected and designed for high reliability. Long duration testing is needed to confirm very low failure rates. Systems design should segregate the failure causes in the smallest, most easily replaceable parts. The system must be designed, developed, integrated, and tested with system reliability in mind. Maintenance and reparability of failed units must not add to the probability of failure. The overall system must be tested sufficiently to identify any design errors. A program to develop ultra reliable space life support systems with acceptable mass should start soon since it must be a long term effort.

Regulators of Long-Term Memory Revealed by Mushroom Body-Specific Gene Expression Profiling in Drosophila melanogaster.

PubMed

Widmer, Yves F; Bilican, Adem; Bruggmann, Rémy; Sprecher, Simon G

2018-06-20

Memory formation is achieved by genetically tightly controlled molecular pathways that result in a change of synaptic strength and synapse organization. While for short-term memory traces rapidly acting biochemical pathways are in place, the formation of long-lasting memories requires changes in the transcriptional program of a cell. Although many genes involved in learning and memory formation have been identified, little is known about the genetic mechanisms required for changing the transcriptional program during different phases of long-term memory formation. With Drosophila melanogaster as a model system we profiled transcriptomic changes in the mushroom body, a memory center in the fly brain, at distinct time intervals during appetitive olfactory long-term memory formation using the targeted DamID technique. We describe the gene expression profiles during these phases and tested 33 selected candidate genes for deficits in long-term memory formation using RNAi knockdown. We identified 10 genes that enhance or decrease memory when knocked-down in the mushroom body. For vajk-1 and hacd1 , the two strongest hits, we gained further support for their crucial role in appetitive learning and forgetting. These findings show that profiling gene expression changes in specific cell-types harboring memory traces provides a powerful entry point to identify new genes involved in learning and memory. The presented transcriptomic data may further be used as resource to study genes acting at different memory phases. Copyright © 2018, Genetics.

Stakeholders' Home and Community Based Services Settings Rule Knowledge

ERIC Educational Resources Information Center

Friedman, Carli

2018-01-01

Medicaid Home and Community Based Services (HCBS) waiver programs provide the majority of long-term services and supports for people with intellectual and developmental disabilities (IDD). Relatively new (2014) HCBS rules (CMS 2249-F/2296-F) governing these programs require "meaningful community" integration of people with disabilities…

Network cyberinfrastructure as a shared platform to support multi-site research

USDA-ARS?s Scientific Manuscript database

Multi-site research across the Long-term Agroecosystem Research (LTAR) network requires access to data and information. We present some existing examples where you can get data from across the network and summarize the rich inventory of measurements taken across LTAR sites. But data management suppo...

Mission and Assets Database

NASA Technical Reports Server (NTRS)

Baldwin, John; Zendejas, Silvino; Gutheinz, Sandy; Borden, Chester; Wang, Yeou-Fang

2009-01-01

Mission and Assets Database (MADB) Version 1.0 is an SQL database system with a Web user interface to centralize information. The database stores flight project support resource requirements, view periods, antenna information, schedule, and forecast results for use in mid-range and long-term planning of Deep Space Network (DSN) assets.

Weight gain and nutritional efficacy in anorexia nervosa.

PubMed

Dempsey, D T; Crosby, L O; Pertschuk, M J; Feurer, I D; Buzby, G P; Mullen, J L

1984-02-01

To evaluate the usefulness of interval weight change in assessing nutritional support efficacy, we studied four anorexia nervosa patients (52% ideal body weight) requiring long-term total parenteral nutrition (TPN) for 63 +/- 18 days. Fluid and electrolyte deficits were corrected before the initiation of nutritional support. Resting energy expenditure was measured before the initiation of TPN and weekly thereafter, using indirect calorimetry. Daily caloric expenditure was estimated at 1.1 X resting energy expenditure, based on previous studies of continuous heart rate monitoring in this patient population. Daily excess calories were calculated as caloric intake minus caloric expenditure. Each patient was weighed daily and linear regression analysis (excess calories versus weight change) was performed for individual patients and the group over intervals of varying length. There was no individual or group correlation between excess calories and weight gain on a daily or weekly interval basis. Cumulative weight changes over the long-term course of TPN correlated significantly with cumulative excess calories for each patient and the whole group (r = +0.82, p less than 0.01). The excess calories required to gain a kilogram body weight ranged from 5569 to 15619 kcal/kg with a mean of 9768. Cumulative long-term weight changes during nutritional repletion in anorexia nervosa are meaningful indicators of caloric balance, but short interval weight changes (daily, weekly) are not. The caloric cost of weight gain is variable in this population.

The Cook Agronomy Farm LTAR: Knowledge Intensive Precision Agro-ecology

NASA Astrophysics Data System (ADS)

Huggins, D. R.

2015-12-01

Drowning in data and starving for knowledge, agricultural decision makers require evidence-based information to enlighten sustainable intensification. The agro-ecological footprint of the Cook Agronomy Farm (CAF) Long-Term Agro-ecosystem Research (LTAR) site is embedded within 9.4 million ha of diverse land uses primarily cropland (2.9 million ha) and rangeland (5.3 million ha) that span a wide annual precipitation gradient (150 mm through 1400 mm) with diverse social and natural capital (see Figure). Sustainable intensification hinges on the development and adoption of precision agro-ecological practices that rely on meaningful spatio-temporal data relevant to land use decisions at within-field to regional scales. Specifically, the CAF LTAR will provide the scientific foundation (socio-economical and bio-physical) for enhancing decision support for precision and conservation agriculture and synergistic cropping system intensification and diversification. Long- and short-term perspectives that recognize and assess trade-offs in ecosystem services inherent in any land use decision will be considered so as to promote the development of more sustainable agricultural systems. Presented will be current and future CAF LTAR research efforts required for the development of sustainable agricultural systems including cropping system cycles and flows of nutrients, water, carbon, greenhouse gases and other biotic and abiotic factors. Evaluation criteria and metrics associated with long-term agro-ecosystem provisioning, supporting, and regulating services will be emphasized.

Nutritional/Growth Status in a Large Cohort of Medically Fragile Children Receiving Long-Term Enteral Nutrition Support.

PubMed

Khan, Zahra; Marinschek, Sabine; Pahsini, Karoline; Scheer, Peter; Morris, Nicholas; Urlesberger, Berndt; Dunitz-Scheer, Marguerite

2016-01-01

The aim of the present study was to assess the nutritional status and growth of medically fragile children receiving long-term enteral nutritional support (ENS). A retrospective cross-sectional survey was conducted at a tertiary-level pediatric hospital. Growth features and nutritional intake of children (n = 287) receiving ENS were evaluated. During a period of 5 years (2009-2013), study patients in the age group of 1 to 36 months had been referred for the explicit reason of tube weaning. Data were documented with the help of ARCHIMED (version 46.2) and analyzed using SPSS for Windows version 21. Nutritional/growth status was determined by using World Health Organization growth standard tables. Anthropometric parameters of children were compared with World Health Organization standards, and the prevalence of underweight, wasting, and stunting was very high despite being exclusively or predominantly on ENS. Results revealed that the age of a child, inadequate amount of caloric supply/day, the diagnosis of small-for-gestational age, and the type of tube (nasogastric tube) were significantly associated with growth/nutritional status (P < 0.05). Duration of ENS in the percentage of the cohort's lifetime and the main diagnosis were not associated with nutritional/growth outcomes. In medically fragile children, ENS does not ensure adequate growth per se. ENS requires highly specialized and individually tailored management and in many cases regular adjustments. Long-term tube feeding plans often seem unable to ensure the required amount of nutritional support, which surely compromise the individual efficacy of ENS.

Interaction of soil pH and phosphorus efficacy: Long-term effects of P fertilizer and lime applications on wheat, barley, and sugar beet.

PubMed

von Tucher, Sabine; Hörndl, Dorothea; Schmidhalter, Urs

2018-01-01

Phosphorus (P), a plant macronutrient, must be adequately supplied for crop growth. In Germany, many soils are high in plant-available P; specifically in arable farming, P fertilizer application has been reduced or even omitted in the last decade. Therefore, it is important to understand how long these soils can support sustainable crop production, and what concentrations of soil P are required for it. We analyzed a 36-year long-term field experiment regarding the effects of different P application and liming rates on plant growth and soil P concentrations with a crop rotation of sugar beet, wheat, and barley. Sugar beet reacted to low soil P and low soil pH levels more sensitively than wheat, which was not significantly affected by the long-term omitted P application. All three crop species showed adequate growth at soil P levels lower than the currently recommended levels, if low soil pH was optimized by liming. The increase in efficacy of soil and fertilizer P by reduced P application rates therefore requires the adaptation of the soil pH to a soil type-specific optimal level.

Anesthesiology Devices; Reclassification of Membrane Lung for Long-Term Pulmonary Support; Redesignation as Extracorporeal Circuit and Accessories for Long-Term Respiratory/Cardiopulmonary Failure. Final order.

PubMed

2016-02-12

The Food and Drug Administration (FDA) is issuing a final order to redesignate membrane lung devices for long-term pulmonary support, a preamendments class III device, as extracorporeal circuit and accessories for long-term respiratory/cardiopulmonary failure, and to reclassify the device to class II (special controls) in patients with acute respiratory failure or acute cardiopulmonary failure where other available treatment options have failed, and continued clinical deterioration is expected or the risk of death is imminent. A membrane lung device for long-term pulmonary support (>6 hours) refers to the oxygenator in an extracorporeal circuit used during long-term procedures, commonly referred to as extracorporeal membrane oxygenation (ECMO). Because a number of other devices and accessories are used with the oxygenator in the circuit, the title and identification of the regulation are revised to include extracorporeal circuit and accessories for long-term respiratory/cardiopulmonary failure. Although an individual device or accessory used in an ECMO circuit may already have its own classification regulation when the device or accessory is intended for short-term use (<=6 hours), such device or accessory will be subject to the same regulatory controls applied to the oxygenator (i.e., class II, special controls) when evaluated as part of the ECMO circuit for long-term use (>6 hours). On its own initiative, based on new information, FDA is revising the classification of the membrane lung device for long-term pulmonary support.

Low back pain and widespread pain predict sickness absence among industrial workers

PubMed Central

Morken, Tone; Riise, Trond; Moen, Bente; Hauge, Signe HV; Holien, Solrun; Langedrag, Anne; Pedersen, Svein; Saue, Inger Lise L; Seljebø, Guri M; Thoppil, Varughese

2003-01-01

Background The prevalence of musculoskeletal disorders (MSD) in the aluminium industry is high, and there is a considerable work-related fraction. More knowledge about the predictors of sickness absence from MSD in this industry will be valuable in determining strategies for prevention. The aim of this study was to analyse the relative impact of body parts, psychosocial and individual factors as predictors for short- and long-term sickness absence from MSD among industrial workers. Methods A follow-up study was conducted among all the workers at eight aluminium plants in Norway. A questionnaire was completed by 5654 workers at baseline in 1998. A total of 3320 of these participated in the follow-up study in 2000. Cox regression analysis was applied to investigate the relative impact of MSD in various parts of the body and of psychosocial and individual factors reported in 1998 on short-term and long-term sickness absence from MSD reported in 2000. Results MSD accounted for 45% of all working days lost the year prior to follow-up in 2000. Blue-collar workers had significantly higher risk than white-collar workers for both short- and long-term sickness absence from MSD (long-term sickness absence: RR = 3.04, 95% CI 2.08–4.45). Widespread and low back pain in 1998 significantly predicted both short- and long-term sickness absence in 2000. In addition, shoulder pain predicted long-term sickness absence. Low social support predicted short-term sickness absence (RR = 1.28, 95% CI 1.11–1.49). Conclusions Reducing sickness absence from MSD among industrial workers requires focusing on the working conditions of blue-collar workers and risk factors for low back pain and widespread pain. Increasing social support in the work environment may have effects in reducing short-term sickness absence from MSD. PMID:12956891

Air Force Global Weather Central System Architecture Study. Final System/Subsystem Summary Report. Volume 2. Requirements Compilation and Analysis. Part 1. User and Model Requirements

DTIC Science & Technology

1976-03-01

Milestones will be established after staffing at 6WW. Long-Term Procedures: A capability will be acquired in automated support to Command and Control under... geocentric latitude f = ZttsinQ g = geopotential a = mean radius of earth Ü = angular rotation of the earth 7.29 x 10" rad/sec u,v

Coordination of short-term and long-term mitigation measures of hydro-meteorological risks: the importance of establishing a link between emergency management and spatial planning

NASA Astrophysics Data System (ADS)

Prenger-Berninghoff, Kathrin; Cortes, V. Juliette; Aye, Zar Chi; Sprague, Teresa

2013-04-01

The management of natural hazards involves, as generally known, the four stages of the risk management cycle: Prevention, preparedness, response and recovery. Accordingly, the mitigation of disasters can be performed in terms of short-term and long-term purposes. Whereas emergency management or civil protection helps to strengthen a community's capacity to be better prepared for natural hazards and to better respond in case a disaster strikes, thus addressing the short-term perspective, spatial planning serves long-term planning goals and can therefore implement long-term prevention measures. A purposefully applied risk mitigation strategy requires coordination of short-term and long-term mitigation measures and thus an effective coordination of emergency management and spatial planning. Several actors are involved in risk management and should consequently be linked throughout the whole risk management cycle. However, these actors, partly because of a historically fragmented administrative system, are hardly connected to each other, with spatial planning only having a negligible role compared to other actors1, a problem to which Young (2002) referred to as the "problem of interplay". In contrast, information transfer and decision-taking happen at the same time and are not coordinated among different actors. This applies to the prevention and preparedness phase as well as to the recovery phase, which basically constitutes the prevention phase for the next disaster2. Since investments in both risk prevention and emergency preparedness and response are considered necessary, a better coordination of the two approaches is required. In this regard, Decision Support Systems (DSS) can be useful in order to provide support in the decision-making aspect of risk management. The research work currently undertaken examines the problem of interplay in the four case study areas of the Marie Curie ITN, CHANGES3. The link between different risk management actors will be explored by means of exploratory questionnaires and interviews with government agencies, local administrations, community and research organizations on each study site. First results provided will address the general role of spatial planning in risk management. Additionally, preliminary observations are made in regard to the coordination of emergency preparedness and long-term spatial planning activities. The observations consider that integration facilitates proactive strategies that aim at preventing disaster occurrence and promote interaction between involved parties. Finally, consideration is given to the potential use of a DSS tool to cover both aspects of spatial planning and emergency management in the risk management cycle.

Semantic and phonological contributions to short-term repetition and long-term cued sentence recall.

PubMed

Meltzer, Jed A; Rose, Nathan S; Deschamps, Tiffany; Leigh, Rosie C; Panamsky, Lilia; Silberberg, Alexandra; Madani, Noushin; Links, Kira A

2016-02-01

The function of verbal short-term memory is supported not only by the phonological loop, but also by semantic resources that may operate on both short and long time scales. Elucidation of the neural underpinnings of these mechanisms requires effective behavioral manipulations that can selectively engage them. We developed a novel cued sentence recall paradigm to assess the effects of two factors on sentence recall accuracy at short-term and long-term stages. Participants initially repeated auditory sentences immediately following a 14-s retention period. After this task was complete, long-term memory for each sentence was probed by a two-word recall cue. The sentences were either concrete (high imageability) or abstract (low imageability), and the initial 14-s retention period was filled with either an undemanding finger-tapping task or a more engaging articulatory suppression task (Exp. 1, counting backward by threes; Exp. 2, repeating a four-syllable nonword). Recall was always better for the concrete sentences. Articulatory suppression reduced accuracy in short-term recall, especially for abstract sentences, but the sentences initially recalled following articulatory suppression were retained better at the subsequent cued-recall test, suggesting that the engagement of semantic mechanisms for short-term retention promoted encoding of the sentence meaning into long-term memory. These results provide a basis for using sentence imageability and subsequent memory performance as probes of semantic engagement in short-term memory for sentences.

Using Simulation to Compare 4 Categories of Intervention for Reducing Cardiovascular Disease Risks

PubMed Central

Homer, Jack; Trogdon, Justin; Wile, Kristina; Orenstein, Diane

2014-01-01

The Prevention Impacts Simulation Model (PRISM) projects the multiyear impacts of 22 different interventions aimed at reducing risk of cardiovascular disease. We grouped these into 4 categories: clinical, behavioral support, health promotion and access, and taxes and regulation. We simulated impacts for the United States overall and also for a less-advantaged county with a higher death rate. Of the 4 categories of intervention, taxes and regulation reduce costs the most in the short term (through 2020) and long term (through 2040) and reduce deaths the most in the long term; they are second to clinical interventions in reducing deaths in the short term. All 4 categories combined were required to bring costs and deaths in the less-advantaged county down to the national level. PMID:24832142

An alternative approach to solar system exploration providing safety of human mission to Mars.

PubMed

Gitelson, J I; Bartsev, S I; Mezhevikin, V V; Okhonin, V A

2003-01-01

For systematic human Mars exploration, meeting crew safety requirements, it seems perspective to assemble into a spacecraft: an electrical rocket, a well-shielded long-term life support system, and a manipulator-robots operating in combined "presence effect" and "master-slave" mode. The electrical spacecraft would carry humans to the orbit of Mars, providing short distance (and low signal time delay) between operator and robot-manipulators, which are landed on the surface of the planet. Long-term hybrid biological and physical/chemical LSS could provide environment supporting human health and well being. Robot-manipulators operating in "presence effect" and "master-slave" mode exclude necessity of human landing on Martian surface decreasing the level of risk for crew. Since crewmen would not have direct contact with the Martian environment then the problem of mutual biological protection is essentially reduced. Lightweight robot-manipulators, without heavy life support systems and without the necessity of returning to the mother vessel, could be sent as scouts to different places on the planet surface, scanning the most interesting for exobiological research site. Some approximate estimations of electric spacecraft, long-term hybrid LSS, radiation protection and mission parameters are conducted and discussed. c2002 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

Characterization of Technetium Speciation in Cast Stone

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

Um, Wooyong; Jung, Hun Bok; Wang, Guohui

2013-11-11

This report describes the results from laboratory tests performed at Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE) EM-31 Support Program (EMSP) subtask, “Production and Long-Term Performance of Low Temperature Waste Forms” to provide additional information on technetium (Tc) speciation characterization in the Cast Stone waste form. To support the use of Cast Stone as an alternative to vitrification for solidifying low-activity waste (LAW) and as the current baseline waste form for secondary waste streams at the Hanford Site, additional understanding of Tc speciation in Cast Stone is needed to predict the long-term Tc leachability frommore » Cast Stone and to meet the regulatory disposal-facility performance requirements for the Integrated Disposal Facility (IDF). Characterizations of the Tc speciation within the Cast Stone after leaching under various conditions provide insights into how the Tc is retained and released. The data generated by the laboratory tests described in this report provide both empirical and more scientific information to increase our understanding of Tc speciation in Cast Stone and its release mechanism under relevant leaching processes for the purpose of filling data gaps and to support the long-term risk and performance assessments of Cast Stone in the IDF at the Hanford Site.« less

Short-term and long-term prognostic outcomes of patients with ST-segment elevation myocardial infarction complicated by profound cardiogenic shock undergoing early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention.

PubMed

Chung, Sheng-Ying; Tong, Meng-Shen; Sheu, Jiunn-Jye; Lee, Fan-Yen; Sung, Pei-Hsun; Chen, Chien-Jen; Yang, Cheng-Hsu; Wu, Chiung-Jen; Yip, Hon-Kan

2016-11-15

This study investigated the 30-day and long-term prognostic outcomes in patients with ST-segment elevation myocardial infarction (STEMI) complicated with profound cardiogenic shock (CS) undergoing early routine extracorporeal membrane oxygenator (ECMO)-assisted primary percutaneous coronary intervention (PCI). Between December 2005 and December 2014, 65 consecutive STEMI patients with profound CS underwent routine ECMO-supported primary PCI. The incidences of acute pulmonary edema, respiratory failure with requirement of mechanical ventilatory support upon presentation, and 30-day mortality rate were 100%, 95.4%, and 43.1%, respectively. The duration of hospitalization, mean long-term follow-up, and survival rate were 32.1±53.1 (days), 733.6±986.7 (days), and 32.3%, respectively. The mean APACHE score (32.6±8.3 vs. 28.5±7.5), peak serum creatinine level (4.3±2.4 vs. 1.7±1.2mg/dL), incidences of failed ECMO weaning (57.1% vs. 0%), successful ECMO weaning but in-hospital death (40.0% vs. 0%) were significantly lower in 30-day survivors than those in non-survivors (all p<0.05), whereas final thrombolysis in myocardial infarction (TIMI)-3 flow [53.6% vs. 91.9%] showed an opposite pattern compared to that of APACHE score in the two groups (p<0.02). Multivariate analysis demonstrated that unsuccessful reperfusion, failed ECMO weaning, and peak creatinine level were independent predictors of 30-day mortality (all p<0.01). Early ECMO-supported primary PCI in STEMI patients with profound CS was feasible as a life-saving strategy with acceptable 30-day and long-term prognostic outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Heart Transplant and Mechanical Circulatory Support in Patients With Advanced Heart Failure.

PubMed

Sánchez-Enrique, Cristina; Jorde, Ulrich P; González-Costello, José

2017-05-01

Patients with advanced heart failure have a poor prognosis and heart transplant is still the best treatment option. However, the scarcity of donors, long waiting times, and an increasing number of unstable patients have favored the development of mechanical circulatory support. This review summarizes the indications for heart transplant, candidate evaluation, current immunosuppression strategies, the evaluation and treatment of rejection, infectious prophylaxis, and short and long-term outcomes. Regarding mechanical circulatory support, we distinguish between short- and long-term support and the distinct strategies that can be used: bridge to decision, recovery, candidacy, transplant, and destination therapy. We then discuss indications, risk assessment, management of complications, especially with long-term support, and outcomes. Finally, we discuss future challenges and how the widespread use of long-term support for patients with advanced heart failure will only be viable if their complications and costs are reduced. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Connecting local support: A qualitative study exploring the role of voluntary organisations in long-term condition management.

PubMed

Morris, Rebecca; Kirk, Susan; Kennedy, Anne; Vassilev, Ivaylo; Mathieson, Amy; Jeffries, Mark; Blickem, Christian; Brooks, Helen; Sanders, Caroline; Rogers, Anne

2015-06-01

To examine the role of community groups to support people living with long-term conditions and the organisational factors that influence this role. Thirty-three semi-structured interviews were conducted with voluntary group organisers purposefully sampled in Greater Manchester from a local database of community groups. Interviews explored the organisations role in supporting people living with a long-term condition, their social networks and the origins of the groups. Respondents' construed their role in supporting individual capacity for management either explicitly (e.g. providing exercise) or implicitly (e.g. emotional support). This role was influenced by a combination of group ideology, funding and social networks. Analysis highlights the role of the non-clinical setting, the social support provided within the group, as well as organisational processes that influenced their capacity to support people living with long-term conditions. By examining the organisation of voluntary groups, this study highlights the way in which they may support or constrain access to an extended range of support for people with long-term conditions. This paper has implications for commissioning of services by the health service from the third sector because of the differing ideological perspectives and limited operational capacity. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Autonomous biological system-an unique method of conducting long duration space flight experiments for pharmaceutical and gravitational biology research

NASA Astrophysics Data System (ADS)

Anderson, G. A.; MacCallum, T. K.; Poynter, J. E.; Klaus, D., Dr.

1998-01-01

Paragon Space Development Corporation (SDC) has developed an Autonomous Biological System (ABS) that can be flown in space to provide for long term growth and breeding of aquatic plants, animals, microbes and algae. The system functions autonomously and in isolation from the spacecraft life support systems and with no mandatory crew time required for function or observation. The ABS can also be used for long term plant and animal life support and breeding on a free flyer space craft. The ABS units are a research tool for both pharmaceutical and basic space biological sciences. Development flights in May of 1996 and September, 1996 through January, 1997 were largely successful, showing both that the hardware and life systems are performing with beneficial results, though some surprises were still found. The two space flights, plus the current flight now on Mir, are expected to result in both a scientific and commercially usable system for breeding and propagation of animals and plants in space.

Sound data management as a foundation for natural resources management and science

USGS Publications Warehouse

Burley, Thomas E.

2012-01-01

Effective decision making is closely related to the quality and completeness of available data and information. Data management helps to ensure data quality in any discipline and supports decision making. Managing data as a long-term scientific asset helps to ensure that data will be usable beyond the original intended application. Emerging issues in water-resources management and climate variability require the ability to analyze change in the conditions of natural resources over time. The availability of quality, well-managed, and documented data from the past and present helps support this requirement.

Efficacy and durability of robotic Heller myotomy for achalasia: patient symptoms and satisfaction at long-term follow-up.

PubMed

Perry, Kyle A; Kanji, Aliyah; Drosdeck, Joseph M; Linn, John G; Chan, Anthony; Muscarella, Peter; Melvin, W Scott

2014-11-01

Laparoscopic Heller myotomy (LHM) has become the standard treatment for achalasia in the USA. Robot-assisted Heller myotomy (RHM) has emerged as an alternative approach due to improved visualization and fine motor control, but long-term follow-up studies have not been reported. We sought to report the long-term outcomes of RHM and compare them to those of LHM. A retrospective cohort study was performed for patients who underwent laparoscopic or RHM between 1995 and 2006. Long-term follow-up was performed via mail or telephone questionnaire. The primary outcome measure was durable relief of dysphagia without need for further intervention. Secondary outcomes included gastroesophageal reflux symptoms, disease-specific quality of life, and patient satisfaction with their operation. Seventy-five patients underwent laparoscopic (n = 19) or robotic (n = 56) myotomy during the study period. Long-term follow-up was obtained in 53 (71 %) patients with a median interval of 9 years. RHM was associated with a decreased mucosal injury rate (0 vs. 16 %, p = 0.01) and median hospital stay (1 vs. 2 days, p < 0.01) compared to conventional laparoscopy. All patients reported initial dysphagia relief, and 80 % required no further intervention. This did not differ between groups. Sixty-two percent required medications to control reflux symptoms at long-term follow-up, including 56 % following robotic myotomy and 80 % after laparoscopic myotomy (p = 0.27). Overall, 95 % of patients were satisfied with their operation, and 91 % would choose surgery again given the benefit of hindsight. There is a dearth of long-term follow-up data to support the effectiveness of RHM. This study demonstrates durable dysphagia relief in the vast majority of patients with a high degree of patient satisfaction and a low rate of esophageal mucosal injury. While a significant proportion of patients report reflux symptoms, these symptoms are well controlled with medical acid suppression.

Preferences for long-term care services: willingness to pay estimates derived from a discrete choice experiment.

PubMed

Nieboer, Anna P; Koolman, Xander; Stolk, Elly A

2010-05-01

Ageing populations increase pressure on long-term care. Optimal resource allocation requires an optimal mix of care services based on costs and benefits. Contrary to costs, benefits remain largely unknown. This study elicits preferences in the general elderly population for long-term care services for varying types of patients. A discrete choice experiment was conducted in a general population subsample aged 50-65 years (N = 1082) drawn from the Dutch Survey Sampling International panel. To ascertain relative preferences for long-term care and willingness to pay for these, participants were asked to choose the best of two care scenarios for four groups of hypothetical patients: frail and demented elderly, with and without partner. The scenarios described long-term care using ten attributes based on Social Production Function theory: hours of care, organized social activities, transportation, living situation, same person delivering care, room for individual preferences, coordination of services, punctuality, time on waiting list, and co-payments. We found the greatest value was attached to same person delivering care and transportation services. Low value was attached to punctuality and room for individual preferences. Nursing homes were generally considered to be detrimental for well-being except for dementia patients without a partner. Overall, long-term care services were thought to produce greatest well-being for the patients 'without a partner' and those 'with dementia'. Individuals combining these two risk factors would benefit the most from all services except transportation which was considered more important for the frail elderly. The results support the notion that long-term care services represent different value for different types of patients and that the value of a service depends upon the social context. Examination of patient profiles confirmed the notion that physical, mental and social vulnerability affect valuation of the services. Policy-making would profit from allocation models in which budgetary requirements of different services can be balanced against the well-being they produce for individuals. Copyright 2010 Elsevier Ltd. All rights reserved.

Calif. Puts Spotlight on Long-Term ELLs

ERIC Educational Resources Information Center

Maxwell, Lesli A.

2012-01-01

California is poised to become the first state to unmask the extent to which English-language learners (ELLs) languish in public schools for years without ever reaching fluency. Under a measure that received broad, bipartisan support from the legislature, the state education department would be required to break out and report data annually on…

Science Teachers' Representations of Classroom Practice in the Process of Formative Assessment Design

ERIC Educational Resources Information Center

Heredia, Sara C.; Furtak, Erin Marie; Morrison, Deb; Renga, Ian Parker

2016-01-01

Formative assessment has been recognized as an essential element of effective classroom practice; as a result, teachers are increasingly required to create formative assessments for their classrooms. This study examines data drawn from a long-term, site-based professional development program that supported a department of biology teachers in the…

78 FR 37106 - Streamlining Requirements Governing the Use of Funding for Supportive Housing for the Elderly and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... excessive, and instead are essential to assure long-term marketability and economic viability of these...) Smoke alarm giveaway and installation programs: an economic evaluation. American Journal of Preventive... 2008, 170 in 2009, and 143 in 2010), the overall economic impact from these potentially small changes...

The relevance of detection and attribution for loss and damage policy

NASA Astrophysics Data System (ADS)

Stone, D. A.; Huggel, C.; Auffhammer, M.; Cramer, W.; Eicken, H.; Hansen, G.; Wallimann, I.

2015-12-01

The concept of loss and damage (L&D), the residual adverse impacts of climate change beyond what can be addressed by adaptation, has featured as a central component of recent discussions on international climate policy, most notably in negotiations under the United Nations Framework Convention on Climate Change. However, it remains unclear what sort of scientific evidence will be required to inform L&D activities, including with respect to issues of responsibility, liability, compensation, and financing. Possible types of scientific evidence include simple observation of the occurrence of weather-related disaster, understanding of causation and the role of anthropogenic emissions, and the comparison of understanding of causation versus observations of long-term trends through detection and attribution (D&A) analysis.In this presentation we will discuss these questions in detail and consider the implications. If L&D policy leans towards a compensation rationale, then it will likely require the most comprehensive form of evidence of the role of anthropogenic emissions in observed L&D, in other words D&A analysis. However, this has restrictive requirements, for instance in the retrospective availability of long-term monitoring, that may be prohibitive in many situations. Unfortunately, conditions that lead to a dearth of sustained long-term monitoring often also lead to greater vulnerability and exposure, and are thus exactly the conditions that L&D activities are intended to address. On the other hand, if L&D activities are motivated as a mechanism for supporting adaptation they may not necessarily require D&A evidence, but can nevertheless benefit from the confirmation and calibration that D&A provides. Thus, even if L&D policy is not focused on compensation, building resources and capacity in long-term monitoring and its analysis remains a priority.

Operational improvements of long-term predicted ephemerides of the Tracking and Data Relay Satellites (TDRSs)

NASA Technical Reports Server (NTRS)

Kostoff, J. L.; Ward, D. T.; Cuevas, O. O.; Beckman, R. M.

1995-01-01

Tracking and Data Relay Satellite (TDRS) orbit determination and prediction are supported by the Flight Dynamics Facility (FDF) of the Goddard Space Flight Center (GSFC) Flight Dynamics Division (FDD). TDRS System (TDRSS)-user satellites require predicted TDRS ephemerides that are up to 10 weeks in length. Previously, long-term ephemerides generated by the FDF included predictions from the White Sands Complex (WSC), which plans and executes TDRS maneuvers. TDRSs typically have monthly stationkeeping maneuvers, and predicted postmaneuver state vectors are received from WSC up to a month in advance. This paper presents the results of an analysis performed in the FDF to investigate more accurate and economical long-term ephemerides for the TDRSs. As a result of this analysis, two new methods for generating long-term TDRS ephemeris predictions have been implemented by the FDF. The Center-of-Box (COB) method models a TDRS as fixed at the center of its stationkeeping box. Using this method, long-term ephemeris updates are made semiannually instead of weekly. The impulse method is used to model more maneuvers. The impulse method yields better short-term accuracy than the COB method, especially for larger stationkeeping boxes. The accuracy of the impulse method depends primarily on the accuracy of maneuver date forecasting.

Conceptual Distinctiveness Supports Detailed Visual Long-Term Memory for Real-World Objects

ERIC Educational Resources Information Center

Konkle, Talia; Brady, Timothy F.; Alvarez, George A.; Oliva, Aude

2010-01-01

Humans have a massive capacity to store detailed information in visual long-term memory. The present studies explored the fidelity of these visual long-term memory representations and examined how conceptual and perceptual features of object categories support this capacity. Observers viewed 2,800 object images with a different number of exemplars…

Baylor Gyro Pump: a completely seal-less centrifugal pump aiming for long-term circulatory support.

PubMed

Ohara, Y; Sakuma, I; Makinouchi, K; Damm, G; Glueck, J; Mizuguchi, K; Naito, K; Tasai, K; Orime, Y; Takatani, S

1993-07-01

A seal-less centrifugal pump aiming for long-term circulatory support has been developed. In this model, shaft seals that cause thrombus formation and blood leakage were eliminated. A brushless direct current motor was incorporated as a driving unit, and pivot bearings were used to support the impeller. With reference to its motor-driven system, this pump was named the M-Gyro Pump. The first model (M1) yielded an index of hemolysis of 0.005 g/100 L using bovine blood and demonstrated satisfactory performance as a right heart assist for 2 days (4 L/min, 60 mm Hg, 1,800 rpm). The second model (M2) has been developed for left heart assist by employing a stronger motor. The pump capacity was improved to 6 L/min against 240 mm Hg at 1,800 rpm, but significant heat generation was observed. By optimization of motor efficiency, the M2 model can be improved to meet the requirements of a pump for left heart assist.

Social networks, time homeless, and social support: A study of men on Skid Row.

PubMed

Green, Harold D; Tucker, Joan S; Golinelli, Daniela; Wenzel, Suzanne L

2013-12-18

Homeless men are frequently unsheltered and isolated, disconnected from supportive organizations and individuals. However, little research has investigated these men's social networks. We investigate the structure and composition of homeless men's social networks, vis-a-vis short- and long-term homelessness with a sample of men drawn randomly from meal lines on Skid Row in Los Angeles. Men continuously homeless for the past six months display networks composed of riskier members when compared to men intermittently homeless during that time. Men who report chronic, long-term homelessness display greater social network fragmentation when compared to non-chronically homeless men. While intermittent homelessness affects network composition in ways that may be addressable with existing interventions, chronic homelessness fragments networks, which may be more difficult to address with those interventions. These findings have implications for access to social support from network members which, in turn, impacts the resources homeless men require from other sources such as the government or NGOs.

Social networks, time homeless, and social support: A study of men on Skid Row

PubMed Central

Green, Harold D.; Tucker, Joan S.; Golinelli, Daniela; Wenzel, Suzanne L.

2014-01-01

Homeless men are frequently unsheltered and isolated, disconnected from supportive organizations and individuals. However, little research has investigated these men’s social networks. We investigate the structure and composition of homeless men’s social networks, vis-a-vis short- and long-term homelessness with a sample of men drawn randomly from meal lines on Skid Row in Los Angeles. Men continuously homeless for the past six months display networks composed of riskier members when compared to men intermittently homeless during that time. Men who report chronic, long-term homelessness display greater social network fragmentation when compared to non-chronically homeless men. While intermittent homelessness affects network composition in ways that may be addressable with existing interventions, chronic homelessness fragments networks, which may be more difficult to address with those interventions. These findings have implications for access to social support from network members which, in turn, impacts the resources homeless men require from other sources such as the government or NGOs. PMID:24466427

45 CFR 144.202 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships: Reporting... to a qualified long-term care insurance policy issued under a qualified State long-term care...

45 CFR 144.202 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships: Reporting... to a qualified long-term care insurance policy issued under a qualified State long-term care...

45 CFR 144.202 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships: Reporting... to a qualified long-term care insurance policy issued under a qualified State long-term care...

45 CFR 144.202 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships: Reporting... to a qualified long-term care insurance policy issued under a qualified State long-term care...

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

PubMed

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

2018-06-01

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

Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial.

PubMed

Roets-Merken, Lieve M; Zuidema, Sytse U; Vernooij-Dassen, Myrra J F J; Teerenstra, Steven; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

2018-01-24

To evaluate the effectiveness of a nurse-supported self-management programme to improve social participation of dual sensory impaired older adults in long-term care homes. Cluster randomised controlled trial. Thirty long-term care homes across the Netherlands. Long-term care homes were randomised into intervention clusters (n=17) and control clusters (n=13), involving 89 dual sensory impaired older adults and 56 licensed practical nurses. Nurse-supported self-management programme. Effectiveness was evaluated by the primary outcome social participation using a participation scale adapted for visually impaired older adults distinguishing four domains: instrumental activities of daily living, social-cultural activities, high-physical-demand and low-physical-demand leisure activities. A questionnaire assessing hearing-related participation problems was added as supportive outcome. Secondary outcomes were autonomy, control, mood and quality of life and nurses' job satisfaction. For effectiveness analyses, linear mixed models were used. Sampling and intervention quality were analysed using descriptive statistics. Self-management did not affect all four domains of social participation; however. the domain 'instrumental activities of daily living' had a significant effect in favour of the intervention group (P=0.04; 95% CI 0.12 to 8.5). Sampling and intervention quality was adequate. A nurse-supported self-management programme was effective in empowering the dual sensory impaired older adults to address the domain 'instrumental activities of daily living', but no differences were found in addressing the other three participation domains. Self-management showed to be beneficial for managing practical problems, but not for those problems requiring behavioural adaptations of other persons. NCT01217502; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Adjuvant psychological therapy in long-term endocrine conditions.

PubMed

Daniels, J; Turner-Cobb, J M

2017-06-01

Consideration of psychological distress in long-term endocrine conditions is of vital importance given the prevalence of anxiety and depression in such disorders. Poor mental health can lead to compromised self-care, higher utilization of health services, lower rates of adherence, reduced quality of life and ultimately poorer outcomes. Adjuvant psychological therapy offers an effective resource to reduce distress in endocrine conditions. While the vast majority of work in this area has focused on psychological screening and intervention in diabetes, identification and recognition of psychological distress are equally important in other endocrinological conditions, with supportive evidence in polycystic ovary syndrome and Addison's disease. Referral pathways and recommendations set out by UK guidelines and the Department of Health mandate requires greater attention across a wider range of long-term endocrine conditions to facilitate improved quality of life and health outcome. © 2017 John Wiley & Sons Ltd.

Role of percutaneous veno-arterial extracorporeal membrane oxygenation as bridge to left ventricular assist device.

PubMed

Toda, Koichi; Fujita, Tomoyuki; Seguchi, Osamu; Yanase, Masanobu; Nakatani, Takeshi

2018-03-01

Percutaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides emergency circulatory support for cardiogenic shock patients and is used as a bridge to a left ventricular assist device (LVAD). The purpose of this study was to determine risk factors for LVAD implantation in patients who required percutaneous VA-ECMO as a bridge to long-term LVAD. We retrospectively investigated 32 consecutive LVAD patients who required percutaneous VA-ECMO as a bridge to long-term LVAD. Twenty-nine patients (91%) were intubated, and their serum creatinine and total bilirubin levels before LVAD implantation were 2.1 ± 2.0 and 3.7 ± 3.7 mg/dl, respectively. Patients were supported by LVAD for 495 ± 393 days, during which 15 died, 6 recovered native cardiac functions and LVAD was explanted, and 11 underwent heart transplantation. Multivariate logistic regression analysis revealed that a preoperative left ventricular end-diastolic diameter (LVDd) ≤54 mm was a significant predictor of 90-day mortality after LVAD implantation (OR 13.64; 95% CI 1.081-172.0; p = 0.0433) and freedom from death during LVAD support was significantly worse in patients with an LVDd ≤54 mm. Furthermore, preoperative LVDd was positively correlated with postoperative right ventricular stroke work index (r = 0.739, p < 0.0001) and patients with an LVDd ≤54 mm had significantly worse postoperative right ventricular, renal, and hepatic functions. We demonstrated that percutaneous VA-ECMO could be utilized as a bridge to long-term LVAD in selected patients. Our results suggest that preoperative LVDd is a useful predictor of mortality and right ventricular function after LVAD implantation in patients requiring VA-ECMO, in whom assessment of right ventricular function is challenging.

Evidence for compliance with long-term medication: a systematic review of randomised controlled trials.

PubMed

King, Michelle A; Pryce, Rebecca L

2014-02-01

Pharmacists play a pivotal role in optimising medication use which often includes actions to maximise compliance with long-term medication. The best evidence to support medication use is derived from randomised controlled trials (RCTs). It is often assumed that 100 % compliance is required to obtain the outcomes identified in the trial. This assumption needs to be examined. To systematically review the reporting of compliance in RCTs of long-term medications. RCTs published in the New England Journal of Medicine, Journal of the American Medical Association, Lancet and BMJ in 2012, were reviewed to identify trials of medications for long-term use in adults. These trials were examined to evaluate the reporting of compliance. The proportion of trials reporting compliance data, the methods used, and the proportion of trials using more than one method to determine compliance. Of the 289 RCTs published in 2012, 25 assessed long-term medications in adults. Compliance was reported in 12 (48 %) studies and only 2 (8 %) studies used more than one method to measure compliance. Pill count was the most commonly reported method for measuring compliance, with patient reports and blood levels also being used. The reporting of compliance in RCTs is poor and the methodology inconsistent. The methods used overestimate compliance. If compliance in a clinical trial is low, the evidence for the effectiveness and most importantly safety of the medication(s) is questionable. Two or more methods, one of which is standardised, should be used to measure compliance in clinical trials. The requirement to report compliance should be included in publication guidelines.

Feeding preterm infants after hospital discharge: a commentary by the ESPGHAN Committee on Nutrition.

PubMed

Aggett, Peter J; Agostoni, Carlo; Axelsson, Irene; De Curtis, Mario; Goulet, Olivier; Hernell, Olle; Koletzko, Berthold; Lafeber, Harry N; Michaelsen, Kim F; Puntis, John W L; Rigo, Jacques; Shamir, Raanan; Szajewska, Hania; Turck, Dominique; Weaver, Lawrence T

2006-05-01

Survival of small premature infants has markedly improved during the last few decades. These infants are discharged from hospital care with body weight below the usual birth weight of healthy term infants. Early nutrition support of preterm infants influences long-term health outcomes. Therefore, the ESPGHAN Committee on Nutrition has reviewed available evidence on feeding preterm infants after hospital discharge. Close monitoring of growth during hospital stay and after discharge is recommended to enable the provision of adequate nutrition support. Measurements of length and head circumference, in addition to weight, must be used to identify those preterm infants with poor growth that may need additional nutrition support. Infants with an appropriate weight for postconceptional age at discharge should be breast-fed when possible. When formula-fed, such infants should be fed regular infant formula with provision of long-chain polyunsaturated fatty acids. Infants discharged with a subnormal weight for postconceptional age are at increased risk of long-term growth failure, and the human milk they consume should be supplemented, for example, with a human milk fortifier to provide an adequate nutrient supply. If formula-fed, such infants should receive special postdischarge formula with high contents of protein, minerals and trace elements as well as an long-chain polyunsaturated fatty acid supply, at least until a postconceptional age of 40 weeks, but possibly until about 52 weeks postconceptional age. Continued growth monitoring is required to adapt feeding choices to the needs of individual infants and to avoid underfeeding or overfeeding.

Long-Term Preservation and Advanced Access Services to Archived Data: The Approach of a System Integrator

NASA Astrophysics Data System (ADS)

Petitjean, Gilles; de Hauteclocque, Bertrand

2004-06-01

EADS Defence and Security Systems (EADS DS SA) have developed an expertise as integrator of archive management systems for both their commercial and defence customers (ESA, CNES, EC, EUMETSAT, French MOD, US DOD, etc.), especially in Earth Observation and in Meteorology fields.The concern of valuable data owners is both their long-term preservation but also the integration of the archive in their information system with in particular an efficient access to archived data for their user community. The system integrator answers to this requirement by a methodology combining understanding of user needs, exhaustive knowledge of the existing solutions both for hardware and software elements and development and integration ability. The system integrator completes the facility development by support activities.The long-term preservation of archived data obviously involves a pertinent selection of storage media and archive library. This selection relies on storage technology survey but the selection criteria depend on the analysis of the user needs. The system integrator will recommend the best compromise for implementing an archive management facility, thanks to its knowledge and its independence of storage market and through the analysis of the user requirements. He will provide a solution, which is able to evolve to take advantage of the storage technology progress.But preserving the data for long-term is not only a question of storage technology. Some functions are required to secure the archive management system against contingency situation: multiple data set copies using operational procedures, active quality control of the archived data, migration policy optimising the cost of ownership.

Long-term depression-associated signaling is required for an in vitro model of NMDA receptor-dependent synapse pruning

PubMed Central

Henson, Maile A.; Tucker, Charles J.; Zhao, Meilan; Dudek, Serena M.

2016-01-01

Activity-dependent pruning of synaptic contacts plays a critical role in shaping neuronal circuitry in response to the environment during postnatal brain development. Although there is compelling evidence that shrinkage of dendritic spines coincides with synaptic long-term depression (LTD), and that LTD is accompanied by synapse loss, whether NMDA receptor (NMDAR)-dependent LTD is a required step in the progression toward synapse pruning is still unknown. Using repeated applications of NMDA to induce LTD in dissociated rat neuronal cultures, we found that synapse density, as measured by colocalization of fluorescent markers for pre- and postsynaptic structures, was decreased irrespective of the presynaptic marker used, post-treatment recovery time, and the dendritic location of synapses. Consistent with previous studies, we found that synapse loss could occur without apparent net spine loss or cell death. Furthermore, synapse loss was unlikely to require direct contact with microglia, as the number of these cells was minimal in our culture preparations. Supporting a model by which NMDAR-LTD is required for synapse loss, the effect of NMDA on fluorescence colocalization was prevented by phosphatase and caspase inhibitors. In addition, gene transcription and protein translation also appeared to be required for loss of putative synapses. These data support the idea that NMDAR-dependent LTD is a required step in synapse pruning and contribute to our understanding of the basic mechanisms of this developmental process. PMID:27794462

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

PubMed

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

2001-01-01

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

Is short-term PEG-tube placement beneficial in acutely ill cognitively intact elderly patients? A proposed decision making algorithm

PubMed Central

Abraham, Rtika R; Girotra, Mohit; Wei, Jeanne Y.; Azhar, Gohar

2014-01-01

Aim Percutaneous Endoscopic Gastrostomy (PEG) tube is an important method of enteral feeding for patients who require temporary or long-term artificial nutritional support to prevent or correct disease-related malnutrition. However, there is paucity of data on the utility of short-term PEG tube placements in acute illnesses in cognitively intact elderly. Methods We present a series of seven, cognitively intact patients (age range = 72 to 93 years), who had PEG tubes placed for short periods. These patients were diagnosed with “failure to thrive” and were managed by placing a PEG tube temporarily for nutritional management. None of these patients had terminal illness or hospice eligibility and all of our patients were community dwellers. Results All our elderly patients experienced good outcomes in terms of their functional status and nutritional support. Conclusions Our series clearly supports the notion that short-term PEG tube placement in cognitively-intact elderly patients could be a successful strategy to support them during an episode of acute illness and to improve their nutritional deficits and survival. PMID:25109444

Adolescents with perinatally acquired HIV: emerging behavioral and health needs for long-term survivors.

PubMed

Koenig, Linda J; Nesheim, Steven; Abramowitz, Susan

2011-10-01

Because of widespread availability of highly active antiretroviral therapy in the developed world, a large proportion of children with perinatally acquired HIV have survived to adolescence and young adulthood. Although their survival is remarkable, many now experience the long-term effects of HIV infection and its treatment. Further, as these youths have entered adolescence, more is known about the impact of normative developmental transitions on health maintenance behaviors. Although perinatally infected adolescents are healthier than they were a decade or more ago, they are significantly experienced with antiretroviral therapy, with increased virological resistance and other consequences of extended antiretroviral use. Three behavioral health challenges have been documented in the first cohort of long-term survivors: decreased medication adherence, sexual debut and accompanying pregnancy and transmission risk, and mental health problems. These issues are consistent with a developmental press for autonomy, mature sexual relationships and future planning, but must be carefully managed to preserve health. Adolescents with perinatally acquired HIV require coordinated multidisciplinary support services - including adherence support, reproductive health counseling addressing both pregnancy planning and disease transmission, and mental health and educational/vocational planning - so that they can fully benefit from treatment advances. (C) 2011 Lippincott Williams & Wilkins, Inc.

Slowing extrusion tectonics: Lowered estimate of post-Early Miocene slip rate for the Altyn Tagh fault

USGS Publications Warehouse

Yue, Y.; Ritts, B.D.; Graham, S.A.; Wooden, J.L.; Gehrels, G.E.; Zhang, Z.

2004-01-01

Determination of long-term slip rate for the Altyn Tagh fault is essential for testing whether Asian tectonics is dominated by lateral extrusion or distributed crustal shortening. Previous slip-history studies focused on either Quaternary slip-rate measurements or pre-Early Miocene total-offset estimates and do not allow a clear distinction between rates based on the two. The magmatic and metamorphic history revealed by SHRIMP zircon dating of clasts from Miocene conglomerate in the Xorkol basin north of the Altyn Tagh fault strikingly matches that of basement in the southern Qilian Shan and northern Qaidam regions south of the fault. This match requires that the post-Early Miocene long-term slip rate along the Altyn Tagh fault cannot exceed 10 mm/year, supporting the hypothesis of distributed crustal thickening for post-Early Miocene times. This low long-term slip rate and recently documented large pre-Early Miocene cumulative offset across the fault support a two-stage evolution, wherein Asian tectonics was dominated by lateral extrusion before the end of Early Miocene, and since then has been dominated by distributed crustal thickening and rapid plateau uplift. ?? 2003 Elsevier B.V. All rights reserved.

Strategies for Stabilizing Nitrogenous Compounds in ECLSS Wastewater: Top-Down System Design and Unit Operation Selection with Focus on Bio-Regenerative Processes for Short and Long Term Scenarios

NASA Technical Reports Server (NTRS)

Lunn, Griffin M.

2011-01-01

Water recycling and eventual nutrient recovery is crucial for surviving in or past low earth orbit. New approaches and syste.m architecture considerations need to be addressed to meet current and future system requirements. This paper proposes a flexible system architecture that breaks down pretreatment , steps into discrete areas where multiple unit operations can be considered. An overview focusing on the urea and ammonia conversion steps allows an analysis on each process's strengths and weaknesses and synergy with upstream and downstream processing. Process technologies to be covered include chemical pretreatment, biological urea hydrolysis, chemical urea hydrolysis, combined nitrification-denitrification, nitrate nitrification, anammox denitrification, and regenerative ammonia absorption through struvite formation. Biological processes are considered mainly for their ability to both maximize water recovery and to produce nutrients for future plant systems. Unit operations can be considered for traditional equivalent system mass requirements in the near term or what they can provide downstream in the form of usable chemicals or nutrients for the long term closed-loop ecological control and life support system. Optimally this would allow a system to meet the former but to support the latter without major modification.

Mathematical Modeling of Food Supply for Long Term Space Missions Using Advanced Life Support

NASA Technical Reports Server (NTRS)

Cruthirds, John E.

2003-01-01

A habitat for long duration missions which utilizes Advanced Life Support (ALS), the Bioregenerative Planetary Life Support Systems Test Complex (BIO-Plex), is currently being built at JSC. In this system all consumables will be recycled and reused. In support of this effort, a menu is being planned utilizing ALS crops that will meet nutritional and psychological requirements. The need exists in the food system to identify specific physical quantities that define life support systems from an analysis and modeling perspective. Once these quantities are defined, they need to be fed into a mathematical model that takes into consideration other systems in the BIO-Plex. This model, if successful, will be used to understand the impacts of changes in the food system on the other systems and vice versa. The Equivalent System Mass (ESM) metric has been used to describe systems and subsystems, including the food system options, in terms of the single parameter, mass. There is concern that this approach might not adequately address the important issues of food quality and psychological impact on crew morale of a supply of fiesh food items. In fact, the mass of food can also depend on the quality of the food. This summer faculty fellow project will involve creating an appropriate mathematical model for the food plan developed by the Food Processing System for BIO-Plex. The desired outcome of this work will be a quantitative model that can be applied to the various options of supplying food on long-term space missions.

Capacity building in food composition for Africa.

PubMed

Schönfeldt, Hettie C; Hall, Nicolette

2013-10-01

Capacity building in food and nutrition involves more than formal training and individual development. Such a process is long term and continues, requiring lasting mentorship, coaching and leadership development, including individual commitment to continued self-development. It expands to include the development of knowledge and skills of an individual within his/her organizational or institutional arrangements, and requires buy-in and support from his/her institution or organization, as well as other funding bodies involved in agriculture and health. It needs to be supported by government and be part of the regional and international agenda for agriculture and health. Under the auspices of International Network of Food Data Systems (INFOODS), an African Network of Food Data Systems (AFROFOODS) was established in September 1994, and a number of training courses, educational and scientific publications, posters, presentations and visits were hosted, organized and delivered with the aim to build enthusiasm, long term commitment and capacity in food composition within the AFROFOODS region. Formal training and human resource development were the major focus to take food composition forward in Africa. Significant progress was made in food composition activities, but constraints including lack of organizational and institutional commitment and financial support are straining the pace of progress. Copyright © 2013 Elsevier Ltd. All rights reserved.

Recent developments in supporting adolescent and young adult siblings of cancer patients.

PubMed

Patterson, Pandora; Medlow, Sharon; McDonald, Fiona E J

2015-07-01

The psychosocial needs of adolescent and young adult (AYA) siblings of cancer patients are easily overlooked. Accordingly, the evidence base informing short and long-term outcomes for these young people is sparse. This review provides an overview of recent research highlighting the experiences, unmet needs and psychosocial issues of AYA siblings, together with recent interventions. The reviewed studies bring focus to the range of informational and supportive care needs that typically remain unmet in AYA siblings. The limited number of interventions designed specifically for this group not only appear to have positive results but also underscore the need for effective risk stratification preintervention and tailoring of interventions to the specific needs of participants. AYA siblings of cancer patients display a range of psychosocial symptoms that can be ameliorated with age-appropriate information and targeted intervention programs. Limited research suggests that the majority of unmet needs for AYA siblings seem to occur during the acute phases of the brother or sister's initial diagnosis, treatment and relapse. Further research is required on siblings' long-term psychosocial assessment and management, bereavement, family systems, the impact of the cancer experience on siblings' personality and identity, and the development and evaluation of tailored psychosocial interventions. Policy research is also required to identify opportunities for expanding established healthcare systems to include sibling support.

Projected trends in forest habitat classes under climate and land-use change scenarios

Treesearch

Brian G. Tavernia; Mark D. Nelson; Brian F. Walters; Chris Toney

2012-01-01

Wildlife species have diverse and sometimes conflicting habitat requirements. To support diverse wildlife communities, natural resource managers need to manage for a variety of habitats across a large area and to create long-term management plans to ensure this variety is maintained. In these efforts, managers would benefit from assessments of potential climate and...

The Effect of a Simple Simulation Game on Long-Term Vocabulary Retention

ERIC Educational Resources Information Center

Franciosi, Stephan J.; Yagi, Junichi; Tomoshige, Yuuki; Ye, Suying

2016-01-01

Recent studies have shown that simulation games may be useful tools for supporting foreign language education. However, much of this research has focused on games using 3D graphic technology, which entail technical requirements that may render them too complex for use in many educational contexts. Accordingly, we wanted to determine if less…

Short and long-term energy intake patterns and their implications for human body weight regulation.

PubMed

Chow, Carson C; Hall, Kevin D

2014-07-01

Adults consume millions of kilocalories over the course of a few years, but the typical weight gain amounts to only a few thousand kilocalories of stored energy. Furthermore, food intake is highly variable from day to day and yet body weight is remarkably stable. These facts have been used as evidence to support the hypothesis that human body weight is regulated by active control of food intake operating on both short and long time scales. Here, we demonstrate that active control of human food intake on short time scales is not required for body weight stability and that the current evidence for long term control of food intake is equivocal. To provide more data on this issue, we emphasize the urgent need for developing new methods for accurately measuring energy intake changes over long time scales. We propose that repeated body weight measurements can be used along with mathematical modeling to calculate long-term changes in energy intake and thereby quantify adherence to a diet intervention and provide dynamic feedback to individuals that seek to control their body weight. Published by Elsevier Inc.

Short and long-term energy intake patterns and their implications for human body weight regulation

PubMed Central

Chow, Carson C.; Hall, Kevin D.

2014-01-01

Adults consume millions of kilocalories over the course of a few years, but the typical weight gain amounts to only a few thousand kilocalories of stored energy. Furthermore, food intake is highly variable from day to day and yet body weight is remarkably stable. These facts have been used as evidence to support the hypothesis that human body weight is regulated by active control of food intake operating on both short and long time scales. Here, we demonstrate that active control of human food intake on short time scales is not required for body weight stability and that the current evidence for long term control of food intake is equivocal. To provide more data on this issue, we emphasize the urgent need for developing new methods for accurately measuring energy intake changes over long time scales. We propose that repeated body weight measurements can be used along with mathematical modeling to calculate long-term changes in energy intake and thereby quantify adherence to a diet intervention and provide dynamic feedback to individuals that seek to control their body weight. PMID:24582679

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

NASA Astrophysics Data System (ADS)

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

2016-04-01

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

Public funding - a solution for technological SMEs and entrepreneurs

NASA Astrophysics Data System (ADS)

Emilia, Calefariu; Traian Alexandru, Buda

2016-11-01

Technological SMEs are in a constant struggle for growth or sometimes maintaining the production capacity, increase market share, supporting tax burden, ensuring employees' salaries, profit growth. They constantly consider short-term survival of the company, with trying to maintain a long-term uptrend for the business. Entrepreneurs are again in a position to access public financing under quite favorable conditions. The paper aims to analyze the opportunity of accessing these external financing options, which have both advantages and a series of long-term constraints which should not be excluded before the final decision to access this funding. New research is required, thus sustainable development can be maintained for the business environment in order to increase efficiency, competitiveness, sustainable development strategies that generate job security, regional growth and rewarding the risk-taking of the entrepreneur.

Using Iterative Repair to Increase the Responsiveness of Planning and Scheduling for Autonomous Spacecraft

NASA Technical Reports Server (NTRS)

Chien, Steve; Knight, Russell; Stechert, Andre; Sherwood, Rob; Rabideau, Gregg

1998-01-01

An autonomous spacecraft must balance long-term and short-term considerations. It must perform purposeful activities that ensure long-term science and engineering goals are achieved and ensure that it maintains positive resource margins. This requires planning in advance to avoid a series of shortsighted decisions that can lead to failure, However, it must also respond in a timely fashion to a somewhat dynamic and unpredictable environment. Thus, spacecraft plans must often be modified due to fortuitous events such as early completion of observations and setbacks such as failure to acquire a guidestar for a science observation. This paper describes the use of iterative repair to support continuous modification and updating of a current working plan in light of changing operating context.

Pneumococcal Vaccination Guidance for Post-Acute and Long-Term Care Settings: Recommendations From AMDA's Infection Advisory Committee.

PubMed

Nace, David A; Archbald-Pannone, Laurie R; Ashraf, Muhammad S; Drinka, Paul J; Frentzel, Elizabeth; Gaur, Swati; Mahajan, Dheeraj; Mehr, David R; Mercer, William C; Sloane, Philip D; Jump, Robin L P

2017-02-01

Efforts at preventing pneumococcal disease are a national health priority, particularly in older adults and especially in post-acute and long-term care settings The Advisory Committee on Immunization Practices recommends that all adults ≥65 years of age, as well as adults 18-64 years of age with specific risk factors, receive both the recently introduced polysaccharide-protein conjugate vaccine against 13 pneumococcal serotypes as well as the polysaccharide vaccine against 23 pneumococcal serotypes. Nursing facility licensure regulations require facilities to assess the pneumococcal vaccination status of each resident, provide education regarding pneumococcal vaccination, and administer the appropriate pneumococcal vaccine when indicated. Sorting out the indications and timing for 13 pneumococcal serotypes and 23 pneumococcal serotypes administration is complex and presents a significant challenge to healthcare providers. Here, we discuss the importance of pneumococcal vaccination for older adults, detail AMDA-The Society for Post-Acute and Long-Term Care Medicine (The Society)'s recommendations for pneumococcal vaccination practice and procedures, and offer guidance to postacute and long-term care providers supporting the development and effective implementation of pneumococcal vaccine policies. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

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

PubMed

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

2005-04-01

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

Do interventions with staff in long-term residential facilities improve quality of care or quality for life people with dementia? A systematic review of the evidence.

PubMed

Bird, Mike; Anderson, Katrina; MacPherson, Sarah; Blair, Annaliese

2016-12-01

Common sense suggests and research indicates relationships between staff factors in residential dementia care and quality of life (QOL) for residents, with poor care increasing suffering. However, we do not have a coherent picture of which staff interventions have an impact on quality of care (QOC) or resident QOL. A comprehensive search of 20 years' peer-reviewed literature using Medline, PsycINFO, Embase, PubMed, CINAHL, and the Cochrane, Campbell Collaboration identified 4,760 studies meriting full text review. Forty-six met the inclusion criteria, namely interventions in long-term facilities helping staff develop their capacity to provide better care and/or QOL for residents with dementia. Thirty-five other papers comprised an associated predictor review. Conclusions from these limited data are further compromised because nine studies failed to measure effects on residents and only half assessed effects after the project team withdrew. Of these, excellent studies produced change over the medium (3-4 months) or longer term, including reduction in challenging behavior and restraint use but this applied only to a minority. A number of studies failed to measure effects on QOC, limiting conclusions about mechanisms underlying change. In general, level of intervention required depended on the target. For outcomes like restraint use, structured education sessions with some support appear adequate. Programs to reduce pain require more support. For complicated issues like challenging behavior and increasing co-operation in showering, detailed, supportive, on-site interventions are required. Improvements in restraint and staff/resident interactions were the most promising findings. (Review registration number: PROSPERO 2014:CRD42014015224).

Pulsatile mechanical cardiac assistance in pediatric patients with the Berlin heart ventricular assist device.

PubMed

Merkle, Frank; Boettcher, Wolfgang; Stiller, Brigitte; Hetzer, Roland

2003-06-01

Mechanical cardiac assistance for neonates, infants, children and adolescents may be accomplished with pulsatile ventricular assist devices (VAD) instead of extracorporeal membrane oxygenation or centrifugal pumps. The Berlin Heart VAD consists of extracorporeal, pneumatically driven blood pumps for pulsatile univentricular or biventricular assistance for patients of all age groups. The blood pumps are heparin-coated. The stationary driving unit (IKUS) has the required enhanced compressor performance for pediatric pump sizes. The Berlin Heart VAD was used in a total number of 424 patients from 1987 to November 2001 at our institution. In 45 pediatric patients aged 2 days-17 years the Berlin Heart VAD was applied for long-term support (1-111 days, mean 20 days). There were three patient groups: Group I: "Bridge to transplantation" with various forms of cardiomyopathy (N = 21) or chronic stages of congenital heart disease (N = 9); Group II: "Rescue" in intractable heart failure after corrective surgery for congenital disease (N = 7) or in early graft failure after heart transplantation (N = 1); and Group III: "Acute myocarditis" (N = 7) as either bridge to transplantation or bridge to recovery. Seventeen patients were transplanted after support periods of between 4 and 111 days with 12 long-term survivors, having now survived for up to 10 years. Five patients (Groups I and III) were weaned from the system with four long-term survivors. In Group II only one patient survived after successful transplantation. Prolonged circulatory support with the Berlin Heart VAD is an effective method for bridging until cardiac recovery or transplantation in the pediatric age group. Extubation, mobilization, and enteral nutrition are possible. For long-term use, the Berlin Heart VAD offers advantages over centrifugal pumps and ECMO in respect to patient mobility and safety.

Cryogenic Fluid Management Technologies for Advanced Green Propulsion Systems

NASA Technical Reports Server (NTRS)

Motil, Susan M.; Meyer, Michael L.; Tucker, Stephen P.

2007-01-01

In support of the Exploration Vision for returning to the Moon and beyond, NASA and its partners are developing and testing critical cryogenic fluid propellant technologies that will meet the need for high performance propellants on long-term missions. Reliable knowledge of low-gravity cryogenic fluid management behavior is lacking and yet is critical in the areas of tank thermal and pressure control, fluid acquisition, mass gauging, and fluid transfer. Such knowledge can significantly reduce or even eliminate tank fluid boil-off losses for long term missions, reduce propellant launch mass and required on-orbit margins, and simplify vehicle operations. The Propulsion and Cryogenic Advanced Development (PCAD) Project is performing experimental and analytical evaluation of several areas within Cryogenic Fluid Management (CFM) to enable NASA's Exploration Vision. This paper discusses the status of the PCAD CFM technology focus areas relative to the anticipated CFM requirements to enable execution of the Vision for Space Exploration.

Improving DLA Aviation Engineering’s Support to its Customers and the DoD Supply Chain

DTIC Science & Technology

2014-10-01

costs and first article test costs) and (2) DLA supply chain responsiveness as measured in terms of the days required to satisfy unfilled orders ( UFOs ...135,000 UFOs or requisitions at any time. This number of UFOs overstates the magnitude of the backorder problem since many of these backorders are...backorders or long term unfilled orders ( UFOs ). This can have serious implications for the materiel readiness of those weapon systems that utilize

Training of Ability for Engineering Design through Long Term Internship Program

NASA Astrophysics Data System (ADS)

Konishi, Masami; Gofuku, Akio; Tomita, Eiji

The education program for engineering design capabilities through long term internship of Okayama University had started in 2006. The program supported by the MEXT is aimed to educate students in the Graduate School of Natural Science and Technology of Okayama University. The internship satellite laboratory of the University is settled in the near place of collaborative companies in which students are engaged with the project themes extracted from problems in the factory of collaborative companies. Through the program, promotion of abilities for setup and solving a problem considering cost and due date together with performance of the solution. Students are also expected to gain knowledge on patent and ethics required for skillful engineers.

NASA Battery Working Group - 2007-2008: Battery Task Summary Report

NASA Technical Reports Server (NTRS)

Manzo, Michelle

2008-01-01

This presentation provides a summary of the 2007-2008 NASA Battery Working Group efforts completed in support of the NASA Engineering Safety Center (NESC). The effort covered a series of pro-active tasks that address the following: Binding Procurements -- guidelines related to requirements for the battery system that should be considered at the time of contract award Wet Life of Ni-H2 Batteries -- issues/strategies for effective storage and impact of long-term storage on performance and life Generic Guidelines for Lithium-ion Safety, Handling and Qualification -- Standardized approaches developed and risk assessments (1) Lithium-ion Performance Assessment -- survey of manufacturers and capabilities to meet mission needs. Guidelines document generated (2) Conditions Required for using Pouch Cells in Aerospace Missions -- focus on corrosion, thermal excursions and long-term performance issues. Document defining requirements to maintain performance and life (3) High Voltage Risk Assessment -- focus on safety and abuse tolerance of battery module assemblies. Recommendations of features required for safe implementation (4) Procedure for Determination of Safe Charge Rates -- evaluation of various cell chemistries and recommendation of safe operating regimes for specific cell designs

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

PubMed

Sawamura, Kanae; Sano, Hiroshi; Nakanishi, Miharu

2015-04-01

Expenditures on long-term care insurance (LTCI) in Japan have been increasing with the aging of the population, which has led to an increase in premiums. To optimize resource allocation, we aim to clarify the priorities of the functions of long-term care facilities from the viewpoint of future beneficiaries. The present study was conducted using a cross-sectional study design. We conducted a mail-in survey targeting 2400 adults aged 50-65 in 8 cities in Japan, and 371 persons responded. Conjoint analysis was applied to measure participants' preferences for long-term care facility services. Participants read 1 of 2 vignettes of an 80-year-old person with either dementia or a fracture, and were asked to envision it as a possible future scenario for themselves. Participants then completed 8 or 9 tasks to select suitable long-term care facilities for the person described. The questionnaire also contained common questions on participants' personal profiles: age, gender, family situation, education, approximate yearly family income, experience as a family caregiver, dwelling status, present health status, and possibility of requiring long-term care services in the future. The results focused mainly on (1) possibilities of individual choice for daily schedules/meals; (2) availability of regular care staff; (3) room; (4) main daily interactions; (5) necessity of relocation associated with medical deterioration; 6) Waiting time; 7) distance from present residence; and (8) monthly fees. Necessity of relocation associated with medical deterioration was consistently given the greatest importance. Participants with experience as a family caregiver showed significantly greater preference for individualized care and communication. The option of avoiding relocation was highly valued by participants compared with private rooms and individualized care. The present situation of high demand for intensive care homes for the elderly, provoked by anxiety about future residence, will not change unless a robust system is built to support residents even when their health has deteriorated. Individualized care has been promoted by long-term care insurance policies, but further advances will require efforts to obtain the understanding of the insured. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Medicare Disease Management in Policy Context

PubMed Central

Linden, Ariel; Adler-Milstein, Julia

2008-01-01

Interim results of the Medicare health support (MHS) demonstration projects suggest that commercial disease management (DM) is unable to deliver short-term medical cost savings. This is not surprising given the current DM program focus on compliance with process measures that may only lead to cost savings in the long term. A program focused on reducing near-term hospitalizations is more likely to deliver savings during the initial 3-year phase of MHS. If the early trends in MHS are indicative of the final results, CMS will face the decision of whether to abandon commercial DM in favor of other chronic care management strategies. This article supports the upcoming assessment by describing the characteristics of the current commercial DM model that limit its ability to deliver short-term medical cost savings and the changes required to overcome these limitations. PMID:18567239

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

PubMed

Choe, Kwisoon; Kang, Hyunwook; Lee, Aekyung

2018-03-01

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

Integrated Science and Logistical Planning to Support Big Questions in Antarctic Science

NASA Astrophysics Data System (ADS)

Vaughan, D. G.; Stockings, T. M.

2015-12-01

Each year, British Antarctic Survey (BAS) supports an extensive programme of science at five Antarctic and sub-Antarctic stations, ranging from the tiny Bird Island Research Station at 54°S in the South Atlantic, to the massive, and fully re-locatable, Halley Research Station on Brunt Ice Shelf at 75°S. The BAS logistics hub, Rothera Research Station on the Antarctic Peninsula supports deployment of deep-field and airborne field campaigns through much of the Antarctic continent, and an innovative new UK polar research vessel is under design, and planned to enter service in the Southern Ocean in 2019. BAS's core science programme covering all aspects of physical, biological and geological science is delivered by our own science teams, but every year many other UK scientists and overseas collaborators also access BAS's Antarctic logistics to support their own programmes. As an integrated science and logistics provider, BAS is continuously reviewing its capabilities and operational procedures to ensure that the future long-term requirements of science are optimally supported. Current trends are towards providing the capacity for heavier remote operations and larger-scale field camps, increasing use of autonomous ocean and airborne platforms, and increasing opportunities to provide turnkey solutions for low-cost experimental deployments. This talk will review of expected trends in Antarctic science and the opportunities to conduct science in Antarctica. It will outline the anticipated logistic developments required to support future stakeholder-led and strategically-directed science programmes, and the long-term ambitions of our science communities indentified in several recent horizon-scanning activities.

Characterization of Ancient DNA Supports Long-Term Survival of Haloarchaea

PubMed Central

Lowenstein, Tim K.; Timofeeff, Michael N.; Schubert, Brian A.; Lum, J. Koji

2014-01-01

Abstract Bacteria and archaea isolated from crystals of halite 104 to 108 years old suggest long-term survival of halophilic microorganisms, but the results are controversial. Independent verification of the authenticity of reputed living prokaryotes in ancient salt is required because of the high potential for environmental and laboratory contamination. Low success rates of prokaryote cultivation from ancient halite, however, hamper direct replication experiments. In such cases, culture-independent approaches that use the polymerase chain reaction (PCR) and sequencing of 16S ribosomal DNA are a robust alternative. Here, we use amplification, cloning, and sequencing of 16S ribosomal DNA to investigate the authenticity of halophilic archaea cultured from subsurface halite, Death Valley, California, 22,000 to 34,000 years old. We recovered 16S ribosomal DNA sequences that are identical, or nearly so (>99%), to two strains, Natronomonas DV462A and Halorubrum DV427, which were previously isolated from the same halite interval. These results provide the best independent support to date for the long-term survival of halophilic archaea in ancient halite. PCR-based approaches are sensitive to small amounts of DNA and could allow investigation of even older halites, 106 to 108 years old, from which microbial cultures have been reported. Such studies of microbial life in ancient salt are particularly important as we search for microbial signatures in similar deposits on Mars and elsewhere in the Solar System. Key Words: Ancient DNA—Halite—Haloarchaea—Long-term survival. Astrobiology 14, 553–560. PMID:24977469

Beyond the biosphere. [aerospace environments and human life support

NASA Technical Reports Server (NTRS)

Nicogossian, A. E.; Parker, J. F.

1985-01-01

The near-earth-space, planetary and interplanetary environments are described with emphasis on their biomedical significance. The characteristics of the microgravity field, low gravity and radiation conditions in earth orbit are described, noting the necessity of avoiding materials which can outgas toxic substances during long-term mission. Details of the atmospheres, global meteorology, and terrains of Venus, Mars, Jupiter, the Jovian satellites, and Saturn are reviewed. Finally, a brief discussion is provided of the life-support systems which will be required on interstellar voyages.

A critical review of the use of technology to provide psychosocial support for children and young people with long-term conditions.

PubMed

Aldiss, Susie; Baggott, Christina; Gibson, Faith; Mobbs, Sarah; Taylor, Rachel M

2015-01-01

Advances in technology have offered health professionals alternative mediums of providing support to patients with long-term conditions. This critical review evaluated and assessed the benefit of electronic media technologies in supporting children and young people with long-term conditions. Of 664 references identified, 40 met the inclusion criteria. Supportive technology tended to increase disease-related knowledge and improve aspects of psychosocial function. Supportive technology did not improve quality of life, reduce health service use or decrease school absences. The poor methodological quality of current evidence and lack of involvement of users in product development contribute to the uncertainty that supportive technology is beneficial. Copyright © 2015 Elsevier Inc. All rights reserved.

Themes of a Long-Term AIDS Support Group for Gay Men.

ERIC Educational Resources Information Center

Stewart, Greig M.; Gregory, Barry C.

1996-01-01

Support groups are established psychosocial treatment modalities where clients address particular problems or diagnoses. Discusses a long-term (five year) AIDS support group and examines the following issues: (1) marginality; (2) making choices; (3) coping with emotions; (4) premature confrontation of life issues; (5) chronic illness versus…

Insulin signaling is acutely required for long-term memory in Drosophila.

PubMed

Chambers, Daniel B; Androschuk, Alaura; Rosenfelt, Cory; Langer, Steven; Harding, Mark; Bolduc, Francois V

2015-01-01

Memory formation has been shown recently to be dependent on energy status in Drosophila. A well-established energy sensor is the insulin signaling (InS) pathway. Previous studies in various animal models including human have revealed the role of insulin levels in short-term memory but its role in long-term memory remains less clear. We therefore investigated genetically the spatial and temporal role of InS using the olfactory learning and long-term memory model in Drosophila. We found that InS is involved in both learning and memory. InS in the mushroom body is required for learning and long-term memory whereas long-term memory specifically is impaired after InS signaling disruption in the ellipsoid body, where it regulates the level of p70s6k, a downstream target of InS and a marker of protein synthesis. Finally, we show also that InS is acutely required for long-term memory formation in adult flies.

High Frequency, Long Time Series Measurements from the Bermuda Testbed Mooring in Support of SIMBIOS. Chapter 8

NASA Technical Reports Server (NTRS)

Dickey, Tommy; Dobeck, Laura; Sigurdson, David; Zedler, Sarah; Manov, Derek; Yu, Xuri

2001-01-01

It has been recognized that optical moorings are important platforms for the validation of Sea-Viewing Wide Field-of-view Sensor (SeaWiFS). It was recommended that optical moorings be maintained in order to: (1) provide long-term time series comparisons between in situ and SeaWIFS measurements of normalized water-leaving radiance; (2) develop and test algorithms for pigment biomass and phytoplankton primary productivity; and (3) provide long-term, virtually continuous in situ observations which can be used to determine and optimize the accuracy of derived satellite products. These applications require the use of in situ radiometers for long periods of time to evaluate and correct for inherent satellite undersampling (aliasing and biasing) and degradation of satellite color sensors (e.g., drifts as experienced by the Coastal Zone Color Scanner). The Bermuda Testbed Mooring (BTM) program was initiated in 1994 at a site located about 80km southeast of Bermuda in waters of about 4530 m depth. In August 1997, with NASA's support, we started to provide the Sensor Intercomparison and Merger for Biological and Interdisciplinary Oceanic Studies (SIMBIOS) program with large volumes of high frequency, long-term time-series bio-optical data from the BTM for SeaWiFS satellite ocean color groundtruthing and algorithm development. This NASA supported portion of the BTM activity spanned three years and covered five BTM deployments. During these three years, the quality of radiometric data has improved dramatically. Excellent agreement between BTM moored data and both SeaWiFS and nearby ship profile radiometric data demonstrate that technical advances in the moored optical observations have reduced the major difficulties that moored platforms face: biofouling and less frequent calibration.

Sharing Responsibility for Data Stewardship Between Scientists and Curators

NASA Astrophysics Data System (ADS)

Hedstrom, M. L.

2012-12-01

Data stewardship is becoming increasingly important to support accurate conclusions from new forms of data, integration of and computation across heterogeneous data types, interactions between models and data, replication of results, data governance and long-term archiving. In addition to increasing recognition of the importance of data management, data science, and data curation by US and international scientific agencies, the National Academies of Science Board on Research Data and Information is sponsoring a study on Data Curation Education and Workforce Issues. Effective data stewardship requires a distributed effort among scientists who produce data, IT staff and/or vendors who provide data storage and computational facilities and services, and curators who enhance data quality, manage data governance, provide access to third parties, and assume responsibility for long-term archiving of data. The expertise necessary for scientific data management includes a mix of knowledge of the scientific domain; an understanding of domain data requirements, standards, ontologies and analytical methods; facility with leading edge information technology; and knowledge of data governance, standards, and best practices for long-term preservation and access that rarely are found in a single individual. Rather than developing data science and data curation as new and distinct occupations, this paper examines the set of tasks required for data stewardship. The paper proposes an alternative model that embeds data stewardship in scientific workflows and coordinates hand-offs between instruments, repositories, analytical processing, publishers, distributors, and archives. This model forms the basis for defining knowledge and skill requirements for specific actors in the processes required for data stewardship and the corresponding educational and training needs.

Managing depression-related occupational disability: a pragmatic approach.

PubMed

Bilsker, Dan; Wiseman, Stephen; Gilbert, Merv

2006-02-01

To identify the crucial issues that arise for psychiatrists and other physicians when dealing with occupational disability in their patients with depression and to suggest practical strategies for responding more effectively to the challenges of this aspect of patient functioning. We identify fundamental concepts in the occupational disability domain and draw crucial distinctions. The wider context for occupational disability is articulated, involving the workplace environment and the disability insurance industry. Research with direct relevance to clinical decision making in this area is highlighted. We make pragmatic suggestions for effective management of occupational disability in patients with depression. To successfully manage issues of occupational disability, psychiatrists and other physicians must understand the distinction between impairment and disability. To make this decision fairly and accurately, the adjudicator requires particular types of information from the physician, with requirements varying across short-term or long-term disability claims; failing to provide relevant information may cause substantial stress or financial harm to the patient. Balanced and collaborative decision making regarding whether and for how long to take work absence will greatly help to maintain occupational function in the long-term. Realistic expectations and support of the patient's sense of personal competence foster recovery of occupational function. Management of depression-related disability is challenging. Thoughtful evaluation of the patient's functional status, careful response to the requirements of disability determination, and a focus on functional recovery yield substantial benefits.

Long-term memory consolidation: The role of RNA-binding proteins with prion-like domains.

PubMed

Sudhakaran, Indulekha P; Ramaswami, Mani

2017-05-04

Long-term and short-term memories differ primarily in the duration of their retention. At a molecular level, long-term memory (LTM) is distinguished from short-term memory (STM) by its requirement for new gene expression. In addition to transcription (nuclear gene expression) the translation of stored mRNAs is necessary for LTM formation. The mechanisms and functions for temporal and spatial regulation of mRNAs required for LTM is a major contemporary problem, of interest from molecular, cell biological, neurobiological and clinical perspectives. This review discusses primary evidence in support for translational regulatory events involved in LTM and a model in which different phases of translation underlie distinct phases of consolidation of memories. However, it focuses largely on mechanisms of memory persistence and the role of prion-like domains in this defining aspect of long-term memory. We consider primary evidence for the concept that Cytoplasmic Polyadenylation Element Binding (CPEB) protein enables the persistence of formed memories by transforming in prion-like manner from a soluble monomeric state to a self-perpetuating and persistent polymeric translationally active state required for maintaining persistent synaptic plasticity. We further discuss prion-like domains prevalent on several other RNA-binding proteins involved in neuronal translational control underlying LTM. Growing evidence indicates that such RNA regulatory proteins are components of mRNP (RiboNucleoProtein) granules. In these proteins, prion-like domains, being intrinsically disordered, could mediate weak transient interactions that allow the assembly of RNP granules, a source of silenced mRNAs whose translation is necessary for LTM. We consider the structural bases for RNA granules formation as well as functions of disordered domains and discuss how these complicate the interpretation of existing experimental data relevant to general mechanisms by which prion-domain containing RBPs function in synapse specific plasticity underlying LTM.

Brief encounters: what do primary care professionals contribute to peoples' self-care support network for long-term conditions? A mixed methods study.

PubMed

Rogers, Anne; Vassilev, Ivaylo; Brooks, Helen; Kennedy, Anne; Blickem, Christian

2016-02-17

Primary care professionals are presumed to play a central role in delivering long-term condition management. However the value of their contribution relative to other sources of support in the life worlds of patients has been less acknowledged. Here we explore the value of primary care professionals in people's personal communities of support for long-term condition management. A mixed methods survey with nested qualitative study designed to identify relationships and social network member's (SNM) contributions to the support work of managing a long-term condition conducted in 2010 in the North West of England. Through engagement with a concentric circles diagram three hundred participants identified 2544 network members who contributed to illness management. The results demonstrated how primary care professionals are involved relative to others in ongoing self-care management. Primary care professionals constituted 15.5 % of overall network members involved in chronic illness work. Their contribution was identified as being related to illness specific work providing less in terms of emotional work than close family members or pets and little to everyday work. The qualitative accounts suggested that primary care professionals are valued mainly for access to medication and nurses for informational and monitoring activities. Overall primary care is perceived as providing less input in terms of extended self-management support than the current literature on policy and practice suggests. Thus primary care professionals can be described as providing 'minimally provided support'. This sense of a 'minimally' provided input reinforces limited expectations and value about what primary care professionals can provide in terms of support for long-term condition management. Primary care was perceived as having an essential but limited role in making a contribution to support work for long-term conditions. This coalesces with evidence of a restricted capacity of primary care to take on the work load of self-management support work. There is a need to prioritise exploring the means by which extended self-care support could be enhanced out-with primary care. Central to this is building a system capable of engaging network capacity to mobilise resources for self-management support from open settings and the broader community.

Stress, Social Support, and Burnout Among Long-Term Care Nursing Staff.

PubMed

Woodhead, Erin L; Northrop, Lynn; Edelstein, Barry

2016-01-01

Long-term care nursing staff are subject to considerable occupational stress and report high levels of burnout, yet little is known about how stress and social support are associated with burnout in this population. The present study utilized the job demands-resources model of burnout to examine relations between job demands (occupational and personal stress), job resources (sources and functions of social support), and burnout in a sample of nursing staff at a long-term care facility (N = 250). Hierarchical linear regression analyses revealed that job demands (greater occupational stress) were associated with more emotional exhaustion, more depersonalization, and less personal accomplishment. Job resources (support from supervisors and friends or family members, reassurance of worth, opportunity for nurturing) were associated with less emotional exhaustion and higher levels of personal accomplishment. Interventions to reduce burnout that include a focus on stress and social support outside of work may be particularly beneficial for long-term care staff. © The Author(s) 2014.

45 CFR 144.200 - Basis.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships: Reporting Requirements... Social Security Act, (Act) which requires the issuer of a long-term care insurance policy issued under a...

45 CFR 144.200 - Basis.

Code of Federal Regulations, 2012 CFR

2012-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships: Reporting Requirements... Social Security Act, (Act) which requires the issuer of a long-term care insurance policy issued under a...

45 CFR 144.200 - Basis.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships: Reporting Requirements... Social Security Act, (Act) which requires the issuer of a long-term care insurance policy issued under a...

45 CFR 144.200 - Basis.

Code of Federal Regulations, 2013 CFR

2013-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships: Reporting Requirements... Social Security Act, (Act) which requires the issuer of a long-term care insurance policy issued under a...

Challenges of Supervising Part-Time PhD Students: Towards Student-Centred Practice

ERIC Educational Resources Information Center

Watts, Jacqueline H.

2008-01-01

The supervision of part-time doctoral students is a long-term academic enterprise requiring stamina both on the part of the supervisor and the student. Because of the fractured student identity of the part-time doctoral candidate, who is usually balancing a range of work, study, and family commitments, strategies to support their progress have to…

Research and development supporting risk-based wildfire effects prediction for fuels and fire management: Status and needs

Treesearch

Kevin Hyde; Matthew B. Dickinson; Gil Bohrer; David Calkin; Louisa Evers; Julie Gilbertson-Day; Tessa Nicolet; Kevin Ryan; Christina Tague

2013-01-01

Wildland fire management has moved beyond a singular focus on suppression, calling for wildfire management for ecological benefit where no critical human assets are at risk. Processes causing direct effects and indirect, long-term ecosystem changes are complex and multidimensional. Robust risk-assessment tools are required that account for highly variable effects on...

Financing strategic plans for not-for-profits.

PubMed

Wong-Hammond, Laca; Damon, Lorie

2013-07-01

To succeed in today's complex economic environment, a not-for-profit health system requires an effective strategic capital planning process that harmonizes three elements: The organization's long-term business plan and mission. Existing financial resources and finance options available to support the organization's business plan. Financial risk and return on equity to the organization's stakeholders (within acceptable parameters for business risk).

Getting Education Right for Long-term Growth in the Czech Republic. OECD Economics Department Working Papers, No. 497

ERIC Educational Resources Information Center

Goglio, Alessandro

2006-01-01

Widening the skills base and improving labour-market efficiency requires the support of good education. This paper describes the structure of the education system, identifies weaknesses and considers ways to improve performance in light of the ongoing rapidly expanding demand for tertiary level education. The paper discusses ways to modernise the…

Sustaining Jamaica's forests: The protected areas resource conservation project

NASA Astrophysics Data System (ADS)

Berke, Philip R.; Beatley, Timothy

1995-07-01

This study examines Jamaica's attempt to protect a tropical forest reserve. The biophysical setting, and the types and magnitude of forest development pressures are reviewed. Next, Jamaica's approach to developing new land-use strategies and compatible environmental protection and economic development programs are examined. Finally, the practical and theoretical implications by which institutions can be designed to encourage planning for sustainable development are reviewed. The implications suggest how to provide an appropriate mix of cooperation and market competition, by which people acting in their own interests accomplish socially equitable economic development, while protecting the environment for the benefit of future generations. The experience illustrates that effective long-term protection of natural areas requires the building of local relationships and support, the development of local economic activities supportive of conservation, the defining of clear boundaries, and significant monitoring and enforcement. Long-term protection of the Blue and John Crow mountains, and other important natural areas of Jamaica, will also require the development of a workable and enforceable system of land-use planning for the island, and adjustments to the economic incentive structure so that sustainable, nonextractive uses of natural capital are placed on equal footing with other economic uses (e.g., coffee production).

Resting State Synchrony in Short-Term versus Long-Term Abstinent Alcoholics

PubMed Central

Camchong, Jazmin; Stenger, Victor Andrew; Fein, George

2012-01-01

BACKGROUND We previously reported that when compared to controls, long-term abstinent alcoholics (LTAA) have increased resting state synchrony (RSS) of the inhibitory control network and reduced synchrony of the appetitive drive network, and hypothesized that these levels of synchrony are adaptive, and support the behavioral changes required to maintain abstinence. In the current study, we investigate whether these RSS patterns can be identified in short-term abstinent alcoholics. METHODS Resting state functional magnetic resonance imaging data were collected from 27 short-term abstinent alcoholics (STAA), 23 LTAA and 23 non-substance abusing controls (NSAC). We examined baseline RSS using seed-based measures. RESULTS We found ordered RSS effects from NSAC to STAA and then to LTAA within both the appetitive drive and executive control networks: increasing RSS of the executive control network, and decreasing RSS of the reward processing network. Finally, we found significant correlations between strength of RSS in these networks and (a) cognitive flexibility and (b) current antisocial behavior. DISCUSSION Findings are consistent with an adaptive progression of RSS from short- to long-term abstinence so that, compared to normal controls, the synchrony (a) within the reward network progressively decreases and (b) within the executive control network progressively increases. PMID:23421812

The Long Term Implication of RTLB Support: Listening to the Voices of Student Experiences

ERIC Educational Resources Information Center

Pillay, Poobie; Flanagan, Paul

2011-01-01

Resource Teachers: Learning and Behaviour (RTLB) have supported more than 15,000 students since RTLB 1999 by assisting teachers to manage and support students with learning or behaviour difficulties within inclusive classroom environments. Research indicates that there are long term positive educational effects for students receiving short-term…

Left ventricular assist device management in patients chronically supported for advanced heart failure.

PubMed

Cowger, Jennifer; Romano, Matthew A; Stulak, John; Pagani, Francis D; Aaronson, Keith D

2011-03-01

This review summarizes management strategies to reduce morbidity and mortality in heart failure patients supported chronically with implantable left ventricular assist devices (LVADs). As the population of patients supported with long-term LVADs has grown, patient selection, operative technique, and patient management strategies have been refined, leading to improved outcomes. This review summarizes recent findings on LVAD candidate selection, and discusses outpatient strategies to optimize device performance and heart failure management. It also reviews important device complications that warrant close outpatient monitoring. Managing patients on chronic LVAD support requires regular patient follow-up, multidisciplinary care teams, and frequent laboratory and echocardiographic surveillance to ensure optimal outcomes.

Impact of childhood cancer on maternal employment in Japan.

PubMed

Okada, Hiromi; Maru, Mitsue; Maeda, Rumi; Iwasaki, Fuminori; Nagasawa, Masayuki; Takahashi, Miyako

2015-01-01

Family members of children with cancer experience various long-term effects as a result of cancer diagnosis and treatment. Therefore, comprehensive and long-term support is needed. As the employment rate of women has increased in recent years, support for working mothers with children diagnosed with cancer is also required. We investigated the following issues and relevant changes that working mothers of children diagnosed with cancer must deal with: (1) work change, (2) stress, (3) social support, (4) work motivation, and (5) employment status after diagnosis. A cross-sectional exploratory study design was used. Data were collected from 62 mothers of children who were diagnosed with cancer using self-report questionnaires. Of the 32 mothers who worked at the time of diagnosis, 10 continued to work, 12 took an extended leave, and 10 quit working, and 70% lost motivation for work following diagnosis. Half of mothers who continued to work during treatment reported financial reasons. These findings indicate that mothers who quit work following diagnosis did not initially consider a long leave of absence. Even mothers who continued to work during treatment desired a long leave of absence to care for their children. Nurses should provide mothers with explanations of the prospects after the completion of cancer treatment and determine their expectations for their lifestyle and work during treatment. We recommend that nurses confirm mothers' willingness to take a long leave of absence from work and give relevant advice about seeking financial assistance.

Space Station logistics policy - Risk management from the top down

NASA Technical Reports Server (NTRS)

Paules, Granville; Graham, James L., Jr.

1990-01-01

Considerations are presented in the area of risk management specifically relating to logistics and system supportability. These considerations form a basis for confident application of concurrent engineering principles to a development program, aiming at simultaneous consideration of support and logistics requirements within the engineering process as the system concept and designs develop. It is shown that, by applying such a process, the chances of minimizing program logistics and supportability risk in the long term can be improved. The problem of analyzing and minimizing integrated logistics risk for the Space Station Freedom Program is discussed.

Glenn's Telescience Support Center Provided Around-the-Clock Operations Support for Space Experiments on the International Space Station

NASA Technical Reports Server (NTRS)

Malarik, Diane C.

2005-01-01

NASA Glenn Research Center s Telescience Support Center (TSC) allows researchers on Earth to operate experiments onboard the International Space Station (ISS) and the space shuttles. NASA s continuing investment in the required software, systems, and networks provides distributed ISS ground operations that enable payload developers and scientists to monitor and control their experiments from the Glenn TSC. The quality of scientific and engineering data is enhanced while the long-term operational costs of experiments are reduced because principal investigators and engineering teams can operate their payloads from their home institutions.

Exploring physiotherapists' experiences of implementing a cognitive behavioural approach for managing low back pain and identifying barriers to long-term implementation.

PubMed

Richmond, Helen; Hall, Amanda M; Hansen, Zara; Williamson, Esther; Davies, David; Lamb, Sarah E

2018-03-01

Our objectives were two-fold: (i) to describe physiotherapists' experiences of implementing a cognitive behavioural approach (CBA) for managing low back pain (LBP) after completing an extensive online training course (iBeST), and (ii) to identify how iBeST could be enhanced to support long-term implementation before scale up for widespread use. We conducted semi-structured interviews with 11 physiotherapists from six National Health Service departments in the Midlands, Oxfordshire and Derbyshire. Questions centred on (i) using iBeST to support implementation, (ii) what barriers they encountered to implementation and (iii) what of information or resources they required to support sustained implementation. Interviews were transcribed and thematically analysed using NVivo. Themes were categorised using the Theoretical Domains Framework (TDF). Evidence-based techniques were identified using the behaviour change technique taxonomy to target relevant TDF domains. Three themes emerged from interviews: anxieties about using a CBA, experiences of implementing a CBA, and sustainability for future implementation of a CBA. Themes crossed multiple TDF domains and indicated concerns with knowledge, beliefs about capabilities and consequences, social and professional roles, social influences, emotion, and environmental context and resources. We identified evidence-based strategies that may support sustainable implementation of a CBA for LBP in a physiotherapy setting. This study highlighted potential challenges for physiotherapists in the provision of evidence-based LBP care within the current UK NHS. Using the TDF provided the foundation to develop a tailored, evidence-based, implementation intervention to support long term use of a CBA by physiotherapists managing LBP within UK NHS outpatient departments. Copyright © 2017 Chartered Society of Physiotherapy. All rights reserved.

One-Click Data Analysis Software for Science Operations

NASA Astrophysics Data System (ADS)

Navarro, Vicente

2015-12-01

One of the important activities of ESA Science Operations Centre is to provide Data Analysis Software (DAS) to enable users and scientists to process data further to higher levels. During operations and post-operations, Data Analysis Software (DAS) is fully maintained and updated for new OS and library releases. Nonetheless, once a Mission goes into the "legacy" phase, there are very limited funds and long-term preservation becomes more and more difficult. Building on Virtual Machine (VM), Cloud computing and Software as a Service (SaaS) technologies, this project has aimed at providing long-term preservation of Data Analysis Software for the following missions: - PIA for ISO (1995) - SAS for XMM-Newton (1999) - Hipe for Herschel (2009) - EXIA for EXOSAT (1983) Following goals have guided the architecture: - Support for all operations, post-operations and archive/legacy phases. - Support for local (user's computer) and cloud environments (ESAC-Cloud, Amazon - AWS). - Support for expert users, requiring full capabilities. - Provision of a simple web-based interface. This talk describes the architecture, challenges, results and lessons learnt gathered in this project.

Cues, context, and long-term memory: the role of the retrosplenial cortex in spatial cognition

PubMed Central

Miller, Adam M. P.; Vedder, Lindsey C.; Law, L. Matthew; Smith, David M.

2014-01-01

Spatial navigation requires memory representations of landmarks and other navigation cues. The retrosplenial cortex (RSC) is anatomically positioned between limbic areas important for memory formation, such as the hippocampus (HPC) and the anterior thalamus, and cortical regions along the dorsal stream known to contribute importantly to long-term spatial representation, such as the posterior parietal cortex. Damage to the RSC severely impairs allocentric representations of the environment, including the ability to derive navigational information from landmarks. The specific deficits seen in tests of human and rodent navigation suggest that the RSC supports allocentric representation by processing the stable features of the environment and the spatial relationships among them. In addition to spatial cognition, the RSC plays a key role in contextual and episodic memory. The RSC also contributes importantly to the acquisition and consolidation of long-term spatial and contextual memory through its interactions with the HPC. Within this framework, the RSC plays a dual role as part of the feedforward network providing sensory and mnemonic input to the HPC and as a target of the hippocampal-dependent systems consolidation of long-term memory. PMID:25140141

Evaluation of the Dawson College Shooting Psychological Intervention: Moving Toward a Multimodal Extensive Plan

PubMed Central

Séguin, Monique; Chawky, Nadia; Lesage, Alain; Boyer, Richard; Guay, Stéphane; Bleau, Pierre; Miquelon, Paule; Szkrumelak, Nadia; Steiner, Warren; Roy, Denise

2013-01-01

In 2006, following the shooting at Dawson College, the authorities implemented an intervention plan. This provided an opportunity to analyze the responses to services offered, and afforded a learning opportunity, which led to the proposal of an extensive multimodal short- and long-term psychological plan for future needs. Both quantitative and qualitative data were gathered 18 months after the event, involving the participation of 948 students and staff. Mental health problems and the perception of services offered after the shooting were investigated, using standardized measures. Second, focus groups and individual interviews were conducted among a subgroup of participants (support team members; teachers and employees; students and parents) and permitted to gather data on services received and services required. Individual report of events, the extent of psychological impact and services offered and received were analyzed in terms of the following dimensions: intervention philosophy, training, ongoing offer of services and finally, detection and outreach. A significant incidence of disorders and a high rate of exacerbation of preexisting mental disorders were observed within the 18 months following the shooting. Postimmediate and short-term intervention appeared adequate, but the long-term collective vision toward community support and availability of mental health services were lacking. Lessons learned from this evaluation and other school shootings suggest that preparedness and long-term community responses are often overlooked. A multimodal extensive plan is proposed based on a theoretical model from which interventions strategies could be drawn. PMID:24795790

Support, shape and number of replicate samples for tree foliage analysis.

PubMed

Luyssaert, Sebastiaan; Mertens, Jan; Raitio, Hannu

2003-06-01

Many fundamental features of a sampling program are determined by the heterogeneity of the object under study and the settings for the error (alpha), the power (beta), the effect size (ES), the number of replicate samples, and sample support, which is a feature that is often overlooked. The number of replicates, alpha, beta, ES, and sample support are interconnected. The effect of the sample support and its shape on the required number of replicate samples was investigated by means of a resampling method. The method was applied to a simulated distribution of Cd in the crown of a Salix fragilis L. tree. Increasing the dimensions of the sample support results in a decrease in the variance of the element concentration under study. Analysis of the variance is often the foundation of statistical tests, therefore, valid statistical testing requires the use of a fixed sample support during the experiment. This requirement might be difficult to meet in time-series analyses and long-term monitoring programs. Sample supports have their largest dimension in the direction with the largest heterogeneity, i.e. the direction representing the crown height, and this will give more accurate results than supports with other shapes. Taking the relationships between the sample support and the variance of the element concentrations in tree crowns into account provides guidelines for sampling efficiency in terms of precision and costs. In terms of time, the optimal support to test whether the average Cd concentration of the crown exceeds a threshold value is 0.405 m3 (alpha = 0.05, beta = 0.20, ES = 1.0 mg kg(-1) dry mass). The average weight of this support is 23 g dry mass, and 11 replicate samples need to be taken. It should be noted that in this case the optimal support applies to Cd under conditions similar to those of the simulation, but not necessarily all the examinations for this tree species, element, and hypothesis test.

F Reactor Inspection

ScienceCinema

Grindstaff, Keith; Hathaway, Boyd; Wilson, Mike

2018-01-16

Workers from Mission Support Alliance, LLC., removed the welds around the steel door of the F Reactor before stepping inside the reactor to complete its periodic inspection. This is the first time the Department of Energy (DOE) has had the reactor open since 2008. The F Reactor is one of nine reactors along the Columbia River at the Department's Hanford Site in southeastern Washington State, where environmental cleanup has been ongoing since 1989. As part of the Tri-Party Agreement, the Department completes surveillance and maintenance activities of cocooned reactors periodically to evaluate the structural integrity of the safe storage enclosure and to ensure confinement of any remaining hazardous materials. "This entry marks a transition of sorts because the Hanford Long-Term Stewardship Program, for the first time, was responsible for conducting the entry and surveillance and maintenance activities," said Keith Grindstaff, Energy Department Long-Term Stewardship Program Manager. "As the River Corridor cleanup work is completed and transitioned to long-term stewardship, our program will manage any on-going requirements."

F Reactor Inspection

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

Grindstaff, Keith; Hathaway, Boyd; Wilson, Mike

2014-10-29

Workers from Mission Support Alliance, LLC., removed the welds around the steel door of the F Reactor before stepping inside the reactor to complete its periodic inspection. This is the first time the Department of Energy (DOE) has had the reactor open since 2008. The F Reactor is one of nine reactors along the Columbia River at the Department's Hanford Site in southeastern Washington State, where environmental cleanup has been ongoing since 1989. As part of the Tri-Party Agreement, the Department completes surveillance and maintenance activities of cocooned reactors periodically to evaluate the structural integrity of the safe storage enclosuremore » and to ensure confinement of any remaining hazardous materials. "This entry marks a transition of sorts because the Hanford Long-Term Stewardship Program, for the first time, was responsible for conducting the entry and surveillance and maintenance activities," said Keith Grindstaff, Energy Department Long-Term Stewardship Program Manager. "As the River Corridor cleanup work is completed and transitioned to long-term stewardship, our program will manage any on-going requirements."« less

Surgical treatment of cholesteatoma: a comparison of three techniques.

PubMed

Toner, J G; Smyth, G D

1990-07-01

The debate regarding the surgical technique for the management of cholesteatoma still continues. The resolution of this issue will only come with the study of the long term results of well controlled series. In this paper long term follow-up on three groups of patients is reported. The groups underwent combined approach tympanoplasty (CAT), mastoid tympanoplasty with obliteration (MOT), and modified radical mastoidectomy (MRM) respectively for cholesteatoma. The factors studied included frequency of required review, condition of the external canal/cavity, and hearing status. The meatal cross-sectional areas and cavity volumes were also measured for the MRM and MOT groups. Analysis of the data showed no significant difference between the groups in either frequency of review or cavity status. The hearing results showed an initial improvement in all groups, however, over the prolonged follow-up period the air conduction threshold gradually increased. In conclusion this data supports the view that a one-stage canal wall down procedure provides maximum long term patient benefit.

78 FR 52125 - Main Hawaiian Islands Deep 7 Bottomfish Annual Catch Limits and Accountability Measures for 2013-14

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... the fishing year. The proposed specifications and fishery closure support the long-term sustainability...-12 and 2012-13 fishing years, and support the long-term sustainability of Hawaii bottomfish. However...

Integration Geflüchteter in Arbeitsmärkte - Potenziale und Herausforderungen

NASA Astrophysics Data System (ADS)

Weingarten, Jörg; Wohlert, Jale

2018-03-01

Against the background of the migration movement in 2015/2016, cities such as Essen are now faced with the task of long-term integration of refugees who have a granted subsidiary protection. Successful integration is possible if participation in working life can be realized. This requires a focussed qualification of refugees and the support of companies and educational institutions through appropriate funding programs. The long duration of language acquisition prior to entry into employment is only one problem that can be solved by training-on-the-job measures.

Integration Geflüchteter in Arbeitsmärkte. Potenziale und Herausforderungen

NASA Astrophysics Data System (ADS)

Weingarten, Jörg; Wohlert, Jale

2018-04-01

Against the background of the migration movement in 2015/2016, cities such as Essen are now faced with the task of long-term integration of refugees who have a granted subsidiary protection. Successful integration is possible if participation in working life can be realized. This requires a focussed qualification of refugees and the support of companies and educational institutions through appropriate funding programs. The long duration of language acquisition prior to entry into employment is only one problem that can be solved by training-on-the-job measures.

Japan's long-term care policy for older people: the emergence of innovative "mobilisation" initiatives following the 2005 reforms.

PubMed

Hayashi, Mayumi

2015-04-01

Japan leads the global race for solutions to the increasing long-term care demand from an ageing population. Initial responses in 2000 saw the launch of the public Long-Term Care Insurance (LTCI) system which witnessed an unexpectedly substantial uptake - with doubts raised about financial viability and sustainability. The post-2005 LTCI reform led to the adoption of innovations - including the "mobilisation" of active, older volunteers to support their frailer peers. This strategy, within the wider government's "2025 Vision" to provide total care for the entire older population, sought to secure financial viability and sustainability. Drawing on qualitative in-depth interviews with 21 provider organisations this study will examine three "mobilisation" schemes and identify those factors contributing to overall strengths while acknowledging complexities, diversities and challenges the schemes encountered. Initial literature written by mobilisation proponents may have been overly optimistic: this study seeks to balance such views through providing an understanding and analysis of these mobilisation schemes' realities. The findings will provide insights and suggest more caution to policy-makers intending to promote such schemes - in both Japan and in countries considering doing so. Furthermore, more evaluation is required to obtain evidence to support financial feasibility and sustainability. Copyright © 2015 Elsevier Inc. All rights reserved.

Supported self-management for cancer survivors to address long-term biopsychosocial consequences of cancer and treatment to optimize living well.

PubMed

Howell, Doris D

2018-03-01

As individuals are living longer with cancer as a chronic disease, they face new health challenges that require the application of self-management behaviors and skills that may not be in their usual repertoire of self-regulatory health behaviors. Increasing attention is focused on supported self-management (SSM) programs to enable survivors in managing the long-term biopsychosocial consequences and health challenges of survivorship. This review explores current directions and evidence for SSM programs that enable survivors to manage these consequences and optimize health. Cancer survivors face complex health challenges that affect daily functioning and well being. Multiple systematic reviews show that SSM programs have positive effects on health outcomes in typical chronic diseases. However, the efficacy of these approaches in cancer survivors are in their infancy; and the 'one-size' fits all approach for chronic disease self-management may not be adequate for cancer as a complex chronic illness. This review suggests that SSM has promising potential for improving health and well being of cancer survivors, but there is a need for standardizing SSM for future research. Although there is increasing enthusiasm for SSM programs tailored to cancer survivors, there is a need for further research of their efficacy on long-term health outcomes.

Information Model Translation to Support a Wider Science Community

NASA Astrophysics Data System (ADS)

Hughes, John S.; Crichton, Daniel; Ritschel, Bernd; Hardman, Sean; Joyner, Ronald

2014-05-01

The Planetary Data System (PDS), NASA's long-term archive for solar system exploration data, has just released PDS4, a modernization of the PDS architecture, data standards, and technical infrastructure. This next generation system positions the PDS to meet the demands of the coming decade, including big data, international cooperation, distributed nodes, and multiple ways of analysing and interpreting data. It also addresses three fundamental project goals: providing more efficient data delivery by data providers to the PDS, enabling a stable, long-term usable planetary science data archive, and enabling services for the data consumer to find, access, and use the data they require in contemporary data formats. The PDS4 information architecture is used to describe all PDS data using a common model. Captured in an ontology modeling tool it supports a hierarchy of data dictionaries built to the ISO/IEC 11179 standard and is designed to increase flexibility, enable complex searches at the product level, and to promote interoperability that facilitates data sharing both nationally and internationally. A PDS4 information architecture design requirement stipulates that the content of the information model must be translatable to external data definition languages such as XML Schema, XMI/XML, and RDF/XML. To support the semantic Web standards we are now in the process of mapping the contents into RDF/XML to support SPARQL capable databases. We are also building a terminological ontology to support virtually unified data retrieval and access. This paper will provide an overview of the PDS4 information architecture focusing on its domain information model and how the translation and mapping are being accomplished.

A Strategy for Skills to meet the demands of Nuclear Decommissioning and Clean-up in the UK

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

Brownridge, M.; Ensor, B.

The NDA remit as set out within the Energy Act includes - 'to ensure the availability of skills required to deliver the overall decommissioning and nuclear clean-up mission'. The NDA approach to meeting their statutory obligation is by: - finding the best ways of re-training, re-skilling or re-deploying people in a way that encourages a more flexible workforce; - identifying and communicating the skills and workforce requirements to deliver the mission; and - developing the infrastructure and capability initiatives in line with long term needs, for example, a National Skills Academy for Nuclear, Nuclear Institute, National Graduate Scheme, and -more » developing locally specific provision. Firstly, NDA has set the requirement for nuclear sites to write down within the Life Time Plans (LTP), at a high level, their Site Skills Strategies; furthermore, a National Skills Working Group has been established to develop tactical cross sector solutions to support the NDA's Skills Strategy. In support of the short, medium and long term needs to meet demands of the NDA sites and the nuclear decommissioning sector, as well as being aware of the broader nuclear sector, investments have been made in infrastructure and skills programmes such as: - A National Skills Academy for Nuclear - including UK wide representation of the whole nuclear sector; - A Nuclear Institute in partnership with the University of Manchester focussing on world class research and skills in Radiation Sciences and Decommissioning Engineering; - Post Graduate sponsorship for decommissioning related projects; - A National Graduate Scheme partnership with nuclear related employers; - Vocational qualifications and Apprenticeship Schemes - Engaging 14-19 year old students to encourage the take up of Science related subjects; and - A sector wide 'Skills Passport'. In conclusion: The skills challenge has many dimensions but requires addressing due to the clear link to improved business performance and the availability of key resources in a diminishing and competitive environment. The diminishing skill base is due to reasons such as demographics and competition from other industries such as the oil industry. Getting the balance between meeting regional and national requirements will prove critical to success. The lack of clarity on the long term needs will also drive the strategy. NDA recognises that the work to date is the beginning of a long term approach and programme. We have developed a skills strategy that is consistent across all 20 sites and examples of key developments in infrastructure are in progress. Looking forward NDA will seek benchmarking opportunities and ways to make tangible links between skills and performance. (authors)« less

Evaluating the feasibility of biological waste processing for long term space missions.

PubMed

Garland, J L; Alazraki, M P; Atkinson, C F; Finger, B W

1998-01-01

Recycling waste products during orbital (e.g., International Space Station) and planetary missions (e.g., lunar base, Mars transit mission, Martian base) will reduce storage and resupply costs. Wastes streams on the space station will include human hygiene water, urine, faeces, and trash. Longer term missions will contain human waste and inedible plant material from plant growth systems used for atmospheric regeneration, food production, and water recycling. The feasibility of biological and physical-chemical waste recycling is being investigated as part of National Aeronautics and Space Administration's (NASA) Advanced Life Support (ALS) Program. In-vessel composting has lower manpower requirements, lower water and volume requirements, and greater potential for sanitization of human waste compared to alternative bioreactor designs such as continuously stirred tank reactors (CSTR). Residual solids from the process (i.e. compost) could be used a biological air filter, a plant nutrient source, and a carbon sink. Potential in-vessel composting designs for both near- and long-term space missions are presented and discussed with respect to the unique aspects of space-based systems.

Evaluating the feasibility of biological waste processing for long term space missions

NASA Technical Reports Server (NTRS)

Garland, J. L.; Alazraki, M. P.; Atkinson, C. F.; Finger, B. W.; Sager, J. C. (Principal Investigator)

1998-01-01

Recycling waste products during orbital (e.g., International Space Station) and planetary missions (e.g., lunar base, Mars transit mission, Martian base) will reduce storage and resupply costs. Wastes streams on the space station will include human hygiene water, urine, faeces, and trash. Longer term missions will contain human waste and inedible plant material from plant growth systems used for atmospheric regeneration, food production, and water recycling. The feasibility of biological and physical-chemical waste recycling is being investigated as part of National Aeronautics and Space Administration's (NASA) Advanced Life Support (ALS) Program. In-vessel composting has lower manpower requirements, lower water and volume requirements, and greater potential for sanitization of human waste compared to alternative bioreactor designs such as continuously stirred tank reactors (CSTR). Residual solids from the process (i.e. compost) could be used a biological air filter, a plant nutrient source, and a carbon sink. Potential in-vessel composting designs for both near- and long-term space missions are presented and discussed with respect to the unique aspects of space-based systems.

Commercial Contributions to the Success of the HEDS Enterprise: A Working Model

NASA Technical Reports Server (NTRS)

Nall, Mark; Askew, Ray

2000-01-01

The future of NASA involves the exploration of space beyond the confines of orbit about the Earth. This includes robotic investigations and Human Exploration and Development of Space (HEDS). The HEDS Strategic Plan states: "HEDS will join with the private sector to stimulate opportunities for commercial development in space as a key to future settlement. Near-term efforts will emphasize joint pilot projects that provide clear benefit to Earth from the development of near-Earth space." In support of this endeavor, NASA has established the Commercial Development of Space as a prime goal and is exploring all the ways in which NASA might make contributions to this development. NASA has long supported the development of space for commercial use. In 1985 it formally established and provided funds to support a program which created a number of joint ventures between universities and industry for this purpose. These were known as Centers for the Commercial Development of Space (CCDS). In 1999 NASA established a broader policy on commercialization with the aim of encouraging near-term commercial investment in conjunction with the International Space Station. Joint pilot projects will be initiated to stimulate this near-term investment. The long-term development of commercial concepts utilizing space access continues through the activities of the Commercial Space Centers (CSC), a sub-set of the original CCDS group. These Centers primarily require access to space for the conduct of their work. The remainder of the initial Centers focus on the development of tools and infrastructure to support users of the space environment. It is in this arena that long term development for commercial use and infrastructure development will occur. This paper will provide a retrospective examination of the Commercial Centers, the variety of models employed, the lessons learned, and the progress to date. This review will provide the bases for how successful models can be employed to accelerate private investment in the development of the infrastructure necessary for the success of the HEDS enterprise.

Long-term central venous access device selection.

PubMed

Gabriel, Janice

Infusion therapy is often viewed as a means to an end - a way to administer medications and fluids. It is one of the few specialties that affect almost all areas of healthcare. Safe, effective and reliable vascular access should be the goal of every health professional who is starting a patient on a prescribed course of intravenous therapy, especially if that patient is undergoing a prolonged course. This article aims to refresh and update nurses' clinical knowledge of the detailed patient assessment required before choosing a central venous access device, as well as supporting a reduction in complications and earlier recognition of potential problems. It discusses clinical indications for devices, the range of long-term intravenous therapies that can be used, and patient assessment.

Factors affecting electronic health record adoption in long-term care facilities.

PubMed

Cherry, Barbara; Carter, Michael; Owen, Donna; Lockhart, Carol

2008-01-01

Electronic health records (EHRs) hold the potential to significantly improve the quality of care in long-term care (LTC) facilities, yet limited research has been done on how facilities decide to adopt these records. This study was conducted to identify factors that hinder and facilitate EHR adoption in LTC facilities. Study participants were LTC nurses, administrators, and corporate executives. Primary barriers identified were costs, the need for training, and the culture change required to embrace technology. Primary facilitators were training programs, well-defined implementation plans, government assistance with implementation costs, evidence that EHRs will improve care outcomes, and support from state regulatory agencies. These results offer a framework of action for policy makers, LTC Leaders, and researchers.

Development and research program for a soil-based bioregenerative agriculture system to feed a four person crew at a Mars base

NASA Astrophysics Data System (ADS)

Silverstone, S.; Nelson, M.; Alling, A.; Allen, J.

For humans to survive during long-term missions on the Martian surface, bioregenerative life support systems including food production will decrease requirements for launch of Earth supplies, and increase mission safety. It is proposed that the development of ``modular biospheres''- closed system units that can be air-locked together and which contain soil-based bioregenerative agriculture, horticulture, with a wetland wastewater treatment system is an approach for Mars habitation scenarios. Based on previous work done in long-term life support at Biosphere 2 and other closed ecological systems, this consortium proposes a research and development program called Mars On Earth™ which will simulate a life support system designed for a four person crew. The structure will consist of /6 × 110 square meter modular agricultural units designed to produce a nutritionally adequate diet for 4 people, recycling all air, water and waste, while utilizing a soil created by the organic enrichment and modification of Mars simulant soils. Further research needs are discussed, such as determining optimal light levels for growth of the necessary range of crops, energy trade-offs for agriculture (e.g. light intensity vs. required area), capabilities of Martian soils and their need for enrichment and elimination of oxides, strategies for use of human waste products, and maintaining atmospheric balance between people, plants and soils.

Short-Term and Long-Term Effects of Orthopedic Biodegradable Implants

PubMed Central

Amini, Ami R.; Wallace, James S.; Nukavarapu, Syam P.

2012-01-01

Presently, orthopedic and oral/maxillofacial implants represent a combined $2.8 billion market, a figure expected to experience significant and continued growth. Although traditional permanent implants have been proved clinically efficacious, they are also associated with several drawbacks, including secondary revision and removal surgeries. Non-permanent, biodegradable implants offer a promising alternative for patients, as they provide temporary support and degrade at a rate matching tissue formation, and thus, eliminate the need for secondary surgeries. These implants have been in clinical use for nearly 25 years, competing directly with, or maybe even exceeding, the performance of permanent implants. The initial implantation of biodegradable materials, as with permanent materials, mounts an acute host inflammatory response. Over time, the implant degradation profile and possible degradation product toxicity mediate long-term biodegradable implant-induced inflammation. However, unlike permanent implants, this inflammation is likely to cease once the material disappears. Implant-mediated inflammation is a critical determinant for implant success. Thus, for the development of a proactive biodegradable implant that has the ability to promote optimal bone regeneration and minimal detrimental inflammation, a thorough understanding of short- and long-term inflammatory events is required. Here, we discuss an array of biodegradable orthopedic implants, their associated short- and long- term inflammatory effects, and methods to mediate these inflammatory events. PMID:22043969

Current Directions in Adding Value to Earth Observation Products for Decision Support

NASA Astrophysics Data System (ADS)

Ryker, S. J.

2015-12-01

Natural resource managers and infrastructure planners face increasingly complex challenges, given competing demands for resources and changing conditions due to climate and land use change. These pressures create demand for high-quality, timely data; for both one-time decision support and long-term monitoring; and for techniques to articulate the value of resources in monetary and nonmonetary terms. To meet the need for data, the U.S. government invests several billion dollars per year in Earth observations collected from satellite, airborne, terrestrial, and ocean-based systems. Earth observation-based decision support is coming of age; user surveys show that these data are used in an increasing variety of analyses. For example, since the U.S. Department of the Interior/U.S. Geological Survey's (USGS) 2008 free and open data policy for the Landsat satellites, downloads from the USGS archive have increased from 20,000 Landsat scenes per year to 10 million per year and climbing, with strong growth in both research and decision support fields. However, Earth observation-based decision support still poses users a number of challenges. Many of those Landsat downloads support a specialized community of remote sensing scientists, though new technologies promise to increase the usability of remotely sensed data for the larger GIS community supporting planning and resource management. Serving this larger community also requires supporting the development of increasingly interpretive products, and of new approaches to host and update products. For example, automating updates will add value to new essential climate variable products such as surface water extent and wildfire burned area extent. Projections of future urbanization in the southeastern U.S. are most useful when long-term land cover trends are integrated with street-level community data and planning tools. The USGS assessment of biological carbon sequestration in vegetation and shallow soils required a significant research investment in satellite and in situ measurements and biogeochemical and climate modeling, and is already providing decision support at a variety of scales; once operationalized, it will be a tool for adaptive management from field-scale soil and wetland conservation projects to national-scale policy.

Short- and long-term effectiveness of a three-month individualized need-supportive physical activity counseling intervention at the workplace.

PubMed

Arrogi, Anass; Schotte, Astrid; Bogaerts, An; Boen, Filip; Seghers, Jan

2017-01-09

The objective of the present study was to evaluate the short- and long-term intervention and mediation effects of a 3-month individualized need-supportive physical activity (PA) counseling intervention on employees' PA and sedentary behavior. Insufficiently active employees (n = 300; mean age 42 ± 9 years; 78% female) were recruited from a large pharmaceutical company in Flanders, Belgium. A quasi-experimental design was used in which the intervention group (N = 246) was recruited separately from the reference group (N = 54). Intervention group participants received a 3-month behavioral support intervention, which consisted of two one-hour face-to-face counseling sessions and three follow-up counseling contacts by e-mail or telephone at weeks three, six and nine. PA counseling, delivered by qualified PA counselors, aimed to satisfy participants' basic psychological needs for autonomy, competence, and relatedness. Reference group participants did not receive individualized PA counseling. Outcome measures included objectively assessed and self-reported PA and sedentary time and psychological need satisfaction. Assessments were held at baseline, immediately after the intervention (short-term) and 6 months post-intervention (long-term). Mixed model analyses and bootstrapping analyses were used to determine intervention and mediation effects, respectively. The intervention group increased weekday daily steps both in the short- and long-term, while the reference group showed reductions in daily step count (ES = .65 and ES = .48 in the short- and long-term, respectively). In the short-term, weekday moderate-to-vigorous PA increased more pronouncedly in the intervention group compared to the reference group (ES = .34). Moreover, the intervention group demonstrated reductions in self-reported sitting time during weekends both in the short- and long-term, whereas the reference group reported increased sitting time (ES = .44 and ES = .32 in the short- and long-term, respectively). Changes in perceived autonomy and competence need satisfaction mediated the long-term intervention effects on daily step count. A 3-month individualized need-supportive PA counseling intervention among employees resulted in significant and sustained improvements in weekday daily step count and in decreased self-reported sitting during weekends. Our findings contribute to the growing evidence of the long-term effectiveness of need-supportive PA counseling. ClinicalTrials.gov NCT01759927 . Registered December 30, 2012.

Site productivity and diversity of the Middle Mountain long-term soil productivity study, West Virginia: Pre-experimental site characterization

Treesearch

Mary Beth Adams

2018-01-01

To better understand the impacts of a changing environment and interactions with forest management options for forest resources, including soil, large long-term experiments are required. Such experiments require careful documentation of reference or pre-experimental conditions. This publication describes the Middle Mountain Long-term Soil Productivity (LTSP) Study,...

IAC level "O" program development

NASA Technical Reports Server (NTRS)

Vos, R. G.

1982-01-01

The current status of the IAC development activity is summarized. The listed prototype software and documentation was delivered, and details were planned for development of the level 1 operational system. The planned end product IAC is required to support LSST design analysis and performance evaluation, with emphasis on the coupling of required technical disciplines. The long term IAC effectively provides two distinct features: a specific set of analysis modules (thermal, structural, controls, antenna radiation performance and instrument optical performance) that will function together with the IAC supporting software in an integrated and user friendly manner; and a general framework whereby new analysis modules can readily be incorporated into IAC or be allowed to communicate with it.

Problems of equipment creation for hygienic treatment of textiles (underwear, garments, hygienic towels and napkins) for long-term space missions

NASA Astrophysics Data System (ADS)

Shumilina, I.

Impossibility of just in time stocks delivery to the International Space Station ISS because of Shuttle space flights absence has led to forced changing of standards of underwear garments and personal hygiene means using Therefore hygienic treatment of textiles underwear garments towels and napkins are necessary for long-term space flight missions Investigations into the ways of cosmonauts sanitary -- hygienic supply are prepared The resent equipment means and methods of cosmonauts sanitary -- hygienic supply were created for space flight conditions with an opportunity of stocks updating This investigations are confirm necessity of new generation system creation for cosmonauts sanitary -- hygienic supply and special designing of hygienic treatment laundry drying equipment and technologies for long-term space flights without an opportunity of stocks updating in particular for martian mission One from main requirements for equipment means and methods of cosmonauts sanitary -- hygienic supply is full safety for human organisms under systematic and long-term application in space flight conditions small energy consumption and combining with space Life-Support Systems Method and program of experimental investigations of textiles laundry with application of washing means for long-term space flight conditions are prepared It is necessary to estimate opportunity and efficiency of washing means application for textiles laundry for space flight missions also to estimate compatibility of washing means for textiles laundry and for washing

Priorities for a 21st-century defense: aligning u.s. Army environmental science and engineering officer resources with the department of defense strategic guidance.

PubMed

Licina, Derek; Rufolo, Dennis; Story, Mike

2013-01-01

The recently published Department of Defense (DoD) strategic guidance highlights the need to ?shape a joint force for the future.? Supporting requirements to shape the joint force while the overall DoD force structure is reduced will be challenging. Fortunately, based on its unique training and experience, the Army Environmental Science and Engineering Officer (ESEO) profession is positioned today to fill anticipated joint public health requirements. Obtaining the U.S. Army Medical Department (AMEDD) approval to meet these requirements will have near-term consequences for the ESEO profession as some existing (albeit antiquated) authorizations may go unfilled. However, long-term dividends for the Medical Service Corps (MSC), AMEDD, Army, and DoD will be achieved by realigning critical resources to future joint and interagency requirements. Assigning ESEOs now to organizations such as the Theater Special Operations Commands (TSOCs), U.S. Agency for International Development (USAID), and the North Atlantic Treaty Organization (NATO) with perceived and real joint force health protection/public health requirements through unique means will ensure our profession remains relevant today and supports the joint force of tomorrow. 2013.

Engineering verification of the biomass production chamber

NASA Technical Reports Server (NTRS)

Prince, R. P.; Knott, W. M., III; Sager, J. C.; Jones, J. D.

1992-01-01

The requirements for life support systems, both biological and physical-chemical, for long-term human attended space missions are under serious study throughout NASA. The KSC 'breadboard' project has focused on biomass production using higher plants for atmospheric regeneration and food production in a special biomass production chamber. This chamber is designed to provide information on food crop growth rate, contaminants in the chamber that alter plant growth requirements for atmospheric regeneration, carbon dioxide consumption, oxygen production, and water utilization. The shape and size, mass, and energy requirements in relation to the overall integrity of the biomass production chamber are under constant study.

[Network for Oncological Advisory Service (NOF) - a Pilot Project for (Long-Term) Follow-Up Care of Pediatric Cancer Patients].

PubMed

Kremeike, K; Mohr, A; Kampschulte, R; Bergmann, J; Beil, S; Neuhaus, U; Dierks, M-L; Driftmann, C; Duhr, A; Groeneveld, S; Kaspar, M; Kowollik, G; Miest, H-H; Schene, I; Reinhardt, D

2016-11-01

Background: In Germany some 2 000 children and adolescent are diagnosed with cancer every year. Curing rates are increasing and therewith also the number of survivors is growing. Survivors frequently suffer from long-term effects of the disease and its treatment, but long-term follow-up care shows deficits. Method: The Network for oncological advisory service (NOF) started in 11/2013, researching and building up a network of available support in Lower Saxony. A telephone hotline was installed in 01/2014 in order to advice survivors on their problems. At the same time, an interview study on survivors needs was conducted throughout Germany. Results: In the first 2 years, the NOF gave advice to 79 patients. Whilst enquiries of medical or psychological nature were transferred to the cooperation partner, requests on psychosocial and social legal issues are being deled by the NOF due to lack of appropriate partners. The evaluation of 25 interviews shows key issues in long-term after-care: (1) transition from acute therapy to everyday life, (2) problems due to pediatric cancer and therapy, (3) patients perception of own disposition, (4) social reactions towards survivors, (5) structure of long-term follow-up care, (6) information flow. Conclusion: Many survivors suffer from long-term effects of cancer and treatment. The lack of available contact person and being in limbo between cured and simultaneously affected by the cancer treatment and chronic diseases is perceived as being problematic. This translates to various requirements on a patient-oriented long-term care, mainly in the psychosocial field. © Georg Thieme Verlag KG Stuttgart · New York.

Prediction of loss to follow-up in long-term supportive periodontal therapy in patients with chronic periodontitis

PubMed Central

Yang, Hai Jing

2018-01-01

Aim This study examined the predictors of loss to follow-up in long-term supportive periodontal therapy in patients with chronic periodontitis. Methods A total of 280 patients with moderate to severe chronic periodontitis in a tertiary care hospital in China were investigated and followed over the course of study. Questionnaires on clinical and demographic characteristics, self-efficacy for oral self-care and dental fear at baseline were completed. Participants were followed to determine whether they could adhere to long-term supportive periodontal therapy. Binary logistic regression analysis was used to examine the association between clinical and demographic characteristics, self-efficacy for oral self-care, dental fear and loss to follow-up in long-term supportive periodontal therapy. Results The loss to follow-up in long-term supportive periodontal therapy was significantly associated with age [adjusted OR = 1.042, 95% confidence interval (CI): 1.012–1.074, p = 0.006], severe periodontitis [adjusted OR = 4.892, 95%CI: 2.280–10.499, p<0.001], periodontal surgery [adjusted OR = 11.334, 95% CI: 2.235–57.472, p = 0.003], and middle and low-scoring of self-efficacy scale for self-care groups. The adjusted ORs of loss to follow-up for the middle- (54–59) and low-scoring groups (15–53) were 71.899 (95%CI: 23.926–216.062, p<0.001) and 4.800 (95% CI: 2.263–10.182, p<0.001), respectively, compared with the high-scoring SESS group (60–75). Conclusion Age, severity of periodontitis, periodontal surgery and the level of self-efficacy for self-care may be effective predictors of loss to follow-up in long-term supportive periodontal therapy in patients with chronic periodontitis. PMID:29420586

Web-based decision support system to predict risk level of long term rice production

NASA Astrophysics Data System (ADS)

Mukhlash, Imam; Maulidiyah, Ratna; Sutikno; Setiyono, Budi

2017-09-01

Appropriate decision making in risk management of rice production is very important in agricultural planning, especially for Indonesia which is an agricultural country. Good decision would be obtained if the supporting data required are satisfied and using appropriate methods. This study aims to develop a Decision Support System that can be used to predict the risk level of rice production in some districts which are central of rice production in East Java. Web-based decision support system is constructed so that the information can be easily accessed and understood. Components of the system are data management, model management, and user interface. This research uses regression models of OLS and Copula. OLS model used to predict rainfall while Copula model used to predict harvested area. Experimental results show that the models used are successfully predict the harvested area of rice production in some districts which are central of rice production in East Java at any given time based on the conditions and climate of a region. Furthermore, it can predict the amount of rice production with the level of risk. System generates prediction of production risk level in the long term for some districts that can be used as a decision support for the authorities.

Biology as a Key Technological Foundation for Settlement Beyond Earth

NASA Technical Reports Server (NTRS)

Rothschild, L. J.; Navarrete, J.; Kent, R. E.; McCutcheon, G.; Pless, E.; Paulino-Lima, I. G.

2017-01-01

Moving materials beyond Earth, whether spacecraft, living organisms, or both, is limited by mass constraints. Yet human survival requires an extensive infrastructure, from environmental regulation to life support. In practice this means habitats, food, oxygen, waste recycling, medicine and so on. Thus, there is a mismatch between what will be required in transit and at destination to fulfill dreams of human settlements and what can realistically moved there. Further, settlement off planet with current transportation systems requires the ability to operate independently of the Earth for prolonged periods of time, requiring long-term storage of supplies and the flexibilityto satisfy new needs.

Wildlife resource trends in the United States: A technical document supporting the 2000 RPA Assessment

Treesearch

Curtis H. Flather; Stephen J. Brady; Michael S. Knowles

1999-01-01

This report documents trends in wildlife resources for the nation as required by the Renewable Resources Planning Act (RPA) of 1974. The report focuses on recent historical trends in wildlife as one indicator of ecosystem health across the United States and updates wildlife trends presented in previous RPA Assessments. The report also shows short- and long-term...

Certification Report: Army Aviation Alternative Fuels Certification Program

DTIC Science & Technology

2016-08-01

combustion, turbine , fuel system hardware, performance system analysis, system integration, and airworthiness engage in iterative meetings and reviews...increased level of fair wear and tear. The CSI is directed at identifying possible long-term maintenance effects. 6.2.1.1 GE T700 Combustor Rig... maintenance and sustainment (supportability) impacts. FSEs can be conducted at almost any operational base but require significant coordination and a

Starting a European Space Agency Sample Analogue Collection (ESA2C) and Curation Facility for Exploration Missions.

NASA Astrophysics Data System (ADS)

Smith, C. L.; Rumsey, M. S.; Manick, K.; Gill, S.-J.; Mavris, C.; Schroeven-Deceuninck, H.; Duvet, L.

2017-09-01

The ESA2C will support current and future technology development activities that are required for human and robotic exploration of Mars, Phobos, Deimos, C-Type Asteroids and the Moon.The long-term goal of this work is to produce a useful, useable and sustainable resource for engineers and scientists developing technologies for ESA space exploration missions.

School Leavers with Learning Disabilities Moving from Child to Adult Speech and Language Therapy (SLT) Teams: SLTs' Views of Successful and Less Successful Transition Co-Working Practices

ERIC Educational Resources Information Center

McCartney, Elspeth; Muir, Margaret

2017-01-01

School-leaving for pupils with long-term speech, language, swallowing or communication difficulties requires careful management. Speech and language therapists (SLTs) support communication, secure assistive technology and manage swallowing difficulties post-school. UK SLTs are employed by health services, with child SLT teams based in schools.…

Making the CARE Comprehensive Geriatric Assessment as the Core of a Total Mobile Long Term Care Support System in China.

PubMed

Cui, Yanyan; Gong, Dongwei; Yang, Bo; Chen, Hua; Tu, Ming-Hsiang; Zhang, Chaonan; Li, Huan; Liang, Naiwen; Jiang, Liping; Chang, Polun

2018-01-01

Comprehensive Geriatric Assessments (CGAs) have been recommended to be used for better monitoring the health status of elder residents and providing quality care. This study reported how our nurses perceived the usability of CGA component of a mobile integrated-care long term care support system developed in China. We used the Continuity Assessment Record and Evaluation (CARE), developed in the US, as the core CGA component of our Android-based support system, in which apps were designed for all key stakeholders for delivering quality long term care. A convenience sample of 18 subjects from local long term care facilities in Shanghai, China were invited to assess the CGA assessment component in terms of Technology Acceptance Model for Mobile based on real field trial assessment. All (100%) were satisfied with the mobile CGA component. 88.9% perceived the system was easy to learn and use. 99.4% showed their willingness to use for their work. We concluded it is technically feasible to implement a CGA-based mobile integrated care support system in China.

Clinical Nursing Leadership Education in Long-Term Care: Intervention Design and Evaluation.

PubMed

Fiset, Valerie; Luciani, Tracy; Hurtubise, Alyssa; Grant, Theresa L

2017-04-01

The main objective of the current case study was to investigate the perceived leadership learning needs and feasibility of delivering leadership education to registered staff involved in direct care in long-term care (LTC) homes. The study was conducted in Ontario, Canada, and participants included RNs, registered practical nurses, and nursing administrators. Phase 1 bilingual web-based survey and bilingual focus group needs assessment data supported a preference for external training along with in-house mentoring to support sustainability. An intervention designed using insights gained from Phase 1 data was delivered via a 2-day, in-person workshop. Phases 2 and 3 evaluation survey data identified aspects of leadership training for LTC that require ongoing refinement. Findings suggest that communication skills and managing day-to-day nursing demands in the context of regulatory frameworks were areas of particular interest for leadership training in the LTC setting. [Journal of Gerontological Nursing, 43(4), 49-56.]. Copyright 2017, SLACK Incorporated.

Evaluating Sustainability Models for Interoperability through Brokering Software

NASA Astrophysics Data System (ADS)

Pearlman, Jay; Benedict, Karl; Best, Mairi; Fyfe, Sue; Jacobs, Cliff; Michener, William; Nativi, Stefano; Powers, Lindsay; Turner, Andrew

2016-04-01

Sustainability of software and research support systems is an element of innovation that is not often discussed. Yet, sustainment is essential if we expect research communities to make the time investment to learn and adopt new technologies. As the Research Data Alliance (RDA) is developing new approaches to interoperability, the question of uptake and sustainability is important. Brokering software sustainability is one of the areas that is being addressed in RDA. The Business Models Team of the Research Data Alliance Brokering Governance Working Group examined several support models proposed to promote the long-term sustainability of brokering middleware. The business model analysis includes examination of funding source, implementation frameworks and challenges, and policy and legal considerations. Results of this comprehensive analysis highlight advantages and disadvantages of the various models with respect to the specific requirements for brokering services. We offer recommendations based on the outcomes of this analysis that suggest that hybrid funding models present the most likely avenue to long term sustainability.

Citizenship, human rights, and dementia: Towards a new embodied relational ethic of sexuality.

PubMed

Kontos, Pia; Grigorovich, Alisa; Kontos, Alexis P; Miller, Karen-Lee

2016-05-01

Sexual citizenship and sexual rights scholarship have made important contributions to broadening citizenship and more fully accommodating rights related to sexuality. However, this scholarship has concentrated primarily on the sexuality and intimacy-related needs of younger people and those who are not cognitively impaired. Consequently, it has inadvertently served to marginalize persons living with dementia who reside in long-term residential care settings. We argue that supporting sexual rights for persons with dementia requires a particular human rights ontology for citizenship-one that recognizes that corporeality is a fundamental source of self-expression, interdependence, and reciprocal engagement. This is an ontology that underpins our model of relational citizenship and that grounds our articulation of an ethic of embodied relational sexuality. In our view, this ethic offers important direction for the development of policy, legislation, and clinical guidelines to support sexual rights for persons with dementia in long-term residential care. © The Author(s) 2016.

The PRISMS taxonomy of self-management support: derivation of a novel taxonomy and initial testing of its utility.

PubMed

Pearce, Gemma; Parke, Hannah L; Pinnock, Hilary; Epiphaniou, Eleni; Bourne, Claire L A; Sheikh, Aziz; Taylor, Stephanie J C

2016-04-01

Supporting self-management is a core response of health care systems globally to the increasing prevalence of long-term conditions. Lack of a comprehensive taxonomy (or classification) of self-management support components hinders characterization and, ultimately, understanding of these frequently complex, multi-component interventions. To develop a comprehensive, descriptive taxonomy of self-management support components. Components were derived from the 969 unique randomized controlled trials described in the 102 systematic reviews and 61 implementation trials, examining 14 diverse long-term conditions included in the Practical Reviews in Self-Management Support (PRISMS) project followed by discussion at an expert stakeholder workshop. The utility of the taxonomy was then tested using a self-management support intervention for cancer survivors. The PRISMS taxonomy comprises 14 components that might be used to support self-management (e.g. information about condition/management, provision of equipment, social support), when delivered to someone with a long-term condition or their carer. Overarching dimensions are delivery mode; personnel delivering the support; intervention targeting; and intensity, frequency and duration of the intervention. The taxonomy does not consider the effectiveness or otherwise of the different components or the overarching dimensions. The PRISMS taxonomy offers a framework to researchers describing self-management support interventions, to reviewers synthesizing evidence and to developers of health services for people with long-term conditions. © The Author(s) 2015.

Does reactivation trigger episodic memory change? A meta-analysis.

PubMed

Scully, Iiona D; Napper, Lucy E; Hupbach, Almut

2017-07-01

According to the reconsolidation hypothesis, long-term memories return to a plastic state upon their reactivation, leaving them vulnerable to interference effects and requiring re-storage processes or else these memories might be permanently lost. The present study used a meta-analytic approach to critically evaluate the evidence for reactivation-induced changes in human episodic memory. Results indicated that reactivation makes episodic memories susceptible to physiological and behavioral interference. When applied shortly after reactivation, interference manipulations altered the amount of information that could be retrieved from the original learning event. This effect was more pronounced for remote memories and memories of narrative structure. Additionally, new learning following reactivation reliably increased the number of intrusions from new information into the original memory. These findings support a dynamic view of long-term memory by showing that memories can be changed long after they were acquired. Copyright © 2016 Elsevier Inc. All rights reserved.

NASA's Long-Term Archive (LTA) of ICESat Data at the National Snow and Ice Data Center (NSIDC)

NASA Astrophysics Data System (ADS)

Fowler, D. K.; Moses, J. F.; Dimarzio, J. P.; Webster, D.

2011-12-01

Data Stewardship, preservation, and reproducibility are becoming principal parts of a data manager's work. In an era of distributed data and information systems, where the host location ought to be transparent to the internet user, it is of vital importance that organizations make a commitment to both current and long-term goals of data management and the preservation of scientific data. NASA's EOS Data and Information System (EOSDIS) is a distributed system of discipline-specific archives and mission-specific science data processing facilities. Satellite missions and instruments go through a lifecycle that involves pre-launch calibration, on-orbit data acquisition and product generation, and final reprocessing. Data products and descriptions flow to the archives for distribution on a regular basis during the active part of the mission. However there is additional information from the product generation and science teams needed to ensure the observations will be useful for long term climate studies. Examples include ancillary input datasets, product generation software, and production history as developed by the team during the course of product generation. These data and information will need to be archived after product data processing is completed. Using inputs from the USGCRP Workshop on Long Term Archive Requirements (1998), discussions with EOS instrument teams, and input from the 2011 ESIPS Federation meeting, NASA is developing a set of Earth science data and information content requirements for long term preservation that will ultimately be used for all the EOS missions as they come to completion. Since the ICESat/GLAS mission is one of the first to come to an end, NASA and NSIDC are preparing for long-term support of the ICESat mission data now. For a long-term archive, it is imperative that there is sufficient information about how products were prepared in order to convince future researchers that the scientific results are accurate, understandable, useable, and reproducible. Our experience suggests data centers know what to preserve in most cases, i.e., the processing algorithms along with the Level 0 or Level 1a input and ancillary products used to create the higher-level products will be archived and made available to users. In other cases the data centers must seek guidance from the science team, e.g., for pre-launch, calibration/validation, and test data. All these data are an important part of product provenance, contributing to and helping establish the integrity of the scientific observations for long term climate studies. In this presentation we will describe application of information content requirements, guidance from the ICESat/GLAS Science Team and the flow of additional information from the ICESat Science team and Science Investigator-Led Processing System to the Distributed Active Archive Center.

Lunar Extravehicular Activity Program

NASA Technical Reports Server (NTRS)

Heartsill, Amy Ellison

2006-01-01

Extravehicular Activity (EVA) has proven an invaluable tool for space exploration since the inception of the space program. There are situations in which the best means to evaluate, observe, explore and potentially troubleshoot space systems are accomplished by direct human intervention. EVA provides this unique capability. There are many aspects of the technology required to enable a "miniature spaceship" to support individuals in a hostile environment in order to accomplish these tasks. This includes not only the space suit assembly itself, but the tools, design interfaces of equipment on which EVA must work and the specific vehicles required to support transfer of humans between habitation areas and the external world. This lunar mission program will require EVA support in three primary areas. The first of these areas include Orbital stage EVA or micro-gravity EVA which includes both Low Earth Orbit (LEO), transfer and Lunar Orbit EVA. The second area is Lunar Lander EVA capability, which is lunar surface EVA and carries slightly different requirements from micro-gravity EVA. The third and final area is Lunar Habitat based surface EVA, which is the final system supporting a long-term presence on the moon.

Medicare and Medicaid programs; fire safety requirements for long term care facilities, automatic sprinkler systems. Final rule.

PubMed

2008-08-13

This final rule requires all long term care facilities to be equipped with sprinkler systems by August 13, 2013. Additionally, this final rule requires affected facilities to maintain their automatic sprinkler systems once they are installed.

Highway-railway at-grade crossing structures : long term settlement measurements and assessments.

DOT National Transportation Integrated Search

2009-05-01

The purpose of this research to evaluate the long-term settlements for a wide variety of at-grade crossings. Twenty-four highway crossings were monitored to determine the effects of enhanced support on minimizing long-term settlements of the crossing...

The effects of refreshing and elaboration on working memory performance, and their contributions to long-term memory formation.

PubMed

Bartsch, Lea M; Singmann, Henrik; Oberauer, Klaus

2018-03-19

Refreshing and elaboration are cognitive processes assumed to underlie verbal working-memory maintenance and assumed to support long-term memory formation. Whereas refreshing refers to the attentional focussing on representations, elaboration refers to linking representations in working memory into existing semantic networks. We measured the impact of instructed refreshing and elaboration on working and long-term memory separately, and investigated to what extent both processes are distinct in their contributions to working as well as long-term memory. Compared with a no-processing baseline, immediate memory was improved by repeating the items, but not by refreshing them. There was no credible effect of elaboration on working memory, except when items were repeated at the same time. Long-term memory benefited from elaboration, but not from refreshing the words. The results replicate the long-term memory benefit for elaboration, but do not support its beneficial role for working memory. Further, refreshing preserves immediate memory, but does not improve it beyond the level achieved without any processing.

Astrocyte-neuron lactate transport is required for long-term memory formation

PubMed Central

Suzuki, Akinobu; Stern, Sarah A.; Bozdagi, Ozlem; Huntley, George W.; Walker, Ruth H.; Magistretti, Pierre J.; Alberini, Cristina M.

2011-01-01

SUMMARY We report that in the rat hippocampus learning leads to a significant increase in extracellular lactate levels, which derive from glycogen, an energy reserve selectively localized in astrocytes. Astrocytic glycogen breakdown and lactate release are essential for long-term but not short-term memory formation, and for the maintenance of long-term potentiation (LTP) of synaptic strength elicited in-vivo. Disrupting the expression of the astrocytic lactate transporters monocarboxylate transporter 4 (MCT4) or MCT1 causes amnesia, which, like LTP impairment, is rescued by lactate but not equicaloric glucose. Disrupting the expression of the neuronal lactate transporter MCT2 also leads to amnesia that is unaffected by either L-lactate or glucose, suggesting that lactate import into neurons is necessary for long-term memory. Glycogenolysis and astrocytic lactate transporters are also critical for the induction of molecular changes required for memory formation, including the induction of phospho-CREB, Arc and phospho-cofilin. We conclude that astrocyte-neuron lactate transport is required for long-term memory formation. PMID:21376239

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

PubMed Central

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

2009-01-01

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

Ethics and Intimate Sexual Activity in Long-Term Care.

PubMed

Metzger, Eran

2017-07-01

A case is presented in which the staff of a long-term care facility discovers that the husband of a resident with dementia is engaged in sexual activity with her. The case illustrates a dilemma for long-term care facilities that create a home-like environment with a goal of maximizing residents' autonomy while ensuring their safety. An approach to assessing capacity to consent to intimate sexual activity is described, followed by guidelines that nursing homes can implement to support residents who wish to engage in sexual activity. Recommendations are also offered for supporting long-term care staff and family members of residents who are interested in intimate sexual activity. © 2017 American Medical Association. All Rights Reserved.

Long-term outcomes of brief, intensive CBT for specific phobias: The negative impact of ADHD symptoms.

PubMed

Halldorsdottir, Thorhildur; Ollendick, Thomas H

2016-05-01

The objectives were twofold: (a) examine long-term treatment effects in youth receiving 1-session treatment (OST) or educational support (EST) for a specific phobia (SP) and (b) examine the differential predictive and moderation effects of attention-deficit/hyperactivity disorder (ADHD) symptoms on immediate and long-term outcomes following the interventions. Eighty-three children (ages 6-15, 47% female, 89% White) with a SP were randomly assigned to receive OST or EST. Follow up assessments occurred at 1 week, 6 months, 1 year, and 4 years. Hierarchical linear growth modeling (HLGM) was used to explore the association of parent-reported ADHD symptoms, the 2 treatment conditions (i.e., OST vs. EST), and the trajectory of change in the severity of the SP from pretreatment to the 4-year follow-up. Age, conduct problems and learning problems were controlled for in all analyses. A greater immediate reduction in severity rating of the SP was observed in the OST compared to EST, whereas the trajectory of long-term outcomes was similar across conditions over time. Higher levels of ADHD symptoms predicted poor immediate and long-term treatment outcomes across treatment conditions. ADHD symptoms, however, did not moderate the relationship between treatment condition and immediate or long-term treatment outcomes. The results of the study need to be interpreted in light of several study limitations. However, if confirmed, the findings suggest that anxious youth with comorbid ADHD symptoms are less likely to benefit from brief, intensive psychotherapy and may require either longer, standard CBT treatment or adjunctive pharmacotherapy. (c) 2016 APA, all rights reserved).

Definition study for an extended manned test of a regenerative life support system, preliminary test plan

NASA Technical Reports Server (NTRS)

1971-01-01

A preliminary plan and procedure are presented for conducting an extended manned test program for a regenerative life support system. Emphasis will be placed on elements associated with long-term system operation and long-term uninterrupted crew confinement.

CO2CARE - Site Closure Assessment Research - Recent Results

NASA Astrophysics Data System (ADS)

Wipki, Mario; Liebscher, Axel; Kühn, Michael; Lüth, Stefan; Durucan, Sevket; Deflandre, Jean-Pierre; Wollenweber, Jens; Chadwick, Andy; Böhm, Gualtiero

2013-04-01

The EU project CO2CARE, which started in January 2011, supports the large scale demonstration of CCS technology by addressing requirements of operators and regulators face in terms of CO2 storage site abandonment. The CO2CARE consortium, consisting of 24 project partners from universities, research institutes, and the industry, investigate technologies and procedures for abandonment and post-closure safety, satisfying the regulatory requirements for the transfer of responsibility. Nine key injections sites in Europe, USA, Japan, and Australia, each with a specific (hydro) geological and environmental character, were selected for investigations. These sites can be divided into the CO2 storage types on-shore, off-shore, natural CO2 reservoir, depleted gas reservoirs, and saline aquifers. The project mainly focuses on three key areas: - well abandonment and long-term integrity; - reservoir management and prediction from closure to the long-term; - risk management methodologies for long-term safety. These key areas are in turn closely linked to the three high-level requirements of the EU Directive 2009/31/EC, Article 18 for CO2 storage which are: (i) absence of any detectable leakage, (ii) conformity of actual behaviour of the injected CO2 with the modeled behaviour, and (iii) the storage site is evolving towards a situation of long-term stability. The identification of criteria and the development of site abandonment procedures and technologies, which guarantee the fulfillment of the high-level requirements, are the major objectives in CO2CARE. These criteria have to be fulfilled prior to subsequent transfer of responsibility to the competent authorities, typically 20 or 30 years after site closure. Finally, the essential results of the different working groups in CO2CARE will feed into overall guidelines for regulatory compliance and "Best Practice" for site abandonment. Dissemination of the results will show policy makers and the general public how site abandonment procedures for CO2 storage sites can be undertaken sustainably, cost-effectively and with no adverse effect to the local population and the natural environment. After more than two-thirds of the project`s lifetime, an overview of the project`s goals and the most relevant research findings are presented.

Late Protein Synthesis-Dependent Phases in CTA Long-Term Memory: BDNF Requirement

PubMed Central

Martínez-Moreno, Araceli; Rodríguez-Durán, Luis F.; Escobar, Martha L.

2011-01-01

It has been proposed that long-term memory (LTM) persistence requires a late protein synthesis-dependent phase, even many hours after memory acquisition. Brain-derived neurotrophic factor (BDNF) is an essential protein synthesis product that has emerged as one of the most potent molecular mediators for long-term synaptic plasticity. Studies in the rat hippocampus have been shown that BDNF is capable to rescue the late-phase of long-term potentiation as well as the hippocampus-related LTM when protein synthesis was inhibited. Our previous studies on the insular cortex (IC), a region of the temporal cortex implicated in the acquisition and storage of conditioned taste aversion (CTA), have demonstrated that intracortical delivery of BDNF reverses the deficit in CTA memory caused by the inhibition of IC protein synthesis due to anisomycin administration during early acquisition. In this work, we first analyze whether CTA memory storage is protein synthesis-dependent in different time windows. We observed that CTA memory become sensible to protein synthesis inhibition 5 and 7 h after acquisition. Then, we explore the effect of BDNF delivery (2 μg/2 μl per side) in the IC during those late protein synthesis-dependent phases. Our results show that BDNF reverses the CTA memory deficit produced by protein synthesis inhibition in both phases. These findings support the notion that recurrent rounds of consolidation-like events take place in the neocortex for maintenance of CTA memory trace and that BDNF is an essential component of these processes. PMID:21960964

Economics of ion propulsion for large space systems

NASA Technical Reports Server (NTRS)

Masek, T. D.; Ward, J. W.; Rawlin, V. K.

1978-01-01

This study of advanced electrostatic ion thrusters for space propulsion was initiated to determine the suitability of the baseline 30-cm thruster for future missions and to identify other thruster concepts that would better satisfy mission requirements. The general scope of the study was to review mission requirements, select thruster designs to meet these requirements, assess the associated thruster technology requirements, and recommend short- and long-term technology directions that would support future thruster needs. Preliminary design concepts for several advanced thrusters were developed to assess the potential practical difficulties of a new design. This study produced useful general methodologies for assessing both planetary and earth orbit missions. For planetary missions, the assessment is in terms of payload performance as a function of propulsion system technology level. For earth orbit missions, the assessment is made on the basis of cost (cost sensitivity to propulsion system technology level).

Mechanisms of Translation Control Underlying Long-lasting Synaptic Plasticity and the Consolidation of Long-term Memory

PubMed Central

Santini, Emanuela; Huynh, Thu N.; Klann, Eric

2018-01-01

The complexity of memory formation and its persistence is a phenomenon that has been studied intensely for centuries. Memory exists in many forms and is stored in various brain regions. Generally speaking, memories are reorganized into broadly distributed cortical networks over time through systems level consolidation. At the cellular level, storage of information is believed to initially occur via altered synaptic strength by processes such as long-term potentiation (LTP). New protein synthesis is required for long-lasting synaptic plasticity as well as for the formation of long-term memory. The mammalian target of rapamycin complex 1 (mTORC1) is a critical regulator of cap-dependent protein synthesis and is required for numerous forms of long-lasting synaptic plasticity and long-term memory. As such, the study of mTORC1 and protein factors that control translation initiation and elongation have enhanced our understanding of how the process of protein synthesis is regulated during memory formation. Herein we will discuss the molecular mechanisms that regulate protein synthesis as well as pharmacological and genetic manipulations that demonstrate the requirement for proper translational control in long-lasting synaptic plasticity and long-term memory formation. PMID:24484700

Myocardial recovery during mechanical circulatory support: long-term outcome and elective ventricular assist device implantation to promote recovery as a treatment goal.

PubMed

Dandel, Michael; Hetzer, Roland

2015-01-01

Even after incomplete myocardial recovery during mechanical circulatory support, long-term survival rates after ventricular assist device (VAD) explantation can be better than those expected after heart transplantation even for patients with chronic non-ischemic cardiomyopathy as the underlying cause for VAD implantation. The elective therapeutic use of ventricular assist devices for heart failure reversal in its early stage is a future goal. It may be possible to achieve it by developing tools to predict heart failure reversibility even before ventricular assist device implantation and increasing the number of weaning candidates by improvement of adjunctive therapies to optimize unloading-promoted recovery.  Special attention is focused on the long-term stability of cardiac remission after VAD removal, the clinical relevance unloading-promoted myocardial recovery and on the current knowledge about a potential prediction of myocardial recovery during long-term VAD support already before VAD implantation.

National Aeronautics and Space Administration (NASA) Environmental Control and Life Support (ECLS) Integrated Roadmap Development

NASA Technical Reports Server (NTRS)

Metcalf, Jordan; Peterson, Laurie; Carrasquillo, Robyn; Bagdigian, Robert

2011-01-01

At present, NASA has considered a number of future human space exploration mission concepts . Yet, detailed mission requirements and vehicle architectures remain mostly undefined, making technology investment strategies difficult to develop and sustain without a top-level roadmap to serve as a guide. This paper documents a roadmap for development of Environmental Control and Life Support Systems (ECLSS) capabilities required to enhance the long-term operation of the International Space Station (ISS) as well as enable beyond-Low Earth Orbit (LEO) human exploration missions. Three generic mission types were defined to serve as a basis for developing a prioritized list of needed capabilities and technologies. Those are 1) a short duration micro gravity mission; 2) a long duration transit microgravity mission; and 3) a long duration surface exploration mission. To organize the effort, ECLSS was categorized into three major functional groups (atmosphere, water, and solid waste management) with each broken down into sub-functions. The ability of existing state-of-the-art (SOA) technologies to meet the functional needs of each of the three mission types was then assessed by NASA subject matter experts. When SOA capabilities were deemed to fall short of meeting the needs of one or more mission types, those gaps were prioritized in terms of whether or not the corresponding capabilities enable or enhance each of the mission types. The result was a list of enabling and enhancing capabilities needs that can be used to guide future ECLSS development, as well as a list of existing hardware that is ready to go for exploration-class missions. A strategy to fulfill those needs over time was then developed in the form of a roadmap. Through execution of this roadmap, the hardware and technologies intended to meet exploration needs will, in many cases, directly benefit the ISS operational capability, benefit the Multi-Purpose Crew Vehicle (MPCV), and guide long-term technology investments for longer duration missions The final product of this paper is an agreed-to ECLSS roadmap detailing ground and flight testing to support the three mission scenarios previously mentioned. This information will also be used to develop the integrated NASA budget submit in January 2012.

Long-term biological investigations in space.

PubMed

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

1975-01-01

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

Psychosocial working conditions and self-reported long-term illness: a population-based study of Swedish-born and foreign-born employed persons.

PubMed

Sundquist, Jan; Ostergren, Per-Olof; Sundquist, Kristina; Johansson, Sven-Erik

2003-11-01

Knowledge pertaining to the relationship between migration status and psychosocial job characteristics and long-term illness is not readily available in the international literature. The aim of this study is to analyse the cross-sectional associations between high psychological job demands and low decision latitude (high job strain), work-related social support and long-term illness among foreign-born and Swedish-born people. The present study combines four annual simple random samples covering 1994-97 from the Swedish Annual Level of Living Survey (SALLS). A sub-sample, including only employed persons and consisting of 10,072 Swedish-born persons, 710 labour migrants and 333 refugees aged 25-64 years, was analysed using logistic regression. Refugees had a higher risk (OR=1.33; 95% CI: 1.05-1.69) of long-term illness than Swedes. Moreover, those experiencing both high job demands and a low decision latitude ran an increased risk (OR=1.74; 95% CI: 1.42-2.13) of long-term illness. About 63% of the refugees among the unskilled/skilled manual workers had low decision latitudes in comparison with 17% of the intermediate and senior salaried employees. There were only small differences in job demands between labour immigrants, refugees and Swedes. There was no interaction between migration status and high job strain. However, refugees with low social support had nearly twice as high a risk of long-term illness as Swedes with high-level work-related social support. Refugees ran a higher risk of long-term illness than Swedes. Although there were no differences in risk between labour immigrants, refugees and Swedes under job strain, refugees with low work-related social support had a high risk of long-term illness. Unskilled/skilled refugee workers had lower decision latitudes than Swedes.

Outcome of long-term mechanical ventilation support in children.

PubMed

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

2012-10-01

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

30 CFR 800.17 - Bonding requirements for underground coal mines and long-term coal-related surface facilities and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Bonding requirements for underground coal mines and long-term coal-related surface facilities and structures. 800.17 Section 800.17 Mineral Resources... REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS BOND AND INSURANCE REQUIREMENTS FOR SURFACE...

30 CFR 800.17 - Bonding requirements for underground coal mines and long-term coal-related surface facilities and...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Bonding requirements for underground coal mines and long-term coal-related surface facilities and structures. 800.17 Section 800.17 Mineral Resources... REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS BOND AND INSURANCE REQUIREMENTS FOR SURFACE...

30 CFR 800.17 - Bonding requirements for underground coal mines and long-term coal-related surface facilities and...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Bonding requirements for underground coal mines and long-term coal-related surface facilities and structures. 800.17 Section 800.17 Mineral Resources... REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS BOND AND INSURANCE REQUIREMENTS FOR SURFACE...

30 CFR 800.17 - Bonding requirements for underground coal mines and long-term coal-related surface facilities and...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Bonding requirements for underground coal mines and long-term coal-related surface facilities and structures. 800.17 Section 800.17 Mineral Resources... REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS BOND AND INSURANCE REQUIREMENTS FOR SURFACE...

30 CFR 800.17 - Bonding requirements for underground coal mines and long-term coal-related surface facilities and...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Bonding requirements for underground coal mines and long-term coal-related surface facilities and structures. 800.17 Section 800.17 Mineral Resources... REQUIREMENTS FOR SURFACE COAL MINING AND RECLAMATION OPERATIONS BOND AND INSURANCE REQUIREMENTS FOR SURFACE...

Lessons Learnt from Applying Action Research to Support Strategy Formation Processes in Long-Term Care Networks

ERIC Educational Resources Information Center

Cramer, Hendrik; Dewulf, Geert; Voordijk, Hans

2015-01-01

This study demonstrates how action research (AR) that is aimed at scaling-up experiments can be applied to support a strategy formation process (SFP) in a subsidized long-term care network. Previous research has developed numerous AR frameworks to support experiments in various domains, but has failed to explain how to apply AR and action learning…

Design and implementation of an interactive website to support long-term maintenance of weight loss.

PubMed

Stevens, Victor J; Funk, Kristine L; Brantley, Phillip J; Erlinger, Thomas P; Myers, Valerie H; Champagne, Catherine M; Bauck, Alan; Samuel-Hodge, Carmen D; Hollis, Jack F

2008-01-25

For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition. This paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year. The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts. The mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use. Developing interactive websites is expensive, complex, and time consuming. We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient. clinicaltrials.gov NCT00054925.

Evidence, Interpretation, and Qualification from Multiple Reports of Long-Term Outcomes in the Multimodal Treatment Study of Children with ADHD (MTA): Part I--Executive Summary

ERIC Educational Resources Information Center

Swanson, James; Arnold, L. Eugene; Kraemer, Helena; Hechtman, Lily; Molina, Brooke; Hinshaw, Stephen; Vitiello, Benedetto; Jensen, Peter; Steinhoff, Ken; Lerner, Marc; Greenhill, Laurence; Abikoff, Howard; Wells, Karen; Epstein, Jeffery; Elliott, Glen; Newcorn, Jeffrey; Hoza, Betsy; Wigal, Timothy

2008-01-01

Objective: To review the primary and secondary findings from the Multimodal Treatment study of ADHD (MTA) published over the past decade as three sets of articles. Method: In a two-part article--Part I: Executive Summary (without distracting details) and Part II: Supporting Details (with additional background and detail required by the complexity…

Discovery of Implementation Factors That Lead to Technology Adoption in Long-Term Care.

PubMed

Schoville, Rhonda R

2017-10-01

The current exploratory, qualitative study discovered and clarified implementation factors that led to technology adoption in long-term care (LTC). The Integrated Technology Implementation model guided the study of an electronic health record used in three LTC settings. Thirty key stakeholders (i.e., directors of nursing, nurses, and certified nurse aides) participated in focus groups or interviews. Findings indicated experiences were more similar than different among groups and facilities. Five major implementation themes supported by a variety of minor themes were identified. Implications for nursing include that leaders must be knowledgeable and committed to the change and engage staff throughout the implementation process. In addition, various communication and education strategies are required. [Journal of Gerontological Nursing, 43(10), 21-26.]. Copyright 2017, SLACK Incorporated.

Extended Operation of Stirling Convertors at NASA Glenn Research Center

NASA Technical Reports Server (NTRS)

Oriti, Salvatore

2011-01-01

Glenn Research Center (GRC) is supporting life and reliability database for free-piston Stirilng conversion via extended convertor operation Ongoing convertor operation: 18 convertors (4 TDCs from Infinia, 14 ASCs from Sunpower). 350,000 total convertor hours of operation. 218,000 on Infinia units and 132,000 on Sunpower units. Demonstrating steady convertor performance requires precise maintenance of operating conditions. Sources of disruption : Investigative tests: Varying operating frequency, hot-end temp, cold-end temp. Hot end control method: Constant heat input mode requires more user-adjustment than constant temperature mode. Long-term transients in hot end insulation were observed. Support facility: Open-bath circulator fluid concentration drifting. Nuisance shutdowns (instrumentation failure, EMI, power outages). Ambient temperature fluctuations due to room HVAC.

Thin film microelectronics materials production in the vacuum of space

NASA Astrophysics Data System (ADS)

Ignatiev, A.; Sterling, M.; Horton, C.; Freundlich, A.; Pei, S.; Hill, R.

1997-01-01

The international Space Station era will open up a new dimension in the use of one of the unique attributes of space, vacuum, for the production of advanced semiconductor materials and devices for microelectronics applications. Ultra-vacuum is required for the fabrication in thin film form of high quality semiconductors. This can be accomplished behind a free flying platform similar to the current Wake Shield Facility which is specifically designed to support in-space production. The platform will require apparatus for thin film growth, a robotics interface to allow for the change out of raw materials and the harvesting of finished product, and a servicing plant incorporating Space Station that will support long-term utilization of the platform.

Experience, Knowledge, and Concerns About Long-Term Services and Supports: Implications for Financing Reform.

PubMed

Khatutsky, Galina; Wiener, Joshua M; Greene, Angela M; Thach, Nga T

2017-01-01

Using the 2014 Survey of Long-Term Care Awareness and Planning, this article examines Americans' experiences, knowledge, and concerns about long-term services and supports (LTSS) and actions they are willing to take if they become disabled. The survey included 15,298 non-institutionalized respondents aged 40 to 70 years drawn from a nationally representative sample. Although many reported some experience with LTSS, knowledge of how LTSS worked was low. Respondents reported widespread concerns about becoming disabled. They preferred informal care over paid care, with a strong desire to remain in their homes. These results can be used to design reform initiatives and to motivate political support.

GLAS Long-Term Archive: Preservation and Stewardship for a Vital Earth Observing Mission

NASA Astrophysics Data System (ADS)

Fowler, D. K.; Moses, J. F.; Zwally, J.; Schutz, B. E.; Hancock, D.; McAllister, M.; Webster, D.; Bond, C.

2012-12-01

Data Stewardship, preservation, and reproducibility are fast becoming principal parts of a data manager's work. In an era of distributed data and information systems, it is of vital importance that organizations make a commitment to both current and long-term goals of data management and the preservation of scientific data. Satellite missions and instruments go through a lifecycle that involves pre-launch calibration, on-orbit data acquisition and product generation, and final reprocessing. Data products and descriptions flow to the archives for distribution on a regular basis during the active part of the mission. However there is additional information from the product generation and science teams needed to ensure the observations will be useful for long term climate studies. Examples include ancillary input datasets, product generation software, and production history as developed by the team during the course of product generation. These data and information will need to be archived after product data processing is completed. NASA has developed a set of Earth science data and information content requirements for long term preservation that is being used for all the EOS missions as they come to completion. Since the ICESat/GLAS mission was one of the first to end, NASA and NSIDC, in collaboration with the science team, are collecting data, software, and documentation, preparing for long-term support of the ICESat mission. For a long-term archive, it is imperative to preserve sufficient information about how products were prepared in order to ensure future researchers that the scientific results are accurate, understandable, and useable. Our experience suggests data centers know what to preserve in most cases. That is, the processing algorithms along with the Level 0 or Level 1a input and ancillary products used to create the higher-level products will be archived and made available to users. In other cases, such as pre-launch, calibration/validation, and test data, the data centers must seek guidance from the science team. All these data are essential for product provenance, contributing to and helping establish the integrity of the scientific observations for long term climate studies. In this presentation we will describe application of information gathering with guidance from the ICESat/GLAS Science Team, and the flow of additional information from the ICESat Science team and Science Investigator-Led Processing System to the NSIDC Distributed Active Archive Center. This presentation will also cover how we envision user support through the years of the Long-Term Archive.

Evaluation of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study

PubMed Central

Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

2016-01-01

Objectives To gain insights into the process of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Design Qualitative study alongside a cluster randomised controlled trial. Setting 17 long-term care homes spread across the Netherlands. Participants 34 licensed practical nurses supporting 54 dual sensory impaired older adults. Intervention A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Primary outcomes Nurses’ perceptions on relevance and feasibility of the self-management programme collected from nurses’ semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers’ reports. Results Nurses’ initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults’ autonomy needs. However, nurses’ initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Conclusions Longitudinal data collection enabled exploration of nurses’ changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond ‘protocol thinking’, discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer more longitudinal coaching of autonomy supportive conversational skills. Intervention programming should acknowledge that change is a process rather than an event, and should include self-evaluations of professional behaviours over a period of time. Trial registration number NCT01217502, Post-results. PMID:27856482

Evaluation of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study.

PubMed

Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

2016-11-17

To gain insights into the process of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Qualitative study alongside a cluster randomised controlled trial. 17 long-term care homes spread across the Netherlands. 34 licensed practical nurses supporting 54 dual sensory impaired older adults. A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Nurses' perceptions on relevance and feasibility of the self-management programme collected from nurses' semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers' reports. Nurses' initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults' autonomy needs. However, nurses' initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Longitudinal data collection enabled exploration of nurses' changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond 'protocol thinking', discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer more longitudinal coaching of autonomy supportive conversational skills. Intervention programming should acknowledge that change is a process rather than an event, and should include self-evaluations of professional behaviours over a period of time. NCT01217502, Post-results. 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/.

Hip protector compliance: a 13-month study on factors and cost in a long-term care facility.

PubMed

Burl, Jeffrey B; Centola, James; Bonner, Alice; Burque, Colleen

2003-01-01

To determine if a high compliance rate for wearing external hip protectors could be achieved and sustained in a long-term care population. A 13-month prospective study of daytime use of external hip protectors in an at-risk long-term care population. One hundred-bed not-for-profit long-term care facility. Thirty-eight ambulatory residents having at least 1 of 4 risk factors (osteoporosis, recent fall, positive fall screen, previous fracture). The rehabilitation department coordinated an implementation program. Members of the rehabilitation team met with eligible participants, primary caregivers, families, and other support staff for educational instruction and a description of the program. The rehabilitation team assumed overall responsibility for measuring and ordering hip protectors and monitoring compliance. By the end of the third month, hip protector compliance averaged greater than 90% daily wear. The average number of falls per month in the hip protector group was 3.9 versus 1.3 in nonparticipants. Estimated total indirect staff time was 7.75 hours. The total cost of the study (hip protectors and indirect staff time) was 6,300 US dollars. High hip protector compliance is both feasible and sustainable in an at-risk long-term care population. Achieving high compliance requires an interdisciplinary approach with one department acting as a champion. The cost of protectors could be a barrier to widespread use. Facilities might be unable to cover the cost until the product is paid for by third-party payers.

Increased efficiency of gamma-irradiated versus mitomycin C-treated feeder cells for the expansion of normal human cells in long-term cultures.

PubMed

Roy, A; Krzykwa, E; Lemieux, R; Néron, S

2001-12-01

Several normal human cells, such as hematopoietic stem cells, dendritic cells, and B cells, can be cultured in vitro in defined optimal conditions. Several ex vivo culture systems require the use of feeder cells to support the growth of target cells. In such systems, proliferation of feeder cells has to be stopped, so that they can be used as nonreplicating viable support cells. Because feeder cells need to provide one or few active signals, it is important to maintain them in an metabolically active state, allowing continued expression of specific ligands or cytokines. Mitomycin C and gamma-irradiation treatments are commonly used to prepare nonproliferating feeder cells and are usually considered to be equivalent. Normal human B lymphocytes can be expanded in vitro in the presence of feeder cells expressing the CD40 ligand CD154. Here we compared the ability of gamma-irradiation- and mitomycin C-treated feeder cells to support the expansion of normal human B lymphocytes. The results indicate that expansion of B cells during a long-term culture was 100 times more potent using gamma-irradiated feeder cells compared to mitomycin C-treated cells. This difference could be related to a significant reduction in both cellular metabolism and level of CD154 expression observed in mitomycin C-treated feeder cells, but not in gamma-irradiated cells nor in control untreated cells. These results indicate that mitomycin C-treated feeder cells are metabolically altered, and consequently less efficient at maintaining cell expansion in the long-term cell culture system used.

Mutual Support Groups for Long-Term Recipients of TANF

ERIC Educational Resources Information Center

Anderson-Butcher, Dawn; Khairallah, Angela Oliver; Race-Bigelow, Janis

2004-01-01

This study examined the effect of involvement in mutual support groups on long-term recipients of Temporary Assistance for Needy Families (TANF) and other vulnerable individuals. From qualitative interviews with nine group members, the study identified key themes, benefits, and barriers related to involvement in the groups. Content analysis of the…

SNAP 19 Pioneer F and G. Final Report

DOE R&D Accomplishments Database

1973-06-01

The generator developed for the Pioneer mission evolved from the SNAP 19 RTG`s launched aboard the NIMBUS III spacecraft. In order to satisfy the power requirements and environment of earth escape trajectory, significant modifications were made to the thermoelectric converter, heat source, and structural configuration. Specifically, a TAGS 2N thermoelectric couple was designed to provide higher efficiency and improved long term power performance, and the electrical circuitry was modified to yield very low magnetic field from current flow in the RTG. A new heat source was employed to satisfy operational requirements and its integration with the generator required alteration to the method of providing support to the fuel capsule.

Longitudinal study of long-term smoking behaviour by biomarker-supported determination of exposure to smoke.

PubMed

Cunningham, Anthony; Sommarström, Johan; Sisodiya, Ajit S; Errington, Graham; Prasad, Krishna

2014-04-12

Long-term studies of smokers who switch to lower nicotine yield cigarettes have been identified by the World Health Organization Study Group TobReg and the US Food and Drug Administration as one key area where new knowledge is required to guide science based regulation. The limited number of long-term switching studies have concluded that smokers who switch to lower nicotine yield cigarettes show evidence of partial compensation. Since the European Union tobacco product directive of 2001 introduced tar and nicotine yield ceilings, there has been no long-term observational switching study. To address the limitations of previous studies where smokers were forced switched for relatively short durations, we plan to undertake a long-term study of spontaneous switching which is appropriately powered and includes non-switchers as a control group. Healthy adult smokers aged 21-64 years will be enrolled into this 5-year non-residential, multicentre study across 10 cities in Germany. They will be assessed at 10 timepoints with 6 month intervals during which inclusion criteria will be reassessed and spent cigarette filter tips, saliva and 24 h urine samples will be collected. These samples will be used to determine average daily cigarette consumption, estimate mouth-level exposure to tar and nicotine and measure selected biomarkers of exposure, respectively. Spontaneous changes in subjects' preferred cigarette products and any consequent change in tar or nicotine yield will be monitored. Subjects will be required to complete questionnaires on quality of life, smoking behaviours, smoking-related sensory attributes and recent life changes. The planned study is anticipated to contribute to understanding smokers' behaviours and their consequent exposure to smoke constituents. It will also allow assessment of compensatory changes in their behaviour following spontaneous switching of cigarette product smoked. Data from this study are expected to provide insights into study design and conduct for non-clinical assessment of smokers' exposure as part of post marketing surveillance programmes. Current Controlled Trials Database reference ISRCTN95019245.

Health-Related Quality of Life: Expanding a Conceptual Framework to Include Older Adults Who Receive Long-Term Services and Supports

ERIC Educational Resources Information Center

Zubritsky, Cynthia; Abbott, Katherine M.; Hirschman, Karen B.; Bowles, Kathryn H.; Foust, Janice B.; Naylor, Mary D.

2013-01-01

For older adults receiving long-term services and supports (LTSS), health-related quality of life (HRQoL) has emerged as a critical construct to examine because of its focus on components of well-being, which are affected by progressive changes in health status, health care, and social support. HRQoL is a health-focused quality of life (QOL)…

Heart Failure and Mortality of Adult Survivors from Acute Myocarditis Requiring Intensive Care Treatment - A Nationwide Cohort Study

PubMed Central

Chang, Jung-Jung; Lin, Ming-Shyan; Chen, Tien-Hsing; Chen, Dong-Yi; Chen, Shao-Wei; Hsu, Jen-Te; Wang, Po-Chang; Lin, Yu-Sheng

2017-01-01

Background The correlation between severity and long-term outcomes of pediatric myocarditis have been reported, however this correlation in adults has rarely been studied. Materials and Methods This nationwide population-based cohort study used data from the National Health Insurance Research Database in Taiwan. Patients aged < 75 and > 18 years admitted to an intensive care unit due to acute myocarditis were enrolled and divided into three groups according to mechanical circulatory support (MCS) after excluding major comorbidities. All-cause mortality, cardiovascular death, and heart failure hospitalization were evaluated from January 1, 2001 to December 31, 2011. Results There were 1145 patients with acute myocarditis (mean age 40.2 years, SD: 14.8 years), of which 851 did not require MCS, 99 underwent intra-aortic balloon pump (IABP) support, and 195 extracorporeal membrane oxygenation (ECMO) support. There was no significant difference in heart failure hospitalization between the three groups after index admission. The incidence of cardiovascular death after discharge ranged from 10 % to 22%, which was highest in the ECMO group, and was also significantly different between the three groups within 3 months (p<0.001) but it disappeared after 3 months (p=0.458). The trend was also noted in incidence of all-cause mortality. Conclusions The severity of acute myocarditis did not affect long-term outcomes, however, it was associated with cardiovascular/all-cause death within 3 months after discharge. PMID:29104480

Ames Research Center FY 2000 Implementation Plan: Leading Technology into the New Millennium

NASA Technical Reports Server (NTRS)

2000-01-01

This document presents the implementation plan for Ames Research Center (ARC) within the overall framework of the NASA Strategic Plan. It describes how ARC intends to implement its Center of Excellence responsibilities, Agency assigned missions, Agency and Enterprise lead programs, and other roles in support of NASA's vision and mission. All Federal agencies are required by the 1993 Government Performance and Results Act to implement a long-term strategic planning process that includes measurable outcomes and strict accountability. At NASA, this planning process is shaped by the Space Act of 1958, annual appropriations, and other external mandates, as well as by customer requirements. The resulting Strategic Plan sets the overall architecture for what we do, identifies who our customers are, and directs where we are going and why. The Strategic Plan is the basis upon which decisions regarding program implementation and resource deployment are made. Whereas the strategic planning process examines the long-term direction of the organization and identifies a specific set of goals, the implementation planning process examines the detailed performance of the organization and allocates resources toward meeting these goals. It is the purpose of this implementation document to provide the connection between the NASA Strategic Plan and the specific programs and support functions that ARC employees perform. This connection flows from the NASA Strategic Plan, through the various Strategic Enterprise plans to the ARC Center of Excellence, primary missions, Lead Center programs, program support responsibilities, and ultimately, to the role of the individual ARC employee.

Development and research program for a soil-based bioregenerative agriculture system to feed a four person crew at a Mars base.

PubMed

Silverstone, S; Nelson, M; Alling, A; Allen, J

2003-01-01

For humans to survive during long-term missions on the Martian surface, bioregenerative life support systems including food production will decrease requirements for launch of Earth supplies, and increase mission safety. It is proposed that the development of "modular biospheres"--closed system units that can be air-locked together and which contain soil-based bioregenerative agriculture, horticulture, with a wetland wastewater treatment system is an approach for Mars habitation scenarios. Based on previous work done in long-term life support at Biosphere 2 and other closed ecological systems, this consortium proposes a research and development program called Mars On Earth(TM) which will simulate a life support system designed for a four person crew. The structure will consist of 6 x 110 square meter modular agricultural units designed to produce a nutritionally adequate diet for 4 people, recycling all air, water and waste, while utilizing a soil created by the organic enrichment and modification of Mars simulant soils. Further research needs are discussed, such as determining optimal light levels for growth of the necessary range of crops, energy trade-offs for agriculture (e.g. light intensity vs. required area), capabilities of Martian soils and their need for enrichment and elimination of oxides, strategies for use of human waste products, and maintaining atmospheric balance between people, plants and soils. c2002 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

Different Phases of Long-Term Memory Require Distinct Temporal Patterns of PKA Activity after Single-Trial Classical Conditioning

ERIC Educational Resources Information Center

Michel, Maximilian; Kemenes, Ildiko; Muller, Uli; Kemenes, Gyorgy

2008-01-01

The cAMP-dependent protein kinase (PKA) is known to play a critical role in both transcription-independent short-term or intermediate-term memory and transcription-dependent long-term memory (LTM). Although distinct phases of LTM already have been demonstrated in some systems, it is not known whether these phases require distinct temporal patterns…

Astrocyte-neuron lactate transport is required for long-term memory formation.

PubMed

Suzuki, Akinobu; Stern, Sarah A; Bozdagi, Ozlem; Huntley, George W; Walker, Ruth H; Magistretti, Pierre J; Alberini, Cristina M

2011-03-04

We report that, in the rat hippocampus, learning leads to a significant increase in extracellular lactate levels that derive from glycogen, an energy reserve selectively localized in astrocytes. Astrocytic glycogen breakdown and lactate release are essential for long-term but not short-term memory formation, and for the maintenance of long-term potentiation (LTP) of synaptic strength elicited in vivo. Disrupting the expression of the astrocytic lactate transporters monocarboxylate transporter 4 (MCT4) or MCT1 causes amnesia, which, like LTP impairment, is rescued by L-lactate but not equicaloric glucose. Disrupting the expression of the neuronal lactate transporter MCT2 also leads to amnesia that is unaffected by either L-lactate or glucose, suggesting that lactate import into neurons is necessary for long-term memory. Glycogenolysis and astrocytic lactate transporters are also critical for the induction of molecular changes required for memory formation, including the induction of phospho-CREB, Arc, and phospho-cofilin. We conclude that astrocyte-neuron lactate transport is required for long-term memory formation. Copyright © 2011 Elsevier Inc. All rights reserved.

Presynaptic Protein Synthesis Is Required for Long-Term Plasticity of GABA Release.

PubMed

Younts, Thomas J; Monday, Hannah R; Dudok, Barna; Klein, Matthew E; Jordan, Bryen A; Katona, István; Castillo, Pablo E

2016-10-19

Long-term changes of neurotransmitter release are critical for proper brain function. However, the molecular mechanisms underlying these changes are poorly understood. While protein synthesis is crucial for the consolidation of postsynaptic plasticity, whether and how protein synthesis regulates presynaptic plasticity in the mature mammalian brain remain unclear. Here, using paired whole-cell recordings in rodent hippocampal slices, we report that presynaptic protein synthesis is required for long-term, but not short-term, plasticity of GABA release from type 1 cannabinoid receptor (CB 1 )-expressing axons. This long-term depression of inhibitory transmission (iLTD) involves cap-dependent protein synthesis in presynaptic interneuron axons, but not somata. Translation is required during the induction, but not maintenance, of iLTD. Mechanistically, CB 1 activation enhances protein synthesis via the mTOR pathway. Furthermore, using super-resolution STORM microscopy, we revealed eukaryotic ribosomes in CB 1 -expressing axon terminals. These findings suggest that presynaptic local protein synthesis controls neurotransmitter release during long-term plasticity in the mature mammalian brain. Copyright © 2016 Elsevier Inc. All rights reserved.

Enabling long-term oceanographic research: Changing data practices, information management strategies and informatics

NASA Astrophysics Data System (ADS)

Baker, Karen S.; Chandler, Cynthia L.

2008-09-01

Interdisciplinary global ocean science requires new ways of thinking about data and data management. With new data policies and growing technological capabilities, datasets of increasing variety and complexity are being made available digitally and data management is coming to be recognized as an integral part of scientific research. To meet the changing expectations of scientists collecting data and of data reuse by others, collaborative strategies involving diverse teams of information professionals are developing. These changes are stimulating the growth of information infrastructures that support multi-scale sampling, data repositories, and data integration. Two examples of oceanographic projects incorporating data management in partnership with science programs are discussed: the Palmer Station Long-Term Ecological Research program (Palmer LTER) and the United States Joint Global Ocean Flux Study (US JGOFS). Lessons learned from a decade of data management within these communities provide an experience base from which to develop information management strategies—short-term and long-term. Ocean Informatics provides one example of a conceptual framework for managing the complexities inherent to sharing oceanographic data. Elements are introduced that address the economies-of-scale and the complexities-of-scale pertinent to a broader vision of information management and scientific research.

A Multi-Stage Maturity Model for Long-Term IT Outsourcing Relationship Success

ERIC Educational Resources Information Center

Luong, Ming; Stevens, Jeff

2015-01-01

The Multi-Stage Maturity Model for Long-Term IT Outsourcing Relationship Success, a theoretical stages-of-growth model, explains long-term success in IT outsourcing relationships. Research showed the IT outsourcing relationship life cycle consists of four distinct, sequential stages: contract, transition, support, and partnership. The model was…

Dilemmas in providing resilience-enhancing social services to long-term social assistance clients. A qualitative study of Swedish social workers.

PubMed

Marttila, Anneli; Johansson, Eva; Whitehead, Margaret; Burström, Bo

2012-07-12

Long-term recipients of social assistance face barriers to social and economic inclusion, and have poorer health and more limited opportunities for improving their health than many other groups in the population. During recent decades there have been changes in Swedish social policy, with cutbacks in public benefits and a re-emphasis on means-tested policies. In this context, it is important to investigate the necessary conditions for social workers to offer social assistance and services, as well as the mediating role of social workers between public policies and their clients. Swedish social services aim to promote social inclusion by strengthening the individual's own resources. We investigated the issues that arise when providing social services to long-term social assistance clients within the framework of resilience, which focuses on the processes leading to positive functioning in adverse conditions. Interviews were conducted with 23 social workers in Stockholm and analysed by qualitative content analysis. The main theme to emerge from the interviews concerned the constraints that the social workers faced in providing social services to social assistance clients. The first subtheme focused on dilemmas in the interaction between social workers and clients resulting from the dual role of exercising authority and supporting and building trust with clients. Working conditions of social workers also played a crucial role. The second subtheme addressed the impact of the societal context, such as labour market opportunities and coordination between authorities. Overall, we found that social workers to a great extent tried to find individual solutions to structural problems. To provide resilience-enhancing social services to long-term social assistance clients with varying obstacles and needs requires a constructive working environment, supportive societal structures and inter-sectoral cooperation between different authorities.

Toward an integrated computerized patient record.

PubMed

Dole, T R; Luberti, A A

2000-04-01

Developing a comprehensive electronic medical record system to serve ambulatory care providers in a large health care enterprise requires significant time and resources. One approach to achieving this system is to devise a series of short-term, workable solutions until a complete system is designed and implemented. The initial solution introduced a basic (mini) medical record system that provided an automated problem/summary sheet and decentralization of ambulatory-based medical records. The next step was to partner with an information system vendor committed to continued development of the long-term system capable of supporting the health care organization well into the future.

Integrated Global Observation Strategy - Ozone and Atmospheric Chemistry Project

NASA Technical Reports Server (NTRS)

Hilsenrath, Ernest; Readings, C. J.; Kaye, J.; Mohnen, V.; Einaudi, Franco (Technical Monitor)

2000-01-01

The "Long Term Continuity of Stratospheric Ozone Measurements and Atmospheric Chemistry" project was one of six established by the Committee on Earth Observing Satellites (CEOS) in response to the Integrated Global Observing Strategy (IGOS) initiative. IGOS links satellite and ground based systems for global environmental observations. The strategy of this project is to develop a consensus of user requirements including the scientific (SPARC, IGAC, WCRP) and the applications community (WMO, UNEP) and to develop a long-term international plan for ozone and atmospheric chemistry measurements. The major components of the observing system include operational and research (meeting certain criteria) satellite platforms planned by the space faring nations which are integrated with a well supported and sustained ground, aircraft, and balloon measurements program for directed observations as well satellite validation. Highly integrated and continuous measurements of ozone, validation, and reanalysis efforts are essential to meet the international scientific and applications goals. In order to understand ozone trends, climate change, and air quality, it is essential to conduct long term measurements of certain other atmospheric species. These species include key source, radical, and reservoir constituents.

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

Lill, R.; Sereno, N.; Yang, B.

The Advanced Photon Source (APS) is currently in the preliminary design phase for the multi-bend achromat (MBA) lattice upgrade. Beam stability is critical for the MBA and will require long term drift defined as beam mo-tion over a seven-day timescale to be no more than 1 mi-cron at the insertion device locations and beam angle change no more than 0.25 micro-radian. Mechanical stabil-ity of beam position monitor (BPM) pickup electrodes mounted on insertion device vacuum chambers place a fun-damental limitation on long-term beam stability for inser-tion device beamlines. We present the design and imple-mentation of prototype mechanical motion system (MMS)more » instrumentation for quantifying this type of motion specif-ically in the APS accelerator tunnel and experiment hall floor under normal operating conditions. The MMS pres-ently provides critical position information on the vacuum chamber and BPM support systems. Initial results of the R&D prototype systems have demonstrated that the cham-ber movements far exceed the long-term drift tolerance specified for the APS Upgrade MBA storage ring.« less

78 FR 66945 - Proposed Collection; 60-Day Comment request: Gulf Long-Term Follow-Up Study (GuLF STUDY)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... Comment request: Gulf Long-Term Follow-Up Study (GuLF STUDY) Summary: In compliance with the requirement... days of the date of this publication. Proposed Collection: Gulf Long-Term Follow-Up Study (GuLF STUDY... GuLF STUDY is to investigate potential short- and long-term health effects associated with oil spill...

Zero-G life support for Space Station Freedom

NASA Technical Reports Server (NTRS)

Kolodney, Matthew; Dall-Bauman, L.

1992-01-01

Optimal design of spacecraft environmental control and life support systems (ECLSS) for long duration missions requires an understanding of microgravity and its long-term influence on ECLSS performance characteristics. This understanding will require examination of the fundamental processes associated with air revitalization and water recovery in a microgravity environment. Short term testing can be performed on NASA's reduced gravity aircraft (a KC-135), but longer tests will need to be conducted on the shuttle or Space Station Freedom. Conceptual designs have been prepared for ECLSS test beds that will allow extended testing of equipment under microgravity conditions. Separate designs have been formulated for air revitalization and water recovery test beds. In order to allow testing of a variety of hardware with minimal alteration of the beds themselves, the designs include storage tanks, plumbing, and limited instrumentation that would be expected to be common to all air (or water) treatment equipment of interest. In the interest of minimizing spacecraft/test bed interface requirements, the beds are designed to recycle process fluids to the greatest extent possible. In most cases, only cooling water and power interfaces are required. A volume equal to that of two SSF lockers was allowed for each design. These bed dimensions would limit testing to equipment with a 0.5- to 1.5-person-equivalent throughput. The mass, volume, and power requirements for the air revitalization test bed are estimated at 125-280 kg, 1.0- 1.4 cubic meters, and 170 min 1070 W. Corresponding ranges for the water recovery test bed are 325-375 kg, 1.0- 1.1 cubic meters, and 350-850 W. These figures include individual test articles and accompanying hardware as well as the tanks, plumbing, and instrumentation included in the bed designs. Process fluid weight (i.e., water weight) is also included.

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

PubMed

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

2015-01-01

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

Genetic Mapping in Mice Reveals the Involvement of Pcdh9 in Long-Term Social and Object Recognition and Sensorimotor Development.

PubMed

Bruining, Hilgo; Matsui, Asuka; Oguro-Ando, Asami; Kahn, René S; Van't Spijker, Heleen M; Akkermans, Guus; Stiedl, Oliver; van Engeland, Herman; Koopmans, Bastijn; van Lith, Hein A; Oppelaar, Hugo; Tieland, Liselotte; Nonkes, Lourens J; Yagi, Takeshi; Kaneko, Ryosuke; Burbach, J Peter H; Yamamoto, Nobuhiko; Kas, Martien J

2015-10-01

Quantitative genetic analysis of basic mouse behaviors is a powerful tool to identify novel genetic phenotypes contributing to neurobehavioral disorders. Here, we analyzed genetic contributions to single-trial, long-term social and nonsocial recognition and subsequently studied the functional impact of an identified candidate gene on behavioral development. Genetic mapping of single-trial social recognition was performed in chromosome substitution strains, a sophisticated tool for detecting quantitative trait loci (QTL) of complex traits. Follow-up occurred by generating and testing knockout (KO) mice of a selected QTL candidate gene. Functional characterization of these mice was performed through behavioral and neurological assessments across developmental stages and analyses of gene expression and brain morphology. Chromosome substitution strain 14 mapping studies revealed an overlapping QTL related to long-term social and object recognition harboring Pcdh9, a cell-adhesion gene previously associated with autism spectrum disorder. Specific long-term social and object recognition deficits were confirmed in homozygous (KO) Pcdh9-deficient mice, while heterozygous mice only showed long-term social recognition impairment. The recognition deficits in KO mice were not associated with alterations in perception, multi-trial discrimination learning, sociability, behavioral flexibility, or fear memory. Rather, KO mice showed additional impairments in sensorimotor development reflected by early touch-evoked biting, rotarod performance, and sensory gating deficits. This profile emerged with structural changes in deep layers of sensory cortices, where Pcdh9 is selectively expressed. This behavior-to-gene study implicates Pcdh9 in cognitive functions required for long-term social and nonsocial recognition. This role is supported by the involvement of Pcdh9 in sensory cortex development and sensorimotor phenotypes. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Epilepsy analytic system with cloud computing.

PubMed

Shen, Chia-Ping; Zhou, Weizhi; Lin, Feng-Seng; Sung, Hsiao-Ya; Lam, Yan-Yu; Chen, Wei; Lin, Jeng-Wei; Pan, Ming-Kai; Chiu, Ming-Jang; Lai, Feipei

2013-01-01

Biomedical data analytic system has played an important role in doing the clinical diagnosis for several decades. Today, it is an emerging research area of analyzing these big data to make decision support for physicians. This paper presents a parallelized web-based tool with cloud computing service architecture to analyze the epilepsy. There are many modern analytic functions which are wavelet transform, genetic algorithm (GA), and support vector machine (SVM) cascaded in the system. To demonstrate the effectiveness of the system, it has been verified by two kinds of electroencephalography (EEG) data, which are short term EEG and long term EEG. The results reveal that our approach achieves the total classification accuracy higher than 90%. In addition, the entire training time accelerate about 4.66 times and prediction time is also meet requirements in real time.

45 CFR 144.204 - Applicability of regulations.

Code of Federal Regulations, 2010 CFR

2010-10-01

....204 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships... insurance policies to individuals under a qualified State long-term care insurance partnership. They do not...

Genetic predictors of weight loss and weight regain after intensive lifestyle modification, metformin treatment, or standard care in the Diabetes Prevention Program.

PubMed

Delahanty, Linda M; Pan, Qing; Jablonski, Kathleen A; Watson, Karol E; McCaffery, Jeanne M; Shuldiner, Alan; Kahn, Steven E; Knowler, William C; Florez, Jose C; Franks, Paul W

2012-02-01

We tested genetic associations with weight loss and weight regain in the Diabetes Prevention Program, a randomized controlled trial of weight loss-inducing interventions (lifestyle and metformin) versus placebo. Sixteen obesity-predisposing single nucleotide polymorphisms (SNPs) were tested for association with short-term (baseline to 6 months) and long-term (baseline to 2 years) weight loss and weight regain (6 months to study end). Irrespective of treatment, the Ala12 allele at PPARG associated with short- and long-term weight loss (-0.63 and -0.93 kg/allele, P ≤ 0.005, respectively). Gene-treatment interactions were observed for short-term (LYPLAL1 rs2605100, P(lifestyle*SNP) = 0.032; GNPDA2 rs10938397, P(lifestyle*SNP) = 0.016; MTCH2 rs10838738, P(lifestyle*SNP) = 0.022) and long-term (NEGR1 rs2815752, P(metformin*SNP) = 0.028; FTO rs9939609, P(lifestyle*SNP) = 0.044) weight loss. Three of 16 SNPs were associated with weight regain (NEGR1 rs2815752, BDNF rs6265, PPARG rs1801282), irrespective of treatment. TMEM18 rs6548238 and KTCD15 rs29941 showed treatment-specific effects (P(lifestyle*SNP) < 0.05). Genetic information may help identify people who require additional support to maintain reduced weight after clinical intervention.

Exercise Countermeasure Hardware Evolution on ISS: The First Decade.

PubMed

Korth, Deborah W

2015-12-01

The hardware systems necessary to support exercise countermeasures to the deconditioning associated with microgravity exposure have evolved and improved significantly during the first decade of the International Space Station (ISS), resulting in both new types of hardware and enhanced performance capabilities for initial hardware items. The original suite of countermeasure hardware supported the first crews to arrive on the ISS and the improved countermeasure system delivered in later missions continues to serve the astronauts today with increased efficacy. Due to aggressive hardware development schedules and constrained budgets, the initial approach was to identify existing spaceflight-certified exercise countermeasure equipment, when available, and modify it for use on the ISS. Program management encouraged the use of commercial-off-the-shelf (COTS) hardware, or hardware previously developed (heritage hardware) for the Space Shuttle Program. However, in many cases the resultant hardware did not meet the additional requirements necessary to support crew health maintenance during long-duration missions (3 to 12 mo) and anticipated future utilization activities in support of biomedical research. Hardware development was further complicated by performance requirements that were not fully defined at the outset and tended to evolve over the course of design and fabrication. Modifications, ranging from simple to extensive, were necessary to meet these evolving requirements in each case where heritage hardware was proposed. Heritage hardware was anticipated to be inherently reliable without the need for extensive ground testing, due to its prior positive history during operational spaceflight utilization. As a result, developmental budgets were typically insufficient and schedules were too constrained to permit long-term evaluation of dedicated ground-test units ("fleet leader" type testing) to identify reliability issues when applied to long-duration use. In most cases, the exercise unit with the most operational history was the unit installed on the ISS.

Environmental Monitoring as Part of Life Support for the Crew Habitat for Lunar and Mars Missions

NASA Technical Reports Server (NTRS)

Jan, Darrell L.

2010-01-01

Like other crewed space missions, future missions to the moon and Mars will have requirements for monitoring the chemical and microbial status of the crew habitat. Monitoring the crew habitat becomes more critical in such long term missions. This paper will describe the state of technology development for environmental monitoring of lunar lander and lunar outpost missions, and the state of plans for future missions.

Long-Term Monitoring of Global Climate Forcings and Feedbacks

NASA Technical Reports Server (NTRS)

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

1993-01-01

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

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

PubMed

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

2016-04-15

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

A Case of Successful Teaching Policy: Connecticut's Long-Term Efforts To Improve Teaching and Learning. A Research Report.

ERIC Educational Resources Information Center

Wilson, Suzanne M.; Darling-Hammond, Linda; Berry, Barnett

In this monograph, the authors describe Connecticut's long-term efforts to implement a comprehensive set of teaching quality policies to support improved student learning. The authors begin by describing the 15-year evolution of policies designed to recruit, prepare, and support teachers, while also creating greater accountability for the…

Counter - Drug: Mandate for the Army.

DTIC Science & Technology

1991-03-01

this comprehensive review will provide a basis for responding to new missions assigned...observations for determining the short-, mid-, and long-term direction of Army support to the national counter-drug effort. Also, this comprehensive review will provide...and long-term direction of Army support to the national counter-drug effort. Also, this comprehensive review will provide a basis for responding

Work attendance among healthcare workers: prevalence, incentives, and long-term consequences for health and performance.

PubMed

Dellve, Lotta; Hadzibajramovic, Emina; Ahlborg, Gunnar

2011-09-01

This paper is a report of a cohort study of healthcare workers' work attendance, and its long-term consequences' on health, burnout, work ability and performance. Concepts and measures of work attendance have varied in the scientific literature. Attending work in spite of being sick can have serious consequences on health. There is little knowledge on which individual and work-related conditions that increase work attendance and the long-term impact on health and performance. Prospective analyses of three measures of work attendance i.e. sickness attendance, uninterrupted long-term attendance and balanced attendance (≤7 days of sick leave per year and no sickness attendance) were done using questionnaire data from a 2-year cohort study (2004-2006) of randomly selected healthcare workers (n = 2624). Incentives (e.g. effort-reward balance, social support, meaningfulness) and requirements (e.g. time-pressure, dutifulness, high responsibility) to attend work as well as general health, burnout, sick leave, work ability and performance were assessed. There was a positive relation between balanced work attendance and incentives, whereas high sickness attendance was associated with requirements. Follow up after 2 years showed that balanced attendance was associated with sustained health and performance while sickness attendance was associated with poor health, burnout, sick-leave and decreased performance. It is important to distinguish between measures of work attendance as they differ in relation to incentives, and health- and performance-related consequences. Sickness attendance seems to be an important risk indicator. A balanced work attendance should be promoted for sustained health and performance in healthcare organisations. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

An approach to quality and security of supply for single-use bioreactors.

PubMed

Barbaroux, Magali; Gerighausen, Susanne; Hackel, Heiko

2014-01-01

Single-use systems (also referred to as disposables) have become a huge part of the bioprocessing industry, which raised concern in the industry regarding quality and security of supply. Processes must be in place to assure the supply and control of outsourced activities and quality of purchased materials along the product life cycle. Quality and security of supply for single-use bioreactors (SUBs) are based on a multidisciplinary approach. Developing a state-of-the-art SUB-system based on quality by design (QbD) principles requires broad expertise and know-how including the cell culture application, polymer chemistry, regulatory requirements, and a deep understanding of the biopharmaceutical industry. Using standardized products reduces the complexity and strengthens the robustness of the supply chain. Well-established supplier relations including risk mitigation strategies are the basis for achieving long-term security of supply. Well-developed quality systems including change control approaches aligned with the requirements of the biopharmaceutical industry are a key factor in supporting long-term product availability. This chapter outlines the approach to security of supply for key materials used in single-use production processes for biopharmaceuticals from a supplier perspective.

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

ERIC Educational Resources Information Center

Older Women's League, Washington, DC.

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

Bridging the gap: support groups do not enhance long-term outcome in chronic back pain.

PubMed

Linton, S J; Hellsing, A L; Larsson, I

1997-09-01

Because back pain patients often relapse within months of treatment, the effects of two types of support groups as a complement to usual medical treatment was investigated on long-term outcome. Regular treatment was compared with an "educational" support group and a professional support group before and 1 year after intervention in a randomized controlled trial. A total of 76 women and 27 men, average age of 50 years and with an accumulated sick leave for musculoskeletal pain of 2-24 weeks during the past year, were randomly assigned to the three groups. Sick leave records were obtained from the National Insurance Authority. A battery of standardized instruments was employed, which featured the Sickness Impact Profile, the Coping Strategies Questionnaire, the Multidimensional Pain Inventory, the Pain and Impairment Relationship Scale, the Pain and Discomfort Scale, the Pain Beliefs and Perceptions Inventory, and the Outcome Evaluation Questionnaire. The Educational Support Group demonstrated greater attendance than did the Professional Support Group. However, long-term outcome was not significantly different between any of the groups for sick leave, coping, function, or experienced pain. Both support groups, relative to the Regular Treatment Group, made greater improvements on the Sickness Impact Profile. This study provides little evidence that support groups, as a complement to regular treatment, enhance long-term outcome for subacute musculoskeletal pain problems. Specific treatment techniques, matched to the patient's needs, stringently taught, and delivered in a more compact form, may be necessary for enhancing outcome.

The CELSS research program - A brief review of recent activities

NASA Technical Reports Server (NTRS)

Macelroy, R. D.; Tremor, J.; Bubenheim, D. L.; Gale, J.

1989-01-01

The history of the Controlled Ecological Life Support System program, initiated by NASA in the late 1970s to explore the use of bioregenerative methods of life support, is reviewed. The project focused on examining the process involved in converting inorganic minerals and gases into life support materials using sunlight as the primary energy source. The research, planning, and technological development required by the CELSS program and conducted at NASA field centers, at various universities, and by commercial organizations are reviewed. Research activities at universities have focused upon exploring methods of reducing the size of the system, reducing system power requirements, understanding issues that are associated with its long-term stability, and identifying new technologies that might be useful in improving its efficiency. Research activities at Ames research center have focused on the use of common duckweed as a high biomass-producing plant, which is high in protein and on waste processing.

45 CFR 144.204 - Applicability of regulations.

Code of Federal Regulations, 2011 CFR

2011-10-01

....204 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Source: § 144.204 Applicability of regulations. The... qualified long-term care insurance policies to individuals under a qualified State long-term care insurance...

45 CFR 144.204 - Applicability of regulations.

Code of Federal Regulations, 2012 CFR

2012-10-01

....204 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships... this subpart for reporting data apply only to those insurers that have issued qualified long-term care...

45 CFR 144.204 - Applicability of regulations.

Code of Federal Regulations, 2013 CFR

2013-10-01

....204 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships... this subpart for reporting data apply only to those insurers that have issued qualified long-term care...

45 CFR 144.204 - Applicability of regulations.

Code of Federal Regulations, 2014 CFR

2014-10-01

....204 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance Partnerships... this subpart for reporting data apply only to those insurers that have issued qualified long-term care...

32 CFR 179.6 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... achieved, and no further action, except for long-term management and recurring reviews, is required. (iii... long-term management and recurring reviews, is required. (iii) No known or suspected CWM hazard. This... provides a consistent Department-wide approach for evaluating the relative risk to human health and the...

32 CFR 179.6 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... achieved, and no further action, except for long-term management and recurring reviews, is required. (iii... long-term management and recurring reviews, is required. (iii) No known or suspected CWM hazard. This... provides a consistent Department-wide approach for evaluating the relative risk to human health and the...

Research opportunities in human behavior and performance

NASA Technical Reports Server (NTRS)

Christensen, J. M. (Editor); Talbot, J. M. (Editor)

1985-01-01

Extant information on the subject of psychological aspects of manned space flight are reviewed; NASA's psychology research program is examined; significant gaps in knowledge are identified; and suggestions are offered for future research program planning. Issues of human behavior and performance related to the United States space station, to the space shuttle program, and to both near and long term problems of a generic nature in applicable disciplines of psychology are considered. Topics covered include: (1) human performance requirements for a 90 day mission; (2) human perceptual, cognitive, and motor capabilities and limitations in space; (3) crew composition, individual competencies, crew competencies, selection criteria, and special training; (4) environmental factors influencing behavior; (5) psychosocial aspects of multiperson space crews in long term missions; (6) career determinants in NASA; (7) investigational methodology and equipment; and (8) psychological support.

Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health.

PubMed

Thornton, Rachel L J; Glover, Crystal M; Cené, Crystal W; Glik, Deborah C; Henderson, Jeffrey A; Williams, David R

2016-08-01

The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels. Project HOPE—The People-to-People Health Foundation, Inc.

Final Inventory Work-Off Plan for ORNL transuranic wastes (1986 version)

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

Dickerson, L.S.

1988-05-01

The Final Inventory Work-Off Plan (IWOP) for ORNL Transuranic Wastes addresses ORNL's strategy for retrieval, certification, and shipment of its stored and newly generated contact-handled (CH) and remote-handled (RH) transuranic (TRU) wastes to the Waste Isolation Pilot Plant (WIPP), the proposed geologic repository near Carlsbad, New Mexico. This document considers certification compliance with the WIPP waste acceptance criteria (WAC) and is consistent with the US Department of Energy's Long-Range Master Plan for Defense Transuranic Waste Management. This document characterizes Oak Ridge National Laboratory's (ORNL's) TRU waste by type and estimates the number of shipments required to dispose of it; describesmore » the methods, facilities, and systems required for its certification and shipment; presents work-off strategies and schedules for retrieval, certification, and transportation; discusses the resource needs and additions that will be required for the effort and forecasts costs for the long-term TRU waste management program; and lists public documentation required to support certification facilities and strategies. 22 refs., 6 figs., 10 tabs.« less

Schizophrenia and relationships: the effect of mental illness on sexuality.

PubMed

Östman, Margareta; Björkman, Ann-Christine

2013-04-01

This paper seeks to investigate the impact of mental illness on the sexuality of patients with a schizophrenic disorder who live in the community in a long-term relationship with a partner. We conducted qualitative, in-depth interviews with five such patients who were in treatment at a psychiatric outpatient clinic, and three of their partners. The data were analyzed by thematic analysis and identified the following areas of concern: relationships outweigh sexuality; uncertainties about one’s sexual capacity; the dwindling of sexual fantasies, feelings of desire, and satisfaction; and, a lack of communication and support in sexual matters. Both patients and partners reported feeling overlooked by psychiatric services as sexual beings. They also expressed dissatisfaction with a patient-therapist treatment model that excluded their partners. Our findings indicate that dysfunctional sexuality affects both patients suffering from severe mental illness and their partners. Patients and partners deplore the lack of opportunity to discuss questions related to their sexuality and long-term relationships with psychiatric clinicians. Sexual problems arising from, or exacerbated by, schizophrenia require supportive services, whether in the form of general, psychiatric, or couples therapy.

Human serum-derived protein removes the need for coating in defined human pluripotent stem cell culture

PubMed Central

Pijuan-Galitó, Sara; Tamm, Christoffer; Schuster, Jens; Sobol, Maria; Forsberg, Lars; Merry, Catherine L. R.; Annerén, Cecilia

2016-01-01

Reliable, scalable and time-efficient culture methods are required to fully realize the clinical and industrial applications of human pluripotent stem (hPS) cells. Here we present a completely defined, xeno-free medium that supports long-term propagation of hPS cells on uncoated tissue culture plastic. The medium consists of the Essential 8 (E8) formulation supplemented with inter-α-inhibitor (IαI), a human serum-derived protein, recently demonstrated to activate key pluripotency pathways in mouse PS cells. IαI efficiently induces attachment and long-term growth of both embryonic and induced hPS cell lines when added as a soluble protein to the medium at seeding. IαI supplementation efficiently supports adaptation of feeder-dependent hPS cells to xeno-free conditions, clonal growth as well as single-cell survival in the absence of Rho-associated kinase inhibitor (ROCKi). This time-efficient and simplified culture method paves the way for large-scale, high-throughput hPS cell culture, and will be valuable for both basic research and commercial applications. PMID:27405751

Dual jaw treatment of edentulism using implant-supported monolithic zirconia fixed prostheses.

PubMed

Altarawneh, Sandra; Limmer, Bryan; Reside, Glenn J; Cooper, Lyndon

2015-01-01

This case report describes restoration of the edentulous maxilla and mandible with implant supported fixed prostheses using monolithic zirconia, where the incisal edges and occluding surfaces were made of monolithic zirconia. Edentulism is a debilitating condition that can be treated with either a removable or fixed dental prosthesis. The most common type of implant-supported fixed prosthesis is the metal acrylic (hybrid), with ceramo-metal prostheses being used less commonly in complete edentulism. However, both of these prostheses designs are associated with reported complications of screw loosening or fracture and chipping of acrylic resin and porcelain. Monolithic zirconia implant-supported fixed prostheses have the potential for reduction of such complications. In this case, the CAD/CAM concept was utilized in fabrication of maxillary and mandibular screw-retained implant-supported fixed prostheses using monolithic zirconia. Proper treatment planning and execution coupled with utilizing advanced technologies contributes to highly esthetic results. However, long-term studies are required to guarantee a satisfactory long-term outcome of this modality of treatment. This case report describes the clinical and technical procedures involved in fabrication of maxillary and mandibular implant-supported fixed prostheses using monolithic zirconia as a treatment of edentulism, and proposes the possible advantages associated with using monolithic zirconia in eliminating dissimilar interfaces in such prostheses that are accountable for the most commonly occurring technical complication for these prostheses being chipping and fracture of the veneering material. © 2015 Wiley Periodicals, Inc.

"Nothing is going to change three months from now": A mixed methods characterization of food bank use in Greater Vancouver.

PubMed

Holmes, Eleanor; Black, Jennifer L; Heckelman, Amber; Lear, Scott A; Seto, Darlene; Fowokan, Adeleke; Wittman, Hannah

2018-03-01

North American food bank use has risen dramatically since the 1980s, and over 850,000 Canadians were estimated to have visited a food bank monthly in 2015. Food banks serve multiple roles in communities, ranging from 'emergency responses' to individualized and short-term experiences of hunger, to 'chronic' supports as part of long-term subsistence strategies. This study used a mixed-methods design to examine the spectrum of food bank user experiences in a large urban context, as part of a community-based project aiming to envision a redesign of the food bank to contribute to broader community food security outcomes. Survey (n = 77) and focus group (n = 27) results suggested that participants widely viewed food banks as a long-term food-access strategy. Inadequate financial resources, steep increases in housing and food costs, and long-term health challenges emerged as the most prominent factors influencing food bank use. Participants commonly reported unmet food needs despite food bank use, limited agency over factors influencing access to sufficient food, and anticipated requiring food bank services in future. These findings contest global constructions of food banks as "emergency" food providers and support growing evidence that food banks are an insufficient response to chronic poverty, lack of affordable housing and insufficient social assistance rates underlying experiences of food insecurity. Participants envisioned changes to the food bank system to increase community food security including improved food quality and quantity (short-term), changes to service delivery and increased connections with health services (capacity building), and a greater role in poverty reduction advocacy (system redesign). Copyright © 2018. Published by Elsevier Ltd.

Examining Long-Term Global Climate Change on the Web.

ERIC Educational Resources Information Center

Huntoon, Jacqueline E.; Ridky, Robert K.

2002-01-01

Describes a web-based, inquiry-oriented activity that enables students to examine long-term global climate change. Supports instruction in other topics such as population growth. (Contains 34 references.) (DDR)

The long term agroecosystem research network - shared research strategy

Treesearch

Jean L. Steiner; Timothy Strickland; Peter J.A. Kleinman; Kris Havstad; Thomas B. Moorman; M.Susan Moran; Phil Hellman; Ray B. Bryant; David Huggins; Greg McCarty

2016-01-01

While current weather patterns and rapidly accelerated changes in technology often focus attention on short-term trends in agriculture, the fundamental demands on modern agriculture to meet society food, feed, fuel and fiber production while providing the foundation for a healthy environment requires long-term perspective. The Long- Term Agroecoystem Research Network...

CD34+ Testicular Stromal Cells Support Long-Term Expansion of Embryonic and Adult Stem and Progenitor Cells

PubMed Central

Kim, Jiyeon; Seandel, Marco; Falciatori, Ilaria; Wen, Duancheng; Rafii, Shahin

2010-01-01

Stem cells reside in specialized microenvironments created by supporting stromal cells that orchestrate self-renewal and lineage-specific differentiation. However, the precise identity of the cellular and molecular pathways that support self-renewal of stem cells is not known. For example, long-term culture of prototypical stem cells, such as adult spermatogonial stem and progenitor cells (SPCs), in vitro has been impeded by the lack of an optimal stromal cell line that initiates and sustains proliferation of these cells. Indeed, current methods, including the use of mouse embryonic fibroblasts (MEFs), have not been efficient and have generally led to inconsistent results. Here, we report the establishment of a novel CD34-positive cell line, referred to as JK1, derived from mouse testicular stromal cells that not only facilitated long-term SPC culture but also allowed faithful generation of SPCs and multipotent stem cells. SPCs generated on JK1 maintained key features of germ line stem cells, including expression of PLZF, DAZL, and GCNA. Furthermore, these feeders also promoted the long-term cultivation of other types of primitive cells including multi-potent adult spermatogonial-derived stem cells, pluripotent murine embryonic stem cells, and embryonic germ cells derived from primordial germ cells. Stem cells could be passaged serially and still maintained expression of characteristic markers such as OCT4 and NANOG in vitro, as well as the ability to generate all three germ layers in vivo. These results indicate that the JK1 cell line is capable of promoting long-term culture of primitive cells. As such, this cell line allows for identification of stromal-derived factors that support long-term proliferation of various types of stem cells and constitutes a convenient alternative to other types of feeder layers. PMID:18669907

Continuous internal counterpulsation as a bridge to recovery in acute and chronic heart failure

PubMed Central

Kontogiannis, Christos D; Malliaras, Konstantinos; Kapelios, Chris J; Mason, Jay W; Nanas, John N

2016-01-01

Cardiac recovery from cardiogenic shock (CS) and end-stage chronic heart failure (HF) remains an often insurmountable therapeutic challenge. The counterpulsation technique exerts numerous beneficial effects on systemic hemodynamics and left ventricular mechanoenergetics, rendering it attractive for promoting myocardial recovery in both acute and chronic HF. Although a recent clinical trial has questioned the clinical effectiveness of short-term hemodynamic support with intra-aortic balloon pump (IABP, the main representative of the counterpulsation technique) in CS complicating myocardial infarction, the issue remains open to further investigation. Moreover, preliminary data suggest that long-term IABP support in patients with end-stage HF is safe and may mediate recovery of left- or/and right-sided cardiac function, facilitating long-term weaning from mechanical support or enabling the application of other permanent, life-saving solutions. The potential of long-term counterpulsation could possibly be enhanced by implementation of novel, fully implantable counterpulsation devices. PMID:27011909

45 CFR 144.208 - Deadlines for submission of reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 144.208 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance... regulations. (b) All reports on the registry of qualified long-term care insurance policies issued to...

45 CFR 144.208 - Deadlines for submission of reports.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Section 144.208 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance... regulations. (b) All reports on the registry of qualified long-term care insurance policies issued to...

45 CFR 144.208 - Deadlines for submission of reports.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Section 144.208 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance... regulations. (b) All reports on the registry of qualified long-term care insurance policies issued to...

45 CFR 144.208 - Deadlines for submission of reports.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Section 144.208 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE Qualified State Long-Term Care Insurance... regulations. (b) All reports on the registry of qualified long-term care insurance policies issued to...

Long-term solar-terrestrial observations

NASA Technical Reports Server (NTRS)

1988-01-01

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

Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling

ERIC Educational Resources Information Center

Caldwell, Joe; Alston, Reginald J.

2012-01-01

The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. This article discusses some of the major provisions, implementations, and implications…

Implementation of Medicaid Managed Long-Term Services and Supports for Adults with Intellectual And/Or Developmental Disabilities in Kansas

ERIC Educational Resources Information Center

Williamson, Heather J.; Perkins, Elizabeth A.; Levin, Bruce L.; Baldwin, Julie A.; Lulinski, Amie; Armstrong, Mary I.; Massey, Oliver T.

2017-01-01

Many adults with intellectual and/or developmental disabilities (IDD) can access health and long-term services and supports (LTSS) through Medicaid. States are reforming their Medicaid LTSS programs from a fee-for-service model to a Medicaid managed LTSS (MLTSS) approach, anticipating improved quality of care and reduced costs, although there is…

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

PubMed

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

2005-06-01

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

Long-term outcome and quality of life of patients requiring prolonged mechanical ventilation after cardiac surgery.

PubMed

Pappalardo, Federico; Franco, Annalisa; Landoni, Giovanni; Cardano, Paola; Zangrillo, Alberto; Alfieri, Ottavio

2004-04-01

To study the long-term survival and quality of life of patients with a complicated post-operative course after cardiac surgery requiring prolonged (>or=7 days) mechanical ventilation (MV), since they represent a heavy burden on hospital resources and their outcome has never been adequately evaluated. Out of 4827 consecutive cardiac surgical patients, 148 (3%) required prolonged post-operative MV: their hospital course was analysed and factors affecting prolonged MV and mortality were identified using multivariate analysis. Long-term survival was assessed using Cox proportional hazard method. Long-term (36+/-12 months) follow-up information was collected and quality of life was assessed by an ad hoc questionnaire. Overall mortality in the study group was 45.3 versus 2% in the control population (P<0.0001). Predictors of death in the prolonged MV group were age (odds ratio, OR 1.049) and diabetes (OR 3.459). Long-term survival was significantly worse in those patients who were extubated after 21 days: 88.9 versus 70.9% at 1 year (P=0.03) and 80.9 versus 64.5% at 5 years (P=0.05). Mild or no limitation in daily living was referred by 69% of the survivors. The hospital mortality of patients requiring prolonged MV is high. The long-term survival of patients who are weaned from MV after 21 days is significantly lower. The great majority of the survivors can enjoy a good quality of life.

HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda

PubMed Central

2014-01-01

Background Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services, but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of disclosure among clients attending an urban HIV clinic in Uganda. Methods Qualitative semi-structured interviews were administered to a purposeful sample of 40 adult HIV clients that was stratified by gender. The information elicited included their lived experiences and outcomes of disclosure in the short and long term. A text data management software (ATLAS.ti) was used for data analysis. Codes were exported to MS Excel and pivot tables, and code counts made to generate statistical data. Results Of the 134 short-term responses elicited during the interview regarding disclosure events, most responses were supportive including encouragement, advice and support regarding HIV care and treatment. The results show on-disclosing to spouse, there was more trust, and use of condoms for HIV prevention. Only one third were negative responses, like emotional shock and feeling of distress. The negative reactions to the spouses included rejection, shock and distress in the short term. Even then, none of these events led to drastic change such as divorce. Other responses reflected HIV prevention and call for behavioural change and advice to change sexual behaviour, recipient seeking HIV testing or care. Women reported more responses of encouragement compared to men. Men reported more preventive behaviour compared to women. Of the 137 long-term outcomes elicited during disclosure, three quarters were positive followed by behavioral change and prevention, and then negative responses. Men reported increased care and support when they disclosed to fellow men compared to when women disclosed to women. There was better or not change in relationship when women disclosed to women than when women disclosed to men. Conclusions There is overwhelming support to individuals that disclose their HIV status, especially in the long term. Besides, gender appears to influence responses to HIV disclosure, highlighting the need for gender specific disclosure support strategies. PMID:24950958

HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda.

PubMed

Atuyambe, Lynn Muhimbuura; Ssegujja, Eric; Ssali, Sarah; Tumwine, Christopher; Nekesa, Nicolate; Nannungi, Annette; Ryan, Gery; Wagner, Glenn

2014-06-21

Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services, but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of disclosure among clients attending an urban HIV clinic in Uganda. Qualitative semi-structured interviews were administered to a purposeful sample of 40 adult HIV clients that was stratified by gender. The information elicited included their lived experiences and outcomes of disclosure in the short and long term. A text data management software (ATLAS.ti) was used for data analysis. Codes were exported to MS Excel and pivot tables, and code counts made to generate statistical data. Of the 134 short-term responses elicited during the interview regarding disclosure events, most responses were supportive including encouragement, advice and support regarding HIV care and treatment. The results show on-disclosing to spouse, there was more trust, and use of condoms for HIV prevention. Only one third were negative responses, like emotional shock and feeling of distress. The negative reactions to the spouses included rejection, shock and distress in the short term. Even then, none of these events led to drastic change such as divorce. Other responses reflected HIV prevention and call for behavioural change and advice to change sexual behaviour, recipient seeking HIV testing or care. Women reported more responses of encouragement compared to men. Men reported more preventive behaviour compared to women. Of the 137 long-term outcomes elicited during disclosure, three quarters were positive followed by behavioral change and prevention, and then negative responses. Men reported increased care and support when they disclosed to fellow men compared to when women disclosed to women. There was better or not change in relationship when women disclosed to women than when women disclosed to men. There is overwhelming support to individuals that disclose their HIV status, especially in the long term. Besides, gender appears to influence responses to HIV disclosure, highlighting the need for gender specific disclosure support strategies.

76 FR 20998 - Additional Allocations and Waivers Granted to and Alternative Requirements for 2010 Community...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-14

... for necessary expenses related to disaster relief, long- term recovery, and restoration of... funds will address long-term recovery, and restoration of infrastructure, housing, and economic... continue to review long-term recovery needs to determine how to allocate the remaining $50 million in aid...

46 CFR 356.43 - Long-term or exclusive sales contracts.

Code of Federal Regulations, 2011 CFR

2011-10-01

... DOCUMENTATION Charters, Management Agreements and Exclusive or Long-Term Contracts § 356.43 Long-term or exclusive sales contracts. (a) An owner or bareboat charterer of a Fishing Industry Vessel may enter into an... a specified period of time. Such contracts or agreements will not require our prior approval...

Issues of Long-Term Cryogenic Propellant Storage in Microgravity

NASA Technical Reports Server (NTRS)

Muratov, C. B.; Osipov, Viatcheslav V.; Smelyanskiy, Vadim N.

2011-01-01

Modern multi-layer insulation (MLI) allows to sharply reduce the heat leak into cryogenic propellant storage tanks through the tank surface and, as a consequence, significantly extend the storage duration. In this situation the MLI penetrations, such as support struts, feed lines, etc., become one of the most significant challenges of the tanks heat management. This problem is especially acute for liquid hydrogen (LH2) storage, since currently no efficient cryocoolers exist that operate at very low LH2 temperatures (20K). Even small heat leaks under microgravity conditions and over the period of many months give rise to a complex slowly-developing, large-scale spatiotemporal physical phenomena in a multi-phase liquid-vapor mixture. These phenomena are not well-understood nor can be easily controlled. They can be of a potentially hazardous nature for long-term on-orbital cryogenic torage, propellant loading, tank chilldown, engine restart, and other in-space cryogenic fluid management operations. To support the engineering design solutions that would mitigate these effects a detailed physics-based analysis of heat transfer, vapor bubble formation, growth, motion, coalescence and collapse is required in the presence of stirring jets of different configurations and passive cooling devices such as MLI, thermodynamic vent system, and vapor-cooled shield. To develop physics-based models and correlations reliable for microgravity conditions and long-time scales there is a need for new fundamental data to be collected from on-orbit cryogenic storage experiments. Our report discusses some of these physical phenomena and the design requirements and future studies necessary for their mitigation. Special attention is payed to the phenomena occurring near MLI penetrations.

Modernization of the migrant women in Dhaka, Bangladesh: analysis of some demographic variables.

PubMed

Huq-hussain, S

1995-04-01

This study examines demographic factors as signs of change among female rural migrants who settled in the slums of Dhaka, Bangladesh, in 1988. Data are obtained from structured and open-ended interviews among 399 migrant women working in selected clusters of Dhaka in 1988. Short-term migrants lived in Dhaka city for 6 months to 5 years. Long-term migrants lived longer than 5 years in Dhaka city. Findings indicate that 81% of all migrant families were nuclear, 18% were joint, and only 1% were extended. A greater proportion of recent migrants had nuclear families (89%) compared to long-term migrants (78%). 90% of recent migrants and 81% of long-term migrants favored nuclear families. Migrant women indicated that small nuclear families were preferred due to economic hardship and the shortage of housing. Interpersonal quarrels were another reason for their preference for nuclear families. Women who desired joint families found their domestic burdens relieved with more people to share responsibilities. 17% of all migrant households were headed by women (15% among recent migrants and 18% among long-term migrants). Female heads reported that their family structure was due to the death of or divorce from their spouse and the preference of independence from family dependency. 43% of families had 4 members, 36% had 5-7 members, and 21% had over 7 members. 52% of recent migrants and 40% of long-term migrants had small families under 4 members. 39% of long-term migrants and 26% of recent migrants had families with 5-7 members. Recent female migrants were characterized as primarily aged 11-30 years compared to long-term female migrants who were aged mainly under 10 years. A distinctive feature of marriage among migrant women was the larger proportion of women marrying at early ages. 43% were married at ages 11-14 years. 29% of recent migrants and only 11% of long-term migrants supported early age at marriage, but over 50% supported a marriage age of 18-20 years. It is argued that the long-term migrants support for lower fertility and modern values was an adjustment to urban life.

Pimecrolimus in atopic dermatitis: Consensus on safety and the need to allow use in infants

PubMed Central

Luger, Thomas; Boguniewicz, Mark; Carr, Warner; Cork, Michael; Deleuran, Mette; Eichenfield, Lawrence; Eigenmann, Philippe; Fölster-Holst, Regina; Gelmetti, Carlo; Gollnick, Harald; Hamelmann, Eckard; Hebert, Adelaide A; Muraro, Antonella; Oranje, Arnold P; Paller, Amy S; Paul, Carle; Puig, Luis; Ring, Johannes; Siegfried, Elaine; Spergel, Jonathan M; Stingl, Georg; Taieb, Alain; Torrelo, Antonio; Werfel, Thomas; Wahn, Ulrich

2015-01-01

Atopic dermatitis (AD) is a distressing dermatological disease, which is highly prevalent during infancy, can persist into later life and requires long-term management with anti-inflammatory compounds. The introduction of the topical calcineurin inhibitors (TCIs), tacrolimus and pimecrolimus, more than 10 yr ago was a major breakthrough for the topical anti-inflammatory treatment of AD. Pimecrolimus 1% is approved for second-line use in children (≥2 yr old) and adults with mild-to-moderate AD. The age restriction was emphasized in a boxed warning added by the FDA in January 2006, which also highlights the lack of long-term safety data and the theoretical risk of skin malignancy and lymphoma. Since then, pimecrolimus has been extensively investigated in short- and long-term studies including over 4000 infants (<2 yr old). These studies showed that pimecrolimus effectively treats AD in infants, with sustained improvement with long-term intermittent use. Unlike topical corticosteroids, long-term TCI use does not carry the risks of skin atrophy, impaired epidermal barrier function or enhanced percutaneous absorption, and so is suitable for AD treatment especially in sensitive skin areas. Most importantly, the studies of pimecrolimus in infants provided no evidence for systemic immunosuppression, and a comprehensive body of evidence from clinical studies, post-marketing surveillance and epidemiological investigations does not support potential safety concerns. In conclusion, the authors consider that the labelling restrictions regarding the use of pimecrolimus in infants are no longer justified and recommend that the validity of the boxed warning for TCIs should be reconsidered. PMID:25557211

Relationship between sea level and climate forcing by CO2 on geological timescales

PubMed Central

Foster, Gavin L.; Rohling, Eelco J.

2013-01-01

On 103- to 106-year timescales, global sea level is determined largely by the volume of ice stored on land, which in turn largely reflects the thermal state of the Earth system. Here we use observations from five well-studied time slices covering the last 40 My to identify a well-defined and clearly sigmoidal relationship between atmospheric CO2 and sea level on geological (near-equilibrium) timescales. This strongly supports the dominant role of CO2 in determining Earth’s climate on these timescales and suggests that other variables that influence long-term global climate (e.g., topography, ocean circulation) play a secondary role. The relationship between CO2 and sea level we describe portrays the “likely” (68% probability) long-term sea-level response after Earth system adjustment over many centuries. Because it appears largely independent of other boundary condition changes, it also may provide useful long-range predictions of future sea level. For instance, with CO2 stabilized at 400–450 ppm (as required for the frequently quoted “acceptable warming” of 2 °C), or even at AD 2011 levels of 392 ppm, we infer a likely (68% confidence) long-term sea-level rise of more than 9 m above the present. Therefore, our results imply that to avoid significantly elevated sea level in the long term, atmospheric CO2 should be reduced to levels similar to those of preindustrial times. PMID:23292932

Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program.

PubMed

Tappen, Ruth M; Wolf, David G; Rahemi, Zahra; Engstrom, Gabriella; Rojido, Carolina; Shutes, Jill M; Ouslander, Joseph G

Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period. Themes related to barriers and facilitators were identified. Six major barriers to implementation were identified: the magnitude and complexity of the change (35%), instability of facility leadership (27%), competing demands (40%), stakeholder resistance (49%), scarce resources (86%), and technical problems (31%). Six facilitating strategies were also reported: organization-wide involvement (68%), leadership support (41%), use of administrative authority (14%), adequate training (66%), persistence and oversight on the part of the champion (73%), and unfolding positive results (14%). Successful introduction of a complex change such as the INTERACT® quality improvement program in a long-term care facility requires attention to the facilitators and barriers identified in this report from those at the frontline.

Planning for the recreational end use of a future LLR waste mound in Canada - Leaving an honourable legacy

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

Kleb, H.R.; Zelmer, R.L.

2007-07-01

The Low-Level Radioactive Waste Management Office was established in 1982 to carry out the federal government's responsibilities for low-level radioactive (LLR) waste management in Canada. In this capacity, the Office operates programs to characterize, delineate, decontaminate and consolidate historic LLR waste for interim and long-term storage. The Office is currently the proponent of the Port Hope Area Initiative; a program directed at the development and implementation of a safe, local long-term management solution for historic LLR waste in the Port Hope area. A legal agreement between the Government of Canada and the host community provides the framework for the implementationmore » of the Port Hope Project. Specifically, the agreement requires that the surface of the long-term LLR waste management facility be 'conducive to passive and active recreational uses such as soccer fields and baseball diamonds'. However, there are currently no examples of licensed LLR waste management facilities in Canada that permit recreational use. Such an end use presents challenges with respect to engineering and design, health and safety and landscape planning. This paper presents the cover system design, the environmental effects assessment and the landscape planning processes that were undertaken in support of the recreational end use of the Port Hope long-term LLR waste management facility. (authors)« less

Amalgamating Esthetics, Function and Comfort in Full Mouth Rehabilitation – A Case Report

PubMed Central

Thakral, Rashmi; Arora, Saurabh; Sharma, Neeraj; Chawla, Chetan

2014-01-01

Restoration of aesthetics, function and comfort in badly compromised dentition and its supporting tissues often poses a great challenge. The long term success of such cases depends largely on simultaneous achieving of satisfying aesthetics and a harmonious occlusion. Proper examination, evaluation and diagnosis of the prevailing oral conditions serve as a prelude to a rationalized treatment plan and its ultimate success. Invariably, it also becomes significant to understand and recognize the consequences of long term negligence by the patient. An unattended such condition, apart from causing compromised oral functions may also lead to neuromuscular problems in and around temporo-mandibular joint (TMJ) causing frequent pain in the region and unyielding headaches. Restoring physiologically advised health conditions from habitual positions and functions may require time, patience and effort by both – the patient and the dentist. A complete rehabilitation may also require involvement of more than one disciplines of dentistry. The case report highlights the contributions from prosthodontists, periodontists, endodontists and the radiologist as a team in complete rehabilitation of the patient. PMID:24959521

Cardiac surgery-associated acute kidney injury.

PubMed

Vives, Marc; Wijeysundera, Duminda; Marczin, Nandor; Monedero, Pablo; Rao, Vivek

2014-05-01

Acute kidney injury develops in up to 30% of patients who undergo cardiac surgery, with up to 3% of patients requiring dialysis. The requirement for dialysis after cardiac surgery is associated with an increased risk of infection, prolonged stay in critical care units and long-term need for dialysis. The development of acute kidney injury is independently associated with substantial short- and long-term morbidity and mortality. Its pathogenesis involves multiple pathways. Haemodynamic, inflammatory, metabolic and nephrotoxic factors are involved and overlap each other leading to kidney injury. Clinical studies have identified predictors for cardiac surgery-associated acute kidney injury that can be used effectively to determine the risk for acute kidney injury in patients undergoing cardiac surgery. High-risk patients can be targeted for renal protective strategies. Nonetheless, there is little compelling evidence from randomized trials supporting specific interventions to protect or prevent acute kidney injury in cardiac surgery patients. Several strategies have shown some promise, including less invasive procedures in those at greatest risk, natriuretic peptide, fenoldopam, preoperative hydration, preoperative optimization of anaemia and postoperative early use of renal replacement therapy. The efficacy of larger-scale trials remains to be confirmed.

Fostering excellence: roles, responsibilities, and expectations of new family physician clinician investigators.

PubMed

Hogg, William; Kendall, Claire; Muggah, Elizabeth; Mayo-Bruinsma, Liesha; Ziebell, Laura

2014-02-01

A key priority in primary health care research is determining how to ensure the advancement of new family physician clinician investigators (FP-CIs). However, there is little consensus on what expectations should be implemented for new investigators to ensure the successful and timely acquisition of independent salary support. Support new FP-CIs to maximize early career research success. This program description aims to summarize the administrative and financial support provided by the C.T. Lamont Primary Health Care Research Centre in Ottawa, Ont, to early career FP-CIs; delineate career expectations; and describe the results in terms of research productivity on the part of new FP-CIs. Family physician CI's achieved a high level of research productivity during their first 5 years, but most did not secure external salary support. It might be unrealistic to expect new FP-CIs to be self-financing by the end of 5 years. This is a career-development program, and supporting new career FP-CIs requires a long-term investment. This understanding is critical to fostering and strengthening sustainable primary care research programs.

Fostering excellence

PubMed Central

Hogg, William; Kendall, Claire; Muggah, Elizabeth; Mayo-Bruinsma, Liesha; Ziebell, Laura

2014-01-01

Abstract Problem addressed A key priority in primary health care research is determining how to ensure the advancement of new family physician clinician investigators (FP-CIs). However, there is little consensus on what expectations should be implemented for new investigators to ensure the successful and timely acquisition of independent salary support. Objective of program Support new FP-CIs to maximize early career research success. Program description This program description aims to summarize the administrative and financial support provided by the C.T. Lamont Primary Health Care Research Centre in Ottawa, Ont, to early career FP-CIs; delineate career expectations; and describe the results in terms of research productivity on the part of new FP-CIs. Conclusion Family physician CI’s achieved a high level of research productivity during their first 5 years, but most did not secure external salary support. It might be unrealistic to expect new FP-CIs to be self-financing by the end of 5 years. This is a career-development program, and supporting new career FP-CIs requires a long-term investment. This understanding is critical to fostering and strengthening sustainable primary care research programs. PMID:24522688

Adaptations in rod outer segment disc membranes in response to environmental lighting conditions.

PubMed

Rakshit, Tatini; Senapati, Subhadip; Parmar, Vipul M; Sahu, Bhubanananda; Maeda, Akiko; Park, Paul S-H

2017-10-01

The light-sensing rod photoreceptor cell exhibits several adaptations in response to the lighting environment. While adaptations to short-term changes in lighting conditions have been examined in depth, adaptations to long-term changes in lighting conditions are less understood. Atomic force microscopy was used to characterize the structure of rod outer segment disc membranes, the site of photon absorption by the pigment rhodopsin, to better understand how photoreceptor cells respond to long-term lighting changes. Structural properties of the disc membrane changed in response to housing mice in constant dark or light conditions and these adaptive changes required output from the phototransduction cascade initiated by rhodopsin. Among these were changes in the packing density of rhodopsin in the membrane, which was independent of rhodopsin synthesis and specifically affected scotopic visual function as assessed by electroretinography. Studies here support the concept of photostasis, which maintains optimal photoreceptor cell function with implications in retinal degenerations. Copyright © 2017 Elsevier B.V. All rights reserved.

Two pairs of mushroom body efferent neurons are required for appetitive long-term memory retrieval in Drosophila.

PubMed

Plaçais, Pierre-Yves; Trannoy, Séverine; Friedrich, Anja B; Tanimoto, Hiromu; Preat, Thomas

2013-11-14

One of the challenges facing memory research is to combine network- and cellular-level descriptions of memory encoding. In this context, Drosophila offers the opportunity to decipher, down to single-cell resolution, memory-relevant circuits in connection with the mushroom bodies (MBs), prominent structures for olfactory learning and memory. Although the MB-afferent circuits involved in appetitive learning were recently described, the circuits underlying appetitive memory retrieval remain unknown. We identified two pairs of cholinergic neurons efferent from the MB α vertical lobes, named MB-V3, that are necessary for the retrieval of appetitive long-term memory (LTM). Furthermore, LTM retrieval was correlated to an enhanced response to the rewarded odor in these neurons. Strikingly, though, silencing the MB-V3 neurons did not affect short-term memory (STM) retrieval. This finding supports a scheme of parallel appetitive STM and LTM processing. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Physical/chemical closed-loop water-recycling for long-duration missions

NASA Technical Reports Server (NTRS)

Herrmann, Cal C.; Wydeven, Ted

1990-01-01

Water needs, water sources, and means for recycling water are examined in terms appropriate to the water quality requirements of a small crew and spacecraft intended for long duration exploration missions. Inorganic, organic, and biological hazards are estimated for waste water sources. Sensitivities to these hazards for human uses are estimated. The water recycling processes considered are humidity condensation, carbon dioxide reduction, waste oxidation, distillation, reverse osmosis, pervaporation, electrodialysis, ion exchange, carbon sorption, and electrochemical oxidation. Limitations and applications of these processes are evaluated in terms of water quality objectives. Computerized simulation of some of these chemical processes is examined. Recommendations are made for development of new water recycling technology and improvement of existing technology for near term application to life support systems for humans in space. The technological developments are equally applicable to water needs on earth, in regions where extensive water ecycling is needed or where advanced water treatment is essential to meet EPA health standards.

Surgical management of sand colic impactions in horses: a retrospective study of 41 cases.

PubMed

Granot, N; Milgram, J; Bdolah-Abram, T; Shemesh, I; Steinman, A

2008-10-01

A retrospective review of the medical records of 41 horses requiring abdominal surgery for sand colic. The diagnosis of sand colic was made when sand was found to be the cause of impaction of the gastrointestinal tract during surgical exploration. The most common clinical signs at presentation were abdominal pain, abdominal distension and diarrhoea. A statistically significant association was found between the respiratory rate on arrival and short-term survival. Sand impaction at multiple locations was detected in one-third of the horses. Concurrent pathology was detected in half of the horses. Four horses were euthanased during surgery; of those that recovered from surgery, 35/37 (95%) were discharged from hospital. Short- and long-term complications were similar to those previously reported. Long-term (1 year) survival of the horses discharged was 100%. The good prognosis for horses undergoing surgery for the treatment of sand impaction supports early surgical intervention in cases where large amounts of sand are suspected.

42 CFR 483.13 - Resident behavior and facility practices.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

77 FR 12227 - Long Term 2 Enhanced Surface Water Treatment Rule: Uncovered Finished Water Reservoirs; Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

... Water Treatment Rule: Uncovered Finished Water Reservoirs; Public Meeting AGENCY: Environmental... review of the uncovered finished water reservoir requirement in the Long Term 2 Enhanced Surface Water... uncovered finished water reservoir requirement and the agency's Six Year Review process. EPA also plans to...

18 CFR 42.1 - Requirement that Transmission Organizations with Organized Electricity Markets Offer Long-Term...

Code of Federal Regulations, 2011 CFR

2011-04-01

... Transmission Organizations with Organized Electricity Markets Offer Long-Term Firm Transmission Rights. 42.1... ELECTRICITY MARKETS § 42.1 Requirement that Transmission Organizations with Organized Electricity Markets... with one or more organized electricity markets (administered either by it or by another entity) to make...

18 CFR 42.1 - Requirement that Transmission Organizations with Organized Electricity Markets Offer Long-Term...

Code of Federal Regulations, 2010 CFR

2010-04-01

... Transmission Organizations with Organized Electricity Markets Offer Long-Term Firm Transmission Rights. 42.1... ELECTRICITY MARKETS § 42.1 Requirement that Transmission Organizations with Organized Electricity Markets... with one or more organized electricity markets (administered either by it or by another entity) to make...

18 CFR 42.1 - Requirement that Transmission Organizations with Organized Electricity Markets Offer Long-Term...

Code of Federal Regulations, 2012 CFR

2012-04-01

... Transmission Organizations with Organized Electricity Markets Offer Long-Term Firm Transmission Rights. 42.1... ELECTRICITY MARKETS § 42.1 Requirement that Transmission Organizations with Organized Electricity Markets... with one or more organized electricity markets (administered either by it or by another entity) to make...

18 CFR 42.1 - Requirement that Transmission Organizations with Organized Electricity Markets Offer Long-Term...

Code of Federal Regulations, 2014 CFR

2014-04-01

... Transmission Organizations with Organized Electricity Markets Offer Long-Term Firm Transmission Rights. 42.1... ELECTRICITY MARKETS § 42.1 Requirement that Transmission Organizations with Organized Electricity Markets... with one or more organized electricity markets (administered either by it or by another entity) to make...

18 CFR 42.1 - Requirement that Transmission Organizations with Organized Electricity Markets Offer Long-Term...

Code of Federal Regulations, 2013 CFR

2013-04-01

... Transmission Organizations with Organized Electricity Markets Offer Long-Term Firm Transmission Rights. 42.1... ELECTRICITY MARKETS § 42.1 Requirement that Transmission Organizations with Organized Electricity Markets... with one or more organized electricity markets (administered either by it or by another entity) to make...

26 CFR 1.460-3 - Long-term construction contracts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... construction contracts. (a) In general. Section 460 generally requires a taxpayer to determine the income from... not real property. (b) Exempt construction contracts—(1) In general. The general requirement to use...) of this section. (2) Home construction contract—(i) In general. A long-term construction contract is...

Russian olive - a suitable target for classical biological control in North America? In: Wu, Yun; Johnson, Tracy; Sing, Sharlene; Raghu, S.; Wheeler, Greg; Pratt, Paul; Warner, Keith; Center, Ted; Goolsby, John; Reardon, Richard, eds

Treesearch

K. Delaney; E. Espeland; A. Norton; S. Sing; K. Keever; J. L. Baker; M. Cristofaro; R. Jashenko; J. Gaskin; U. Schaffner

2013-01-01

Projects to develop biological control solutions against invasive plants are midto long-term endeavors that require considerable financial support over several years. Discussions of concerns and potential conflicts of interests often occur when biological control agents are first being proposed for release into the environment. Such late discussion, which in some cases...

Social Network Type and Long-Term Condition Management Support: A Cross-Sectional Study in Six European Countries.

PubMed

Vassilev, Ivaylo; Rogers, Anne; Kennedy, Anne; Wensing, Michel; Koetsenruijter, Jan; Orlando, Rosanna; Portillo, Maria Carmen; Culliford, David

2016-01-01

Network types and characteristics have been linked to the capacity of inter-personal environments to mobilise and share resources. The aim of this paper is to examine personal network types in relation to long-term condition management in order to identify the properties of network types most likely to provide support for those with a long-term condition. A cross-sectional observational survey of people with type 2 diabetes using interviews and questionnaires was conducted between April and October 2013 in six European countries: Greece, Spain, Bulgaria, Norway, United Kingdom, and Netherlands. 1862 people with predominantly lower socio-economic status were recruited from each country. We used k-means clustering analysis to derive the network types, and one-way analysis of variance and multivariate logistic regression analysis to explore the relationship between network type socio-economic characteristics, self-management monitoring and skills, well-being, and network member work. Five network types of people with long-term conditions were identified: restricted, minimal family, family, weak ties, and diverse. Restricted network types represented those with the poorest self-management skills and were associated with limited support from social network members. Restricted networks were associated with poor indicators across self-management capacity, network support, and well-being. Diverse networks were associated with more enhanced self-management skills amongst those with a long-term condition and high level of emotional support. It was the three network types which had a large number of network members (diverse, weak ties, and family) where healthcare utilisation was most likely to correspond to existing health needs. Our findings suggest that type of increased social involvement is linked to greater self-management capacity and potentially lower formal health care costs indicating that diverse networks constitute the optimal network type as a policy in terms of the design of LTCM interventions and building support for people with LTCs.

Emergency Cardiac Surgery in Patients with Acute Coronary Syndromes: A Review of the Evidence and Perioperative Implications of Medical and Mechanical Therapeutics

PubMed Central

Brown, Charles; Joshi, Brijen; Faraday, Nauder; Shah, Ashish; Yuh, David; Rade, Jeffrey J.; Hogue, Charles W.

2011-01-01

Patients with acute coronary syndromes who require emergency cardiac surgery present complex management challenges. The early administration of antiplatelet and antithrombotic drugs has improved overall survival for patients with acute myocardial infarction, but to achieve maximal benefit, these drugs are given before coronary anatomy is known and before the decision to perform percutaneous coronary interventions or surgical revascularization has been made. A major bleeding event secondary to these drugs is associated with a high rate of death in medically treated patients with acute coronary syndrome possibly due to subsequent withholding of antiplatelet and antithrombotic therapies that otherwise reduce the rate of death, stroke, or recurrent myocardial infarcation. Whether the added risk of bleeding and blood transfusion in cardiac surgical patients receiving such potent antiplatelet or antithrombotic therapy before surgery specifically for acute coronary syndromes affects long-term mortality has not been clearly established. For patients who do proceed to surgery, strategies to minimize bleeding include stopping the anticoagulation therapy and considering platelet and/or coagulation factor transfusion and possibly rFVIIa administration for refractory bleeding. Mechanical hemodynamic support has emerged as an important option for patients with acute coronary syndromes in cardiogenic shock. For these patients, perioperative considerations include maintaining appropriate anticoagulation, ensuring suitable device flow, and periodically verifying correct device placement. Data supporting the use of these devices are derived from small trials that did not address long-term postoperative outcomes. Future directions of research will seek to optimize the balance between reducing myocardial ischemic risk with antiplatelet and antithrombotics versus the higher rate perioperative bleeding by better risk-stratifying surgical candidates and by assessing the effectiveness of newer reversible drugs. The effects of mechanical hemodynamic support on long-term patient outcomes needs more stringent analysis. PMID:21385977

Actions by the Bonneville Power Administration to Implement the Long- Term Contracting Provisions of P.L. 96-501

DTIC Science & Technology

1981-09-04

begin necessary negotiations for initial long-term contracts. Third, the term "offer" is not defined in the Act. Under general contract law , a valid...The position that the Administrator must offer coplete and definite contracts within 9 months of December 5, 1980, is supported by general contract law definitions...conititute "offers" in contract law . This interpretation is supported by Williston, who states that an offer is always a conditional promise, which wll

Addressing homelessness among people with mental illnesses: a model of long-term philanthropic effectiveness.

PubMed

Brousseau, Ruth Tebbets

2009-01-01

Foundations are often criticized for their short attention spans and inability to continue funding the toughest social problems. Homelessness among people with mental illnesses is considered among the most intractable of social issues. This paper explores the role of permanent supportive housing in reducing homelessness among the mentally ill; the role of the Corporation for Supportive Housing in developing, authenticating, and disseminating its model; and its long-term funding relationship with the Conrad N. Hilton Foundation, which has facilitated this trajectory. The paper tells the story of how long-term funding, strategically used, is making inroads into this serious mental health problem.

An assessment of long term ecosystem research activities across European socio-ecological gradients.

PubMed

Metzger, M J; Bunce, R G H; van Eupen, M; Mirtl, M

2010-06-01

Integration of European long term ecosystem research (LTER) would provide important support for the management of the pan-European environment and ecosystems, as well as international policy commitments. This does require appropriate coverage of Europe and standardised frameworks and research methods between countries. Emerging interest in socio-ecological systems prompted the present assessment of the distribution of LTER activities across European socio-ecological gradients. This paper presents a European stratification with a 1 km(2) resolution, delineating 48 broad socio-ecological regions. The dataset is based on an existing biogeophysical stratification constructed using multivariate clustering of mainly climatic variables and a newly developed socio-economic stratification based on an economic density indicator. The coverage of European LTER facilities across the socio-ecological gradients is tested using this dataset. The analysis shows two strong biases in the present LTER effort. Firstly, urban and disturbed regions are consistently under-represented, illustrating a bias for traditional ecological research away from human activity. Secondly, the Mediterranean, for which some of the most extreme global change impacts are projected, is receiving comparatively little attention. Both findings can help guide future investment in the European LTER network - and especially in a Long Term Socio-Ecological Research (LTSER) component- to provide a more balanced coverage. This will provide better scientific understanding of pan-European environmental concerns and support the management of natural resources and international policy commitments in the European Union. (c) 2010 Elsevier Ltd. All rights reserved.

Focusing a Transition: A Report by the Defense Business Board

DTIC Science & Technology

2009-01-01

2. NEAR-TERM OBSTACLES THAT COULD HAMPER LONG -TERM SUCCESS .................................................................25 Lowering the Overhead...requiring immediate att ention, (2) near-term obstacles that could hamper long -term success, (3) organizational issues for the Department to address for...begin early – long before January 20th - to avoid major leadership gaps (see Figure 1-2) and unnecessary vulnerabilities to the Department. Department

Long-term pavement performance ancillary information management system (AIMS) reference guide.

DOT National Transportation Integrated Search

2012-11-01

This document provides information on the Long-Term Pavement Performance (LTPP) program ancillary information. : Ancillary information includes data, images, reference materials, resource documents, and other information that : support and extend the...

Nursing home diversification requires caution by hospitals.

PubMed

Monroe, S M

1988-12-01

Hospital executives considering diversifying into long-term care for the elderly need to understand the ways the nursing home acquisition market and the long-term care industry have changed in the past two years and how to best respond to those changes. Diversification into the nursing home business must be carefully planned, taking into account such factors as state Medicaid reimbursement policies; the respective advantages of buying an existing facility or constructing a new one; the need for executives with expertise in long-term care; and the financial requirements of the proposal.

Plant-module for autonomous space-support (p-mass).

NASA Technical Reports Server (NTRS)

Luttges, M. W.; Stodieck, L.; Hoehn, A.

1994-01-01

A wide variety of technical and science questions arise when attempting to envision the long-term support of plants, algae and bacteria in space. Currently, spaceflight data remain elusive since there are no U.S. carriers for investigating either the germane technical or scientific issues. The first flight of the Commercial Experiment Transporter (COMET) will provide a nominal 30 day orbital opportunity to evlauate such issues. The P-Mass is a small payload that is designed to meet the mass (40 lbs), Volume (1.5cu. ft.), and power (120 W0 constraints of one of several COMET payloads while enabling flight evaluations of plants, algae and bacteria. Various biological sub-systems have been similarly evaluated. Through a variety of sensors coupled with color video, the P-Mass performance and the supported biological systems will be compared for terrestrial controls versus spaceflight materials. This small, low cost payload should return valuable regarding the requirements for hardware and biological systems needed to move toward biogenerative life support systems in space. In addition, it should be possible to accurately identify major unresolved difficulties that may arise in the long-term, this generic spaceflight capability should enable a variety of plant research programs focused on the use of microgravity to modulate and exploit plant products for commercial applications ranging from new agricultural products to pharmacological feedstocks and new controlled agricultural strategies.

A strategic informatics approach to autoverification.

PubMed

Jones, Jay B

2013-03-01

Autoverification is rapidly expanding with increased functionality provided by middleware tools. It is imperative that autoverification of laboratory test results be viewed as a process evolving into a broader, more sophisticated form of decision support, which will require strategic planning to form a foundational tool set for the laboratory. One must strategically plan to expand autoverification in the future to include a vision of instrument-generated order interfaces, reflexive testing, and interoperability with other information systems. It is hoped that the observations, examples, and opinions expressed in this article will stimulate such short-term and long-term strategic planning. Copyright © 2013 Elsevier Inc. All rights reserved.

TESSX: A Mission for Space Exploration with Tethers

NASA Technical Reports Server (NTRS)

Cosmo, Mario L.; Lorenzini, Enrico C.; Gramer, Daniel J.; Hoffman, John H.; Mazzoleni, Andre P.

2005-01-01

Tethers offer significant potential for substantially increasing payload mass fraction, increasing spacecraft lifetime, enhancing long-term space travel, and enabling the understanding and development of gravity-dependent technologies required for Moon and Mars exploration. The development of the Tether Electrodynamic Spin-up and Survivability Experiment (TESSX) will support applications relevant to NASA's new exploration initiative, including: artificial gravity generation, formation flying, electrodynamic propulsion, momentum exchange, and multi-amp current collection and emission. Under the broad term TESSX, we are currently evaluating several different tether system configurations and operational modes. The initial results of this work are presented, including hardware development, orbital dynamics simulations, and electrodynamics design and analysis.

Short-Term Memory Depends on Dissociable Medial Temporal Lobe Regions in Amnestic Mild Cognitive Impairment

PubMed Central

Das, Sandhitsu R.; Mancuso, Lauren; Olson, Ingrid R.; Arnold, Steven E.; Wolk, David A.

2016-01-01

Short-term memory (STM) has generally been thought to be independent of the medial temporal lobe (MTL) in contrast to long-term memory (LTM). Prodromal Alzheimer's disease (AD) is a condition in which the MTL is a major early focus of pathology and LTM is thought disproportionately affected relative to STM. However, recent studies have suggested a role for the MTL in STM, particularly hippocampus, when binding of different elements is required. Other work has suggested involvement of extrahippocampal MTL structures, particularly in STM tasks that involve item-level memory. We examined STM for individual objects, locations, and object-location conjunctions in amnestic mild cognitive impairment (MCI), often associated with prodromal AD. Relative to age-matched, cognitively normal controls, MCI patients not only displayed impairment on object-location conjunctions but were similarly impaired for non-bound objects and locations. Moreover, across all participants, these conditions displayed dissociable correlations of cortical thinning along the long axis of the MTL and associated cortical nodes of anterior and posterior MTL networks. These findings support the role of the MTL in visual STM tasks and the division of labor of MTL in support of different types of memory representations, overlapping with findings in LTM. PMID:25725042

Advance care planning for nursing home residents with dementia: Influence of 'we DECide' on policy and practice.

PubMed

Ampe, Sophie; Sevenants, Aline; Smets, Tinne; Declercq, Anja; Van Audenhove, Chantal

2017-01-01

(1) To pilot 'we DECide' in terms of influence on advance care planning policy and practice in nursing home dementia care units. (2) To investigate barriers and facilitators for implementing 'we DECide'. This was a pre-test-post-test study in 18 nursing homes. Measurements included: compliance with best practice of advance care planning policy (ACP-audit); advance care planning practice (ACP criteria: degree to which advance care planning was discussed, and OPTION scale: degree of involvement of residents and families in conversations). Advance care planning policy was significantly more compliant with best practice after 'we DECide'; policy in the control group was not. Advance care planning was not discussed more frequently, nor were residents and families involved to a higher degree in conversations after 'we DECide'. Barriers to realizing advance care planning included staff's limited responsibilities; facilitators included support by management staff, and involvement of the whole organization. 'We DECide' had a positive influence on advance care planning policy. Daily practice, however, did not change. Future studies should pay more attention to long-term implementation strategies. Long-term implementation of advance care planning requires involvement of the whole organization and a continuing support system for health care professionals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Informatics: essential infrastructure for quality assessment and improvement in nursing.

PubMed Central

Henry, S B

1995-01-01

In recent decades there have been major advances in the creation and implementation of information technologies and in the development of measures of health care quality. The premise of this article is that informatics provides essential infrastructure for quality assessment and improvement in nursing. In this context, the term quality assessment and improvement comprises both short-term processes such as continuous quality improvement (CQI) and long-term outcomes management. This premise is supported by 1) presentation of a historical perspective on quality assessment and improvement; 2) delineation of the types of data required for quality assessment and improvement; and 3) description of the current and potential uses of information technology in the acquisition, storage, transformation, and presentation of quality data, information, and knowledge. PMID:7614118

Establishing pediatric surgical services in emerging countries: What the first world can learn from Vanuatu.

PubMed

Leodoro, Basil M; Beasley, Spencer W; Maoate, Kiki

2015-05-01

Conventional surgical aid to emerging countries often does little to build capacity or infrastructure. An evolving model in the South Pacific has been designed to promote local expertise by training local surgeons to a high standard and helping establish sustainable pediatric surgical services in those regions. This review identifies the key elements required to improve and expand local specialist pediatric surgical capacity in Vanuatu. It highlights some of the challenges that face external agencies in helping to create sufficient local infrastructure to achieve these goals and describes how the impediments can be overcome. We conducted a review of the program that provides a sustainable pediatric surgical service to the small and poor Pacific nation of Vanuatu through the involvement and support of the Pacific Island Project administered by the Royal Australasian College of Surgeons. A needs assessment must be done from the recipient's perspective and can be achieved by collaboration between an external agency and existing local surgeons. The key to a sustainable service is identifying and training high quality young indigenous doctors early and providing mentorship and support, including after their return. A sustainable and viable service requires an adequately resourced position for the new surgeons(s) within a framework of a long term strategic plan for the specialty and adequate infrastructure in place on their return. Development of rapport with government and influencing strategic health priorities is a prerequisite of a new national specialty service. (1) Establishing long term viable pediatric surgical capability can only be achieved through the local health system with local leadership and ownership. (2) Internal capability includes governance, alignment with ministry of health priorities and policies, and effective clinical leadership. (3) Selection of person(s) to be trained is best done early, and he/she must be supported throughout training and afterwards. (4) Long term dependence on a single person makes the service vulnerable. (5) Ultimately, a service configuration that ensures children have timely access to quality specialist advice and which reflects the needs of the population is the main determinant of clinical outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

A feasibility assessment of magnetic bearings for free-piston Stirling space power converters

NASA Technical Reports Server (NTRS)

Curwen, Peter W.; Rao, Dantam K.; Wilson, Donald R.

1992-01-01

This report describes a design and analysis study performed by Mechanical Technology Incorporated (MTI) under NASA Contract NAS3-26061. The objective of the study was to assess the feasibility and efficacy of applying magnetic bearings to free-piston Stirling-cycle power conversion machinery of the type currently being evaluated for possible use in long-term space missions. The study was performed for a 50-kWe Reference Stirling Space Power Converter (RSSPC) system consisting of two 25-kWe free-piston Stirling engine modules. Two different versions of the RSSPC engine modules have been defined under NASA Contract NAS3-25463. These modules currently use hydrostatic gas bearings to support the reciprocating displacer and power piston assemblies. Results of this study show that active magnetic bearings of the attractive electromagnetic type are technically feasible for RSSPC application provided that wire insulation with 60,000-hr life capability at 300 C can be developed for the bearing coils. From a design integration standpoint, both versions of the RSSPC were found to be conceptually amenable to magnetic support of the power piston assembly. However, only one version of the RSSPC was found to be amendable to magnetic support of the displacer assembly. Unacceptable changes to the basic engine design would be required to incorporate magnetic displacer bearings into the second version. Complete magnetic suspension of the RSSPC can potentially increase overall efficiency of the Stirling cycle power converter by 0.53 to 1.4 percent (0.15 to 0.4 efficiency points). Magnetic bearings will also overcome several operational concerns associated with hydrostatic gas bearing systems. However, these advantages are accompanied by a 5 to 8 percent increase in specific mass of the RSSPC, depending on the RSSPC version employed. Additionally, magnetic bearings are much more complex, both mechanically and particularly electronically, than hydrostatic bearings. Accordingly, long-term stability and reliability represent areas of uncertainty for magnetic bearings. Considerable development effort will be required to establish the long-term suitability of these bearings for Stirling space power applications.

76 FR 12651 - Approval and Promulgation of Implementation Plans; State of Oregon; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... reasonable progress goals and the long term strategy. A. Definition of Regional Haze Regional haze is... Addressing Regional Haze Successful implementation of the Regional Haze Program will require long-term...'s long term strategy for addressing regional haze. The reasonable progress goals in the draft and...

76 FR 36450 - Approval and Promulgation of Air Quality Implementation Plans; State of Nevada; Regional Haze...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-22

... Technology (BART) E. Long-Term Strategy (LTS) F. Coordination of the Regional Haze SIP and Reasonably... for 2018 2. Establishing the Reasonable Progress Goal 3. Interstate Consultation G. Long-Term Strategy... implementation of the regional haze program will require long-term coordination among states, Tribal governments...

77 FR 11879 - Approval and Promulgation of Air Quality Implementation Plans; State of Mississippi; Regional...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Goals (RPGs) D. Best Available Retrofit Technology (BART) E. Long-Term Strategy (LTS) F. Coordinating... analysis of Mississippi's regional haze submittal? A. No Affected Class I Areas in Mississippi B. Long-Term... haze program will require long-term regional coordination among states, tribal governments, and various...

77 FR 30454 - Approval and Promulgation of Implementation Plans; State of Oregon; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-23

.... Determination of Reasonable Progress Goals F. Long Term Strategy G. Coordinating Regional Haze and Reasonably... Reasonable Progress Goals (RPGs) and the Long Term Strategy (LTS). A. Definition of Regional Haze Regional... implementation of the regional haze program will require long-term regional coordination among states, tribal...

Comparison of two humidification systems for long-term noninvasive mechanical ventilation.

PubMed

Nava, S; Cirio, S; Fanfulla, F; Carlucci, A; Navarra, A; Negri, A; Ceriana, P

2008-08-01

There is no consensus concerning the best system of humidification during long-term noninvasive mechanical ventilation (NIMV). In a technical pilot randomised crossover 12-month study, 16 patients with stable chronic hypercapnic respiratory failure received either heated humidification or heat and moisture exchanger. Compliance with long-term NIMV, airway symptoms, side-effects and number of severe acute pulmonary exacerbations requiring hospitalisation were recorded. Two patients died. Intention-to-treat statistical analysis was performed on 14 patients. No significant differences were observed in compliance with long-term NIMV, but 10 out of 14 patients decided to continue long-term NIMV with heated humidification at the end of the trial. The incidence of side-effects, except for dry throat (significantly more often present using heat and moisture exchanger), hospitalisations and pneumonia were not significantly different. In the present pilot study, the use heated humidification and heat and moisture exchanger showed similar tolerance and side-effects, but a higher number of patients decided to continue long-term noninvasive mechanical ventilation with heated humidification. Further larger studies are required in order to confirm these findings.

Correlated individual differences suggest a common mechanism underlying metacognition in visual perception and visual short-term memory.

PubMed

Samaha, Jason; Postle, Bradley R

2017-11-29

Adaptive behaviour depends on the ability to introspect accurately about one's own performance. Whether this metacognitive ability is supported by the same mechanisms across different tasks is unclear. We investigated the relationship between metacognition of visual perception and metacognition of visual short-term memory (VSTM). Experiments 1 and 2 required subjects to estimate the perceived or remembered orientation of a grating stimulus and rate their confidence. We observed strong positive correlations between individual differences in metacognitive accuracy between the two tasks. This relationship was not accounted for by individual differences in task performance or average confidence, and was present across two different metrics of metacognition and in both experiments. A model-based analysis of data from a third experiment showed that a cross-domain correlation only emerged when both tasks shared the same task-relevant stimulus feature. That is, metacognition for perception and VSTM were correlated when both tasks required orientation judgements, but not when the perceptual task was switched to require contrast judgements. In contrast with previous results comparing perception and long-term memory, which have largely provided evidence for domain-specific metacognitive processes, the current findings suggest that metacognition of visual perception and VSTM is supported by a domain-general metacognitive architecture, but only when both domains share the same task-relevant stimulus feature. © 2017 The Author(s).

Phonotactic Probability Effect in Nonword Recall and Its Relationship with Vocabulary in Monolingual and Bilingual Preschoolers

ERIC Educational Resources Information Center

Messer, Marielle H.; Leseman, Paul P. M.; Boom, Jan; Mayo, Aziza Y.

2010-01-01

The current study examined to what extent information in long-term memory concerning the distribution of phoneme clusters in a language, so-called long-term phonotactic knowledge, increased the capacity of verbal short-term memory in young language learners and, through increased verbal short-term memory capacity, supported these children's first…

Effectiveness of Career Counseling: A One-Year Follow-Up

ERIC Educational Resources Information Center

Perdrix, Sophie; Stauffer, Sarah; Masdonati, Jonas; Massoudi, Koorosh; Rossier, Jerome

2012-01-01

The short-term effectiveness of career counseling is well supported in the literature. However, the long-term impact is often overlooked. This study quantitatively investigated the long-term stability of the positive effects gained through the career counseling process and qualitatively observed participants' levels of career project…

Long-Term Memory and Learning

ERIC Educational Resources Information Center

Crossland, John

2011-01-01

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

The DOD Humanitarian and Civic Assistance Program Concepts, Trends, Medical Challenges

DTIC Science & Technology

1997-03-01

program improvements; measuring program performance and effectiveness; and defining military roles relevant to training, long term benefits, and the...support conclusions relevant to trends, benefits, challenges, suggested improvements, and suggested areas for future research. 15. SUBJECT TERMS 16...a Long Term Medical Benefit ................ 28 CONCLUSION

Science support for managing migratory waterfowl.

USGS Publications Warehouse

Fleskes, Joseph P.; Miller, Michael R.; Takekawa, John Y.

2003-01-01

Migratory birds in North America are an international resource shared by Canada, the United States, and Mexico. Ultimate population management authority in the U.S. lies with the U.S. Fish and Wildlife Service (FWS), but states participate in development of management decisions through the Flyway system. The FWS, state wildlife agencies, and nongovernmental organizations participate through independent actions and cooperative Joint Ventures under the North American Waterfowl Management Plan (NAWMP) to acquire, protect, restore, and enhance wetlands and other habitats critical to the long-term conservation of breeding, migrating, and wintering waterfowl. A thorough base of scientific information is required to support and evaluate waterfowl populations and habitat management in North America.

Ensuring Support for Research and Quality Improvement (QI) Networks: Four Pillars of Sustainability-An Emerging Framework.

PubMed

Holve, Erin

2013-01-01

Multi-institutional research and quality improvement (QI) projects using electronic clinical data (ECD) hold great promise for improving quality of care and patient outcomes but typically require significant infrastructure investments both to initiate and maintain the project over its duration. Consequently, it is important for these projects to think holistically about sustainability to ensure their long-term success. Four "pillars" of sustainability are discussed based on the experiences of EDM Forum grantees and other research and QI networks. These include trust and value, governance, management, and financial and administrative support. Two "foundational considerations," adaptive capacity and policy levers, are also discussed.

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

PubMed

Jones, Gary; Macken, Bill

2018-02-01

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

Recycling and source reduction for long duration space habitation

NASA Technical Reports Server (NTRS)

Hightower, T. M.

1992-01-01

A direct mathematical approach has been established for characterizing the performance of closed-loop life support systems. The understanding that this approach gives clearly illustrates the options available for increasing the performance of a life support system by changing various parameters. New terms are defined and utilized, such as Segregation Factor, Resource Recovery Efficiency, Overall Reclamation Efficiency, Resupply Reduction Factor, and Life Support Extension Factor. The effects of increases in expendable system supplies required due to increases in life support system complexity are shown. Minimizing resupply through increased recycling and source reduction is illustrated. The effects of recycling upon resupply launch cost is also shown. Finally, material balance analyses have been performed based on quantity and composition data for both supplies and wastes, to illustrate the use of this approach by comparing ten different closed-loop life support system cases.

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

NASA Technical Reports Server (NTRS)

Bazley, Jesse

2015-01-01

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

Design and Implementation of an Interactive Website to Support Long-Term Maintenance of Weight Loss

PubMed Central

Stevens, Victor J; Brantley, Phillip J; Erlinger, Thomas P; Myers, Valerie H; Champagne, Catherine M; Bauck, Alan; Samuel-Hodge, Carmen D; Hollis, Jack F

2008-01-01

Background For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition. Objective This paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year. Methods The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts. Results The mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use. Conclusions Developing interactive websites is expensive, complex, and time consuming. We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient. Trial Registration clinicaltrials.gov NCT00054925 PMID:18244892

Transgenic Mice Expressing an Inhibitory Truncated Form of p300 Exhibit Long-Term Memory Deficits

ERIC Educational Resources Information Center

Oliveira, Ana M. M.; Wood, Marcelo A.; McDonough, Conor B.; Abel, Ted

2007-01-01

The formation of many forms of long-term memory requires several molecular mechanisms including regulation of gene expression. The mechanisms directing transcription require not only activation of individual transcription factors but also recruitment of transcriptional coactivators. CBP and p300 are transcriptional coactivators that interact with…

25 CFR 166.208 - How long is a permit term?

Code of Federal Regulations, 2010 CFR

2010-04-01

... Requirements General Requirements § 166.208 How long is a permit term? (a) The duration must be reasonable... tribe may determine the duration of permits composed entirely of its tribal land or in combination with government land, subject to the same limitations provided in paragraph (d) of this section. (e) A permit will...

Are community-living and institutionalized dementia patients cared for differently? Evidence on service utilization and costs of care from German insurance claims data

PubMed Central

2013-01-01

Background Dementia patients are often cared for in institutional arrangements, which are associated with substantial spending on professional long-term care services. Nevertheless, there is little evidence on the exact cost differences between community-based and institutional dementia care, especially when it comes to the distinct health care services. Adopting the perspective of the German social security system, which combines Statutory Health Insurance and Compulsory Long-Term Care Insurance (payer perspective), our study aimed to compare community-living and institutionalized dementia patients regarding their health care service utilization profiles and to contrast the respective expenditures. Methods We analysed 2006 claims data for 2,934 institutionalized and 5,484 community-living individuals stratified by so-called care levels, which reflect different needs for support in activities of daily living. Concordant general linear models adjusting for clinical and demographic differences were run for each stratum separately to estimate mean per capita utilization and expenditures in both settings. Subsequently, spending for the community-living and the institutionalized population as a whole was compared within an extended overall model. Results Regarding both settings, health and long-term care expenditures rose the higher the care level. Thus, long-term care spending was always increased in nursing homes, but health care spending was comparable. However, the underlying service utilization profiles differed, with nursing home residents receiving more frequent visits from medical specialists but fewer in-hospital services and anti-dementia drug prescriptions. Altogether, institutional care required additional yearly per capita expenses of ca. €200 on health and ca. €11,200 on long-term care. Conclusion Community-based dementia care is cost saving from the payer perspective due to substantially lower long-term care expenditures. Health care spending is comparable but community-living and institutionalized individuals present characteristic service utilization patterns. This apparently reflects the existence of setting-specific care strategies. However, the bare economic figures do not indicate whether these different concepts affect the quality of care provision and disregard patient preferences and caregiver-related aspects. Hence, additional research combining primary and secondary data seems to be required to foster both, sound allocation of scarce resources and the development of patient-centred dementia care in each setting. PMID:23286826

Are community-living and institutionalized dementia patients cared for differently? Evidence on service utilization and costs of care from German insurance claims data.

PubMed

Schwarzkopf, Larissa; Menn, Petra; Leidl, Reiner; Graessel, Elmar; Holle, Rolf

2013-01-03

Dementia patients are often cared for in institutional arrangements, which are associated with substantial spending on professional long-term care services. Nevertheless, there is little evidence on the exact cost differences between community-based and institutional dementia care, especially when it comes to the distinct health care services. Adopting the perspective of the German social security system, which combines Statutory Health Insurance and Compulsory Long-Term Care Insurance (payer perspective), our study aimed to compare community-living and institutionalized dementia patients regarding their health care service utilization profiles and to contrast the respective expenditures. We analysed 2006 claims data for 2,934 institutionalized and 5,484 community-living individuals stratified by so-called care levels, which reflect different needs for support in activities of daily living. Concordant general linear models adjusting for clinical and demographic differences were run for each stratum separately to estimate mean per capita utilization and expenditures in both settings. Subsequently, spending for the community-living and the institutionalized population as a whole was compared within an extended overall model. Regarding both settings, health and long-term care expenditures rose the higher the care level. Thus, long-term care spending was always increased in nursing homes, but health care spending was comparable. However, the underlying service utilization profiles differed, with nursing home residents receiving more frequent visits from medical specialists but fewer in-hospital services and anti-dementia drug prescriptions. Altogether, institutional care required additional yearly per capita expenses of ca. €200 on health and ca. €11,200 on long-term care. Community-based dementia care is cost saving from the payer perspective due to substantially lower long-term care expenditures. Health care spending is comparable but community-living and institutionalized individuals present characteristic service utilization patterns. This apparently reflects the existence of setting-specific care strategies. However, the bare economic figures do not indicate whether these different concepts affect the quality of care provision and disregard patient preferences and caregiver-related aspects. Hence, additional research combining primary and secondary data seems to be required to foster both, sound allocation of scarce resources and the development of patient-centred dementia care in each setting.

A Novel Unsupervised Adaptive Learning Method for Long-Term Electromyography (EMG) Pattern Recognition

PubMed Central

Huang, Qi; Yang, Dapeng; Jiang, Li; Zhang, Huajie; Liu, Hong; Kotani, Kiyoshi

2017-01-01

Performance degradation will be caused by a variety of interfering factors for pattern recognition-based myoelectric control methods in the long term. This paper proposes an adaptive learning method with low computational cost to mitigate the effect in unsupervised adaptive learning scenarios. We presents a particle adaptive classifier (PAC), by constructing a particle adaptive learning strategy and universal incremental least square support vector classifier (LS-SVC). We compared PAC performance with incremental support vector classifier (ISVC) and non-adapting SVC (NSVC) in a long-term pattern recognition task in both unsupervised and supervised adaptive learning scenarios. Retraining time cost and recognition accuracy were compared by validating the classification performance on both simulated and realistic long-term EMG data. The classification results of realistic long-term EMG data showed that the PAC significantly decreased the performance degradation in unsupervised adaptive learning scenarios compared with NSVC (9.03% ± 2.23%, p < 0.05) and ISVC (13.38% ± 2.62%, p = 0.001), and reduced the retraining time cost compared with ISVC (2 ms per updating cycle vs. 50 ms per updating cycle). PMID:28608824

A Novel Unsupervised Adaptive Learning Method for Long-Term Electromyography (EMG) Pattern Recognition.

PubMed

Huang, Qi; Yang, Dapeng; Jiang, Li; Zhang, Huajie; Liu, Hong; Kotani, Kiyoshi

2017-06-13

Performance degradation will be caused by a variety of interfering factors for pattern recognition-based myoelectric control methods in the long term. This paper proposes an adaptive learning method with low computational cost to mitigate the effect in unsupervised adaptive learning scenarios. We presents a particle adaptive classifier (PAC), by constructing a particle adaptive learning strategy and universal incremental least square support vector classifier (LS-SVC). We compared PAC performance with incremental support vector classifier (ISVC) and non-adapting SVC (NSVC) in a long-term pattern recognition task in both unsupervised and supervised adaptive learning scenarios. Retraining time cost and recognition accuracy were compared by validating the classification performance on both simulated and realistic long-term EMG data. The classification results of realistic long-term EMG data showed that the PAC significantly decreased the performance degradation in unsupervised adaptive learning scenarios compared with NSVC (9.03% ± 2.23%, p < 0.05) and ISVC (13.38% ± 2.62%, p = 0.001), and reduced the retraining time cost compared with ISVC (2 ms per updating cycle vs. 50 ms per updating cycle).

The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence

PubMed Central

Williams, Geoffrey C.; Niemiec, Christopher P.; Patrick, Heather; Ryan, Richard M.; Deci, Edward L.

2010-01-01

Background The Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence (1) recommends supporting autonomy and perceived competence to facilitate tobacco abstinence. Purpose To evaluate the effectiveness of an intensive tobacco-dependence intervention based on self-determination theory (SDT) and intended to support autonomy and perceived competence in facilitating long-term tobacco abstinence. Methods One thousand and six adult smokers were recruited into a randomized cessation-induction trial. Community care participants received cessation pamphlets and information on local treatment programs. Intervention participants received the same materials and were asked to meet four times with counselors over six months to discuss their health in a manner intended to support autonomy and perceived competence. The primary outcome was 24-month prolonged abstinence from tobacco. The secondary outcome was 7-day point prevalence tobacco abstinence at 24 months post-intervention. Results Smokers in the intervention were more likely to attain both tobacco abstinence outcomes and these effects were partially mediated by change in both autonomous self-regulation and perceived competence from baseline to six months. Structural equation modeling confirmed the SDT model of health-behavior change in facilitating long-term tobacco abstinence. Conclusions An intervention based on SDT and consistent with the PHS Guideline, which was intended to support autonomy and perceived competence, facilitated long-term tobacco abstinence. PMID:19373517

The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence.

PubMed

Williams, Geoffrey C; Niemiec, Christopher P; Patrick, Heather; Ryan, Richard M; Deci, Edward L

2009-06-01

The Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence (Fiore et al. 2000) recommends supporting autonomy and perceived competence to facilitate tobacco abstinence. The aim of the study was to evaluate the effectiveness of an intensive tobacco-dependence intervention based on self-determination theory (SDT) and intended to support autonomy and perceived competence in facilitating long-term tobacco abstinence. One thousand and six adult smokers were recruited into a randomized cessation-induction trial. Community care participants received cessation pamphlets and information on local treatment programs. Intervention participants received the same materials and were asked to meet four times with counselors over 6 months to discuss their health in a manner intended to support autonomy and perceived competence. The primary outcome was 24-month prolonged abstinence from tobacco. The secondary outcome was 7-day point prevalence tobacco abstinence at 24 months postintervention. Smokers in the intervention were more likely to attain both tobacco abstinence outcomes and these effects were partially mediated by change in both autonomous self-regulation and perceived competence from baseline to 6 months. Structural equation modeling confirmed the SDT model of health-behavior change in facilitating long-term tobacco abstinence. An intervention based on SDT and consistent with the PHS Guideline, which was intended to support autonomy and perceived competence, facilitated long-term tobacco abstinence.

What Infant Memory Tells Us about Infantile Amnesia: Long-Term Recall and Deferred Imitation

PubMed Central

Meltzoff, Andrew N.

2013-01-01

Long-term recall memory was assessed using a nonverbal method requiring subjects to reenact a past event from memory (deferred imitation). A large sample of infants (N = 192), evenly divided between 14- and 16-months old, was tested across two experiments. A delay of 2 months was used in Experiment 1 and a delay of 4 months in Experiment 2. In both experiments two treatment groups were used, In one treatment group, motor practice (immediate imitation) was allowed before the delay was imposed; in the other group, subjects were prevented from motor practice before the delay. Age-matched control groups were used lo assess the spontaneous production of the target acts in the absence of exposure to the model in both experiments. The results demonstrated significant deferred imitation for both treatment groups at both delay intervals, and moreover showed that infants retained and imitated multiple acts. These findings suggest that infants have a nonverbal declarative memory system that supports the recall of past events across long-term delays. The implications of these findings for the multiple memory system debate in cognitive science and neuroscience and for theories of infantile amnesia are considered. PMID:7622990

Activation of the central melanocortin system chronically reduces body mass without the necessity of long-term caloric restriction.

PubMed

Côté, I; Sakarya, Y; Kirichenko, N; Morgan, D; Carter, C S; Tümer, N; Scarpace, P J

2017-02-01

Melanotan II (MTII) is a potent appetite suppressor that rapidly reduces body mass. Given the rapid loss of anorexic response upon chronic MTII treatment, most investigations have focused on the initial physiological adaptations. However, other evidence supports MTII as a long-term modulator of energy balance that remains to be established. Therefore, we examined the chronic effects of MTII on energy homeostasis. MTII (high or low dose) or artificial cerebrospinal fluid (aCSF) was infused into the lateral ventricle of the brain of 6-month-old F344BN rats (6-7/group) over 40 days. MTII suppressed appetite in a dose-dependent manner (P < 0.05). Although food intake promptly rose back to control level, body mass was persistently reduced in both MTII groups (P < 0.01). At day 40, both MTII groups displayed lower adiposity than the aCSF animals (P < 0.01). These results show that MTII chronically reduces body mass without the requirement of long-term caloric restriction. Our study proposes that food restriction helps initiate mass loss; however, combined with a secondary pharmacological approach preserving a negative energy balance state over time may help combat obesity.

Satellite networks in the ISDN era

NASA Astrophysics Data System (ADS)

Amadesi, P.; Haines, P.; Patacchini, A.

1986-12-01

The development of an integrated service digital network (ISDN) capable of supporting a wide range of services using a small set of standard multipurpose user-network interfaces is examined. The ISDN environment is expected to consist of functional elements such as, circuit switching, packet switching, and common channel signaling. The use of satellites or fiber optics in the ISDN is evaluated. The relation between satellites and the ISDN in the short-, medium-, and long-terms is analyzed. The recommendations of the consultative committee, CCIR, concerning the definition of the hypothetical reference digital path and the required quality and availability for ISDN applications, and the proposed plans of Eutelsat and Intelsat for satellite systems compatible with an ISDN are discussed. The application of business satellite networks and packet satellite networks to an ISDN is studied. The long-term objectives for an ISDN is a wideband system that accommodates digital transmission on circuit and packet switched bases.

AOSSM Early Sport Specialization Consensus Statement.

PubMed

LaPrade, Robert F; Agel, Julie; Baker, Joseph; Brenner, Joel S; Cordasco, Frank A; Côté, Jean; Engebretsen, Lars; Feeley, Brian T; Gould, Daniel; Hainline, Brian; Hewett, Timothy; Jayanthi, Neeru; Kocher, Mininder S; Myer, Gregory D; Nissen, Carl W; Philippon, Marc J; Provencher, Matthew T

2016-04-01

Early sport specialization is not a requirement for success at the highest levels of competition and is believed to be unhealthy physically and mentally for young athletes. It also discourages unstructured free play, which has many benefits. To review the available evidence on early sports specialization and identify areas where scientific data are lacking. Think tank, roundtable discussion. The primary outcome of this think tank was that there is no evidence that young children will benefit from early sport specialization in the majority of sports. They are subject to overuse injury and burnout from concentrated activity. Early multisport participation will not deter young athletes from long-term competitive athletic success. Youth advocates, parents, clinicians, and coaches need to work together with the sport governing bodies to ensure healthy environments for play and competition that do not create long-term health issues yet support athletic competition at the highest level desired.

AOSSM Early Sport Specialization Consensus Statement

PubMed Central

LaPrade, Robert F.; Agel, Julie; Baker, Joseph; Brenner, Joel S.; Cordasco, Frank A.; Côté, Jean; Engebretsen, Lars; Feeley, Brian T.; Gould, Daniel; Hainline, Brian; Hewett, Timothy E.; Jayanthi, Neeru; Kocher, Mininder S.; Myer, Gregory D.; Nissen, Carl W.; Philippon, Marc J.; Provencher, Matthew T.

2016-01-01

Background: Early sport specialization is not a requirement for success at the highest levels of competition and is believed to be unhealthy physically and mentally for young athletes. It also discourages unstructured free play, which has many benefits. Purpose: To review the available evidence on early sports specialization and identify areas where scientific data are lacking. Study Design: Think tank, roundtable discussion. Results: The primary outcome of this think tank was that there is no evidence that young children will benefit from early sport specialization in the majority of sports. They are subject to overuse injury and burnout from concentrated activity. Early multisport participation will not deter young athletes from long-term competitive athletic success. Conclusion: Youth advocates, parents, clinicians, and coaches need to work together with the sport governing bodies to ensure healthy environments for play and competition that do not create long-term health issues yet support athletic competition at the highest level desired. PMID:27169132

“Mentoring International Research Ethics Trainees: Identifying Best Practices”

PubMed Central

Loue, Sana; Loff, Bebe

2014-01-01

Mentoring is an important component of training in the basic and clinical sciences due to the increasing complexities associated with establishing a career. Methods Data relating to 466 long term trainees in research ethics training programs were obtained from the Fogarty International Center's database. Data were supplemented with survey data (n=17) and telephone interviews (n=10) of the 21 principal investigators whose programs offered long-term training. The programs most successful with mentoring involved (1) the provision of an orientation to the trainees at the commencement of training; (2) a highly structured process of mentoring that required regular meetings and task achievement timelines; (3) intensive, frequent contact with the PI; and (4) support with personal issues that were troublesome to trainees. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education & Curriculum Development program. PMID:24384516

Providing a sound habitat for man in space

NASA Astrophysics Data System (ADS)

Stranger-Johannessen, Maria

Microbiological growth on materials in an indoor environment contributes to the well known "sick building syndrome". The inhabitants' health and well-being is affected by injurious vapours and odours given off to the air. This is particularly pronounced in new and better tightened houses with unconventional building materials and wider employment of air conditioning. The European Space Agency has recognized the problems to be expected in a totally closed and self-supported long-term habitat and has induced work on the selection of materials, resistant to microbiological growth, and on other microbial contamination control measures. Requirements and procedures are being established as a basis for the microbiological cleanliness of the manned space environment and for the avoidance of microbiological growth on materials and equipment. Methods are being developed, suitable for testing and predicting the resistivity to microbiological growth of materials to be used in long-term space habitats.

Thermodynamics and Diffusion Coupling in Alloys—Application-Driven Science

NASA Astrophysics Data System (ADS)

Ågren, John

2012-10-01

As emphasized by Stokes (1997), the common assumption of a linear progression from basic research (science), via applied research, to technological innovations (engineering) should be questioned. In fact, society would gain much by supporting long-term research that stems from practical problems and has usefulness as a key word. Such research may be fundamental, and often, it cannot be distinguished from "basic" research if it were not for its different motivation. The development of the Calphad method and the more recent development of accompanying kinetic approaches for diffusion serve as excellent examples and are the themes of this symposium. The drivers are, e.g., the development of new materials, processes, and lifetime predictions. Many challenges of the utmost practical importance require long-term fundamental research. This presentation will address some of them, e.g., the effect of various ordering phenomena on activation barriers, and the strength and practical importance of correlation effects.

Methods to evvaluate normal rainfall for short-term wetland hydrology assessment

Treesearch

Jaclyn Sumner; Michael J. Vepraskas; Randall K. Kolka

2009-01-01

Identifying sites meeting wetland hydrology requirements is simple when long-term (>10 years) records are available. Because such data are rare, we hypothesized that a single-year of hydrology data could be used to reach the same conclusion as with long-term data, if the data were obtained during a period of normal or below normal rainfall. Long-term (40-45 years)...

Feasibility study of a clinical decision support system for the management of multimorbid seniors in primary care: study protocol.

PubMed

Weltermann, Birgitta; Kersting, Christine

2016-01-01

Care for seniors is complex because patients often have more than one disease, one medication, and one physician. It is a key challenge for primary care physicians to structure the various aspects of each patient's care, to integrate each patient's preferences, and to maintain a long-term overview. This article describes the design for the development and feasibility testing of the clinical decision support system (CDSS) eCare*Seniors© which is electronic health record (EHR)-based allowing for a long-term, comprehensive, evidence-based, and patient preference-oriented management of multimorbid seniors. This mixed-methods study is designed in three steps. First, focus groups and practice observations will be conducted to develop criteria for software design from a physicians' and practice assistants' perspective. Second, based on these criteria, a CDSS prototype will be developed. Third, the prototype's feasibility will be tested by five primary care practices in the care of 30 multimorbid seniors. Primary outcome is the usability of the software measured by the validated system usability scale (SUS) after 3 months. Secondary outcomes are the (a) willingness to routinely use the CDSS, (b) degree of utilization of the CDSS, (c) acceptance of the CDSS, (d) willingness of the physicians to purchase the CDSS, and (e) willingness of the practice assistants to use the CDSS in the long term. These outcomes will be measured using semi-structured interviews and software usage data. If the SUS score reaches ≥70 %, feasibility testing will be judged successful. Otherwise, the CDSS prototype will be refined according to the users' needs and retested by the physicians and practice assistants until it is fully adapted to their requirements and reaches a usability score ≥70 %. The study will support the development of a CDSS which is primary care-defined, user-friendly, easy-to-comprehend, workflow-oriented, and comprehensive. The software will assist physicians and practices in their long-term, individualized care for multimorbid seniors. German Clinical Trials Register, DRKS00008777.

α6β1- and αV-integrins are required for long-term self-renewal of murine embryonic stem cells in the absence of LIF.

PubMed

Cattavarayane, Sandhanakrishnan; Palovuori, Riitta; Tanjore Ramanathan, Jayendrakishore; Manninen, Aki

2015-02-27

The growth properties and self-renewal capacity of embryonic stem (ES) cells are regulated by their immediate microenvironment such as the extracellular matrix (ECM). Integrins, a central family of cellular ECM receptors, have been implicated in these processes but their specific role in ES cell self-renewal remains unclear. Here we have studied the effects of different ECM substrates and integrins in mouse ES cells in the absence of Leukemia Inhibitory Factor (LIF) using short-term assays as well as long-term cultures. Removal of LIF from ES cell culture medium induced morphological differentiation of ES cells into polarized epistem cell-like cells. These cells maintained epithelial morphology and expression of key stemness markers for at least 10 passages in the absence of LIF when cultured on laminin, fibronectin or collagen IV substrates. The specific functional roles of α6-, αV- and β1-integrin subunits were dissected using stable lentivirus-mediated RNAi methodology. β1-integrins were required for ES cell survival in long-term cultures and for the maintenance of stem cell marker expression. Inhibition of α6-integrin expression compromised self-renewal on collagen while αV-integrins were required for robust ES cell adhesion on laminin. Analysis of the stemness marker expression revealed subtle differences between α6- and αV-depleted ES cells but the expression of both was required for optimal self-renewal in long-term ES cell cultures. In the absence of LIF, long-term ES cell cultures adapt an epistem cell-like epithelial phenotype and retain the expression of multiple stem cell markers. Long-term maintenance of such self-renewing cultures depends on the expression of β1-, α6- and αV-integrins.

Association of social network and social support with health-related quality of life and fatigue in long-term survivors of Hodgkin lymphoma.

PubMed

Soares, A; Biasoli, I; Scheliga, A; Baptista, R L; Brabo, E P; Morais, J C; Werneck, G L; Spector, N

2013-08-01

As the number of survivors of Hodgkin's lymphoma (HL) increases, there has been a growing interest in long-term treatment-related side effects and their impact on the quality of life (QoL). The aim of this study was to assess the association of social network and social support with the QoL and fatigue among long-term HL survivors. A total of 200 HL survivors were included. The generic Short Form-12 (SF-12) questionnaire, the QoL cancer survivor's questionnaire (QOL-CS), and the Multidimensional Fatigue Inventory were used to assess QoL and fatigue. Social network and social support were evaluated with the Social Support Survey. Social network and all social support measures were favorably associated with two or more SF-12 scales, mainly with physical functioning and the mental health scales. Social network and social support dimensions were also associated with better QOL-CS scores. Affective support, informational support, positive interaction, and emotional support were associated with less fatigue. Both social network and social support are associated with better QoL and lower levels of fatigue in HL survivors. This information may be useful to health professionals and community organizations in implementing effective interventions to improve these patients' quality of life.

mTORC1 controls long-term memory retrieval.

PubMed

Pereyra, Magdalena; Katche, Cynthia; de Landeta, Ana Belén; Medina, Jorge H

2018-06-08

Understanding how stored information emerges is a main question in the neurobiology of memory that is now increasingly gaining attention. However, molecular events underlying this memory stage, including involvement of protein synthesis, are not well defined. Mammalian target of rapamycin complex 1 (mTORC1), a central regulator of protein synthesis, has been implicated in synaptic plasticity and is required for memory formation. Using inhibitory avoidance (IA), we evaluated the role of mTORC1 in memory retrieval. Infusion of a selective mTORC1 inhibitor, rapamycin, into the dorsal hippocampus 15 or 40 min but not 3 h before testing at 24 h reversibly disrupted memory expression even in animals that had already expressed IA memory. Emetine, a general protein synthesis inhibitor, provoked a similar impairment. mTORC1 inhibition did not interfere with short-term memory retrieval. When infused before test at 7 or 14 but not at 28 days after training, rapamycin impaired memory expression. mTORC1 blockade in retrosplenial cortex, another structure required for IA memory, also impaired memory retention. In addition, pretest intrahippocampal rapamycin infusion impaired object location memory retrieval. Our results support the idea that ongoing protein synthesis mediated by activation of mTORC1 pathway is necessary for long but not for short term memory.

Mutual support groups for long-term recipients of TANF.

PubMed

Anderson-Butcher, Dawn; Khairallah, Angela Oliver; Race-Bigelow, Janis

2004-01-01

This study examined the effect of involvement in mutual support groups on long-term recipients of Temporary Assistance for Needy Families (TANF) and other vulnerable individuals. From qualitative interviews with nine group members, the study identified key themes, benefits, and barriers related to involvement in the groups. Content analysis of the data revealed insights about characteristics of effective self-help and mutual support groups, which social workers and other professionals can use to develop effective support groups in the future. Participants discussed benefits for themselves and their families, such as enhanced parenting and social skills, increased knowledge, and enhanced self-esteem.

1. Exterior view of LongTerm Hydrazine Silo (T28E), looking southeast. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Exterior view of Long-Term Hydrazine Silo (T-28E), looking southeast. The structure was designed to assess long-term environmental impacts on storage of the Titan's fuel (hydrazine). The low-lying building to the immediate right of the silo is the Fuel Purification Structure (T-28E), constructed during the late 1960s to purify hydrazine for long-term hardware requirements for satellites and space expedition vehicles associated with the Titan III. - Air Force Plant PJKS, Systems Integration Laboratory, Long-Term Hydrazine Silo, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

Comparison of Models of Stress Relaxation in Failure Analysis for Connectors under Long-term Storage

NASA Astrophysics Data System (ADS)

Zhou, Yilin; Wan, Mengru

2018-03-01

Reliability requirements of the system equipment under long-term storage are put forward especially for the military products, so that the connectors in the equipment also need long-term storage life correspondingly. In this paper, the effects of stress relaxation of the elastic components on electrical contact of the connectors in long-term storage process were studied from the failure mechanism and degradation models. A wire spring connector was taken as an example to discuss the life prediction method for electrical contacts of the connectors based on stress relaxation degradation under long -term storage.

Data Stewardship and Long-Term Archive of ICESat Data at the National Snow and Ice Data Center (NSIDC)

NASA Astrophysics Data System (ADS)

Fowler, D. K.; Moses, J. F.; Duerr, R. E.; Webster, D.; Korn, D.

2010-12-01

Data Stewardship is becoming a principal part of a data manager’s work at NSIDC. It is vitally important that our organization makes a commitment to both current and long-term goals of data management and the preservation of our scientific data. Data must be available to researchers not only during active missions, but long after missions end. This includes maintaining accurate documentation, data tools, and a knowledgeable user support staff. NSIDC is preparing for long-term support of the ICESat mission data. Though ICESat has seen its last operational day, the data is still being improved and NSIDC is scheduled to archive the final release, Release 33, starting late in 2010. This release will include the final adjustments to the processing algorithms and will produce the best possible products to date. Along with the higher-level data sets, all supporting documentation will be archived at NSIDC. For the long-term archive, it is imperative that there is sufficient information about how products were prepared in order to convince future researchers that the scientific results are reproducible. The processing algorithms along with the Level 0 and ancillary products used to create the higher-level products will be archived and made available to users. This can enable users to examine production history, to derive revised products and to create their own products. Also contained in the long-term archive will be pre-launch, calibration/validation, and test data. These data are an important part of the provenance which must be preserved. For longevity, we’ll need to archive the data and documentation in formats that will be supported in the years to come.

The accessibility and acceptability of self-management support interventions for men with long term conditions: a systematic review and meta-synthesis of qualitative studies.

PubMed

Galdas, Paul; Darwin, Zoe; Kidd, Lisa; Blickem, Christian; McPherson, Kerri; Hunt, Kate; Bower, Peter; Gilbody, Simon; Richardson, Gerry

2014-11-27

Self-management support interventions can improve health outcomes, but their impact is limited by the numbers of people able or willing to access them. Men's attendance at existing self-management support services appears suboptimal despite their increased risk of developing many of the most serious long term conditions. The aim of this review was to determine whether current self-management support interventions are acceptable and accessible to men with long term conditions, and explore what may act as facilitators and barriers to access of interventions and support activities. A systematic search for qualitative research was undertaken on CINAHL, EMBASE, MEDLINE, PsycINFO and Social Science Citation Index, in July 2013. Reference lists of relevant articles were also examined. Studies that used a qualitative design to explore men's experiences of, or perceptions towards, self-management support for one or more long term condition were included. Studies which focused on experiences of living with a long term condition without consideration of self-management support were excluded. Thirty-eight studies met the inclusion criteria. A meta-ethnography approach was employed to synthesise the findings. Four constructs associated with men's experience of, and perceptions towards, self-management support were identified: 1) need for purpose; 2) trusted environments; 3) value of peers; and 4) becoming an expert. The synthesis showed that men may feel less comfortable participating in self-management support if it is viewed as incongruous with valued aspects of their identity, particularly when activities are perceived to challenge masculine ideals associated with independence, stoicism, and control. Men may find self-management support more attractive when it is perceived as action-oriented, having a clear purpose, and offering personally meaningful information and practical strategies that can be integrated into daily life. Self-management support is most likely to be successful in engaging men when it is congruent with key aspects of their masculine identity. In order to overcome barriers to access and fully engage with interventions, some men may need self-management support interventions to be delivered in an environment that offers a sense of shared understanding, connectedness, and normality, and involves and/or is facilitated by men with a shared illness experience.

Design and Formative Evaluation of the Policy Liaison Initiative: A Long-Term Knowledge Translation Strategy to Encourage and Support the Use of Cochrane Systematic Reviews for Informing

ERIC Educational Resources Information Center

Brennan, Sue E.; Cumpston, Miranda; Misso, Marie L.; McDonald, Steve; Murphy, Matthew J.; Green, Sally E.

2016-01-01

The Policy Liaison Initiative (PLI) is a long-term knowledge translation initiative designed to support the use of Cochrane systematic reviews in health policy. A joint initiative between the Australasian Cochrane Centre and Australian Government Department of Health and Ageing, the PLI includes: 1) a community of practice for evidence-informed…

A Literature Review on the Experience of Long-Term Mental Illness.

PubMed

Collier, Elizabeth; Grant, Maria J

2018-06-01

To illuminate long-term experiences of mental illness from both research and autobiographical accounts. A literature review of English-language papers, 1950-2014, relating to the experience of long-term mental illness indexed in AgeInfo, AMED, ASSIA, British Nursing Index (BNI), CINAHL, MEDLINE, PsycEXTRA, and PsychINFO. Twenty-five research papers and nine autobiographic accounts met the review criteria. Thematic analysis revealed nine themes: fear, explanation seeking, stigma, disability, coping strategies, control, support, change and learning, and life history. Specific gaps of note relate to age differences, acknowledgement of longevity of mental illnesses, and different cultural perspectives. Research Implications: There is an absence of longitudinal studies focused on experiences of long-term mental illness. The considerable length-of-time implicated in the experiences suggests that more individual life experience rather than illness focused studies are needed, enabling a holistic understanding. This includes studies from cultures other than the Western world. Greater transparency is needed in justifying age inclusions or passive exclusion of older peoples' perspectives. Knowledge of long-term mental illness experiences is of great importance to mental health practitioners. Evidence-based services cannot be provided if we do not have an holistic understanding of long-term mental illness. Social Implications: This review questions our ability to provide effective support for those experiencing long-term mental illness, in particular older people and different cultural perspectives. There appear to be no literature reviews that focus on the individual experience of long-term mental illness. It highlights the surprisingly small number of research studies available to inform mental health practitioners.

Long-Term Survival in Patients Receiving a Continuous-Flow Left Ventricular Assist Device.

PubMed

Gosev, Igor; Kiernan, Michael S; Eckman, Peter; Soleimani, Behzad; Kilic, Ahmet; Uriel, Nir; Rich, Jonathan D; Katz, Jason N; Cowger, Jennifer; Lima, Brian; McGurk, Siobhan; Brisco-Bacik, Meredith A; Lee, Sanjin; Joseph, Susan M; Patel, Chetan B

2018-03-01

Long-term survivors after implantation of left ventricular assist devices (LVADs) are increasing in prevalence. We describe the characteristics and outcomes in patients surviving longer than 4 years on LVAD support. We performed a multicenter, retrospective analysis of patients surviving at least 4 years on continuous-flow LVAD (CF-LVAD) support with a HeartMate II at centers participating in the Evolving Mechanical support Research Group. Between 2005 and 2010, 156 long-term survivors were identified with a mean survival of 7.1 years (95% confidence interval: 6.7 to 7.5 years). The mean age was 58.2 ± 15.2 years and 30.1% were women. Readmission rate was low at 1.1 events per patient per year with the most common reasons leading to readmission being infection (0.10 readmissions per patient per year) and gastrointestinal bleeding (0.07 readmissions per patient per year). Two years after implantation, 97% of patients were either New York Heart Association functional class I or II, with 92% at 4 years. Patients surviving 4 years on CF-LVAD support can anticipate ongoing long-term survival with sustained improvements in functionality and low rates of rehospitalization. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Structural synaptic plasticity in the hippocampus induced by spatial experience and its implications in information processing.

PubMed

Carasatorre, M; Ramírez-Amaya, V; Díaz Cintra, S

2016-10-01

Long-lasting memory formation requires that groups of neurons processing new information develop the ability to reproduce the patterns of neural activity acquired by experience. Changes in synaptic efficiency let neurons organise to form ensembles that repeat certain activity patterns again and again. Among other changes in synaptic plasticity, structural modifications tend to be long-lasting which suggests that they underlie long-term memory. There is a large body of evidence supporting that experience promotes changes in the synaptic structure, particularly in the hippocampus. Structural changes to the hippocampus may be functionally implicated in stabilising acquired memories and encoding new information. Copyright © 2012 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Qualification of Coatings for Launch Facilities and Ground Support Equipment Through the NASA Corrosion Technology Laboratory

NASA Technical Reports Server (NTRS)

Kolody, Mark R.; Curran, Jerome P.; Calle, Luz Marina

2014-01-01

Corrosion protection at NASA's Kennedy Space Center is a high priority item. The launch facilities at the Kennedy Space Center are located approximately 1000 feet from the Atlantic Ocean where they are exposed to salt deposits, high humidity, high UV degradation, and acidic exhaust from solid rocket boosters. These assets are constructed from carbon steel, which requires a suitable coating to provide long-term protection to reduce corrosion and its associated costs.

The Effects of Thermal Cycling on Gallium Nitride and Silicon Carbide Semiconductor Devices for Aerospace Use

NASA Technical Reports Server (NTRS)

Patterson, Richard L.; Hammoud, Ahmad

2012-01-01

Electronics designed for use in NASA space missions are required to work efficiently and reliably under harsh environment conditions. These Include radiation, extreme temperatures, thermal cycling, to name a few. Preliminary data obtained on new Gallium Nitride and Silicon Carbide power devices under exposure to radiation followed by long term thermal cycling are presented. This work was done in collaboration with GSFC and JPL in support of the NASA Electronic Parts and Packaging (NEPP) Program

A comprehensive cost model for NASA data archiving

NASA Technical Reports Server (NTRS)

Green, J. L.; Klenk, K. F.; Treinish, L. A.

1990-01-01

A simple archive cost model has been developed to help predict NASA's archiving costs. The model covers data management activities from the beginning of the mission through launch, acquisition, and support of retrospective users by the long-term archive; it is capable of determining the life cycle costs for archived data depending on how the data need to be managed to meet user requirements. The model, which currently contains 48 equations with a menu-driven user interface, is available for use on an IBM PC or AT.

Practical Approaches to Forced Degradation Studies of Vaccines.

PubMed

Hasija, Manvi; Aboutorabian, Sepideh; Rahman, Nausheen; Ausar, Salvador F

2016-01-01

During the early stages of vaccine development, forced degradation studies are conducted to provide information about the degradation properties of vaccine formulations. In addition to supporting the development of analytical methods for the detection of degradation products, these stress studies are used to identify optimal long-term storage conditions and are part of the regulatory requirements for the submission of stability data. In this chapter, we provide detailed methods for forced degradation analysis under thermal, light, and mechanical stress conditions.

National Water Quality Laboratory - A Profile

USGS Publications Warehouse

Raese, Jon W.

2001-01-01

The U.S. Geological Survey (USGS) National Water Quality Laboratory (NWQL) is a full-service laboratory that specializes in environmental analytical chemistry. The NWQL's primary mission is to support USGS programs requiring environmental analyses that provide consistent methodology for national assessment and trends analysis. The NWQL provides the following: high-quality chemical data; consistent, published, state-of-the-art methodology; extremely low-detection levels; high-volume capability; biological unit for identifying benthic invertebrates; quality assurance for determining long-term water-quality trends; and a professional staff.

Let's be sure to do our homework

NASA Astrophysics Data System (ADS)

Grew, Priscilla C.

A strong federal budget for geophysical research requires the active support of Congress. AGU needs to raise the general level of awareness among members of key congressional committees and their staffs of the importance of geophysical phenomena to society and the contributions geophysicists can make in providing scientific information as an ingredient in the formulation of public policy.Effective communication with any legislative body, be it a state legislature or Congress, requires long-term repeated contact—not just a sudden appearance at the final stage of a budget deliberation or during a crisis when some geophysical event like a catastrophic earthquake or volcanic eruption captures the attention of legislators.

Subregion-Specific p300 Conditional Knock-Out Mice Exhibit Long-Term Memory Impairments

ERIC Educational Resources Information Center

Oliveira, Ana M. M.; Estevez, Marcel A.; Hawk, Joshua D.; Grimes, Shannon; Brindle, Paul K.; Abel, Ted

2011-01-01

Histone acetylation plays a critical role during long-term memory formation. Several studies have demonstrated that the histone acetyltransferase (HAT) CBP is required during long-term memory formation, but the involvement of other HAT proteins has not been extensively investigated. The HATs CBP and p300 have at least 400 described interacting…

Differential role of calpain-dependent protein cleavage in intermediate and long-term operant memory in Aplysia.

PubMed

Lyons, Lisa C; Gardner, Jacob S; Lentsch, Cassidy T; Gandour, Catherine E; Krishnan, Harini C; Noakes, Eric J

2017-01-01

In addition to protein synthesis, protein degradation or protein cleavage may be necessary for intermediate (ITM) and long-term memory (LTM) to remove molecular constraints, facilitate persistent kinase activity and modulate synaptic plasticity. Calpains, a family of conserved calcium dependent cysteine proteases, modulate synaptic function through protein cleavage. We used the marine mollusk Aplysia californica to investigate the in vivo role of calpains during intermediate and long-term operant memory formation using the learning that food is inedible (LFI) paradigm. A single LFI training session, in which the animal associates a specific netted seaweed with the failure to swallow, generates short (30min), intermediate (4-6h) and long-term (24h) memory. Using the calpain inhibitors calpeptin and MDL-28170, we found that ITM requires calpain activity for induction and consolidation similar to the previously reported requirements for persistent protein kinase C activity in intermediate-term LFI memory. The induction of LTM also required calpain activity. In contrast to ITM, calpain activity was not necessary for the molecular consolidation of LTM. Surprisingly, six hours after LFI training we found that calpain activity was necessary for LTM, although this is a time at which neither persistent PKC activity nor protein synthesis is required for the maintenance of long-term LFI memory. These results demonstrate that calpains function in multiple roles in vivo during associative memory formation. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care: the role of Primary Care Mental Health Specialists.

PubMed

Hamilton-West, Kate; Hotham, Sarah; Yang, Wei; Hedayioglu, Julie; Brigden, Charlotte

2017-07-01

Aim We aimed to evaluate a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care. Patients with stable long-term mental health conditions are often not discharged from secondary mental health services when no longer needed due to insufficient systems and processes to enable safe, effective, recovery-focussed treatment and support. The Primary Care Mental Health Specialist (PCMHS) Service was developed to address this gap; new PCMHS posts were introduced to act as a conduit for patients being discharged from secondary care and a single point of referral back into secondary care, should it be required. The two-year pilot, across six Clinical Commissioning Groups in South East England, began in March 2013. Interviews were conducted with all PCMHS employed in the pilot service (n=13) and a sample of service users (n=12). The views of professionals working alongside the service, including GPs, Psychiatrists and Mental Health Nurses, were captured using a brief online questionnaire (n=50). Time and Activity Recording Sheets were used to capture data required for economic analysis. Findings Our findings indicate that the service is working well from the perspective of patients; staff employed within the service and professionals working alongside the service. Patients described the service as a 'safety net' they could fall back on in case of difficulties, whereas staff used the analogy of a 'bridge' to describe the way the service improved communication and collaboration between the various professionals and organisations involved in the patient's care. Improvements in well-being were seen to result from increased support for those transitioning from secondary to primary care, a more pro-active approach to relapse prevention and increased engagement in daily activities. Each PCMHS covered 36 patients in a one-month period, with a unit cost of £73.01 per patient.

Consumer direction in long-term care policy: overcoming barriers to promoting older adults' opportunity for self-direction.

PubMed

Ruggiano, Nicole

2012-01-01

There has been a growing trend in long-term care policy to offer individuals with disabilities the option of consumer direction (CD), where responsibility of managing care and support services is transferred from agencies to care recipients, thus supporting clients' self-determination. Although CD has been accepted as an option for non-elderly individuals with disabilities, barriers persist to promoting older adults' autonomy through CD. This article reviews the incorporation of CD in long-term care policy, addresses the current barriers to providing older adults the right to self-direct, and makes recommendations for overcoming these barriers through social work practice, policy, and research.

Factors related to intention to stay in the current workplace among long-term care nurses: A nationwide survey.

PubMed

Eltaybani, Sameh; Noguchi-Watanabe, Maiko; Igarashi, Ayumi; Saito, Yumiko; Yamamoto-Mitani, Noriko

2018-04-01

Keeping long-term care nurses employed is necessary to sustain the current and future demand for high-quality long-term care services. Understanding the factors relating to intention to stay among long-term care nurses is limited by the scarcity of studies in long-term care settings, lack of investigation of multiple factors, and the weakness of existing explanatory models. To identify the factors associated with long-term care nurses' intention to stay in their current workplace. A cross-sectional questionnaire survey. Two hundred and fifty-seven hospitals with long-term care wards across Japan. A total of 3128 staff nurses and 257 nurse managers from the long-term care wards of the participating hospitals. The questionnaire assessed nurses' intention to continue working in the current workplace as well as potential related factors, including individual factors (demographic data, reason for choosing current workplace, burnout, work engagement, somatic symptom burden) and unit factors (unit size, nurse-manager-related data, patients' medical acuity, average number of overtime hours, recreational activities, social support, perceived quality of care process, educational opportunities, feeling of loneliness, and ability to request days off). Multilevel logistic regression analysis was used to determine which variables best explained nurses' intention to stay in their workplace. Only 40.1% of the respondents reported wanting to continue working at their current workplace. The regression analysis revealed that long-term care nurses' intention to stay was positively associated with nurses' age (odds ratio [95% confidence interval]: 1.02 [1.01-1.03]), work engagement (1.24 [1.14-1.35]), getting appropriate support from nurse managers (2.78 [1.60-4.82]), perceived quality of care process (1.04 [1.01-1.06]), educational opportunities (1.06 [1.0-1.13]), and various specific reasons for choosing their workplace (e.g., a good workplace atmosphere, being interested in gerontological nursing, and a high salary). By contrast, intention to stay was negatively associated with emotional exhaustion (0.93 [0.91-0.95]) and depersonalization (0.91 [0.89-0.93]). Intention to stay was associated with neither nurses' qualifications nor patient medical acuity. Reason for choosing the workplace, work engagement, getting support from the nurse manager, and perceived quality of care process are significant predictors of long-term care nurses' intention to stay in the workplace. Promoting such nurses' work engagement, provision of high-quality care, and access to educational opportunities might augment long-term care nurses' intention to stay. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

PubMed

Venturato, Lorraine; Kellett, Ursula; Windsor, Carol

2007-01-01

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

Operational environmental satellite archives in the 21st Century

NASA Astrophysics Data System (ADS)

Barkstrom, Bruce R.; Bates, John J.; Privette, Jeff; Vizbulis, Rick

2007-09-01

NASA, NOAA, and USGS collections of Earth science data are large, federated, and have active user communities and collections. Our experience raises five categories of issues for long-term archival: *Organization of the data in the collections is not well-described by text-based categorization principles *Metadata organization for these data is not well-described by Dublin Core and needs attention to data access and data use patterns *Long-term archival requires risk management approaches to dealing with the unique threats to knowledge preservation specific to digital information *Long-term archival requires careful attention to archival cost management *Professional data stewards for these collections may require special training. This paper suggests three mechanisms for improving the quality of long-term archival: *Using a maturity model to assess the readiness of data for accession, for preservation, and for future data usefulness *Developing a risk management strategy for systematically dealing with threats of data loss *Developing a life-cycle cost model for continuously evolving the collections and the data centers that house them.

Long-Term Experiences in Cash and Counseling for Young Adults with Intellectual Disabilities: Familial Programme Representative Descriptions.

PubMed

Harry, Melissa L; MacDonald, Lynn; McLuckie, Althea; Battista, Christina; Mahoney, Ellen K; Mahoney, Kevin J

2017-07-01

Our aim was to explore previously unknown long-term outcomes of self-directed personal care services for young adults with intellectual disabilities and limitations in activities of daily living. The present authors utilized participatory action research and qualitative content analysis in interviewing 11 unpaid familial programme representatives of young adults with intellectual disabilities, ages 23-34, who were eligible for income-based Medicaid and enrolled five or more years in a Cash and Counseling-based programme of self-direction in the United States. Young adults are represented as receiving services and supports in a supportive and stable environment, with previously identified short-term programme benefits evident over the long-term. Young adults are also transitioning to adulthood at home with their families as primary social support and caregivers, bridging a service gap. Our results show that self-direction helps meet these young adults' personal care and community engagement needs over time. © 2016 John Wiley & Sons Ltd.

Design and development of the second generation Mars Habitat

NASA Technical Reports Server (NTRS)

Sabouni, Ikhlas; Smith, Roy; Taylor, Steven; Harrell, Brock; Crawford, Earnest

1992-01-01

The second generation of Mars Habitat is to be utilized as an advanced permanent base for 20 crew members to live on Mars for a period of 6-12 months. It is designed to be a self-contained environment accommodating five main facilities: living, working, service, medical, and a greenhouse. The objective of the design is to create a comfortable, safe, living environment. Hexamars-2 and Lavapolis-2 are two different concepts for the advanced Mars Habitat. The design team assumes there will be an initial habitat located near or on the site from earlier missions that satisfies the requirement for a short-term habitation for the crew to use while constructing Hexamars-2 or Lavapolis-2. Prefabricated structures and materials will be shipped to the site before the long-term crew members arrive. Partial construction and preparation for the long-term habitat will be done by crew members or robotics from a previous mission. The construction of the long-term base will occur in phases. Hexamars-2 consists of six sphere-shaped inflatable modules that will be partially buried below the Martian surface. The construction of each sphere will occur in ten steps. Shape charges will be used to create the crater in which the spherical structure will be placed. The interior core will be unloaded and put into place followed by the exterior structure. The foundation will be filled, the interior bladder will be inflated, floor-to-floor joists connected, and sand pockets filled. Finally, the life support system and interior partitions are put in place. Each sphere consists of three levels of which the lower level will be safe haven. Particular attention is given to structural support, the dominance of internal pressure, the process of construction, and human factors.

Deep carbon reductions in California require electrification and integration across economic sectors

NASA Astrophysics Data System (ADS)

Wei, Max; Nelson, James H.; Greenblatt, Jeffery B.; Mileva, Ana; Johnston, Josiah; Ting, Michael; Yang, Christopher; Jones, Chris; McMahon, James E.; Kammen, Daniel M.

2013-03-01

Meeting a greenhouse gas (GHG) reduction target of 80% below 1990 levels in the year 2050 requires detailed long-term planning due to complexity, inertia, and path dependency in the energy system. A detailed investigation of supply and demand alternatives is conducted to assess requirements for future California energy systems that can meet the 2050 GHG target. Two components are developed here that build novel analytic capacity and extend previous studies: (1) detailed bottom-up projections of energy demand across the building, industry and transportation sectors; and (2) a high-resolution variable renewable resource capacity planning model (SWITCH) that minimizes the cost of electricity while meeting GHG policy goals in the 2050 timeframe. Multiple pathways exist to a low-GHG future, all involving increased efficiency, electrification, and a dramatic shift from fossil fuels to low-GHG energy. The electricity system is found to have a diverse, cost-effective set of options that meet aggressive GHG reduction targets. This conclusion holds even with increased demand from transportation and heating, but the optimal levels of wind and solar deployment depend on the temporal characteristics of the resulting load profile. Long-term policy support is found to be a key missing element for the successful attainment of the 2050 GHG target in California.

Digital Repositories and the Question of Data Usefulness

NASA Astrophysics Data System (ADS)

Hughes, J. S.; Downs, R. R.

2017-12-01

The advent of ISO standards for trustworthy long-term digital repositories provides both a set of principles to develop long-term data repositories and the instruments to assess them for trustworthiness. Such mandatory high-level requirements are broad enough to be achievable, to some extent, by many scientific data centers, archives, and other repositories. But the requirement that the data be useful in the future, the requirement that is usually considered to be most relevant to the value of the repository for its user communities, largely remains subject to various interpretations and misunderstanding. However, current and future users will be relying on repositories to preserve and disseminate the data and information needed to discover, understand, and utilize these resources to support their research, learning, and decision-making objectives. Therefore, further study is needed to determine the approaches that can be adopted by repositories to make data useful to future communities of users. This presentation will describe approaches for enabling scientific data and related information, such as software, to be useful for current and potential future user communities and will present the methodology chosen to make one science discipline's data useful for both current and future users. The method uses an ontology-based information model to define and capture the information necessary to make the data useful for contemporary and future users.

75 FR 54497 - Ocean Dumping; Guam Ocean Dredged Material Disposal Site Designation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... of special scientific importance, and other legitimate uses of the ocean. Minor short-term... option available since 1997. EPA determined that there is a long-term need for an ocean disposal site... Guam and surrounding waters. This is based on the long-term need to support the Naval and commercial...

Short Term Objectives. (SCAT Project, Title VI-G).

ERIC Educational Resources Information Center

Archer, Anita

Developed by the staff of the SCAT (Support, Competency-Assistance and Training) Project, the document deals with the third step of the systematic instructional model--sequencing short term objectives for exceptional students. The manual focuses on reviewing long term goals established by the child study team, converting these goals into long term…

Language and Short-Term Memory: The Role of Perceptual-Motor Affordance

ERIC Educational Resources Information Center

Macken, Bill; Taylor, John C.; Jones, Dylan M.

2014-01-01

The advantage for real words over nonwords in serial recall--the "lexicality effect"--is typically attributed to support for item-level phonology, either via redintegration, whereby partially degraded short-term traces are "cleaned up" via support from long-term representations of the phonological material or via the more…

National Aeronautics and Space Administration (NASA) Environmental Control and Life Support (ECLS) Integrated Roadmap Development

NASA Technical Reports Server (NTRS)

Metcalf, Jordan; Peterson, Laurie; Carrasquillo, Robyn; Bagdigian, Robert

2012-01-01

Although NASA is currently considering a number of future human space exploration mission concepts, detailed mission requirements and vehicle architectures remain mostly undefined, making technology investment strategies difficult to develop and sustain without a top-level roadmap to serve as a guide. This paper documents the process and results of an effort to define a roadmap for Environmental Control and Life Support Systems (ECLSS) capabilities required to enhance the long-term operation of the International Space Station (ISS) as well as enable beyond-Low Earth Orbit (LEO) human exploration missions. Three generic mission types were defined to serve as a basis for developing a prioritized list of needed capabilities and technologies. Those are 1) a short duration micro-gravity mission; 2) a long duration microgravity mission; and 3) a long duration partial gravity (surface) exploration mission. To organize the effort, a functional decomposition of ECLSS was completed starting with the three primary functions: atmosphere, water, and solid waste management. Each was further decomposed into sub-functions to the point that current state-of-the-art (SOA) technologies could be tied to the sub-function. Each technology was then assessed by NASA subject matter experts as to its ability to meet the functional needs of each of the three mission types. When SOA capabilities were deemed to fall short of meeting the needs of one or more mission types, those gaps were prioritized in terms of whether or not the corresponding capabilities enable or enhance each of the mission types. The result was a list of enabling and enhancing capability needs that can be used to guide future ECLSS development, as well as a list of existing hardware that is ready to go for exploration-class missions. A strategy to fulfill those needs over time was then developed in the form of a roadmap. Through execution of this roadmap, the hardware and technologies intended to meet exploration needs will, in many cases, directly benefit the ISS operational capability, benefit the Multi-Purpose Crew Vehicle (MPCV), and guide long-term technology investments for longer duration missions.

Organizational return to work support and sick leave duration: a cohort of Spanish workers with a long-term non-work-related sick leave episode.

PubMed

Sampere, Maite; Gimeno, David; Serra, Consol; Plana, Manel; Martínez, José Miguel; Delclos, George L; Benavides, Fernando G

2011-06-01

To analyze the association between organizational support and time to return to work (RTW) in workers with long-term non-work-related sick leave. Cohort participants were 571 workers, with a non-work-related sick leave episode of more than 15 days, recruited during the first visit in a health insurance company (mutua). Workers completed a baseline questionnaire regarding organizational RTW support measures and were followed until the end of the episodes. Return to work and time to RTW were established on the basis of the mutua's register. Multivariate Cox regression models were used. Workers in companies with an overall high organizational RTW support returned to work earlier. This effect was mainly due to workers in companies that provided specific RTW programs. Our findings suggest that companies play an important role in facilitating RTW for workers with long-term non-work-related sick leave episodes.

Greenhouses and their humanizing synergies

NASA Astrophysics Data System (ADS)

Haeuplik-Meusburger, Sandra; Paterson, Carrie; Schubert, Daniel; Zabel, Paul

2014-03-01

Greenhouses in space will require advanced technical systems of automatic watering, soil-less cultivation, artificial lighting, and computerized observation of plants. Functions discussed for plants in space habitats include physical/health requirements and human psychology, social cohesion, as well as the complex sensorial benefits of plants for humans. The authors consider the role of plants in long-term space missions historically since 1971 (Salyut 1) and propose a set of priorities to be considered within the design requirements for greenhouses and constructed environments given a range of benefits associated with plant-human relationships. They cite recent research into the use of greenhouses in extreme environments to reveal the relative importance of greenhouses for people living in isolated locations. Additionally, they put forward hypotheses about where greenhouses might factor into several strata of human health. In a recent design-in-use study of astronauts' experiences in space habitats discussed in Architecture for Astronauts (Springer Press 2011) it was found that besides the basic advantages for life support there are clearly additional "side benefits" for habitability and physical wellbeing, and thus long-term mission success. The authors have composed several key theses regarding the need to promote plant-human relationships in space, including areas where synergy and symbiosis occur. They cite new comprehensive research into the early US Space Program to reveal where programmatic requirements could be added to space architecture to increase the less quantifiable benefits to astronauts of art, recreation, and poetic engagement with their existential condition of estrangement from the planet. Specifically in terms of the technological requirements, the authors propose the integration of a new greenhouse subsystem component into space greenhouses—the Mobile Plant Cultivation Subsystem—a portable, personal greenhouse that can be integrated functionally into future greenhouse constructions in space.

Two Waves of Transcription Are Required for Long-Term Memory in the Honeybee

ERIC Educational Resources Information Center

Lefer, Damien; Perisse, Emmanuel; Hourcade, Benoit; Sandoz, JeanChristophe; Devaud, Jean-Marc

2013-01-01

Storage of information into long-term memory (LTM) usually requires at least two waves of transcription in many species. However, there is no clear evidence of this phenomenon in insects, which are influential models for memory studies. We measured retention in honeybees after injecting a transcription inhibitor at different times before and after…

77 FR 14378 - Family Violence Prevention and Services/Grants for Domestic Violence Shelters and Supportive...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

...- being (Section 308(b)(1)(B)). Provision of individual and group counseling, peer support groups, and..., domestic violence, or dating violence, including age- appropriate counseling, supportive services, and... violence, and their dependents, for short-term, transitional, or long-term safety; and Provide counseling...

Mars transit vehicle thermal protection system: Issues, options, and trades

NASA Technical Reports Server (NTRS)

Brown, Norman

1986-01-01

A Mars mission is characterized by different mission phases. The thermal control of cryogenic propellant in a propulsive vehicle must withstand the different mission environments. Long term cryogenic storage may be achieved by passive or active systems. Passive cryo boiloff management features will include multilayer insulation, vapor cooled shield, and low conductance structural supports and penetrations. Active boiloff management incorporates the use of a refrigeration system. Key system trade areas include active verses passive system boiloff management (with respect to safety, reliability, and cost) and propellant tank insulation optimizations. Technology requirements include refrigeration technology advancements, insulation performance during long exposure, and cryogenic fluid transfer system for mission vehicle propellant tanking during vehicle buildip in LEO.

A role for autophagy in long-term spatial memory formation in male rodents.

PubMed

Hylin, Michael J; Zhao, Jing; Tangavelou, Karthikeyan; Rozas, Natalia S; Hood, Kimberly N; MacGowan, Jacalyn S; Moore, Anthony N; Dash, Pramod K

2018-03-01

A hallmark of long-term memory formation is the requirement for protein synthesis. Administration of protein synthesis inhibitors impairs long-term memory formation without influencing short-term memory. Rapamycin is a specific inhibitor of target of rapamycin complex 1 (TORC1) that has been shown to block protein synthesis and impair long-term memory. In addition to regulating protein synthesis, TORC1 also phosphorylates Unc-51-like autophagy activating kinase-1 (Ulk-1) to suppress autophagy. As autophagy can be activated by rapamycin (and rapamycin inhibits long-term memory), our aim was to test the hypothesis that autophagy inhibitors would enhance long-term memory. To examine if learning alters autophagosome number, we used male reporter mice carrying the GFP-LC3 transgene. Using these mice, we observed that training in the Morris water maze task increases the number of autophagosomes, a finding contrary to our expectations. For learning and memory studies, male Long Evans rats were used due to their relatively larger size (compared to mice), making it easier to perform intrahippocampal infusions in awake, moving animals. When the autophagy inhibitors 3-methyladenine (3-MA) or Spautin-1 were administered bilaterally into the hippocampii prior to training in the Morris water maze task, the drugs did not alter learning. In contrast, when memory was tested 24 hours later by a probe trial, significant impairments were observed. In addition, intrahippocampal infusion of an autophagy activator peptide (TAT-Beclin-1) improved long-term memory. These results indicate that autophagy is not necessary for learning, but is required for long-term memory formation. © 2017 Wiley Periodicals, Inc.

Pimecrolimus in atopic dermatitis: consensus on safety and the need to allow use in infants.

PubMed

Luger, Thomas; Boguniewicz, Mark; Carr, Warner; Cork, Michael; Deleuran, Mette; Eichenfield, Lawrence; Eigenmann, Philippe; Fölster-Holst, Regina; Gelmetti, Carlo; Gollnick, Harald; Hamelmann, Eckard; Hebert, Adelaide A; Muraro, Antonella; Oranje, Arnold P; Paller, Amy S; Paul, Carle; Puig, Luis; Ring, Johannes; Siegfried, Elaine; Spergel, Jonathan M; Stingl, Georg; Taieb, Alain; Torrelo, Antonio; Werfel, Thomas; Wahn, Ulrich

2015-06-01

Atopic dermatitis (AD) is a distressing dermatological disease, which is highly prevalent during infancy, can persist into later life and requires long-term management with anti-inflammatory compounds. The introduction of the topical calcineurin inhibitors (TCIs), tacrolimus and pimecrolimus, more than 10 yr ago was a major breakthrough for the topical anti-inflammatory treatment of AD. Pimecrolimus 1% is approved for second-line use in children (≥2 yr old) and adults with mild-to-moderate AD. The age restriction was emphasized in a boxed warning added by the FDA in January 2006, which also highlights the lack of long-term safety data and the theoretical risk of skin malignancy and lymphoma. Since then, pimecrolimus has been extensively investigated in short- and long-term studies including over 4000 infants (<2 yr old). These studies showed that pimecrolimus effectively treats AD in infants, with sustained improvement with long-term intermittent use. Unlike topical corticosteroids, long-term TCI use does not carry the risks of skin atrophy, impaired epidermal barrier function or enhanced percutaneous absorption, and so is suitable for AD treatment especially in sensitive skin areas. Most importantly, the studies of pimecrolimus in infants provided no evidence for systemic immunosuppression, and a comprehensive body of evidence from clinical studies, post-marketing surveillance and epidemiological investigations does not support potential safety concerns. In conclusion, the authors consider that the labelling restrictions regarding the use of pimecrolimus in infants are no longer justified and recommend that the validity of the boxed warning for TCIs should be reconsidered. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Family caregiver issues: gender, privacy, and public policy perspectives].

PubMed

Lee, I; Chou, Fan-Hao; Chen, Chung-Hey

2011-04-01

Due to the phenomenon of Taiwan'saging population has made, long-term care has become an issue of increasingly emphasized importance. According to the statistics, the family takes responsibility for most long-term care duties and more than 70% of primary family caregivers are female. In the past, because of gender-based divisions of labor and gender role expectations made, it was taken for granted that females would be the socially preferred family caregivers. Those men who devoting in themselves to such work were regarded as a rare precious. As such, family care signified entailed different life experiences for males and females. Over the years, amendments to the civil code have recognized family care contributions, and the allowance for caregivers underlines that care responsibilities have shifted away from the family to society. Traditional gender divisions of labor today are significantly more blurred; family structures have become smaller in size; female labor in the workplace has increased; and ten-year long-term care plans and long-term care insurance have been successively implemented. These transformations will make labor outsourcing more and more popular and transform family care from a private problem to a pubic policy issue. In the future, family caregivers require consideration and support on a sustained basis. It is also important to improve and monitor the quality of care services. Nurses, the major professional members of long-term care teams, should be concerned over the issue of family care while providing nursing care. They should include family caregivers in the care plan so that they can make sure that patients receive comprehensive and constant care in order to enhance the overall quality of nursing care.

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

PubMed

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

2017-01-11

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

Auditory short-term memory in the primate auditory cortex

PubMed Central

Scott, Brian H.; Mishkin, Mortimer

2015-01-01

Sounds are fleeting, and assembling the sequence of inputs at the ear into a coherent percept requires auditory memory across various time scales. Auditory short-term memory comprises at least two components: an active ‘working memory’ bolstered by rehearsal, and a sensory trace that may be passively retained. Working memory relies on representations recalled from long-term memory, and their rehearsal may require phonological mechanisms unique to humans. The sensory component, passive short-term memory (pSTM), is tractable to study in nonhuman primates, whose brain architecture and behavioral repertoire are comparable to our own. This review discusses recent advances in the behavioral and neurophysiological study of auditory memory with a focus on single-unit recordings from macaque monkeys performing delayed-match-to-sample (DMS) tasks. Monkeys appear to employ pSTM to solve these tasks, as evidenced by the impact of interfering stimuli on memory performance. In several regards, pSTM in monkeys resembles pitch memory in humans, and may engage similar neural mechanisms. Neural correlates of DMS performance have been observed throughout the auditory and prefrontal cortex, defining a network of areas supporting auditory STM with parallels to that supporting visual STM. These correlates include persistent neural firing, or a suppression of firing, during the delay period of the memory task, as well as suppression or (less commonly) enhancement of sensory responses when a sound is repeated as a ‘match’ stimulus. Auditory STM is supported by a distributed temporo-frontal network in which sensitivity to stimulus history is an intrinsic feature of auditory processing. PMID:26541581

Guidelines for the collection of long-term pavement performance data

DOT National Transportation Integrated Search

2006-03-01

A set of data collection guidelines has been provided for the collection of all data obtained for the Long-Term Pavement Performance (LTPP) program. These guidelines were provided to the Regional Support Contractors (RSC) to facilitate data collectio...

It's more than money: policy options to secure medical specialist workforce for regional centres.

PubMed

May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

2017-12-01

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes. What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

Corrigendum to: It's more than money: policy options to secure medical specialist workforce for regional centres.

PubMed

May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

2017-12-01

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes. What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

Hanford immobilized low-activity tank waste performance assessment

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

Mann, F.M.

1998-03-26

The Hanford Immobilized Low-Activity Tank Waste Performance Assessment examines the long-term environmental and human health effects associated with the planned disposal of the vitrified low-level fraction of waste presently contained in Hanford Site tanks. The tank waste is the by-product of separating special nuclear materials from irradiated nuclear fuels over the past 50 years. This waste has been stored in underground single and double-shell tanks. The tank waste is to be retrieved, separated into low and high-activity fractions, and then immobilized by private vendors. The US Department of Energy (DOE) will receive the vitrified waste from private vendors and plansmore » to dispose of the low-activity fraction in the Hanford Site 200 East Area. The high-level fraction will be stored at Hanford until a national repository is approved. This report provides the site-specific long-term environmental information needed by the DOE to issue a Disposal Authorization Statement that would allow the modification of the four existing concrete disposal vaults to provide better access for emplacement of the immobilized low-activity waste (ILAW) containers; filling of the modified vaults with the approximately 5,000 ILAW containers and filler material with the intent to dispose of the containers; construction of the first set of next-generation disposal facilities. The performance assessment activity will continue beyond this assessment. The activity will collect additional data on the geotechnical features of the disposal sites, the disposal facility design and construction, and the long-term performance of the waste. Better estimates of long-term performance will be produced and reviewed on a regular basis. Performance assessments supporting closure of filled facilities will be issued seeking approval of those actions necessary to conclude active disposal facility operations. This report also analyzes the long-term performance of the currently planned disposal system as a basis to set requirements on the waste form and the facility design that will protect the long-term public health and safety and protect the environment.« less

Long-term personality data collection in support of spaceflight and analogue research.

PubMed

Musson, David M; Helmreich, Robert L

2005-06-01

This is a review of past and present research into personality and performance at the University of Texas (UT) Human Factors Research Project. Specifically, personality trait data collected from astronauts, pilots, Antarctic personnel, and other groups over a 15-yr period is discussed with particular emphasis on research in space and space analogue environments. The UT Human Factors Research Project conducts studies in personality and group dynamics in aviation, space, and medicine. Current studies include personality determinants of professional cultures, team effectiveness in both medicine and aviation, and personality predictors of long-term astronaut performance. The Project also studies the design and effectiveness of behavioral strategies used to minimize error and maximize team performance in safety-critical work settings. A multi-year personality and performance dataset presents many opportunities for research, including long-term and follow-up studies of human performance, analyses of trends in recruiting and attrition, and the ability to adapt research design to operational changes and methodological advances. Special problems posed by such long-duration projects include issues of confidentiality and security, as well as practical limitations imposed by current peer-review and short-term funding practices. Practical considerations for ongoing dataset management include consistency of assessment instruments over time, variations in data acquisition from one year to the next, and dealing with changes in theory and practice that occur over the life of the project. A fundamental change in how research into human performance is funded would be required to ensure the ongoing development of such long-duration research databases.

The ERM protein Moesin is essential for neuronal morphogenesis and long-term memory in Drosophila.

PubMed

Freymuth, Patrick S; Fitzsimons, Helen L

2017-08-29

Moesin is a cytoskeletal adaptor protein that plays an important role in modification of the actin cytoskeleton. Rearrangement of the actin cytoskeleton drives both neuronal morphogenesis and the structural changes in neurons that are required for long-term memory formation. Moesin has been identified as a candidate memory gene in Drosophila, however, whether it is required for memory formation has not been evaluated. Here, we investigate the role of Moesin in neuronal morphogenesis and in short- and long-term memory formation in the courtship suppression assay, a model of associative memory. We found that both knockdown and overexpression of Moesin led to defects in axon growth and guidance as well as dendritic arborization. Moreover, reduction of Moesin expression or expression of a constitutively active phosphomimetic in the adult Drosophila brain had no effect on short term memory, but prevented long-term memory formation, an effect that was independent of its role in development. These results indicate a critical role for Moesin in both neuronal morphogenesis and long-term memory formation.

NIAAA Alcohol Treatment Navigator

MedlinePlus

... Decide Which Option is Best Support Through the Process Starting the Conversation Managing Expectations Understanding Relapse Long-term Recovery Support Caretaker Support Resources FAQS Helpful Links Toolkit ...

Perspectives of Parents and Tutors on a Self-Management Program for Parents/Guardians of Children with Long-Term and Life-Limiting Conditions: "A Life Raft We Can Sail along with"

ERIC Educational Resources Information Center

Barlow, Julie; Swaby, Laura; Turner, Andrew

2008-01-01

The lay-led, community-based Supporting Parents Programme (SPP) aims to assist parents caring for children with long-term or life-limiting conditions through support and cognitive behavioral techniques. The value of the SPP from the perspectives of parent participants and tutors was examined in focus groups and telephone interviews. Data were…

Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports

PubMed Central

Newquist, Deborah D.; DeLiema, Marguerite; Wilber, Kathleen H.

2016-01-01

Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. PMID:26062611

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

PubMed

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

2017-11-01

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

Future Marine Polar Research Capacities - Science Planning and Research Services for a Multi-National Research Icebreaker

NASA Astrophysics Data System (ADS)

Biebow, N.; Lembke-Jene, L.; Wolff-Boenisch, B.; Bergamasco, A.; De Santis, L.; Eldholm, O.; Mevel, C.; Willmott, V.; Thiede, J.

2011-12-01

Despite significant advances in Arctic and Antarctic marine science over the past years, the polar Southern Ocean remains a formidable frontier due to challenging technical and operational requirements. Thus, key data and observations from this important region are still missing or lack adequate lateral and temporal coverage, especially from time slots outside optimal weather seasons and ice conditions. These barriers combined with the obligation to efficiently use financial resources and funding for expeditions call for new approaches to create optimally equipped, but cost-effective infrastructures. These must serve the international science community in a dedicated long-term mode and enable participation in multi-disciplinary expeditions, with secured access to optimally equipped marine platforms for world-class research in a wide range of Antarctic science topics. The high operational and technical performance capacity of a future joint European Research Icebreaker and Deep-sea Drilling Vessel (the AURORA BOREALIS concept) aims at integrating still separately operating national science programmes with different strategic priorities into joint development of long-term research missions with international cooperation both in Arctic and Antarctica. The icebreaker is planned to enable, as a worldwide first, autonomous year-round operations in the central Arctic and polar Southern Ocean, including severest ice conditions in winter, and serving all polar marine disciplines. It will facilitate the implementation of atmospheric, oceanographic, cryospheric or geophysical observatories for long-term monitoring of the polar environment. Access to the biosphere and hydrosphere e.g. beneath ice shelves or in remote regions is made possible by acting as advanced deployment platform for instruments, robotic and autonomous vehicles and ship-based air operations. In addition to a report on the long-term strategic science and operational planning objectives, we describe foreseen on- and offshore science support infrastructure, recommended operational and scientific support structures and the relevance of AURORA BOREALIS for other present and future Antarctic science programmes and initiatives.

Dilemmas in providing resilience-enhancing social services to long-term social assistance clients. A qualitative study of Swedish social workers

PubMed Central

2012-01-01

Background Long-term recipients of social assistance face barriers to social and economic inclusion, and have poorer health and more limited opportunities for improving their health than many other groups in the population. During recent decades there have been changes in Swedish social policy, with cutbacks in public benefits and a re-emphasis on means-tested policies. In this context, it is important to investigate the necessary conditions for social workers to offer social assistance and services, as well as the mediating role of social workers between public policies and their clients. Swedish social services aim to promote social inclusion by strengthening the individual´s own resources. We investigated the issues that arise when providing social services to long-term social assistance clients within the framework of resilience, which focuses on the processes leading to positive functioning in adverse conditions. Methods Interviews were conducted with 23 social workers in Stockholm and analysed by qualitative content analysis. Results The main theme to emerge from the interviews concerned the constraints that the social workers faced in providing social services to social assistance clients. The first subtheme focused on dilemmas in the interaction between social workers and clients resulting from the dual role of exercising authority and supporting and building trust with clients. Working conditions of social workers also played a crucial role. The second subtheme addressed the impact of the societal context, such as labour market opportunities and coordination between authorities. Conclusions Overall, we found that social workers to a great extent tried to find individual solutions to structural problems. To provide resilience-enhancing social services to long-term social assistance clients with varying obstacles and needs requires a constructive working environment, supportive societal structures and inter-sectoral cooperation between different authorities. PMID:22789127

A Transcription Factor-Binding Domain of the Coactivator CBP Is Essential for Long-Term Memory and the Expression of Specific Target Genes

ERIC Educational Resources Information Center

Oliveira, Ana M. M.; Brindle, Paul K.; Abel, Ted; Wood, Marcelo A.; Attner, Michelle A.

2006-01-01

Transcriptional activation is a key process required for long-term memory formation. Recently, the transcriptional coactivator CREB-binding protein (CBP) was shown to be critical for hippocampus-dependent long-term memory and hippocampal synaptic plasticity. As a coactivator with intrinsic histone acetyltransferase activity, CBP interacts with…

Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable.

PubMed

McMullen, Sarah

2014-08-01

The worldwide prevalence of overweight and obesity in the adult population is estimated to be 35%. These trends are reflected in childhood obesity prevalence, and the potential impact of early-onset obesity is of great concern. The aim of this review was to investigate the long-term implications of childhood obesity for metabolic and cardiovascular health, focusing on the independent contribution of childhood obesity to adult disease risk, as distinct from associations mediated by tracking of obesity across the lifespan. The data systematically reviewed provide little evidence to suggest that childhood overweight and obesity are independent risk factors for metabolic and cardiovascular risk during adulthood. Instead, the data demonstrate that the relationships observed are dependent on tracking of BMI between childhood and adulthood, alongside persistence of dietary patterns and physical activity. Adjustment for adult BMI uncovers unexpected negative associations between childhood BMI and adult disease, suggesting a protective effect of childhood obesity at any given level of adult BMI. Further work is required to explain these findings, both in terms of pathways and statistical artefacts. To conclude, it must be stressed that it is not suggested that childhood obesity is without negative consequence. Childhood obesity is clearly associated with a range of adverse physical and psychological outcomes. However, the data are important in supporting a positive message that the long-term consequences of childhood obesity are avoidable; and that there remains opportunity for intervention across the lifespan. This nuance in understanding long-term risk is important when considering the effectiveness of interventions at different stages of the lifespan.

System considerations favoring rotary artificial hearts with blood-immersed bearings.

PubMed

Jarvik, R K

1995-07-01

Hydrodynamic blood pumps provide such advantages as not requiring an air vent or compliance chamber as well as a great reduction in mechanical complexity with the potential for very long durability. The detailed design of their bearings is emerging as the single most important determinant of long-term success. Three categories of bearings include remote force, such as magnetic suspension; blood-isolated, which require a shaft seal; and blood-immersed using either mechanical or hydrodynamic support. Blood-immersed bearings permit maximum simplification and miniaturization of the entire system, require no flush fluid, and require no electronics as with magnetic suspension. The Jarvik 2000 heart represents an example of their potential. The intraventricular titanium pump (25 mm diameter, 25 cc, 85 g), uses blood flow through the motor air gap with blood-immersed bearings. The longest in vitro bearing durability test is ongoing at 20,000,000,000 revolutions with minimal wear (3 years at 15,000 rpm). In vivo results include 5-month calf survival, no thromboembolism, plasma Hb 2-5 mg%, and power under 10 W.

Operational seasonal forecasting of crop performance.

PubMed

Stone, Roger C; Meinke, Holger

2005-11-29

Integrated, interdisciplinary crop performance forecasting systems, linked with appropriate decision and discussion support tools, could substantially improve operational decision making in agricultural management. Recent developments in connecting numerical weather prediction models and general circulation models with quantitative crop growth models offer the potential for development of integrated systems that incorporate components of long-term climate change. However, operational seasonal forecasting systems have little or no value unless they are able to change key management decisions. Changed decision making through incorporation of seasonal forecasting ultimately has to demonstrate improved long-term performance of the cropping enterprise. Simulation analyses conducted on specific production scenarios are especially useful in improving decisions, particularly if this is done in conjunction with development of decision-support systems and associated facilitated discussion groups. Improved management of the overall crop production system requires an interdisciplinary approach, where climate scientists, agricultural scientists and extension specialists are intimately linked with crop production managers in the development of targeted seasonal forecast systems. The same principle applies in developing improved operational management systems for commodity trading organizations, milling companies and agricultural marketing organizations. Application of seasonal forecast systems across the whole value chain in agricultural production offers considerable benefits in improving overall operational management of agricultural production.

Operational seasonal forecasting of crop performance

PubMed Central

Stone, Roger C; Meinke, Holger

2005-01-01

Integrated, interdisciplinary crop performance forecasting systems, linked with appropriate decision and discussion support tools, could substantially improve operational decision making in agricultural management. Recent developments in connecting numerical weather prediction models and general circulation models with quantitative crop growth models offer the potential for development of integrated systems that incorporate components of long-term climate change. However, operational seasonal forecasting systems have little or no value unless they are able to change key management decisions. Changed decision making through incorporation of seasonal forecasting ultimately has to demonstrate improved long-term performance of the cropping enterprise. Simulation analyses conducted on specific production scenarios are especially useful in improving decisions, particularly if this is done in conjunction with development of decision-support systems and associated facilitated discussion groups. Improved management of the overall crop production system requires an interdisciplinary approach, where climate scientists, agricultural scientists and extension specialists are intimately linked with crop production managers in the development of targeted seasonal forecast systems. The same principle applies in developing improved operational management systems for commodity trading organizations, milling companies and agricultural marketing organizations. Application of seasonal forecast systems across the whole value chain in agricultural production offers considerable benefits in improving overall operational management of agricultural production. PMID:16433097

Managing Records for the Long Term - 12363

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

Montgomery, John V.; Gueretta, Jeanie

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

The treatment of adolescent idiopathic scoliosis (AIS) according to present evidence. A systematic review.

PubMed

Weiss, H-R; Goodall, D

2008-06-01

Traditionally, the treatment options for adolescent idiopathic scoliosis (AIS), the most common form of scoliosis, are exercises; in-patient rehabilitation; braces and surgery. The outcomes of treatments are usually compared with the natural history or observation (non-intervention). The aim of this paper was to provide a synopsis of all treatment options in the light of evidence based practice (EBP). A systematic review was carried out using the most encompassing databases available. Literature has been searched for the outcome parameter ''rate of progression'' and only prospective controlled studies that have considered the treatment versus the natural history have been included. The search strategy included the following terms: ''adolescent idiopathic scoliosis''; ''idiopathic scoliosis''; ''natural history''; ''observation''; ''physiotherapy''; ''physical therapy''; ''rehabilitation''; ''bracing''; ''orthotics'' and ''surgery''. Prospective short-term studies have been found to support outpatient physiotherapy. One prospective controlled study was found to support scoliosis in-patient rehabilitation (SIR). One prospective multi-centre study, a long-term prospective controlled study and a meta-analysis have been found to support bracing. No controlled study, neither short, mid nor long-term, was found to reveal any substantial evidence to support surgery as a treatment for this condition. There is some evidence supporting the conservative treatment for AIS. No substantial evidence has been found in terms of prospective controlled studies to support surgical intervention. In light of the unknown long-term effects of surgery, a randomised controlled trial (RCT) seems necessary. Due to the presence of evidence to support conservative treatments, a plan to compose a RCT for conservative treatment options seems unethical. But it is also important to conclude that the evidence for conservative treatments is weak in number and length.

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

PubMed

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

2014-01-01

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

A Critical Role for the Nucleus Reuniens in Long-Term, But Not Short-Term Associative Recognition Memory Formation.

PubMed

Barker, Gareth R I; Warburton, Elizabeth Clea

2018-03-28

Recognition memory for single items requires the perirhinal cortex (PRH), whereas recognition of an item and its associated location requires a functional interaction among the PRH, hippocampus (HPC), and medial prefrontal cortex (mPFC). Although the precise mechanisms through which these interactions are effected are unknown, the nucleus reuniens (NRe) has bidirectional connections with each regions and thus may play a role in recognition memory. Here we investigated, in male rats, whether specific manipulations of NRe function affected performance of recognition memory for single items, object location, or object-in-place associations. Permanent lesions in the NRe significantly impaired long-term, but not short-term, object-in-place associative recognition memory, whereas single item recognition memory and object location memory were unaffected. Temporary inactivation of the NRe during distinct phases of the object-in-place task revealed its importance in both the encoding and retrieval stages of long-term associative recognition memory. Infusions of specific receptor antagonists showed that encoding was dependent on muscarinic and nicotinic cholinergic neurotransmission, whereas NMDA receptor neurotransmission was not required. Finally, we found that long-term object-in-place memory required protein synthesis within the NRe. These data reveal a specific role for the NRe in long-term associative recognition memory through its interactions with the HPC and mPFC, but not the PRH. The delay-dependent involvement of the NRe suggests that it is not a simple relay station between brain regions, but, rather, during high mnemonic demand, facilitates interactions between the mPFC and HPC, a process that requires both cholinergic neurotransmission and protein synthesis. SIGNIFICANCE STATEMENT Recognizing an object and its associated location, which is fundamental to our everyday memory, requires specific hippocampal-cortical interactions, potentially facilitated by the nucleus reuniens (NRe) of the thalamus. However, the role of the NRe itself in associative recognition memory is unknown. Here, we reveal the crucial role of the NRe in encoding and retrieval of long-term object-in-place memory, but not for remembrance of an individual object or individual location and such involvement is cholinergic receptor and protein synthesis dependent. This is the first demonstration that the NRe is a key node within an associative recognition memory network and is not just a simple relay for information within the network. Rather, we argue, the NRe actively modulates information processing during long-term associative memory formation. Copyright © 2018 the authors 0270-6474/18/383208-10$15.00/0.

Axiomatic Design of Space Life Support Systems

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2017-01-01

Systems engineering is an organized way to design and develop systems, but the initial system design concepts are usually seen as the products of unexplained but highly creative intuition. Axiomatic design is a mathematical approach to produce and compare system architectures. The two axioms are:- Maintain the independence of the functional requirements.- Minimize the information content (or complexity) of the design. The first axiom generates good system design structures and the second axiom ranks them. The closed system human life support architecture now implemented in the International Space Station has been essentially unchanged for fifty years. In contrast, brief missions such as Apollo and Shuttle have used open loop life support. As mission length increases, greater system closure and increased recycling become more cost-effective.Closure can be gradually increased, first recycling humidity condensate, then hygiene wastewater, urine, carbon dioxide, and water recovery brine. A long term space station or planetary base could implement nearly full closure, including food production. Dynamic systems theory supports the axioms by showing that fewer requirements, fewer subsystems, and fewer interconnections all increase system stability. If systems are too complex and interconnected, reliability is reduced and operations and maintenance become more difficult. Using axiomatic design shows how the mission duration and other requirements determine the best life support system design including the degree of closure.

Oral medicine modification for older adults: a qualitative study of nurses

PubMed Central

Crean, Abina M; Kelly, Maria; Sahm, Laura

2017-01-01

Objective Oral medicines are frequently modified (eg, tablets crushed) for older adults. However, these modifications can have clinical, legal and/or ethical implications. Nurses bear responsibility for medicine administration and hence, perform these modifications. The aim of this study was to investigate the knowledge, attitudes and beliefs of nurses about oral medicine modification for older adults. Design A qualitative study was conducted using semi-structured, face-to-face interviews with nurses providing care to older adults in acute and long-term care settings. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Settings Sixteen purposively selected care settings; 4 acute-care and 12 long-term care settings were included. Nurses were recruited by convenience sampling at these sites. Participants Eighteen nurses participated (83% female, 67% long-term care, 33% acute-care, median age (IQR) 38 years (32.5–52.0)). Results Three major themes: modifying—a necessary evil, nurses’ role as patient advocate and modifying—we are working very much as a team and two minor themes: fractional dosing, and covert administration emerged from the data. Nurses viewed oral medicine modifications as being a routine and necessary occurrence in geriatric patient care due to limitations of available formulations and the presence of age-related challenges in drug administration. Nurses’ knowledge of residents’ requirements ensured that they advocate for those with individualised formulation needs, however, nurses rely on pharmacists for information about modifications. Nurses expressed a desire for supports including increased education and ward-specific, pharmacist-developed recommendations on common modifications. Conclusions This study has provided useful insights into the views of nurses regarding oral medicine modification for older adults. The unique and varied formulation requirements of older adults must be acknowledged. Increased engagement by healthcare professionals, the pharmaceutical industry, regulatory agencies and policy-makers is required to facilitate the development of age-appropriate formulations. In the interim, practical interventions, informed by the findings of this study, are required. PMID:29247094

Aerosol Microphysics and Radiation Integration

DTIC Science & Technology

2005-09-30

www.nrlmry.navy.mil/ flambe / LONG-TERM GOALS This long-term goals of this project is the development of systems that support real time global... FLAMBE ) project is currently being utilized by Internet Community, Air quality/human health research (University of Kansas Medical Center), Environment

Molecular brake pad hypothesis: pulling off the brakes for emotional memory

PubMed Central

Vogel-Ciernia, Annie

2015-01-01

Under basal conditions histone deacetylases (HDACs) and their associated co-repressor complexes serve as molecular ‘brake pads’ to prevent the gene expression required for long-term memory formation. Following a learning event, HDACs and their co-repressor complexes are removed from a subset of specific gene promoters, allowing the histone acetylation and active gene expression required for long-term memory formation. Inhibition of HDACs increases histone acetylation, extends gene expression profiles, and allows for the formation of persistent long-term memories for training events that are otherwise forgotten. We propose that emotionally salient experiences have utilized this system to form strong and persistent memories for behaviorally significant events. Consequently, the presence or absence of HDACs at a selection of specific gene promoters could serve as a critical barrier for permitting the formation of long-term memories. PMID:23096102

Public support for alcohol policies associated with knowledge of cancer risk.

PubMed

Buykx, Penny; Gilligan, Conor; Ward, Bernadette; Kippen, Rebecca; Chapman, Kathy

2015-04-01

Several options are advocated by policy experts to mitigate alcohol-related harms, although the most effective strategies often have the least public support. While knowledge of tobacco-related health risks predicts support for relevant public health measures, it is not known whether knowledge of alcohol health risks is similarly associated with the acceptability of policies intended to reduce alcohol consumption and related harms. This study aims to gauge public support for a range of alcohol policies and to determine whether or not support is associated with knowledge of a long-term health risk of alcohol consumption, specifically cancer. 2482 adults in New South Wales (NSW), Australia, participated in an online survey. Logistic regression analysis was used to examine the association between demographic data, alcohol consumption, smoking status, knowledge of alcohol as a risk factor for cancer and support for alcohol-related policies. Most participants were supportive of health warnings, restricting access to internet alcohol advertising to young people, and requiring information on national drinking guidelines on alcohol containers. Almost half of participants supported a ban on sport sponsorship, while less than 41% supported price increases, volumetric taxation, or reducing the number of retail outlets. Only 47% of participants identified drinking too much alcohol as a risk factor for cancer. Knowledge of alcohol as a risk factor for cancer was a significant predictor of support for all policies, while level of alcohol consumption had a significant inverse relationship with policy support. The finding that support for alcohol management policies is associated with awareness that drinking too much alcohol may contribute to cancer could assist in the planning of future public health interventions. Improving awareness of the long term health risks of alcohol consumption may be one avenue to increasing public support for effective alcohol harm-reduction policies. Copyright © 2015 Elsevier B.V. All rights reserved.

Development of a requirements management system for technical decision - making processes in the geological disposal project

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

Hiroyoshi Ueda; Katsuhiko Ishiguro; Kazumi Kitayama

2007-07-01

NUMO (Nuclear Waste Management Organization of Japan) has a responsibility for implementing geological disposal of vitrified HLW (High-Level radioactive Waste) in the Japanese nuclear waste management programme. Its staged siting procedure was initiated in 2002 by an open call for volunteer sites. Careful management strategy and methodology for the technical decision-making at every milestone are required to prepare for the volunteer site application and the site investigation stages after that. The formal Requirement Management System (RMS) is planned to support the computerized implementation of the specific management methodology, termed the NUMO Structured Approach (NSA). This planned RMS will help formore » comprehensive management of the decision-making processes in the geological disposal project, change management towards the anticipated project deviations, efficient project driving such as well programmed R and D etc. and structured record-keeping regarding the past decisions, which leads to soundness of the project in terms of the long-term continuity. The system should have handling/management functions for the database including the decisions/requirements in the project in consideration, their associated information and the structures composed of them in every decision-making process. The information relating to the premises, boundary conditions and time plan of the project should also be prepared in the system. Effective user interface and efficient operation on the in-house network are necessary. As a living system for the long-term formal use, flexibility to updating is indispensable. In advance of the formal system development, two-year activity to develop the preliminary RMS was already started. The purpose of this preliminary system is to template the decision/requirement structure, prototype the decision making management and thus show the feasibility of the innovative RMS. The paper describes the current status of the development, focusing on the initial stage including work analysis/modeling and the system conceptualization. (authors)« less

Structural Analyses of Stirling Power Convertor Heater Head for Long-Term Reliability, Durability, and Performance

NASA Technical Reports Server (NTRS)

Halford, Gary R.; Shah, Ashwin; Arya, Vinod K.; Krause, David L.; Bartolotta, Paul A.

2002-01-01

Deep-space missions require onboard electric power systems with reliable design lifetimes of up to 10 yr and beyond. A high-efficiency Stirling radioisotope power system is a likely candidate for future deep-space missions and Mars rover applications. To ensure ample durability, the structurally critical heater head of the Stirling power convertor has undergone extensive computational analyses of operating temperatures (up to 650 C), stresses, and creep resistance of the thin-walled Inconel 718 bill of material. Durability predictions are presented in terms of the probability of survival. A benchmark structural testing program has commenced to support the analyses. This report presents the current status of durability assessments.

The Calmodulin-Binding Transcription Activator CAMTA1 Is Required for Long-Term Memory Formation in Mice

ERIC Educational Resources Information Center

Bas-Orth, Carlos; Tan, Yan-Wei; Oliveira, Ana M. M.; Bengtson, C. Peter; Bading, Hilmar

2016-01-01

The formation of long-term memory requires signaling from the synapse to the nucleus to mediate neuronal activity-dependent gene transcription. Synapse-to-nucleus communication is initiated by influx of calcium ions through synaptic NMDA receptors and/or L-type voltage-gated calcium channels and involves the activation of transcription factors by…

The experience of facilitators and participants of long term condition self-management group programmes: A qualitative synthesis.

PubMed

Hughes, Stephen; Lewis, Sophie; Willis, Karen; Rogers, Anne; Wyke, Sally; Smith, Lorraine

2017-12-01

Our aim was to systematically review the qualitative literature about the experiences of both facilitators and participants in a range of group-based programmes to support the self-management of long-term conditions. We searched 7 databases using the terms 'self-management', 'group' and 'qualitative'. Full text articles meeting the inclusion criteria were retrieved for review. A thematic synthesis approach was used to analyse the studies. 2126 articles were identified and 24 were included for review. Group participants valued being with similar others and perceived peer support benefits. Facilitators (HCP and lay) had limited group specific training, were uncertain of purpose and prioritised education and medical conformity over supportive group processes and the promotion of self-management agency and engagement. Overall, studies prioritised positive descriptions. Group programmes' medical self-management focus may reduce their ability to contribute to patient-valued outcomes. Further research is needed to explore this disconnect. This review supports broadening the scope of group-based programmes to foreground shared learning, social support and development of agency. It is of relevance to developers and facilitators of group self-management programmes and their ability to address the burden of long-term conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

Joint association of sleep problems and psychosocial working conditions with registered long-term sickness absence. A Danish cohort study.

PubMed

Madsen, Ida Eh; Larsen, Ann D; Thorsen, Sannie V; Pejtersen, Jan H; Rugulies, Reiner; Sivertsen, Børge

2016-07-01

Sleep problems and adverse psychosocial working conditions are associated with increased risk of long-term sickness absence. Because sleep problems affect role functioning they may also exacerbate any effects of psychosocial working conditions and vice versa. We examined whether sleep problems and psychosocial working conditions interact in their associations with long-term sickness absence. We linked questionnaire data from participants to two surveys of random samples of the Danish working population (N=10 752) with registries on long-term sick leave during five years after questionnaire response. We defined sleep problems by self-reported symptoms and/or register data on hypnotics purchases of hypnotics. Psychosocial working conditions included quantitative and emotional demands, influence, supervisor recognition and social support, leadership quality, and social support from colleagues. Using time-to-event models, we calculated hazard ratios (HR) and differences and examined interaction as departure from multiplicativity and additivity. During 40 165 person-years of follow-up, we identified 2313 episodes of long-terms sickness absence. Sleep problems predicted risk of long-term sickness absence [HR 1.54, 95% confidence interval (95% CI) 1.38-1.73]. This association was statistically significantly stronger among participants with high quantitative demands and weaker among those with high supervisor recognition (P<0.0001). High quantitative demands exacerbated the association of sleep problems with risk of long-term sickness absence whereas high supervisor recognition buffered this association. To prevent long-term sickness absence among employees with sleep problems, workplace modifications focusing on quantitative demands and supervisor recognition may be considered. Workplace interventions for these factors may more effectively prevent sickness absence when targeted at this group. The efficacy and effectiveness of such interventions needs to be established in future studies.

An exploration of the effectiveness of artificial mini-magnetospheres as a potential Solar Storm shelter for long term human space missions

NASA Astrophysics Data System (ADS)

Bamford, Ruth; Kellett, Barry; Bradford, John; Todd, Tom N.; Stafford-Allen, Robin; Alves, E. Paulo; Silva, Luis; Collingwood, Cheryl; Crawford, Ian A.; Bingham, Robert

2014-12-01

In this paper we explore the effectiveness of an artificial mini-magnetosphere as a potential radiation shelter for long term human space missions. Our study includes the differences that the plasma environment makes to the efficiency of the shielding from the high energy charged particle component of solar and cosmic rays, which radically alters the power requirements. The incoming electrostatic charges are shielded by fields supported by the self captured environmental plasma of the solar wind, potentially augmented with additional density. The artificial magnetic field generated on board acts as the means of confinement and control. Evidence for similar behaviour of electromagnetic fields and ionised particles in interplanetary space can be gained by the example of the enhanced shielding effectiveness of naturally occurring "mini-magnetospheres" on the moon. The shielding effect of surface magnetic fields of the order of ~100s nanoTesla is sufficient to provide effective shielding from solar proton bombardment that culminate in visible discolouration of the lunar regolith known as "lunar swirls". Supporting evidence comes from theory, laboratory experiments and computer simulations that have been obtained on this topic. The result of this work is, hopefully, to provide the tools for a more realistic estimation of the resources versus effectiveness and risk that spacecraft engineers need to work with in designing radiation protection for long-duration human space missions.

Roles of vascular and metabolic components in cognitive dysfunction of Alzheimer disease: short- and long-term modification by non-genetic risk factors.

PubMed

Sato, Naoyuki; Morishita, Ryuichi

2013-11-05

It is well known that a specific set of genetic and non-genetic risk factors contributes to the onset of Alzheimer disease (AD). Non-genetic risk factors include diabetes, hypertension in mid-life, and probably dyslipidemia in mid-life. This review focuses on the vascular and metabolic components of non-genetic risk factors. The mechanisms whereby non-genetic risk factors modify cognitive dysfunction are divided into four components, short- and long-term effects of vascular and metabolic factors. These consist of (1) compromised vascular reactivity, (2) vascular lesions, (3) hypo/hyperglycemia, and (4) exacerbated AD histopathological features, respectively. Vascular factors compromise cerebrovascular reactivity in response to neuronal activity and also cause irreversible vascular lesions. On the other hand, representative short-term effects of metabolic factors on cognitive dysfunction occur due to hypoglycemia or hyperglycemia. Non-genetic risk factors also modify the pathological manifestations of AD in the long-term. Therefore, vascular and metabolic factors contribute to aggravation of cognitive dysfunction in AD through short-term and long-term effects. β-amyloid could be involved in both vascular and metabolic components. It might be beneficial to support treatment in AD patients by appropriate therapeutic management of non-genetic risk factors, considering the contributions of these four elements to the manifestation of cognitive dysfunction in individual patients, though all components are not always present. It should be clarified how these four components interact with each other. To answer this question, a clinical prospective study that follows up clinical features with respect to these four components: (1) functional MRI or SPECT for cerebrovascular reactivity, (2) MRI for ischemic lesions and atrophy, (3) clinical episodes of hypoglycemia and hyperglycemia, (4) amyloid-PET and tau-PET for pathological features of AD, would be required.

Enterprise tools to promote interoperability: MonitoringResources.org supports design and documentation of large-scale, long-term monitoringprograms

NASA Astrophysics Data System (ADS)

Weltzin, J. F.; Scully, R. A.; Bayer, J.

2016-12-01

Individual natural resource monitoring programs have evolved in response to different organizational mandates, jurisdictional needs, issues and questions. We are establishing a collaborative forum for large-scale, long-term monitoring programs to identify opportunities where collaboration could yield efficiency in monitoring design, implementation, analyses, and data sharing. We anticipate these monitoring programs will have similar requirements - e.g. survey design, standardization of protocols and methods, information management and delivery - that could be met by enterprise tools to promote sustainability, efficiency and interoperability of information across geopolitical boundaries or organizational cultures. MonitoringResources.org, a project of the Pacific Northwest Aquatic Monitoring Partnership, provides an on-line suite of enterprise tools focused on aquatic systems in the Pacific Northwest Region of the United States. We will leverage on and expand this existing capacity to support continental-scale monitoring of both aquatic and terrestrial systems. The current stakeholder group is focused on programs led by bureaus with the Department of Interior, but the tools will be readily and freely available to a broad variety of other stakeholders. Here, we report the results of two initial stakeholder workshops focused on (1) establishing a collaborative forum of large scale monitoring programs, (2) identifying and prioritizing shared needs, (3) evaluating existing enterprise resources, (4) defining priorities for development of enhanced capacity for MonitoringResources.org, and (5) identifying a small number of pilot projects that can be used to define and test development requirements for specific monitoring programs.

Report on ESA Topical Team on the Large Radius Human Centrifuge: "The Human Hypergravity Habitat; H3"

NASA Astrophysics Data System (ADS)

van Loon, Jack J. W. A.; Bücker, N.; Berte, J.; Bok, K.; Bos, J.; Boyle, R.; Bravenoer, N.; Chouker, A.; Clement, G.; Cras, P.; Denise, D.; Eekhoff, M.; Felsenberg, D.; Fong, K.; Fuller, C.; Groen, E.; Heer, M.; Hinghofer-Szalkay, H.; Iwase, S.; Karemaker, J. M.; Linnarsson, D.; Lüthen, C.; Narici, M.; Norsk, P.; Paloski, W.; Rutten, M.; Saggini, R.; Stephan, A.; Ullrich, O.; Vautmans, V.; Wuyts, F.; Young, L.

Over the last decades a significant amount of knowledge has been accumulated on the adap-tation of the human body going into near weightless conditions and on its re-adaptation to 1g Earth conditions after space flight. Ground-based paradigms for microgravity simulation have been developed such as head down tilted bed rest and dry-immersion. In such systems the adaptations to long term immobilization and to head-ward fluid shifts have been studied. Questions we address here are: can long-term ground-based centrifugation help us to under-stand and even predict the adaptations to long-term increased gravity conditions? How does the body adapt to chronic (days, weeks or longer) exposure to a hypergravity environment? And, once the body has fully adapted to a hypergravity environment, how does it re-adapt going from a hypergravity state back to a relatively hypo-gravity condition of 1g, or even going from a centrifuge / hypergravity environment into a bed-rest setting? Can such transitions in well-controlled studies bring us closer to understanding the consequences of gravity transitions that the crews will likely experience going to the Moon or to Mars. Is hypergravity a good model to study the effect of re-entry in gravitational environments after long duration space flight? In an ESA -supported Topical Team we address all organ systems known so far to change directly or indirectly by altered gravity conditions. We will identify to which gravity levels the human body can be exposed for longer periods of time and what protocols could be applied to address the questions at hand. We also identify the technology required to ac-complish such long duration hypergravity and re-adaptation studies. Issues like ethics, safety and required logistics should be addressed. As there is limited experience with exposure of hu-man test subjects to prolonged periods of moderately increased g-forces, unexpected harm may occur. Therefore, the information, disclosure and informed consent procedures need special attention. The final outcome of the Topical Team will be a clear answer about the feasibility of the use of hypergravity as a tool and analogue for space research, and if and how hypergravity studies can provide useful knowledge to support future space flight on the one hand and current medical issues in the ageing population (osteoporosis, cardiovascular diseases, obesity) on the other hand.

Mesenchymal stem cells from the Wharton's jelly of umbilical cord segments provide stromal support for the maintenance of cord blood hematopoietic stem cells during long-term ex vivo culture.

PubMed

Bakhshi, Tiki; Zabriskie, Ryan C; Bodie, Shamanique; Kidd, Shannon; Ramin, Susan; Paganessi, Laura A; Gregory, Stephanie A; Fung, Henry C; Christopherson, Kent W

2008-12-01

Hematopoietic stem cells (HSCs) are routinely obtained from marrow, mobilized peripheral blood, and umbilical cord blood. Mesenchymal stem cells (MSCs) are traditionally isolated from marrow. Bone marrow-derived MSCs (BM-MSCs) have previously demonstrated their ability to act as a feeder layer in support of ex vivo cord blood expansion. However, the use of BM-MSCs to support the growth, differentiation, and engraftment of cord blood may not be ideal for transplant purposes. Therefore, the potential of MSCs from a novel source, the Wharton's jelly of umbilical cords, to act as stromal support for the long-term culture of cord blood HSC was evaluated. Umbilical cord-derived MSCs (UC-MSCs) were cultured from the Wharton's jelly of umbilical cord segments. The UC-MSCs were then profiled for expression of 12 cell surface receptors and tested for their ability to support cord blood HSCs in a long-term culture-initiating cell (LTC-IC) assay. Upon culture, UC-MSCs express a defined set of cell surface markers (CD29, CD44, CD73, CD90, CD105, CD166, and HLA-A) and lack other markers (CD45, CD34, CD38, CD117, and HLA-DR) similar to BM-MSCs. Like BM-MSCs, UC-MSCs effectively support the growth of CD34+ cord blood cells in LTC-IC assays. These data suggest the potential therapeutic application of Wharton's jelly-derived UC-MSCs to provide stromal support structure for the long-term culture of cord blood HSCs as well as the possibility of cotransplantation of genetically identical, HLA-matched, or unmatched cord blood HSCs and UC-MSCs in the setting of HSC transplantation.

Metabotropic glutamate receptors are required for the induction of long-term potentiation

NASA Technical Reports Server (NTRS)

Zheng, F.; Gallagher, J. P.

1992-01-01

Recent observations have led to the suggestion that the metabotropic glutamate receptor may play a role in the induction or maintenance of long-term potentiation (LTP). However, experimental evidence supporting a role for this receptor in the induction of LTP is still inconclusive and controversial. Here we report that, in rat dorsolateral septal nucleus (DLSN) neurons, which have the highest density of metabotropic receptors and show functional responses, the induction of LTP is not blocked by the NMDA receptor antagonist 2-amino-5-phosphonovalerate, but is blocked by two putative metabotropic glutamate receptor antagonists, L-2-amino-3-phosphonopropionic acid and L-2-amino-4-phosphonobutyrate. Furthermore, superfusion of (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid, a selective metabotropic glutamate agonist, resulted in a long-lasting potentiation of synaptic transmission similar to that induced by tetanic stimuli. Our results demonstrated that activation of postsynaptic metabotropic receptors is both necessary and sufficient for the induction of LTP in the DLSN, and we suggest that such a mechanism may be important at other CNS synapses.

Operational Support for Instrument Stability through ODI-PPA Metadata Visualization and Analysis

NASA Astrophysics Data System (ADS)

Young, M. D.; Hayashi, S.; Gopu, A.; Kotulla, R.; Harbeck, D.; Liu, W.

2015-09-01

Over long time scales, quality assurance metrics taken from calibration and calibrated data products can aid observatory operations in quantifying the performance and stability of the instrument, and identify potential areas of concern or guide troubleshooting and engineering efforts. Such methods traditionally require manual SQL entries, assuming the requisite metadata has even been ingested into a database. With the ODI-PPA system, QA metadata has been harvested and indexed for all data products produced over the life of the instrument. In this paper we will describe how, utilizing the industry standard Highcharts Javascript charting package with a customized AngularJS-driven user interface, we have made the process of visualizing the long-term behavior of these QA metadata simple and easily replicated. Operators can easily craft a custom query using the powerful and flexible ODI-PPA search interface and visualize the associated metadata in a variety of ways. These customized visualizations can be bookmarked, shared, or embedded externally, and will be dynamically updated as new data products enter the system, enabling operators to monitor the long-term health of their instrument with ease.

Development and psychometric evaluation of supportive leadership scales.

PubMed

McGilton, Katherine S

2003-12-01

The purpose of this study was to develop and evaluate the psychometric properties of 2 supportive leadership scales, the Charge Nurse Support Scale and the Unit Manager Support Scale, designed for long-term-care environments. These 6-item self-report scales were administered to 70 nursing staff and their internal consistency reliability, test-retest reliability, content validity, factor structure, and construct validity investigated. Content validity was established with the assistance of experts. Both scales were deemed reliable. As hypothesized, a significant relationship was found between the measure of how nursing staff related to residents and measures of charge nurses' supportive behaviours (r = .42, p = .05). Reliable and valid measures of supportive leadership could be developed for use in identifying the quality of support provided to staff in long-term-care environments.

Effect Of Pressure Support Versus Unassisted Breathing Through A Tracheostomy Collar On Weaning Duration In Patients Requiring Prolonged Mechanical Ventilation: A Randomized Trial

PubMed Central

Jubran, Amal; Grant, Brydon J.B.; Duffner, Lisa A.; Collins, Eileen G.; Lanuza, Dorothy M.; Hoffman, Leslie A.; Tobin, Martin J.

2013-01-01

Context Patients requiring prolonged mechanical ventilation (more than 21 days) are commonly weaned at long-term acute care hospitals (LTACHs). The most effective method of weaning such patients has not been investigated. Objective To compare weaning duration with pressure support versus unassisted breathing through a tracheostomy (trach collar) in patients transferred to a LTACH for weaning from prolonged ventilation. Design, Settings, and Participants Between 2000 and 2010, a randomized study was conducted in tracheotomized patients transferred to a single LTACH for weaning from prolonged ventilation. Of 500 patients who underwent a five-day screening procedure, 316 failed and were randomly assigned to wean with pressure support (n=155) or a trach collar (n=161). Six- and twelve-month survival was also determined. Main outcome measure Primary outcome was weaning duration. Secondary outcome was survival at six and twelve months after enrollment. Results Of 316 patients, four were withdrawn and not included in analysis. Of 152 patients in the pressure-support arm, 68 (44.7%) were weaned; 22 (14.5%) died. Of 160 patients in the trach-collar arm, 85 (53.1%) were weaned; 16 (10.0%) died. Median weaning time was shorter with trach collar than with pressure support: 15 [interquartile range, 8–25] versus 19 [12–31] days, p=0.004. The hazard ratio (HR) for successful weaning rate was higher with trach collar than with pressure support (HR, 1.43; 95% confidence interval [CI], 1.03–1.98, p<0.03) after adjusting for baseline clinical covariates. Trach collar achieved faster weaning than did pressure support among subjects who failed the screening procedure at 12–120 hours (HR, 3.33; 95% CI, 1.44–7.70, p<0.01), whereas weaning time was equivalent with the two methods in patients who failed the screening procedure within 0–12 hours. Mortality was equivalent in the pressure-support and trach-collar arms at six months (55.9% versus 51.3%; 4.7 difference, 95% CI −6.4 to 15.7%) and twelve months (66.4% versus 60.0%; 6.5 difference, 95% CI −4.2 to 17.1 %). Conclusion Among patients requiring prolonged mechanical ventilation and treated at a single long-term care facility, unassisted breathing through a tracheostomy, compared with pressure support, resulted in shorter median weaning time, although weaning mode had no effect on survival at 6 and 12 months. PMID:23340588

Effect of pressure support vs unassisted breathing through a tracheostomy collar on weaning duration in patients requiring prolonged mechanical ventilation: a randomized trial.

PubMed

Jubran, Amal; Grant, Brydon J B; Duffner, Lisa A; Collins, Eileen G; Lanuza, Dorothy M; Hoffman, Leslie A; Tobin, Martin J

2013-02-20

Patients requiring prolonged mechanical ventilation (>21 days) are commonly weaned at long-term acute care hospitals (LTACHs). The most effective method of weaning such patients has not been investigated. To compare weaning duration with pressure support vs unassisted breathing through a tracheostomy collar in patients transferred to an LTACH for weaning from prolonged ventilation. Between 2000 and 2010, a randomized study was conducted in tracheotomized patients transferred to a single LTACH for weaning from prolonged ventilation. Of 500 patients who underwent a 5-day screening procedure, 316 did not tolerate the procedure and were randomly assigned to receive weaning with pressure support (n = 155) or a tracheostomy collar (n = 161). Survival at 6- and 12-month time points was also determined. Primary outcome was weaning duration. Secondary outcome was survival at 6 and 12 months after enrollment. Of 316 patients, 4 were withdrawn and not included in analysis. Of 152 patients in the pressure-support group, 68 (44.7%) were weaned; 22 (14.5%) died. Of 160 patients in the tracheostomy collar group, 85 (53.1%) were weaned; 16 (10.0%) died. Median weaning time was shorter with tracheostomy collar use (15 days; interquartile range [IQR], 8-25) than with pressure support (19 days; IQR, 12-31), P = .004. The hazard ratio (HR) for successful weaning rate was higher with tracheostomy collar use than with pressure support (HR, 1.43; 95% CI, 1.03-1.98; P = .033) after adjusting for baseline clinical covariates. Use of the tracheostomy collar achieved faster weaning than did pressure support among patients who did not tolerate the screening procedure between 12 and 120 hours (HR, 3.33; 95% CI, 1.44-7.70; P = .005), whereas weaning time was equivalent with the 2 methods in patients who did not tolerate the screening procedure within 0 to 12 hours. Mortality was equivalent in the pressure-support and tracheostomy collar groups at 6 months (55.92% vs 51.25%; 4.67% difference, 95% CI, -6.4% to 15.7%) and at 12 months (66.45% vs 60.00%; 6.45% difference, 95% CI, -4.2% to 17.1%). Among patients requiring prolonged mechanical ventilation and treated at a single long-term care facility, unassisted breathing through a tracheostomy, compared with pressure support, resulted in shorter median weaning time, although weaning mode had no effect on survival at 6 and 12 months. clinicaltrials.gov Identifier: NCT01541462.

Enhancing patient engagement in chronic disease self-management support initiatives in Australia: the need for an integrated approach.

PubMed

Jordan, Joanne E; Briggs, Andrew M; Brand, Caroline A; Osborne, Richard H

2008-11-17

Although emphasis on the prevention of chronic disease is important, governments in Australia need to balance this with continued assistance to the 77% of Australians reported to have at least one long-term medical condition. Self-management support is provided by health care and community services to enhance patients' ability to care for their chronic conditions in a cooperative framework. In Australia, there is a range of self-management support initiatives that have targeted patients (most notably, chronic disease self-management education programs) and health professionals (financial incentives, education and training). To date, there has been little coordination or integration of these self-management initiatives to enhance the patient-health professional clinical encounter. If self-management support is to work, there is a need to better understand the infrastructure, systems and training that are required to engage the key stakeholders - patients, carers, health professionals, and health care organisations. A coordinated approach is required in implementing these elements within existing and new health service models to enhance uptake and sustainability.

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

PubMed

Pirhonen, Jari; Pietilä, Ilkka

2015-12-01

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

The Impact of Consumer Numeracy on the Purchase of Long-Term Care Insurance.

PubMed

McGarry, Brian E; Temkin-Greener, Helena; Chapman, Benjamin P; Grabowski, David C; Li, Yue

2016-08-01

To determine the effect of consumers' numeric abilities on the likelihood of owning private long-term care insurance. The 2010 wave of the Health and Retirement Study, a nationally representative survey of Americans age 50 and older, was used (n = 12,796). Multivariate logistic regression was used to isolate the relationship between numeracy and long-term care insurance ownership. Each additional question answered correctly on a numeracy scale was associated with a 13 percent increase in the likelihood of holding LTCI, after controlling for predictors of policy demand, education, and cognitive function. Poor numeracy may create barriers to long-term care insurance purchase. Policy efforts aimed at increasing consumer decision support or restructuring the marketplace for long-term care insurance may be needed to increase older adults' ability to prepare for future long-term care expenses. © Health Research and Educational Trust.

Long-term Planning for Sustainable Water and Wastewater Infrastructure in Wellpinit, Washington, for the Spokane Tribe of Indians

EPA Pesticide Factsheets

The Spokane Tribe initiated a long-term planning process for a water and wastewater infrastructure system that can support the tribe’s goals to add compact, mixed-use development in the town of Wellpinit.

Philosophical origins of the social rate of discount in cost-benefit analysis.

PubMed

Robinson, J C

1990-01-01

The social rate of discount--that is, the way decision makers today evaluate future consequences of collective activity--raises difficult issues of intergenerational justice. When benefits are discounted at the present rate the United States government requires, serious efforts to promote public health over the long term will fail cost-benefit tests. No consensus exists among theorists to establish fair rates; philosophers support discounting with economic arguments that economists reject, while economists no less paradoxically support the concept using philosophical arguments that philosophers disavow. A new emphasis on the role of consumers' and citizens' time preferences, however, will keep open rather than close debates on the social discount rate.

Ensuring Support for Research and Quality Improvement (QI) Networks: Four Pillars of Sustainability—An Emerging Framework

PubMed Central

Holve, Erin

2013-01-01

Multi-institutional research and quality improvement (QI) projects using electronic clinical data (ECD) hold great promise for improving quality of care and patient outcomes but typically require significant infrastructure investments both to initiate and maintain the project over its duration. Consequently, it is important for these projects to think holistically about sustainability to ensure their long-term success. Four “pillars” of sustainability are discussed based on the experiences of EDM Forum grantees and other research and QI networks. These include trust and value, governance, management, and financial and administrative support. Two “foundational considerations,” adaptive capacity and policy levers, are also discussed. PMID:25848557