Science.gov

Sample records for serving vulnerable patients

  1. Vulnerability of older patients in critical care.

    PubMed

    Hardin, Sonya R

    2015-06-01

    One of the patient characteristics in the AACN Synergy Model is vulnerability. Vulnerability is defined in the model as the susceptibility to actual or potential stressors that may adversely affect patients' outcomes. The risk of vulnerability increases in older patients in critical care units.

  2. Use of the NatureServe Climate Change Vulnerability Index as an Assessment Tool for Reptiles and Amphibians: Lessons Learned

    NASA Astrophysics Data System (ADS)

    Tuberville, Tracey D.; Andrews, Kimberly M.; Sperry, Jinelle H.; Grosse, Andrew M.

    2015-10-01

    Climate change threatens biodiversity globally, yet it can be challenging to predict which species may be most vulnerable. Given the scope of the problem, it is imperative to rapidly assess vulnerability and identify actions to decrease risk. Although a variety of tools have been developed to assess climate change vulnerability, few have been evaluated with regard to their suitability for certain taxonomic groups. Due to their ectothermic physiology, low vagility, and strong association with temporary wetlands, reptiles and amphibians may be particularly vulnerable relative to other groups. Here, we evaluate use of the NatureServe Climate Change Vulnerability Index (CCVI) to assess a large suite of herpetofauna from the Sand Hills Ecoregion of the southeastern United States. Although data were frequently lacking for certain variables (e.g., phenological response to climate change, genetic variation), sufficient data were available to evaluate all 117 species. Sensitivity analyses indicated that results were highly dependent on size of assessment area and climate scenario selection. In addition, several ecological traits common in, but relatively unique to, herpetofauna are likely to contribute to their vulnerability and need special consideration during the scoring process. Despite some limitations, the NatureServe CCVI was a useful tool for screening large numbers of reptile and amphibian species. We provide general recommendations as to how the CCVI tool's application to herpetofauna can be improved through more specific guidance to the user regarding how to incorporate unique physiological and behavioral traits into scoring existing sensitivity factors and through modification to the assessment tool itself.

  3. Use of the NatureServe Climate Change Vulnerability Index as an Assessment Tool for Reptiles and Amphibians: Lessons Learned.

    PubMed

    Tuberville, Tracey D; Andrews, Kimberly M; Sperry, Jinelle H; Grosse, Andrew M

    2015-10-01

    Climate change threatens biodiversity globally, yet it can be challenging to predict which species may be most vulnerable. Given the scope of the problem, it is imperative to rapidly assess vulnerability and identify actions to decrease risk. Although a variety of tools have been developed to assess climate change vulnerability, few have been evaluated with regard to their suitability for certain taxonomic groups. Due to their ectothermic physiology, low vagility, and strong association with temporary wetlands, reptiles and amphibians may be particularly vulnerable relative to other groups. Here, we evaluate use of the NatureServe Climate Change Vulnerability Index (CCVI) to assess a large suite of herpetofauna from the Sand Hills Ecoregion of the southeastern United States. Although data were frequently lacking for certain variables (e.g., phenological response to climate change, genetic variation), sufficient data were available to evaluate all 117 species. Sensitivity analyses indicated that results were highly dependent on size of assessment area and climate scenario selection. In addition, several ecological traits common in, but relatively unique to, herpetofauna are likely to contribute to their vulnerability and need special consideration during the scoring process. Despite some limitations, the NatureServe CCVI was a useful tool for screening large numbers of reptile and amphibian species. We provide general recommendations as to how the CCVI tool's application to herpetofauna can be improved through more specific guidance to the user regarding how to incorporate unique physiological and behavioral traits into scoring existing sensitivity factors and through modification to the assessment tool itself.

  4. Accelerated RN-to-BSN Service-Learning Program Serves the Vulnerable.

    PubMed

    Barnes, Margaret

    The definition, implementation, and benefits support the value of service-learning for nursing education. However, accelerated RN-to-BSN programs may have difficulty requiring service-learning experiences. This article offers a biblical rationale for service with vulnerable populations and an example of how service-learning is implemented into the curriculum of an accelerated, nontraditional, online/onsite RN-BSN completion program at a Christian university.

  5. Vulnerability

    NASA Technical Reports Server (NTRS)

    Taback, I.

    1979-01-01

    The discussion of vulnerability begins with a description of some of the electrical characteristics of fibers before definiting how vulnerability calculations are done. The vulnerability results secured to date are presented. The discussion touches on post exposure vulnerability. After a description of some shock hazard work now underway, the discussion leads into a description of the planned effort and some preliminary conclusions are presented.

  6. [Psychiatric patient: the most vulnerable traveller].

    PubMed

    Felkai, Péter; Kurimay, Tamás; Fülöp, Emoke

    2011-01-23

    Authors analyse questions of medical evacuation of the psychotic patient from abroad to homeland. This task can be considered the most difficult problem for the attending physician and the escorting medical team as well. The main challenge is to recognise the psychotic patient in a foreign country with a different health-care system and to overcome the language barrier and the different cultural background. The second issue is to prepare the patients - who are usually in a poor condition - for the medical evacuation by commercial aircraft. Another important issue is to take the patient through the strict security control. All of these (partially unsolved) problems make the mentally ill patient defenceless. Although the repatriation of a mentally ill patient is vital and urgent, travel insurance policy mostly excludes to cover the cost of treatment and repatriation. The high cost of treatment and repatriation of the patient should be paid by the patient or the family, who are often in the position of insolvency. In this paper authors present the history of a patient and give a brief review on travel-related mental disorders, the epidemiology of mental alterations during travel as well as the problems of appropriate evacuation. Authors conclude that there is a need for a better approach of the airport authorities and insurance decision makers to the mentally ill patient travelling abroad.

  7. Glycemic control in diabetic patients served by community health centers.

    PubMed

    Maizlish, Neil A; Shaw, Beryl; Hendry, Khati

    2004-01-01

    The Community Health Center Network measured the prevalence of glycemic control in diabetic patients at 7 community health centers as part of its clinical quality improvement program. A cross-sectional survey was carried out in a random sample of 1817 diabetic patients having 1 or more encounters from October 1, 2000 to September 30, 2001. Computerized laboratory results for hemoglobin A1c (HbA1c) tests were available for half the sample. Manual review of medical charts was carried out for the rest. The proportion of diabetic patients with 1 or more HbA1c tests in the measurement year was 91% (CI95%: 90-93%) and poor glycemic control (HbA1c > 9%) occurred in 27% (CIM%: 25-30%). The mean of the most recent test was 7.8%. The frequency of testing varied significantly by clinic from 79% to 94% and increased with the number of encounters. Poor glycemic control also varied significantly by clinic (17-48%) and was significantly better in females and older patients. Measures of glycemic control were not associated with ethnicity or insurance status in multivariate analyses. A high proportion of diabetic patients received appropriate care, and this care was not associated with ethnicity or insurance status. The data warehouse was an essential tool for the clinical quality improvement program.

  8. Competing values in serving older and vulnerable adults: adult protective services, mandated reporting, and domestic violence programs.

    PubMed

    Cramer, Elizabeth P; Brady, Shane R

    2013-01-01

    State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.

  9. Aspects of vulnerable patients and informed consent in clinical trials

    PubMed Central

    Kuthning, Maria; Hundt, Ferdinand

    2013-01-01

    Scope: To discuss the rationale behind informed consent in clinical trials focusing on vulnerable patients from a European and German viewpoint. Methods: Scientific literature search via PubMed, Medline, Google. Results: Voluntary informed consent is the cornerstone of policies regulating clinical trials. To enroll a patient into a clinical trial without having obtained written and signed consent is to be considered as a serious issue in the conduct of a clinical trial. Development of ethical guidance for physicians started before Christ Era with the Hippocratic Oath. Main function of consent, as articulated in all guidelines developed for clinical research, is to facilitate an individual’s freedom of choice, respect autonomy, and thus to ensure welfare of the participants in clinical trials. Minors are unable to provide legally binding informed consent, this issue is addressed through a combination of parental permission and minor’s assent. Illiteracy is a critical problem that affects all corners of our earth; it has no boundaries and exists among every race and ethnicity, age group, and economic class. New strategies to improve communication with patients including the use of videotapes or animated cartoon illustrations could be taught. Finally the time with the potential participant seems to be the best way to improve understanding. Conclusion: Discovery of life saving and life enhancing new treatments requires partnership that is based on good communication and trust between patients and researchers, sponsors, ethics committees, authorities, lawyers and politicians so that vulnerable patients can benefit from the results of well controlled clinical trials. PMID:23346043

  10. Neurocognitive Vulnerability: Suicidal and Homicidal Behaviours in Patients With Schizophrenia

    PubMed Central

    Richard-Devantoy, Stéphane; Orsat, Manuel; Dumais, Alexandre; Turecki, Gustavo; Jollant, Fabrice

    2014-01-01

    Objective Schizophrenia is associated with an increase in the risk of both homicide and suicide. The objectives of this study were to systematically review all published articles that examined the relation between neurocognitive deficits and suicidal or homicidal behaviours in schizophrenia, and to identify vulnerabilities in suicidal and homicidal behaviour that may share a common pathway in schizophrenia. Methods: A systematic review of the literature was performed using MEDLINE to include all studies published up to August 31, 2012. Results: Among the 1760 studies, 7 neuropsychological and 12 brain imaging studies met the selection criteria and were included in the final analysis. The neuropsychological and functional neuroimaging studies were inconclusive. The structural imaging studies reported various alterations in patients with schizophrenia and a history of homicidal behaviour, including: reduced inferior frontal and temporal cortices, increased mediodorsal white matter, and increased amygdala volumes. Patients with a history of suicidal acts showed volumetric reductions in left orbitofrontal and superior temporal cortices, while right amygdala volume was increased, though, these findings have rarely been replicated. Finally, no study has directly compared neurocognitive markers of suicidal and homicidal risk. Conclusion: These results suggest that brain alterations, in addition to those associated with schizophrenia, may predispose some patients to a higher risk of homicide or suicide in particular circumstances. Moreover, some of these alterations may be shared between homicidal and suicidal patients. However, owing to several limitations, including the small number of available studies, no firm conclusions can be drawn and further investigations are necessary. PMID:24444320

  11. Developing Dental Students' Awareness of Health Care Disparities and Desire to Serve Vulnerable Populations Through Service-Learning.

    PubMed

    Behar-Horenstein, Linda S; Feng, Xiaoying; Roberts, Kellie W; Gibbs, Micaela; Catalanotto, Frank A; Hudson-Vassell, Charisse M

    2015-10-01

    Service-learning in dental education helps students integrate knowledge with practice in an underserved community setting. The aim of this study was to explore how a service-learning experience affected a small group of dental students' beliefs about cultural competence, professionalism, career development, desire to practice in a community service setting, and perceptions about access and disparities issues. Prior to beginning their first year of dental school, five first-year dental students at one U.S. dental school participated in a six-week service-learning program in which they interned at one of three at-risk settings in order to experience health care delivery there. After the program, 60 reflective writing assignments completed by the participants were analyzed using grounded theory methods; interviews with the students were used to corroborate the findings from that analysis. Seven themes identified in the journal reflections and interview findings showed enhanced awareness of social health care issues and patient differences, as well as a social justice orientation and desire to address disparities. Building on this study, future research should explore the curricular components of service-learning programs to ensure students receive ample opportunity to reflect upon their experiences in order to integrate previously held assumptions with their newfound knowledge.

  12. Psychological vulnerabilities in patients with major depression vs panic disorder.

    PubMed

    Cox, B J; Enns, M W; Walker, J R; Kjernisted, K; Pidlubny, S R

    2001-05-01

    The tripartite model (Clark & Watson, 1991: Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316-336) posits that anxiety and depression share nonspecific features of neuroticism but that somatic arousal appears unique to anxiety, and low positive affect appears unique to depression. The present study controlled for these higher-order effects and evaluated the relative contributions of four, specific lower-order vulnerabilities (anxiety sensitivity, rumination, self-criticism, self-oriented perfectionism). Participants were 38 depressed patients and 38 patients with panic disorder matched as closely as possible for age and gender, and all were diagnosed using the same structured interview by an experienced clinician. Results from hierarchical logistic regression analysis were consistent with predictions from the tripartite model in that only the unique features of arousal and positive affectivity differentiated the two diagnostic groups. At a lower-order level, only anxiety sensitivity (and its facet of fear of physical symptoms) and a ruminative response style demonstrated incremental predictive ability. The discussion focuses on the relationships among these higher-order and lower-order variables, and their potential importance for understanding specific manifestations of psychopathology.

  13. Vulnerable, but strong: The spinal cord-injured patient during rehabilitation

    PubMed Central

    Angel, Sanne

    2010-01-01

    A traumatic spinal cord injury affects the body to an extent that the patient requires the assistance of others to survive and recover. The rehabilitation phase puts the patient in a vulnerable position and involves a considerable amount of strength on the patient's part. The aim of this paper is to explore the vulnerability of the spinal cord patient and how this vulnerability connects to the necessary strength, as the patient struggles to survive the injury and get through the rehabilitation. The circumstances of 12 traumatic spinal cord-injured patients were observed in the rehabilitation unit and after discharge. A phenomenological–hermeneutic narrative approach applying Ricoeur's theory was used. Data were collected by field observation and interviews during the first 2 years after the spinal cord injury. The patient's strength during the rehabilitation was portrayed by their endurance and from their narratives of how they handled difficult situations. The patient's perception of vulnerability varied, and strength was mobilised as a response to the vulnerability to overcome the imbalance between demands and resources. Vulnerability should therefore refer to a person's experience of the situation rather than the person, as it may hinder the professionals' open, explorative approach towards the person. PMID:20927203

  14. Changes to criminal records checks used to safeguard vulnerable patients.

    PubMed

    Griffith, Richard; Tengnah, Cassam

    2012-07-01

    The Protection of Freedoms Act 2012 is introducing changes to the Criminal Records Bureau (CRB) checks carried out on those people who work with vulnerable groups. The new law is the coalition Government's response to the criticism of the Safeguarding Vulnerable Group Act 2006. It will merge the CRB and Independent Safeguarding Authority into a new Disclosure and Barring Service and will enhance the rights of applicants to challenge the CRB's right to disclose non-conviction information as part of an enhanced criminal records check. In the first of two articles on the Protection of Freedoms Act 2012, Richard Griffith and Cassam Tengnah discuss the current framework for disclosing criminal records and the impact of the changes on district nurses applying for new posts.

  15. Patient safety through RFID: vulnerabilities in recently proposed grouping protocols.

    PubMed

    Wickboldt, Anne-Katrin; Piramuthu, Selwyn

    2012-04-01

    As RFID-tagged systems become ubiquitous, acceptance of this technology by the general public necessitates addressing related security/privacy issues. The past eight years have seen an increasing number of publications in this direction, specifically using cryptographic approaches. Recently, the Journal of Medical Systems published two papers addressing security/privacy issues through cryptographic protocols. We consider the proposed protocols and identify some existing vulnerabilities.

  16. Can Erectile Dysfunction in Young Patients Serve as a Surrogate Marker for Coronary Artery Disease?

    PubMed Central

    Dattatrya, Kaje Yogesh; Gorakhnath, Wagaska Vinayak; kiran, Patwardhan Sujata

    2015-01-01

    Introduction Early diagnosis and expeditious management of coronary artery disease (CAD) has a rewarding survival benefit. Aim To study whether erectile dysfunction (ED) serves as a surrogate marker for CAD in a young patient. Settings and Design Males (n=207) between ages 20-60 years with ED were evaluated prospectively for risk factors for CAD. Materials and Methods Blood Glucose Levels (BGL) fasting and post meal), lipid profile (LP) and 12 lead electrocardiogram (ECG) was done in all of them. International Index of Erectile Function-5 (IEF-5) was used for the evaluation of ED. Those with abnormal parameters were assessed by cardiologists by echocardiography, stress test and if necessary coronary angiography (Non-Invasive or Invasive). Statistical Analysis All the data were analysed using SPSS. 16 statistical software (SPSS Inc., Chicago, IL, USA). All data are expressed as mean and standard deviation. The Student’s t-test was used to compare means between groups, and the chi-square test was used to compare proportions between the groups. P-value <0.05 was considered statistically significant. All confidence intervals (CIs) are two tailed and calculated at the 0.05 level. Results Out of 207, 149 patients had at least one abnormal screening parameter. All underwent cardiology consultation and 2D ECHO and Stress test. Thirty six patients underwent coronary angiography. CAD was found in 22 patients. Of these, 19 patients had severe ED. Nine patients were between 20-40 years of age (13.23%). All 9 young patients had deranged LP; severe ED. Six patients were smokers while nobody was hypertensive. Conclusion ED serves as a surrogate marker for CAD in young patients (p=0.001). Presence of risk factors and lab abnormalities in young patients with ED warrants a cardiology referral to detect CAD. PMID:26674799

  17. Serving Those That Serve.

    PubMed

    Torrens Armstrong, Anna

    2017-03-01

    Since 1986, health promotion has had a place within the U.S. Department of Defense. Emphasizing the leading health indicators of Healthy People, the role of health promotion has continued to support the U.S. Armed Forces in perhaps one of the most challenging decades of wartime operations. Serving a sizable population with both typical and mission-related health issues, health promotion plays a critical role in maintaining and improving health. The purpose of this article is to highlight military health promotion by offering insight into the day-to-day life of a "boots on the ground" military health educator, reviewing the challenges and opportunities of working with a unique population. A summary of a variety of military specific initiatives is provided. Additionally, the article highlights the barriers and benefits to military health promotion. Last, the article concludes with a call to action to consider the role of all health educators in serving those that serve.

  18. Differences in risk factors for suicidality between African American and White patients vulnerable to suicide.

    PubMed

    Vanderwerker, Lauren C; Chen, Joyce H; Charpentier, Peter; Paulk, Mary Elizabeth; Michalski, Marion; Prigerson, Holly G

    2007-02-01

    Risk factors for suicidal ideation and attempts have been shown to differ between African Americans and Whites across the lifespan. In the present study, risk factors for suicidality were examined separately by race/ethnicity in a population of 131 older adult patients considered vulnerable to suicide due to substance abuse and/or medical frailty. In adjusted analyses, social support was significantly associated with suicidality in African American patients, while younger age and the presence of an anxiety disorder were significantly associated with suicidality in White patients. The results suggest that race/ethnicity-specific risk profiles may improve the detection of suicidality in vulnerable populations.

  19. Ethical vulnerabilities in nursing history: conflicting loyalties and the patient as 'other'.

    PubMed

    Lagerwey, Mary Deane

    2010-09-01

    The purpose of this article is to explore enduring ethical vulnerabilities of the nursing profession as illustrated in historical chapters of nursing's past. It describes these events, then explores two ethical vulnerabilities in depth: conflicting loyalties and duties, and relationships with patients as 'other'. The article concludes with suggestions for more ethical approaches to the other in current nursing practice. The past may be one of the most fruitful sites for examining enduring ethical vulnerabilities of the nursing profession. First of all, professional identity, which includes moral identity, comes in part from knowledge of the nursing profession's past. Second, looking to the past to understand better how events and ideologies have brought vulnerabilities to the fore raises questions about ethical nursing practice today.

  20. Spine and Pain Clinics Serving North Carolina Patients With Back and Neck Pain

    PubMed Central

    Castel, Liana D.; Freburger, Janet K.; Holmes, George M.; Scheinman, Rachael P.; Jackman, Anne M.; Carey, Timothy S.

    2009-01-01

    Study Design Cross-sectional survey. Objective Our primary objective was to describe spine and pain clinics serving North Carolina residents with respect to organizational characteristics. Our secondary objective was to assess the multidisciplinary nature of the clinics surveyed. Summary of Background Data Pain clinics have become common in the United States, and patients with chronic back pain have increasingly been seeking services at these clinics. Little is known about the organizational characteristics of spine and pain clinics. Methods We identified and surveyed spine and pain clinics serving North Carolina residents with chronic back and neck pain. Practice managers at 46 clinics completed a 20-minute questionnaire about the characteristics of their clinic, including providers on staff and services offered. Descriptive and exploratory analyses were conducted to summarize the data. Several variables were constructed to assess the multidisciplinary nature of the clinics. Results The response rate was 75%. There was marked heterogeneity among the clinics surveyed. Fifty-nine percent of practices were free-standing (n = 27) and 61% were physician-owned (n = 28). Twenty-five clinics (54%) had an anesthesiologist. Other common physician providers were physiatrists and surgeons. Less than one third of sites had mental health providers (n = 12; 26%); only 26% employed physical therapists. Seventy-six percent of sites offered epidural injections, 74% long-term narcotic prescriptions, and 67% antidepressants. The majority of clinics (30 of 33) prescribing narcotics provided monitoring of therapy using periodic urine toxicology testing. Forty-eight percent of sites (n = 22) offered exercise instruction. Few clinics were multidisciplinary in nature. Only 3 (7%) met the criteria of having a medical physician, registered nurse, physical therapist, and mental health specialist. Conclusion Clinics varied widely in their organizational characteristics, including providers

  1. Serum liver enzymes serve as prognostic factors in patients with intrahepatic cholangiocarcinoma

    PubMed Central

    Zhang, Chenyue; Wang, Haiyong; Ning, Zhouyu; Xu, Litao; Zhuang, Liping; Wang, Peng; Meng, Zhiqiang

    2017-01-01

    Objective Liver functions, reflective of the overall status of the host, have been reported to be important factors affecting the prognosis in many types of cancers. In this study, we explored the influences of liver enzymes albumin (ALB), globulin (GELO), total protein (TP), alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), gamma glutamyltranspeptidase (GGT), and lactate dehydrogenase (LDH) on the overall survival (OS) in a number of 173 patients with intrahepatic cholangiocarcinoma (ICC). Patients and methods Between 2011 and 2015, we enrolled patients with pathologically proven locally advanced or metastatic ICC. The impact of ALB, GELO, TP, ALP, ALT, AST, TBIL, DBIL, GGT, and LDH on OS were analyzed using Kaplan–Meier analysis. Next, the associations between these liver enzymes and OS were evaluated by univariate and multivariate analyses. Finally, the role of these enzymes in OS was evaluated in the subgroups. Results Elevated liver enzymes were linked with OS. We revealed that independent prognostic factors of poor outcome were ALP, TBIL, DBIL, and GGT, whereas ALB is a protective factor in ICC patients. Conclusion Our results demonstrate that these liver enzymes may serve as valuable predictive markers in ICC patients. PMID:28331337

  2. Differences in Risk Factors for Suicidality between African American and White Patients Vulnerable to Suicide

    ERIC Educational Resources Information Center

    Vanderwerker, Lauren C.; Chen, Joyce H; Charpentier, Peter; Paulk, Mary Elizabeth; Michalski, Marion; Prigerson, Holly G.

    2007-01-01

    Risk factors for suicidal ideation and attempts have been shown to differ between African Americans and Whites across the lifespan. In the present study, risk factors for suicidality were examined separately by race/ethnicity in a population of 131 older adult patients considered vulnerable to suicide due to substance abuse and/or medical frailty.…

  3. Psychological vulnerability, ventricular tachyarrhythmias and mortality in implantable cardioverter defibrillator patients: is there a link?

    PubMed

    Pedersen, Susanne S; Brouwers, Corline; Versteeg, Henneke

    2012-07-01

    Implantable cardioverter defibrillator (ICD) therapy is the first-line treatment for the prevention of sudden cardiac death. Despite the demonstrated survival benefits of the ICD, predicting which patients will die from a ventricular tachyarrhythmia remains a major challenge. So far, psychological factors have not been considered as potential risk markers that might enhance the prediction of sudden cardiac death. This article evaluates the evidence for a link between psychological vulnerability, ventricular tachyarrhythmias and mortality and the pathways that might explain such a link. This review demonstrates that there is cumulative evidence supporting a link between psychological vulnerability and risk of ventricular tachyarrhythmias and mortality in ICD patients independent of disease severity and other biomedical risk factors. It may be premature to include psychological factors in risk algorithms, but information on the psychological profile of the patient may help to optimize the management and care of these patients in clinical practice.

  4. Report of the ASHP Task Force on Caring for Patients Served by Specialty Suppliers.

    PubMed

    Caselnova, Dominick; Donley, Kathy; Ehlers, Diane; Hyduk, Amy E; Koontz, Susannah E; Nowobilski-Vasilios, Anna; Pawlicki, Kathleen S; Poikonen, John C; Poremba, Art C; Sasser, Cathy L; Schell, Kenneth H; Schwab, Jay L; Swinarski, Dave; Chen, David; Kirschenbaum, Bonnie; Armitstead, John

    2010-10-01

    Task Force recommendations are discussed in more detail in eAppendix A (available at www.ajhp.org). What follows is a brief summary of those recommendations. In very abbreviated terms, the Task Force suggested that ASHP: 1. Consider creating and maintaining a Web resource center on ASHP's website to provide information about restricted drug distributions systems (RDDSs), risk evaluation and mitigation strategies (REMSs), risk assessment and minimization plans (RiskMAPs), and specialty suppliers and products. 2. Provide comprehensive education to members, other health professionals, regulators, third-party payers, patients, and other stakeholders about RDDSs, REMSs, RiskMAPs, and specialty suppliers and products. 3. Develop policies to advocate that a. Pharmacists serve as the institutional leaders in compliance and utilization challenges of safely managing externally supplied medications and related drug administration devices, b. Agencies, organizations, and associations that influence the distribution, sale, and dispensing of medications under these alternative distribution models address issues these models create in continuity of care, reimbursement, and patient safety, c. The Centers for Medicare and Medicaid Services and the Joint Commission develop standards and interpretations that accommodate hospital use of these products and devices when currently available technology (e.g., cold-chain storage, e-pedigree) is used to ensure patient safety, d. Group purchasing organizations negotiate contractual arrangements for specialty pharmaceuticals for both acquisition costs and distribution arrangements, and e. Information technology (IT) be used to resolve issues created by alternative distribution models and that ASHP work with IT vendors to ensure that programs are designed to meet the needs of these evolving models. 4. Quantify through research, perhaps in cooperation with entities such as the Agency for Healthcare Research and Quality, the Institute of

  5. Hemodialysis patients have plasmatic hypercoagulability and decreased fibrinolytic vulnerability: role of carbon monoxide.

    PubMed

    Matika, Ryan W; Nielsen, Vance G; Steinbrenner, Evangelina B; Sussman, Amy N; Madhrira, Machaiah

    2014-01-01

    Chronic hemodialysis is associated with significant thrombophilia. Of interest, hemodialysis patients have increased carboxyhemoglobin (COHb) and exhaled carbon monoxide (CO), signs of upregulated heme oxygenase (Hmox) activity. Given that CO enhances plasmatic coagulation, we determined whether patients requiring chronic hemodialysis had an increase in endogenous CO, plasmatic hypercoagulability and decreased fibrinolytic vulnerability. Carbon monoxide was determined by noninvasive pulse oximetry measurement of COHb. Blood samples were obtained just before hemodialysis. Thrombelastographic methods to assess plasma coagulation kinetics, fibrinolytic kinetics, and formation of carboxyhemefibrinogen (COHF) were used. Hemodialysis patients (n = 45) had abnormally increased COHb concentrations of 2.2 ± 1.9%, indicative of Hmox upregulation. Coagulation and fibrinolytic parameter normal values were determined with normal individual (n = 30) plasma. Thirty-seven patients of the hemodialysis cohort had COHF formation (82.2%, [67.9%-92.0%]; mean, [95% confidence interval]), and many of this group of patients had abnormally great velocity of clot growth (73.3%, [58.1%-85.4%]) and strength (75.6%, [60.5%-87.1%]). Furthermore, over half of COHF positive patients had a hypofibrinolytic state, evidenced by an abnormally prolonged time to maximum rate of lysis (53.3%, [37.9%-68.6%]) and clot lysis time (64.4%, [48.8%-78.1%]). Carbon monoxide enhanced coagulation and diminished fibrinolytic vulnerability in hemodialysis patients. Future investigation of hemodialysis, CO-related thrombophilia is warranted.

  6. Psychiatric patients' vulnerability in the wake of the September 11th terrorist attacks.

    PubMed

    Franklin, C Laurel; Young, Diane; Zimmerman, Mark

    2002-12-01

    The September 11, 2001 (9/11) terrorist attacks led to speculation about the vulnerability of psychiatric patients to psychological distress following such events. This study examined the impact of national terrorist attacks on psychiatric and medical outpatients living approximately 150 to 200 miles from the attack sites (N = 308). Two to 3 weeks following 9/11, patients were given questionnaires assessing background information, healthcare service utilization, and posttraumatic stress disorder (PTSD) symptoms. Psychiatric patients (33%) were significantly more likely than medical patients (13%) to report distressing symptoms meeting criteria for PTSD (except for the duration criterion) despite no differences in learning about the attacks or personal involvement with the victims. Patients meeting PTSD criteria were more likely to schedule an appointment to speak with their physician about their reactions. Psychiatric patients not directly impacted by the 9/11 terrorist attacks are at increased risk for experiencing distressing symptoms following national terrorist attacks.

  7. Older, vulnerable patient view: a pilot and feasibility study of the patient measure of safety (PMOS) with patients in Australia

    PubMed Central

    Taylor, Natalie; Hogden, Emily; Clay-Williams, Robyn; Li, Zhicheng; Lawton, Rebecca; Braithwaite, Jeffrey

    2016-01-01

    Objectives The UK-developed patient measure of safety (PMOS) is a validated tool which captures patient perceptions of safety in hospitals. We aimed (1) to investigate the extent to which the PMOS is appropriate for use with stroke, acute myocardial infarction (AMI) and hip fracture patients in Australian hospitals and (2) to pilot the PMOS for use in a large-scale, national study ‘Deepening our Understanding of Quality in Australia’ (DUQuA). Participants Stroke, AMI and hip fracture patients (n=34) receiving care in 3 wards in 1 large hospital. Methods 2 phases were conducted. First, a ‘think aloud’ study was used to determine the validity of PMOS with this population in an international setting, and to make amendments based on patient feedback. The second phase tested the revised measure to establish the internal consistency reliability of the revised subscales, and piloted the recruitment and administration processes to ensure feasibility of the PMOS for use in DUQuA. Results Of the 43 questions in the PMOS, 13 (30%) were amended based on issues patients highlighted for improvement in phase 1. In phase 2, a total of 34 patients were approached and 29 included, with a mean age of 71.3 years (SD=16.39). Internal consistency reliability was established using interitem correlation and Cronbach's α for all but 1 subscale. The most and least favourably rated aspects of safety differed between the 3 wards. A study log was categorised into 10 key feasibility factors, including liaising with wards to understand operational procedures and identify patterns of patient discharge. Conclusions Capturing patient perceptions of care is crucial in improving patient safety. The revised PMOS is appropriate for use with vulnerable older adult groups. The findings from this study have informed key decisions made for the deployment of this measure as part of the DUQuA study. PMID:27279478

  8. Feeling “overloaded” and “shortcomings”: milieu therapists’ experiences of vulnerability in caring for severely mentally ill patients

    PubMed Central

    Bachmann, Liv; Michaelsen, Ragnhild A; Vatne, Solfrid

    2016-01-01

    Background Milieu therapists’ relationships with patients with severe mental illnesses are viewed as challenging. Elucidating vulnerability from their perspective in daily face-to-face encounters with patients might contribute to extending our knowledge about milieu therapists’ vulnerability and the dynamics of the interaction between patients in mental health services and expertise in building caring and therapeutic relationships. The aim of this project was to study educated milieu therapists’ experiences of their own vulnerability in their interactions with patients in mental health services. Materials and methods The data collection method was focus-group interviews. Thirteen part-time master’s in mental health students (eight nurses, three social workers, two social educators) participated. All participants had experience with community or specialized mental health services (2–8 years). Results The milieu therapists mainly related their experiences of vulnerability to negative feelings elicited by challenging work conditions, disclosed as two main themes: 1) “overloaded”, by the possibility of being physically and mentally hurt and the burdens of long-lasting close relationships; milieu therapists were extremely vulnerable because of their difficulty in protecting themselves; and 2) “shortcomings”, connected to feelings of despair associated with not acting in concordance with their professional standards and insecurity about their skills to handle challenging situations, which was a threat to their professional integrity. There seemed to be coherence between vulnerability and professional inauthenticity. A misunderstanding that professionalism refers to altruism seems to increase milieu therapist vulnerability. Conclusion Vulnerability in health care is of interest to multiple disciplines, and is of relevance for knowledge development in higher education. Extended knowledge and understanding about milieu therapists’ vulnerability might

  9. Narcissistic vulnerability is a common cause for depression in patients with Gilles de la Tourette syndrome.

    PubMed

    Trillini, Morounke O; Müller-Vahl, Kirsten R

    2015-12-15

    The aim of this study was to assess for the first time different dimensions of narcissistic self-regulation in a large cohort of adult patients with Gilles de la Tourette syndrome (GTS) (n=50). From preliminary studies it is suggested that narcissistic personality trait and disorder, respectively, are relatively uncommon and occur in only 6-10% of GTS patients. In this study we used the Narcissism Inventory (NI), a 163-items questionnaire that measures four different dimensions of narcissism. The main result was that the prevalence of narcissism strongly depends on the subtype of narcissism: while the vulnerable narcissism ("threatened self" and "hypochondriac self") was common, the "classic narcissistic self" (grandiose narcissism) was rare. From our data an association between comorbid depression and increased values of the "threatened self" and comorbid OCD with increased values of the "hypochondriac self" is suggested. Narcissism correlated positively with the personality domain neuroticism and had a significantly negative impact on patients' quality of life. Therefore it can be speculated that vulnerable narcissism is - among several others - one cause for depression in patients with GTS. These findings may open new psychotherapeutic perspectives in the treatment of depression in patients with GTS.

  10. Medicare home health payment reform may jeopardize access for clinically complex and socially vulnerable patients.

    PubMed

    Rosati, Robert J; Russell, David; Peng, Timothy; Brickner, Carlin; Kurowski, Daniel; Christopher, Mary Ann; Sheehan, Kathleen M

    2014-06-01

    The Affordable Care Act directed Medicare to update its home health prospective payment system to reflect more recent data on costs and use of services-an exercise known as rebasing. As a result, the Centers for Medicare and Medicaid Services will reduce home health payments 3.5 percent per year in the period 2014-17. To determine the impact that these reductions could have on beneficiaries using home health care, we examined the Medicare reimbursement margins and the use of services in a national sample of 96,621 episodes of care provided by twenty-six not-for-profit home health agencies in 2011. We found that patients with clinically complex conditions and social vulnerability factors, such as living alone, had substantially higher service delivery costs than other home health patients. Thus, the socially vulnerable patients with complex conditions represent less profit-lower-to-negative Medicare margins-for home health agencies. This financial disincentive could reduce such patients' access to care as Medicare payments decline. Policy makers should consider the unique characteristics of these patients and ensure their continued access to Medicare's home health services when planning rebasing and future adjustments to the prospective payment system.

  11. The relationship between vulnerable attachment style, psychopathology, drug abuse, and retention in treatment among methadone maintenance treatment patients.

    PubMed

    Potik, David; Peles, Einat; Abramsohn, Yahli; Adelson, Miriam; Schreiber, Shaul

    2014-01-01

    The relationship between vulnerable attachment style, psychopathology, drug abuse, and retention in treatment among patients in methadone maintenance treatment (MMT) was examined by the Vulnerable Attachment Style Questionnaire (VASQ), the Symptom Checklist-90 (SCL-90), and drug abuse urine tests. After six years, retention in treatment and repeated urine test results were studied. Patients with vulnerable attachment style (a high VASQ score) had higher rates of drug abuse and higher psychopathology levels compared to patients with secure attachment style, especially on the interpersonal sensitivity, anxiety, hostility, phobic anxiety, and paranoid ideation scales. Drug abstinence at baseline was related to retention in treatment and to higher rates of drug abstinence after six years in MMT, whereas a vulnerable attachment style could not predict drug abstinence and retention in treatment. Clinical Implications concerning treatment of drug abusing populations and methodological issues concerning the VASQ's subscales are also discussed.

  12. Plaque Vulnerability as Assessed by Radiofrequency Intravascular Ultrasound in Patients with Valvular Calcification

    PubMed Central

    Senguttuvan, Nagendra Boopathy; Kumar, Sharath; Mishra, Sundeep; Cho, Jun Hwan; Kwon, Jee Eun; Hyeon, Seong Hyeop; Jeong, Yun Sang; Won, Hoyoun; Shin, Seung Yong; Lee, Kwang Je; Kim, Tae Ho; Kim, Chee Jeong; Kim, Sang-Wook

    2016-01-01

    Background Cardiac valvular calcification is associated with the overall coronary plaque burden and considered an independent cardiovascular risk and prognostic factor. The purpose of this study was to evaluate the relationship between the presence of valvular calcification and plaque morphology and/or vulnerability. Methods Transthoracic echocardiography was used to assess valvular calcification in 280 patients with coronary artery disease who underwent radiofrequency intravascular ultrasound (Virtual Histology IVUS, VH-IVUS). A propensity score–matched cohort of 192 patients (n = 96 in each group) was analyzed. Thin-capped fibroatheroma (TCFA) was defined as a necrotic core (NC) >10% of the plaque area with a plaque burden >40% and NC in contact with the lumen for ≥3 image slices. A remodeling index (lesion/reference vessel area) >1.05 was considered to be positive. Results Patients were divided into two groups: any calcification in at least one valve (152 patients) vs. no detectable valvular calcification (128 patients). Groups were similar in terms of age, risk factors, clinical diagnosis, and angiographic analysis after propensity score-matched analysis. Gray-scale IVUS analysis showed that the vessel size, plaque burden, minimal lumen area, and remodeling index were similar. By VH-IVUS, % NC and % dense calcium (DC) were greater in patients with valvular calcification (p = 0.024, and p = 0.016, respectively). However, only % DC was higher at the maximal NC site by propensity score-matched analysis (p = 0.029). The frequency of VH-TCFA occurrence was higher depending on the complexity (p = 0.0064) and severity (p = 0.013) of valvular calcification. Conclusions There is a significant relationship between valvular calcifications and VH-IVUS assessment of TCFAs. Valvular calcification indicates a greater atherosclerosis disease complexity (increased calcification of the coronary plaque) and vulnerable coronary plaques (higher incidence of VH-TCFA). PMID

  13. The Spatial Distribution of Plaque Vulnerabilities in Patients with Acute Myocardial Infarction

    PubMed Central

    Zheng, Guian; Li, Yuxin; Takayama, Tadateru; Nishida, Toshihiko; Sudo, Mitsumasa; Haruta, Hironori; Fukamachi, Daisuke; Okubo, Kimie; Higuchi, Yoshiharu; Hiro, Takafumi; Saito, Satoshi; Hirayama, Atsushi

    2016-01-01

    Objective Although the plaque characteristics have been recognized in patients with acute myocardial infarction (AMI), the plaque spatial distribution is not well clarified. Using color-mapping intravascular ultrasound (iMAP-IVUS), we examined culprit lesions to clarify plaque morphology, composition and spatial distribution of the sites of potential vulnerability. Methods Sixty-eight culprit lesions in 64 consecutive AMI patients who underwent angiography and IVUS examinations before intervention were analyzed. Plaque morphology and composition were quantified with iMAP-IVUS. The spatial distribution of the sites of potential vulnerability was assessed with longitudinal reconstruction of the consecutive IVUS images. The plaque characteristics were also compared between ruptured and non-ruptured lesions, and between totally occlusive (TO) and non-TO lesions. Results The sites with maximum necrotic area (maxNA), maximum plaque burden (maxPB) and most severely narrowed (minimal luminal area, MLA) were recognized vulnerability. In the majority of cases, maxNA sites were proximal to the maxPB sites, and MLA sites were distal to the maxNA and maxPB sites. Ruptures usually occurred close to maxNA sites and proximal to maxPB and MLA sites. The average distance from the site of rupture to the maxNA site was 0.33 ± 4.04 mm. Ruptured lesions showed significant vessel remodeling, greater plaque volume, and greater lipidic volume compared to those of non-ruptured lesions. Both the length and plaque burden (PB) of TO lesions were greater than those of non-TO lesions. Conclusions Instead of overlapping on maxPB sites, most maxNA sites are proximal to the maxPB sites and are the sites most likely to rupture. Plaque morphology and composition play critical roles in plaque rupture and coronary occlusion. PMID:27031514

  14. Specific vulnerability of face perception to noise: a similar effect in schizophrenia patients and healthy individuals.

    PubMed

    Chen, Yue; McBain, Ryan; Norton, Daniel

    2015-02-28

    Face perception plays a foundational role in the social world. This perceptual ability is deficient in schizophrenia. A noise-filtering mechanism is essential for perceptual processing. It remains unclear as to whether a specific noise-filtering mechanism is implicated in the face perception problem or a general noise-filtering mechanism is involved which also mediates non-face visual perception problems associated with this psychiatric disorder. This study examined and compared the effects of external noise on the performance of face discrimination and car discrimination in schizophrenia patients (n=25) and healthy controls (n=27). Superimposing the external visual noise on face or car stimuli elevated perceptual thresholds (i.e. degraded performance levels) for both face and car discrimination. However, the effect of noise was significantly larger on face than on car discrimination, both in patients and controls. This pattern of results suggests specific vulnerability of face processing to noise in healthy individuals and those with schizophrenia.

  15. Implementing the Ten Steps for Successful Breastfeeding in Hospitals Serving Low-Wealth Patients

    PubMed Central

    Taylor, Emily C.; Nickel, Nathan C.

    2012-01-01

    Objectives. The Ten Steps to Successful Breastfeeding is a proven approach to support breastfeeding in maternity settings; however, scant literature exists on the relative impact and interpretation of each step on breastfeeding. We assessed the Ten Steps and their relationship with in-hospital breastfeeding rates at facilities serving low-wealth populations and explored the outcomes to identify step-specific actions. Methods. We present descriptive and nonparametric comparisons and qualitative findings to examine the relationship between the Ten Steps and breastfeeding rates from each hospital using baseline data collection. Results. Some steps (1-policy, 2-training, 4-skin-to-skin, 6-no supplements, and 9-no artificial nipples, followed by 3-prenatal counseling, 7-rooming-in) reflected differences in relative baseline breastfeeding rates between settings. Key informant interviews revealed misunderstanding of some steps. Conclusions. Self-appraisal may be less valid when not all elements of the criteria for evaluating Step implementation may be fully understood. Limited exposure and understanding may lead to self-appraisal errors, resulting in scores that are not reflective of actual practices. Nonetheless, the indication that breastfeeding rates may be better mirrored by a defined subset of steps may provide some constructive insight toward prioritizing implementation activities and simplifying assessment. These issues will be further explored in the next phase of this study. PMID:23078473

  16. HLA alleles may serve as a tool to discriminate atypical type 2 diabetic patients

    PubMed Central

    Fernández, Mariana; Fabregat, Matías; Javiel, Gerardo; Mimbacas, Adriana

    2014-01-01

    AIM: To investigate whether the presence of human leukocyte antigen (HLA) marker could add new information to discriminated atypical diabetic type 2 patients. METHODS: We analyzed 199 patients initially diagnosed as type 2 diabetes who are treated in special care diabetes clinics (3rd level). This population was classified in “atypical” (sample A) and “classic” (sample B) according to HLA typing. We consider “classic patient” when has absence of type 1 diabetes associated HLA alleles and no difficulties in their diagnosis and treatments. By the other hand, we considered “atypical patient” when show type 1 diabetes associated HLA alleles and difficulties in their diagnosis and treatments. The standard protocol Asociacion Latinoamericana de Diabetes 2006 was used for patients follow up. To analyze differences between both populations in paraclinical parameters we used unpaired t tests and contingence tables. Bivariate and multivariate analyses were carried out using the SPSS software program. In all studies we assume differences statistically significant, with a P-value < 0.05 corrected and 95%CI. RESULTS: The typing HLA in the “atypical” populations show that 92.47% patients presented at list one type 1 diabetes associated HLA alleles (DQB1*0201-0302 and DR 3-4) and 7.53% had two of its. The results showed for categorical variables (family history, presence or absence of hypertension and/or dyslipidemia, reason for initial consultation) the only difference found was at dyslipidemia (OR = 0.45, 0.243 < OD < 0.822 (P < 0.001). In relation to continuous variables we found significant differences between atypical vs classic only in cholesterol (5.07 ± 1.1 vs 5.56 ± 1.5, P < 0.05), high density lipoproteins (1.23 ± 0.3 vs 1.33 ± 0.3, P < 0.05) and low density lipoproteins (2.86 ± 0.9 vs 3.38 ± 1.7, P < 0.01). None of the variables had discriminating power when logistic regression was done. CONCLUSION: We propose an algorithm including HLA

  17. “It's like two worlds apart”: an analysis of vulnerable patient handover practices at discharge from hospital

    PubMed Central

    Groene, Raluca Oana; Orrego, Carola; Suñol, Rosa; Barach, Paul; Groene, Oliver

    2012-01-01

    Background Handover practices at hospital discharge are relatively under-researched, particularly as regards the specific risks and additional requirements for handovers involving vulnerable patients with limited language, cognitive and social resources. Objective To explore handover practices at discharge and to focus on the patients’ role in handovers and on the potential additional risks for vulnerable patients. Methods We conducted qualitative interviews with patients, hospital professionals and primary care professionals in two hospitals and their associated primary care centres in Catalonia, Spain. Results We identified handover practices at discharge that potentially put patients at risk. Patients did not feel empowered in the handover but were expected to transfer information between care providers. Professionals identified lack of medication reconciliation at discharge, loss of discharge information, and absence of plans for follow-up care in the community as quality and safety problems for discharge handovers. These occurred for all patients, but appeared to be more frequent and have a greater negative effect in patients with limited language comprehension and/or lack of family and social support systems. Conclusions Discharge handovers are often haphazard. Healthcare professionals do not consider current handover practices safe, with patients expected to transfer information without being empowered to understand and act on it. This can lead to misinformation, omission or duplication of tests or interventions and, potentially, patient harm. Vulnerable patients may be at greater risk given their limited language, cognitive and social resources. Patient safety at discharge could benefit from strategies to enhance patient education and promote empowerment. PMID:23112285

  18. Communication vulnerable patients in the pediatric ICU: Enhancing care through augmentative and alternative communication.

    PubMed

    Costello, John M; Patak, Lance; Pritchard, Jennifer

    2010-01-01

    Children in pediatric intensive care units (PICUs) may experience a broad range of motor, sensory, cognitive, and linguistic difficulties that make it difficult for them to communicate effectively. Being unable to communicate is emotionally frightening for children and can lead to an increase in sentinel events, medical errors and extended lengths of stay. Implementation of augmentative and alternative communication (AAC) tools and strategies can address the communication needs of children in the PICU by enabling them to communicate their wants, needs and feelings to healthcare providers and family members and participate in their own care more productively. Hospitals around the world are increasingly recognizing and addressing patients' needs for communication access and have begun to implement communication screenings and assessments and interventions at admission and throughout the hospital stay. New standards for all American hospitals, in fact, mandate efforts to improve patient communication. When patient-provider communication improves, treatment success goes up, hospital-caused errors decrease and patient and family satisfaction improve. This article describes three phases of intervention for communication vulnerable children in the PICU and provides examples of treatment approaches that ensure communication access as their medical condition changes.

  19. From vulnerable plaque to vulnerable patient--Part III: Executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force report.

    PubMed

    Naghavi, Morteza; Falk, Erling; Hecht, Harvey S; Jamieson, Michael J; Kaul, Sanjay; Berman, Daniel; Fayad, Zahi; Budoff, Matthew J; Rumberger, John; Naqvi, Tasneem Z; Shaw, Leslee J; Faergeman, Ole; Cohn, Jay; Bahr, Raymond; Koenig, Wolfgang; Demirovic, Jasenka; Arking, Dan; Herrera, Victoria L M; Badimon, Juan; Goldstein, James A; Rudy, Yoram; Airaksinen, Juhani; Schwartz, Robert S; Riley, Ward A; Mendes, Robert A; Douglas, Pamela; Shah, Prediman K

    2006-07-17

    Screening for early-stage asymptomatic cancers (eg, cancers of breast and colon) to prevent late-stage malignancies has been widely accepted. However, although atherosclerotic cardiovascular disease (eg, heart attack and stroke) accounts for more death and disability than all cancers combined, there are no national screening guidelines for asymptomatic (subclinical) atherosclerosis, and there is no government- or healthcare-sponsored reimbursement for atherosclerosis screening. Part I and Part II of this consensus statement elaborated on new discoveries in the field of atherosclerosis that led to the concept of the "vulnerable patient." These landmark discoveries, along with new diagnostic and therapeutic options, have set the stage for the next step: translation of this knowledge into a new practice of preventive cardiology. The identification and treatment of the vulnerable patient are the focuses of this consensus statement. In this report, the Screening for Heart Attack Prevention and Education (SHAPE) Task Force presents a new practice guideline for cardiovascular screening in the asymptomatic at-risk population. In summary, the SHAPE Guideline calls for noninvasive screening of all asymptomatic men 45-75 years of age and asymptomatic women 55-75 years of age (except those defined as very low risk) to detect and treat those with subclinical atherosclerosis. A variety of screening tests are available, and the cost-effectiveness of their use in a comprehensive strategy must be validated. Some of these screening tests, such as measurement of coronary artery calcification by computed tomography scanning and carotid artery intima-media thickness and plaque by ultrasonography, have been available longer than others and are capable of providing direct evidence for the presence and extent of atherosclerosis. Both of these imaging methods provide prognostic information of proven value regarding the future risk of heart attack and stroke. Careful and responsible

  20. Serving Families.

    ERIC Educational Resources Information Center

    Link, Geoffrey; Beggs, Marjorie; Seiderman, Ethel

    Parent Services Project (PSP), the first comprehensive program of resources and mental health activities for parents offered at child care centers in the San Francisco Bay Area (California), has expanded to centers in six states, serving over 19,000 families. This report describes the program's history, aims, and achievements, along with specific…

  1. GPR155 Serves as a Predictive Biomarker for Hematogenous Metastasis in Patients with Gastric Cancer

    PubMed Central

    Shimizu, Dai; Kanda, Mitsuro; Tanaka, Haruyoshi; Kobayashi, Daisuke; Tanaka, Chie; Hayashi, Masamichi; Iwata, Naoki; Niwa, Yukiko; Takami, Hideki; Yamada, Suguru; Fujii, Tsutomu; Nakayama, Goro; Fujiwara, Michitaka; Kodera, Yasuhiro

    2017-01-01

    The prognosis of patients with gastric cancer (GC) with hematogenous metastasis is dismal. Identification of biomarkers specific for hematogenous metastasis is required to develop personalized treatments that improve patients’ outcomes. Global expression profiling of GC tissues with synchronous hepatic metastasis without metastasis to the peritoneal cavity or distant lymph nodes was conducted using next-generation sequencing and identified the G protein-coupled receptor 155 (GPR155) as a candidate biomarker. GPR155 transcription was suppressed in GC cell lines compared with a nontumorigenic cell line. DNA methylation of the GPR155 promoter region was not detected, albeit 20% of GC cell lines harbored copy number loss at GPR155 locus. The expression levels of GPR155 mRNA correlated inversely with those of TWIST1 and WNT5B. Inhibition of GPR155 expression increased the levels of p-ERK1/2 and p-STAT1, significantly increased cell proliferation, and increased the invasiveness of a GC cell lines. GPR155 mRNA levels in GC clinical samples correlated with hematogenous metastasis and recurrence. Multivariate analysis revealed that reduced expression of GPR155 mRNA was an independent predictive marker of hematogenous metastasis. GPR155 may represent a biomarker for diagnosing and predicting hematogenous metastasis of GC. PMID:28165032

  2. Vulnerable Blood in High Risk Vascular Patients: Study Design and Methods

    PubMed Central

    McDermott, Mary M.; Greenland, Philip; Liu, Kiang; Tian, Lu; Green, David; Shah, Sanjiv J.; Huffman, Mark; Wilkins, John; Kibbe, Melina; Liao, Yihua; Huang, Chiang-Ching; Skelly, Christopher; Jacobs, Chad; McCarthy, Walter; Auerbach, Amanda; Lloyd-Jones, Donald

    2014-01-01

    BACKGROUND Basic research suggests that rapid increases in circulating inflammatory and hemostatic blood markers may trigger or indicate impending plaque rupture and coronary thrombosis, resulting in acute ischemic heart disease (IHD) events. However, these associations are not established in humans. METHODS AND RESULTS The Biomarker Risk Assessment in Vulnerable Outpatients (BRAVO) Study will determine whether levels of inflammatory and hemostatic biomarkers rapidly increase during the weeks prior to an acute IHD event in people with lower extremity peripheral artery disease (PAD). The BRAVO Study will determine whether biomarker levels measured immediately prior to an IHD event are higher than levels not preceding an IHD event; whether participants who experience an IHD event (cases) have higher biomarker levels immediately prior to the event and higher biomarker levels at each time point leading up to the IHD event than participants without an IHD event (controls); and whether case participants have greater increases in biomarkers during the months leading up to the event than controls. BRAVO enrolled 595 patients with PAD, a population at high risk for acute IHD events. After a baseline visit, participants returned every two months for blood collection, underwent an electrocardiogram to identify new silent myocardial infarctions, and were queried about new hospitalizations since their prior study visit. Mortality data were also collected. Participants were followed prospectively for up to three years. CONCLUSIONS BRAVO results will provide important information about the pathophysiology of IHD events and may lead to improved therapies for preventing IHD events in high-risk patients. PMID:24721480

  3. Study of stress and vulnerability in patients with somatoform and dissociative disorders in a psychiatric clinic in North India.

    PubMed

    Irpati, Anand S; Avasthi, Ajit; Sharan, Pratap

    2006-10-01

    The authors compared perceived stress in subgroups of patients defined by vulnerability (high and low) and disorder (somatoform and dissociative). A total of 30 patients each of somatoform and dissociative disorders diagnosed according to the classification of mental and behavioral disorders criteria were assessed with Presumptive Stressful Life Event Scale, The Hassles Scale, Psychoticism Extraversion Neuroticism Inventory, Dissociative Experience Scale, Twenty-Item Toronto Alexithyma Scale, and Illness Behavior Questionnaire. Somatoform and dissociative disorder groups had comparable scores on measures of perceived stress and vulnerability. Two-way anova showed significant main effect of neuroticism (F = 13.65, d.f. = 1.56, P < 0.01), psychoticism (F = 7.92, d.f. = 1.56, P < 0.01), illness behavior (F = 5.82, d.f. = 1.56, P < 0.05), and dissociative experience (F = 8.45, d.f. = 1.56, P < 0.01) on total hassles score, but no significant main effect of disorder groups or interaction effect for disorder and vulnerability was seen on total hassles score. No significant main or interaction effect was seen on life events score. Similarities were seen in stress and vulnerability factors in the two disorders. Neuroticism, psychoticism, dissociative experience, and abnormal illness behavior were significantly related to stress (daily hassles) perceived by the patient, irrespective of the disorder.

  4. Abstinence and Teenagers: Prevention Counseling Practices of Health Care Providers Serving High-Risk Patients in the United States

    PubMed Central

    Harper, Cynthia C.; Henderson, Jillian T.; Schalet, Amy; Becker, Davida; Stratton, Laura; Raine, Tina R.

    2010-01-01

    CONTEXT Abstinence-only education has had little demonstrable impact on teenagers’ sexual behaviors, despite significant policy and funding efforts. Given the struggle over resources to improve teenagers’ reproductive health outcomes, the views of clinicians serving teenagers at high risk for unintended pregnancy and STDs merit particular attention. METHODS In 2005, a qualitative study with 31 clinicians serving low-income, at-risk patients was conducted. A semistructured interview guide was used to ask clinicians about adolescent pregnancy, HIV and STD prevention counseling, and when they include abstinence. Thematic content analysis was used to examine the content of the counseling and the techniques used in different situations. RESULTS Providers reported offering comprehensive counseling, presenting abstinence as a choice for teenagers, along with information about contraceptives and condoms. Several providers mentioned that with young, sexually inexperienced teenagers, they discuss delaying sexual activity and suggest other ways to be affectionate, while giving information on condoms. Providers explained how they assess whether teenagers feel ready to be sexually active and try to impart skills for healthy relationships. Some described abstinence as giving teenagers a way to opt out of unwanted sexual activity. Many support abstinence if that is the patient’s desire, but routinely dispense condoms and contraceptives. CONCLUSIONS Overall, providers did not give abstinence counseling as a rigid categorical concept in their preventive practices, but as a health tool to give agency to teenagers within a harm reduction framework. Their approach may be informative for adolescent policies and programs in the future. PMID:20618752

  5. Academic health centers and community health centers partnering to build a system of care for vulnerable patients: lessons from Carolina Health Net.

    PubMed

    Denham, Amy C; Hay, Sherry S; Steiner, Beat D; Newton, Warren P

    2013-05-01

    Academic health centers (AHCs) are challenged to meet their core missions in a time of strain on the health care system from rising costs, an aging population, increased rates of chronic disease, and growing numbers of uninsured patients. AHCs should be leaders in developing creative solutions to these challenges and training future leaders in new models of care. The authors present a case study describing the development, implementation, and early results of Carolina Health Net, a partnership between an AHC and a community health center to manage the most vulnerable uninsured by providing access to primary care medical homes and care management systems. This partnership was formed in 2008 to help transform the delivery of health care for the uninsured. As a result, 4,400 uninsured patients have been connected to primary care services. Emergency department use by enrolled patients has decreased. Patients have begun accessing subspecialty care within the medical home. More than 2,200 uninsured patients have been assisted to enroll in Medicaid. The experience of Carolina Health Net demonstrates that developing a system of care with primary care and wrap-around services such as pharmacy and case management can improve the cost-effectiveness and quality of care, thereby helping AHCs meet their broader missions. This project can serve as a model for other AHCs looking to partner with community-based providers to improve care and control costs for underserved populations.

  6. Serum Osteopontin Predicts Degree of Hepatic Fibrosis and Serves as a Biomarker in Patients with Hepatitis C Virus Infection

    PubMed Central

    Matsue, Yasuhiro; Tsutsumi, Mikihiro; Hayashi, Nobuhiko; Saito, Takashi; Tsuchishima, Mutsumi; Toshikuni, Nobuyuki; Arisawa, Tomiyasu; George, Joseph

    2015-01-01

    Background & Aims Osteopontin (OPN) is a matricellular protein that upregulates during pathogenesis of hepatic fibrosis. The present study was aimed to evaluate whether serum OPN could be used as a biomarker to assess the degree of hepatic fibrosis in patients with hepatitis C virus (HCV) infection. Methods Needle biopsy was performed on HCV patients and scored as zero fibrosis (F0), mild fibrosis (F1), moderate fibrosis (F2), severe fibrosis (F3) and liver cirrhosis (F4) based on Masson’s trichrome and α-smooth muscle actin (α-SMA) staining. Serum OPN levels were measured using ELISA and correlated with the degree of fibrosis. Furthermore, the OPN values were correlated and evaluated with platelets count, serum hyaluronic acid (HA), and collagen type IV and subjected to receiver operating characteristic (ROC) curve analysis. Results Serum OPN levels were remarkably increased from F0 through F4 in a progressive manner and the differences were significant (P < 0.001) between each group. The data were highly correlated with the degree of hepatic fibrosis. The ROC curve analysis depicted that serum OPN is an independent risk factor and an excellent biomarker and a prognostic index in HCV patients. Conclusions The results of the present study indicate that serum OPN levels reflect the degree of hepatic fibrosis and could be used as a biomarker to assess the stage of fibrosis in HCV patients which would help to reduce the number of liver biopsies. Furthermore, serum OPN serves as a prognostic index towards the progression of hepatic fibrosis to cirrhosis and hepatocellular carcinoma. PMID:25760884

  7. When hope makes us vulnerable: a discussion of patient-healthcare provider interactions in the context of hope.

    PubMed

    Simpson, Christy

    2004-09-01

    When hope is discussed in bioethics' literature, it is most often in the context of 'false hopes' and/or how to maintain hope while breaking bad news to patients. Little or no time is generally devoted to the description of hope that supports these analyses. In this paper, I present a detailed description of hope, one designed primarily for the healthcare context. Noting that hope is an emotional attitude, four key aspects are explored. In particular, the function of imagination in hope is discussed in depth. Through an examination of the relationship between hope and vulnerability, I demonstrate how adequately describing hope can broaden the normative inquiry into the role of hope in healthcare. Three ways in which persons with hope can be vulnerable are illustrated, and the challenge of how healthcare providers can attend in moral ways to the hopes of patients is identified.

  8. [Panaceas disseminated over the Internet and vulnerable patients: how to check a market of illusions?].

    PubMed

    Vasconcellos-Silva, Paulo R; Castiel, Luis David; Bagrichevsky, Marcos; Griep, Rosane Harter

    2011-06-01

    This article discusses the proliferation of medical quackery and fraud appearing and disappearing daily on the Internet. The customers of these scams, made vulnerable by disease or the prospect of death, use the Internet to buy products that would probably be ignored in other contexts. This vulnerability is linked to strenuous physical demands that compromise the ability to make decisions. The attempt to control the phenomenon of fraud as strictly rational, without taking into account the vulnerability of consumers who have little to lose and not considering their demands for comprehensive care, can lead to disappointing results, since these nostrums seem to be filling the gaps left by health care structures that have been insensitive to the immaterial nature of human fears.

  9. Current and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs

    PubMed Central

    Eibner, Christine; Krull, Heather; Brown, Kristine M.; Cefalu, Matthew; Mulcahy, Andrew W.; Pollard, Michael; Shetty, Kanaka; Adamson, David M.; Amaral, Ernesto F. L.; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii; Mendelsohn, Joshua; Ross, Rachel; Rutter, Carolyn M.; Weinick, Robin M.; Woods, Dulani; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next decade, and the demographic mix and geographic locations of these veterans will change. While the number of veterans using VA health care has increased over time, demand will level off in the coming years. Veterans have more favorable economic circumstances than non-veterans, but they are also older and more likely to be diagnosed with many health conditions. Not all veterans are eligible for or use VA health care. Whether and to what extent an eligible veteran uses VA health care depends on a number of factors, including access to other sources of health care. Veterans who rely on VA health care are older and less healthy than veterans who do not, and the prevalence of costly conditions in this population is projected to increase. Potential changes to VA policy and the context for VA health care, including effects of the Affordable Care Act, could affect demand. Analysis of a range of data sources provided insight into how the veteran population is likely to change in the next decade. PMID:28083423

  10. Relation of microchannel structure identified by optical coherence tomography to plaque vulnerability in patients with coronary artery disease.

    PubMed

    Kitabata, Hironori; Tanaka, Atsushi; Kubo, Takashi; Takarada, Shigeho; Kashiwagi, Manabu; Tsujioka, Hiroto; Ikejima, Hideyuki; Kuroi, Akio; Kataiwa, Hideaki; Ishibashi, Kohei; Komukai, Kenichi; Tanimoto, Takashi; Ino, Yasushi; Hirata, Kumiko; Nakamura, Nobuo; Mizukoshi, Masato; Imanishi, Toshio; Akasaka, Takashi

    2010-06-15

    Increased neovascularization in atherosclerotic plaques is associated with plaque vulnerability. The high resolution of optical coherence tomography (OCT) might provide a chance to directly visualize plaque neovascularization in vivo. The aim of the present study was to investigate the relation between microchannels in culprit plaques identified by OCT and plaque vulnerability in patients with coronary artery disease. A total of 63 consecutive patients with coronary artery disease who had undergone both OCT and intravascular ultrasound before any interventions to examine culprit lesion morphologies were enrolled. Microchannel was defined as a no-signal tubuloluminal structure on the cross-sectional optical coherence tomographic image. Microchannels were found in 24 (38%) of the 63 patients. The patients were divided into 2 groups according to the presence or absence of microchannels. The frequency of plaque rupture tended to be greater in the microchannel group (50% vs 28%, p = 0.11). The thickness of the fibrous cap (median 60 vs 100 microm, p = 0.001) was significantly less in the patients with microchannels, and significant differences were found in the frequency of thin-cap fibroatheroma (54% vs 21%, p = 0.012) and positive remodeling (67% vs 36%, p = 0.02) between the 2 groups. The high-sensitivity C-reactive protein levels in the microchannel group was significantly greater than those in the no-microchannel group (median 0.27 vs 0.13 mg/dl, p = 0.015). Moreover, increased microchannel counts were associated with greater high-sensitivity C-reactive protein levels (p = 0.01). In conclusion, a significant relation was found between the presence of microchannels in plaques identified by OCT and plaque vulnerability in patients with coronary artery disease.

  11. Vulnerable patients going to court: a psychiatrist's guide to special measures

    PubMed Central

    Cooper, Penny; Grace, Janet

    2016-01-01

    There have been significant changes to how vulnerable people are treated in the court system, including the introduction of special measures to support people both as witness and as accused. This paper summarises the use of special measures and their application to people with mental health diagnoses or cognitive impairment. PMID:27512594

  12. Vulnerabilities in Older Patients when Cancer Treatment is Initiated: Does a Cognitive Impairment Impact the Two-Year Survival?

    PubMed Central

    Borghgraef, Cindy; Etienne, Anne-Marie; Merckaert, Isabelle; Paesmans, Marianne; Reynaert, Christine; Roos, Myriam; Slachmuylder, Jean-Louis; Vandenbossche, Sandrine; Bron, Dominique; Razavi, Darius

    2016-01-01

    Introduction Dementia is a known predictor of shorter survival times in older cancer patients. However, no empirical evidence is available to determine how much a cognitive impairment shortens survival in older patients when cancer treatment is initiated. Purpose To longitudinally investigate how much a cognitive impairment detected at the initiation of cancer treatment influences survival of older patients during a two-year follow-up duration and to compare the predictive value of a cognitive impairment on patients survival with the predictive value of other vulnerabilities associated with older age. Methods Three hundred and fifty-seven consecutive patients (≥65 years old) admitted for breast, prostate, or colorectal cancer surgeries were prospectively recruited. A cognitive impairment was assessed with the Montreal Cognitive Assessment (MoCA<26). Socio-demographic, disease-related, and geriatric vulnerabilities were assessed using validated tools. Univariate and subsequent multivariate Cox proportional hazards models stratified for diagnosis (breast/prostate cancer versus colorectal cancer) and disease status (metastatic versus non-metastatic) were used. Results A cognitive impairment was detected in 46% (n = 163) of patients. Survival was significantly influenced by a cognitive impairment (HR = 6.13; 95% confidence interval [CI] = 2.07–18.09; p = 0.001), a loss in instrumental autonomy (IADL ≤7) (HR = 3.06; 95% CI = 1.31–7.11; p = 0.009) and fatigue (Mob-T<5) (HR = 5.98; 95% CI = 2.47–14.44; p <0.001). Conclusions During the two years following cancer treatment initiation, older patients with a cognitive impairment were up to six times more likely to die than patients without. Older patients should be screened for cognitive impairments at cancer treatment initiation to enable interventions to reduce morbidity and mortality. Further studies should address processes underlying the relationship between cognitive impairments and an increased risk of dying

  13. Hippocampal Substructural Vulnerability to Sleep Disturbance and Cognitive Impairment in Patients with Chronic Primary Insomnia: Magnetic Resonance Imaging Morphometry

    PubMed Central

    Joo, Eun Yeon; Kim, Hosung; Suh, Sooyeon; Hong, Seung Bong

    2014-01-01

    Study Objectives: Despite compelling evidence from animal studies indicating hippocampal subfield-specific vulnerability to poor sleep quality and related cognitive impairment, there have been no human magnetic resonance imaging (MRI) studies investigating the relationship between hippocampal subfield volume and sleep disturbance. Our aim was to investigate the pattern of volume changes across hippocampal subfields in patients with primary insomnia relative to controls. Design: Pointwise morphometry allowed for volume measurements of hippocampal regions on T1-weighted MRI. Setting: University hospital. Patients: Twenty-seven unmedicated patients (age: 51.2 ± 9.6 y) and 30 good sleepers as controls (50.4 ± 7.1 y). Interventions: N/A. Measurements: We compared hippocampal subfield volumes between patients and controls and correlated volume with clinical and neuropsychological features in patients. Results: Patients exhibited bilateral atrophy across all hippocampal subfields (P < 0.05 corrected). Cornu ammonis (CA) 1 subfield atrophy was associated with worse sleep quality (higher Pittsburgh Sleep Quality Index and higher arousal index of polysomnography) (r < -0.45, P < 0.005). The volume of the combined region, including the dentate gyrus (DG) and CA3-4, negatively correlated with verbal memory, verbal information processing, and verbal fluency in patients (|r| > 0.45, P < 0.05). Hemispheric volume asymmetry of this region (left smaller than right) was associated with impaired verbal domain functions (r = 0.50, P < 0.005). Conclusion: Hippocampal subfield atrophy in chronic insomnia suggests reduced neurogenesis in the dentate gyrus (DG) and neuronal loss in the cornu ammonis (CA) subfields in conditions of sleep fragmentation and related chronic stress condition. Atrophy in the CA3-4-DG region was associated with impaired cognitive functions in patients. These observations may provide insight into pathophysiological mechanisms that make patients with chronic

  14. Circulating CD36 and fractalkine levels are associated with vulnerable plaque progression in patients with unstable angina pectoris.

    PubMed

    Li, Rui Jian; Yang, Ming; Li, Ji Fu; Xue, Li; Chen, Yu Guo; Chen, Wen Qiang

    2014-11-01

    The chemokine, fractalkine, independently enhances the vulnerability of coronary atherosclerotic plaques. The present study investigated the combined effects of CD36 and fractalkine on coronary plaque progression in patients with unstable angina pectoris. In the present study, 120 unstable angina pectoris patients undergoing coronary angiography and intravascular ultrasound were divided into two groups: an intermediate lesion group (lumen diameter stenosis 50-70%, 80 patients) and a severe lesion group (at least one lesion with lumen diameter stenosis > 70%, 40 patients). The control group consisted of 40 healthy age- and sex-matched subjects. Concentrations of CD36 and fractalkine were measured by enzyme-linked immunosorbent assay. Major adverse cardiovascular events were monitored over a 2-year follow up. Intravascular ultrasound showed that patients with severe lesions had more calcified and mixed plaques, and a larger plaque area and plaque burden than patients with intermediate lesions (P < 0.05-0.01). More patients with severe lesions underwent stent deployment (P < 0.05) than those with intermediate lesions. CD36 and fractalkine concentrations were significantly higher in the severe lesion patients (P < 0.05), and both had significant positive correlations (P < 0.05) with the plaque burden of atherosclerotic lesions. Using the matched nested case-control study, we found that CD36 and fractalkine levels were higher in patients with recurrent major adverse cardiovascular events than controls (P < 0.05). In conclusion, CD36 and fractalkine both promote, and might synergistically enhance, the progression of coronary atherosclerotic plaques.

  15. Perfectionism dimensions and dependency in relation to personality vulnerability and psychosocial adjustment in patients with coronary artery disease.

    PubMed

    Dunkley, David M; Schwartzman, Deborah; Looper, Karl J; Sigal, John J; Pierre, Andrena; Kotowycz, Mark A

    2012-06-01

    The present study sought to illuminate self-criticism and personal standards dimensions of perfectionism and dependency as specific cognitive-personality vulnerability factors that might contribute to a better understanding of numerous psychosocial problem areas that are relevant to coronary artery disease (CAD). One hundred and twenty-three patients diagnosed with clinically significant CAD completed self-report questionnaires. Zero-order correlations and factor analysis results revealed that self-criticism was primarily related to personality vulnerability (aggression/anger/hostility, Type D negative affectivity) and psychosocial maladjustment (depressive symptoms, worry, avoidant coping, support dissatisfaction), whereas personal standards was primarily related to adaptive coping (problem-focused coping, positive reinterpretation) and dependency was primarily related to worry. Hierarchical regression results demonstrated the incremental utility of self-criticism, personal standards, and dependency in relation to (mal)adjustment over and above aggression/anger/hostility, negative affectivity, and social inhibition. Continued efforts to understand the role of perfectionism dimensions and dependency in CAD appear warranted.

  16. Post-traumatic Vertical Gaze Paresis in Nine Patients: Special Vulnerability of the Artery of Percheron in Trauma?

    PubMed Central

    Galvez-Ruiz, Alberto

    2015-01-01

    Purpose: The purpose was to present a case series of vertical gaze paresis in patients with a history of cranioencephalic trauma (CET). Methods: The clinical characteristics and management are presented of nine patients with a history of CET secondary to motor vehicle accidents with associated vertical gaze paresis. Results: Neuroimaging studies indicated posttraumatic contusion of the thalamic-mesencephalic region in all nine patients who corresponded to the artery of Percheron region; four patients had signs of hemorrhagic transformation. Vertical gaze paresis was present in all patients, ranging from complete paralysis of the upward and downward gaze to a slight limitation of upward gaze. Discussion: Posttraumatic vertical gaze paresis is a rare phenomenon that can occur in isolation or in association with other neurological deficits and can cause a significant limitation in the quality-of-life. Studies in the literature have postulated that the unique anatomy of the angle of penetration of the thalamoperforating and lenticulostriate arteries makes these vessels more vulnerable to isolated selective damage in certain individuals and can cause-specific patterns of CET. PMID:26180479

  17. Drip-and-Ship Thrombolytic Therapy Supported by the Telestroke System for Acute Ischemic Stroke Patients Living in Medically Under-served Areas

    PubMed Central

    KAGEJI, Teruyoshi; OBATA, Fumiaki; OKA, Hirofumi; KANEMATSU, Yasuhisa; TABATA, Ryo; TANI, Kenji; BANDO, Hiroyasu; NAGAHIRO, Shinji

    2016-01-01

    There are a few stroke specialists in medically under-served areas in Japan. Consequently, in remote area patients may not receive thrombolysis with intravenous recombinant tissue plasminogen activator (iv rt-PA), the standard treatment for acute ischemic stroke. Using a mobile telestroke support system (TSS) that accesses the internet via a smart phone, we implemented iv rt-PA infusion therapy under a drip-and-ship protocol to treat the stroke patients in medically under-served areas. The physicians at the Tokushima Prefectural Kaifu Hospital (TPKH), located in rural Japan, can relay CT or MRI scans and other patient data via their smart phone to off-site stroke specialists. In the course of 34 months, we used the TSS in 321 emergencies. A total of 9 of 188 (4.8%) with acute ischemic stroke, received iv rt-PA infusion therapy using a mobile TSS; in 5 among these (55.6%), we obtained partial or complete recanalization of occluded arteries. None suffered post-treatment hemorrhage and their average NIH stroke score fell from 14.6 at the time of admission to 6.8 at 24 h post-infusion. The drip-and-ship protocol contributed to the safe and effective treatment of the stroke patients living in medically under-served rural areas. PMID:27333939

  18. Consenting of the vulnerable: the informed consent procedure in advanced cancer patients in Mexico

    PubMed Central

    Verástegui, Emma L

    2006-01-01

    Background A topic of great concern in bioethics is the medical research conducted in poor countries sponsored by wealthy nations. Western drug companies increasingly view Latin America as a proper place for clinical research trials. The region combines a large population, modern medical facilities, and low per capita incomes. Participants from developing countries may have little or non alternative means of treatment other than that offered through clinical trials. Therefore, the provision of a valid informed consent is important. Methods To gain insight about some aspects of the informed consent procedure in a major cancer centre in Mexico, we conducted a three-step evaluation process: 1) a ten point multiple choice survey questionnaires, was used to explore some aspects of the patients' experiences during the informed consent process, 2) researchers' knowledge about specific aspects of the informed consent was evaluated in this study using survey questionnaires; and 3) the comprehensibility, readability and number of pages of the consent forms were analysed. The socioeconomic and educational level of the patients, were also considered. Results were reported using a numerical scale. Results Thirty five patients, 20 doctors, and 10 individuals working at the hospital agreed to participate in the study. Eighty three percent of the patients in the study were classified as living in poverty; education level was poor or non existent, and 31% of the patients were illiterate. The consent forms were difficult to understand according to 49% of the patients, most doctors agreed that the forms were not comprehensible to the patients. The average length of the IC documents analysed was 14 pages, and the readability average score was equivalent to 8TH Grade. Conclusion The results presented in this work describe some relevant characteristics of the population seen at public health care institutions in Mexico. Poverty, limited or no education, and the complexity of the

  19. Vulnerable populations: considerations for wound care.

    PubMed

    Pieper, Barbara

    2009-05-01

    Race/ethnicity, immigration, health insurance, and literacy--along with patient-provider communication and understanding of and adherence to treatment protocols--are societal factors that affect the provision of optimal healthcare. Wound care practitioners should be aware of the need to address these factors in vulnerable groups, including the effects of racial/ethnic care disparities, immigration, low income, uninsured or underinsured status, and literacy/health literacy on health and wound care. The literature shows that care is not always perceived to be or equitably provided across different ethnic and economically diverse populations. Hence, clinicians must strive to listen to and interact non-judgmentally with vulnerable patients. Each patient's physical and psychosocial concerns must be assessed without malice and clinicians must work with community, state, and federal agencies to enhance access to necessary services. Wound care patient teaching materials need to be developed that consider the literacy and language skills of the community served. Once the type of wound and its appropriate treatment are determined, wound care practitioners must consider patient teaching, vulnerability, cultural, and economic constraints of care, along with strategies for prevention of complications and hospitalizations.

  20. Stroop and emotional Stroop interference in unaffected relatives of patients with schizophrenic and bipolar disorders: distinct markers of vulnerability?

    PubMed

    Besnier, Nathalie; Richard, Floriane; Zendjidjian, Xavier; Kaladjian, Arthur; Mazzola-Pomietto, Pascale; Adida, Marc; Azorin, Jean-Michel

    2009-01-01

    Reduced inhibition has been demonstrated in both schizophrenic and bipolar patients through the findings of increased interference on the Stroop Colour-Word Task (SCWT) and increased emotional interference on specific versions of the Emotional Stroop Task (EST). Despite previous findings of enhanced interference in unaffected relatives of schizophrenic and bipolar patients, it remains unclear whether interference might be a candidate endophenotype to both disorders. Moreover, data regarding emotional interference in unaffected relatives are critically lacking. In the present study, we aimed to compare unaffected relatives of patients with schizophrenia (SZ-rel, N = 30) and bipolar disorder (BD-rel, N= 30) with normal controls (N = 60) when performing the SCWT and an EST designed with neutral, depressive, paranoid and manic words. SZ-rel exhibited greater interference effect on both the SCWT and the EST as compared to either BD-rel or normal controls. BD-rel, and by contrast to SZ-rel and controls, showed increased emotional interference effect on the EST that was specifically associated to the disease-related words. The findings support the hypothesis of different markers of vulnerability to schizophrenic and bipolar disorders; impairment in cognitive inhibition could characterize high-risk individuals for schizophrenia whereas an emotional bias towards mood-related information could be a trait marker of bipolar disease.

  1. How practice contributes to trolley food waste. A qualitative study among staff involved in serving meals to hospital patients.

    PubMed

    Ofei, K T; Holst, M; Rasmussen, H H; Mikkelsen, B E

    2014-12-01

    This study investigated the generation of trolley food waste at the ward level in a hospital in order to provide recommendations for how practice could be changed to reduce food waste. Three separate focus group discussions were held with four nurses, four dietitians and four service assistants engaged in food service. Furthermore, single qualitative interviews were conducted with a nurse, a dietitian and two service assistants. Observations of procedures around trolley food serving were carried out during lunch and supper for a total of 10 weekdays in two different wards. All unserved food items discarded as waste were weighed after each service. Analysis of interview and observation data revealed five key themes. The findings indicate that trolley food waste generation is a practice embedded within the limitations related to the procedures of meal ordering. This includes portion size choices and delivery, communication, tools for menu information, portioning and monitoring of food waste, as well as the use of unserved food. Considering positive changes to these can be a way forward to develop strategies to reduce trolley food waste at the ward level.

  2. Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients.

    PubMed

    Morris, Timothy A; Gay, Peter C; MacIntyre, Neil R; Hess, Dean R; Hanneman, Sandra K; Lamberti, James P; Doherty, Dennis E; Chang, Lydia; Seckel, Maureen A

    2017-04-01

    Acute respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Identifying patients at risk for respiratory compromise coupled with monitoring of patients who have developed respiratory compromise might allow earlier interventions to prevent or mitigate further decompensation. The National Association for the Medical Direction of Respiratory Care (NAMDRC) organized a workshop meeting with representation from many national societies to address the unmet needs of respiratory compromise from a clinical practice perspective. Respiratory compromise may arise de novo or may complicate preexisting lung disease. The group identified distinct subsets of respiratory compromise that present similar opportunities for early detection and useful intervention to prevent respiratory failure. The subtypes were characterized by the pathophysiological mechanisms they had in common: impaired control of breathing, impaired airway protection, parenchymal lung disease, increased airway resistance, hydrostatic pulmonary edema, and right-ventricular failure. Classification of acutely ill respiratory patients into one or more of these categories may help in selecting the screening and monitoring strategies that are most appropriate for the patient's particular pathophysiology. Standardized screening and monitoring practices for patients with similar mechanisms of deterioration may enhance the ability to predict respiratory failure early and prevent its occurrence.

  3. 42 CFR 412.106 - Special treatment: Hospitals that serve a disproportionate share of low-income patients.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-income patients. (a) General considerations. (1) The factors considered in determining whether a hospital... within 24 hours for 30 consecutive days. (iii) The hospital's location, in an urban or rural area, is... an urban hospital reclassified as rural as set forth in § 412.103 is classified as rural. (2)...

  4. Guidelines for Libraries Serving Hospital Patients and Disabled People in the Community. IFLA Professional Reports, No. 2.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    These guidelines are based on the experiences of a number of librarians working in the area of library services for hospital patients and disabled people in the community, as well as work done previously by a number of national library associations. The guidelines indicate the essential features of services to disabled people and suggest…

  5. Fleshing out vulnerability.

    PubMed

    Tavaglione, Nicolas; Martin, Angela K; Mezger, Nathalie; Durieux-Paillard, Sophie; François, Anne; Jackson, Yves; Hurst, Samia A

    2015-02-01

    In the literature on medical ethics, it is generally admitted that vulnerable persons or groups deserve special attention, care or protection. One can define vulnerable persons as those having a greater likelihood of being wronged - that is, of being denied adequate satisfaction of certain legitimate claims. The conjunction of these two points entails what we call the Special Protection Thesis. It asserts that persons with a greater likelihood of being denied adequate satisfaction of their legitimate claims deserve special attention, care or protection. Such a thesis remains vague, however, as long as we do not know what legitimate claims are. This article aims at dispelling this vagueness by exploring what claims we have in relation to health care - thus fleshing out a claim-based conception of vulnerability. We argue that the Special Protection Thesis must be enriched as follows: If individual or group X has a greater likelihood of being denied adequate satisfaction of some of their legitimate claims to (i) physical integrity, (ii) autonomy, (iii) freedom, (iv) social provision, (v) impartial quality of government, (vi) social bases of self-respect or (vii) communal belonging, then X deserves special attention, care or protection. With this improved understanding of vulnerability, vulnerability talk in healthcare ethics can escape vagueness and serve as an adequate basis for practice.

  6. Urinary Macrophage Migration Inhibitory Factor Serves as a Potential Biomarker for Acute Kidney Injury in Patients with Acute Pyelonephritis

    PubMed Central

    Hong, Ming-Yuan; Tseng, Chin-Chung; Chuang, Chia-Chang; Chen, Chia-Ling; Lin, Sheng-Hsiang; Lin, Chiou-Feng

    2012-01-01

    Conventional markers of kidney function that are familiar to clinicians, including the serum creatinine and blood urea nitrogen levels, are unable to reveal genuine injury to the kidney, and their use may delay treatment. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine, and the predictive role and pathogenic mechanism of MIF deregulation during kidney infections involving acute kidney injury (AKI) are not currently known. In this study, we showed that elevated urinary MIF levels accompanied the development of AKI during kidney infection in patients with acute pyelonephritis (APN). In addition to the MIF level, the urinary levels of interleukin (IL)-1β and kidney injury molecule (KIM)-1 were also upregulated and were positively correlated with the levels of urinary MIF. An elevated urinary MIF level, along with elevated IL-1β and KIM-1 levels, is speculated to be a potential biomarker for the presence of AKI in APN patients. PMID:23319831

  7. Carbapenem-resistant Enterobacteriaceae: A menace to our most vulnerable patients

    PubMed Central

    PEREZ, FEDERICO; VAN DUIN, DAVID

    2014-01-01

    The emergence of carbapenem-resistant Enterobacteriaceae (CRE) highlights the importance of effective antibiotics to maintain the safety of our health care system. Clinicians will encounter CRE as a cause of difficult-to-treat and often fatal infections in hospitalized patients. We review the mechanisms of carbapenem resistance, the dissemination and clinical impact of these resistant organisms, and challenges to their detection, treatment, and control. PMID:23547093

  8. Could gut microbiota serve as prognostic biomarker associated with colorectal cancer patients' survival? A pilot study on relevant mechanism

    PubMed Central

    Wei, Zhiliang; Cao, Shougen; Liu, Shanglong; Yao, Zengwu; Sun, Teng; Li, Yi; Li, Jiante; Zhang, Dongfeng; Zhou, Yanbing

    2016-01-01

    Evidences have shown that dysbiosis could promote the progression of colorectal cancer (CRC). However, the association of dysbiosis and prognosis of CRC is barely investigated. Therefore, we used 16S rRNA gene sequencing approach to determine differences in microbiota among tumor tissues of different prognosis and found that Fusobacterium nucleatum and Bacteroides fragilis were more abundant in worse prognosis groups, while Faecalibacterium prausnitzii displayed higher abundance in survival group. To further explore the prognostic value of the found bacteria, Kaplan–Meier and Cox proportional regression analyses were used and the results exhibited that high abundance of F. nucleatum and B. fragilis were independent indicators of poor patient's survival. Besides, the expression of major inflammatory mediator were analyzed using PCR and western blot methods, and it turned out that high abundance of F. nucleatum was associated with increased expression of TNF-α, β-catenin and NF-κB, while COX-2, MMP-9 and NF-κB were positively related with high B. fragilis level, and high level of F. prausnitzii showed lower expression of β-catenin, MMP-9 and NF-κB. Moreover, immunohistochemical analysis indicated that KRAS and BRAF expression were prominent in F. nucleatum and B. fragilis high abundance group, while MLH1 showed lower expression. In conclusion, F. nucleatum, B. fragilis and F. prausnitzii can be identified as useful prognostic biomarkers for CRC, and dysbiosis might worsen the patients' prognosis by up-regulating gut inflammation level. PMID:27323816

  9. Vulnerability of white matter to insult during childhood: evidence from patients treated for medulloblastoma.

    PubMed

    Moxon-Emre, Iska; Bouffet, Eric; Taylor, Michael D; Laperriere, Normand; Sharpe, Michael B; Laughlin, Suzanne; Bartels, Ute; Scantlebury, Nadia; Law, Nicole; Malkin, David; Skocic, Jovanka; Richard, Logan; Mabbott, Donald J

    2016-07-01

    OBJECTIVE Craniospinal irradiation damages the white matter in children treated for medulloblastoma, but the treatment-intensity effects are unclear. In a cross-sectional retrospective study, the effects of treatment with the least intensive radiation protocol versus protocols that delivered more radiation to the brain, in addition to the effects of continuous radiation dose, on white matter architecture were evaluated. METHODS Diffusion tensor imaging was used to assess fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity. First, regional white matter analyses and tract-based spatial statistics were conducted in 34 medulloblastoma patients and 38 healthy controls. Patients were stratified according to those treated with 1) the least intensive radiation protocol, specifically reduced-dose craniospinal irradiation plus a boost to the tumor bed only (n = 17), or 2) any other dose and boost combination that delivered more radiation to the brain, which was also termed the "all-other-treatments" group (n = 17), and comprised patients treated with standard-dose craniospinal irradiation plus a posterior fossa boost, standard-dose craniospinal irradiation plus a tumor bed boost, or reduced-dose craniospinal irradiation plus a posterior fossa boost. Second, voxel-wise dose-distribution analyses were conducted on a separate cohort of medulloblastoma patients (n = 15). RESULTS The all-other-treatments group, but not the reduced-dose craniospinal irradiation plus tumor bed group, had lower fractional anisotropy and higher radial diffusivity than controls in all brain regions (all p < 0.05). The reduced-dose craniospinal irradiation plus tumor bed boost group had higher fractional anisotropy (p = 0.05) and lower radial diffusivity (p = 0.04) in the temporal region, and higher fractional anisotropy in the frontal region (p = 0.04), than the all-other-treatments group. Linear mixed-effects modeling revealed that the dose and age at diagnosis together

  10. Can hydroxyurea serve as a free radical scavenger and reduce iron overload in β-thalassemia patients?

    PubMed

    Italia, Khushnooma; Chandrakala, S; Ghosh, Kanjaksha; Colah, Roshan

    2016-09-01

    In this study, we hypothesize that hydroxyurea could provide an additional benefit as a free radical scavenger and/or iron chelator in β-thalassemia patients with iron overload. Twenty-one β-thalassemia intermedia patients who presented between 3 and 17 years but later required regular blood transfusions were enrolled for hydroxyurea therapy for a year. Fourteen patients responded to the therapy with hemoglobin levels maintained above 7.5 g/dl without transfusions. Hydroxyurea was discontinued after 6 months in seven patients who did not respond to the therapy and had to be continued on regular blood transfusions. We observed a statistically significant decrease in serum ferritin levels from 4194 ± 4850 ng/ml to 2129 ± 2380 ng/ml among the responders and from 2955 ± 2909 ng/ml to 2040 ± 2432 ng/ml among the non-responders and statistically significant decrease in labile iron pool from 18678.7 ± 10067.4 mean fluorescence intensity (MFI) to 14888.5 ± 5284.0 MFI among responders and from 17986.3 ± 9079.8 MFI to 15634.8 ± 8976.9 MFI among the non-responders after therapy. Phosphatidylserine externalization also showed a statistically significant decrease from 44.2 ± 22.2 MFI to 16.6 ± 6.7 MFI among the responders and from 46.9 ± 33.1 MFI to 39.8 ± 7.4 MFI among the non-responders along with a statistically significant decrease in the levels of reactive oxygen species from 72.8 ± 35.5 MFI to 29.0 ± 8.3 MFI among the responders and from 80.9 ± 41.4 MFI to 40.5 ± 15.8 MFI among the non-responders after therapy. A statistically significant increase in reduced glutathione levels was also observed from 430.8 ± 201.1 MFI to 715.5 ± 292.4 MFI among the responders and from 359.6 ± 165.6 MFI to 450.3 ± 279.5 MFI among the non-responders after therapy. This suggests the possible additional role of hydroxyurea as a free radical scavenger and

  11. Vulnerability of Purkinje Cells Generated from Spinocerebellar Ataxia Type 6 Patient-Derived iPSCs.

    PubMed

    Ishida, Yoshihito; Kawakami, Hideshi; Kitajima, Hiroyuki; Nishiyama, Ayaka; Sasai, Yoshiki; Inoue, Haruhisa; Muguruma, Keiko

    2016-11-01

    Spinocerebellar ataxia type 6 (SCA6) is a dominantly inherited neurodegenerative disease characterized by loss of Purkinje cells in the cerebellum. SCA6 is caused by CAG trinucleotide repeat expansion in CACNA1A, which encodes Cav2.1, α1A subunit of P/Q-type calcium channel. However, the pathogenic mechanism and effective therapeutic treatments are still unknown. Here, we have succeeded in generating differentiated Purkinje cells that carry patient genes by combining disease-specific iPSCs and self-organizing culture technologies. Patient-derived Purkinje cells exhibit increased levels of full-length Cav2.1 protein but decreased levels of its C-terminal fragment and downregulation of the transcriptional targets TAF1 and BTG1. We further demonstrate that SCA6 Purkinje cells exhibit thyroid hormone depletion-dependent degeneration, which can be suppressed by two compounds, thyroid releasing hormone and Riluzole. Thus, we have constructed an in vitro disease model recapitulating both ontogenesis and pathogenesis. This model may be useful for pathogenic investigation and drug screening.

  12. Executive (Dys)Functioning and Impulsivity as Possible Vulnerability Factors for Aggression in Forensic Patients.

    PubMed

    Tonnaer, Franca; Cima, Maaike; Arntz, Arnoud

    2016-04-01

    This study investigated whether executive dysfunction and impulsivity are both predictors of reactive aggression and is the first to use behavioral assessment of aggression in response to provocation by means of a personalized boxing body opponent bag giving harassing feedback. Aggressive behavior, self-reported aggression, executive functioning (ie, working memory, flexibility, and divided attention), and impulsivity dimensions (i.e., Sensation Seeking, Impulsive Decision Making, and [inadequate] Response Inhibition) were measured in 44 incarcerated psychiatric patients. Results show that both executive functioning (working memory) and impulsivity (Impulsive Decision Making) predicted self-reported reactive aggression, whereas Response Inhibition was the only predictor for reactive aggressive behavioral responses. The study suggests that Response Inhibition is a stronger predictor of reactive aggressive behavior than executive capacities of working memory, flexibility, and divided attention. Therefore, future research should investigate whether (inadequate) Response Inhibition could also be a valuable predictor for violent recidivism.

  13. Shared networks of interpreter services, at relatively low cost, can help providers serve patients with limited english skills.

    PubMed

    Jacobs, Elizabeth A; Leos, Ginelle Sanchez; Rathouz, Paul J; Fu, Paul

    2011-10-01

    Language barriers in health care-a large and growing problem in the United States-contribute to disparities in health care quality and outcomes in populations with limited English proficiency. Providing access to adequate interpreter services has been shown to reduce health disparities in these populations. However, many health care organizations do not provide such services because of the perceived high cost. In this observational study we calculated the costs incurred by a group of California public hospitals that formed a network to make trained interpreters available via videoconference and telephone. We found that encounters in this network where interpreters helped patients and providers communicate lasted an average of 10.6 minutes and cost an average of $24.86 per encounter. Such costs should be weighed against the likely alternatives, such as the opportunity costs of having other hospital staff act as ad hoc interpreters; medical errors that could result from inadequate interpretation; and the fact that not providing such services may leave providers out of compliance with federal law. We also discuss ways in which providers could be compensated for providing interpreter services.

  14. [Evaluation of professional practices: Implication of hospital pharmacist in improving care for vulnerable patients].

    PubMed

    Bataille, J; Bardo-Brouard, P; Cordonnier-Jourdin, C; Kini-Matondo, W; Simpelaere, S; Astier, A; Paul, M

    2017-03-01

    As drug delivery activity to outpatients in precarious situation is rising continuously, the goal of this work was to perform an assessment of the professional practices of the care pathway of these patients, called PASS in France (permanence d'accès aux soins de santé). At first, two pharmacists did an audit of this care pathway. Then, options for improvement were suggested and established after a multidisciplinary work with pharmacists, physicians and social workers of the relevant services. Finally, after six months, those actions and their impact were evaluated. Over a three-year period, the audit showed an increase by a factor of 1.77 of the average number of prescriptions provided per year. Over the same period, the number of dispensed lines was increased by 2.2 and the annual costs were multiplied per 1.82. The pharmacy department suggested several corrective actions: at first, initiating new schedules suited to the activity; then, making adjustments in the reception zone; but also, establishing two new specific prescriptions and 89 helps cards about the most frequently delivered medications. As a result, the time dedicated to drug delivery has been cut in half while the number of pharmaceutical actions remained constant. This assessment of the professional practices showed how hard it is to formalize a transversal circuit as the PASS in hospital. The actions established had improved the organization and the drug delivery activity in the pharmacy department.

  15. Serving Vulnerable Families: The Important Work of Head Start Programs

    ERIC Educational Resources Information Center

    Vinci, Yasmina

    2012-01-01

    The Obama Administration's most recent regulation on designation renewal of Early/Head Start grantees opens opportunities for early childhood programs in some communities to compete with existing grantees for the federal funding. Understanding some of the behind-the-scenes work that goes into Head Start may be helpful to centers deciding whether…

  16. Isolated tumor cells are frequently detectable in the peritoneal cavity of gastric and colorectal cancer patients and serve as a new prognostic marker.

    PubMed Central

    Schott, A; Vogel, I; Krueger, U; Kalthoff, H; Schreiber, H W; Schmiegel, W; Henne-Bruns, D; Kremer, B; Juhl, H

    1998-01-01

    OBJECTIVE: To evaluate the prognostic significance of isolated tumor cells detected by a panel of various monoclonal antibodies. SUMMARY BACKGROUND DATA: Previously, we showed by using immunocytology that cancer cells are frequently found in bone marrow and peritoneal cavity samples of gastrointestinal cancer patients. METHODS: Findings in bone marrow and peritoneal cavity samples were compared and correlated with the 4-year survival rate of 84 gastric and 109 colorectal patients with cancer. RESULTS: Although positive results in the bone marrow showed little prognostic significance, the peritoneal cavity results correlated with the 4-year survival rate (gastric cancer: p = 0.0038; colorectal cancer: p = 0.0079). Additionally, in subgroups of patients with early (gastric cancer: p = 0.02, colorectal cancer: p = 0.48) and advanced (gastric cancer: p = 0.02, colorectal cancer: p < 0.0001) tumor stages, a correlation of immunocytologic findings and the survival rate was seen. CONCLUSIONS: The detection of minimal residual disease in the peritoneal cavity serves as a new prognostic marker. Images Figure 5. PMID:9527060

  17. A Helpful Serving

    ERIC Educational Resources Information Center

    Rockower, David

    2006-01-01

    This article briefly describes how a fifth-grade class collaborated with a downtown diner for several months and then actually ran the restaurant for four hours. Through the Chatters Cafe, a local high school cafe that serves as a culinary arts training ground for high school students, fifth graders had the opportunity to prepare and serve dinner…

  18. Elevated hemoglobin A1c Is Associated with Carotid Plaque Vulnerability: Novel Findings from Magnetic Resonance Imaging Study in Hypertensive Stroke Patients

    PubMed Central

    Sun, Beibei; Zhao, Huilin; Liu, Xiaosheng; Lu, Qing; Zhao, Xihai; Pu, Jun; Xu, Jianrong

    2016-01-01

    The association between hemoglobin A1c (HbA1c) level and carotid plaque vulnerability has been rarely studied by magnetic resonance imaging (MRI). The present study of MRI-identified carotid atherosclerotic lesions in hypertensive patients with acute stroke therefore sought to determine the associations between HbA1c level and plaque morphological and compositional characteristics and acute cerebral infarction (ACI) severity. Eighty hypertensive patients with acute stroke were enrolled; stratified into high (≥6.5%) and low (<6.5%) HbA1c groups; and underwent carotid and brain MRI to assess carotid plaque features and ACI volume in the region supplied by the internal carotid artery (ICA) in the symptomatic side. Plaque burden [percent wall volume (PWV), max wall thickness (max-WT)] and lipid-rich necrotic core (LRNC) were larger in the high as compared to the low HbA1c group. High HbA1c was an independent risk factor for the presence of plaque (odds ratio [OR] = 3.71) and LRNC plaque (OR = 7.08). HbA1c independently correlated with ACI severity among patients with ICA region cerebral infarction and carotid plaque. Our study suggested that an elevated HbA1c may have an adverse effect on carotid plaque vulnerability especially those with larger LRNC volumes in hypertensive stroke patients, which might exacerbate the severity of ACIs. PMID:27629481

  19. The importance of negative predictive value (NPV) of vulnerable elderly survey (VES 13) as a pre-screening test in older patients with cancer.

    PubMed

    Castagneto, B; Di Pietrantonj, C; Stevani, I; Anfossi, A; Arzese, M; Giorcelli, L; Giaretto, L

    2013-12-01

    The importance of prognostic value of the comprehensive geriatric assessment (CGA) is well known in geriatric oncology, but there is no consensus on the use of alternative abbreviated screening methods for the evaluation of older patient disabilities. The participants in this study underwent vulnerable elderly survey 13 (VES 13) at first entry in Oncology Department and were later assessed by a geriatrician according to CGA. A score >3 for VES 13 identified patients as vulnerable. Aim of this study was to evaluate the specificity, sensibility, positive predictive value (PPV), and negative predictive value (NPV) of VES 13 versus cumulative illness rating scale (CIRS), activities of daily living (ADL), instrumental activities of daily living (IADL), and short portable mental status questionnaire (SPMSQ). Hundred and seventeen patients (mean age 78.8 years) entered the study. The NPV of VES was 74.6% for CIRS, 90.1% for IADL, 93.0% for ADL, and 100% for SPMSQ. As for PPV, the VES 13 showed no accuracy. We can conclude that VES 13 demonstrated sufficient accuracy as a screening test in identifying elderly "fit" patients in order to spare the more time-consuming CGA.

  20. H19 serves as a diagnostic biomarker and up-regulation of H19 expression contributes to poor prognosis in patients with gastric cancer.

    PubMed

    Chen, J S; Wang, Y F; Zhang, X Q; Lv, J M; Li, Y; Liu, X X; Xu, T P

    2016-01-01

    Emerging evidences indicate that dysregulated long noncoding RNAs (lncRNAs) are implicated in cancer tumorigenesis and progression and might be used as diagnosis and prognosis biomarker, or potential therapeutic targets. LncRNA H19 has been reported to be upregulated in diverse human cancers; however, its clinical significance in gastric cancer (GC) remains elusive. Expression levels of H19 in 128 pairs of GC and adjacent normal tissues, GC cell lines and GC juices compared to their corresponding controls were detected by real-time quantitative polymerase chain reaction (qPCR) assay. A receiver operating characteristic (ROC) curve and Kaplan-Meier analysis were constructed to evaluate the diagnostic and prognostic values. Univariate and multivariate analysis were performed using the Cox proportional hazard analysis. H19 expression was remarkably increased in GC tissues and cell lines compared with that in the normal control, and its up-regulation was significantly correlated to invasion depth (P < 0.001), advanced TNM stage (P = 0.002) and regional lymph nodes metastasis (P < 0.001) in GC. H19 levels were robust in differentiating GC tissues from controls [area under the curve (AUC) = 0.697; 95% confidence interval (CI) = 0.636-0.752, p<0.01]. Kaplan-Meier analysis demonstrated that increased H19 expression contributed to poor overall survival (P = 0.017) and disease-free survival (P = 0.024) of patients. A multivariate survival analysis also indicated that H19 could be an independent prognostic marker. The levels of H19 in gastric juice from gastric patients were significantly higher than those from normal subjects (P = 0.034). Furthermore, knockdown of H19 expression by siRNA could inhibit cell migration and invasion in GC cells partly via regulating E-cadherin protein expression. H19 might serve as a promising biomarker for early detection and prognosis prediction of GC.

  1. Vulnerability Evaluation Framework

    EPA Pesticide Factsheets

    View the Vulnerability Evaluation Framework, which provides policy-makers, stakeholders, industry, and the public with a transparent framework to evaluate vulnerabilities associated with geologic sequestration sites.

  2. Electricity Serves Our Community.

    ERIC Educational Resources Information Center

    Rakow, Steven J., Ed.

    1992-01-01

    Features a color poster entitled "Electricity Serves Our Community" and describes how the poster can be used to help teach about energy, electricity concepts, and types of electrical generation. Explains how teachers can obtain other resources such as posters, lesson plans, and kits from the National Energy Foundation. (PR)

  3. Serving the Undocumented

    ERIC Educational Resources Information Center

    Pluviose, David

    2007-01-01

    Undocumented immigrant students in California are eligible to receive only private scholarships that "[aren't] enough to support a very expensive education," says CCLC CEO Scott Lay. Dr. Gerardo E. de los Santos, CEO of the League for Innovation in the Community College, calls "serving the undocumented" one of the major…

  4. Software Vulnerability Taxonomy Consolidation

    SciTech Connect

    Polepeddi, Sriram S.

    2004-12-07

    In today's environment, computers and networks are increasing exposed to a number of software vulnerabilities. Information about these vulnerabilities is collected and disseminated via various large publicly available databases such as BugTraq, OSVDB and ICAT. Each of these databases, individually, do not cover all aspects of a vulnerability and lack a standard format among them, making it difficult for end-users to easily compare various vulnerabilities. A central database of vulnerabilities has not been available until today for a number of reasons, such as the non-uniform methods by which current vulnerability database providers receive information, disagreement over which features of a particular vulnerability are important and how best to present them, and the non-utility of the information presented in many databases. The goal of this software vulnerability taxonomy consolidation project is to address the need for a universally accepted vulnerability taxonomy that classifies vulnerabilities in an unambiguous manner. A consolidated vulnerability database (CVDB) was implemented that coalesces and organizes vulnerability data from disparate data sources. Based on the work done in this paper, there is strong evidence that a consolidated taxonomy encompassing and organizing all relevant data can be achieved. However, three primary obstacles remain: lack of referencing a common ''primary key'', un-structured and free-form descriptions of necessary vulnerability data, and lack of data on all aspects of a vulnerability. This work has only considered data that can be unambiguously extracted from various data sources by straightforward parsers. It is felt that even with the use of more advanced, information mining tools, which can wade through the sea of unstructured vulnerability data, this current integration methodology would still provide repeatable, unambiguous, and exhaustive results. Though the goal of coalescing all available data, which would be of use to

  5. Modeling Coastal Vulnerability through Space and Time.

    PubMed

    Hopper, Thomas; Meixler, Marcia S

    2016-01-01

    Coastal ecosystems experience a wide range of stressors including wave forces, storm surge, sea-level rise, and anthropogenic modification and are thus vulnerable to erosion. Urban coastal ecosystems are especially important due to the large populations these limited ecosystems serve. However, few studies have addressed the issue of urban coastal vulnerability at the landscape scale with spatial data that are finely resolved. The purpose of this study was to model and map coastal vulnerability and the role of natural habitats in reducing vulnerability in Jamaica Bay, New York, in terms of nine coastal vulnerability metrics (relief, wave exposure, geomorphology, natural habitats, exposure, exposure with no habitat, habitat role, erodible shoreline, and surge) under past (1609), current (2015), and future (2080) scenarios using InVEST 3.2.0. We analyzed vulnerability results both spatially and across all time periods, by stakeholder (ownership) and by distance to damage from Hurricane Sandy. We found significant differences in vulnerability metrics between past, current and future scenarios for all nine metrics except relief and wave exposure. The marsh islands in the center of the bay are currently vulnerable. In the future, these islands will likely be inundated, placing additional areas of the shoreline increasingly at risk. Significant differences in vulnerability exist between stakeholders; the Breezy Point Cooperative and Gateway National Recreation Area had the largest erodible shoreline segments. Significant correlations exist for all vulnerability (exposure/surge) and storm damage combinations except for exposure and distance to artificial debris. Coastal protective features, ranging from storm surge barriers and levees to natural features (e.g. wetlands), have been promoted to decrease future flood risk to communities in coastal areas around the world. Our methods of combining coastal vulnerability results with additional data and across multiple time

  6. Modeling Coastal Vulnerability through Space and Time

    PubMed Central

    2016-01-01

    Coastal ecosystems experience a wide range of stressors including wave forces, storm surge, sea-level rise, and anthropogenic modification and are thus vulnerable to erosion. Urban coastal ecosystems are especially important due to the large populations these limited ecosystems serve. However, few studies have addressed the issue of urban coastal vulnerability at the landscape scale with spatial data that are finely resolved. The purpose of this study was to model and map coastal vulnerability and the role of natural habitats in reducing vulnerability in Jamaica Bay, New York, in terms of nine coastal vulnerability metrics (relief, wave exposure, geomorphology, natural habitats, exposure, exposure with no habitat, habitat role, erodible shoreline, and surge) under past (1609), current (2015), and future (2080) scenarios using InVEST 3.2.0. We analyzed vulnerability results both spatially and across all time periods, by stakeholder (ownership) and by distance to damage from Hurricane Sandy. We found significant differences in vulnerability metrics between past, current and future scenarios for all nine metrics except relief and wave exposure. The marsh islands in the center of the bay are currently vulnerable. In the future, these islands will likely be inundated, placing additional areas of the shoreline increasingly at risk. Significant differences in vulnerability exist between stakeholders; the Breezy Point Cooperative and Gateway National Recreation Area had the largest erodible shoreline segments. Significant correlations exist for all vulnerability (exposure/surge) and storm damage combinations except for exposure and distance to artificial debris. Coastal protective features, ranging from storm surge barriers and levees to natural features (e.g. wetlands), have been promoted to decrease future flood risk to communities in coastal areas around the world. Our methods of combining coastal vulnerability results with additional data and across multiple time

  7. What Does Vulnerability Mean?

    ERIC Educational Resources Information Center

    Parley, Fiona F

    2011-01-01

    Protection of those deemed vulnerable has received increasing attention since 2000. This article reports on care staff views of vulnerability using original data from a research study (Parley. "Vulnerability and abuse: an exploration of views of care staff working with people who have learning disabilities," PhD Thesis, 2007) in which care staff…

  8. HIV-AIDS Patients' Evaluation of Health Information on the Internet: The Digital Divide and Vulnerability to Fraudulent Claims

    ERIC Educational Resources Information Center

    Benotsch, Eric G.; Kalichman, Seth; Weinhardt, Lance S.

    2004-01-01

    Access to health information on the Internet has revolutionized how medical patients learn about their illnesses. Valuable information can be found online; however, many health Web sites contain inaccurate or misleading information. The authors surveyed 324 adults with HIV concerning their Internet use for obtaining health information. Health…

  9. Genetic Variations of PIP4K2A Confer Vulnerability to Poor Antipsychotic Response in Severely Ill Schizophrenia Patients

    PubMed Central

    Kaur, Harpreet; Jajodia, Ajay; Grover, Sandeep; Baghel, Ruchi; Gupta, Meenal; Jain, Sanjeev; Kukreti, Ritushree

    2014-01-01

    Literature suggests that disease severity and neurotransmitter signaling pathway genes can accurately identify antipsychotic response in schizophrenia patients. However, putative role of signaling molecules has not been tested in schizophrenia patients based on severity of illness, despite its biological plausibility. In the present study we investigated the possible association of polymorphisms from five candidate genes RGS4, SLC6A3, PIP4K2A, BDNF, PI4KA with response to antipsychotic in variably ill schizophrenia patients. Thus in present study, a total 53 SNPs on the basis of previous reports and functional grounds were examined for their association with antipsychotic response in 423 schizophrenia patients segregated into low and high severity groups. Additionally, haplotype, diplotype, multivariate logistic regression and multifactor-dimensionality reduction (MDR) analyses were performed. Furthermore, observed associations were investigated in atypical monotherapy (n = 355) and risperidone (n = 260) treated subgroups. All associations were estimated as odds ratio (OR) and 95% confidence interval (CI) and test for multiple corrections was applied. Single locus analysis showed significant association of nine variants from SLC6A3, PIP4K2A and BDNF genes with incomplete antipsychotic response in schizophrenia patients with high severity. We identified significant association of six marker diplotype ATTGCT/ATTGCT (rs746203-rs10828317-rs7094131-rs2296624-rs11013052-rs1409396) of PIP4K2A gene in incomplete responders (corrected p-value = 0.001; adjusted-OR = 3.19, 95%-CI = 1.46–6.98) with high severity. These associations were further observed in atypical monotherapy and risperidone sub-groups. MDR approach identified gene-gene interaction among BDNF_rs7103411-BDNF_rs1491851-SLC6A3_rs40184 in severely ill incomplete responders (OR = 7.91, 95%-CI = 4.08–15.36). While RGS4_rs2842026-SLC6A3_rs2975226 interacted synergistically in

  10. Selected Cytokines Serve as Potential Biomarkers for Predicting Liver Inflammation and Fibrosis in Chronic Hepatitis B Patients With Normal to Mildly Elevated Aminotransferases.

    PubMed

    Deng, Yong-Qiong; Zhao, Hong; Ma, An-Lin; Zhou, Ji-Yuan; Xie, Shi-Bin; Zhang, Xu-Qing; Zhang, Da-Zhi; Xie, Qing; Zhang, Guo; Shang, Jia; Cheng, Jun; Zhao, Wei-Feng; Zou, Zhi-Qiang; Zhang, Ming-Xiang; Wang, Gui-Qiang

    2015-11-01

    Previous studies of small cohorts have implicated several circulating cytokines with progression of chronic hepatitis B (CHB). However, to date there have been no reliable biomarkers for assessing histological liver damage in CHB patients with normal or mildly elevated alanine aminotransferase (ALT). The aim of the present study was to investigate the association between circulating cytokines and histological liver damage in a large cohort. Also, this study was designed to assess the utility of circulating cytokines in diagnosing liver inflammation and fibrosis in CHB patients with ALT less than 2 times the upper limit of normal range (ULN). A total of 227 CHB patients were prospectively enrolled. All patients underwent liver biopsy and staging by Ishak system. Patients with at least moderate inflammation showed significantly higher levels of CXCL-11, CXCL-10, and interleukin (IL)-2 receptor (R) than patients with less than moderate inflammation (P < 0.001). Patients with significant fibrosis had higher levels of IL-8 (P = 0.027), transforming growth factor alpha (TGF-α) (P = 0.011), IL-2R (P = 0.002), and CXCL-11 (P = 0.032) than the group without significant fibrosis. In addition, 31.8% and 29.1% of 151 patients with ALT < 2 × ULN had at least moderate inflammation and significant fibrosis, respectively. Multivariate analysis demonstrated that CXCL-11 was independently associated with at least moderate inflammation, and TGF-α and IL-2R independently correlated with significant fibrosis in patients with ALT < 2 × ULN. Based on certain cytokines and clinical parameters, an inflammation-index and fib-index were developed, which showed areas under the receiver operating characteristics curve (AUROC) of 0.75 (95% CI 0.66-0.84) for at least moderate inflammation and 0.82 (95% CI 0.75-0.90) for significant fibrosis, correspondingly. Compared to existing scores, fib-index was significantly superior to aspartate aminotransferase

  11. Selected Cytokines Serve as Potential Biomarkers for Predicting Liver Inflammation and Fibrosis in Chronic Hepatitis B Patients With Normal to Mildly Elevated Aminotransferases

    PubMed Central

    Deng, Yong-Qiong; Zhao, Hong; Ma, An-Lin; Zhou, Ji-Yuan; Xie, Shi-Bin; Zhang, Xu-Qing; Zhang, Da-Zhi; Xie, Qing; Zhang, Guo; Shang, Jia; Cheng, Jun; Zhao, Wei-Feng; Zou, Zhi-Qiang; Zhang, Ming-Xiang; Wang, Gui-Qiang

    2015-01-01

    Abstract Previous studies of small cohorts have implicated several circulating cytokines with progression of chronic hepatitis B (CHB). However, to date there have been no reliable biomarkers for assessing histological liver damage in CHB patients with normal or mildly elevated alanine aminotransferase (ALT). The aim of the present study was to investigate the association between circulating cytokines and histological liver damage in a large cohort. Also, this study was designed to assess the utility of circulating cytokines in diagnosing liver inflammation and fibrosis in CHB patients with ALT less than 2 times the upper limit of normal range (ULN). A total of 227 CHB patients were prospectively enrolled. All patients underwent liver biopsy and staging by Ishak system. Patients with at least moderate inflammation showed significantly higher levels of CXCL-11, CXCL-10, and interleukin (IL)-2 receptor (R) than patients with less than moderate inflammation (P < 0.001). Patients with significant fibrosis had higher levels of IL-8 (P = 0.027), transforming growth factor alpha (TGF-α) (P = 0.011), IL-2R (P = 0.002), and CXCL-11 (P = 0.032) than the group without significant fibrosis. In addition, 31.8% and 29.1% of 151 patients with ALT < 2 × ULN had at least moderate inflammation and significant fibrosis, respectively. Multivariate analysis demonstrated that CXCL-11 was independently associated with at least moderate inflammation, and TGF-α and IL-2R independently correlated with significant fibrosis in patients with ALT < 2 × ULN. Based on certain cytokines and clinical parameters, an inflammation-index and fib-index were developed, which showed areas under the receiver operating characteristics curve (AUROC) of 0.75 (95% CI 0.66–0.84) for at least moderate inflammation and 0.82 (95% CI 0.75–0.90) for significant fibrosis, correspondingly. Compared to existing scores, fib-index was significantly superior to aspartate

  12. Building Capacity for Trauma Intervention across Child-Serving Systems

    ERIC Educational Resources Information Center

    Chinitz, Susan; Stettler, Erin M.; Giammanco, Denise; Silverman, Marian; Briggs, Rahil D.; Loeb, Joanne

    2010-01-01

    Infants most vulnerable to trauma are often the least able to access interventions. Universal child-serving systems, such as primary pediatrics, early care and education, and the child welfare system, can offer a port of entry for millions of children annually for trauma-related supports and services. However, practitioners in these systems have…

  13. Meeting the needs of vulnerable patients: The need for team working across general practice and community nursing services

    PubMed Central

    While, Alison E

    2014-01-01

    General practitioners and district nurses have a long history of providing care outside the hospital setting. With health care increasingly moving out of the hospital setting, there are more opportunities for general practitioners and district nurses to work together to meet the health needs of the local population. However, the reduction in qualified specialist practitioner district nurses over the last decade is concerning. The need for an effective district nursing service has been recognised by the Department of Health in their own model – the nature of district nursing work, often over a long period, enables relationships to develop with the patient, family and informal carers as a basis for anticipatory care to manage long-term conditions. Communication and understanding of the role are central to enhance effective working between general practitioners and district nurses, which can be fostered by engagement in community-oriented integrated care and case management. PMID:25949736

  14. Meeting the needs of vulnerable patients: The need for team working across general practice and community nursing services.

    PubMed

    Bliss, Julie; While, Alison E

    2014-01-01

    General practitioners and district nurses have a long history of providing care outside the hospital setting. With health care increasingly moving out of the hospital setting, there are more opportunities for general practitioners and district nurses to work together to meet the health needs of the local population. However, the reduction in qualified specialist practitioner district nurses over the last decade is concerning. The need for an effective district nursing service has been recognised by the Department of Health in their own model - the nature of district nursing work, often over a long period, enables relationships to develop with the patient, family and informal carers as a basis for anticipatory care to manage long-term conditions. Communication and understanding of the role are central to enhance effective working between general practitioners and district nurses, which can be fostered by engagement in community-oriented integrated care and case management.

  15. Serving Bowl Selection Biases the Amount of Food Served

    ERIC Educational Resources Information Center

    van Kleef, Ellen; Shimizu, Mitsuru; Wansink, Brian

    2012-01-01

    Objective: To determine how common serving bowls containing food for multiple persons influence serving behavior and consumption and whether they do so independently of satiation and food evaluation. Methods: In this between-subjects experiment, 68 participants were randomly assigned to either a group serving pasta from a large-sized bowl (6.9-L…

  16. Should sulfonylureas remain an acceptable first-line add-on to metformin therapy in patients with type 2 diabetes? Yes, they continue to serve us well!

    PubMed

    Abrahamson, Martin J

    2015-01-01

    Since their introduction to clinical practice in the 1950s, sulfonylureas have been widely prescribed for use in patients with type 2 diabetes. Of all the other medications currently available for clinical use, only metformin has been used more frequently. However, several new drug classes have emerged that are reported to have equal glucose-lowering efficacy and greater safety when added to treatment of patients in whom metformin monotherapy is no longer sufficient. Moreover, current arguments also suggest that the alternative drugs may be superior to sulfonylureas with regard to the risk of cardiovascular complications. Thus, while there is universal agreement that metformin should remain the first-line pharmacologic therapy for those in whom lifestyle modification is insufficient to control hyperglycemia, there is no consensus as to which drug should be added to metformin. Therefore, given the current controversy, we provide a Point-Counterpoint on this issue. In the point narrative presented below, Dr. Abrahamson provides his argument suggesting that avoiding use of sulfonylureas as a class of medication as an add-on to metformin is not appropriate as there are many patients whose glycemic control would improve with use of these drugs with minimal risk of adverse events. In the following counterpoint narrative, Dr. Genuth suggests there is no longer a need for sulfonylureas to remain a first-line addition to metformin for those patients whose clinical characteristics are appropriate and whose health insurance and/or financial resources make an alternative drug affordable.

  17. Data-Driven Human Rights: Using Dual Loyalty Trainings to Promote the Care of Vulnerable Patients in Jail.

    PubMed

    Glowa-Kollisch, Sarah; Graves, Jasmine; Dickey, Nathaniel; MacDonald, Ross; Rosner, Zachary; Waters, Anthony; Venters, Homer

    2015-06-11

    Dual loyalty is an omnipresent feature of correctional health. As part of a human rights quality improvement committee, and utilizing the unique advantage of a fully integrated electronic health record system, we undertook an assessment of dual loyalty in the New York City jail system. The evaluation revealed significant concerns about the extent to which the mental health service is involved in assessments that are part of the punishment process of the security apparatus. As a result, dual loyalty training was developed and delivered to all types of health staff in the jail system via anonymous survey. Six clinical scenarios were presented in this training and staff members were asked to indicate whether they had encountered similar circumstances and how they would respond. Staff responses to the survey raised concerns about the frequency with which they are pressured or asked to put aside their primary goal of patient care for the interests of the security mission. The online training and follow-up small group sessions have revealed widespread support for more training on dual loyalty.

  18. Variation in resistance traits, phylogenetic backgrounds, and virulence genotypes among Escherichia coli clinical isolates from adjacent hospital campuses serving distinct patient populations.

    PubMed

    Drawz, Sarah M; Porter, Stephen; Kuskowski, Michael A; Johnston, Brian; Clabots, Connie; Kline, Susan; Ferrieri, Patricia; Johnson, James R

    2015-09-01

    Escherichia coli sequence type 13 (ST131), an emergent cause of multidrug-resistant extraintestinal infections, has important phylogenetic subsets, notably the H30 and H30Rx subclones, with distinctive resistance profiles and, possibly, clinical associations. To clarify the local prevalence of these ST131 subclones and their associations with antimicrobial resistance, ecological source, and virulence traits, we extensively characterized 233 consecutive E. coli clinical isolates (July and August 2013) from the University of Minnesota Medical Center-Fairview Infectious Diseases and Diagnostic Laboratory, Minneapolis, MN, which serves three adjacent facilities (a children's hospital and low- and high-acuity adult facilities). ST131 accounted for 26% of the study isolates (more than any other clonal group), was distributed similarly by facility, and was closely associated with ciprofloxacin resistance and extended-spectrum β-lactamase (ESBL) production. The H30 and H30Rx subclones accounted for most ST131 isolates and for the association of ST131 with fluoroquinolone resistance and ESBL production. Unlike ST131 per se, these subclones were distributed differentially by hospital, being most prevalent at the high-acuity adult facility and were absent from the children's hospital. The virulence gene profiles of ST131 and its subclones were distinctive and more extensive than those of other fluoroquinolone-resistant or ESBL-producing isolates. Within ST131, bla CTX-M-15 was confined to H30Rx isolates and other bla CTX-M variants to non-Rx H30 isolates. Pulsed-field gel electrophoresis documented a predominance of globally distributed pulsotypes and no local outbreak pattern. These findings help clarify the epidemiology, ecology, and bacterial correlates of the H30 and H30Rx ST131 subclones by documenting a high overall prevalence but significant segregation by facility, strong associations with fluoroquinolone resistance and specific ESBL variants, and distinctive

  19. Mitochondrial Vulnerability and Increased Susceptibility to Nutrient-Induced Cytotoxicity in Fibroblasts from Leigh Syndrome French Canadian Patients

    PubMed Central

    Burelle, Yan; Thompson Legault, Julie; Boucher, Gabrielle; Morin, Charles; Coderre, Lise; Des Rosiers, Christine

    2015-01-01

    nature of the diets, particularly excess fat intake, as well as on the use of antioxidants in patients with LSFC and, possibly, other COX defects. PMID:25835550

  20. Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration’s “Homeless Patient Aligned Care Team” Program

    PubMed Central

    Johnson, Erin E.; Aiello, Riccardo; Kane, Vincent; Pape, Lisa

    2016-01-01

    Introduction Although the clinical consequences of homelessness are well described, less is known about the role for health care systems in improving clinical and social outcomes for the homeless. We described the national implementation of a “homeless medical home” initiative in the Veterans Health Administration (VHA) and correlated patient health outcomes with characteristics of high-performing sites. Methods We conducted an observational study of 33 VHA facilities with homeless medical homes and patient- aligned care teams that served more than 14,000 patients. We correlated site-specific health care performance data for the 3,543 homeless veterans enrolled in the program from October 2013 through March 2014, including those receiving ambulatory or acute health care services during the 6 months prior to enrollment in our study and 6 months post-enrollment with corresponding survey data on the Homeless Patient Aligned Care Team (H-PACT) program implementation. We defined high performance as high rates of ambulatory care and reduced use of acute care services. Results More than 96% of VHA patients enrolled in these programs were concurrently receiving VHA homeless services. Of the 33 sites studied, 82% provided hygiene care (on-site showers, hygiene kits, and laundry), 76% provided transportation, and 55% had an on-site clothes pantry; 42% had a food pantry and provided on-site meals or other food assistance. Six-month patterns of acute-care use pre-enrollment and post-enrollment for 3,543 consecutively enrolled patients showed a 19.0% reduction in emergency department use and a 34.7% reduction in hospitalizations. Three features were significantly associated with high performance: 1) higher staffing ratios than other sites, 1) integration of social supports and social services into clinical care, and 3) outreach to and integration with community agencies. Conclusion Integrating social determinants of health into clinical care can be effective for high

  1. VEGF-B promotes cancer metastasis through a VEGF-A-independent mechanism and serves as a marker of poor prognosis for cancer patients.

    PubMed

    Yang, Xiaojuan; Zhang, Yin; Hosaka, Kayoko; Andersson, Patrik; Wang, Jian; Tholander, Fredrik; Cao, Ziquan; Morikawa, Hiromasa; Tegnér, Jesper; Yang, Yunlong; Iwamoto, Hideki; Lim, Sharon; Cao, Yihai

    2015-06-02

    The biological functions of VEGF-B in cancer progression remain poorly understood. Here, we report that VEGF-B promotes cancer metastasis through the remodeling of tumor microvasculature. Knockdown of VEGF-B in tumors resulted in increased perivascular cell coverage and impaired pulmonary metastasis of human melanomas. In contrast, the gain of VEGF-B function in tumors led to pseudonormalized tumor vasculatures that were highly leaky and poorly perfused. Tumors expressing high levels of VEGF-B were more metastatic, although primary tumor growth was largely impaired. Similarly, VEGF-B in a VEGF-A-null tumor resulted in attenuated primary tumor growth but substantial pulmonary metastases. VEGF-B also led to highly metastatic phenotypes in Vegfr1 tk(-/-) mice and mice treated with anti-VEGF-A. These data indicate that VEGF-B promotes cancer metastasis through a VEGF-A-independent mechanism. High expression levels of VEGF-B in two large-cohort studies of human patients with lung squamous cell carcinoma and melanoma correlated with poor survival. Taken together, our findings demonstrate that VEGF-B is a vascular remodeling factor promoting cancer metastasis and that targeting VEGF-B may be an important therapeutic approach for cancer metastasis.

  2. Emerging Hispanic-Serving Institutions (HSIs): Serving Latino Students

    ERIC Educational Resources Information Center

    Santiago, Deborah A.; Andrade, Sally J.

    2010-01-01

    In this fifth brief in "Excelencia" in Education's series on Hispanic-Serving Institutions (HSIs) the focus is on the methods and strategies that are producing successful results in a growing sector of colleges and universities we call, "Emerging" Hispanic-Serving Institutions. These Emerging HSIs are institutions that…

  3. Predicting Volleyball Serve-Reception.

    PubMed

    Paulo, Ana; Zaal, Frank T J M; Fonseca, Sofia; Araújo, Duarte

    2016-01-01

    Serve and serve-reception performance have predicted success in volleyball. Given the impact of serve-reception on the game, we aimed at understanding what it is in the serve and receiver's actions that determines the selection of the type of pass used in serve-reception and its efficacy. Four high-level volleyball players received jump-float serves from four servers in two reception zones-zone 1 and 5. The ball and the receiver's head were tracked with two video cameras, allowing 3D world-coordinates reconstruction. Logistic-regression models were used to predict the type of pass used (overhand or underhand) and serve-reception efficacy (error, out, or effective) from variables related with the serve kinematics and related with the receiver's on-court positioning and movement. Receivers' initial position was different when in zone 1 and 5. This influenced the serve-related variables as well as the type of pass used. Strong predictors of using an underhand rather than overhand pass were higher ball contact of the server, reception in zone 1, receiver's initial position more to the back of the court and backward receiver movement. Receiver's larger longitudinal displacements and an initial position more to the back of the court had a strong relationship with the decreasing of the serve-reception efficacy. Receivers' positioning and movement were the factors with the largest impact on the type of pass used and the efficacy of the reception. Reception zone affected the variance in the ball's kinematics (with the exception of the ball's lateral displacement), as well as in the receivers' positioning (distances from the net and from the target). Also the reception zone was associated with the type of pass used by the receiver but not with reception efficacy. Given volleyball's rotation rule, the receiver needs to master receiving in the different reception zones; he/she needs to adapt to the diverse constraints of each zone to maintain performance efficacy. Thus, being

  4. Predicting Volleyball Serve-Reception

    PubMed Central

    Paulo, Ana; Zaal, Frank T. J. M.; Fonseca, Sofia; Araújo, Duarte

    2016-01-01

    Serve and serve-reception performance have predicted success in volleyball. Given the impact of serve-reception on the game, we aimed at understanding what it is in the serve and receiver's actions that determines the selection of the type of pass used in serve-reception and its efficacy. Four high-level volleyball players received jump-float serves from four servers in two reception zones—zone 1 and 5. The ball and the receiver's head were tracked with two video cameras, allowing 3D world-coordinates reconstruction. Logistic-regression models were used to predict the type of pass used (overhand or underhand) and serve-reception efficacy (error, out, or effective) from variables related with the serve kinematics and related with the receiver's on-court positioning and movement. Receivers' initial position was different when in zone 1 and 5. This influenced the serve-related variables as well as the type of pass used. Strong predictors of using an underhand rather than overhand pass were higher ball contact of the server, reception in zone 1, receiver's initial position more to the back of the court and backward receiver movement. Receiver's larger longitudinal displacements and an initial position more to the back of the court had a strong relationship with the decreasing of the serve-reception efficacy. Receivers' positioning and movement were the factors with the largest impact on the type of pass used and the efficacy of the reception. Reception zone affected the variance in the ball's kinematics (with the exception of the ball's lateral displacement), as well as in the receivers' positioning (distances from the net and from the target). Also the reception zone was associated with the type of pass used by the receiver but not with reception efficacy. Given volleyball's rotation rule, the receiver needs to master receiving in the different reception zones; he/she needs to adapt to the diverse constraints of each zone to maintain performance efficacy. Thus

  5. Narcissistic grandiosity and narcissistic vulnerability in psychotherapy.

    PubMed

    Pincus, Aaron L; Cain, Nicole M; Wright, Aidan G C

    2014-10-01

    This article briefly summarizes the empirical and clinical literature underlying a contemporary clinical model of pathological narcissism. Unlike the DSM Narcissistic Personality Disorder (NPD), this clinical model identifies and differentiates between two phenotypic themes of dysfunction-narcissistic grandiosity and narcissistic vulnerability-that can be expressed both overtly and covertly in patients' ways of thinking, feeling, behaving, and participating in treatment. Clinical recognition that narcissistic patients can and often do present for psychotherapy in vulnerable states of depression, anxiety, shame, and even suicidality increases the likelihood of accurate diagnosis and effective treatment planning. This article provides case examples derived from psychotherapies with narcissistic patients to demonstrate how narcissistic grandiosity and narcissistic vulnerability concurrently present in patients who seek treatment.

  6. Facility Environmental Vulnerability Assessment

    SciTech Connect

    Van Hoesen, S.D.

    2001-07-09

    From mid-April through the end of June 2001, a Facility Environmental Vulnerability Assessment (FEVA) was performed at Oak Ridge National Laboratory (ORNL). The primary goal of this FEVA was to establish an environmental vulnerability baseline at ORNL that could be used to support the Laboratory planning process and place environmental vulnerabilities in perspective. The information developed during the FEVA was intended to provide the basis for management to initiate immediate, near-term, and long-term actions to respond to the identified vulnerabilities. It was expected that further evaluation of the vulnerabilities identified during the FEVA could be carried out to support a more quantitative characterization of the sources, evaluation of contaminant pathways, and definition of risks. The FEVA was modeled after the Battelle-supported response to the problems identified at the High Flux Beam Reactor at Brookhaven National Laboratory. This FEVA report satisfies Corrective Action 3A1 contained in the Corrective Action Plan in Response to Independent Review of the High Flux Isotope Reactor Tritium Leak at the Oak Ridge National Laboratory, submitted to the Department of Energy (DOE) ORNL Site Office Manager on April 16, 2001. This assessment successfully achieved its primary goal as defined by Laboratory management. The assessment team was able to develop information about sources and pathway analyses although the following factors impacted the team's ability to provide additional quantitative information: the complexity and scope of the facilities, infrastructure, and programs; the significantly degraded physical condition of the facilities and infrastructure; the large number of known environmental vulnerabilities; the scope of legacy contamination issues [not currently addressed in the Environmental Management (EM) Program]; the lack of facility process and environmental pathway analysis performed by the accountable line management or facility owner; and poor

  7. TB in Vulnerable Populations

    PubMed Central

    Ugarte-Gil, César; Caro, Godofredo; Aylas, Rula; Castro, César; Lema, Claudia

    2016-01-01

    Abstract This article analyzes the factors associated with vulnerability of the Ashaninka, the most populous indigenous Peruvian Amazonian people, to tuberculosis (TB). By applying a human rights-based analytical framework that assesses public policy against human rights standards and principles, and by offering a step-by-step framework for a full assessment of compliance, it provides evidence of the relationship between the incidence of TB among the Ashaninka and Peru’s poor level of compliance with its human rights obligations. The article argues that one of the main reasons for the historical vulnerability of the Ashaninka to diseases such as TB is a lack of political will on the part of the national government to increase public health spending, ensure that resources reach the most vulnerable population, and adopt and invest in a culturally appropriate health system. PMID:27780999

  8. Energy vulnerability relationships

    SciTech Connect

    Shaw, B.R.; Boesen, J.L.

    1998-02-01

    The US consumption of crude oil resources has been a steadily growing indicator of the vitality and strength of the US economy. At the same time import diversity has also been a rapidly developing dimension of the import picture. In the early 1970`s, embargoes of crude oil from Organization of Producing and Exporting Countries (OPEC) created economic and political havoc due to a significant lack of diversity and a unique set of economic, political and domestic regulatory circumstances. The continued rise of imports has again led to concerns over the security of our crude oil resource but threats to this system must be considered in light of the diversity and current setting of imported oil. This report develops several important issues concerning vulnerability to the disruption of oil imports: (1) The Middle East is not the major supplier of oil to the United States, (2) The US is not vulnerable to having its entire import stream disrupted, (3) Even in stable countries, there exist vulnerabilities to disruption of the export stream of oil, (4) Vulnerability reduction requires a focus on international solutions, and (5) DOE program and policy development must reflect the requirements of the diverse supply. Does this increasing proportion of imported oil create a {open_quotes}dependence{close_quotes}? Does this increasing proportion of imported oil present a vulnerability to {open_quotes}price shocks{close_quotes} and the tremendous dislocations experienced during the 1970`s? Finally, what is the vulnerability of supply disruptions from the current sources of imported oil? If oil is considered to be a finite, rapidly depleting resource, then the answers to these questions must be {open_quotes}yes.{close_quotes} However, if the supply of oil is expanding, and not limited, then dependence is relative to regional supply sources.

  9. Plutonium Vulnerability Management Plan

    SciTech Connect

    1995-03-01

    This Plutonium Vulnerability Management Plan describes the Department of Energy`s response to the vulnerabilities identified in the Plutonium Working Group Report which are a result of the cessation of nuclear weapons production. The responses contained in this document are only part of an overall, coordinated approach designed to enable the Department to accelerate conversion of all nuclear materials, including plutonium, to forms suitable for safe, interim storage. The overall actions being taken are discussed in detail in the Department`s Implementation Plan in response to the Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 94-1. This is included as Attachment B.

  10. S100A9 and ORM1 serve as predictors of therapeutic response and prognostic factors in advanced extranodal NK/T cell lymphoma patients treated with pegaspargase/gemcitabine

    PubMed Central

    Zhou, Zhiyuan; Li, Zhaoming; Sun, Zhenchang; Zhang, Xudong; Lu, Lisha; Wang, Yingjun; Zhang, Mingzhi

    2016-01-01

    Pegaspargase combined with gemcitabine have greatly improved the outcomes of advanced extranodal NK/T cell lymphoma (ENKL). However, patients frequently undergo recurrent disease due to chemoresistance, and few predictive parameters are available. The present study explored potential biomarkers to predict the therapeutic response of advanced ENKL treated with pegaspargase/gemcitabine and evaluate the prognostic significance. Through serum proteomic analysis, we identified 61 upregulated and 22 downregulated proteins in nonresponders compared with responders. We further validated that patients with unfavourable treatment outcomes displayed higher levels of S100A9 and ORM1 via enzyme-linked immunosorbent assay (ELISA). Moreover, the sensitivity and specificity for detecting refractory patients were 81.5% and 71.4% for S100A9 > 62.0 ng/ml, 85.2% and 77.1% for ORM1 > 1436 ug/ml, 100% and 57.1% for S100A9 combined with ORM1. Furthermore, in multivariate analysis elevated levels of S100A9 were associated with poor 2-year OS (40.2% vs. 76.6%, RR = 2.92, p = 0.005) and 2-year PFS (33.1% vs. 61.1%, RR = 2.61 p = 0.011). High ORM1 also predicted inferior 2-year OS (38.7% vs.76.1, RR = 2.46, p = 0.023) and 2-year PFS (18.4% vs. 73.2%, RR = 2.86, p = 0.009). Our results indicated that S100A9 and ORM1 could serve as reliable predictors of therapeutic response and independent prognostic factors of survival in advanced ENKL patients treated with pegaspargase/gemcitabine. PMID:27021626

  11. Meals Served in Public Schools.

    ERIC Educational Resources Information Center

    Vivigal, Lisa

    The Physicians Committee for Responsible Medicine (PCRM) contacted public school districts around the United States to determine if they offered low-fat, healthful meals. The PCRM ranked the schools according to whether they served low-fat and vegetarian meals daily, whether these meals varied through the week, and whether children needed to…

  12. Offer Versus Serve. Training Manual.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Health and Drug Education and Services.

    A growing awareness about food supplies, food shortages, and conservation of natural resources has resulted in public concern over food waste within the National School Lunch Program. Prior to 1976, all participating students were required to take all five items offered on a planned menu. In October 1975, the Offer v. Serve Provision was enacted…

  13. Delinquent Recidivists: Vulnerable Children.

    ERIC Educational Resources Information Center

    Moore, Roslyn; And Others

    1984-01-01

    This study examines the relationship between vulnerability factors and recidivism of juvenile offenders. Four factors are identified which distinguish recedivists from nonrecidivists in a sample of 96 first offenders matched by age and sex. Results are discussed from an epidemiological and early intervention perspective. (Author/BS)

  14. Biological Vulnerability to Alcoholism.

    ERIC Educational Resources Information Center

    Schuckit, Marc A.

    1987-01-01

    Reviews the role of biological factors in the risk for alcoholism. Notes the importance of the definition of primary alcoholism and highlights data indicating that this disorder is genetically influenced. In studies of men at high risk for the future development of alcoholism, vulnerability shows up in reactions to ethanol brain wave amplitude and…

  15. ADVANCING PATIENT-CENTERED CARE FOR STRUCTURALLY VULNERABLE DRUG-USING POPULATIONS: A QUALITATIVE STUDY OF THE PERSPECTIVES OF PEOPLE WHO USE DRUGS REGARDING THE POTENTIAL INTEGRATION OF HARM REDUCTION INTERVENTIONS INTO HOSPITALS

    PubMed Central

    McNeil, Ryan; Kerr, Thomas; Pauly, Bernie; Wood, Evan; Small, Will

    2015-01-01

    Aims To explore the perspectives of structurally vulnerable people who use drugs (PWUD) regarding: (1) the potential integration of harm reduction interventions (e.g., supervised drug consumption services, opioid assisted treatment) into hospitals; and, (2) the implications of these interventions for patient-centered care, hospital outcomes, and drug-related risks and harms. Design Semi-structured qualitative interviews. Setting Vancouver, Canada. Participants 30 structurally vulnerable PWUD who had been discharged from hospital against medical advice within the past two years, and hospitalized multiple times over the past five years. Measurements Semi-structured interview guide including questions to elicit perspectives on hospital-based harm reduction interventions. Findings Participant accounts highlighted that hospital-based harm reduction interventions would promote patient-centered care by: (1) prioritizing hospital care access and risk reduction over the enforcement of abstinence-based drug policies; (2) increasing responsiveness to subjective health needs (e.g., pain and withdrawal symptoms); and, (3) fostering ‘culturally safe’ care. Conclusions Hospital-based harm reduction interventions for people who use drugs, such as supervised drug consumption services and opioid assisted treatment, can potentially improve hospital care retention, promote patient-centred care, and reduce adverse health outcomes among people who use drugs. PMID:26498577

  16. Could local dynamic stability serve as an early predictor of falls in patients with moderate neurological gait disorders? A reliability and comparison study in healthy individuals and in patients with paresis of the lower extremities.

    PubMed

    Reynard, Fabienne; Vuadens, Philippe; Deriaz, Olivier; Terrier, Philippe

    2014-01-01

    Falls while walking are frequent in patients with muscular dysfunction resulting from neurological disorders. Falls induce injuries that may lead to deconditioning and disabilities, which further increase the risk of falling. Therefore, an early gait stability index would be useful to evaluate patients in order to prevent the occurrence of future falls. Derived from chaos theory, local dynamic stability (LDS), defined by the maximal Lyapunov exponent, assesses the sensitivity of a dynamic system to small perturbations. LDS has already been used for fall risk prediction in elderly people. The aim of the present study was to provide information to facilitate future researches regarding gait stability in patients with neurological gait disorders. The main objectives were 1) to evaluate the intra-session repeatability of LDS in patients and 2) to assess the discriminative power of LDS to differentiate between healthy individuals and neurological patients. Eighty-three patients with mild to moderate neurological disorders associated with paresis of the lower extremities and 40 healthy controls participated in the study. The participants performed 2×30 s walking wearing a 3D accelerometer attached to the lower back, from which 2×35 steps were extracted. LDS was defined as the average exponential rate of divergence among trajectories in a reconstructed state-space that reflected the gait dynamics. LDS assessed along the medio-lateral axis offered the highest repeatability and discriminative power. Intra-session repeatability (intraclass correlation coefficient between the two repetitions) in the patients was 0.89 and the smallest detectable difference was 16%. LDS was substantially lower in the patients than in the controls (33% relative difference, standardized effect size 2.3). LDS measured in short over-ground walking tests seems sufficiently reliable. LDS exhibits good discriminative power to differentiate fall-prone individuals and opens up the possibility of

  17. Vulnerabilities in snakebites in Sao Paulo, Brazil

    PubMed Central

    Bertolozzi, Maria Rita; Scatena, Camila Morato da Conceição; França, Francisco Oscar de Siqueira

    2015-01-01

    ABSTRACT OBJECTIVE To describe elements of vulnerability of victims of snakebite. METHODS This qualitative, descriptive, cross-sectional study had, as theoretical framework, the concept of vulnerability in individual, social, and programmatic dimensions. We interviewed 21 patients admitted into a hospital specialized in the care of accidents caused by venomous animals. The interviews were analyzed according to a discourse analysis technique. RESULTS Patients were mainly young men, living in remote countryside areas, where health services frequently have limited resources. We found social and individual conditions of vulnerability, such as precarious schooling, low professional qualification, housing without access to piped water, no sewage treated, and no regular garbage collection, and lack of knowledge on this health problem. Regarding the programmatic dimension, we found limited accessibility to the health services that could affect the prognosis and the frequency of sequelae and deaths. CONCLUSIONS Considering such vulnerabilities evoke the need to improve the program for control the Accidents by Venomous Animals and the training of health workers, we highlight the potential use of the concept of vulnerability, which may amplify the understanding and the recommendations for the practice and education related to snakebites. PMID:26603351

  18. Vulnerability to Climate Change in Rural Nicaragua

    NASA Astrophysics Data System (ADS)

    Byrne, T. R.; Townshend, I.; Byrne, J. M.; McDaniel, S. A.

    2013-12-01

    While there is a growing recognition of the impact that climate change may have on human development, there has been a shift in focus from an impacts-led assessment approach towards a vulnerability-led assessment approach. This research operationalizes the IPCC's definition of vulnerability in a sub-national assessment to understand how different factors that shape vulnerability to climate change vary spatially across rural Nicaragua. The research utilizes the Food and Agriculture Organization of the United Nations' (FAO UN) CropWat model to evaluate how the annual yield of two of Nicaragua's staple crops may change under projected changes in temperature and precipitation. This analysis of agricultural sensitivity under exposure to climate change is then overlain with an indicator-based assessment of adaptive capacity in rural Nicaraguan farming households. Adaptive capacity was evaluated using household survey data from the 2001 National Household Survey on Living Standards Measurement, which was provided to us by the FAO UN. The result is a map representing current vulnerability to future climate change, and can serve as a basis for targeting policy interventions in rural Nicaragua.

  19. Optimizing health care delivery by integrating workplaces, homes, and communities: how occupational and environmental medicine can serve as a vital connecting link between accountable care organizations and the patient-centered medical home.

    PubMed

    McLellan, Robert K; Sherman, Bruce; Loeppke, Ronald R; McKenzie, Judith; Mueller, Kathryn L; Yarborough, Charles M; Grundy, Paul; Allen, Harris; Larson, Paul W

    2012-04-01

    momentum and evolving among physicians. But, the potential exists for implementation of both of these concepts across a much broader community of patients. By extending the well-conceived integrative concepts of the PCMH model and ACOs into the workforce via occupational and environmental medicine (OEM) physicians, the power of these concepts would be significantly enhanced. Occupational and environmental medicine provides a well-established infrastructure and parallel strategies that could serve as a force multiplier in achieving the fundamental goals of the PCMH model and ACOs. In this paradigm, the workplace-where millions of Americans spend a major portion of their daily lives-becomes an essential element, next to communities and homes, in an integrated system of health anchored by the PCMH and ACO concepts. To be successful, OEM physicians will need to think and work innovatively about how they can provide today's employer health services-ranging from primary care and preventive care to workers' compensation and disability management-within tomorrow's PCMH and ACO models.

  20. Self-serving confabulation in prose recall.

    PubMed

    Fotopoulou, Aikaterini; Conway, Martin A; Solms, Mark; Tyrer, Stephen; Kopelman, Michael

    2008-04-01

    Recent studies suggest that the content of confabulation is mainly positive and self-enhancing. In this group study, we aimed to investigate whether this positive bias is specific to self-referent information. Confabulating amnesic patients, amnesic non-confabulating patients and healthy controls were asked to reproduce a series of short stories. We manipulated the emotional valence of the material by including positive, negative and neutral story plots. We also manipulated the self-reference of the material by including self-referent versus other-referent encoding instructions. Confabulating patients were as impaired as a group of amnesic patients in the amount of information they recalled, both groups being worse than healthy controls. Importantly, confabulating patients showed a selective bias in the negative self-referent condition, in that they recalled such information in a manner which portrayed a more positive image of themselves. This positive bias was not present in stories that were not encoded in a self-referent manner and it was not significantly correlated to patients' self-reported mood. We propose that both confabulation and its motivated content result from a deficit in the control and regulation of memory retrieval, which allows motivational factors to acquire a greater role than usual in determining which memories are selected for retrieval. To this extent, the self-enhancing content of confabulation could be explained as a neurogenic exaggeration of normal self-serving memory distortion.

  1. Patterns of Electronic Portal Use among Vulnerable Patients in a Nationwide Practice-based Research Network: From the OCHIN Practice-based Research Network (PBRN)

    PubMed Central

    Wallace, Lorraine S.; Angier, Heather; Huguet, Nathalie; Gaudino, James A.; Krist, Alex; Dearing, Marla; Killerby, Marie; Marino, Miguel; DeVoe, Jennifer E.

    2017-01-01

    Background Underserved patient populations experience barriers to accessing and engaging within the complex health care system. Electronic patient portals have been proposed as a potential new way to improve access and engagement. We studied patient portal use for 12 consecutive months (365 days) among a large, nationally distributed, underserved patient population within the OCHIN (originally created as the Oregon Community Health Information Network and renamed OCHIN as other states joined) practice-based research network (PBRN). Methods We retrospectively assessed adoption and use of Epic’s MyChart patient portal in the first 12 months after MyChart was made available to the OCHIN PBRN. We examined electronic health record data from 36,549 patients aged ≥18 years who were offered a MyChart access code between May 1, 2012, and April 30, 2013, across the OCHIN PBRN in 13 states. Results Overall, 29% of patients offered an access code logged into their MyChart account. Superusers (minimum of 2 logins per month over a 12-month period) accounted for 6% of users overall. Men, nonwhite patients, Hispanic patients, Spanish-speaking patients, and those with the lowest incomes were significantly less likely to activate. Publicly insured and uninsured patients were also less likely to log in to their MyChart account, but once activated they were more likely than privately insured patients to use MyChart functions. Conclusions Our findings suggest that, compared with others, certain patient groups may be less interested in using patient portals or may have experienced significant barriers that prevented use. Making portal access available is a first step. Additional studies need to specifically identify health system–, clinic-, and patient-level barriers and facilitators to portal adoption and use. PMID:27613792

  2. Aging and Neuronal Vulnerability

    PubMed Central

    Mattson, Mark P.; Magnus, Tim

    2011-01-01

    Everyone ages, but only some will acquire a neurodegenerative disorder in the process. Disease might occur when cells fail to respond adaptively to age-related increases in oxidative, metabolic and ionic stress resulting in excessive accumulation of damaged proteins, DNA and membranes. Determinants of neuronal vulnerability might include cell size and location, metabolism of disease-specific proteins, and repertoire of signal transduction pathways and stress resistance mechanisms. Emerging evidence on protein interaction networks that monitor and respond to the normal aging process suggests that successful neural aging is possible for most, but also cautions that cures for neurodegenerative disorders are unlikely in the near future. PMID:16552414

  3. An Integrated Approach for Urban Earthquake Vulnerability Analyses

    NASA Astrophysics Data System (ADS)

    Düzgün, H. S.; Yücemen, M. S.; Kalaycioglu, H. S.

    2009-04-01

    -economical, structural, coastal, ground condition, organizational vulnerabilities, as well as accessibility to critical services within the framework. The proposed framework has the following eight components: Seismic hazard analysis, soil response analysis, tsunami inundation analysis, structural vulnerability analysis, socio-economic vulnerability analysis, accessibility to critical services, GIS-based integrated vulnerability assessment, and visualization of vulnerabilities in 3D virtual city model The integrated model for various vulnerabilities obtained for the urban area is developed in GIS environment by using individual vulnerability assessments for considered elements at risk and serve for establishing the backbone of the spatial decision support system. The stages followed in the model are: Determination of a common mapping unit for each aspect of urban earthquake vulnerability, formation of a geo-database for the vulnerabilities, evaluation of urban vulnerability based on multi attribute utility theory with various weighting algorithms, mapping of the evaluated integrated earthquake risk in geographic information systems (GIS) in the neighborhood scale. The framework is also applicable to larger geographical mapping scales, for example, the building scale. When illustrating the results in building scale, 3-D visualizations with remote sensing data is used so that decision-makers can easily interpret the outputs. The proposed vulnerability assessment framework is flexible and can easily be applied to urban environments at various geographical scales with different mapping units. The obtained total vulnerability maps for the urban area provide a baseline for the development of risk reduction strategies for the decision makers. Moreover, as several aspects of elements at risk for an urban area is considered through vulnerability analyses, effect on changes in vulnerability conditions on the total can easily be determined. The developed approach also enables decision makers to

  4. Vulnerability Assessment of Selected Buildings Designated as Shelters: Anguilla.

    ERIC Educational Resources Information Center

    Gibbs, Tony

    Educational facilities in the Caribbean often serve roles as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools located on Anguilla to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with some of the…

  5. Vulnerability Assessment of Selected Buildings Designated as Shelters: Grenada.

    ERIC Educational Resources Information Center

    Gibbs, Tony

    Educational facilities in the Caribbean often serve as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools, located in Grenada, to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with some of the input…

  6. Vulnerability Assessment of Selected Buildings Designated as Shelters: Dominica.

    ERIC Educational Resources Information Center

    Agency for International Development (IDCA), Washington, DC.

    Educational facilities in the Caribbean often serve roles as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools located on Dominica to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with some of the…

  7. [Trust and palliative care, the risk of vulnerability].

    PubMed

    Miniac, Véronique

    2013-10-01

    Patients receiving palliative care experience extreme vulnerability reminding them of the fragility of their human condition. How are they to trust nurses bearing bad news in these crucial moments? Trust is built on team coherence and rigorous support.

  8. Beyond 'vulnerable groups': contexts and dynamics of vulnerability.

    PubMed

    Zarowsky, Christina; Haddad, Slim; Nguyen, Vinh-Kim

    2013-03-01

    This paper reviews approaches to vulnerability in public health, introducing a series of 10 papers addressing vulnerability in health in Africa. We understand vulnerability as simultaneously a condition and a process. Social inequalities are manifest in and exacerbate three key dimensions of vulnerability: the initial level of wellbeing, the degree of exposure to risk, and the capacity to manage risk effectively. We stress the dynamic interactions linking material and social deprivation, poverty, powerlessness and ill health: risks or shocks and their health impacts are intimately interconnected and reinforce each other in a cycle which in the absence of effective interventions, increases vulnerability. An inductive process which does not begin with an a priori definition or measurement of 'vulnerability' and which does not assume the existence of fixed 'vulnerable groups' allowed us both to re-affirm core aspects of existing conceptual frameworks, and to engage in new ways with literature specifically addressing vulnerability and resilience at the population level as well as with literature - for example in ecology, and on the concept of frailty in research on aging - with which researchers on health and poverty in Africa may not be familiar. We invite conceptual and empirical work on vulnerability in complex systems frameworks. These perspectives emphasize contexts and nonlinear causality thus supporting analyses of vulnerability and resilience as both markers and emergent properties of dynamic interactions. We accept a working definition of vulnerability, and recognize that some definable groups of people are more likely than others to suffer harm from exposure to health risks. But we suggest that the real work - at both intellectual and policy/political levels - lies in understanding and responding to the dynamics, meanings and power relations underlying actual instances and processes of vulnerability and harm.

  9. A preliminary analysis of quantifying computer security vulnerability data in "the wild"

    NASA Astrophysics Data System (ADS)

    Farris, Katheryn A.; McNamara, Sean R.; Goldstein, Adam; Cybenko, George

    2016-05-01

    A system of computers, networks and software has some level of vulnerability exposure that puts it at risk to criminal hackers. Presently, most vulnerability research uses data from software vendors, and the National Vulnerability Database (NVD). We propose an alternative path forward through grounding our analysis in data from the operational information security community, i.e. vulnerability data from "the wild". In this paper, we propose a vulnerability data parsing algorithm and an in-depth univariate and multivariate analysis of the vulnerability arrival and deletion process (also referred to as the vulnerability birth-death process). We find that vulnerability arrivals are best characterized by the log-normal distribution and vulnerability deletions are best characterized by the exponential distribution. These distributions can serve as prior probabilities for future Bayesian analysis. We also find that over 22% of the deleted vulnerability data have a rate of zero, and that the arrival vulnerability data is always greater than zero. Finally, we quantify and visualize the dependencies between vulnerability arrivals and deletions through a bivariate scatterplot and statistical observations.

  10. Serving the world's poor, profitably.

    PubMed

    Prahalad, C K; Hammond, Allen

    2002-09-01

    By stimulating commerce and development at the bottom of the economic pyramid, multi-nationals could radically improve the lives of billions of people and help create a more stable, less dangerous world. Achieving this goal does not require MNCs to spearhead global social-development initiatives for charitable purposes. They need only act in their own self-interest. How? The authors lay out the business case for entering the world's poorest markets. Fully 65% of the world's population earns less than $2,000 per year--that's 4 billion people. But despite the vastness of this market, it remains largely untapped. The reluctance to invest is easy to understand, but it is, by and large, based on outdated assumptions of the developing world. While individual incomes may be low, the aggregate buying power of poor communities is actually quite large, representing a substantial market in many countries for what some might consider luxury goods like satellite television and phone services. Prices, and margins, are often much higher in poor neighborhoods than in their middle-class counterparts. And new technologies are already steadily reducing the effects of corruption, illiteracy, inadequate infrastructure, and other such barriers. Because these markets are in the earliest stages of economic development, revenue growth for multi-nationals entering them can be extremely rapid. MNCs can also lower costs, not only through low-cost labor but by transferring operating efficiencies and innovations developed to serve their existing operations. Certainly, succeeding in such markets requires MNCs to think creatively. The biggest change, though, has to come from executives: Unless business leaders confront their own preconceptions--particularly about the value of high-volume, low-margin businesses--companies are unlikely to master the challenges or reap the rewards of these developing markets.

  11. How electroencephalography serves the anesthesiologist.

    PubMed

    Marchant, Nicolas; Sanders, Robert; Sleigh, Jamie; Vanhaudenhuyse, Audrey; Bruno, Marie-Aurélie; Brichant, Jean François; Laureys, Steven; Bonhomme, Vincent

    2014-01-01

    Major clinical endpoints of general anesthesia, such as the alteration of consciousness, are achieved through effects of anesthetic agents on the central nervous system, and, more precisely, on the brain. Historically, clinicians and researchers have always been interested in quantifying and characterizing those effects through recordings of surface brain electrical activity, namely electroencephalography (EEG). Over decades of research, the complex signal has been dissected to extract its core substance, with significant advances in the interpretation of the information it may contain. Methodological, engineering, statistical, mathematical, and computer progress now furnishes advanced tools that not only allow quantification of the effects of anesthesia, but also shed light on some aspects of anesthetic mechanisms. In this article, we will review how advanced EEG serves the anesthesiologist in that respect, but will not review other intraoperative utilities that have no direct relationship with consciousness, such as monitoring of brain and spinal cord integrity. We will start with a reminder of anesthestic effects on raw EEG and its time and frequency domain components, as well as a summary of the EEG analysis techniques of use for the anesthesiologist. This will introduce the description of the use of EEG to assess the depth of the hypnotic and anti-nociceptive components of anesthesia, and its clinical utility. The last part will describe the use of EEG for the understanding of mechanisms of anesthesia-induced alteration of consciousness. We will see how, eventually in association with transcranial magnetic stimulation, it allows exploring functional cerebral networks during anesthesia. We will also see how EEG recordings during anesthesia, and their sophisticated analysis, may help corroborate current theories of mental content generation.

  12. Multiscale vulnerability of complex networks.

    PubMed

    Boccaletti, Stefano; Buldú, Javier; Criado, Regino; Flores, Julio; Latora, Vito; Pello, Javier; Romance, Miguel

    2007-12-01

    We present a novel approach to quantify the vulnerability of a complex network, i.e., the capacity of a graph to maintain its functional performance under random damages or malicious attacks. The proposed measure represents a multiscale evaluation of vulnerability, and makes use of combined powers of the links' betweenness. We show that the proposed approach is able to properly describe some cases for which earlier measures of vulnerability fail. The relevant applications of our method for technological network design are outlined.

  13. Reduction of Behavioral Psychological Symptoms of Dementia by Multimodal Comprehensive Care for Vulnerable Geriatric Patients in an Acute Care Hospital: A Case Series

    PubMed Central

    Honda, Miwako; Ito, Mio; Ishikawa, Shogo; Takebayashi, Yoichi; Tierney, Lawrence

    2016-01-01

    Management of Behavioral and Psychological Symptoms of Dementia (BPSD) is a key challenge in geriatric dementia care. A multimodal comprehensive care methodology, Humanitude, with eye contact, verbal communication, and touch as its elements, was provided to three geriatric dementia patients for whom conventional nursing care failed in an acute care hospital. Each episode was evaluated by video analysis. All patients had advanced dementia with BPSD. Failure of care was identified by patient's shouting, screaming, or abrupt movements of limbs. In this case series, conventional care failed for all three patients. Each element of care communication was much shorter than in Humanitude care, which was accepted by the patients. The average of the elements performed during the care was eye contact 0.6%, verbal communication 15.7%, and touch 0.1% in conventional care and 12.5%, 54.8%, and 44.5% in Humanitude care, respectively. The duration of aggressive behavior of each patient during care was 25.0%, 25.4%, and 66.3% in conventional care and 0%, 0%, and 0.3% in Humanitude, respectively. In our case series, conventional care was provided by less eye contact, verbal communication, and touch. The multimodal comprehensive care approach, Humanitude, decreased BPSD and showed success by patients' acceptance of care. PMID:27069478

  14. A Systematic Review of Patients' Experiences in Communicating with Primary Care Physicians: Intercultural Encounters and a Balance between Vulnerability and Integrity.

    PubMed

    Rocque, Rhea; Leanza, Yvan

    2015-01-01

    Communication difficulties persist between patients and physicians. In order to improve care, patients' experiences of this communication must be understood. The main objective of this study is to synthesize qualitative studies exploring patients' experiences in communicating with a primary care physician. A secondary objective is to explore specific factors pertaining to ethnic minority or majority patients and their influence on patients' experiences of communication. Pertinent health and social sciences electronic databases were searched systematically (PubMed, Cinahl, PsychNet, and IBSS). Fifty-seven articles were included in the review on the basis of being qualitative studies targeting patients' experiences of communication with a primary care physician. The meta-ethnography method for qualitative studies was used to interpret data and the COREQ checklist was used to evaluate the quality of included studies. Three concepts emerged from analyses: negative experiences, positive experiences, and outcomes of communication. Negative experiences related to being treated with disrespect, experiencing pressure due to time constraints, and feeling helpless due to the dominance of biomedical culture in the medical encounter. Positive experiences are attributed to certain relational skills, technical skills, as well as certain approaches to care privileged by the physician. Outcomes of communication depend on patients' evaluation of the consultation. Four categories of specific factors exerted mainly a negative influence on consultations for ethnic minorities: language barriers, discrimination, differing values, and acculturation. Ethnic majorities also raised specific factors influencing their experience: differing values and discrimination. Findings of this review are limited by the fact that more than half of the studies did not explore cultural aspects relating to this experience. Future research should address these aspects in more detail. In conclusion, all

  15. Adolescent (in)vulnerability.

    PubMed

    Quadrel, M J; Fischhoff, B; Davis, W

    1993-02-01

    Three groups of subjects were asked to judge the probability that they and several target others (a friend, an acquaintance, a parent, a child) would experience various risks. Subjects were middle-class adults, their teenage children, and high-risk adolescents from treatment homes. All three groups saw themselves as facing somewhat less risk than the target others. However, this perception of relative invulnerability was no more pronounced for adolescents than for adults. Indeed, the parents were viewed as less vulnerable than their teenage children by both the adults and those teens. These results are consistent with others showing small differences in the cognitive decision-making processes of adolescents and adults. Underestimating teens' competence can mean misdiagnosing the sources of their risk behaviors, denying them deserved freedoms, and failing to provide needed assistance.

  16. VuWiki: An Ontology-Based Semantic Wiki for Vulnerability Assessments

    NASA Astrophysics Data System (ADS)

    Khazai, Bijan; Kunz-Plapp, Tina; Büscher, Christian; Wegner, Antje

    2014-05-01

    vulnerability assessments with the possibility for any user to retrieve assessments using specific research criteria. Furthermore, Vuwiki can serve as a collaborative knowledge platform that allows for the active participation of those generating and using the knowledge represented in the wiki.

  17. Attending to social vulnerability when rationing pandemic resources.

    PubMed

    Vawter, Dorothy E; Garrett, J Eline; Gervais, Karen G; Prehn, Angela Witt; DeBruin, Debra A

    2011-01-01

    Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. Some plans that concern rationing during a severe pandemic recommend ways to protect socially vulnerable groups without prioritizing access to scarce resources based on social vulnerability per se. The Minnesota Pandemic Ethics Project (MPEP), a public engagement project on rationing scarce health resources during a severe influenza pandemic, agrees and recommends an integrated set of ways to attend to the needs of socially vulnerable people and avoid exacerbation of health disparities during a severe influenza pandemic. Among other things, MPEP recommends: 1. Engaging socially vulnerable populations to clarify unique needs and effective strategies; 2. Engaging socially vulnerable populations to elicit ethical values and perspectives on rationing; 3. Rejecting rationing based on race, socioeconomic class, citizenship, quality of life, length of life-extension and first-come, first-served; 4. Prioritizing those in the general population for access to resources based on combinations of risk (of death or severe complications from influenza, exposure to influenza, transmitting influenza to vulnerable groups) and the likelihood of responding well to the resource in question. 5. Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and

  18. Vendor System Vulnerability Testing Test Plan

    SciTech Connect

    James R. Davidson

    2005-01-01

    The Idaho National Laboratory (INL) prepared this generic test plan to provide clients (vendors, end users, program sponsors, etc.) with a sense of the scope and depth of vulnerability testing performed at the INL’s Supervisory Control and Data Acquisition (SCADA) Test Bed and to serve as an example of such a plan. Although this test plan specifically addresses vulnerability testing of systems applied to the energy sector (electric/power transmission and distribution and oil and gas systems), it is generic enough to be applied to control systems used in other critical infrastructures such as the transportation sector, water/waste water sector, or hazardous chemical production facilities. The SCADA Test Bed is established at the INL as a testing environment to evaluate the security vulnerabilities of SCADA systems, energy management systems (EMS), and distributed control systems. It now supports multiple programs sponsored by the U.S. Department of Energy, the U.S. Department of Homeland Security, other government agencies, and private sector clients. This particular test plan applies to testing conducted on a SCADA/EMS provided by a vendor. Before performing detailed vulnerability testing of a SCADA/EMS, an as delivered baseline examination of the system is conducted, to establish a starting point for all-subsequent testing. The series of baseline tests document factory delivered defaults, system configuration, and potential configuration changes to aid in the development of a security plan for in depth vulnerability testing. The baseline test document is provided to the System Provider,a who evaluates the baseline report and provides recommendations to the system configuration to enhance the security profile of the baseline system. Vulnerability testing is then conducted at the SCADA Test Bed, which provides an in-depth security analysis of the Vendor’s system.b a. The term System Provider replaces the name of the company/organization providing the system

  19. Reduced cardiac autonomic response to deep breathing: A heritable vulnerability trait in patients with schizophrenia and their healthy first-degree relatives.

    PubMed

    Liu, Yu-Wen; Tzeng, Nian-Sheng; Yeh, Chin-Bin; Kuo, Terry B J; Huang, San-Yuan; Chang, Chuan-Chia; Chang, Hsin-An

    2016-09-30

    Reduced resting heart rate variability (HRV) has been observed in patients with schizophrenia and their relatives, suggesting genetic predispositions. However, findings have not been consistent. We assessed cardiac autonomic response to deep breathing in first-degree relatives of patients with schizophrenia (n=45; 26 female; aged 39.69±14.82 years). Data were compared to healthy controls (n=45; 26 female; aged 38.27±9.79 years) matched for age, gender, body mass index and physical activity as well as to unmedicated patients with acute schizophrenia (n=45; 25 female; aged 37.31±12.65 years). Electrocardiograms were recorded under supine resting and deep-breathing conditions (10-12breaths/min). We measured HRV components including variance, low-frequency (LF) power, which may reflect baroreflex function, high-frequency (HF) power, which reflects cardiac parasympathetic activity, and LF/HF ratio, which may reflect sympatho-vagal balance. Patients rather than relatives exhibited lower resting-state HRV (variance, LF, and HF) than controls. As expected, deep breathing induced an increase in variance and HF-HRV in controls. However, such a response was significantly reduced in both patients and their relatives. In conclusion, the diminished cardiac autonomic reactivity to deep breathing seen in patients and their unaffected relatives indicates that this pattern of cardiac autonomic dysregulation may be regarded as a genetic trait marker for schizophrenia.

  20. The Naïve nurse: revisiting vulnerability for nursing

    PubMed Central

    2012-01-01

    Background Nurses in the Western world have given considerable attention to the concept of vulnerability in recent decades. However, nurses have tended to view vulnerability from an individualistic perspective, and have rarely taken into account structural or collective dimensions of the concept. As the need grows for health workers to engage in the global health agenda, nurses must broaden earlier works on vulnerability, noting that conventional conceptualizations and practical applications on the notion of vulnerability warrant extension to include more collective conceptualizations thereby making a more complete understanding of vulnerability in nursing discourse. Discussion The purpose of this paper is to examine nursing contributions to the concept of vulnerability and consider how a broader perspective that includes socio-political dimensions may assist nurses to reach beyond the immediate milieu of the patient into the dominant social, political, and economic structures that produce and sustain vulnerability. Summary By broadening nurse’s conceptualization of vulnerability, nurses can obtain the consciousness needed to move beyond a peripheral role of nursing that has been dominantly situated within institutional settings to contribute in the larger arena of social, economic, political and global affairs. PMID:22520841

  1. Severe hypoglycemia identifies vulnerable patients with type 2 diabetes at risk for premature death and all-site cancer: the Hong Kong diabetes registry.

    PubMed

    Kong, Alice P S; Yang, Xilin; Luk, Andrea; Ma, Ronald C W; So, Wing Yee; Ozaki, Risa; Ting, Rose; Cheung, Kitty; Ho, Chung Shun; Chan, Michael H M; Chow, Chun Chung; Chan, Juliana C N

    2014-04-01

    OBJECTIVE We examined the associations of clinical profiles in type 2 diabetic patients who developed severe hypoglycemia and their clinical outcomes, including death and all-site cancer. RESEARCH DESIGN AND METHODS A consecutive cohort of 8,767 type 2 diabetic patients with and without severe hypoglycemia in the 12 months before enrollment were recruited between 1995 and 2007, with follow-up until 2009. Severe hypoglycemia was defined by ICD-9 codes as hospitalizations resulting from hypoglycemia. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% CIs of clinical factors collected at enrollment for severe hypoglycemia. RESULTS In this cohort, mean age was 57.4 (SD 13.2) years and median disease duration of diabetes was 5 (interquartile range [IQR] 1-11) years. During a median follow-up of 6.71 (IQR 3.47-10.38) years, 235 patients had severe hypoglycemia (incidence 3.96 [95% CI 3.45-4.46] per 1,000 patient-years). At enrollment, patients with and without severe hypoglycemia had similar cancer rates. During follow-up, patients with severe hypoglycemia had a higher incidence of all-site cancer (13.4 vs. 6.4%, P < 0.0001) and mortality (32.8 vs. 11.2%, P < 0.0001) than those without severe hypoglycemia. After adjusting for confounders, old age, low BMI, high glycated hemoglobin, low triglyceride (TG), low LDL cholesterol (LDL-C), albuminuria, and chronic kidney disease were independent predictors for severe hypoglycemia. CONCLUSIONS In type 2 diabetes, severe hypoglycemia is associated with advanced age, renal dysfunction, poor glycemic control, and cancer subphenotypes (low BMI, low LDL-C, and low TG).

  2. The Vulnerability of Elderly Consumers.

    ERIC Educational Resources Information Center

    McGhee, Jerrie L.

    1983-01-01

    Reviews research on the vulnerability of the elderly to consumer fraud. Patterns of consumption, situational characteristics, education and product knowledge, psychological losses, social isolation, and psychosocial transitions influence the elderly's vulnerability and ability to cope with consumer abuse. Higher educational attainment and greater…

  3. Schizophrenia: vulnerability versus disease.

    PubMed Central

    Tsuang, Ming T.; Stone, William S.; Faraone, Stephen V.

    2000-01-01

    One of the most important trends in the treatment of schizophrenia involves its early diagnosis and intervention. The ultimate goal of research is the prevention of the disorder, A major impediment to the development of prevention strategies, however, is that we do not yet know what the liability for schizophrenia is before the onset of psychosis. Consequently, early treatment attempts are focused on the “prodrome,” which involves the early symptoms of psychosis. In a companion paper, we recently suggested that prevention work should focus not only on the prodrome, but also on “schizotaxia,” which is a clinically meaningful condition that may reflect the vulnerability to schizophrenia in the absence of psychosis. Because schizotaxia can be assessed prior to the prodrome, studies of schizotaxia might lead to more effective prevention programs. We continue the characterization of schizotaxia in this paper by focusing on the etiological roots of schizotaxia, plus its likely neurodevelopmental course, clinical expression, and treatment. Finally, the importance of including neurobiological variables in the conceptualization and eventual diagnosis of schizotaxia is reviewed. PMID:22034456

  4. Healthy Foods under $1 Per Serving

    MedlinePlus

    ... foods under $1 into your weekly menu planning. Apples (raw with skin) Great for: Snacks, green salads, ... and fruit salads What's a serving? 1 large apple Nutrition Info per serving: About 116 calories, 5. ...

  5. Research with vulnerable human beings.

    PubMed

    Tangwa, Godfrey B

    2009-11-01

    Some categories of human beings are particularly vulnerable vis-à-vis medical research. Vulnerability could be considered as the liability to be harmed, exploited, deceived, cheated, wronged, or otherwise unfairly treated, in roughly that descending order of importance. Vulnerable human beings obviously include the incompetent (minors and mentally handicapped adults), the desperately poor, ill or ignorant, prisoners, refugees, pregnant women, subordinates in highly authoritarian systems, etc. Vulnerability in itself does not imply that no research whatsoever should be carried out with such categories of humans but only that it should be carried out only under very special conditions. In this paper I treat of vulnerability in research of particularly developing world populations; of the types of research which exploit such vulnerability, and of why and how research subjects should be protected. The aim in this paper is to stimulate practical reflection on the possible vulnerabilities of potential research subjects that researchers or investigators need to avoid exploiting rather than on an adequate theoretical treatment of the issue.

  6. Attentional biases and vulnerability to depression.

    PubMed

    Gallardo Pérez, M; Baños Rivera, R M; Belloch Fuster, A; Ruipérez Rodríguez, M A

    1999-05-01

    This study was designed to examine selective processing of emotional information in depression. It focuses on possible attentional biases in depression, and whether such biases constitute a cognitive vulnerability factor to suffer from the disorder or, on the contrary, they reflect a feature associated exclusively with the clinical level of depression. 81 participants were included in the study: 15 with a diagnosis of Major Depression; 17 were diagnosed as Dysthymia; 11 participants scored over 18 in the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979); 15 participants, in whom a sad mood state was induced by an experimental mood induction (Velten technique + music, or biographical recall + music); and 23 participants as a normal-control group. All participants were presented with the emotional Stroop task. The data indicated that attentional bias was only present in the group of patients with Major Depression, so it does not seem to be a cognitive vulnerability factor for this disorder.

  7. Identifying Frailty Among Vulnerable Populations

    PubMed Central

    Salem, Benissa E.; Nyamathi, Adeline; Phillips, Linda R.; Mentes, Janet; Sarkisian, Catherine; Brecht, Lynn

    2014-01-01

    Frailty is a significant public health issue which is experienced by homeless and other vulnerable adults; to date, a frailty framework has not been proposed to guide researchers who study this hard-to-reach population. The Frailty Framework among Homeless and other Vulnerable Populations (FFHVP) has been developed from empirical research and consultation with frailty experts in an effort to characterize antecedents, i.e. situational, health-related, behavioral, resource, biological, and environmental factors which contribute to physical, psychological and social frailty domains and impact adverse outcomes. As vulnerable populations continue to age, a greater understanding of frailty will enable the development of nursing interventions. PMID:24469090

  8. The brain norepinephrine system, stress and cardiovascular vulnerability.

    PubMed

    Wood, Susan K; Valentino, Rita J

    2017-03-01

    Chronic exposure to psychosocial stress has adverse effects on cardiovascular health, however the stress-sensitive neurocircuitry involved remains to be elucidated. The anatomical and physiological characteristics of the locus coeruleus (LC)-norepinephrine (NE) system position it to contribute to stress-induced cardiovascular disease. This review focuses on cardiovascular dysfunction produced by social stress and a major theme highlighted is that differences in coping strategy determine individual differences in social stress-induced cardiovascular vulnerability. The establishment of different coping strategies and cardiovascular vulnerability during repeated social stress has recently been shown to parallel a unique plasticity in LC afferent regulation, resulting in either excitatory or inhibitory input to the LC. This contrasting regulation of the LC would translate to differences in cardiovascular regulation and may serve as the basis for individual differences in the cardiopathological consequences of social stress. The advances described suggest new directions for developing treatments and/or strategies for decreasing stress-induced cardiovascular vulnerability.

  9. Cognitive vulnerabilities as mediators between emotional abuse and depressive symptoms.

    PubMed

    Padilla Paredes, Patricia; Calvete, Esther

    2014-01-01

    This study tested whether childhood parental emotional abuse and peer emotional bullying serve as antecedents of depression in adolescence and identified the cognitive mechanisms involved in this process. It was hypothesized that the experience of emotional abuse would predict depressive symptoms via development of rumination and negative inferences. A 3-wave longitudinal study was carried out with 998 adolescents (471 girls and 526 boys) between 13 and 17 years of age. Results showed that emotional abuse by parents and peers at Time 1 predicted a worsening of several cognitive vulnerabilities at Time 2. In addition, brooding mediated between the experiences of abuse and the increase of depressive symptoms at Time 3. Thus, findings suggest that the experiences of childhood emotional abuse by parents and peers serve as antecedents to develop a negative cognitive style, vulnerability that, once developed, is a risk factor for the onset of depressive symptoms in adolescence.

  10. Multimodal spectroscopy detects features of vulnerable atherosclerotic plaque

    NASA Astrophysics Data System (ADS)

    Šćepanović, Obrad R.; Fitzmaurice, Maryann; Miller, Arnold; Kong, Chae-Ryon; Volynskaya, Zoya; Dasari, Ramachandra R.; Kramer, John R.; Feld, Michael S.

    2011-01-01

    Early detection and treatment of rupture-prone vulnerable atherosclerotic plaques is critical to reducing patient mortality associated with cardiovascular disease. The combination of reflectance, fluorescence, and Raman spectroscopy-termed multimodal spectroscopy (MMS)-provides detailed biochemical information about tissue and can detect vulnerable plaque features: thin fibrous cap (TFC), necrotic core (NC), superficial foam cells (SFC), and thrombus. Ex vivo MMS spectra are collected from 12 patients that underwent carotid endarterectomy or femoral bypass surgery. Data are collected by means of a unitary MMS optical fiber probe and a portable clinical instrument. Blinded histopathological analysis is used to assess the vulnerability of each spectrally evaluated artery lesion. Modeling of the ex vivo MMS spectra produce objective parameters that correlate with the presence of vulnerable plaque features: TFC with fluorescence parameters indicative of collagen presence; NC/SFC with a combination of diffuse reflectance β-carotene/ceroid absorption and the Raman spectral signature of lipids; and thrombus with its Raman signature. Using these parameters, suspected vulnerable plaques can be detected with a sensitivity of 96% and specificity of 72%. These encouraging results warrant the continued development of MMS as a catheter-based clinical diagnostic technique for early detection of vulnerable plaques.

  11. Assessing the Agricultural Vulnerability for India under Changing Climate

    NASA Astrophysics Data System (ADS)

    Sharma, Tarul; Vardhan Murari, Harsha; Karmakar, Subhankar; Ghosh, Subimal; Singh, Jitendra

    2016-04-01

    Global climate change has proven to show majorly negative impacts for the far future. These negative impacts adversely affect almost all the fields including agriculture, water resources, tourism, and marine ecosystem. Among these, the effects on agriculture are considered to be of prime importance since its regional impacts can directly affect the global food security. Under such lines, it becomes essential to understand how climate change directs agricultural production for a region along with its vulnerability. In India, rice and wheat are considered as major staple diet and hence understanding its production loss/gain due to regional vulnerability to climate change becomes necessary. Here, an attempt has been made to understand the agricultural vulnerability for rice and wheat, considering yield as a function of temperature and precipitation during growing period. In order to accomplish this objective, the ratio of actual to potential evapo-transpiration has been considered which serves as a reliable indicator; with more this ratio towards unity, less vulnerable will be the region. The current objective needs an integration of climatic, hydrological and agricultural parameters; that can be achieved by simulating a climate data driven hydrologic (Variable Infiltration Capacity, VIC) model and a crop (Decision Support System for Agrotechnology Transfer, DSSAT) model. The proposed framework is an attempt to derive a crop vulnerability map that can facilitate in strategizing adaption practices which can reduce the adverse impacts of climate change in future.

  12. Groundwater vulnerability on small islands

    NASA Astrophysics Data System (ADS)

    Holding, S.; Allen, D. M.; Foster, S.; Hsieh, A.; Larocque, I.; Klassen, J.; van Pelt, S. C.

    2016-12-01

    The majority of naturally occurring freshwater on small islands is groundwater, which is primarily recharged by precipitation. Recharge rates are therefore likely to be impacted by climate change. Freshwater resources on small islands are particularly vulnerable to climate change because they are limited in size and easily compromised. Here we have compiled available aquifer system characteristics and water-use data for 43 small island developing states distributed worldwide, based on local expert knowledge, publications and regional data sets. Current vulnerability was assessed by evaluating the recharge volume per capita. For future vulnerability, climate change projections were used to estimate changes in aquifer recharge. We find that 44% of islands are in a state of water stress, and while recharge is projected to increase by as much as 117% on 12 islands situated in the western Pacific and Indian Ocean, recharge is projected to decrease by up to 58% on the remaining 31 islands. Of great concern is the lack of enacted groundwater protection legislation for many of the small island developing states identified as highly vulnerable to current and future conditions. Recharge indicators, shown alongside the state of legal groundwater protections, provide a global picture of groundwater supply vulnerability under current and future climate change conditions.

  13. Are Vulnerability Disclosure Deadlines Justified?

    SciTech Connect

    Miles McQueen; Jason L. Wright; Lawrence Wellman

    2011-09-01

    Vulnerability research organizations Rapid7, Google Security team, and Zero Day Initiative recently imposed grace periods for public disclosure of vulnerabilities. The grace periods ranged from 45 to 182 days, after which disclosure might occur with or without an effective mitigation from the affected software vendor. At this time there is indirect evidence that the shorter grace periods of 45 and 60 days may not be practical. However, there is strong evidence that the recently announced Zero Day Initiative grace period of 182 days yields benefit in speeding up the patch creation process, and may be practical for many software products. Unfortunately, there is also evidence that the 182 day grace period results in more vulnerability announcements without an available patch.

  14. The Vulnerable Plaque: the Real Villain in Acute Coronary Syndromes

    PubMed Central

    Liang, Michael; Puri, Aniket; Devlin, Gerard

    2011-01-01

    The term "vulnerable plaque" refers to a vascular lesion that is prone to rupture and may result in life-threatening events which include myocardial infarction. It consists of thin-cap fibroatheroma and a large lipid core which is highly thrombogenic. Acute coronary syndromes often result from rupture of vulnerable plaques which frequently are only moderately stenosed and not visible by conventional angiography. Several invasive and non-invasive strategies have been developed to assess the burden of vulnerable plaques. Intravascular ultrasound provides a two-dimensional cross-sectional image of the arterial wall and can help assess the plaque burden and composition. Optical coherent tomography offers superior resolution over intravascular ultrasound. High-resolution magnetic resonance imaging provides non-invasive imaging for visualizing fibrous cap thickness and rupture in plaques. In addition, it may be of value in assessing the effects of treatments, such as lipid-lowering therapy. Technical issues however limit its clinical applicability. The role of multi-slice computed tomography, a well established screening tool for coronary artery disease, remains to be determined. Fractional flow reserve (FFR) may provide physiological functional assessment of plaque vulnerability; however, its role in the management of vulnerable plaque requires further studies. Treatment of the vulnerable patient may involve systemic therapy which currently include statins, ACE inhibitors, beta-blockers, aspirin, and calcium-channel blockers and in the future local therapeutic options such as drug-eluting stents or photodynamic therapy. PMID:21673834

  15. Selected items from the Charcot-Marie-Tooth (CMT) Neuropathy Score and secondary clinical outcome measures serve as sensitive clinical markers of disease severity in CMT1A patients.

    PubMed

    Mannil, Manoj; Solari, Alessandra; Leha, Andreas; Pelayo-Negro, Ana L; Berciano, José; Schlotter-Weigel, Beate; Walter, Maggie C; Rautenstrauss, Bernd; Schnizer, Tuuli J; Schenone, Angelo; Seeman, Pavel; Kadian, Chandini; Schreiber, Olivia; Angarita, Natalia G; Fabrizi, Gian Maria; Gemignani, Franco; Padua, Luca; Santoro, Lucio; Quattrone, Aldo; Vita, Giuseppe; Calabrese, Daniela; Young, Peter; Laurà, Matilde; Haberlová, Jana; Mazanec, Radim; Paulus, Walter; Beissbarth, Tim; Shy, Michael E; Reilly, Mary M; Pareyson, Davide; Sereda, Michael W

    2014-11-01

    This study evaluates primary and secondary clinical outcome measures in Charcot-Marie-Tooth disease type 1A (CMT1A) with regard to their contribution towards discrimination of disease severity. The nine components of the composite Charcot-Marie-Tooth disease Neuropathy Score and six additional secondary clinical outcome measures were assessed in 479 adult patients with genetically proven CMT1A and 126 healthy controls. Using hierarchical clustering, we identified four significant clusters of patients according to clinical severity. We then tested the impact of each of the CMTNS components and of the secondary clinical parameters with regard to their power to differentiate these four clusters. The CMTNS components ulnar sensory nerve action potential (SNAP), pin sensibility, vibration and strength of arms did not increase the discriminant value of the remaining five CMTNS components (Ulnar compound motor action potential [CMAP], leg motor symptoms, arm motor symptoms, leg strength and sensory symptoms). However, three of the six additional clinical outcome measures - the 10m-timed walking test (T10MW), 9 hole-peg test (9HPT), and foot dorsal flexion dynamometry - further improved discrimination between severely and mildly affected patients. From these findings, we identified three different composite measures as score hypotheses and compared their discriminant power with that of the CMTNS. A composite of eight components CMAP, Motor symptoms legs, Motor symptoms arms, Strength of Legs, Sensory symptoms), displayed the strongest power to discriminate between the clusters. As a conclusion, five items from the CMTNS and three secondary clinical outcome measures improve the clinical assessment of patients with CMT1A significantly and are beneficial for upcoming clinical and therapeutic trials.

  16. Calories and fat per serving (image)

    MedlinePlus

    ... and stores the rest in the form of fat. A calorie is a calorie, whether it comes ... between them is the number of calories, nutrients, fat, and other ingredients in a typical serving . Calories ...

  17. Endogenous kynurenate controls the vulnerability of striatal neurons to quinolinate: Implications for Huntington's disease.

    PubMed

    Sapko, Michael T; Guidetti, Paolo; Yu, Ping; Tagle, Danilo A; Pellicciari, Roberto; Schwarcz, Robert

    2006-01-01

    Excessive activation of NMDA receptors results in excitotoxic nerve cell loss, which is believed to play a critical role in the pathophysiology of Huntington's disease (HD) and several other catastrophic neurodegenerative diseases. Kynurenic acid (KYNA), a neuroinhibitory tryptophan metabolite, has neuroprotective properties and may serve as an endogenous anti-excitotoxic agent. This hypothesis was tested in the striatum, using mice with a targeted deletion of kynurenine aminotransferase II (KAT II), a major biosynthetic enzyme of KYNA in the mammalian brain. On post-natal day (PND) 14, the striatum of mkat-2-/- mice showed a reduction in KYNA levels but contained normal concentrations of the metabolically related neurotoxins 3-hydroxykynurenine and quinolinic acid (QUIN). Intrastriatal injections of QUIN, a NMDA receptor agonist, caused significantly larger lesions in these immature mutant mice than in age-matched wild-type animals. This lesion enlargement was not observed when mkat-2-/- mice were acutely pre-treated with the kynurenine 3-hydroxylase inhibitor UPF 648, which counteracted the striatal KYNA deficit. Moreover, no increased vulnerability to QUIN was observed in 2-month-old mkat-2-/- mice, which present with normal brain KYNA levels. Intrastriatal injections of the non-NMDA receptor agonist kainate caused similar lesion sizes in both genotypes regardless of age. These results indicate that endogenous KYNA preferentially controls the vulnerability of striatal neurons to QUIN. Our data suggest that timely pharmacological interventions resulting in an up-regulation of brain KYNA levels may benefit patients suffering from HD or other neurodegenerative diseases.

  18. Vulnerability in research ethics: a way forward.

    PubMed

    Lange, Margaret Meek; Rogers, Wendy; Dodds, Susan

    2013-07-01

    Several foundational documents of bioethics mention the special obligation researchers have to vulnerable research participants. However, the treatment of vulnerability offered by these documents often relies on enumeration of vulnerable groups rather than an analysis of the features that make such groups vulnerable. Recent attempts in the scholarly literature to lend philosophical weight to the concept of vulnerability are offered by Luna and Hurst. Luna suggests that vulnerability is irreducibly contextual and that Institutional Review Boards (Research Ethics Committees) can only identify vulnerable participants by carefully examining the details of the proposed research. Hurst, in contrast, defines the vulnerable as those especially at risk of incurring the wrongs to which all research ethics participants are exposed. We offer a more substantive conception of vulnerability than Luna but one that gives rise to a different rubric of responsibilities from Hurst's. While we understand vulnerability to be an ontological condition of human existence, in the context of research ethics, we take the vulnerable to be research subjects who are especially prone to harm or exploitation. Our analysis rests on developing a typology of sources of vulnerability and showing how distinct sources generate distinct obligations on the part of the researcher. Our account emphasizes that the researcher's first obligation is not to make the research participant even more vulnerable than they already are. To illustrate our framework, we consider two cases: that of a vulnerable population involved in international research and that of a domestic population of people with diminished capacity.

  19. Interactive Vulnerability Analysis Enhancement Results

    DTIC Science & Technology

    2012-12-01

    PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD- MM -YYYY) DECEMBER 2012 2. REPORT TYPE FINAL TECHNICAL REPORT 3. DATES...application. Here is a screenshot of IAST finding a Cross-Site Scripting (XSS) vulnerability in a “ Hello World” Scala application: Approved for Public

  20. Glaciology: Vulnerable Antarctic ice shelves

    NASA Astrophysics Data System (ADS)

    Siegert, Martin

    2017-01-01

    The decay of floating ice shelves around Antarctica speeds up ice flow from the continent and contributes to increased sea-level rise. Now, meltwater attributed to warm winds has been discovered on an East Antarctic ice shelf, suggesting greater vulnerability than previously thought.

  1. The Vulnerability Assessment & Mitigation Methodology

    DTIC Science & Technology

    2003-01-01

    Defense Systems........................................ 111 A.37. Vulnerabilities That Can Be Incurred from Vaccination ........... 112 A.38...protect against future threats or system failures while mitigating current and past threats and weaknesses. Also, sophisticated adver - saries are...and recovery • Adaptability and learning • Immunological defense systems • Vaccination ISR and Self-Awareness • Intelligence operations • Self

  2. [Vulnerability and National Health Service].

    PubMed

    Lima, Cristina

    2006-01-01

    to value life. The article concludes drawing attention to the need to invest in health education, which is just as important as the fair distribution of precious health care resources in reducing harmful risks to the most vulnerable patients.

  3. Selective Neuronal Vulnerability to Oxidative Stress in the Brain

    PubMed Central

    Wang, Xinkun; Michaelis, Elias K.

    2010-01-01

    Oxidative stress (OS), caused by the imbalance between the generation and detoxification of reactive oxygen and nitrogen species (ROS/RNS), plays an important role in brain aging, neurodegenerative diseases, and other related adverse conditions, such as ischemia. While ROS/RNS serve as signaling molecules at physiological levels, an excessive amount of these molecules leads to oxidative modification and, therefore, dysfunction of proteins, nucleic acids, and lipids. The response of neurons to this pervasive stress, however, is not uniform in the brain. While many brain neurons can cope with a rise in OS, there are select populations of neurons in the brain that are vulnerable. Because of their selective vulnerability, these neurons are usually the first to exhibit functional decline and cell death during normal aging, or in age-associated neurodegenerative diseases, such as Alzheimer's disease. Understanding the molecular and cellular mechanisms of selective neuronal vulnerability (SNV) to OS is important in the development of future intervention approaches to protect such vulnerable neurons from the stresses of the aging process and the pathological states that lead to neurodegeneration. In this review, the currently known molecular and cellular factors that contribute to SNV to OS are summarized. Included among the major underlying factors are high intrinsic OS, high demand for ROS/RNS-based signaling, low ATP production, mitochondrial dysfunction, and high inflammatory response in vulnerable neurons. The contribution to the selective vulnerability of neurons to OS by other intrinsic or extrinsic factors, such as deficient DNA damage repair, low calcium-buffering capacity, and glutamate excitotoxicity, are also discussed. PMID:20552050

  4. Vulnerable Subjects: Why Does Informed Consent Matter?

    PubMed

    Goodwin, Michele

    2016-09-01

    This special issue of the Journal Law, Medicine & Ethics takes up the concern of informed consent, particularly in times of controversy. The dominant moral dilemmas that frame traditional bioethical concerns address medical experimentation on vulnerable subjects; physicians assisting their patients in suicide or euthanasia; scarce resource allocation and medical futility; human trials to develop drugs; organ and tissue donation; cloning; xenotransplantation; abortion; human enhancement; mandatory vaccination; and much more. The term "bioethics" provides a lens, language, and guideposts to the study of medical ethics. It is worth noting, however, that medical experimentation is neither new nor exclusive to one country. Authors in this issue address thorny subjects that span borders and patients: from matters dealing with children and vaccination to the language and perception of consent.

  5. Global trends and vulnerabilities of mangrove forests

    NASA Astrophysics Data System (ADS)

    Simard, M.; Fatoyinbo, T. E.; Rivera-Monroy, V. H.; Castaneda, E.; Roy Chowdhury, R.

    2015-12-01

    Mangrove forests are located along Earth's coastlines and estuaries within tropical and subtropical latitudes. They provide numerous services functioning as an extraordinary carbon sequestration system and serving as habitat and nursery for fish, crustaceans and amphibians. To coastal populations, they provide livelihood, food, lumber and act as an effective protection against tsunamis, storm surges and hurricanes. Their vulnerability to sea level rise is strongly related to their extraordinary ability to accumulate soils, which is in part related to their productivity and therefore canopy structure. As a first step to understand their vulnerability, we seek to understand mangrove dependencies on environmental and geophysical setting. To achieve this, we mapped mangrove canopy height and above ground biomass (AGB) at the Global scale. To identify mangrove forests, existing maps derived from a collection of Landsat data around the 2000 era were used. Using the Shuttle Radar Topography Mission elevation data collected in February of 2000, we produced a Global map of mangrove canopy height. The estimated heights were validated with the ICESat/Geoscience Altimeter System (GLAS) and in situ field data. Most importantly, field data were also used to derive relationships between canopy height and AGB. While the geographical coverage of in situ data is limited, ICESat/GLAS data provided extensive geographical coverage with independent estimates of maximum canopy height. These estimates were used to calibrate SRTM-estimates of height at the Global scale. We found the difference between GLAS RH100 and SRTM resulted from several sources of uncertainty that are difficult to isolate. These include natural variations of canopy structure with time, system errors from GLAS and SRTM, geo-location errors and discrepancies in spatial resolution. The Global canopy height map was trnasormed into AGB using the field-derived allometry. Depending on the scale of analysis and geographical

  6. Unipolar Depression, Life Context Vulnerabilities, and Drinking to Cope

    ERIC Educational Resources Information Center

    Holahan, Charles J.; Moos, Rudolf H.; Holahan, Carole K.; Cronkite, Ruth C.; Randall, Patrick K.

    2004-01-01

    This study followed baseline samples of 424 unipolar depressed patients and 424 community controls across 10 years to investigate the association between depression and alcohol-related coping and to examine how life context vulnerabilities underlie the risk for depressed individuals to rely on drinking to cope. Findings supported all hypotheses.…

  7. Childhood Cancer and Vulnerability for Significant Academic Underachievement.

    ERIC Educational Resources Information Center

    Ott, Jeanne S.; And Others

    1982-01-01

    Learning difficulties related to childhood cancer were examined by comparison of 22 oncology patients and 22 children (6 to 17 years old) referred for psychiatric/psychological evaluation. Findings demonstrated, among children undergoing treatment of cancer, some academic vulnerabilities for which psychosocial aspects may not fully account.…

  8. Assessing European wild fire vulnerability

    NASA Astrophysics Data System (ADS)

    Oehler, F.; Oliveira, S.; Barredo, J. I.; Camia, A.; Ayanz, J. San Miguel; Pettenella, D.; Mavsar, R.

    2012-04-01

    Wild fire vulnerability is a measure of potential socio-economic damage caused by a fire in a specific area. As such it is an important component of long-term fire risk management, helping policy-makers take informed decisions about adequate expenditures for fire prevention and suppression, and to target those regions at highest risk. This paper presents a first approach to assess wild fire vulnerability at the European level. A conservative approach was chosen that assesses the cost of restoring the previous land cover after a potential fire. Based on the CORINE Land Cover, a restoration cost was established for each land cover class at country level, and an average restoration time was assigned according to the recovery capacity of the land cover. The damage caused by fire was then assessed by discounting the cost of restoring the previous land cover over the restoration period. Three different vulnerability scenarios were considered assuming low, medium and high fire severity causing different levels of damage. Over Europe, the potential damage of wild land fires ranges from 10 - 13, 732 Euro*ha-1*yr-1 for low fire severity, 32 - 45,772 Euro*ha-1*yr-1 for medium fire severity and 54 - 77,812 Euro*ha-1*yr-1 for high fire severity. The least vulnerable are natural grasslands, moors and heathland and sclerophyllous vegetation, while the highest cost occurs for restoring broad-leaved forest. Preliminary validation comparing these estimates with official damage assessments for past fires shows reasonable results. The restoration cost approach allows for a straightforward, data extensive assessment of fire vulnerability at European level. A disadvantage is the inherent simplification of the evaluation procedure with the underestimation of non-markets goods and services. Thus, a second approach has been developed, valuing individual wild land goods and services and assessing their annual flow which is lost for a certain period of time in case of a fire event. However

  9. MID-ATLANTIC REGIONAL VULNERABILITY ASSESSMENT

    EPA Science Inventory

    ORD's Regional Vulnerability Assessment (REVA) Program is developing and demonstrating approaches to assess current and future environmental vulnerabilities so that risk management activities can be targeted. The sister program to EMA.P (Environmental Monitoring Assessment Progr...

  10. Infrastructure Vulnerability Assessment Model (I-VAM).

    PubMed

    Ezell, Barry Charles

    2007-06-01

    Quantifying vulnerability to critical infrastructure has not been adequately addressed in the literature. Thus, the purpose of this article is to present a model that quantifies vulnerability. Vulnerability is defined as a measure of system susceptibility to threat scenarios. This article asserts that vulnerability is a condition of the system and it can be quantified using the Infrastructure Vulnerability Assessment Model (I-VAM). The model is presented and then applied to a medium-sized clean water system. The model requires subject matter experts (SMEs) to establish value functions and weights, and to assess protection measures of the system. Simulation is used to account for uncertainty in measurement, aggregate expert assessment, and to yield a vulnerability (Omega) density function. Results demonstrate that I-VAM is useful to decisionmakers who prefer quantification to qualitative treatment of vulnerability. I-VAM can be used to quantify vulnerability to other infrastructures, supervisory control and data acquisition systems (SCADA), and distributed control systems (DCS).

  11. Intensified tuberculosis case finding amongst vulnerable communities in southern India.

    PubMed

    Reddy, K K; Ananthakrishnan, R; Jacob, A G; Das, M; Isaakidis, P; Kumar, A M V

    2015-12-21

    India mainly uses passive case finding to detect tuberculosis (TB) patients through the Revised National Tuberculosis Control Programme (RNTCP). An intensified case finding (ICF) intervention was conducted among vulnerable communities in two districts of Karnataka during July-December 2013; 658 sputum smear-positive TB cases were detected. The number of smear-positive cases detected increased by 8.8% relative to the pre-intervention period (July-December 2012) in intervention communities as compared to an 8.6% decrease in communities without the ICF intervention. ICF activities brought TB services closer to vulnerable communities, moderately increasing TB case detection rates.

  12. Vulnerabilities to misinformation in online pharmaceutical marketing.

    PubMed

    De Freitas, Julian; Falls, Brian A; Haque, Omar S; Bursztajn, Harold J

    2013-05-01

    Given the large percentage of Internet users who search for health information online, pharmaceutical companies have invested significantly in online marketing of their products. Although online pharmaceutical marketing can potentially benefit both physicians and patients, it can also harm these groups by misleading them. Indeed, some pharmaceutical companies have been guilty of undue influence, which has threatened public health and trust. We conducted a review of the available literature on online pharmaceutical marketing, undue influence and the psychology of decision-making, in order to identify factors that contribute to Internet users' vulnerability to online pharmaceutical misinformation. We find five converging factors: Internet dependence, excessive trust in the veracity of online information, unawareness of pharmaceutical company influence, social isolation and detail fixation. As the Internet continues to change, it is important that regulators keep in mind not only misinformation that surrounds new web technologies and their contents, but also the factors that make Internet users vulnerable to misinformation in the first place. Psychological components are a critical, although often neglected, risk factor for Internet users becoming misinformed upon exposure to online pharmaceutical marketing. Awareness of these psychological factors may help Internet users attentively and safely navigate an evolving web terrain.

  13. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...), you may electronically serve documents on us. (ii) Serve documents electronically through the Internet... HAZARDOUS MATERIALS PROGRAM DEFINITIONS AND GENERAL PROCEDURES General Procedures Serving Documents §...

  14. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HAZARDOUS MATERIALS PROGRAM DEFINITIONS AND GENERAL PROCEDURES General Procedures Serving Documents § 105.35... electronically serve documents on us. (ii) Serve documents electronically through the Internet at...

  15. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HAZARDOUS MATERIALS PROGRAM DEFINITIONS AND GENERAL PROCEDURES General Procedures Serving Documents § 105.35... electronically serve documents on us. (ii) Serve documents electronically through the Internet at...

  16. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HAZARDOUS MATERIALS PROGRAM DEFINITIONS AND GENERAL PROCEDURES General Procedures Serving Documents § 105.35... electronically serve documents on us. (ii) Serve documents electronically through the Internet at...

  17. Soil vulnerability for cesium transfer.

    PubMed

    Vandenhove, Hildegarde; Sweeck, Lieve

    2011-07-01

    The recent events at the Fukushima Daiichi nuclear power plant in Japan have raised questions about the accumulation of radionuclides in soils and the possible impacts on agriculture surrounding nuclear power plants. This article summarizes the knowledge gained after the nuclear power plant accident in Chernobyl, Ukraine, on how soil parameters influence soil vulnerability for radiocesium bioavailability, discusses some potential agrochemical countermeasures, and presents some predictions of radiocesium crop concentrations for areas affected by the Fukushima accident.

  18. Vulnerabilities

    DTIC Science & Technology

    2009-05-04

    May 1, 2006)”, http://www.mod.go.jp/e/d_policy/dp13.html (accessed 1 April 2009). 6 ibid 7 Hongo , Jun. “Japan, U.S. sign accord on forces,” The...Jacobs, G. Keith. "Guam Becoming US Pacific Linchpin." Asia-Pacific Defence Reporter 29 (2003): 38-39. Jun, Hongo . "Japan, U.S. sign accord on forces

  19. Cotton genetic resources and crop vulnerability

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A report on the genetic vulnerability of cotton was provided to the National Genetic Resources Advisory Council. The report discussed crop vulnerabilities associated with emerging diseases, emerging pests, and a narrowing genetic base. To address these crop vulnerabilities, the report discussed the ...

  20. How Finland Serves Gifted and Talented Pupils

    ERIC Educational Resources Information Center

    Tirri, Kirsi; Kuusisto, Elina

    2013-01-01

    The purpose of this article is to provide an overview of the ways gifted and talented pupils are served in Finland. The trend toward individualism and freedom of choice as well as national policy affecting gifted education are discussed. Empirical research on Finnish teachers' attitudes toward gifted education with respect to the national…

  1. Pyramid Servings Database (PSDB) for NHANES III

    Cancer.gov

    The National Cancer Institute developed a database to examine dietary data from the National Center for Health Statistics' Third National Health and Nutrition Examination Survey in terms of servings from each of United States Department of Agriculture's The Food Guide Pyramid's major and minor food groups.

  2. Making a Difference by Serving All Students

    ERIC Educational Resources Information Center

    Olley, Rivka I.

    2009-01-01

    Randi Brown came to school psychology almost as a family business. Her grandmother was a school psychologist and the first licensed psychologist in the state of New York. Randi graduated with a doctoral degree from Yeshiva University and has served students in Westchester County, New York, for 18 years. She exemplifies the dedication typical of so…

  3. Serving up Success! Team Nutrition Days, 1997.

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Washington, DC.

    This publication presents success stories and actual activities from Team Nutrition Days 1997 to serve as a starting point for other schools wanting to create their own nutrition education activities. Team Nutrition Days was a 1-week celebration that used innovative, interactive activities to teach children that nutrition is the link between…

  4. Getting It Together: Serving the Adult Community.

    ERIC Educational Resources Information Center

    Bakshis, Robert D.

    1979-01-01

    Describes a community needs assessment survey conducted by the College of DuPage (Illinois) which served to advertise existing programs, provide public relations for the adult education council, and obtain measures of need for existing or expanded educational and leisure activities. (MB)

  5. 350 Ways Colleges are Serving Adult Learners.

    ERIC Educational Resources Information Center

    College Entrance Examination Board, New York, NY. Future Directions for a Learning Society.

    Designed for colleges and universities desiring to serve adult students, this booklet presents new practices that have been effective on campuses throughout the U.S. Listed are 350 practices reported in a telephone survey of approximately fifty representive institutions. The first of nine sections lists practices for assessing needs. Section 2,…

  6. Serving Distant Learners through Instructional Technologies.

    ERIC Educational Resources Information Center

    Drea, John T.; Armistead, L. Pendleton

    John Wood Community College (JWCC) serves a district population of approximately 90,000 in a predominantly rural section of west-central Illinois. In an effort to address the needs of the rural long-distance learner, JWCC has implemented a variety of instructional delivery techniques. Since its inception, JWCC has contracted with other area…

  7. 77 FR 13173 - Best Equipped Best Served

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-05

    ... technical input on proposed operational incentive scenarios for possible implementation in the 2012-2014... scenarios. The candidate proposals for discussion have been designed to deliver on the best equipped, best performing, best served concept for implementation in the 2012-2014 timeframe. The proposed scenarios...

  8. Serving Business in an Information Economy.

    ERIC Educational Resources Information Center

    The Bookmark, 1988

    1988-01-01

    The 23 articles in this theme issue focus on various aspects of library services to business in an information economy: "Serving Business in an Information Economy" (C. Bain); "New York's Resurging Economy and State Economic Development Information" (R. G. Paolino); "Department of Economic Development Library: Services to…

  9. "Gateway" Districts Struggle to Serve Immigrant Parents

    ERIC Educational Resources Information Center

    Maxwell, Lesli A.

    2012-01-01

    As thousands of communities--especially in the South--became booming gateways for immigrant families during the 1990s and the early years of the new century, public schools struggled with the unfamiliar task of serving the large numbers of English-learners arriving in their classrooms. Instructional programs were built from scratch. Districts had…

  10. Serving Stakeholders at a Small Regional University

    ERIC Educational Resources Information Center

    Burrage, Sean

    2015-01-01

    The Southeastern Oklahoma State University Honors Program serves a unique role in a small, rural setting such as Durant, Oklahoma. The honors program has a traditional mission in a university that offers a nontraditional setting and history within the context of higher education. The program thus offers special rewards to its students and to the…

  11. Serving Ethnic Minorities. Topical Paper 73.

    ERIC Educational Resources Information Center

    Harcleroad, Fred F.; And Others

    Dedicated to the memory of Raymond E. Schultz, the essays in this monograph discuss the role of the community college in serving minority students. An introductory essay by Fred F. Harcleroad summarizes Schultz's contributions to community college education. John E. Roueche then discusses the provision of equal educational opportunity to…

  12. Graduate Students Serve Extension as Evaluation Consultants

    ERIC Educational Resources Information Center

    McClure, Megan; Fuhrman, Nicholas E.

    2011-01-01

    In an effort to provide graduate students at a distance with field-based learning experiences and evaluation resources to statewide Extension programs, 24 Master's students participating in a distance-delivered program evaluation course served as evaluation consultants for Extension programs. State evaluation specialists unable to conduct…

  13. Health status of vulnerable populations.

    PubMed

    Aday, L A

    1994-01-01

    The notion of risk underlying the concept of vulnerability implies that everyone is potentially vulnerable (or at risk), that is, there is always a chance of developing health problems. The risk is, however, greater for those with the least social status, social capital, and human capital resources to either prevent or ameliorate the origins and consequences of poor physical, psychological, or social health. The completeness and accuracy of information on the health status of the vulnerable populations examined here varies substantially across groups. Methodological work is needed to derive standardized definitions of terms, specify the content and timing for collecting information for minimum basic data sets, and develop uniform standards for evaluating and reporting data quality on the health status of vulnerable populations. The variety of indicators of vulnerable populations examined indicates that during the decade of the 1980s the incidence of serious physical, psychological, and/or social needs increased (at worst) and was unameliorated (at best) for millions of Americans. AIDS emerged as a new and deadly threat from a handful of cases classified as Gay-Related Immune Deficiency in the early part of the 1980s to what now may be over a million Americans who are HIV-positive. The number of homeless has increased an average of 20% a year to estimates now ranging up to one million men, women, or children homeless on any given night to twice that number who may be homeless sometime during the year. Over seven million people immigrated to the United States during the period from 1981 to 1990--an increasing proportion of whom are refugees carrying with them the physical, psychological, and social wounds of war. The number of children abused by family members or other intimates has burgeoned to an estimated 1.6 to 1.7 million per year, and with the greater use of firearms, intentional acts of violence towards oneself or others are becoming increasingly deadly in

  14. Measuring vulnerability to disaster displacement

    NASA Astrophysics Data System (ADS)

    Brink, Susan A.; Khazai, Bijan; Power, Christopher; Wenzel, Friedemann

    2015-04-01

    Large scale disasters can cause devastating impacts in terms of population displacement. Between 2008 and 2013, on average 27 million people were displaced annually by disasters (Yonetani 2014). After large events such as hurricane Katrina or the Port-au-Prince earthquake, images of inadequate public shelter and concerns about large scale and often inequitable migration have been broadcast around the world. Population displacement can often be one of the most devastating and visible impacts of a natural disaster. Despite the importance of population displacement in disaster events, measures to understand the socio-economic vulnerability of a community often use broad metrics to estimate the total socio-economic risk of an event rather than focusing on the specific impacts that a community faces in a disaster. Population displacement is complex and multi-causal with the physical impact of a disaster interacting with vulnerability arising from the response, environmental issues (e.g., weather), cultural concerns (e.g., expectations of adequate shelter), and many individual factors (e.g., mobility, risk perception). In addition to the complexity of the causes, population displacement is difficult to measure because of the wide variety of different terms and definitions and its multi-dimensional nature. When we speak of severe population displacement, we may refer to a large number of displaced people, an extended length of displacement or associated difficulties such as poor shelter quality, risk of violence and crime in shelter communities, discrimination in aid, a lack of access to employment or other difficulties that can be associated with large scale population displacement. We have completed a thorough review of the literature on disaster population displacement. Research has been conducted on historic events to understand the types of negative impacts associated with population displacement and also the vulnerability of different groups to these impacts. We

  15. Patterns of Freshwater Species Richness, Endemism, and Vulnerability in California.

    PubMed

    Howard, Jeanette K; Klausmeyer, Kirk R; Fesenmyer, Kurt A; Furnish, Joseph; Gardali, Thomas; Grantham, Ted; Katz, Jacob V E; Kupferberg, Sarah; McIntyre, Patrick; Moyle, Peter B; Ode, Peter R; Peek, Ryan; Quiñones, Rebecca M; Rehn, Andrew C; Santos, Nick; Schoenig, Steve; Serpa, Larry; Shedd, Jackson D; Slusark, Joe; Viers, Joshua H; Wright, Amber; Morrison, Scott A

    2015-01-01

    The ranges and abundances of species that depend on freshwater habitats are declining worldwide. Efforts to counteract those trends are often hampered by a lack of information about species distribution and conservation status and are often strongly biased toward a few well-studied groups. We identified the 3,906 vascular plants, macroinvertebrates, and vertebrates native to California, USA, that depend on fresh water for at least one stage of their life history. We evaluated the conservation status for these taxa using existing government and non-governmental organization assessments (e.g., endangered species act, NatureServe), created a spatial database of locality observations or distribution information from ~400 data sources, and mapped patterns of richness, endemism, and vulnerability. Although nearly half of all taxa with conservation status (n = 1,939) are vulnerable to extinction, only 114 (6%) of those vulnerable taxa have a legal mandate for protection in the form of formal inclusion on a state or federal endangered species list. Endemic taxa are at greater risk than non-endemics, with 90% of the 927 endemic taxa vulnerable to extinction. Records with spatial data were available for a total of 2,276 species (61%). The patterns of species richness differ depending on the taxonomic group analyzed, but are similar across taxonomic level. No particular taxonomic group represents an umbrella for all species, but hotspots of high richness for listed species cover 40% of the hotspots for all other species and 58% of the hotspots for vulnerable freshwater species. By mapping freshwater species hotspots we show locations that represent the top priority for conservation action in the state. This study identifies opportunities to fill gaps in the evaluation of conservation status for freshwater taxa in California, to address the lack of occurrence information for nearly 40% of freshwater taxa and nearly 40% of watersheds in the state, and to implement adequate

  16. Patterns of Freshwater Species Richness, Endemism, and Vulnerability in California

    PubMed Central

    Furnish, Joseph; Gardali, Thomas; Grantham, Ted; Katz, Jacob V. E.; Kupferberg, Sarah; McIntyre, Patrick; Moyle, Peter B.; Ode, Peter R.; Peek, Ryan; Quiñones, Rebecca M.; Rehn, Andrew C.; Santos, Nick; Schoenig, Steve; Serpa, Larry; Shedd, Jackson D.; Slusark, Joe; Viers, Joshua H.; Wright, Amber; Morrison, Scott A.

    2015-01-01

    The ranges and abundances of species that depend on freshwater habitats are declining worldwide. Efforts to counteract those trends are often hampered by a lack of information about species distribution and conservation status and are often strongly biased toward a few well-studied groups. We identified the 3,906 vascular plants, macroinvertebrates, and vertebrates native to California, USA, that depend on fresh water for at least one stage of their life history. We evaluated the conservation status for these taxa using existing government and non-governmental organization assessments (e.g., endangered species act, NatureServe), created a spatial database of locality observations or distribution information from ~400 data sources, and mapped patterns of richness, endemism, and vulnerability. Although nearly half of all taxa with conservation status (n = 1,939) are vulnerable to extinction, only 114 (6%) of those vulnerable taxa have a legal mandate for protection in the form of formal inclusion on a state or federal endangered species list. Endemic taxa are at greater risk than non-endemics, with 90% of the 927 endemic taxa vulnerable to extinction. Records with spatial data were available for a total of 2,276 species (61%). The patterns of species richness differ depending on the taxonomic group analyzed, but are similar across taxonomic level. No particular taxonomic group represents an umbrella for all species, but hotspots of high richness for listed species cover 40% of the hotspots for all other species and 58% of the hotspots for vulnerable freshwater species. By mapping freshwater species hotspots we show locations that represent the top priority for conservation action in the state. This study identifies opportunities to fill gaps in the evaluation of conservation status for freshwater taxa in California, to address the lack of occurrence information for nearly 40% of freshwater taxa and nearly 40% of watersheds in the state, and to implement adequate

  17. Research on security vulnerability of chip

    NASA Astrophysics Data System (ADS)

    Chen, Zhifeng; Li, Qingbao; Li, Zhou

    2013-03-01

    The 21st century is the information era. IC (Integrated Circuit) is the basis of the modern information industry. The security vulnerability or back door of IC is directly related to the entire information system security. From the perspective of information security, security vulnerability of chip is led out through the practical examples and then the importance of security vulnerability of chip is emphasized. By comparing the security vulnerability of chip with the software virus, the characteristics of the chip vulnerabilities are summed up. Moreover, this paper describes the security vulnerability models of different control logic chips, combinational and sequential logic chips models. Finally it puts forward two kinds of detecting methods of security vulnerability of chip against the two models.

  18. Acquaintance molestation and youth-serving organizations.

    PubMed

    Lanning, Kenneth V; Dietz, Park

    2014-10-01

    This article is based not only on the research literature but also on the extensive field experience of the authors in consulting with investigators, attorneys, and organizations on the prevention, investigation, prosecution, and civil litigation of molestation of children within or in connection with youth-serving organizations. Acquaintance molesters have often pursued careers or sought out paid or volunteer work with organizations through which they can meet children. To address the problem of such offenders, it is necessary for youth-serving organizations to recognize the diversity of sexual activity, the phenomena of "nice-guy" offenders and compliant child victims, and the grooming/seduction process, each of which is reviewed here. The four most important protection practices for organizations are screening; management, and supervision; response to suspicions, allegations, and complaints; and prevention and awareness programs. The authors recommend general approaches to each of these and describe the reasons many organizations resist implementing available preventive measures.

  19. Emerging Hispanic-Serving Institutions (HSIs): Serving Latino Students. Executive Summary

    ERIC Educational Resources Information Center

    Excelencia in Education (NJ1), 2010

    2010-01-01

    The invention of Hispanic-serving Institutions (HSIs) in the 1980s was grounded in the theory that institutions enrolling a large concentration of Latino students would adapt their institutional practices to serve these students better. Specifically, critical mass theory suggests once a definable group reaches a certain size within an…

  20. Complicating a Latina/o-Serving Identity at a Hispanic Serving Institution

    ERIC Educational Resources Information Center

    Garcia, Gina A.

    2016-01-01

    As institutions not founded to "serve" Latina/o students, Hispanic Serving Institutions (HSIs) are criticized for solely being "Hispanic-enrolling," with access and graduation rates being hypothesized as indicators of an organizational identity for HSIs. Drawing from a case study with 88 participants, the purpose of this…

  1. Culturally Relevant Practices That "Serve" Students at a Hispanic Serving Institution

    ERIC Educational Resources Information Center

    Garcia, Gina A.; Okhidoi, Otgonjargal

    2015-01-01

    As institutions not founded to "serve" Latina/o students, Hispanic Serving Institutions (HSIs) must actively change their curricula and programs to meet the needs of their diverse population, including Latina/o, low income, and first generation students. Using a case study approach, including interviews and focus groups, this study…

  2. Student workshop Risks and the state of crisis and vulnerability

    NASA Astrophysics Data System (ADS)

    Gociman, Cristina; Florescu, Tiberiu; Bostenaru Dan, Maria

    2010-05-01

    This contribution presents the purpose and results of a workshop run with students of master II Bologna "Urban design" within the joint framework of two courses: "The state of urban crisis and vulnerability" and "Protection of localities against natural and man-made risks" in February 2010. This is the second workshop of this kind, the first being run within the frame of a CNCSIS (Romanian Authority for Funding Research in Higher Education) project led by Cristina Gociman. The results of the two workshops will also be compared. Now this second workshop serves the purpose of the established Centre for Emergency Architecture.

  3. Equipment for Hot-to-serve Foods

    NASA Technical Reports Server (NTRS)

    Smith, D. P.

    1985-01-01

    Patented surface heating devices with a much faster air-to-solid heat transfer rate than previous air ovens were developed. The accelerated surface heating can brown, sear or crisp much more rapidly than in conventional ovens so that partially prepared food can be finished quickly and tastefully immediately before serving. The crisp, freshly browned surfaces result from the faster heat transfer which does not dry out the food. The devices are then compared to convection ovens and microwave heating processes.

  4. Vulnerability Assessment of Selected Buildings Designated as Shelters: St. Kitts--Nevis.

    ERIC Educational Resources Information Center

    Gibbs, Tony

    Educational facilities in the Caribbean often serve roles as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools located on St. Kitts and Nevis to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with…

  5. Vulnerability Assessment of Selected Buildings Designated as Shelters: Antigua and Barbuda.

    ERIC Educational Resources Information Center

    Gibbs, Tony

    Educational facilities in the Caribbean often serve roles as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools located on Antigua and Barbuda to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with…

  6. A Peer-to-Peer Health Education Program for Vulnerable Children in Uganda

    ERIC Educational Resources Information Center

    Falk, Diane S.; Pettet, Kristen; Mpagi, Charles

    2016-01-01

    In this paper, children attending a U.S.-sponsored private primary school serving orphaned and vulnerable children in Uganda were interviewed in focus groups about their participation in a peer-to-peer health education program in which they used music, dance, poetry, art, and drama to convey health information. The children reported enhanced…

  7. Mountain torrents: Quantifying vulnerability and assessing uncertainties

    PubMed Central

    Totschnig, Reinhold; Fuchs, Sven

    2013-01-01

    Vulnerability assessment for elements at risk is an important component in the framework of risk assessment. The vulnerability of buildings affected by torrent processes can be quantified by vulnerability functions that express a mathematical relationship between the degree of loss of individual elements at risk and the intensity of the impacting process. Based on data from the Austrian Alps, we extended a vulnerability curve for residential buildings affected by fluvial sediment transport processes to other torrent processes and other building types. With respect to this goal to merge different data based on different processes and building types, several statistical tests were conducted. The calculation of vulnerability functions was based on a nonlinear regression approach applying cumulative distribution functions. The results suggest that there is no need to distinguish between different sediment-laden torrent processes when assessing vulnerability of residential buildings towards torrent processes. The final vulnerability functions were further validated with data from the Italian Alps and different vulnerability functions presented in the literature. This comparison showed the wider applicability of the derived vulnerability functions. The uncertainty inherent to regression functions was quantified by the calculation of confidence bands. The derived vulnerability functions may be applied within the framework of risk management for mountain hazards within the European Alps. The method is transferable to other mountain regions if the input data needed are available. PMID:27087696

  8. Integrated Estimation of Seismic Physical Vulnerability of Tehran Using Rule Based Granular Computing

    NASA Astrophysics Data System (ADS)

    Sheikhian, H.; Delavar, M. R.; Stein, A.

    2015-08-01

    Tehran, the capital of Iran, is surrounded by the North Tehran fault, the Mosha fault and the Rey fault. This exposes the city to possibly huge earthquakes followed by dramatic human loss and physical damage, in particular as it contains a large number of non-standard constructions and aged buildings. Estimation of the likely consequences of an earthquake facilitates mitigation of these losses. Mitigation of the earthquake fatalities may be achieved by promoting awareness of earthquake vulnerability and implementation of seismic vulnerability reduction measures. In this research, granular computing using generality and absolute support for rule extraction is applied. It uses coverage and entropy for rule prioritization. These rules are combined to form a granule tree that shows the order and relation of the extracted rules. In this way the seismic physical vulnerability is assessed, integrating the effects of the three major known faults. Effective parameters considered in the physical seismic vulnerability assessment are slope, seismic intensity, height and age of the buildings. Experts were asked to predict seismic vulnerability for 100 randomly selected samples among more than 3000 statistical units in Tehran. The integrated experts' point of views serve as input into granular computing. Non-redundant covering rules preserve the consistency in the model, which resulted in 84% accuracy in the seismic vulnerability assessment based on the validation of the predicted test data against expected vulnerability degree. The study concluded that granular computing is a useful method to assess the effects of earthquakes in an earthquake prone area.

  9. Spatial characteristics of professional tennis serves with implications for serving aces: A machine learning approach.

    PubMed

    Whiteside, David; Reid, Machar

    2017-04-01

    This study sought to determine the features of an ideal serve in men's professional tennis. A total of 25,680 first serves executed by 151 male tennis players during Australian Open competition were classified as either aces or returned into play. Spatiotemporal (impact location, speed, projection angles, landing location and relative player locations) and contextual (score) features of each serve were extracted from Hawk-Eye data and used to construct a classification tree model (with decision rules) that predicted serve outcome. k-means clustering was applied to the landing locations to quantify optimal landing locations for aces. The classification tree revealed that (1) serve directionality, relative to the returner; (2) the ball's landing proximity to the nearest service box line and (3) serve speed classified aces with an accuracy of 87.02%. Hitting aces appeared more contingent on accuracy than speed, with serves directed >5.88° from the returner and landing <15.27 cm from a service box line most indicative of an ace. k-means clustering revealed four distinct locations (≈0.73 m wide × 2.35 m deep) in the corners of the service box that corresponded to aces. These landing locations provide empirically derived target locations for players to adhere to during practice and competition.

  10. Scenarios for coastal vulnerability assessment

    USGS Publications Warehouse

    Nicholls, Robert J.; Woodroffe, Colin D.; Burkett, Virginia; Hay, John; Wong, Poh Poh; Nurse, Leonard; Wolanski, Eric; McLusky, Donald S.

    2011-01-01

    Coastal vulnerability assessments tend to focus mainly on climate change and especially on sea-level rise. Assessment of the influence of nonclimatic environmental change or socioeconomic change is less well developed and these drivers are often completely ignored. Given that the most profound coastal changes of the twentieth century due to nonclimate drivers are likely to continue through the twenty-first century, this is a major omission. It may result in not only overstating the importance of climate change but also overlooking significant interactions of climate change and other drivers. To support the development of policies relating to climate change and coastal management, integrated assessments of climatic change in coastal areas are required, including the effects of all the relevant drivers. This chapter explores the development of scenarios (or "plausible futures") of relevant climate and nonclimate drivers that can be used for coastal analysis, with an emphasis on the nonclimate drivers. It shows the importance of analyzing the impacts of climate change and sea-level rise in a broader context of coastal change and all its drivers. This will improve the analysis of impacts, key vulnerabilities, and adaptation needs and, hence, inform climate and coastal policy. Stakeholder engagement is important in the development of scenarios, and the underlying assumptions need to be explicit, transparent, and open to scientific debate concerning their uncertainties/realism and likelihood.

  11. Vulnerable to HIV / AIDS. Migration.

    PubMed

    Fernandez, I

    1998-01-01

    This special report discusses the impact of globalization, patterns of migration in Southeast Asia, gender issues in migration, the links between migration and HIV/AIDS, and spatial mobility and social networks. Migrants are particularly marginalized in countries that blame migrants for transmission of infectious and communicable diseases and other social ills. Effective control of HIV/AIDS among migrant and native populations requires a multisectoral approach. Programs should critically review the privatization of health care services and challenge economic models that polarize the rich and the poor, men and women, North and South, and migrant and native. Programs should recognize the equality between locals and migrants in receipt of health services. Countermeasures should have input from migrants in order to reduce the conditions that increase vulnerability to HIV/AIDS. Gender-oriented research is needed to understand women's role in migration. Rapid assessment has obscured the human dimension of migrants' vulnerability to HIV. Condom promotion is not enough. Migration is a major consequence of globalization, which holds the promise, real or imagined, of prosperity for all. Mass migration can be fueled by explosive regional developments. In Southeast Asia, migration has been part of the process of economic development. The potential to emigrate increases with greater per capita income. "Tiger" economies have been labor importers. Safe sex is not practiced in many Asian countries because risk is not taken seriously. Migrants tend to be used as economic tools, without consideration of social adjustment and sex behavior among singles.

  12. Vulnerability of network of networks

    NASA Astrophysics Data System (ADS)

    Havlin, S.; Kenett, D. Y.; Bashan, A.; Gao, J.; Stanley, H. E.

    2014-10-01

    Our dependence on networks - be they infrastructure, economic, social or others - leaves us prone to crises caused by the vulnerabilities of these networks. There is a great need to develop new methods to protect infrastructure networks and prevent cascade of failures (especially in cases of coupled networks). Terrorist attacks on transportation networks have traumatized modern societies. With a single blast, it has become possible to paralyze airline traffic, electric power supply, ground transportation or Internet communication. How, and at which cost can one restructure the network such that it will become more robust against malicious attacks? The gradual increase in attacks on the networks society depends on - Internet, mobile phone, transportation, air travel, banking, etc. - emphasize the need to develop new strategies to protect and defend these crucial networks of communication and infrastructure networks. One example is the threat of liquid explosives a few years ago, which completely shut down air travel for days, and has created extreme changes in regulations. Such threats and dangers warrant the need for new tools and strategies to defend critical infrastructure. In this paper we review recent advances in the theoretical understanding of the vulnerabilities of interdependent networks with and without spatial embedding, attack strategies and their affect on such networks of networks as well as recently developed strategies to optimize and repair failures caused by such attacks.

  13. Dynamics of immune system vulnerabilities

    NASA Astrophysics Data System (ADS)

    Stromberg, Sean P.

    The adaptive immune system can be viewed as a complex system, which adapts, over time, to reflect the history of infections experienced by the organism. Understanding its operation requires viewing it in terms of tradeoffs under constraints and evolutionary history. It typically displays "robust, yet fragile" behavior, meaning common tasks are robust to small changes but novel threats or changes in environment can have dire consequences. In this dissertation we use mechanistic models to study several biological processes: the immune response, the homeostasis of cells in the lymphatic system, and the process that normally prevents autoreactive cells from entering the lymphatic system. Using these models we then study the effects of these processes interacting. We show that the mechanisms that regulate the numbers of cells in the immune system, in conjunction with the immune response, can act to suppress autoreactive cells from proliferating, thus showing quantitatively how pathogenic infections can suppress autoimmune disease. We also show that over long periods of time this same effect can thin the repertoire of cells that defend against novel threats, leading to an age correlated vulnerability. This vulnerability is shown to be a consequence of system dynamics, not due to degradation of immune system components with age. Finally, modeling a specific tolerance mechanism that normally prevents autoimmune disease, in conjunction with models of the immune response and homeostasis we look at the consequences of the immune system mistakenly incorporating pathogenic molecules into its tolerizing mechanisms. The signature of this dynamic matches closely that of the dengue virus system.

  14. Maternal screening for early postnatal vulnerability.

    PubMed

    Vivilaki, V G; Dafermos, V; Patelarou, Ev; Bick, D; Syngelaki, Ar; Tsopelas, N D; Bitsios, P; Petridou, E T; Vgontzas, Al N; Lionis, Chr

    2016-01-01

    -Efficacy (Factor III: Eigen- value=3.144) and especially attitudes regarding body image, sex and coping resources and options of dealing with the stressor, has been demonstrated that serve as a mediator or buffer for psychological distress. The results of this study have implications for the prevention and intervention of postnatal adjustment difficulties both of which need to be intensified in order to minimise perinatal mental vulnerability.

  15. Pipelines jockey to serve Florida gas market

    SciTech Connect

    Not Available

    1992-09-07

    This paper reports that Florida Gas Transmission Corp. (FGT), Houston, appears to have taken the lead in competition to serve Florida's growing gas markets. Florida Power and Light (FPL), Miami, decided to reserve transportation capacity on FGT's proposed Phase III expansion rather than the Sun Coast pipeline proposed by United Gas Pipe Line Co. (UGPL), Houston, and Coastal Corp. unit ANR Pipeline Co., Detroit (OGJ, Aug. 31, p. 31). Withdrawal of FPL, Florida's largest electric utility, from Sun Coast left the proposed 560 mile, 400 MMcfd intrastate gas transmission pipeline with only one major prospective client, Florida Power Corp., St. Petersburg. That forces UGPL and ANR to dissolve the partnership.

  16. PREPARING HEALTH PROFESSIONS VOLUNTEERS TO SERVE GLOBALLY.

    PubMed

    Carey, Rebekah E; Carter-Templeton, Heather; Paltzer, Jason

    2015-01-01

    Scant literature exists to describe the global health and collaboration competence of international healthcare professional volunteers. An educational program to prepare volunteers for short-term service in resource-poor settings was developed. Pre- and post- program competence and team collaboration levels were assessed in 18 healthcare professionals. A significant improvement (p < .05) occurred in global health competence after education. Formal educational preparation of international health volunteers can enhance their overall effectiveness when serving in resource-poor settings. Extensive resources for global health education are referenced.

  17. Skylab Food Heating and Serving Tray

    NASA Technical Reports Server (NTRS)

    1970-01-01

    Shown here is the Skylab food heating and serving tray with food, drink, and utensils. The tray contained heating elements for preparing the individual food packets. The food on Skylab was a great improvement over that on earlier spaceflights. It was no longer necessary to squeeze liquified food from plastic tubes. Skylab's kitchen in the Orbital Workshop wardroom was so equipped that each crewman could select his own menu and prepare it to his own taste. The Marshall Space Flight Center had program management responsibility for the development of Skylab hardware and experiments.

  18. Assessing human vulnerability: Daytime residential distribution as a vulnerability indicator

    NASA Astrophysics Data System (ADS)

    Gokesch, Karin; Promper, Catrin; Papathoma-Köhle, Maria; Glade, Thomas

    2014-05-01

    Natural hazard risk management is based on detailed information on potential impacts of natural hazards. Especially concerning fast onset hazards such as flash floods, earthquakes but also debris flows and landslides, knowing potential hotspots of impact to both, assets and human lives is essential. This information is important for emergency management and decision making in the response phase of the disaster management cycle. Emergency managers are in need of information regarding not only the number of humans being potentially affected but also the respective vulnerability of the group affected based on characteristics such as age, income, health condition, mobility, etc. regarding a certain hazard. The analysis presented focuses on the distribution of the population, assuming a certain pattern of people in a certain radius of action. The method applied is based on a regular pattern of movement of different groups of people and a pattern of presence in certain units, e.g. schools, businesses or residential buildings. The distribution is calculated on a minimum of available data including the average household size, as well as information on building types. The study area is located in the Southwest of Lower Austria, Austria. The city of Waidhofen/Ybbs can be regarded as a regional center providing basic infrastructure, shops and schools. The high concentration of buildings combining shops and residential units leads to a high damage potential throughout the whole study area. The presented results indicate the population distribution within the study area on an average working day. It is clear that explicitly high numbers of people are located in specific buildings (e.g. schools and hospitals) which also include highly vulnerable groups especially to fast onset hazards. The results provide emergency services with the information that they need in order to intervene directly where large numbers of victims or people that need to be evacuated are located. In this

  19. An holistic view on aquifer vulnerability based on a distinction of different types of vulnerability

    NASA Astrophysics Data System (ADS)

    De Luca, Domenico Antonio; Lasagna, Manuela; Franchino, Elisa

    2016-04-01

    AN HOLISTIC VIEW ON AQUIFER VULNERABILITY BASED ON A DISTINCTION OF DIFFERENT TYPES OF VULNERABILITY D.A. De Luca1 , M. Lasagna1, E. Franchino1 1Department of Earth Sciences, University of Turin The concept of vulnerability is certainly useful in the field of groundwater protection. Nevertheless, within the scientific community, the definition of groundwater vulnerability is still debatable and not clear and conclusive. This is probably due to the fact that researchers often have very different experiences and education. A positive effect of it is a constant exchange of ideas, but there are also negative consequences and difficulties in deepening the issue. The different approaches are very important but they are usable only if the concept of vulnerability is standardized: thus, for the sake of clarity, a number of definitions should be laid down, based on the different types of vulnerability. These definitions can then provide the necessary holistic view for the aquifer vulnerability assessment. Nowadays vulnerability methods focus on the degree of vulnerability and the parameters needed for its evaluation, often neglecting to clarify what is the type of vulnerability the proposed methods are referred. The type of vulnerability, indeed, is both logically and hierarchically superior to the degree of vulnerability. More specifically the type of vulnerability represents the evaluation of the hydrogeological conditions considered in the vulnerability assessment and able to influence the way in which the contamination can take place. Currently the only distinction, based on of the type of vulnerability, is referred to intrinsic and specific vulnerability. Intrinsic vulnerability assesses the susceptibility of the receptor based on the natural properties of the land and subsurface; specific vulnerability also includes properties of the analyzed contaminant. This distinction is useful but not exhaustive. In addition to this, e.g., a distinction of vertical vulnerability

  20. Metadata for selecting or submitting generic seismic vulnerability functions via GEM's vulnerability database

    USGS Publications Warehouse

    Jaiswal, Kishor

    2013-01-01

    This memo lays out a procedure for the GEM software to offer an available vulnerability function for any acceptable set of attributes that the user specifies for a particular building category. The memo also provides general guidelines on how to submit the vulnerability or fragility functions to the GEM vulnerability repository, stipulating which attributes modelers must provide so that their vulnerability or fragility functions can be queried appropriately by the vulnerability database. An important objective is to provide users guidance on limitations and applicability by providing the associated modeling assumptions and applicability of each vulnerability or fragility function.

  1. NV: Nessus Vulnerability Visualization for the Web

    SciTech Connect

    Harrison, Lane; Spahn, Riley B; Iannacone, Michael D; Downing, Evan P; Goodall, John R

    2012-01-01

    Network vulnerability is a critical component of network se- curity. Yet vulnerability analysis has received relatively lit- tle attention from the security visualization community. In this paper we describe nv, a web-based Nessus vulnerability visualization. Nv utilizes treemaps and linked histograms to allow system administrators to discover, analyze, and man- age vulnerabilities on their networks. In addition to visual- izing single Nessus scans, nv supports the analysis of sequen- tial scans by showing which vulnerabilities have been fixed, remain open, or are newly discovered. Nv was also designed to operate completely in-browser, to avoid sending sensitive data to outside servers. We discuss the design of nv, as well as provide case studies demonstrating vulnerability analysis workflows which include a multiple-node testbed and data from the 2011 VAST Challenge.

  2. Assessing the Security Vulnerabilities of Correctional Facilities

    SciTech Connect

    Morrison, G.S.; Spencer, D.S.

    1998-10-27

    The National Institute of Justice has tasked their Satellite Facility at Sandia National Laboratories and their Southeast Regional Technology Center in Charleston, South Carolina to devise new procedures and tools for helping correctional facilities to assess their security vulnerabilities. Thus, a team is visiting selected correctional facilities and performing vulnerability assessments. A vulnerability assessment helps to identi~ the easiest paths for inmate escape, for introduction of contraband such as drugs or weapons, for unexpected intrusion fi-om outside of the facility, and for the perpetration of violent acts on other inmates and correctional employees, In addition, the vulnerability assessment helps to quantify the security risks for the facility. From these initial assessments will come better procedures for performing vulnerability assessments in general at other correctional facilities, as well as the development of tools to assist with the performance of such vulnerability assessments.

  3. Vulnerability and resilience: a critical nexus.

    PubMed

    Lotz, Mianna

    2016-02-01

    Not all forms of human fragility or vulnerability are unavoidable. Sometimes we knowingly and intentionally impose conditions of vulnerability on others; and sometimes we knowingly and intentionally enter into and assume conditions of vulnerability for ourselves (for example, when we decide to trust or forgive, enter into intimate relationships with others, become a parent, become a subject of medical or psychotherapeutic treatment, and the like). In this article, I propose a presently overlooked basis on which one might evaluate whether the imposition or assumption of vulnerability is acceptable, and on which one might ground a significant class of vulnerability-related obligations. Distinct from existing accounts of the importance of promoting autonomy in conditions of vulnerability, this article offers a preliminary exploration of the nature, role, and importance of resilience promotion, its relationship to autonomy promotion, and its prospects for improving human wellbeing in autonomy inhibiting conditions.

  4. [Clinical trials: vulnerability and ethical relativism].

    PubMed

    Lima, Cristina

    2005-01-01

    Research in human beings is an important chapter of medical ethics. In recent years, investigation has been taken over by profit driven corporations that must guarantee the medical and commercial application of results. This new model of investigation has generated conflicts of interest in doctor-patient, researcher-subject relationship. The inevitable debate and media reaction has led. These trials of controversial design to regions of the globe where the vulnerability of the populations continues to allow their undertaking. This article includes a historical perspective on experimentation in human beings and the conditions that led to its regulation: the Nuremberg CODE, followed by the Helsinky Declaration in its different versions, and the Belmont Report, that defend the subject according to the ethic of principles used in western medicine. There is then a review of the attempts to change international regulation to reintroduce clinical trials with placebo--which since 1996 is only permitted where there are no therapeutic or diagnostic methods--on populations that would otherwise have no access to treatment. This then leads on to the issue of double standards in medical investigation defended by many investigators and some official entities. The article concludes that it may be prudent to allow local ethical commissions to approve deviation from the established norm if such is necessary to resolve urgent questions of health in the country, but it is unacceptable that any such emergency is used as a reason to reduce the ethical prerequisites, in clinical trials. It also concludes that true urgency is in making available to all who need it the effective products already in existence. Furthermore, that the acceptance of ethical relativism can result in the exploitation of vulnerable third world populations for research programmes that cannot be undertaken in their sponsoring countries due to the ethical restrictions in place.

  5. Mining Bug Databases for Unidentified Software Vulnerabilities

    SciTech Connect

    Dumidu Wijayasekara; Milos Manic; Jason Wright; Miles McQueen

    2012-06-01

    Identifying software vulnerabilities is becoming more important as critical and sensitive systems increasingly rely on complex software systems. It has been suggested in previous work that some bugs are only identified as vulnerabilities long after the bug has been made public. These vulnerabilities are known as hidden impact vulnerabilities. This paper discusses the feasibility and necessity to mine common publicly available bug databases for vulnerabilities that are yet to be identified. We present bug database analysis of two well known and frequently used software packages, namely Linux kernel and MySQL. It is shown that for both Linux and MySQL, a significant portion of vulnerabilities that were discovered for the time period from January 2006 to April 2011 were hidden impact vulnerabilities. It is also shown that the percentage of hidden impact vulnerabilities has increased in the last two years, for both software packages. We then propose an improved hidden impact vulnerability identification methodology based on text mining bug databases, and conclude by discussing a few potential problems faced by such a classifier.

  6. Proliferation Vulnerability Red Team report

    SciTech Connect

    Hinton, J.P.; Barnard, R.W.; Bennett, D.E.

    1996-10-01

    This report is the product of a four-month independent technical assessment of potential proliferation vulnerabilities associated with the plutonium disposition alternatives currently under review by DOE/MD. The scope of this MD-chartered/Sandia-led study was limited to technical considerations that could reduce proliferation resistance during various stages of the disposition processes below the Stored Weapon/Spent Fuel standards. Both overt and covert threats from host nation and unauthorized parties were considered. The results of this study will be integrated with complementary work by others into an overall Nonproliferation and Arms Control Assessment in support of a Secretarial Record of Decision later this year for disposition of surplus U.S. weapons plutonium.

  7. Attack Vulnerability of Network Controllability

    PubMed Central

    2016-01-01

    Controllability of complex networks has attracted much attention, and understanding the robustness of network controllability against potential attacks and failures is of practical significance. In this paper, we systematically investigate the attack vulnerability of network controllability for the canonical model networks as well as the real-world networks subject to attacks on nodes and edges. The attack strategies are selected based on degree and betweenness centralities calculated for either the initial network or the current network during the removal, among which random failure is as a comparison. It is found that the node-based strategies are often more harmful to the network controllability than the edge-based ones, and so are the recalculated strategies than their counterparts. The Barabási-Albert scale-free model, which has a highly biased structure, proves to be the most vulnerable of the tested model networks. In contrast, the Erdős-Rényi random model, which lacks structural bias, exhibits much better robustness to both node-based and edge-based attacks. We also survey the control robustness of 25 real-world networks, and the numerical results show that most real networks are control robust to random node failures, which has not been observed in the model networks. And the recalculated betweenness-based strategy is the most efficient way to harm the controllability of real-world networks. Besides, we find that the edge degree is not a good quantity to measure the importance of an edge in terms of network controllability. PMID:27588941

  8. Utilities` ``obligation to serve`` under deregulation

    SciTech Connect

    Alexander, C.B.

    1997-02-01

    The utility no longer has protected status, and the traditional franchise concept is under attack. Exclusive rights once conveyed to the utilities are being denied and not just in the area of gas sales. Exclusive rights once conveyed to utilities will be denied in more areas. State by state, the utilities` franchise is being examined to see which, if any, of its provisions are necessary in a deregulated environment. Can the free market provide everything that`s been provided for many years under monopolistic arrangements? Some of the most critical and difficult of these provisions concern the obligation to serve, which utilities, in most states, have assumed as part of their franchise agreement. Regulators, courts, utilities, marketers and others are busy sorting through these issues, but resolution could take years. The paper discusses deregulation, universal service fee, representation without taxation, suppliers and marketer restrictions.

  9. Proposal of a Mediterranean Diet Serving Score

    PubMed Central

    Monteagudo, Celia; Mariscal-Arcas, Miguel; Rivas, Ana; Lorenzo-Tovar, María Luisa; Tur, Josep A.; Olea-Serrano, Fátima

    2015-01-01

    Background and Aims Numerous studies have demonstrated a relationship between Mediterranean Diet (MD) adherence and the prevention of cardiovascular diseases, cancer, and diabetes, etc. The study aim was to validate a novel instrument to measure MD adherence based on the consumption of food servings and food groups, and apply it in a female population from southern Spain and determining influential factors. Methods and Results The study included 1,155 women aged 12-83 yrs, classified as adolescents, adults, and over-60-yr-olds. All completed a validated semi-quantitative food frequency questionnaire (FFQ). The Mediterranean Dietary Serving Score (MDSS) is based on the latest update of the Mediterranean Diet Pyramid, using the recommended consumption frequency of foods and food groups; the MDSS ranges from 0 to 24. The discriminative power or correct subject classification capacity of the MDSS was analyzed with the Receiver Operating Characteristic (ROC) curve, using the MDS as reference method. Predictive factors for higher MDSS adherence were determined with a logistic regression model, adjusting for age. According to ROC curve analysis, MDSS evidenced a significant discriminative capacity between adherents and non-adherents to the MD pattern (optimal cutoff point=13.50; sensitivity=74%; specificity=48%). The mean MDSS was 12.45 (2.69) and was significantly higher with older age (p<0.001). Logistic regression analysis showed highest MD adherence by over 60-year-olds with low BMI and no habit of eating between meals. Conclusions The MDSS is an updated, easy, valid, and accurate instrument to assess MD adherence based on the consumption of foods and food groups per meal, day, and week. It may be useful in future nutritional education programs to prevent the early onset of chronic non-transmittable diseases in younger populations. PMID:26035442

  10. Effect of whiskey on atrial vulnerability and "holiday heart".

    PubMed

    Engel, T R; Luck, J C

    1983-03-01

    Vulnerability to atrial fibrillation and flutter was examined in 11 alcohol abusers who did not have cardiomyopathy or manifest heart failure. Atrial extrastimulation was done with rapid pacing (drive cycle length 500 ms) to facilitate induction of atrial vulnerability, seen in four alcohol abusers. The remaining seven were retested 30 minutes after drinking 60 to 120 ml of 86 proof whiskey (ethanol blood levels were 49 to 101 mg/100 ml but pulmonary capillary wedge pressure remained normal in all) and atrial fibrillation or flutter was induced in three of the drinkers. Three nondrinkers, symptomatic with sinus bradycardia but not in heart failure, were found not to be vulnerable to atrial fibrillation or flutter, but flutter was induced in two of the three after drinking whiskey. Whiskey did not alter atrial functional refractory periods (mean +/- standard error of the mean 297 +/- 14 to 290 +/- 12 ms) or widen the dispersion among three disparate right atrial sites (57 +/- 13 to 47 +/- 12 ms). Thus, whiskey enhanced vulnerability to atrial fibrillation and flutter in patients without heart failure or cardiomyopathy, substantiating the "holiday heart" syndrome.

  11. Vulnerabilities of children admitted to a pediatric inpatient care unit☆

    PubMed Central

    de Oliveira, Larissa Natacha; Breigeiron, Márcia Koja; Hallmann, Sofia; Witkowski, Maria Carolina

    2014-01-01

    OBJECTIVE: To identify the vulnerabilities of children admitted to a pediatric inpatient unit of a university hospital. METHODS: Cross-sectional, descriptive study from April to September 2013 with36 children aged 30 days to 12 years old, admitted to medical-surgical pediatric inpatient units of a university hospital and their caregivers. Data concerning sociocultural, socioeconomic and clinical context of children and their families were collected by interview with the child caregiver and from patients, records, and analyzed by descriptive statistics. RESULTS: Of the total sample, 97.1% (n=132) of children had at least one type of vulnerability, the majority related to the caregiver's level of education, followed by caregiver's financial situation, health history of the child, caregiver's family situation, use of alcohol, tobacco, and illicit drugs by the caregiver, family's living conditions, caregiver's schooling, and bonding between the caregiver and the child. Only 2.9% (n=4) of the children did not show any criteria to be classified in a category of vulnerability. CONCLUSIONS: Most children were classified has having a social vulnerability. It is imperative to create networks of support between the hospital and the primary healthcare service to promote healthcare practices directed to the needs of the child and family. PMID:25511001

  12. Structural Vulnerability: Operationalizing the Concept to Address Health Disparities in Clinical Care.

    PubMed

    Bourgois, Philippe; Holmes, Seth M; Sue, Kim; Quesada, James

    2017-03-01

    The authors propose reinvigorating and extending the traditional social history beyond its narrow range of risk behaviors to enable clinicians to address negative health outcomes imposed by social determinants of health. In this Perspective, they outline a novel, practical medical vulnerability assessment questionnaire that operationalizes for clinical practice the social science concept of "structural vulnerability." A structural vulnerability assessment tool designed to highlight the pathways through which specific local hierarchies and broader sets of power relationships exacerbate individual patients' health problems is presented to help clinicians identify patients likely to benefit from additional multidisciplinary health and social services. To illustrate how the tool could be implemented in time- and resource-limited settings (e.g., emergency department), the authors contrast two cases of structurally vulnerable patients with differing outcomes. Operationalizing structural vulnerability in clinical practice and introducing it in medical education can help health care practitioners think more clearly, critically, and practically about the ways social structures make people sick. Use of the assessment tool could promote "structural competency," a potential new medical education priority, to improve understanding of how social conditions and practical logistics undermine the capacities of patients to access health care, adhere to treatment, and modify lifestyles successfully. Adoption of a structural vulnerability framework in health care could also justify the mobilization of resources inside and outside clinical settings to improve a patient's immediate access to care and long-term health outcomes. Ultimately, the concept may orient health care providers toward policy leadership to reduce health disparities and foster health equity.

  13. Callahan's Vulnerability Thesis and "Dissatisfaction Theory."

    ERIC Educational Resources Information Center

    Iannaccone, Laurence

    1996-01-01

    In discussing school superintendent vulnerability, the paper addresses diverse meanings among scholars of Callahan's vulnerability thesis, highlighting other articles within this theme issue. The paper reflects on discussions of Callahan's "Education and the Cult of Efficacy" before its 1962 publication and investigates the relation…

  14. Predicting Vulnerability Risks Using Software Characteristics

    ERIC Educational Resources Information Center

    Roumani, Yaman

    2012-01-01

    Software vulnerabilities have been regarded as one of the key reasons for computer security breaches that have resulted in billions of dollars in losses per year (Telang and Wattal 2005). With the growth of the software industry and the Internet, the number of vulnerability attacks and the ease with which an attack can be made have increased. From…

  15. Vulnerable Youth and Transitions to Adulthood

    ERIC Educational Resources Information Center

    Xie, Rongbing; Sen, Bisakha; Foster, E. Michael

    2014-01-01

    This chapter focuses on vulnerable youth, the challenges they face during their transitions to adulthood, and the adverse effects of limited support systems on those transitions. The authors offer recommendations on how adult educators can help facilitate smooth transitions into adulthood for vulnerable youth.

  16. Chemical facility vulnerability assessment project.

    PubMed

    Jaeger, Calvin D

    2003-11-14

    Sandia National Laboratories, under the direction of the Office of Science and Technology, National Institute of Justice, conducted the chemical facility vulnerability assessment (CFVA) project. The primary objective of this project was to develop, test and validate a vulnerability assessment methodology (VAM) for determining the security of chemical facilities against terrorist or criminal attacks (VAM-CF). The project also included a report to the Department of Justice for Congress that in addition to describing the VAM-CF also addressed general observations related to security practices, threats and risks at chemical facilities and chemical transport. In the development of the VAM-CF Sandia leveraged the experience gained from the use and development of VAs in other areas and the input from the chemical industry and Federal agencies. The VAM-CF is a systematic, risk-based approach where risk is a function of the severity of consequences of an undesired event, the attack potential, and the likelihood of adversary success in causing the undesired event. For the purpose of the VAM-CF analyses Risk is a function of S, L(A), and L(AS), where S is the severity of consequence of an event, L(A) is the attack potential and L(AS) likelihood of adversary success in causing a catastrophic event. The VAM-CF consists of 13 basic steps. It involves an initial screening step, which helps to identify and prioritize facilities for further analysis. This step is similar to the prioritization approach developed by the American Chemistry Council (ACC). Other steps help to determine the components of the risk equation and ultimately the risk. The VAM-CF process involves identifying the hazardous chemicals and processes at a chemical facility. It helps chemical facilities to focus their attention on the most critical areas. The VAM-CF is not a quantitative analysis but, rather, compares relative security risks. If the risks are deemed too high, recommendations are developed for

  17. Biodiversity Information Serving Our Nation (BISON)

    USGS Publications Warehouse

    ,

    2013-01-01

    Researchers collect species occurrence data, records of an organism at a particular time in a particular place, as a primary or ancillary function of many biological field investigations. Presently, these data reside in numerous distributed systems and formats (including publications) and are consequently not being used to their full potential. As a step toward addressing this challenge, the Core Science Analytics and Synthesis (CSAS) program of the US Geological Survey (USGS) is developing Biodiversity Information Serving Our Nation (BISON), an integrated and permanent resource for biological occurrence data from the United States. BISON will leverage the accumulated human and infrastructural resources of the long-term USGS investment in research and information management and delivery. CSAS is also the U.S. Node of the Global Biodiversity Information Facility (GBIF), an international, government-initiated and funded effort focused on making biodiversity data freely available for scientific research, conservation and sustainable development. CSAS, with its partners at Department of Energy's Oak Ridge National Laboratory (ORNL), hosts a full mirror of the hundreds of millions of global records to which GBIF provides access. BISON has been initiated with the 110 million records GBIF makes available from the U.S. and is integrating millions more records from other sources each year.

  18. Serving Those Who Serve: Meeting the Complex Needs of Students Returning Home from War

    ERIC Educational Resources Information Center

    Veislind, Emili

    2013-01-01

    As community colleges across the country strive to improve completion rates and serve a growing number of students returned home from war, the need for programs that meet the unique needs of veterans--including job training, social acclimation, referral programs for mental health counseling, and academic tutoring, to name a few--is more pressing…

  19. Offer versus Serve or Serve Only: Does Service Method Affect Elementary Children's Fruit and Vegetable Consumption?

    ERIC Educational Resources Information Center

    Goggans, Margaret Harbison; Lambert, Laurel; Chang, Yunhee

    2011-01-01

    Purpose/Objectives: The purpose of this study was to determine if the use of the Offer versus Serve (OVS) provision in the National School Lunch Program would result in a significant difference in fruit and vegetable consumption by fourth and fifth grade elementary students, and in plate waste cost. Methods: Weighed and visual plate waste data…

  20. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem.

    PubMed

    Williams, Patricia Ah; Woodward, Andrew J

    2015-01-01

    The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat.

  1. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem

    PubMed Central

    Williams, Patricia AH; Woodward, Andrew J

    2015-01-01

    The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat. PMID:26229513

  2. Bone marrow osteoblast vulnerability to chemotherapy.

    PubMed

    Gencheva, Marieta; Hare, Ian; Kurian, Susan; Fortney, Jim; Piktel, Debbie; Wysolmerski, Robert; Gibson, Laura F

    2013-06-01

    Osteoblasts are a major component of the bone marrow microenvironment, which provide support for hematopoietic cell development. Functional disruption of any element of the bone marrow niche, including osteoblasts, can potentially impair hematopoiesis. We have studied the effect of two widely used drugs with different mechanisms of action, etoposide (VP16) and melphalan, on murine osteoblasts at distinct stages of maturation. VP16 and melphalan delayed maturation of preosteoblasts and altered CXCL12 protein levels, a key regulator of hematopoietic cell homing to the bone marrow. Sublethal concentrations of VP16 and melphalan also decreased the levels of several transcripts which contribute to the composition of the extracellular matrix (ECM) including osteopontin (OPN), osteocalcin (OCN), and collagen 1A1 (Col1a1). The impact of chemotherapy on message and protein levels for some targets was not always aligned, suggesting differential responses at the transcription and translation or protein stability levels. As one of the main functions of a mature osteoblast is to synthesize ECM of a defined composition, disruption of the ratio of its components may be one mechanism by which chemotherapy affects the ability of osteoblasts to support hematopoietic recovery coincident with altered marrow architecture. Collectively, these observations suggest that the osteoblast compartment of the marrow hematopoietic niche is vulnerable to functional dysregulation by damage imposed by agents frequently used in clinical settings. Understanding the mechanistic underpinning of chemotherapy-induced changes on the hematopoietic support capacity of the marrow microenvironment may contribute to improved strategies to optimize patient recovery post-transplantation.

  3. Development and implementation of a Bayesian-based aquifer vulnerability assessment in Florida

    USGS Publications Warehouse

    Arthur, J.D.; Wood, H.A.R.; Baker, A.E.; Cichon, J.R.; Raines, G.L.

    2007-01-01

    The Florida Aquifer Vulnerability Assessment (FAVA) was designed to provide a tool for environmental, regulatory, resource management, and planning professionals to facilitate protection of groundwater resources from surface sources of contamination. The FAVA project implements weights-of-evidence (WofE), a data-driven, Bayesian-probabilistic model to generate a series of maps reflecting relative aquifer vulnerability of Florida's principal aquifer systems. The vulnerability assessment process, from project design to map implementation is described herein in reference to the Floridan aquifer system (FAS). The WofE model calculates weighted relationships between hydrogeologic data layers that influence aquifer vulnerability and ambient groundwater parameters in wells that reflect relative degrees of vulnerability. Statewide model input data layers (evidential themes) include soil hydraulic conductivity, density of karst features, thickness of aquifer confinement, and hydraulic head difference between the FAS and the watertable. Wells with median dissolved nitrogen concentrations exceeding statistically established thresholds serve as training points in the WofE model. The resulting vulnerability map (response theme) reflects classified posterior probabilities based on spatial relationships between the evidential themes and training points. The response theme is subjected to extensive sensitivity and validation testing. Among the model validation techniques is calculation of a response theme based on a different water-quality indicator of relative recharge or vulnerability: dissolved oxygen. Successful implementation of the FAVA maps was facilitated by the overall project design, which included a needs assessment and iterative technical advisory committee input and review. Ongoing programs to protect Florida's springsheds have led to development of larger-scale WofE-based vulnerability assessments. Additional applications of the maps include land-use planning

  4. Groundwater vulnerability mapping of Qatar aquifers

    NASA Astrophysics Data System (ADS)

    Baalousha, Husam Musa

    2016-12-01

    Qatar is one of the most arid countries in the world with limited water resources. With little rainfall and no surface water, groundwater is the only natural source of fresh water in the country. Whilst the country relies mainly on desalination of seawater to secure water supply, groundwater has extensively been used for irrigation over the last three decades, which caused adverse environmental impact. Vulnerability assessment is a widely used tool for groundwater protection and land-use management. Aquifers in Qatar are carbonate with lots of fractures, depressions and cavities. Karst aquifers are generally more vulnerable to contamination than other aquifers as any anthropogenic-sourced contaminant, especially above a highly fractured zone, can infiltrate quickly into the aquifer and spread over a wide area. The vulnerability assessment method presented in this study is based on two approaches: DRASTIC and EPIK, within the framework of Geographical Information System (GIS). Results of this study show that DRASTIC vulnerability method suits Qatar hydrogeological settings more than EPIK. The produced vulnerability map using DRASTIC shows coastal and karst areas have the highest vulnerability class. The southern part of the country is located in the low vulnerability class due to occurrence of shale formation within aquifer media, which averts downward movement of contaminants.

  5. Vulnerability, Health Agency and Capability to Health.

    PubMed

    Straehle, Christine

    2016-01-01

    One of the defining features of the capability approach (CA) to health, as developed in Venkatapuram's book Health Justice, is its aim to enable individual health agency. Furthermore, the CA to health hopes to provide a strong guideline for assessing the health-enabling content of social and political conditions. In this article, I employ the recent literature on the liberal concept of vulnerability to assess the CA. I distinguish two kinds of vulnerability. Considering circumstantial vulnerability, I argue that liberal accounts of vulnerability concerned with individual autonomy, align with the CA to health. Individuals should, as far as possible, be able to make health-enabling decisions about their lives, and their capability to do so should certainly not be hindered by public policy. The CA to health and a vulnerability-based analysis then work alongside to define moral responsibilities and designate those who hold them. Both approaches demand social policy to address circumstances that hinder individuals from taking health-enabling decisions. A background condition of vulnerability, on the other hand, even though it hampers the capability for health, does not warrant the strong moral claim proposed by the CA to health to define health as a meta-capability that should guide social policy. Nothing in our designing social policy could change the challenge to health agency when we deal with background conditions of vulnerability.

  6. Vulnerability indicators of sea water intrusion.

    PubMed

    Werner, Adrian D; Ward, James D; Morgan, Leanne K; Simmons, Craig T; Robinson, Neville I; Teubner, Michael D

    2012-01-01

    In this paper, simple indicators of the propensity for sea water intrusion (SWI) to occur (referred to as "SWI vulnerability indicators") are devised. The analysis is based on an existing analytical solution for the steady-state position of a sharp fresh water-salt water interface. Interface characteristics, that is, the wedge toe location and sea water volume, are used in quantifying SWI in both confined and unconfined aquifers. Rates-of-change (partial derivatives of the analytical solution) in the wedge toe or sea water volume are used to quantify the aquifer vulnerability to various stress situations, including (1) sea-level rise; (2) change in recharge (e.g., due to climate change); and (3) change in seaward discharge. A selection of coastal aquifer cases is used to apply the SWI vulnerability indicators, and the proposed methodology produces interpretations of SWI vulnerability that are broadly consistent with more comprehensive investigations. Several inferences regarding SWI vulnerability arise from the analysis, including: (1) sea-level rise impacts are more extensive in aquifers with head-controlled rather than flux-controlled inland boundaries, whereas the opposite is true for recharge change impacts; (2) sea-level rise does not induce SWI in constant-discharge confined aquifers; (3) SWI vulnerability varies depending on the causal factor, and therefore vulnerability composites are needed that differentiate vulnerability to such threats as sea-level rise, climate change, and changes in seaward groundwater discharge. We contend that the approach is an improvement over existing methods for characterizing SWI vulnerability, because the method has theoretical underpinnings and yet calculations are simple, although the coastal aquifer conceptualization is highly idealized.

  7. Determining Vulnerability Importance in Environmental Impact Assessment

    SciTech Connect

    Toro, Javier; Duarte, Oscar; Requena, Ignacio; Zamorano, Montserrat

    2012-01-15

    The concept of vulnerability has been used to describe the susceptibility of physical, biotic, and social systems to harm or hazard. In this sense, it is a tool that reduces the uncertainties of Environmental Impact Assessment (EIA) since it does not depend exclusively on the value assessments of the evaluator, but rather is based on the environmental state indicators of the site where the projects or activities are being carried out. The concept of vulnerability thus reduces the possibility that evaluators will subjectively interpret results, and be influenced by outside interests and pressures during projects. However, up until now, EIA has been hindered by a lack of effective methods. This research study analyzes the concept of vulnerability, defines Vulnerability Importance and proposes its inclusion in qualitative EIA methodology. The method used to quantify Vulnerability Importance is based on a set of environmental factors and indicators that provide a comprehensive overview of the environmental state. The results obtained in Colombia highlight the usefulness and objectivity of this method since there is a direct relation between this value and the environmental state of the departments analyzed. - Research Highlights: Black-Right-Pointing-Pointer The concept of vulnerability could be considered defining Vulnerability Importance included in qualitative EIA methodology. Black-Right-Pointing-Pointer The use of the concept of environmental vulnerability could reduce the subjectivity of qualitative methods of EIA. Black-Right-Pointing-Pointer A method to quantify the Vulnerability Importance proposed provides a comprehensive overview of the environmental state. Black-Right-Pointing-Pointer Results in Colombia highlight the usefulness and objectivity of this method.

  8. [Aged woman's vulnerability related to AIDS].

    PubMed

    Silva, Carla Marins; Lopes, Fernanda Maria do Valle Martins; Vargens, Octavio Muniz da Costa

    2010-09-01

    This article is a systhematic literature review including the period from 1994 to 2009, whose objective was to discuss the aged woman's vulnerability in relation to Acquired Imunodeficiency Syndrome (Aids). The search for scientific texts was accomplished in the following databases: Biblioteca Virtual em Saúde, Scientific Eletronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Medical Literature Analysis and Retrieval System Online (MEDLINE). The descriptors used were vulnerability, woman and Aids. Eighteen texts were analyzed, including articles in scientific journals, thesis and dissertations. As a conclusion, it was noted that aged women and vulnerability to Aids are directly related, through gender characteristics including submission and that were built historical and socially. We consider as fundamental the development of studies which may generate publications accessible to women, in order to help them see themselves as persons vulnerable to Aids contagion just for being women.

  9. Vulnerable Zone Indicator System (Option 2)

    EPA Pesticide Factsheets

    Enter your latitude and longitude to access the Vulnerable Zone Indicator System. VZIS can help you determine if your area could be affected by a chemical accident at a facility that submitted a Risk Management Plan (RMP).

  10. Salt vulnerability assessment methodology for urban streams

    NASA Astrophysics Data System (ADS)

    Betts, A. R.; Gharabaghi, B.; McBean, E. A.

    2014-09-01

    De-icing agents such as road salts while used for winter road maintenance can cause negative effects on urban stream water quality and drinking water supplies. A new methodology using readily available spatial data to identify Salt Vulnerable Areas (SVAs) for urban streams is used to prioritize implementation of best management practices. The methodology calculates the probable chloride concentration statistics at specified points in the urban stream network and compares the results with known aquatic species exposure tolerance limits to characterize the vulnerability scores. The approach prioritizes implementation of best management practices to areas identified as vulnerable to road salt. The vulnerability assessment is performed on seven sites in four watersheds in the Greater Toronto Area and validated using the Hanlon Creek watershed in Guelph. The mean annual in-stream chloride concentration equation uses readily available spatial data - with province-wide coverage - that can be easily used in any urban watershed.

  11. Extinction vulnerability of coral reef fishes

    PubMed Central

    Graham, Nicholas A J; Chabanet, Pascale; Evans, Richard D; Jennings, Simon; Letourneur, Yves; Aaron MacNeil, M; McClanahan, Tim R; Öhman, Marcus C; Polunin, Nicholas V C; Wilson, Shaun K

    2011-01-01

    With rapidly increasing rates of contemporary extinction, predicting extinction vulnerability and identifying how multiple stressors drive non-random species loss have become key challenges in ecology. These assessments are crucial for avoiding the loss of key functional groups that sustain ecosystem processes and services. We developed a novel predictive framework of species extinction vulnerability and applied it to coral reef fishes. Although relatively few coral reef fishes are at risk of global extinction from climate disturbances, a negative convex relationship between fish species locally vulnerable to climate change vs. fisheries exploitation indicates that the entire community is vulnerable on the many reefs where both stressors co-occur. Fishes involved in maintaining key ecosystem functions are more at risk from fishing than climate disturbances. This finding is encouraging as local and regional commitment to fisheries management action can maintain reef ecosystem functions pending progress towards the more complex global problem of stabilizing the climate. PMID:21320260

  12. Individual and social vulnerabilities upon acquiring tuberculosis: a literature systematic review

    PubMed Central

    2014-01-01

    Tuberculosis is a contagious infectious disease mainly caused by the bacteria Mycobacterium tuberculosis that still meets the priority criteria - high magnitude, transcendence and vulnerability - due to the threat it poses to public health. When taking into consideration the vulnerability conditions that favor the onset of the disease, this article aimed to investigate the implications originated from individual and social vulnerability conditions in which tuberculosis patients are inserted. Databases like MEDLINE, LILACS and SciELO were searched in Portuguese, Spanish and English using the descriptors tuberculosis and vulnerability, and 183 articles were found. After the selection criterion was applied, there were 22 publications left to be discussed. Some of the aspects that characterize the vulnerability to tuberculosis are: low-income and low-education families, age, poor living conditions, chemical dependency, pre-existing conditions/aggravations like diabetes mellitus and malnutrition, indigenous communities, variables related to health professionals, intense border crossings and migration, difficulty in accessing information and health services and lack of knowledge on tuberculosis. Much as such aspects are present and favor the onset of the disease, several reports show high incidence rates of tuberculosis in low vulnerability places, suggesting that some factors related to the disease are still unclear. In conclusion, health promotion is important in order to disfavor such conditions or factors of vulnerability to tuberculosis, making them a primary target in the public health planning process and disease control. PMID:25067955

  13. Camana, Peru, and Tsunami Vulnerability

    NASA Technical Reports Server (NTRS)

    2002-01-01

    A tsunami washed over the low-lying coastal resort region near Camana, southern Peru, following a strong earthquake on June 23, 2001. The earthquake was one of the most powerful of the last 35 years and had a magnitude of 8.4. After the initial quake, coastal residents witnessed a sudden drawdown of the ocean and knew a tsunami was imminent. They had less than 20 minutes to reach higher ground before the tsunami hit. Waves as high as 8 m came in four destructive surges reaching as far as 1.2 km inland. The dashed line marks the approximate area of tsunami inundation. Thousands of buildings were destroyed, and the combined earthquake and tsunami killed as many as 139 people. This image (ISS004-ESC-6128) was taken by astronauts onboard the International Space Station on 10 January 2002. It shows some of the reasons that the Camana area was so vulnerable to tsunami damage. The area has a 1 km band of coastal plain that is less than 5 m in elevation. Much of the plain can be seen by the bright green fields of irrigated agriculture that contrast with the light-colored desert high ground. Many of the tsunami-related deaths were workers in the onion fields in the coastal plain that were unwilling to leave their jobs before the end of the shift. A number of lives were spared because the tsunami occurred during the resort off-season, during the daylight when people could see the ocean drawdown, and during one of the lowest tides of the year. Information on the Tsunami that hit Camana can be found in a reports on the visit by the International Tsunami Survey Team and the USC Tsunami Research Lab. Earthquake Epicenter, Peru shows another image of the area. Image provided by the Earth Sciences and Image Analysis Laboratory at Johnson Space Center. Additional images taken by astronauts and cosmonauts can be viewed at the NASA-JSC Gateway to Astronaut Photography of Earth.

  14. Target Vulnerability to Air Defense Weapons.

    DTIC Science & Technology

    1984-12-01

    AD-A155 033 TARGET VULNERABILITY TO AIR DEFENSE WEAPONSIUI NAVAL ’ POSTGRADUATE SCHOOL MONTEREY CA B E REINARD DEC 04 UCASFDF/ 14NL mhmHmmhmhmhhhh... SCHOOL Monterey, California 0 Ln DTIC if) 1C t JUN14 1985 B THESIS TARGET VULNERABILITY TO AIR DEFENSE WEAPONS by P_ Bruce Edward Reinard C.D...TASK AREA i WORK UNIT NUMUERS Naval Postgraduate School Monterey, California 93a43 It. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE Naval

  15. Application of PRA to HEMP vulnerability analysis

    SciTech Connect

    Mensing, R.W.

    1985-09-01

    Vulnerability analyses of large systems, e.g., control and communication centers, aircraft, ships, are subject to many uncertainties. A basic source of uncertainty is the random variation inherent in the physical world. Thus, vulnerability is appropriately described by an estimate of the probability of survival (or failure). A second source of uncertainty that also needs to be recognized is the uncertainty associated with the analysis or estimation process itself. This uncertainty, often called modeling uncertainty, has many contributors. There are the approximations introduced by using mathematical models to describe reality. Also, the appropriate values of the model parameters are derived from several sources, e.g., based on experimental or test data, based on expert judgment and opinion. In any case, these values are subject to uncertainty. This uncertainty must be considered in the description of vulnerability. Thus, the estimate of the probability of survival is not a single value but a range of values. Probabilistic risk analysis (PRA) is a methodology which deals with these uncertainty issues. This report discusses the application of PRA to HEMP vulnerability analyses. Vulnerability analysis and PRA are briefly outlined and the need to distinguish between random variation and modeling uncertainty is discussed. Then a sequence of steps appropriate for applying PRA to vulnerability problems is outlined. Finally, methods for handling modeling uncertainty are identified and discussed.

  16. Global Distributions of Vulnerability to Climate Change

    SciTech Connect

    Yohe, Gary; Malone, Elizabeth L.; Brenkert, Antoinette L.; Schlesinger, Michael; Meij, Henk; Xiaoshi, Xing

    2006-12-01

    Signatories of the United Nations Framework Convention on Climate Change (UNFCCC) have committed themselves to addressing the “specific needs and special circumstances of developing country parties, especially those that are particularly vulnerable to the adverse effects of climate change”.1 The Intergovernmental Panel on Climate Change (IPCC) has since concluded with high confidence that “developing countries will be more vulnerable to climate change than developed countries”.2 In their most recent report, however, the IPCC notes that “current knowledge of adaptation and adaptive capacity is insufficient for reliable prediction of adaptations” 3 because “the capacity to adapt varies considerably among regions, countries and socioeconomic groups and will vary over time”.4 Here, we respond to the apparent contradiction in these two statements by exploring how variation in adaptive capacity and climate impacts combine to influence the global distribution of vulnerability. We find that all countries will be vulnerable to climate change, even if their adaptive capacities are enhanced. Developing nations are most vulnerable to modest climate change. Reducing greenhouse-gas emissions would diminish their vulnerabilities significantly. Developed countries would benefit most from mitigation for moderate climate change. Extreme climate change overwhelms the abilities of all countries to adapt. These findings should inform both ongoing negotiations for the next commitment period of the Kyoto Protocol and emerging plans for implementing UNFCCC-sponsored adaptation funds.

  17. Molecular Imaging of Vulnerable Atherosclerotic Plaques in Animal Models

    PubMed Central

    Gargiulo, Sara; Gramanzini, Matteo; Mancini, Marcello

    2016-01-01

    Atherosclerosis is characterized by intimal plaques of the arterial vessels that develop slowly and, in some cases, may undergo spontaneous rupture with subsequent heart attack or stroke. Currently, noninvasive diagnostic tools are inadequate to screen atherosclerotic lesions at high risk of acute complications. Therefore, the attention of the scientific community has been focused on the use of molecular imaging for identifying vulnerable plaques. Genetically engineered murine models such as ApoE−/− and ApoE−/−Fbn1C1039G+/− mice have been shown to be useful for testing new probes targeting biomarkers of relevant molecular processes for the characterization of vulnerable plaques, such as vascular endothelial growth factor receptor (VEGFR)-1, VEGFR-2, intercellular adhesion molecule (ICAM)-1, P-selectin, and integrins, and for the potential development of translational tools to identify high-risk patients who could benefit from early therapeutic interventions. This review summarizes the main animal models of vulnerable plaques, with an emphasis on genetically altered mice, and the state-of-the-art preclinical molecular imaging strategies. PMID:27618031

  18. Partnering with those we serve: using experiential learning activities to support community nursing practice.

    PubMed

    Fries, Kathleen; Stewart, Julie G

    2012-01-01

    The concept of community is multidimensional and may include geographical boundaries and/or the shared interests of its members. Community nursing practice involves nurses, patients, and families who collaborate to address health issues and to promote positive health initiatives. Informed by community health theorists, experiential learning activities provide the structure to promote partnering in community nursing practice to achieve outcomes that benefit those who serve and those who are served.

  19. Drought vulnerability assesssment and mapping in Morocco

    NASA Astrophysics Data System (ADS)

    Imani, Yasmina; Lahlou, Ouiam; Bennasser Alaoui, Si; Naumann, Gustavo; Barbosa, Paulo; Vogt, Juergen

    2014-05-01

    Drought vulnerability assessment and mapping in Morocco Authors: Yasmina Imani 1, Ouiam Lahlou 1, Si Bennasser Alaoui 1 Paulo Barbosa 2, Jurgen Vogt 2, Gustavo Naumann 2 1: Institut Agronomique et Vétérinaire Hassan II (IAV Hassan II), Rabat Morocco. 2: European Commission, Joint Research Centre (JRC), Institute for Environment and Sustainability (IES), Ispra, Italy. In Morocco, nearly 50% of the population lives in rural areas. They are mostly small subsistent farmers whose production depends almost entirely on rainfall. They are therefore very sensitive to drought episodes that may dramatically affect their incomes. Although, as a consequence of the increasing frequency, length and severity of drought episodes in the late 90's, the Moroccan government decided, to move on from a crisis to a risk management approach, drought management remains in practice mainly reactive and often ineffective. The lack of effectiveness of public policy is in part a consequence of the poor understanding of drought vulnerability at the rural community level, which prevents the development of efficient mitigation actions and adaptation strategies, tailored to the needs and specificities of each rural community. Thus, the aim of this study is to assess and map drought vulnerability at the rural commune level in the Oum Er-Rbia basin which is a very heterogeneous basin, showing a big variability of climates, landscapes, cropping systems and social habits. Agricultural data collected from the provincial and local administrations of Agriculture and socio-economic data from the National Department of Statistics were used to compute a composite vulnerability index (DVI) integrating four different components: (i) the renewable natural capacity, (ii) the economic capacity, (iii) human and civic resources, and (iv) infrastructure and technology. The drought vulnerability maps that were derived from the computation of the DVI shows that except very specific areas, most of the Oum er Rbia

  20. Linking local vulnerability to climatic hazard damage assessment for integrated river basin management

    NASA Astrophysics Data System (ADS)

    Hung, Hung-Chih; Liu, Yi-Chung; Chien, Sung-Ying

    2015-04-01

    1. Background Major portions of areas in Asia are expected to increase exposure and vulnerability to climate change and weather extremes due to rapid urbanization and overdevelopment in hazard-prone areas. To prepare and confront the potential impacts of climate change and related hazard risk, many countries have implemented programs of integrated river basin management. This has led to an impending challenge for the police-makers in many developing countries to build effective mechanism to assess how the vulnerability distributes over river basins, and to understand how the local vulnerability links to climatic (climate-related) hazard damages and risks. However, the related studies have received relatively little attention. This study aims to examine whether geographic localities characterized by high vulnerability experience significantly more damages owing to onset weather extreme events at the river basin level, and to explain what vulnerability factors influence these damages or losses. 2. Methods and data An indicator-based assessment framework is constructed with the goal of identifying composite indicators (including exposure, biophysical, socioeconomic, land-use and adaptive capacity factors) that could serve as proxies for attributes of local vulnerability. This framework is applied by combining geographical information system (GIS) techniques with multicriteria decision analysis (MCDA) to evaluate and map integrated vulnerability to climatic hazards across river basins. Furthermore, to explain the relationship between vulnerability factors and disaster damages, we develop a disaster damage model (DDM) based on existing disaster impact theory. We then synthesize a Zero-Inflated Poisson regression model with a Tobit regression analysis to identify and examine how the disaster impacts and vulnerability factors connect to typhoon disaster damages and losses. To illustrate the proposed methodology, the study collects data on the vulnerability attributes of

  1. Unexpected high vulnerability of functions in wilderness areas: evidence from coral reef fishes

    PubMed Central

    Vigliola, Laurent; Graham, Nicholas A. J.; Wantiez, Laurent; Parravicini, Valeriano; Villéger, Sébastien; Mou-Tham, Gerard; Frolla, Philippe; Friedlander, Alan M.; Kulbicki, Michel; Mouillot, David

    2016-01-01

    High species richness is thought to support the delivery of multiple ecosystem functions and services under changing environments. Yet, some species might perform unique functional roles while others are redundant. Thus, the benefits of high species richness in maintaining ecosystem functioning are uncertain if functions have little redundancy, potentially leading to high vulnerability of functions. We studied the natural propensity of assemblages to be functionally buffered against loss prior to fishing activities, using functional trait combinations, in coral reef fish assemblages across unfished wilderness areas of the Indo-Pacific: Chagos Archipelago, New Caledonia and French Polynesia. Fish functional diversity in these wilderness areas is highly vulnerable to fishing, explained by species- and abundance-based redundancy packed into a small combination of traits, leaving most other trait combinations (60%) sensitive to fishing, with no redundancy. Functional vulnerability peaks for mobile and sedentary top predators, and large species in general. Functional vulnerability decreases for certain functional entities in New Caledonia, where overall functional redundancy was higher. Uncovering these baseline patterns of functional vulnerability can offer early warning signals of the damaging effects from fishing, and may serve as baselines to guide precautionary and even proactive conservation actions. PMID:27928042

  2. Unexpected high vulnerability of functions in wilderness areas: evidence from coral reef fishes.

    PubMed

    D'agata, Stéphanie; Vigliola, Laurent; Graham, Nicholas A J; Wantiez, Laurent; Parravicini, Valeriano; Villéger, Sébastien; Mou-Tham, Gerard; Frolla, Philippe; Friedlander, Alan M; Kulbicki, Michel; Mouillot, David

    2016-12-14

    High species richness is thought to support the delivery of multiple ecosystem functions and services under changing environments. Yet, some species might perform unique functional roles while others are redundant. Thus, the benefits of high species richness in maintaining ecosystem functioning are uncertain if functions have little redundancy, potentially leading to high vulnerability of functions. We studied the natural propensity of assemblages to be functionally buffered against loss prior to fishing activities, using functional trait combinations, in coral reef fish assemblages across unfished wilderness areas of the Indo-Pacific: Chagos Archipelago, New Caledonia and French Polynesia. Fish functional diversity in these wilderness areas is highly vulnerable to fishing, explained by species- and abundance-based redundancy packed into a small combination of traits, leaving most other trait combinations (60%) sensitive to fishing, with no redundancy. Functional vulnerability peaks for mobile and sedentary top predators, and large species in general. Functional vulnerability decreases for certain functional entities in New Caledonia, where overall functional redundancy was higher. Uncovering these baseline patterns of functional vulnerability can offer early warning signals of the damaging effects from fishing, and may serve as baselines to guide precautionary and even proactive conservation actions.

  3. 76 FR 59499 - National Hispanic-Serving Institutions Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-26

    ... Documents#0;#0; ] Proclamation 8718 of September 21, 2011 National Hispanic-Serving Institutions Week, 2011... National Hispanic-Serving Institutions (HSIs) Week, we renew our commitment to strengthening and expanding... education institutions serving Hispanic students to provide the best education possible. This week, as...

  4. 75 FR 58283 - National Hispanic-Serving Institutions Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-23

    ... Documents#0;#0; ] Proclamation 8566 of September 17, 2010 National Hispanic-Serving Institutions Week, 2010... stage. This week, we celebrate the contributions of the more than 200 Hispanic-Serving Institutions in... proclaim September 19 through September 25, 2010, as National Hispanic-Serving Institutions Week. I...

  5. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 2 2012-10-01 2012-10-01 false Serving documents in PHMSA proceedings. 105.35 Section 105.35 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS... Serving documents in PHMSA proceedings. (a) Service by PHMSA. We may serve the document by one of...

  6. Cyber/Physical Security Vulnerability Assessment Integration

    SciTech Connect

    MacDonald, Douglas G.; Clements, Samuel L.; Patrick, Scott W.; Perkins, Casey J.; Muller, George; Lancaster, Mary J.; Hutton, William J.

    2013-02-28

    Securing high value and critical assets is one of the biggest challenges facing this nation and others around the world. In modern integrated systems, there are four potential modes of attack available to an adversary: • physical only attack, • cyber only attack, • physical-enabled cyber attack, • cyber-enabled physical attack. Blended attacks involve an adversary working in one domain to reduce system effectiveness in another domain. This enables the attacker to penetrate further into the overall layered defenses. Existing vulnerability assessment (VA) processes and software tools which predict facility vulnerabilities typically evaluate the physical and cyber domains separately. Vulnerabilities which result from the integration of cyber-physical control systems are not well characterized and are often overlooked by existing assessment approaches. In this paper, we modified modification of the timely detection methodology, used for decades in physical security VAs, to include cyber components. The Physical and Cyber Risk Analysis Tool (PACRAT) prototype illustrates an integrated vulnerability assessment that includes cyber-physical interdependencies. Information about facility layout, network topology, and emplaced safeguards is used to evaluate how well suited a facility is to detect, delay, and respond to attacks, to identify the pathways most vulnerable to attack, and to evaluate how often safeguards are compromised for a given threat or adversary type. We have tested the PACRAT prototype on critical infrastructure facilities and the results are promising. Future work includes extending the model to prescribe the recommended security improvements via an automated cost-benefit analysis.

  7. Vulnerability synthetic indices: a literature integrative review.

    PubMed

    Schumann, Lívia Rejane Miguel Amaral; Schumann, Lívia Amaral; Moura, Leides Baroso Azevedo

    2015-07-01

    The concept of vulnerability is delimited by dynamic social and multigenerational processes involving at least three dimensions: exposure to risk trajectories, internal and external capabilities of reaction and possibilities of adaptation based on both the intensity of risk and the resilience of people. In order to identify and describe the synthetic indices of vulnerability, there was an integrative literature review. We consulted free access articles indexed in the following databases: BioMed, Bireme, PubMed, Reldalyc, SciELO and Web of Science; and we used controlled descriptors in English and Portuguese for all time slots available with selection and analysis of 47 studies that reported results of 23 synthetic indices of vulnerability. The results showed that the synthetic indices of vulnerability address four themes: social determinants of health; environmental and climatic conditions; family and course of life; territories and specific geographic areas. It was concluded that the definition of the components and indicators, as well as the methodologies adopted for the construction of synthetic indices need to be evaluated by means of the limitations and advantages of reporting the vulnerability through summary measures in policy formulation and decision-making aimed at human development.

  8. Immune and Neuroendocrine Mechanisms of Stress Vulnerability and Resilience.

    PubMed

    Ménard, Caroline; Pfau, Madeline L; Hodes, Georgia E; Russo, Scott J

    2017-01-01

    Diagnostic criteria for mood disorders including major depressive disorder (MDD) largely ignore biological factors in favor of behavioral symptoms. Compounding this paucity of psychiatric biomarkers is a need for therapeutics to adequately treat the 30-50% of MDD patients who are unresponsive to traditional antidepressant medications. Interestingly, MDD is highly prevalent in patients suffering from chronic inflammatory conditions, and MDD patients exhibit higher levels of circulating pro-inflammatory cytokines. Together, these clinical findings suggest a role for the immune system in vulnerability to stress-related psychiatric illness. A growing body of literature also implicates the immune system in stress resilience and coping. In this review, we discuss the mechanisms by which peripheral and central immune cells act on the brain to affect stress-related neurobiological and neuroendocrine responses. We specifically focus on the roles of pro-inflammatory cytokine signaling, peripheral monocyte infiltration, microglial activation, and hypothalamic-pituitary-adrenal axis hyperactivity in stress vulnerability. We also highlight recent evidence suggesting that adaptive immune responses and treatment with immune modulators (exogenous glucocorticoids, humanized antibodies against cytokines) may decrease depressive symptoms and thus represent an attractive alternative to the current antidepressant treatments.

  9. Which Stratum of Urban Elderly Is Most Vulnerable for Dementia?

    PubMed Central

    2016-01-01

    Many factors associated with a patient's lifestyle may disrupt timely access to dementia diagnosis and management. The aim of this study was to compare characteristics of lifestyle factors at the time of initial evaluation for dementia across degrees of dementia, and to identify risk factors relating to late detection of dementia, in order to understand the various lifestyle barriers to timely recognition of the disease. We reviewed medical records of 1,409 subjects who were diagnosed as dementia among 35,723 inhabitants of Gwangjin-gu. Dementia severity was divided into three degrees. Age, sex, education, income, smoking, heavy drinking, physical activity, religion, and living conditions were evaluated. There was a significantly greater proportion of individuals who were old age, female, less educated, who had never smoked or drank heavily, without physical activity, with no religious activity and living with family other than spouse in the severe dementia group. The lifestyle risks of late detection were old age, lower education, less social interactions, less physical activity or living with family. We can define this group of patients as the vulnerable stratum to dementia evaluation. Health policy or community health services might find ways to better engage patients in this vulnerable stratum to dementia. PMID:27550494

  10. Which Stratum of Urban Elderly Is Most Vulnerable for Dementia?

    PubMed

    Moon, Yeonsil; Lee, Heeyoung; Namgung, Ok Kyoung; Han, Seol Heui

    2016-10-01

    Many factors associated with a patient's lifestyle may disrupt timely access to dementia diagnosis and management. The aim of this study was to compare characteristics of lifestyle factors at the time of initial evaluation for dementia across degrees of dementia, and to identify risk factors relating to late detection of dementia, in order to understand the various lifestyle barriers to timely recognition of the disease. We reviewed medical records of 1,409 subjects who were diagnosed as dementia among 35,723 inhabitants of Gwangjin-gu. Dementia severity was divided into three degrees. Age, sex, education, income, smoking, heavy drinking, physical activity, religion, and living conditions were evaluated. There was a significantly greater proportion of individuals who were old age, female, less educated, who had never smoked or drank heavily, without physical activity, with no religious activity and living with family other than spouse in the severe dementia group. The lifestyle risks of late detection were old age, lower education, less social interactions, less physical activity or living with family. We can define this group of patients as the vulnerable stratum to dementia evaluation. Health policy or community health services might find ways to better engage patients in this vulnerable stratum to dementia.

  11. Vulnerability of schools to floods in Nyando River catchment, Kenya.

    PubMed

    Ochola, Samuel O; Eitel, Bernhard; Olago, Daniel O

    2010-07-01

    This paper assesses the vulnerability of schools to floods in the Nyando River catchment (3,600 km(2)) in western Kenya and identifies measures needed to reduce this vulnerability. It surveys 130 schools in the lower reaches, where flooding is a recurrent phenomenon. Of the primary schools assessed, 40% were vulnerable, 48% were marginally vulnerable and 12% were not vulnerable. Of the secondary schools, 8% were vulnerable, 73% were marginally vulnerable and 19% were not vulnerable. Vulnerability to floods is due to a lack of funds, poor building standards, local topography, soil types and inadequate drainage. The Constituencies Development Fund (CDF), established in 2003, provides financial support to cover school construction and reconstruction costs; CDF Committees are expected to adopt school building standards. In an effort to promote safe and resilient construction and retrofitting to withstand floods, this paper presents vulnerability reduction strategies and recommendations for incorporating minimum standards in the on-going Primary School Infrastructure Programme Design.

  12. Self-Serving Bias or Simply Serving the Self? Evidence for a Dimensional Approach to Narcissism.

    PubMed

    Tamborski, Michael; Brown, Ryan P; Chowning, Karolyn

    2012-06-01

    Previous research has suggested that narcissism can be conceptualized as a multidimensional construct consisting of the related, but unique, dimensions of grandiosity and entitlement. The current studies examined the divergent associations of grandiosity and entitlement with respect to different types of self-serving strategies. In Study 1, we found that narcissistic grandiosity, but not entitlement, was positively associated with a self-enhancing strategy of unrealistic optimism. This association was not mediated by self-esteem. In Study 2, narcissistic entitlement, but not grandiosity, was predictive of unethical decision-making, an interpersonal self-promotional strategy that advances the self at the expense of others. Together, both studies support a model of narcissism consisting of a relatively intrapersonal dimension of grandiosity and a relatively interpersonal dimension of entitlement.

  13. Upfront lower dose lenalidomide is less toxic and does not compromise efficacy for vulnerable patients with relapsed refractory multiple myeloma: final analysis of the phase II RevLite study.

    PubMed

    Quach, Hang; Fernyhough, Liam; Henderson, Ross; Corbett, Gillian; Baker, Bart; Browett, Peter; Blacklock, Hilary; Forsyth, Cecily; Underhill, Craig; Cannell, Paul; Trotman, Judith; Neylon, Annette; Harrison, Simon; Link, Emma; Swern, Arlene; Cowan, Linda; Dimopoulos, Meletios A; Miles Prince, H

    2017-02-15

    The combination of lenalidomide and dexamethasone is an established treatment for patients with multiple myeloma (MM). Increasingly, treatment attenuation is advocated for frail/elderly patients to minimize toxicity even though there have been no prospective studies to demonstrate whether lenalidomide dose attenuation impacts on response and survival outcome. This prospective multicentre phase II study assessed the efficacy and tolerability of lower dose lenalidomide (15 mg) and dexamethasone (20 mg) in 149 eligible patients with relapsed/refractory MM aged over 59 years and/or with renal impairment. The overall response rate was 71% (complete response 15%). Median (range) progression-free survival (PFS) and overall survival (OS) were 8·9 (6·9-11·5) and 30·5 (20·0-36·2) months, respectively. Upon formal statistical comparison of these endpoints to that of a matched cohort of patients from the pivotal phase III MM009/MM010 studies who received standard-dose lenalidomide (25 mg) and high-dose dexamethasone (40 mg) no difference was seen in PFS (P = 0·34) and OS (P = 0·21). Importantly, grade 3-4 toxicities were reduced with low-dose lenalidomide, mainly lower neutropenia (29% vs. 41%), infections (23% vs. 31%) and venous thromboembolism (3% vs. 13%). This study supports a strategy of lenalidomide dose reduction at the outset for at-risk patients, and prospectively confirms that such an approach reduces adverse events while not compromising patient response or survival outcomes.

  14. Creativity and psychopathology: a shared vulnerability model.

    PubMed

    Carson, Shelley H

    2011-03-01

    Creativity is considered a positive personal trait. However, highly creative people have demonstrated elevated risk for certain forms of psychopathology, including mood disorders, schizophrenia spectrum disorders, and alcoholism. A model of shared vulnerability explains the relation between creativity and psychopathology. This model, supported by recent findings from neuroscience and molecular genetics, suggests that the biological determinants conferring risk for psychopathology interact with protective cognitive factors to enhance creative ideation. Elements of shared vulnerability include cognitive disinhibition (which allows more stimuli into conscious awareness), an attentional style driven by novelty salience, and neural hyperconnectivity that may increase associations among disparate stimuli. These vulnerabilities interact with superior meta-cognitive protective factors, such as high IQ, increased working memory capacity, and enhanced cognitive flexibility, to enlarge the range and depth of stimuli available in conscious awareness to be manipulated and combined to form novel and original ideas.

  15. Measuring Road Network Vulnerability with Sensitivity Analysis

    PubMed Central

    Jun-qiang, Leng; Long-hai, Yang; Liu, Wei-yi; Zhao, Lin

    2017-01-01

    This paper focuses on the development of a method for road network vulnerability analysis, from the perspective of capacity degradation, which seeks to identify the critical infrastructures in the road network and the operational performance of the whole traffic system. This research involves defining the traffic utility index and modeling vulnerability of road segment, route, OD (Origin Destination) pair and road network. Meanwhile, sensitivity analysis method is utilized to calculate the change of traffic utility index due to capacity degradation. This method, compared to traditional traffic assignment, can improve calculation efficiency and make the application of vulnerability analysis to large actual road network possible. Finally, all the above models and calculation method is applied to actual road network evaluation to verify its efficiency and utility. This approach can be used as a decision-supporting tool for evaluating the performance of road network and identifying critical infrastructures in transportation planning and management, especially in the resource allocation for mitigation and recovery. PMID:28125706

  16. Mapping Regional Drought Vulnerability: a Case Study

    NASA Astrophysics Data System (ADS)

    Karamouz, M.; Zeynolabedin, A.; Olyaei, M. A.

    2015-12-01

    Drought is among the natural disaster that causes damages and affects many people's life in many part of the world including in Iran. Recently, some factors such as climate variability and the impact of climate change have influenced drought frequency and intensity in many parts of the world. Drought can be divided into four categories of meteorological, hydrological, agricultural and social-economic. In meteorological the important feature is lack of rainfall. In hydrological drought river flows and dam storage are considered. Lack of soil moisture is the key factor in agricultural droughts while in social-economic type of drought the relation between supply and demand and social-economic damages due to water deficiency is studied. While the first three types relates to the lack of some hydrological characteristics, social-economic type of drought is actually the consequence of other types expressed in monetary values. Many indices are used in assessing drought; each has its own advantages and disadvantages and can be used for specific types of drought. Therefore knowing the types of drought can provide a better understanding of shortages and their characteristics. Drought vulnerability is a concept which shows the likelihood of damages from hazard in a particular place by focusing on the system status prior to the disaster. Drought vulnerability has been viewed as a potential for losses in the region due to water deficiency at the time of drought. In this study the application of vulnerability concept in drought management in East Azarbaijan province in Iran is investigated by providing vulnerability maps which demonstrates spatial characteristics of drought vulnerability. In the first step, certain governing parameters in drought analysis such as precipitation, temperature, land use, topography, solar radiation and ground water elevation have been investigated in the region. They are described in details and calculated in suitable time series. Vulnerabilities

  17. Nuclear Molecular Imaging for Vulnerable Atherosclerotic Plaques

    PubMed Central

    Lee, Soo Jin

    2015-01-01

    Atherosclerosis is an inflammatory disease as well as a lipid disorder. Atherosclerotic plaque formed in vessel walls may cause ischemia, and the rupture of vulnerable plaque may result in fatal events, like myocardial infarction or stroke. Because morphological imaging has limitations in diagnosing vulnerable plaque, molecular imaging has been developed, in particular, the use of nuclear imaging probes. Molecular imaging targets various aspects of vulnerable plaque, such as inflammatory cell accumulation, endothelial activation, proteolysis, neoangiogenesis, hypoxia, apoptosis, and calcification. Many preclinical and clinical studies have been conducted with various imaging probes and some of them have exhibited promising results. Despite some limitations in imaging technology, molecular imaging is expected to be used both in the research and clinical fields as imaging instruments become more advanced. PMID:26357491

  18. Imaging atherosclerosis and vulnerable plaque.

    PubMed

    Sadeghi, Mehran M; Glover, David K; Lanza, Gregory M; Fayad, Zahi A; Johnson, Lynne L

    2010-05-01

    Identifying patients at high risk for an acute cardiovascular event such as myocardial infarction or stroke and assessing the total atherosclerotic burden are clinically important. Currently available imaging modalities can delineate vascular wall anatomy and, with novel probes, target biologic processes important in plaque evolution and plaque stability. Expansion of the vessel wall involving remodeling of the extracellular matrix can be imaged, as can angiogenesis of the vasa vasorum, plaque inflammation, and fibrin deposits on early nonocclusive vascular thrombosis. Several imaging platforms are available for targeted vascular imaging to acquire information on both anatomy and pathobiology in the same imaging session using either hybrid technology (nuclear combined with CT) or MRI combined with novel probes targeting processes identified by molecular biology to be of importance. This article will discuss the current state of the art of these modalities and challenges to clinical translation.

  19. The effects of increased serving sizes on consumption.

    PubMed

    Hydock, Chris; Wilson, Anne; Easwar, Karthik

    2016-06-01

    The US Food and Drug Administration recently revealed that it is considering modifying the Nutrition Facts Panels required on packaged foods. One proposed change is increasing serving sizes included on labels, which has two potential implications. Larger serving sizes could increase consumption if consumers use the serving sizes displayed as a reference point for their own consumption (McFerran et al., 2010). Alternatively, larger serving sizes that depict increased values of negative nutrients (e.g. calories) could lead consumers to perceive foods as less healthy, thereby reducing consumption (Russo et al., 1986). In study 1 (Online sample, N = 208, Mage = 32, SDage = 12), participants saw pictures of packaged food items and nutrition labels. The labels, depicted either the existing or larger serving size. Across all foods, larger serving sizes led to lower health perceptions. Labels with larger serving sizes were rated as more representative of typical consumption. Study 2 (Online sample, N = 347, Mage = 31, SDage = 10) used the same design as study 1, but required participants to virtually portion foods. While serving sizes did not impact the amount of food consumers portioned, those who saw labels with larger serving sizes estimated that they portioned out more calories. In study 3 (Student sample, N = 198, Mage = 20, SDage = 1), participants were given M&Ms to eat, paired with a nutritional label depicting either the current or a larger serving size, while participating in unrelated surveys. Participants presented with the larger serving size label consumed less than those presented with the current serving size label. Together, the results suggest that the proposed increase in serving sizes on Nutrition Facts Panels could lower consumption of high-calorie foods.

  20. Assessment of Chemical and Radiological Vulnerabilities

    SciTech Connect

    SETH, S.S.

    2000-05-17

    Following the May 14, 1997 chemical explosion at Hanford's Plutonium Reclamation Facility, the Department of Energy Richland Operations Office and its prime contractor, Fluor Hanford, Inc., completed an extensive assessment to identify and address chemical and radiological safety vulnerabilities at all facilities under the Project Hanford Management Contract. This was a challenging undertaking because of the immense size of the problem, unique technical issues, and competing priorities. This paper focuses on the assessment process, including the criteria and methodology for data collection, evaluation, and risk-based scoring. It does not provide details on the facility-specific results and corrective actions, but discusses the approach taken to address the identified vulnerabilities.

  1. Climate challenges, vulnerabilities, and food security.

    PubMed

    Nelson, Margaret C; Ingram, Scott E; Dugmore, Andrew J; Streeter, Richard; Peeples, Matthew A; McGovern, Thomas H; Hegmon, Michelle; Arneborg, Jette; Kintigh, Keith W; Brewington, Seth; Spielmann, Katherine A; Simpson, Ian A; Strawhacker, Colleen; Comeau, Laura E L; Torvinen, Andrea; Madsen, Christian K; Hambrecht, George; Smiarowski, Konrad

    2016-01-12

    This paper identifies rare climate challenges in the long-term history of seven areas, three in the subpolar North Atlantic Islands and four in the arid-to-semiarid deserts of the US Southwest. For each case, the vulnerability to food shortage before the climate challenge is quantified based on eight variables encompassing both environmental and social domains. These data are used to evaluate the relationship between the "weight" of vulnerability before a climate challenge and the nature of social change and food security following a challenge. The outcome of this work is directly applicable to debates about disaster management policy.

  2. Climate challenges, vulnerabilities, and food security

    PubMed Central

    Nelson, Margaret C.; Ingram, Scott E.; Dugmore, Andrew J.; Streeter, Richard; Peeples, Matthew A.; McGovern, Thomas H.; Hegmon, Michelle; Arneborg, Jette; Brewington, Seth; Spielmann, Katherine A.; Simpson, Ian A.; Strawhacker, Colleen; Comeau, Laura E. L.; Torvinen, Andrea; Madsen, Christian K.; Hambrecht, George; Smiarowski, Konrad

    2016-01-01

    This paper identifies rare climate challenges in the long-term history of seven areas, three in the subpolar North Atlantic Islands and four in the arid-to-semiarid deserts of the US Southwest. For each case, the vulnerability to food shortage before the climate challenge is quantified based on eight variables encompassing both environmental and social domains. These data are used to evaluate the relationship between the “weight” of vulnerability before a climate challenge and the nature of social change and food security following a challenge. The outcome of this work is directly applicable to debates about disaster management policy. PMID:26712017

  3. Microbiological Food Safety for Vulnerable People

    PubMed Central

    Lund, Barbara M.

    2015-01-01

    Foodborne pathogens are more likely to cause infection and to result in serious consequences in vulnerable people than in healthy adults. People with some increase in susceptibility may form nearly 20% of the population in the UK and the USA. Conditions leading to increased susceptibility are listed. The main factors leading to foodborne disease caused by major pathogens are outlined and examples are given of outbreaks resulting from these factors. Measures to prevent foodborne disease include procedures based on Hazard Analysis Critical Control Point principles and prerequisite programmes and, especially for vulnerable people, the use of lower-risk foods in place of higher-risk products. PMID:26308030

  4. Microbiological Food Safety for Vulnerable People.

    PubMed

    Lund, Barbara M

    2015-08-21

    Foodborne pathogens are more likely to cause infection and to result in serious consequences in vulnerable people than in healthy adults. People with some increase in susceptibility may form nearly 20% of the population in the UK and the USA. Conditions leading to increased susceptibility are listed. The main factors leading to foodborne disease caused by major pathogens are outlined and examples are given of outbreaks resulting from these factors. Measures to prevent foodborne disease include procedures based on Hazard Analysis Critical Control Point principles and prerequisite programmes and, especially for vulnerable people, the use of lower-risk foods in place of higher-risk products.

  5. Earthquake resistant construction of electric transmission and telecommunication facilities serving the Federal government report

    SciTech Connect

    Yokel, F.Y.

    1990-02-01

    The vulnerability of electrical transmission and telecommunication facilities to damage in past earthquakes, as well as available standards and technologies to protect these facilities against earthquake damage are reviewed. An overview is presented of measures taken by various Federal agencies to protect electrical transmission and telecommunication facilities against earthquake hazards. It is concluded that while most new facilities which are owned and operated by Federal agencies are presently designed to provide some, though not necessarily adequate, earthquake resistance, there generally is no effort to retrofit existing facilities. No evidence was found of requirements to protect electrical transmission and communication facilities which have major contractual obligations to serve the Federal Government and only limited seismic design requirements are stipulated for electrical transmission systems constructed with Federal funding.

  6. Climate vulnerability of drinking water supplies

    NASA Astrophysics Data System (ADS)

    Selmeczi, Pál; Homolya, Emese; Rotárné Szalkai, Ágnes

    2016-04-01

    Extreme weather conditions in Hungary led to difficulties in drinking water management on diverse occasions in the past. Due to reduced water resources and the coexisting high demand for drinking water in dry summer periods the availability of a number of water supplies became insufficient therefore causing limitations in water access. In some other cases, as a result of floods and flash floods over karstic areas evolving in consequence of excessive precipitation, several water supplies had to be excluded in order to avoid the risk of infections. More frequent occurrence of extreme weather conditions and further possible changes in the future induce the necessity for an analysis of the vulnerability of drinking water resources to climate change. Since 95% of the total drinking water supply in Hungary originates from subsurface layers, significance of groundwater resources is outstanding. The aim of our work carried out in the frames of the NAGiS (National Adaptation Geo-information System) project was to build up a methodology for the study and determination of the vulnerability of drinking water supplies to climate. The task covered analyses of climatic parameters influencing drinking water supplies principally and hydrogeological characteristics of the geological media that significantly determines vulnerability. Effects on drinking water resources and their reduction or exclusion may imply societal and economic consequences therefore we extended the analyses to the investigation of possibilities concerning the adaptation capacity to changed conditions. We applied the CIVAS (Climate Impact and Vulnerability Assessment Scheme) model developed in the frames of the international climate research project CLAVIER (Climate Change and Variability: Impact on Central and Eastern Europe) to characterize climate vulnerability of drinking water supplies. The CIVAS model, being based on the combined evaluation of exposure, sensitivity and adaptability, provides a unified

  7. Antiretroviral drug diversion links social vulnerability to poor medication adherence in substance abusing populations.

    PubMed

    Tsuyuki, Kiyomi; Surratt, Hilary L

    2015-05-01

    Antiretroviral (ARV) medication diversion to the illicit market has been documented in South Florida, and linked to sub-optimal adherence in people living with HIV. ARV diversion reflects an unmet need for care in vulnerable populations that have difficulty engaging in consistent HIV care due to competing needs and co-morbidities. This study applies the Gelberg-Andersen behavioral model of health care utilization for vulnerable populations to understand how social vulnerability is linked to ARV diversion and adherence. Cross-sectional data were collected from a targeted sample of vulnerable people living with HIV in South Florida between 2010 and 2012 (n = 503). Structured interviews collected quantitative data on ARV diversion, access and utilization of care, and ARV adherence. Logistic regression was used to estimate the goodness-of-fit of additive models that test domain fit. Linear regression was used to estimate the effects of social vulnerability and ARV diversion on ARV adherence. The best fitting model to predict ARV diversion identifies having a low monthly income and unstable HIV care as salient enabling factors that promote ARV diversion. Importantly, health care need factors did not protect against ARV diversion, evidence that immediate competing needs are prioritized even in the face of poor health for this sample. We also find that ARV diversion provides a link between social vulnerability and sub-optimal ARV adherence, with ARV diversion and domains from the Behavioral Model explaining 25 % of the variation in ARV adherence. Our analyses reveal great need to improve engagement in HIV care for vulnerable populations by strengthening enabling factors (e.g. patient-provider relationship) to improve retention in HIV care and ARV adherence for vulnerable populations.

  8. Antiretroviral Drug Diversion Links Social Vulnerability to Poor Medication Adherence in Substance Abusing Populations

    PubMed Central

    Tsuyuki, Kiyomi; Surratt, Hilary L.

    2015-01-01

    Antiretroviral (ARV) medication diversion to the illicit market has been documented in South Florida, and linked to sub-optimal adherence in people living with HIV. ARV diversion reflects an unmet need for care in vulnerable populations that have difficulty engaging in consistent HIV care due to competing needs and co-morbidities. This study applies the Gelberg-Andersen Behavioral Model of Health Care Utilization for Vulnerable Populations to understand how social vulnerability is linked to ARV diversion and adherence. Cross-sectional data were collected from a targeted sample of vulnerable people living with HIV in South Florida between 2010 and 2012 (n=503). Structured interviews collected quantitative data on ARV diversion, access and utilization of care, and ARV adherence. Logistic regression was used to estimate the goodness-of-fit of additive models that test domain fit. Linear regression was used to estimate the effects of social vulnerability and ARV diversion on ARV adherence. The best fitting model to predict ARV diversion identifies having a low monthly income and unstable HIV care as salient enabling factors that promote ARV diversion. Importantly, health care need factors did not protect against ARV diversion, evidence that immediate competing needs are prioritized even in the face of poor health for this sample. We also find that ARV diversion provides a link between social vulnerability and sub-optimal ARV adherence, with ARV diversion and domains from the Behavioral Model explaining 25% of the variation in ARV adherence. Our analyses reveal great need to improve engagement in HIV care for vulnerable populations by strengthening enabling factors (e.g. patient-provider relationship) to improve retention in HIV care and ARV adherence for vulnerable populations. PMID:25893656

  9. Cardiac surgery as a stressor and the response of the vulnerable older adult.

    PubMed

    Neupane, Iva; Arora, Rakesh C; Rudolph, James L

    2017-01-01

    In an aging population, recovery and restoration of function are critical to maintaining independence. Over the past 50years, there have been dramatic improvements made in cardiac surgery processes and outcomes that allow for procedures to be performed on an increasingly older population with the goal of improving function. Although improved function is possible, major surgical procedures are associated with substantial stress, which can severely impact outcomes. Past literature has identified that frail patients, who are vulnerable to the stress of surgery, are more likely to have postoperative major adverse cardiac and cerebrovascular events (OR 4.9, 95% confidence interval 1.6, 14.6). The objective of this manuscript is to examine preoperative frailty in biological, psychological, and social domains using cardiac surgery to induce stress. We systematically searched PubMed for keywords including "cardiac surgery, frailty, and aged" in addition to the biological, psychological, and social keywords. In the biological domain, we examine the association of physiological and physical vulnerabilities, as well as, the impact of comorbidities and inflammation on negative surgical outcomes. In the psychological domain, the impact of cognitive impairment, depression, and anxiety as vulnerabilities were examined. In the social domain, social structure, coping, disparities, and addiction as vulnerabilities are described. Importantly, there is substantial overlap in the domains of vulnerability. While frailty research has largely focused on discrete physical vulnerability criteria, a broader definition of frailty demonstrates that vulnerabilities in biological, psychological, and social domains can limit recovery after the stress of cardiac surgery. Identification of vulnerability in these domains can allow better understanding of the risks of cardiac surgery and tailoring of interventions to improve outcomes.

  10. Public Health Consequences on Vulnerable Populations from Acute Chemical Releases

    PubMed Central

    Ruckart, Perri Zeitz; Orr, Maureen F.

    2008-01-01

    Data from a large, multi-state surveillance system on acute chemical releases were analyzed to describe the type of events that are potentially affecting vulnerable populations (children, elderly and hospitalized patients) in order to better prevent and plan for these types of incidents in the future. During 2003–2005, there were 231 events where vulnerable populations were within ¼ mile of the event and the area of impact was greater than 200 feet from the facility/point of release. Most events occurred on a weekday during times when day care centers or schools were likely to be in session. Equipment failure and human error caused a majority of the releases. Agencies involved in preparing for and responding to chemical emergencies should work with hospitals, nursing homes, day care centers, and schools to develop policies and procedures for initiating appropriate protective measures and managing the medical needs of patients. Chemical emergency response drills should involve the entire community to protect those that may be more susceptible to harm. PMID:21572842

  11. Optical coherence tomography for imaging the vulnerable plaque

    NASA Astrophysics Data System (ADS)

    Tearney, Guillermo J.; Jang, Ik-Kyung; Bouma, Brett E.

    2006-03-01

    While our understanding of vulnerable coronary plaque is still at an early stage, the concept that certain types of plaques predispose patients to developing an acute myocardial infarction continues to be at the forefront of cardiology research. Intracoronary optical coherence tomography (OCT) has been developed to both identify and study these lesions due to its distinct resolution advantage over other imaging modalities. We review clinical research conducted at the Massachusetts General Hospital over the past five years to develop, validate, and utilize this technology to improve our understanding of vulnerable plaque. Our results show that intracoronary OCT may be safely conducted in patients and that it provides abundant information regarding plaque microscopic morphology, which is essential to the identification and study of high-risk lesions. Even though many basic biological, clinical, and technological challenges must be addressed prior to widespread use of this technology, the unique capabilities of OCT ensure that it will have a prominent role in shaping the future of cardiology.

  12. The Occurrence and Prevention of Foodborne Disease in Vulnerable People

    PubMed Central

    O'Brien, Sarah J.

    2011-01-01

    Abstract In developed countries, such as the United Kingdom and the United States, between 15% and 20% of the population show greater susceptibility than the general population to foodborne disease. This proportion includes people with primary immunodeficiency, patients treated with radiation or with immunosuppressive drugs for cancer and diseases of the immune system, those with acquired immune-deficiency syndrome and diabetics, people suffering from liver or kidney disease or with excessive iron in the blood, pregnant women, infants, and the elderly. Malnutrition and use of antacids, particularly proton-pump inhibitors, also increase susceptibility. We review the occurrence of infection by foodborne pathogens in these groups of people and measures to prevent infection. The nature and use of low microbial diets to reduce the risk of foodborne disease in immunocompromised patients are very variable. Diets for vulnerable people in care should exclude higher-risk foods, and vulnerable people in the community should receive clear advice about food safety, in particular avoidance of higher-risk foods and substitution of safer, nutritious foods. PMID:21561383

  13. The occurrence and prevention of foodborne disease in vulnerable people.

    PubMed

    Lund, Barbara M; O'Brien, Sarah J

    2011-09-01

    In developed countries, such as the United Kingdom and the United States, between 15% and 20% of the population show greater susceptibility than the general population to foodborne disease. This proportion includes people with primary immunodeficiency, patients treated with radiation or with immunosuppressive drugs for cancer and diseases of the immune system, those with acquired immune-deficiency syndrome and diabetics, people suffering from liver or kidney disease or with excessive iron in the blood, pregnant women, infants, and the elderly. Malnutrition and use of antacids, particularly proton-pump inhibitors, also increase susceptibility. We review the occurrence of infection by foodborne pathogens in these groups of people and measures to prevent infection. The nature and use of low microbial diets to reduce the risk of foodborne disease in immunocompromised patients are very variable. Diets for vulnerable people in care should exclude higher-risk foods, and vulnerable people in the community should receive clear advice about food safety, in particular avoidance of higher-risk foods and substitution of safer, nutritious foods.

  14. Criminal injuries compensation: Protecting vulnerable applicants.

    PubMed

    Guthrie, Robert

    2015-09-01

    Each year large numbers of persons sustain injury as a consequence of criminal behaviour. All Australian jurisdictions provide State-funded compensation to those harmed in this way. In the case of vulnerable applicants, the Assessor must consider not simply the appropriate and fair amount of compensation, but also how a person will be affected by the payment of compensation. Often a vulnerable applicant will apply through a guardian or a public trustee, although many apply in person. This article examines the use of legislative provisions, rules, regulations and practices in the various Australian jurisdictions in relation to how vulnerable applicants may be protected and supported once an award of compensation is made in their favour. Most jurisdictions provide for a mechanism by which compensation may be held in trust where the Assessor considers that the applicant may be unable to manage his or her financial affairs in his or her best interests. This article explores what factors are taken into account by Assessors in the absence of and pursuant to legislative directions. It considers how the approach may vary across jurisdictions and creative approaches to financial protection of vulnerable applicants.

  15. Chemical Safety Vulnerability Working Group Report

    SciTech Connect

    Not Available

    1994-09-01

    This report marks the culmination of a 4-month review conducted to identify chemical safety vulnerabilities existing at DOE facilities. This review is an integral part of DOE's efforts to raise its commitment to chemical safety to the same level as that for nuclear safety.

  16. Evaluating Youth Work with Vulnerable Young People.

    ERIC Educational Resources Information Center

    Furlong, Andy; Cartmel, Fred; Powney, Janet; Hall, Stuart

    This report presents the results of an 18-month research project that studied the effectiveness of youth work with vulnerable young people. The research, representing six distinct geographical areas of Scotland characterized by disadvantage, focused on young people aged 13 to 16. In each neighborhood, the project examined the experiences of young…

  17. U.S. vulnerable to major hurricane

    NASA Astrophysics Data System (ADS)

    Bell, Peter M.

    The nation is ‘in the most vulnerable position in history’ should a major hurricane strike this year, according to James P. Walsh, acting NOAA Administrator.He warned that mushrooming coastal populations, public inexperience and apathy, and limited evacuation routes could combine to create a major catastrophe.

  18. Web vulnerability study of online pharmacy sites.

    PubMed

    Kuzma, Joanne

    2011-01-01

    Consumers are increasingly using online pharmacies, but these sites may not provide an adequate level of security with the consumers' personal data. There is a gap in this research addressing the problems of security vulnerabilities in this industry. The objective is to identify the level of web application security vulnerabilities in online pharmacies and the common types of flaws, thus expanding on prior studies. Technical, managerial and legal recommendations on how to mitigate security issues are presented. The proposed four-step method first consists of choosing an online testing tool. The next steps involve choosing a list of 60 online pharmacy sites to test, and then running the software analysis to compile a list of flaws. Finally, an in-depth analysis is performed on the types of web application vulnerabilities. The majority of sites had serious vulnerabilities, with the majority of flaws being cross-site scripting or old versions of software that have not been updated. A method is proposed for the securing of web pharmacy sites, using a multi-phased approach of technical and managerial techniques together with a thorough understanding of national legal requirements for securing systems.

  19. Retrieval from Memory: Vulnerable or Inviolable?

    ERIC Educational Resources Information Center

    Jones, Dylan M.; Marsh, John E.; Hughes, Robert W.

    2012-01-01

    We show that retrieval from semantic memory is vulnerable even to the mere presence of speech. Irrelevant speech impairs semantic fluency--namely, lexical retrieval cued by a semantic category name--but only if it is meaningful (forward speech compared to reversed speech or words compared to nonwords). Moreover, speech related semantically to the…

  20. CYBER/PHYSICAL SECURITY VULNERABILITY ASSESSMENT INTEGRATION

    SciTech Connect

    MacDonald, Douglas G.; Key, Brad; Clements, Samuel L.; Hutton, William J.; Craig, Philip A.; Patrick, Scott W.; Crawford, Cary E.

    2011-07-17

    This internally funded Laboratory-Directed R&D project by the Pacific Northwest National Laboratory, in conjunction with QinetiQ North America, is intended to identify and properly assess areas of overlap (and interaction) in the vulnerability assessment process between cyber security and physical protection. Existing vulnerability analysis (VA) processes and software tools exist, and these are heavily utilized in the determination of predicted vulnerability within the physical and cyber security domains. These determinations are normally performed independently of one another, and only interact on a superficial level. Both physical and cyber security subject matter experts have come to realize that though the various interactive elements exist, they are not currently quantified in most periodic security assessments. This endeavor aims to evaluate both physical and cyber VA techniques and provide a strategic approach to integrate the interdependent relationships of each into a single VA capability. This effort will also transform the existing suite of software currently utilized in the physical protection world to more accurately quantify the risk associated with a blended attack scenario. Performance databases will be created to support the characterization of the cyber security elements, and roll them into prototype software tools. This new methodology and software capability will enable analysts to better identify and assess the overall risk during a vulnerability analysis.

  1. Flood vulnerability evaluation in complex urban areas

    NASA Astrophysics Data System (ADS)

    Giosa, L.; Pascale, S.; Sdao, F.; Sole, A.; Cantisani, A.

    2009-04-01

    This paper deals the conception, the development and the subsequent validation of an integrated numerical model for the assessment of systemic vulnerability in complex and urbanized areas, subject to flood risk. The proposed methodology is based on the application of the concept of "systemic vulnerability", the model is a mathematician-decisional model action to estimate the vulnerability of complex a territorial system during a flood event. The model uses a group of "pressure pointers" in order to define, qualitatively and quantitatively, the influence exercised on the territorial system from factors like as those physicists, social, economic, etc.. The model evaluates the exposure to the flood risk of the elements that belong to a system. The proposed model, which is based on the studies of Tamura et al., 2000; Minciardi et al., 2004; Pascale et al., 2008; considers the vulnerability not as a characteristic of a particular element at risk, but as a peculiarity of a complex territorial system, in which the different elements are reciprocally linked in a functional way. The proposed model points out the elements with the major functional lost and that make the whole system critical. This characteristic makes the proposed model able to support a correct territorial planning and a suitable management of the emergency following natural disasters such as floods. The proposed approach was tested on the study area in the city of Potenza, southern Italy.

  2. Who's Vulnerable in Infant Child Care Centers?

    ERIC Educational Resources Information Center

    Kendall, Earline D.; Moukaddem, Virginia E.

    1992-01-01

    Maintains that infants and toddlers, parents, and child caregivers are vulnerable to a variety of infectious diseases from infant-toddler child care centers. These diseases include infectious diarrhea; rubella; cytomeglovirus; hepatitis A, and haemophilus influenza type B. Suggests ways to prevent the spread of such diseases. (BB)

  3. Perceived Vulnerability to Disease Predicts Environmental Attitudes

    ERIC Educational Resources Information Center

    Prokop, Pavol; Kubiatko, Milan

    2014-01-01

    Investigating predictors of environmental attitudes may bring valuable benefits in terms of improving public awareness about biodiversity degradation and increased pro-environmental behaviour. Here we used an evolutionary approach to study environmental attitudes based on disease-threat model. We hypothesized that people vulnerable to diseases may…

  4. "Vulnerable Families": Reflections on a Difficult Category

    ERIC Educational Resources Information Center

    Bauer, Petra; Wiezorek, Christine

    2016-01-01

    The term "vulnerable families" refers to familial living situations that are considered problematic, with a particular need for socially responsible, professionally provided support. This means of categorising families is extremely ambivalent, indicating not only a need for society to support forms of family life and family achievements,…

  5. The vulnerable and unstable atherosclerotic plaque.

    PubMed

    Fishbein, Michael C

    2010-01-01

    The lesion responsible for the overwhelming majority of acute coronary events is plaque disruption or erosion with superimposed thrombosis. The term "vulnerable plaque" has been used to describe those atherosclerotic plaques that are particularly susceptible to disruption. Vulnerable plaques are generally characterized as those having a thin inflamed fibrous cap over a very large lipid core. However, only a small percentage of such plaques rupture, and plaques with different characteristics may also rupture and thrombose. Most autopsy, intravascular ultrasound, and recent computed tomography angiographic studies of coronary arteries reveal large plaques at sites of rupture. While angiographic data are said to show less severe narrowing at sites of plaque rupture, actual review of data indicates that, even angiographically, more than 50% of plaques have greater than 75% cross-sectional area stenosis at sites of plaque rupture. If plaque rupture is more common at the shoulder region of a plaque, one could envision that this would be at a peripheral site of the plaque where the plaque may not be as large or occlusive. New knowledge about vulnerable plaques is emerging through the evolution of novel techniques used to study plaques in vivo. These methods combine sophisticated imaging techniques, often in conjunction with molecular biomarkers, that provide new insights into plaque biology. Since atherosclerotic coronary artery disease is such a widespread and fatal disease, it is important that we continue to strive for a greater understanding of the nature of the vulnerable plaque. Only then can rational interventions for this disorder be developed and implemented.

  6. Consumer Vulnerability to Fraud: Influencing Factors.

    ERIC Educational Resources Information Center

    Lee, Jinkook; Soberon-Ferrer, Horacio

    1997-01-01

    A questionnaire on market knowledge and awareness of unfair business practices was completed by 464 adults aged 18-64 and by 493 over 64. Consumers were more susceptible to fraud if they were older, poor, less educated, and/or living without spouses. Gender and race were not significant predictors of vulnerability. (SK)

  7. Predicting risk in space: Genetic markers for differential vulnerability to sleep restriction

    NASA Astrophysics Data System (ADS)

    Goel, Namni; Dinges, David F.

    2012-08-01

    Several laboratories have found large, highly reliable individual differences in the magnitude of cognitive performance, fatigue and sleepiness, and sleep homeostatic vulnerability to acute total sleep deprivation and to chronic sleep restriction in healthy adults. Such individual differences in neurobehavioral performance are also observed in space flight as a result of sleep loss. The reasons for these stable phenotypic differential vulnerabilities are unknown: such differences are not yet accounted for by demographic factors, IQ or sleep need, and moreover, psychometric scales do not predict those individuals cognitively vulnerable to sleep loss. The stable, trait-like (phenotypic) inter-individual differences observed in response to sleep loss—with intraclass correlation coefficients accounting for 58-92% of the variance in neurobehavioral measures—point to an underlying genetic component. To this end, we utilized multi-day highly controlled laboratory studies to investigate the role of various common candidate gene variants—each independently—in relation to cumulative neurobehavioral and sleep homeostatic responses to sleep restriction. These data suggest that common genetic variations (polymorphisms) involved in sleep-wake, circadian, and cognitive regulation may serve as markers for prediction of inter-individual differences in sleep homeostatic and neurobehavioral vulnerability to sleep restriction in healthy adults. Identification of genetic predictors of differential vulnerability to sleep restriction—as determined from candidate gene studies—will help identify astronauts most in need of fatigue countermeasures in space flight and inform medical standards for obtaining adequate sleep in space. This review summarizes individual differences in neurobehavioral vulnerability to sleep deprivation and ongoing genetic efforts to identify markers of such differences.

  8. Predicting Risk in Space: Genetic Markers for Differential Vulnerability to Sleep Restriction.

    PubMed

    Goel, Namni; Dinges, David F

    2012-08-01

    Several laboratories have found large, highly reliable individual differences in the magnitude of cognitive performance, fatigue and sleepiness, and sleep homeostatic vulnerability to acute total sleep deprivation and to chronic sleep restriction in healthy adults. Such individual differences in neurobehavioral performance are also observed in space flight as a result of sleep loss. The reasons for these stable phenotypic differential vulnerabilities are unknown: such differences are not yet accounted for by demographic factors, IQ or sleep need, and moreover, psychometric scales do not predict those individuals cognitively vulnerable to sleep loss. The stable, trait-like (phenotypic) inter-individual differences observed in response to sleep loss-with intraclass correlation coefficients accounting for 58%-92% of the variance in neurobehavioral measures- point to an underlying genetic component. To this end, we utilized multi-day highly controlled laboratory studies to investigate the role of various common candidate gene variants-each independently-in relation to cumulative neurobehavioral and sleep homeostatic responses to sleep restriction. These data suggest that common genetic variations (polymorphisms) involved in sleep-wake, circadian, and cognitive regulation may serve as markers for prediction of inter-individual differences in sleep homeostatic and neurobehavioral vulnerability to sleep restriction in healthy adults. Identification of genetic predictors of differential vulnerability to sleep restriction-as determined from candidate gene studies-will help identify astronauts most in need of fatigue countermeasures in space flight and inform medical standards for obtaining adequate sleep in space. This review summarizes individual differences in neurobehavioral vulnerability to sleep deprivation and ongoing genetic efforts to identify markers of such differences.

  9. Seismic vulnerability assessments in risk analysis

    NASA Astrophysics Data System (ADS)

    Frolova, Nina; Larionov, Valery; Bonnin, Jean; Ugarov, Alexander

    2013-04-01

    The assessment of seismic vulnerability is a critical issue within natural and technological risk analysis. In general, there are three common types of methods used for development of vulnerability functions of different elements at risk: empirical, analytical and expert estimations. The paper addresses the empirical methods for seismic vulnerability estimation for residential buildings and industrial facilities. The results of engineering analysis of past earthquake consequences, as well as the statistical data on buildings behavior during strong earthquakes presented in the different seismic intensity scales, are used to verify the regional parameters of mathematical models in order to simulate physical and economic vulnerability for different building types classified according to seismic scale MMSK-86. Verified procedure has been used to estimate the physical and economic vulnerability of buildings and constructions against earthquakes for the Northern Caucasus Federal region of the Russian Federation and Krasnodar area, which are characterized by rather high level of seismic activity and high population density. In order to estimate expected damage states to buildings and constructions in the case of the earthquakes according to the OSR-97B (return period T=1,000 years) within big cities and towns, they were divided into unit sites and their coordinates were presented as dots located in the centers of unit sites. Then the indexes obtained for each unit site were summed up. The maps of physical vulnerability zoning for Northern Caucasus Federal region of the Russian Federation and Krasnodar area includes two elements: percent of different damage states for settlements with number of inhabitants less than 1,000 and vulnerability for cities and towns with number of inhabitants more than 1,000. The hypsometric scale is used to represent both elements on the maps. Taking into account the size of oil pipe line systems located in the highly active seismic zones in

  10. Lectin Pathway of Complement Activation Is Associated with Vulnerability of Atherosclerotic Plaques

    PubMed Central

    Fumagalli, Stefano; Perego, Carlo; Zangari, Rosalia; De Blasio, Daiana; Oggioni, Marco; De Nigris, Francesca; Snider, Francesco; Garred, Peter; Ferrante, Angela M. R.; De Simoni, Maria-Grazia

    2017-01-01

    Inflammatory mechanisms may be involved in atherosclerotic plaque rupture. By using a novel histology-based method to quantify plaque instability here, we assess whether lectin pathway (LP) of complement activation, a major inflammation arm, could represent an index of plaque instability. Plaques from 42 consecutive patients undergoing carotid endarterectomy were stained with hematoxylin-eosin and the lipid core, cholesterol clefts, hemorrhagic content, thickness of tunica media, and intima, including or not infiltration of cellular debris and cholesterol, were determined. The presence of ficolin-1, -2, and -3 and mannose-binding lectin (MBL), LP initiators, was assessed in the plaques by immunofluorescence and in plasma by ELISA. LP activation was assessed in plasma by functional in vitro assays. Patients presenting low stenosis (≤75%) had higher hemorrhagic content than those with high stenosis (>75%), indicating increased erosion. Increased hemorrhagic content and tunica media thickness, as well as decreased lipid core and infiltrated content were associated with vulnerable plaques and therefore used to establish a plaque vulnerability score that allowed to classify patients according to plaque vulnerability. Ficolins and MBL were found both in plaques’ necrotic core and tunica media. Patients with vulnerable plaques showed decreased plasma levels and intraplaque deposition of ficolin-2. Symptomatic patients experiencing a transient ischemic attack had lower plasma levels of ficolin-1. We show that the LP initiators are present within the plaques and their circulating levels change in atherosclerotic patients. In particular, we show that decreased ficolin-2 levels are associated with rupture-prone vulnerable plaques, indicating its potential use as marker for cardiovascular risk assessment in atherosclerotic patients. PMID:28360913

  11. Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma

    PubMed Central

    Gilbertson, Mark W.; Shenton, Martha E.; Ciszewski, Aleksandra; Kasai, Kiyoto; Lasko, Natasha B.; Orr, Scott P.; Pitman, Roger K.

    2010-01-01

    In animals, exposure to severe stress can damage the hippocampus. Recent human studies show smaller hippocampal volume in individuals with the stress-related psychiatric condition posttraumatic stress disorder (PTSD). Does this represent the neurotoxic effect of trauma, or is smaller hippocampal volume a pre-existing condition that renders the brain more vulnerable to the development of pathological stress responses? In monozygotic twins discordant for trauma exposure, we found evidence that smaller hippocampi indeed constitute a risk factor for the development of stress-related psychopathology. Disorder severity in PTSD patients who were exposed to trauma was negatively correlated with the hippocampal volume of both the patients and the patients’ trauma-unexposed identical co-twin. Furthermore, severe PTSD twin pairs—both the trauma-exposed and unexposed members—had significantly smaller hippocampi than non-PTSD pairs. PMID:12379862

  12. [Customer satisfaction study in two roman hospitals: comparison between "cook & serve" and "cook & chill"].

    PubMed

    Perata, E; Ferrari, P; Tarsitani, G

    2005-01-01

    We studied patient's satisfaction rate for hospital dishes comparing "cook & chill" method with "cook & serve". As principal instrument we used a comparative questionnaire, anonymous and self-compiled, which is able to evaluate the differences of customer satisfaction's rate between the two methods.

  13. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  14. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  15. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  16. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  17. Fruit Juice for Kids: A Serving a Day OK

    MedlinePlus

    ... html Fruit Juice for Kids: A Serving a Day OK Review of studies finds 1 glass of 100-percent juice a day not linked with weight gain To use the ... one serving [of 100-percent fruit juice] a day contributes to weight gain in children," said study ...

  18. 27 CFR 31.42 - Restaurants serving liquors with meals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... liquors with meals. 31.42 Section 31.42 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Part Certain Organizations, Agencies, and Persons § 31.42 Restaurants serving liquors with meals. Proprietors of restaurants and other persons who serve liquors with meals to paying customers, even if...

  19. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  20. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  1. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  2. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  3. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  4. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  5. Inventing Hispanic-Serving Institutions (HSIs): The Basics

    ERIC Educational Resources Information Center

    Santiago, Deborah

    2006-01-01

    HSIs (Hispanic-Serving Institutions) are important institutions for Latinos, yet little research exists on them. This brief serves as a primer on the conditions and history behind their invention, the processes for identification, and the general institutional characteristics of HSIs. It also offers an overview of how these institutions are…

  6. Estimation of Food Guide Pyramid Serving Sizes by College Students.

    ERIC Educational Resources Information Center

    Knaust, Gretchen; Foster, Irene M.

    2000-01-01

    College students (n=158) used the Food Guide Pyramid to select serving sizes on a questionnaire (73% had been instructed in its use). Overall mean scores (31% correct) indicated they generally did not know recommended serving sizes. Those who had read about or received instruction in the pyramid had higher mean scores. (SK)

  7. 14 CFR 406.115 - Serving documents on other parties.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Serving documents on other parties. 406.115 Section 406.115 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION... Practice in FAA Space Transportation Adjudications § 406.115 Serving documents on other parties....

  8. 14 CFR 406.115 - Serving documents on other parties.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Serving documents on other parties. 406.115 Section 406.115 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION... Practice in FAA Space Transportation Adjudications § 406.115 Serving documents on other parties....

  9. 14 CFR 406.115 - Serving documents on other parties.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Serving documents on other parties. 406.115 Section 406.115 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION... Practice in FAA Space Transportation Adjudications § 406.115 Serving documents on other parties....

  10. 14 CFR 406.115 - Serving documents on other parties.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Serving documents on other parties. 406.115 Section 406.115 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION... Practice in FAA Space Transportation Adjudications § 406.115 Serving documents on other parties....

  11. 14 CFR 406.115 - Serving documents on other parties.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Serving documents on other parties. 406.115 Section 406.115 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION... Practice in FAA Space Transportation Adjudications § 406.115 Serving documents on other parties....

  12. The National Insurance Academy: Serving India's Insurance Professionals and Researchers

    ERIC Educational Resources Information Center

    Sane, Bhagyashree

    2011-01-01

    This article discusses how a special library can meet the needs of a specific industry. The author focuses on India's National Insurance Academy (NIA) Library, which serves the insurance industry of India and some neighboring countries. It is where the author serves as the chief librarian.

  13. 32 CFR 516.13 - Assistance in serving process overseas.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Assistance in serving process overseas. 516.13 Section 516.13 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Service of Process § 516.13 Assistance in serving process...

  14. 40 CFR 791.34 - Serving of notice.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Serving of notice. 791.34 Section 791.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) DATA REIMBURSEMENT Hearing Procedures § 791.34 Serving of notice. (a) Each party shall be...

  15. 36 CFR 703.22 - Where to serve demands.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....22 Section 703.22 Parks, Forests, and Public Property LIBRARY OF CONGRESS DISCLOSURE OR PRODUCTION OF... Where the Library Is Not a Party § 703.22 Where to serve demands. Requesting parties must serve..., Library of Congress, Washington, DC 20540. (b) For Law Library matters: Law Librarian, LM 240, Library...

  16. 36 CFR 703.22 - Where to serve demands.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Section 703.22 Parks, Forests, and Public Property LIBRARY OF CONGRESS DISCLOSURE OR PRODUCTION OF RECORDS... the Library Is Not a Party § 703.22 Where to serve demands. Requesting parties must serve subpoenas..., Library of Congress, Washington, DC 20540. (b) For Law Library matters: Law Librarian, LM 240, Library...

  17. 20 CFR 639.8 - How is the notice served?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How is the notice served? 639.8 Section 639.8 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR WORKER ADJUSTMENT AND RETRAINING NOTIFICATION § 639.8 How is the notice served? Any reasonable method of delivery to the...

  18. School Administrator Quality in Minority-Serving Institutions

    ERIC Educational Resources Information Center

    Rodríguez, Mariela A.; Mullen, Carol A.; Allen, Tawannah G.

    2015-01-01

    This commentary brings together the topics of geographically-oriented diversity, minority-serving institutions, and educational leadership programs. The geospatial context for this discussion about school administrator quality focuses on Hispanic-serving institutions (HSIs) and historically Black colleges and universities (HBCUs) in the United…

  19. Environmental Health Related Socio-Spatial Inequalities: Identifying “Hotspots” of Environmental Burdens and Social Vulnerability

    PubMed Central

    Shrestha, Rehana; Flacke, Johannes; Martinez, Javier; van Maarseveen, Martin

    2016-01-01

    Differential exposure to multiple environmental burdens and benefits and their distribution across a population with varying vulnerability can contribute heavily to health inequalities. Particularly relevant are areas with high cumulative burdens and high social vulnerability termed as “hotspots”. This paper develops an index-based approach to assess these multiple burdens and benefits in combination with vulnerability factors at detailed intra-urban level. The method is applied to the city of Dortmund, Germany. Using non-spatial and spatial methods we assessed inequalities and identified “hotspot” areas in the city. We found modest inequalities burdening higher vulnerable groups in Dortmund (CI = −0.020 at p < 0.05). At the detailed intra-urban level, however, inequalities showed strong geographical patterns. Large numbers of “hotspots” exist in the northern part of the city compared to the southern part. A holistic assessment, particularly at a detailed local level, considering both environmental burdens and benefits and their distribution across the population with the different vulnerability, is essential to inform environmental justice debates and to mobilize local stakeholders. Locating “hotspot” areas at this detailed spatial level can serve as a basis to develop interventions that target vulnerable groups to ensure a health conducive equal environment. PMID:27409625

  20. AVVAM-1 (Armored Vehicle Vulnerability Analysis Model) and Tank Vulnerability Sensitivity Studies

    DTIC Science & Technology

    1973-01-01

    Ground , Maryland 0 Introduction I AVVAM-I ( Armored Vehicle Vulnerability Analysis Model -first version) is a conceptuil model-and associateS digital... measure of the ballistic shielding provided by a tank component. *The higher this value the harder it is for a spall fragment to perforate the component...in vulnerability to ballistic damage from behind-the- armor frag- ments and in the ability of noncritical components to provide ballistic shielding for

  1. Aircraft vulnerability analysis by modeling and simulation

    NASA Astrophysics Data System (ADS)

    Willers, Cornelius J.; Willers, Maria S.; de Waal, Alta

    2014-10-01

    Infrared missiles pose a significant threat to civilian and military aviation. ManPADS missiles are especially dangerous in the hands of rogue and undisciplined forces. Yet, not all the launched missiles hit their targets; the miss being either attributable to misuse of the weapon or to missile performance restrictions. This paper analyses some of the factors affecting aircraft vulnerability and demonstrates a structured analysis of the risk and aircraft vulnerability problem. The aircraft-missile engagement is a complex series of events, many of which are only partially understood. Aircraft and missile designers focus on the optimal design and performance of their respective systems, often testing only in a limited set of scenarios. Most missiles react to the contrast intensity, but the variability of the background is rarely considered. Finally, the vulnerability of the aircraft depends jointly on the missile's performance and the doctrine governing the missile's launch. These factors are considered in a holistic investigation. The view direction, altitude, time of day, sun position, latitude/longitude and terrain determine the background against which the aircraft is observed. Especially high gradients in sky radiance occur around the sun and on the horizon. This paper considers uncluttered background scenes (uniform terrain and clear sky) and presents examples of background radiance at all view angles across a sphere around the sensor. A detailed geometrical and spatially distributed radiometric model is used to model the aircraft. This model provides the signature at all possible view angles across the sphere around the aircraft. The signature is determined in absolute terms (no background) and in contrast terms (with background). It is shown that the background significantly affects the contrast signature as observed by the missile sensor. A simplified missile model is constructed by defining the thrust and mass profiles, maximum seeker tracking rate, maximum

  2. Vulnerability of Mesostriatal Dopaminergic Neurons in Parkinson's Disease

    PubMed Central

    González-Hernández, Tomás; Cruz-Muros, Ignacio; Afonso-Oramas, Domingo; Salas-Hernandez, Josmar; Castro-Hernandez, Javier

    2010-01-01

    The term vulnerability was first associated with the midbrain dopaminergic neurons 85 years ago, before they were identified as monoaminergic neurons, when Foix and Nicolesco (1925) reported the loss of neuromelanin containing neurons in the midbrain of patients with post-encephalitic Parkinson's disease (PD). A few years later, Hassler (1938) showed that degeneration is more intense in the ventral tier of the substantia nigra compacta than in its dorsal tier and the ventral tegmental area (VTA), outlining the concept of differential vulnerability of midbrain dopaminergic (DA-) neurons. Nowadays, we know that other neuronal groups degenerate in PD, but the massive loss of nigral DA-cells is its pathological hallmark, having a pivotal position in the pathophysiology of the disease as it is responsible for the motor symptoms. Data from humans as well as cellular and animal models indicate that DA-cell degeneration is a complex process, probably precipitated by the convergence of different risk factors, mediated by oxidative stress, and involving pathogenic factors arising within the DA-neuron (intrinsic factors), and from its environment and distant interconnected brain regions (extrinsic factors). In light of current data, intrinsic factors seem to be preferentially involved in the first steps of the degenerative process, and extrinsic factors in its progression. A controversial issue is the relative weight of the impairment of common cell functions, such as energy metabolism and proteostasis, and specific dopaminergic functions, such as pacemaking activity and DA handling, in the pathogenesis of DA-cell degeneration. Here we will review the current knowledge about the relevance of these factors at the beginning and during the progression of PD, and in the differential vulnerability of midbrain DA-cells. PMID:21079748

  3. NEK2 serves as a prognostic biomarker for hepatocellular carcinoma

    PubMed Central

    Li, Gang; Zhong, Yanping; Shen, Qingrong; Zhou, Yi; Deng, Xiaofang; Li, Cuiping; Chen, Jiagui; Zhou, Ying; He, Min

    2017-01-01

    Never in mitosis gene A (NIMA)-related kinase 2 (NEK2) is a microtubule-associated protein that regulates spindle assembly in human cells and is overexpressed in various malignancies. However, the role of NEK2 in hepatocellular carcinoma (HCC) remains undetermined. We performed RNA-seq of the HCC cell line SMMC-7721 and the normal liver cell line HL-7702 using the Ion Proton System. NEK2 expression was detected using quantitative reverse transcription polymerase chain reaction in two cell lines and 5 matched HCC and adjacent non-tumorous liver tissues. The correlation between survival and NEK2 expression was analyzed in 359 patients with HCC using RNASeqV2 data available from The Cancer Genome Atlas (TCGA) website (https://tcga-data.nci.nih.gov/tcga/). The expression of NEK2, phospho-AKT and MMP-2 was evaluated by immunohistochemistry in 63 cases of HCC and matched adjacent non-tumorous liver tissues. Relationships between protein expression and clinicopathological parameters were assessed, and the correlations between NEK2 with phospho-AKT and MMP-2 expressions were evaluated. A total of 610 differentially expressed genes (DEGs) were revealed in the transcriptome comparison, 297 of which were upregulated and 313 were downregulated in HCC. NEK2, as the most obviously different DEG in cells and tissues from the RNA-seq data, was listed as an HCC candidate biomarker for further verification. NEK2 was overexpressed in HCC cells and tissues (P=0.002, P=0.013) and HCC patients with a high expression of NEK2 had a poor prognosis (P=0.0145). Clinical analysis indicated that the overexpression of NEK2 in HCC was significantly correlated with diolame complete (P<0.001), tumor nodule number (P=0.012) and recurrence (P=0.004). NEK2 expression was positively correlated with the expression of phospho-AKT (r=0.883, P<0.01) and MMP-2 (r=0.781, P<0.01). Overexpression of NEK2 was associated with clinicopathological characteristics and poor patient outcomes, suggesting that NEK2

  4. Contemporary carotid imaging: from degree of stenosis to plaque vulnerability.

    PubMed

    Brinjikji, Waleed; Huston, John; Rabinstein, Alejandro A; Kim, Gyeong-Moon; Lerman, Amir; Lanzino, Giuseppe

    2016-01-01

    Carotid artery stenosis is a well-established risk factor of ischemic stroke, contributing to up to 10%-20% of strokes or transient ischemic attacks. Many clinical trials over the last 20 years have used measurements of carotid artery stenosis as a means to risk stratify patients. However, with improvements in vascular imaging techniques such as CT angiography and MR angiography, ultrasonography, and PET/CT, it is now possible to risk stratify patients, not just on the degree of carotid artery stenosis but also on how vulnerable the plaque is to rupture, resulting in ischemic stroke. These imaging techniques are ushering in an emerging paradigm shift that allows for risk stratifications based on the presence of imaging features such as intraplaque hemorrhage (IPH), plaque ulceration, plaque neovascularity, fibrous cap thickness, and presence of a lipid-rich necrotic core (LRNC). It is important for the neurosurgeon to be aware of these new imaging techniques that allow for improved patient risk stratification and outcomes. For example, a patient with a low-grade stenosis but an ulcerated plaque may benefit more from a revascularization procedure than a patient with a stable 70% asymptomatic stenosis with a thick fibrous cap. This review summarizes the current state-of-the-art advances in carotid plaque imaging. Currently, MRI is the gold standard in carotid plaque imaging, with its high resolution and high sensitivity for identifying IPH, ulceration, LRNC, and inflammation. However, MRI is limited due to time constraints. CT also allows for high-resolution imaging and can accurately detect ulceration and calcification, but cannot reliably differentiate LRNC from IPH. PET/CT is an effective technique to identify active inflammation within the plaque, but it does not allow for assessment of anatomy, ulceration, IPH, or LRNC. Ultrasonography, with the aid of contrast enhancement, is a cost-effective technique to assess plaque morphology and characteristics, but it is

  5. Modelling farm vulnerability to flooding: A step toward vulnerability mitigation policies appraisal

    NASA Astrophysics Data System (ADS)

    Brémond, P.; Abrami, G.; Blanc, C.; Grelot, F.

    2009-04-01

    Recent catastrophic flood events such as Elbe in 2002 or Rhône in 2003 have shown limits of flood management policies relying on dykes protection: worsening of flood impacts downstream, increased damage by dykes rupture. Those events, among others, contributes to radical changes on the philosophy of flood prevention, with the promotion of new orientations for mitigating flood exposition. Two new trends may have a significant impact on rural areas: floodplain restoration and vulnerability mitigation. The Rhône River program, which is an contract of objectives signed between French Government and local collectivites, is highly illustrative of these new trends and their impact on agricultural sector. In this program, it appears that areas to be concerned by floodplain restoration are agricultural ones, because their supposed vulnerability to flood is expected to be less important to urban areas. As a consequence, agricultural sector is particularly concerned by planned actions on mitigation of assets vulnerability, an important part of the program (financial support of European Union of 7.5 Million euros). Mitigation of agricultural assets vulnerability reveals particularly interesting for two following reasons. Firstly, it is a way to maintain agricultural activities in floodplains yet existing, without promoting flood protection. Secondly, in case of floodplain restoration, vulnerability mitigation is a way for local authorities to compensate over-flooding impacts. In practice, local authorities may financially support farmers for implementing measures to mitigate their farm vulnerability. On the Rhône River, an important work has already been done to identify farm vulnerability to flooding, and propose measures to mitigate it. More than 3 000 farms exposed to flood risk have been identified representing 88 690 ha of agricultural areas which is estimated to generate damage between 400 and 800 Million euros depending on the season of occurrence for a catastrophic

  6. A Study of Health Care Needs of the Community Served by Kimbrough Army Community Hospital, Fort Meade, Maryland

    DTIC Science & Technology

    1981-04-01

    hospital acute care capacity is measured in patient beds and utilization is measured and projected in terms of patient days or admissions times length...the Community Served by Kimbrough Army Comunity Hospital , Ft. Meade, Maryland 12. PERSONAL AUITHOR(S) Captain Donald C. Curry, Jr., 13a. TYPE OF REPORT...COMMUNITY SERVED BY KIMBROUGH ARMY COMMUNITY HOSPITAL FORT MEADE, MARYLAND A Problem Solving Project Submitted to the Faculty of Baylor University In

  7. Empirical Estimates and Observations of 0Day Vulnerabilities

    SciTech Connect

    Miles A. McQueen; Trevor A. McQueen; Wayne F. Boyer; May R. Chaffin

    2009-01-01

    We define a 0Day vulnerability to be any vulnerability, in deployed software, that has been discovered by at least one person but has not yet been publicly announced or patched. These 0Day vulnerabilities are of particular interest when assessing the risk to a system from exploit of vulnerabilities which are not generally known to the public or, most importantly, to the owners of the system. Using the 0Day definition given above, we analyzed the 0Day lifespans of 491 vulnerabilities and conservatively estimated that in the worst year there were on average 2500 0Day vulnerabilities in existence on any given day. Then using a small but intriguing set of 15 0Day vulnerability lifespans representing the time from actual discovery to public disclosure, we made a more aggressive estimate. In this case, we estimated that in the worst year there were, on average, 4500 0Day vulnerabilities in existence on any given day.

  8. On the Library and Information Literacy Education of Vulnerable Groups

    ERIC Educational Resources Information Center

    Zhu, Tian-hui

    2009-01-01

    This paper defines and classifies vulnerable groups, elaborates the necessity of information literacy education of vulnerable groups, analyzes the feasibility for the library to carry out the education, and then discusses specific measures taken by the library to fulfill it.

  9. Psychological Vulnerability to Completed Suicide: A Review of Empirical Studies.

    ERIC Educational Resources Information Center

    Conner, Kenneth R.; Duberstein, Paul R.; Conwell, Yeates; Seidlitz, Larry; Caine, Eric D.

    2001-01-01

    This article reviews empirical literature on psychological vulnerability to completed suicide. Five constructs have been consistently associated with completed suicide: impulsivity/aggression; depression; anxiety; hopelessness; and self-consciousness/social disengagement. Current knowledge of psychological vulnerability could inform social…

  10. Vulnerability curves vs. vulnerability indicators: application of an indicator-based methodology for debris-flow hazards

    NASA Astrophysics Data System (ADS)

    Papathoma-Köhle, Maria

    2016-08-01

    The assessment of the physical vulnerability of elements at risk as part of the risk analysis is an essential aspect for the development of strategies and structural measures for risk reduction. Understanding, analysing and, if possible, quantifying physical vulnerability is a prerequisite for designing strategies and adopting tools for its reduction. The most common methods for assessing physical vulnerability are vulnerability matrices, vulnerability curves and vulnerability indicators; however, in most of the cases, these methods are used in a conflicting way rather than in combination. The article focuses on two of these methods: vulnerability curves and vulnerability indicators. Vulnerability curves express physical vulnerability as a function of the intensity of the process and the degree of loss, considering, in individual cases only, some structural characteristics of the affected buildings. However, a considerable amount of studies argue that vulnerability assessment should focus on the identification of these variables that influence the vulnerability of an element at risk (vulnerability indicators). In this study, an indicator-based methodology (IBM) for mountain hazards including debris flow (Kappes et al., 2012) is applied to a case study for debris flows in South Tyrol, where in the past a vulnerability curve has been developed. The relatively "new" indicator-based method is being scrutinised and recommendations for its improvement are outlined. The comparison of the two methodological approaches and their results is challenging since both methodological approaches deal with vulnerability in a different way. However, it is still possible to highlight their weaknesses and strengths, show clearly that both methodologies are necessary for the assessment of physical vulnerability and provide a preliminary "holistic methodological framework" for physical vulnerability assessment showing how the two approaches may be used in combination in the future.

  11. Human Illness and the Experience of Vulnerability: A Summary and Reflection upon the Opening Keynote by His Grace Archbishop Emeritus Desmond Tutu

    ERIC Educational Resources Information Center

    Mazonde, Isaac N.

    2010-01-01

    In his speech, "Human Illness and the Experience of Vulnerability," Archbishop Tutu used his experience, eloquence and humour to emphasize the vulnerability of human beings during illness. The Archbishop emphasized the need for healthcare professionals to realize that patients are not simply numbers or cases, but fellow human beings who are in…

  12. Computational discovery of pathway-level genetic vulnerabilities in non-small-cell lung cancer | Office of Cancer Genomics

    Cancer.gov

    Novel approaches are needed for discovery of targeted therapies for non-small-cell lung cancer (NSCLC) that are specific to certain patients. Whole genome RNAi screening of lung cancer cell lines provides an ideal source for determining candidate drug targets. Unsupervised learning algorithms uncovered patterns of differential vulnerability across lung cancer cell lines to loss of functionally related genes. Such genetic vulnerabilities represent candidate targets for therapy and are found to be involved in splicing, translation and protein folding.

  13. Selective Neuronal Vulnerability in Human Prion Diseases

    PubMed Central

    Guentchev, Marin; Wanschitz, Julia; Voigtländer, Till; Flicker, Helga; Budka, Herbert

    1999-01-01

    Human transmissible spongiform encephalopathies (TSEs) or prion diseases are neurodegenerative disorders of infectious, inherited or sporadic origin and include Creutzfeldt-Jakob disease (CJD), Gerstmann-Sträussler-Scheinker disease (GSS), kuru and fatal familial insomnia (FFI). Clinicopathologic features of FFI differ markedly from other human TSEs. Previous studies demonstrated selective neuronal vulnerability of parvalbumin positive (PV+) GABAergic inhibitory interneurons in sporadic CJD and experimental TSEs. In this report we show uniform severe loss of PV+ neurons also in other TSEs such as GSS, kuru, new variant and familial CJD. In contrast, these neurons are mostly well preserved, or only moderately reduced, in FFI. Only PV+ neurons surrounded by isolectin-B4 positive perineuronal nets were severely affected in TSEs, suggesting a factor residing in this type of extracellular matrix around PV+ neurons as modulator for the selective neuronal vulnerability. PMID:10550300

  14. Noninvasive diagnosis of vulnerable coronary plaque

    PubMed Central

    Pozo, Eduardo; Agudo-Quilez, Pilar; Rojas-González, Antonio; Alvarado, Teresa; Olivera, María José; Jiménez-Borreguero, Luis Jesús; Alfonso, Fernando

    2016-01-01

    Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease. For this reason, screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine. Necropsy studies have described histopathological changes associated with the development of acute coronary events. In this regard, thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature. Hence, many imaging techniques, such as coronary computed tomography, cardiac magnetic resonance or positron emission tomography, have tried to detect noninvasively these histomorphological characteristics with different approaches. In this article, we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings. PMID:27721935

  15. Information systems vulnerability: A systems analysis perspective

    SciTech Connect

    Wyss, G.D.; Daniel, S.L.; Schriner, H.K.; Gaylor, T.R.

    1996-07-01

    Vulnerability analyses for information systems are complicated because the systems are often geographically distributed. Sandia National Laboratories has assembled an interdisciplinary team to explore the applicability of probabilistic logic modeling (PLM) techniques (including vulnerability and vital area analysis) to examine the risks associated with networked information systems. The authors have found that the reliability and failure modes of many network technologies can be effectively assessed using fault trees and other PLM methods. The results of these models are compatible with an expanded set of vital area analysis techniques that can model both physical locations and virtual (logical) locations to identify both categories of vital areas simultaneously. These results can also be used with optimization techniques to direct the analyst toward the most cost-effective security solution.

  16. Disaster risk, social vulnerability, and economic development.

    PubMed

    Ward, Patrick S; Shively, Gerald E

    2017-04-01

    This paper examines the extent to which economic development decreases a country's risk of experiencing climate-related disasters as well as the societal impacts of those events. The paper proceeds from the underlying assumption that disasters are not inherently natural, but arise from the intersection of naturally-occurring hazards within fragile environments. It uses data from the International Disaster Database (EM-DAT), representing country-year-level observations over the period 1980-2007. The study finds that low-income countries are significantly more at risk of climate-related disasters, even after controlling for exposure to climate hazards and other factors that may confound disaster reporting. Following the occurrence of a disaster, higher income generally diminishes a country's social vulnerability to such happenings, resulting in lower levels of mortality and morbidity. This implies that continued economic development may be a powerful tool for lessening social vulnerability to climate change.

  17. Social Media: Strategic Asset or Operational Vulnerability?

    DTIC Science & Technology

    2012-05-04

    instantly, and influence opinions. This ability to communicate globally, when viewed operationally, has caused social media to become another element of...unchecked social media can be a critical strategic and operational vulnerability that can have an impact on operational success if it is not protected and...used properly. Operational commanders must be aware of the advantages and disadvantages of social media and have safeguards in place to ensure it does

  18. Commercial Air Carrier Vulnerabilities to Information Operations

    DTIC Science & Technology

    2007-11-02

    GMO /ENS/02E-11 DEPARTMENT OF THE AIR FORCE AIR UNIVERSITY AIR FORCE INSTITUTE OF TECHNOLOGY Wright-Patterson Air Force Base, Ohio...AFIT/ GMO /ENS/02E-11 COMMERCIAL AIR CARRIER VULNERABILITIES TO INFORMATION OPERATIONS...networks that without them, “there is no water coming out of your tap; there is no electricity lighting your room; there is no food being transported to

  19. Information Systems Vulnerability: A Systems Analysis Perspective

    DTIC Science & Technology

    1996-06-01

    viewgraph, video ,electronicposting(Internet, WorldWideWeb, external network), etc.) Information S stems Vulnerability : A S st . .Ctlve Sandiaauthor...12614 (8815) for videos ; Interactive Media 12616 (8815) for multimedia products or technical artwork; Corporate Exhibits 12613 (8815) for exhibits.) DOE...Conference Paper (3 copies) ❑ Exhibit/Display/Poster ❑ Publication ❑ SlidesNiewgraphs ❑ .Audio/ Video /Film ❑ Electronic Posting ❑ Journal Article

  20. Seaside, Oregon, Tsunami Vulnerability Assessment Pilot Study

    NASA Astrophysics Data System (ADS)

    Dunbar, P. K.; Dominey-Howes, D.; Varner, J.

    2006-12-01

    The results of a pilot study to assess the risk from tsunamis for the Seaside-Gearhart, Oregon region will be presented. To determine the risk from tsunamis, it is first necessary to establish the hazard or probability that a tsunami of a particular magnitude will occur within a certain period of time. Tsunami inundation maps that provide 100-year and 500-year probabilistic tsunami wave height contours for the Seaside-Gearhart, Oregon, region were developed as part of an interagency Tsunami Pilot Study(1). These maps provided the probability of the tsunami hazard. The next step in determining risk is to determine the vulnerability or degree of loss resulting from the occurrence of tsunamis due to exposure and fragility. The tsunami vulnerability assessment methodology used in this study was developed by M. Papathoma and others(2). This model incorporates multiple factors (e.g. parameters related to the natural and built environments and socio-demographics) that contribute to tsunami vulnerability. Data provided with FEMA's HAZUS loss estimation software and Clatsop County, Oregon, tax assessment data were used as input to the model. The results, presented within a geographic information system, reveal the percentage of buildings in need of reinforcement and the population density in different inundation depth zones. These results can be used for tsunami mitigation, local planning, and for determining post-tsunami disaster response by emergency services. (1)Tsunami Pilot Study Working Group, Seaside, Oregon Tsunami Pilot Study--Modernization of FEMA Flood Hazard Maps, Joint NOAA/USGS/FEMA Special Report, U.S. National Oceanic and Atmospheric Administration, U.S. Geological Survey, U.S. Federal Emergency Management Agency, 2006, Final Draft. (2)Papathoma, M., D. Dominey-Howes, D.,Y. Zong, D. Smith, Assessing Tsunami Vulnerability, an example from Herakleio, Crete, Natural Hazards and Earth System Sciences, Vol. 3, 2003, p. 377-389.

  1. Surface Vulnerability of Cerebral Cortex to Major Depressive Disorder

    PubMed Central

    Li, Gang; Fralick, Drew; Shen, Ting; Qiu, Meihui; Liu, Jun; Jiang, Kaida; Shen, Dinggang; Fang, Yiru

    2015-01-01

    Major depressive disorder (MDD) is accompanied by atypical brain structure. This study first presents the alterations in the cortical surface of patients with MDD using multidimensional structural patterns that reflect different neurodevelopment. Sixteen first-episode, untreated patients with MDD and 16 matched healthy controls underwent a magnetic resonance imaging (MRI) scan. The cortical maps of thickness, surface area, and gyrification were examined using the surface-based morphometry (SBM) approach. Increase of cortical thickness was observed in the right posterior cingulate region and the parietal cortex involving the bilateral inferior, left superior parietal and right paracentral regions, while decreased thickness was noted in the parietal cortex including bilateral pars opercularis and left precentral region, as well as the left rostral-middle frontal regions in patients with MDD. Likewise, increased or decreased surface area was found in five sub-regions of the cingulate gyrus, parietal and frontal cortices (e.g., bilateral inferior parietal and superior frontal regions). In addition, MDD patients exhibited a significant hypergyrification in the right precentral and supramarginal region. This integrated structural assessment of cortical surface suggests that MDD patients have cortical alterations of the frontal, parietal and cingulate regions, indicating a vulnerability to MDD during earlier neurodevelopmental process. PMID:25793287

  2. Growth of Necrotic Cores in Vulnerable Plaque

    NASA Astrophysics Data System (ADS)

    Fok, Pak-Wing

    2011-03-01

    Plaques are fatty deposits that grow mainly in arteries and develop as a result of a chronic inflammatory response. Plaques are called vulnerable when they are prone to mechanical rupture. Vulnerable Plaques (VPs) are characterized by lipid-rich, necrotic cores that are heavily infiltrated with macrophages. The rupture of VPs releases thrombogenic agents into the bloodstream, usually resulting in myocardial infarctions. We propose a quantitative model to predict the development of a plaque's necrotic core. By solving coupled reaction-diffusion equations for macrophages and dead cells, we explore the joint effects of hypoxic cell death and chemo-attraction to Ox-LDL, a molecule that is strongly linked to atherosclerosis. Our model predicts cores that have approximately the right size and shape. Normal mode analysis and subsequent calculation of the smallest eigenvalues allow us to compute the times required for the system to reach its steady state. This study allows us to make quantitative predictions for how quickly vulnerable plaques develop and how their growth depends on system parameters such as chemotactic coefficients and cell death rates.

  3. Network vulnerability assessment using Bayesian networks

    NASA Astrophysics Data System (ADS)

    Liu, Yu; Man, Hong

    2005-03-01

    While computer vulnerabilities have been continually reported in laundry-list format by most commercial scanners, a comprehensive network vulnerability assessment has been an increasing challenge to security analysts. Researchers have proposed a variety of methods to build attack trees with chains of exploits, based on which post-graph vulnerability analysis can be performed. The most recent approaches attempt to build attack trees by enumerating all potential attack paths, which are space consuming and result in poor scalability. This paper presents an approach to use Bayesian network to model potential attack paths. We call such graph as "Bayesian attack graph". It provides a more compact representation of attack paths than conventional methods. Bayesian inference methods can be conveniently used for probabilistic analysis. In particular, we use the Bucket Elimination algorithm for belief updating, and we use Maximum Probability Explanation algorithm to compute an optimal subset of attack paths relative to prior knowledge on attackers and attack mechanisms. We tested our model on an experimental network. Test results demonstrate the effectiveness of our approach.

  4. Vulnerability assessment using two complementary analysis tools

    SciTech Connect

    Paulus, W.K.

    1993-07-01

    To analyze the vulnerability of nuclear materials to theft or sabotage, Department of Energy facilities have been using, since 1989, a computer program called ASSESS, Analytic System and Software for Evaluation of Safeguards and Security. During the past year Sandia National Laboratories has begun using an additional program, SEES, Security Exercise Evaluation Simulation, enhancing the picture of vulnerability beyond what either program achieves alone. Assess analyzes all possible paths of attack on a target and, assuming that an attack occurs, ranks them by the probability that a response force of adequate size can interrupt the attack before theft or sabotage is accomplished. A Neutralization module pits, collectively, a security force against the interrupted adversary force in a fire fight and calculates the probability that the adversaries are defeated. SEES examines a single scenario and simulates in detail the interactions among all combatants. its output includes shots fired between shooter and target, and the hits and kills. Whereas ASSESS gives breadth of analysis, expressed statistically and performed relatively quickly, SEES adds depth of detail, modeling tactical behavior. ASSESS finds scenarios that exploit the greatest weakness of a facility. SEES explores these scenarios to demonstrate in detail how various tactics to nullify the attack might work out. Without ASSESS to find the facility weakness, it is difficult to focus SEES objectively on scenarios worth analyzing. Without SEES to simulate the details of response vs. adversary interaction, it is not possible to test tactical assumptions and hypotheses. Using both programs together, vulnerability analyses achieve both breadth and depth.

  5. NASA's Research in Aircraft Vulnerability Mitigation

    NASA Technical Reports Server (NTRS)

    Allen, Cheryl L.

    2005-01-01

    Since its inception in 1958, the National Aeronautics and Space Administration s (NASA) role in civil aeronautics has been to develop high-risk, high-payoff technologies to meet critical national aviation challenges. Following the events of Sept. 11, 2001, NASA recognized that it now shared the responsibility for improving homeland security. The NASA Strategic Plan was modified to include requirements to enable a more secure air transportation system by investing in technologies and collaborating with other agencies, industry, and academia. NASA is conducting research to develop and advance innovative and commercially viable technologies that will reduce the vulnerability of aircraft to threats or hostile actions, and identify and inform users of potential vulnerabilities in a timely manner. Presented in this paper are research plans and preliminary status for mitigating the effects of damage due to direct attacks on civil transport aircraft. The NASA approach to mitigation includes: preventing loss of an aircraft due to a hit from man-portable air defense systems; developing fuel system technologies that prevent or minimize in-flight vulnerability to small arms or other projectiles; providing protection from electromagnetic energy attacks by detecting directed energy threats to aircraft and on/off-board systems; and minimizing the damage due to high-energy attacks (explosions and fire) by developing advanced lightweight, damage-resistant composites and structural concepts. An approach to preventing aircraft from being used as weapons of mass destruction will also be discussed.

  6. Reconceptualizing Vulnerability in Personal Narrative Writing with Youths

    ERIC Educational Resources Information Center

    Johnson, Elisabeth

    2014-01-01

    Through a student/teacher classroom conflict, the author explores ways adults produce student writers as vulnerable. Drawing on post-structural concepts of adolescence, identity production, interrogation, and vulnerability, the author details how an English teacher invited students to perform vulnerability in personal narratives about issues like…

  7. An Empirical Measure of Computer Security Strength for Vulnerability Remediation

    ERIC Educational Resources Information Center

    Villegas, Rafael

    2010-01-01

    Remediating all vulnerabilities on computer systems in a timely and cost effective manner is difficult given that the window of time between the announcement of a new vulnerability and an automated attack has decreased. Hence, organizations need to prioritize the vulnerability remediation process on their computer systems. The goal of this…

  8. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....102 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SORGHUM... agreement to: (a) Serve on the Board if appointed; (b) Disclose any relationship with any sorghum...

  9. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SORGHUM PROMOTION, RESEARCH, AND INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum... agreement to: (a) Serve on the Board if appointed; (b) Disclose any relationship with any sorghum...

  10. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SORGHUM PROMOTION, RESEARCH, AND INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum... agreement to: (a) Serve on the Board if appointed; (b) Disclose any relationship with any sorghum...

  11. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SORGHUM PROMOTION, RESEARCH, AND INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum... agreement to: (a) Serve on the Board if appointed; (b) Disclose any relationship with any sorghum...

  12. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SORGHUM PROMOTION, RESEARCH, AND INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum... agreement to: (a) Serve on the Board if appointed; (b) Disclose any relationship with any sorghum...

  13. 13. ENGINE TEST CELL BUILDING INTERIOR. EQUIPMENT ROOM SERVING CELLS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. ENGINE TEST CELL BUILDING INTERIOR. EQUIPMENT ROOM SERVING CELLS 2 AND 4. LOOKING SOUTHEAST. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

  14. Environmental Finance Center Serving EPA's Region 8 States

    EPA Pesticide Factsheets

    The National Rural Water Association, headquartered in Duncan Oklahoma, has been selected through a competitive grants process to establish a regional Environmental Finance Center (EFC) serving EPA Region 8 states.

  15. 7 CFR 1150.134 - Nominee's agreement to serve.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE DAIRY PROMOTION PROGRAM Dairy Promotion and Research Order National Dairy Promotion and Research Board § 1150.134 Nominee's agreement to serve. Any...

  16. 7 CFR 1160.203 - Nominee's agreement to serve.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE FLUID MILK PROMOTION PROGRAM Fluid Milk Promotion Order National Fluid Milk Processor Promotion Board § 1160.203 Nominee's agreement to serve....

  17. 4. 150105 PACIFIC AVE. SPRAGUE BUILDING (1889). THIS BUILDING SERVED ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. 1501-05 PACIFIC AVE. SPRAGUE BUILDING (1889). THIS BUILDING SERVED AS A MODEL FOR MOST OF THE 'JOBBERS' (FOODSTUFF WHOLESALERS) BUILDING IN TACOMA. - Union Depot Area Study, Tacoma, Pierce County, WA

  18. Mobile Phones and Psychosocial Therapies with Vulnerable People: a First State of the Art.

    PubMed

    Vázquez, Maria Yolanda García; Sexto, Carlos Ferrás; Rocha, Álvaro; Aguilera, Adrián

    2016-06-01

    Mobile phones are becoming a communication tool commonly used by people all over the world; and they are started to be adopted in psychosocial therapies involving vulnerable people. We are herein presenting the results of an academic literature review. We identified scientific papers published between 2006 and 2015 resorting to academic databases available on the Internet, applying a systematic selection method based on quality criteria. Secondly, we analysed contents, highlighting the scarcity of research involving vulnerable people. The available literature specialized in psychosocial therapies offers investigation results which involve mobile phones and patients in general, focusing particularly on the clinical psychology field and, to a lesser extent, on the social work field. Particularly significant are the investigation works developed in the United States. In the present paper we introduce a first "state of the art", identifying opportunities and also the limitations surrounding the use of mobile phones in psychosocial therapies targeting the vulnerable. Issues concerning privacy and data confidentiality, and the access of vulnerable people to mobile phones and how they use them, pose significant challenges; but they offer the opportunity to reach isolated or impoverished populations, or even to facilitate access to social and healthcare services. We close this paper formulating possible orientations, hypotheses and goals to design new investigation works involving vulnerable populations.

  19. Quality Indicators of Continuity and Coordination of Care for Vulnerable Elder Persons

    DTIC Science & Technology

    2004-08-01

    observational study showed that at one week post-discharge, 72% of elderly patients were taking incorrectly at least one medication started in the inpatient...a treatment (e.g., physical therapy or radiation oncology), THEN the medical record should document that the visit or treatment took place or that...has evaluated the clinical outcomes of isolated hospital follow-up. However, vulnerable elderly patients discharged from the hospital to their

  20. Relationship Between Quality of Care and Functional Decline in Hospitalized Vulnerable Elders

    PubMed Central

    Arora, Vineet M.; Plein, Colleen; Chen, Stuart; Siddique, Juned; Sachs, Greg A.; Meltzer, David O.

    2009-01-01

    Background While process of care is a valuable dimension of quality, process-of-care-based quality indicators (POC-QIs) are ideally associated with meaningful patient outcomes. The relationship between POC-QIs for hospitalized older patients and functional decline, a relevant outcome for older patients, is unknown. Objective To assess the relationship between POC-QIs for hospitalized elders and functional decline Research Design Observational cohort study. Subjects Hospitalized vulnerable elder patients age 65 or older admitted to a general medicine inpatient service from 1 June 2004 to 1 June 2007. Measures POC-QIs received by hospitalized patients (measured by ACOVE QIs) and functional decline (increased Activities of Daily Living impairments post discharge). Results For 898 vulnerable elder patients, mean adherence to six universally applied quality indicators was 57.8%. After adjustment for factors likely associated with functional decline (comorbidity, vulnerability, baseline functional limitation, number of POC-QIs triggered, length of stay, code status, and interaction between frailty and QI adherence), there was no association between higher quality of care (using the composite score) and increased risk of functional decline. Patients who received a mobility plan were 1.48 (95% CI 1.07-2.05; p=0.017) times more likely to suffer functional decline after discharge. Patients who received an assessment of nutritional status had a lower odds of suffering functional decline after discharge (OR 0.37 (95% CI 0.21-0.64; p<0.001). Conclusions Hospitalized vulnerable elders who receive higher quality of care, as measured by ACOVE QIs, are not less likely to suffer decline after discharge. PMID:19597372

  1. No Myocardial Vulnerability to Mental Stress in Takotsubo Stress Cardiomyopathy

    PubMed Central

    Collste, Olov; Tornvall, Per; Sundin, Örjan; Alam, Mahbubul; Frick, Mats

    2014-01-01

    Objectives Due to the frequent use of coronary angiography the awareness of Takotsubo stress cardiomyopathy (TSC) has increased although the exact pathophysiology of TSC is still largely unknown. Our objective was to investigate the effects of mental stress on myocardial function, heart rate variability (HRV) and salivary cortisol (SC) in TSC patients. Design This study is a case-control study and a sub-study of the Stockholm Myocardial Infarction with Normal Coronaries (SMINC) study. Setting Mental stress test was performed more than 6 months after the acute event in TSC patients and age- and sex-matched controls. Standard echocardiography and tissue Doppler imaging (TDI) - derived time-phases of cardiac cycle were recorded to calculate myocardial performance index (MPI) to assess ventricular function before and during mental stress. Holter-ECG recording was made to estimate HRV before, during and after mental stress. SC was measured at baseline, before and 20 minutes after mental stress. Subjects Twenty-two TSC patients and 22 sex-and age-matched controls were recruited from the SMINC-study and investigated with a mental stress test. All TSC patients had a previous normal cardiovascular magnetic resonance investigation. Results There were no significant differences at rest or during mental stress for left and right ventricular MPI or other standard diastolic variables between TSC patients and controls. HRV did not differ between TSC patients and controls. There was a trend towards less increase in SC after mental stress in TSC patients compared to controls. Conclusion Mental stress did not induce a significant difference in myocardial function or HRV response between TSC and controls. Moreover, no significant difference could be seen in SC response at baseline, during or after mental stress. This study indicates that myocardial vulnerability to mental stress does not persist in TSC patients. PMID:24695370

  2. Vulnerability of Coastal Communities from Storm Surge and Flood Disasters.

    PubMed

    Bathi, Jejal Reddy; Das, Himangshu S

    2016-02-19

    Disasters in the form of coastal storms and hurricanes can be very destructive. Preparing for anticipated effects of such disasters can help reduce the public health and economic burden. Identifying vulnerable population groups can help prioritize resources for the most needed communities. This paper presents a quantitative framework for vulnerability measurement that incorporates both socioeconomic and flood inundation vulnerability. The approach is demonstrated for three coastal communities in Mississippi with census tracts being the study unit. The vulnerability results are illustrated as thematic maps for easy usage by planners and emergency responders to assist in prioritizing their actions to vulnerable populations during storm surge and flood disasters.

  3. Vulnerability of Coastal Communities from Storm Surge and Flood Disasters

    PubMed Central

    Bathi, Jejal Reddy; Das, Himangshu S.

    2016-01-01

    Disasters in the form of coastal storms and hurricanes can be very destructive. Preparing for anticipated effects of such disasters can help reduce the public health and economic burden. Identifying vulnerable population groups can help prioritize resources for the most needed communities. This paper presents a quantitative framework for vulnerability measurement that incorporates both socioeconomic and flood inundation vulnerability. The approach is demonstrated for three coastal communities in Mississippi with census tracts being the study unit. The vulnerability results are illustrated as thematic maps for easy usage by planners and emergency responders to assist in prioritizing their actions to vulnerable populations during storm surge and flood disasters. PMID:26907313

  4. Vulnerability-based evaluation of water supply design under climate change

    NASA Astrophysics Data System (ADS)

    Umit Taner, Mehmet; Ray, Patrick; Brown, Casey

    2015-04-01

    Long-lived water supply infrastructures are strategic investments in the developing world, serving the purpose of balancing water deficits compounded by both population growth and socio-economic development. Robust infrastructure design under climate change is compelling, and often addressed by focusing on the outcomes of climate model projections ('scenario-led' planning), or by identifying design options that are less vulnerable to a wide range of plausible futures ('vulnerability-based' planning). Decision-Scaling framework combines these two approaches by first applying a climate stress test on the system to explore vulnerabilities across many traces of the future, and then employing climate projections to inform the decision-making process. In this work, we develop decision scaling's nascent risk management concepts further, directing actions on vulnerabilities identified during the climate stress test. In the process, we present a new way to inform climate vulnerability space using climate projections, and demonstrate the use of multiple decision criteria to guide to a final design recommendation. The concepts are demonstrated for a water supply project in the Mombasa Province of Kenya, planned to provide domestic and irrigation supply. Six storage design capacities (from 40 to 140 million cubic meters) are explored through a stress test, under a large number climate traces representing both natural climate variability and plausible climate changes. Design outcomes are simulated over a 40-year planning period with a coupled hydrologic-water resources systems model and using standard reservoir operation rules. Resulting performance is expressed in terms of water supply reliability and economic efficiency. Ensemble climate projections are used for assigning conditional likelihoods to the climate traces using a statistical distance measure. The final design recommendations are presented and discussed for the decision criteria of expected regret, satisficing, and

  5. Determinants of choice, and vulnerability and recovery in addiction.

    PubMed

    Lamb, R J; Maguire, David R; Ginsburg, Brett C; Pinkston, Jonathan W; France, Charles P

    2016-06-01

    Addiction may be viewed as choice governed by competing contingencies. One factor impacting choice, particularly as it relates to addiction, is sensitivity to delayed rewards. Discounting of delayed rewards influences addiction vulnerability because of competition between relatively immediate gains of drug use, e.g. intoxication, versus relatively remote gains of abstinence, e.g. family stability. Factors modifying delay sensitivity can be modeled in the laboratory. For instance, increased delay sensitivity can be similarly observed in adolescent humans and non-human animals. Similarly, genetic factors influence delay sensitivity in humans and animals. Recovery from addiction may also be viewed as choice behavior. Thus, reinforcing alternative behavior facilitates recovery because reinforcing alternative behavior decreases the frequency of using drugs. How reinforcing alternative behavior influences recovery can also be modeled in the laboratory. For instance, relapse risk decreases as abstinence duration increases, and this decreasing risk can be modeled in animals using choice procedures. In summary, addiction in many respects can be conceptualized as a problem of choice. Animal models of choice disorders stand to increase our understanding of the core processes that establish and maintain addiction and serve as a proving ground for development of novel treatments.

  6. Vulnerabilities in GSM technology and feasibility of selected attacks

    NASA Astrophysics Data System (ADS)

    Voznak, M.; Prokes, M.; Sevcik, L.; Frnda, J.; Toral-Cruz, Homer; Jakovlev, Sergej; Fazio, Peppino; Mehic, M.; Mikulec, M.

    2015-05-01

    Global System for Mobile communication (GSM) is the most widespread technology for mobile communications in the world and serving over 7 billion users. Since first publication of system documentation there has been notified a potential safety problem's occurrence. Selected types of attacks, based on the analysis of the technical feasibility and the degree of risk of these weaknesses, were implemented and demonstrated in laboratory of the VSB-Technical University of Ostrava, Czech Republic. These vulnerabilities were analyzed and afterwards possible attacks were described. These attacks were implemented using open-source tools, software programmable radio USRP (Universal Software RadioPeripheral) and DVB-T (Digital Video Broadcasting - Terrestrial) receiver. GSM security architecture is being scrutinized since first public releases of its specification mainly pointing out weaknesses in authentication and ciphering mechanisms. This contribution also summarizes practically proofed and used scenarios that are performed using opensource software tools and variety of scripts mostly written in Python. Main goal of this paper is in analyzing security issues in GSM network and practical demonstration of selected attacks.

  7. NMDA receptor genotypes associated with the vulnerability to develop dyskinesia.

    PubMed

    Ivanova, S A; Loonen, A J M; Pechlivanoglou, P; Freidin, M B; Al Hadithy, A F Y; Rudikov, E V; Zhukova, I A; Govorin, N V; Sorokina, V A; Fedorenko, O Y; Alifirova, V M; Semke, A V; Brouwers, J R B J; Wilffert, B

    2012-01-10

    Dyskinesias are involuntary muscle movements that occur spontaneously in Huntington's disease (HD) and after long-term treatments for Parkinson's disease (levodopa-induced dyskinesia; LID) or for schizophrenia (tardive dyskinesia, TD). Previous studies suggested that dyskinesias in these three conditions originate from different neuronal pathways that converge on overstimulation of the motor cortex. We hypothesized that the same variants of the N-methyl-D-aspartate receptor gene that were previously associated with the age of dyskinesia onset in HD were also associated with the vulnerability for TD and not LID. Genotyping patients with LID and TD revealed, however, that these two variants were dose-dependently associated with susceptibility to LID, but not TD. This suggested that LID, TD and HD might arise from the same neuronal pathways, but TD results from a different mechanism.

  8. Technological solution for vulnerable communities: How does its approach matter?

    NASA Astrophysics Data System (ADS)

    Sianipar, C. P. M.; Dowaki, K.; Yudoko, G.

    2014-06-01

    Vulnerability is an emerging term for both scientific communities and practitioners. Vulnerabilities attributed to a particular community are then aggregated to state it as a vulnerable community. Vulnerability-related study is recognized as an interdisciplinary one due to the complex characteristics of vulnerabilities in each contextual situation. In common understandings, technology is recognized as an interdisciplinary solution, making it possible for supporting any activity in eradicating vulnerability. This study aims to observe such possibilities. Literature survey is taken to investigate the interconnection between vulnerability eradication and technology. Brief comparison between several developing countries and particular focus on Indonesia become a medium of further investigation to reveal issues surrounding technology-related efforts for vulnerability eradication in vulnerable communities. The study reveals that developing countries, particularly Indonesia, tend to adopt approaches from Northern hemisphere, including transferring technologies from developed countries without proper propagation. It means that local knowledge and power are largely ignored in the pursuit of local problem solving for vulnerability eradication. These facts become a signpost to emphasize that approach in implementing technological solution for such purpose is the critical mechanism to ensure the success in every contextual situation. Then, looking at the results of this brief study, its emphasis indicates further requirements to shift the paradigm of typical community development to contextual community empowerment in order to ensure the continuity of every technological solution for a consistent eradication of local vulnerabilities, including possible changes of required approach alongside the shift.

  9. Not the usual suspects: addressing layers of vulnerability.

    PubMed

    Luna, Florencia; Vanderpoel, Sheryl

    2013-07-01

    This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities.

  10. Assessing flood vulnerability using a rule-based fuzzy system.

    PubMed

    Yazdi, J; Neyshabouri, S A A S

    2012-01-01

    Population growth and urbanization in the last decades have increased the vulnerability of properties and societies in flood-prone areas. Vulnerability analysis is one of the main factors used to determine the necessary measures of flood risk reduction in floodplains. At present, the vulnerability of natural disasters is analyzed by defining the various physical and social indices. This study presents a model based on a fuzzy rule-based system to address various ambiguities and uncertainties from natural variability, and human knowledge and preferences in vulnerability analysis. The proposed method is applied for a small watershed as a case study and the obtained results are compared with one of the index approaches. Both approaches present the same ranking for the sub-basin's vulnerability in the watershed. Finally, using the scores of vulnerability in different sub-basins, a vulnerability map of the watershed is presented.

  11. Static analysis assisted vulnerability-oriented evolutionary fuzzing

    NASA Astrophysics Data System (ADS)

    Yang, Gang; Feng, Chao; Tang, Chaojing

    2017-03-01

    The blindness of fuzzing test is the main reason for its inefficiency in practical vulnerability discovery. In this paper, we proposed a static analysis assisted and vulnerability-oriented fuzzing testing technology. Through the static analysis, the suspect vulnerable code areas can be located roughly. And combined with dynamics update based on the fuzzing feedback, the vulnerable code areas can be further accurately located. By applying the distances to the located vulnerable code areas as one of metrics of the evolutionary fuzzing test, the vulnerability-oriented test cases are generated. The results in the experiment showed that the method proposed in this paper could effectually improve the vulnerability discovering efficiency of fuzzing test.

  12. Cultural knowledge and local vulnerability in African American communities

    NASA Astrophysics Data System (ADS)

    Miller Hesed, Christine D.; Paolisso, Michael

    2015-07-01

    Policymakers need to know what factors are most important in determining local vulnerability to facilitate effective adaptation to climate change. Quantitative vulnerability indices are helpful in this endeavour but are limited in their ability to capture subtle yet important aspects of vulnerability such as social networks, knowledge and access to resources. Working with three African American communities on Maryland’s Eastern Shore, we systematically elicit local cultural knowledge on climate change and connect it with a scientific vulnerability framework. The results of this study show that: a given social-ecological factor can substantially differ in the way in which it affects local vulnerability, even among communities with similar demographics and climate-related risks; and social and political isolation inhibits access to sources of adaptive capacity, thereby exacerbating local vulnerability. These results show that employing methods for analysing cultural knowledge can yield new insights to complement those generated by quantitative vulnerability indices.

  13. Extending Vulnerability Assessment to Include Life Stages Considerations

    PubMed Central

    Hodgson, Emma E.; Essington, Timothy E.; Kaplan, Isaac C.

    2016-01-01

    Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill–Euphausia pacifica and Thysanoessa spinifera, pteropod–Limacina helicina, pink shrimp–Pandalus jordani, Dungeness crab–Metacarcinus magister and Pacific hake–Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species’ vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate. PMID:27416031

  14. Extending Vulnerability Assessment to Include Life Stages Considerations.

    PubMed

    Hodgson, Emma E; Essington, Timothy E; Kaplan, Isaac C

    2016-01-01

    Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill-Euphausia pacifica and Thysanoessa spinifera, pteropod-Limacina helicina, pink shrimp-Pandalus jordani, Dungeness crab-Metacarcinus magister and Pacific hake-Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species' vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate.

  15. Integrated flash flood vulnerability assessment: Insights from East Attica, Greece

    NASA Astrophysics Data System (ADS)

    Karagiorgos, Konstantinos; Thaler, Thomas; Heiser, Micha; Hübl, Johannes; Fuchs, Sven

    2016-10-01

    In the framework of flood risk assessment, vulnerability is a key concept to assess the susceptibility of elements at risk. Besides the increasing amount of studies on flash floods available, in-depth information on vulnerability in Mediterranean countries was missing so far. Moreover, current approaches in vulnerability research are driven by a divide between social scientists who tend to view vulnerability as representing a set of socio-economic factors, and natural scientists who view vulnerability in terms of the degree of loss to an element at risk. Further, vulnerability studies in response to flash flood processes are rarely answered in the literature. In order to close this gap, this paper implemented an integrated vulnerability approach focusing on residential buildings exposed to flash floods in Greece. In general, both physical and social vulnerability was comparable low, which is interpreted as a result from (a) specific building regulations in Greece as well as general design principles leading to less structural susceptibility of elements at risk exposed, and (b) relatively low economic losses leading to less social vulnerability of citizens exposed. The population show high risk awareness and coping capacity to response to natural hazards event and in the same time the impact of the events are quite low, because of the already high use of local protection measures. The low vulnerability score for East Attica can be attributed especially to the low physical vulnerability and the moderate socio-economic well-being of the area. The consequence is to focus risk management strategies mainly in the reduction of the social vulnerability. By analysing both physical and social vulnerability an attempt was made to bridge the gap between scholars from sciences and humanities, and to integrate the results of the analysis into the broader vulnerability context.

  16. Vulnerability of Buildings for Tbilisi City

    NASA Astrophysics Data System (ADS)

    Vepkhvadze, Sopio; Arabidze, Vakhtang; Arevadze, Nika; Mukhadze, Temur; Jangveladze, Shota

    2013-04-01

    The risk always exists when cities are built on. Population growth in cities and urbanization in seismic-prone zones leads to infrastructure expansion. The goal of the society is to construct earthquake resistant infrastructure and minimize the expected losses. Work presented here was initiated by working package wp5 of regional projects EMME (Earthquake Model for Middle East Region). The primary scientific objective of this work was to combine analysis of the contemporary elements at risk inventories, seismicity and vulnerability to assess seismic hazard and seismic risk for the 0capital of Georgia - Tbilisi. Creation data bases (inventory) of elements at risk (building population) in GIS system were the first step of this work. Creation inventory databases are based on two approaches. One is monitoring and second is analyses of photos and aerial photos by expert. During the monitoring were realized that we have many cases of roof types, materials and functionality. For roof type, materials and functionality special program was prepared in GIS that allow manually create these ones in databases and then assigned to the building. Depending the choice of these ones, the program automatically assigned code to the building, finely on the bases of this codes program will be prepared that automatically calculate the taxonomy of the building. The European building taxonomy classification proposed in Giovinazzi (2005) were used for these building and taxonomy classification was done. On the bases of empirical data that was collected for Racha earthquake (Ms = 6.9) on 29 April of 1991 and Tbilisi earthquake (Ms= 4.5) on 25 April of 2002 some intensity based vulnerability study were completed and the regional vulnerability factors were developed for these typologies.

  17. Assessing internal biophysical vulnerability to landslide hazards - a nested catchment approach: Xiangxi Watershed / Three Gorges Reservoir

    NASA Astrophysics Data System (ADS)

    Wiegand, Matthias; Seeber, Christoph; Hartmann, Heike; Xiang, Wei; King, Lorenz

    2010-05-01

    The Three Gorges dam construction was completed in 2006. Besides the international media, also the responsible authorities and various scholarly communities pay close attention to potential and actual environmental impacts related to the impoundment and development activities. The geo-environment within the Three Gorges region is highly conducive to landslides. Consequently, a scientific monitoring and risk mitigation system was established and is still under development. Risk analysis with regard to gravity driven mass movements is highly complex and strongly site specific - several aspects hamper a universal methodology applicable for landslide risk and site assessment. The interdisciplinary Sino-German Yangtze-Project Research co-operation aims, among others, to support the sustainable cultivation of the newly developed ecosystems within the Yangtze catchments. Land use change and increasing population growth are causing severe pressure on the scarce land resources. Landslides are acknowledged as important threat, hence vulnerability of certain landscape components have to be identified, quantified and monitored. A nested quantitative approach for vulnerability analysis is developed. The applied risk and vulnerability model understands risk as the product of hazard and vulnerability. Whereas vulnerability is characterized by: mass movement intensity and susceptibility of the respective element at risk. The watershed of Xiangxi river serves as study area. In general, catchment approaches intent and proved to be a functional geographical unit for successful integrated resources management. Several limitations with regard to data accessibility, availability and accuracy have to be considered due to restrictions of feasible scales. Comprehensive large-scale site investigations are confined to training areas for model calibration and validation. Remote sensing potentials are utilised for land use/ land cover change analysis and localization of selected elements

  18. An 8-Stage Model for Evaluating the Tennis Serve

    PubMed Central

    Kovacs, Mark; Ellenbecker, Todd

    2011-01-01

    Background: The tennis serve is a complex stroke characterized by a series of segmental rotations involving the entire kinetic chain. Many overhead athletes use a basic 6-stage throwing model; however, the tennis serve does provide some differences. Evidence Acquisition: To support the present 8-stage descriptive model, data were gathered from PubMed and SPORTDiscus databases using keywords tennis and serve for publications between 1980 and 2010. Results: An 8-stage model of analysis for the tennis serve that includes 3 distinct phases—preparation, acceleration, and follow-through—provides a more tennis-specific analysis than that previously presented in the clinical tennis literature. When a serve is evaluated, the total body perspective is just as important as the individual segments alone. Conclusion: The 8-stage model provides a more in-depth analysis that should be utilized in all tennis players to help better understand areas of weakness, potential areas of injury, as well as components that can be improved for greater performance. PMID:23016050

  19. Influence of a Prolonged Tennis Match Play on Serve Biomechanics

    PubMed Central

    Martin, Caroline; Bideau, Benoit; Delamarche, Paul; Kulpa, Richard

    2016-01-01

    The aim of this study was to quantify kinematic, kinetic and performance changes that occur in the serve throughout a prolonged tennis match play. Serves of eight male advanced tennis players were recorded with a motion capture system before, at mid-match, and after a 3-hour tennis match. Before and after each match, electromyographic data of 8 upper limb muscles obtained during isometric maximal voluntary contraction were compared to determine the presence of muscular fatigue. Vertical ground reaction forces, rating of perceived exertion, ball speed, and ball impact height were measured. Kinematic and upper limb kinetic variables were computed. The results show decrease in mean power frequency values for several upper limb muscles that is an indicator of local muscular fatigue. Decreases in serve ball speed, ball impact height, maximal angular velocities and an increase in rating of perceived exertion were also observed between the beginning and the end of the match. With fatigue, the majority of the upper limb joint kinetics decreases at the end of the match. No change in timing of maximal angular velocities was observed between the beginning and the end of the match. A prolonged tennis match play may induce fatigue in upper limb muscles, which decrease performance and cause changes in serve maximal angular velocities and joint kinetics. The consistency in timing of maximal angular velocities suggests that advanced tennis players are able to maintain the temporal pattern of their serve technique, in spite of the muscular fatigue development. PMID:27532421

  20. Influence of a Prolonged Tennis Match Play on Serve Biomechanics.

    PubMed

    Martin, Caroline; Bideau, Benoit; Delamarche, Paul; Kulpa, Richard

    2016-01-01

    The aim of this study was to quantify kinematic, kinetic and performance changes that occur in the serve throughout a prolonged tennis match play. Serves of eight male advanced tennis players were recorded with a motion capture system before, at mid-match, and after a 3-hour tennis match. Before and after each match, electromyographic data of 8 upper limb muscles obtained during isometric maximal voluntary contraction were compared to determine the presence of muscular fatigue. Vertical ground reaction forces, rating of perceived exertion, ball speed, and ball impact height were measured. Kinematic and upper limb kinetic variables were computed. The results show decrease in mean power frequency values for several upper limb muscles that is an indicator of local muscular fatigue. Decreases in serve ball speed, ball impact height, maximal angular velocities and an increase in rating of perceived exertion were also observed between the beginning and the end of the match. With fatigue, the majority of the upper limb joint kinetics decreases at the end of the match. No change in timing of maximal angular velocities was observed between the beginning and the end of the match. A prolonged tennis match play may induce fatigue in upper limb muscles, which decrease performance and cause changes in serve maximal angular velocities and joint kinetics. The consistency in timing of maximal angular velocities suggests that advanced tennis players are able to maintain the temporal pattern of their serve technique, in spite of the muscular fatigue development.

  1. Sensitivity Characterization of Low Vulnerability (LOVA) Propellants

    DTIC Science & Technology

    1983-03-01

    1.987 cal K -1 g-mole-1 ) 4 n - gas volume (g-mole g-1 ) P = pressure (MPa) V = chamber volume (cm3 g-1) b - covolume (cm3g - ) 2 The thermochemical...Polyurethanes binders Covolume 21L AINITRAcr (contaum -sa,ermn oftlo fneoeemy md identify by block mnber) Low vulnerability (LOVA) propellants are being developed...with inert binders and plasticizers. Such propellants have higher igntion thresholds and reduced burning rates at low pressures and offer significant

  2. Power grid vulnerability: a complex network approach.

    PubMed

    Arianos, S; Bompard, E; Carbone, A; Xue, F

    2009-03-01

    Power grids exhibit patterns of reaction to outages similar to complex networks. Blackout sequences follow power laws, as complex systems operating near a critical point. Here, the tolerance of electric power grids to both accidental and malicious outages is analyzed in the framework of complex network theory. In particular, the quantity known as efficiency is modified by introducing a new concept of distance between nodes. As a result, a new parameter called net-ability is proposed to evaluate the performance of power grids. A comparison between efficiency and net-ability is provided by estimating the vulnerability of sample networks, in terms of both the metrics.

  3. Power grid vulnerability: A complex network approach

    NASA Astrophysics Data System (ADS)

    Arianos, S.; Bompard, E.; Carbone, A.; Xue, F.

    2009-03-01

    Power grids exhibit patterns of reaction to outages similar to complex networks. Blackout sequences follow power laws, as complex systems operating near a critical point. Here, the tolerance of electric power grids to both accidental and malicious outages is analyzed in the framework of complex network theory. In particular, the quantity known as efficiency is modified by introducing a new concept of distance between nodes. As a result, a new parameter called net-ability is proposed to evaluate the performance of power grids. A comparison between efficiency and net-ability is provided by estimating the vulnerability of sample networks, in terms of both the metrics.

  4. Ruptures of vulnerability: Linda Stein's Knight Series.

    PubMed

    Bible, Ann Vollmann

    2010-01-01

    Drawing on the work of Monique Wittig, this article understands Linda Stein's Knight Series as a lacunary writing communicating both her challenges to come to representation and her creative registration of subjectivity. The argument is grounded in an exploration of the rich interplay of power and vulnerability across the series as against the discourse of escapist fashion. Specifically, Stein's critical contradictions of inside and outside, conflated temporality, disjunctions between decoration and abstraction, and fluidity of sex and gender are examined. The discussion is elaborated through consideration of the work of Julia Kristeva, Elizabeth Grosz, and Hayao Miyazaki.

  5. Airplane Vulnerability and Overall Armament Effectiveness

    DTIC Science & Technology

    1947-05-01

    obtaining-such damage to the B-25 is obtained ss ss similarly cothe P-47, described above. -3, Fuel Tanks, Since the available-B-25 aircraft are...respectively for lö random hits on the B-25. The lice of fire-considered is from the rear and above with 9 = 20° and ß = 13°. Ali hits are assumed delivered...PRESENTED AREAS A view of the P-47 model in the aspect employed in the vulnerability computations of the body -of this report is shown in Fig. HI. Figures

  6. Aspects of vulnerable patients and informed consent in clinical trials.

    PubMed

    Kuthning, Maria; Hundt, Ferdinand

    2013-01-01

    Ziel: Diskussion der Aspekte der Einwilligung schutzbedürftiger Patienten nach Aufklärung zur Teilnahme an klinischen Prüfungen aus europäischem und deutschem Blick.Methoden: Wissenschaftliche Literaturrecherche via PubMed, Medline und Google. Ergebnis: Das freiwillige Einverständnis ist ein Eckpfeiler aller Regularien von klinischen Prüfungen. Einen Patienten in eine klinische Prüfung aufzunehmen, ohne zuvor die mit seiner Unterschrift versehene schriftliche Einverständnis eingeholt zu haben, ist als schwerwiegendes Fehlverhalten anzusehen. Die Entstehung ethischer Leitlinien begann bereits vor christlicher Zeitrechnung mit dem Hippokratischen Eid. In allen danach für die klinische Forschung entwickelten Leitlinien wird verdeutlicht, dass eine Hauptfunktion der Einwilligung nach Aufklärung die Sicherstellung der Willensfreiheit ist, um auch so das Wohl der Teilnehmer in klinischen Prüfungen sicherzustellen. Minderjährigen ist es nicht möglich ein diesbezüglich bindendes Einverständnis zu geben, dieses Problem wird durch eine Kombination von elterlicher Zustimmung sowie soweit möglich der Einwilligung des Minderjährigen adressiert. Analphabetismus ist betreffs der informierten Einwilligung ein kritischer Aspekt, der die ganze Welt betrifft. Er existiert in allen Gesellschaften, allen Bevölkerungsschichten und in jeder Altersgruppe. Um die Kommunikation mit diesen Patienten zu verbessern, können neue Strategien mittels Verwendung von Videotapes oder animierten Illustrationen und Trickfilmen gelehrt werden. Letztlich scheint die mit dem potentiellen Teilnehmer verbrachte Zeit der beste Weg zu sein, um die Verständigung zu verbessern.Schlussfolgerung: Die Erforschung lebensrettender und lebensverbessernder neuer Behandlungen erfordert eine Partnerschaft, die auf guter Kommunikation und Vertrauen zwischen Patienten und Forschern, Sponsoren, Ethikkommissionen, Behörden, Juristen und Politikern basiert, damit auch schutzbedürftige Patienten ohne Einschränkung von den Ergebnissen kontrollierter klinischer Prüfungen profitieren können.

  7. The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability

    PubMed Central

    Løberg, Else-Marie; Helle, Siri; Nygård, Merethe; Berle, Jan Øystein; Kroken, Rune A.; Johnsen, Erik

    2014-01-01

    There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings PMID:25477825

  8. Ultrasound-Based Carotid Elastography for Detection of Vulnerable Atherosclerotic Plaques Validated by Magnetic Resonance Imaging.

    PubMed

    Huang, Chengwu; Pan, Xiaochang; He, Qiong; Huang, Manwei; Huang, Lingyun; Zhao, Xihai; Yuan, Chun; Bai, Jing; Luo, Jianwen

    2016-02-01

    Ultrasound-based carotid elastography has been developed to estimate the mechanical properties of atherosclerotic plaques. The objective of this study was to evaluate the in vivo capability of carotid elastography in vulnerable plaque detection using high-resolution magnetic resonance imaging as reference. Ultrasound radiofrequency data of 46 carotid plaques from 29 patients (74 ± 5 y old) were acquired and inter-frame axial strain was estimated with an optical flow method. The maximum value of absolute strain rate for each plaque was derived as an indicator for plaque classification. Magnetic resonance imaging of carotid arteries was performed on the same patients to classify the plaques into stable and vulnerable groups for carotid elastography validation. The maximum value of absolute strain rate was found to be significantly higher in vulnerable plaques (2.15 ± 0.79 s(-1), n = 27) than in stable plaques (1.21 ± 0.37 s(-1), n = 19) (p < 0.0001). Receiver operating characteristic curve analysis was performed, and the area under the curve was 0.848. Therefore, the in vivo capability of carotid elastography to detect vulnerable plaques, validated by magnetic resonance imaging, was proven, revealing the potential of carotid elastography as an important tool in atherosclerosis assessment and stroke prevention.

  9. Serve the people: understanding ideology and professional ethics of medicine in China.

    PubMed

    Yang, Jingqing

    2010-09-01

    The article explores the communist ideology that has guided the formation of professional ethics of medicine in China. It first explores the constitutions of the People's Republic of China and the Chinese Communist Party and codes of practice for medicine enforced since 1949, showing that the core of the ideology in relation to health provision and doctor-patient relationship has always been 'serving the people wholeheartedly'. The ideological undertaking, however, has never been successfully exercised. In the pre-reform era, the bureaucratisation of health professionals led to the emergence of 'bureaucratic medicine' featuring negligence of patients' interests. In the reform era, the prevailing commercialisation of health care is in fundamental conflict with the ideological commitment to serving the people. As a result, the socialist professional ethics of medicine has not been satisfactorily practiced in reality.

  10. Perspectives on contextual vulnerability in discourses of climate conflict

    NASA Astrophysics Data System (ADS)

    Okpara, U. T.; Stringer, L. C.; Dougill, A. J.

    2015-12-01

    The science of climate security and conflict is replete with controversies. Yet the increasing vulnerability of politically fragile countries to the security consequences of climate change is widely acknowledged. Although climate conflict reflects a continuum of conditional forces that coalesce around the notion of vulnerability, how different portrayals of vulnerability influence the discursive formation of climate conflict relations remains an exceptional but under-researched issue. This paper combines a systematic discourse analysis with a vulnerability interpretation diagnostic tool to explore: (i) how discourses of climate conflict are constructed and represented, (ii) how vulnerability is communicated across discourse lines, and (iii) the strength of contextual vulnerability against a deterministic narrative of scarcity-induced conflict, such as that pertaining to land. Systematically characterising climate conflict discourses based on the central issues constructed, assumptions about mechanistic relationships, implicit normative judgements and vulnerability portrayals, provides a useful way of understanding where discourses differ. While discourses show a wide range of opinions "for" and "against" climate conflict relations, engagement with vulnerability has been less pronounced - except for the dominant context centrism discourse concerned about human security (particularly in Africa). In exploring this discourse, we observe an increasing sense of contextual vulnerability that is oriented towards a concern for complexity rather than predictability. The article concludes by illustrating that a turn towards contextual vulnerability thinking will help advance a constructivist theory-informed climate conflict scholarship that recognises historicity, specificity and variability as crucial elements of contextual totalities of any area affected by climate conflict.

  11. Perspectives on contextual vulnerability in discourses of climate conflict

    NASA Astrophysics Data System (ADS)

    Okpara, U. T.; Stringer, L. C.; Dougill, A. J.

    2016-02-01

    The science of climate security and conflict is replete with controversies. Yet the increasing vulnerability of politically fragile countries to the security consequences of climate change is widely acknowledged. Although climate conflict reflects a continuum of conditional forces that coalesce around the notion of vulnerability, how different portrayals of vulnerability influence the discursive formation of climate conflict relations remains an exceptional but under-researched issue. This paper combines a systematic discourse analysis with a vulnerability interpretation diagnostic tool to explore (i) how discourses of climate conflict are constructed and represented, (ii) how vulnerability is communicated across discourse lines, and (iii) the strength of contextual vulnerability against a deterministic narrative of scarcity-induced conflict, such as that pertaining to land. Systematically characterising climate conflict discourses based on the central issues constructed, assumptions about mechanistic relationships, implicit normative judgements and vulnerability portrayals, provides a useful way of understanding where discourses differ. While discourses show a wide range of opinions "for" and "against" climate conflict relations, engagement with vulnerability has been less pronounced - except for the dominant context centrism discourse concerned about human security (particularly in Africa). In exploring this discourse, we observe an increasing sense of contextual vulnerability that is oriented towards a concern for complexity rather than predictability. The article concludes by illustrating that a turn towards contextual vulnerability thinking will help advance a constructivist theory-informed climate conflict scholarship that recognises historicity, specificity, and variability as crucial elements of contextual totalities of any area affected by climate conflict.

  12. A socioeconomic profile of vulnerable land to desertification in Italy.

    PubMed

    Salvati, Luca

    2014-01-01

    Climate changes, soil vulnerability, loss in biodiversity, and growing human pressure are threatening Mediterranean-type ecosystems which are increasingly considered as a desertification hotspot. In this region, land vulnerability to desertification strongly depends on the interplay between natural and anthropogenic factors. The present study proposes a multivariate exploratory analysis of the relationship between the spatial distribution of land vulnerability to desertification and the socioeconomic contexts found in three geographical divisions of Italy (north, center and south) based on statistical indicators. A total of 111 indicators describing different themes (demography, human settlements, labor market and human capital, rural development, income and wealth) were used to discriminate vulnerable from non-vulnerable areas. The resulting socioeconomic profile of vulnerable areas in northern and southern Italy diverged significantly, the importance of demographic and economic indicators being higher in southern Italy than in northern Italy. On the contrary, human settlement indicators were found more important to discriminate vulnerable and non-vulnerable areas in northern Italy, suggesting a role for peri-urbanization in shaping the future vulnerable areas. An in-depth knowledge of the socioeconomic characteristics of vulnerable land may contribute to scenarios' modeling and the development of more effective policies to combat desertification.

  13. The perils of protection: vulnerability and women in clinical research.

    PubMed

    Schonfeld, Toby

    2013-06-01

    Subpart B of 45 Code of Federal Regulations Part 46 (CFR) identifies the criteria according to which research involving pregnant women, human fetuses, and neonates can be conducted ethically in the United States. As such, pregnant women and fetuses fall into a category requiring "additional protections," often referred to as "vulnerable populations." The CFR does not define vulnerability, but merely gives examples of vulnerable groups by pointing to different categories of potential research subjects needing additional protections. In this paper, I assess critically the role of this categorization of pregnant women involved in research as "vulnerable," both as separate entities and in combination with the fetuses they carry. In particular, I do three things: (1) demonstrate that pregnant women qua pregnancy are either not "vulnerable" according to any meaningful definition of that term or that such vulnerability is irrelevant to her status as a research participant; (2) argue that while a fetus may be vulnerable in terms of dependency, this categorization does not equate to the vulnerability of the pregnant woman; and (3) suggest that any vulnerability that appends to women is precisely the result of federal regulations and dubious public perceptions about pregnant women. I conclude by demonstrating how this erroneous characterization of pregnant women as "vulnerable" and its associated protections have not only impeded vital research for pregnant women and their fetuses, but have also negatively affected the inclusion of all women in clinical research.

  14. Mapping of earthquakes vulnerability area in Papua

    NASA Astrophysics Data System (ADS)

    Muhammad Fawzy Ismullah, M.; Massinai, Muh. Altin

    2016-05-01

    Geohazard is a geological occurrence which may lead to a huge loss for human. A mitigation of these natural disasters is one important thing to be done properly in order to reduce the risks. One of the natural disasters that frequently occurs in the Papua Province is the earthquake. This study applies the principle of Geospatial and its application for mapping the earthquake-prone area in the Papua region. It uses earthquake data, which is recorded for 36 years (1973-2009), fault location map, and ground acceleration map of the area. The earthquakes and fault map are rearranged into an earthquake density map, as well as an earthquake depth density map and fault density map. The overlaid data of these three maps onto ground acceleration map are then (compiled) to obtain an earthquake unit map. Some districts area, such as Sarmi, Nabire, and Dogiyai, are identified by a high vulnerability index. In the other hand, Waropen, Puncak, Merauke, Asmat, Mappi, and Bouven Digoel area shows lower index. Finally, the vulnerability index in other places is detected as moderate.

  15. Framework for Vulnerability Assessment of Coastal Infrastructure

    NASA Astrophysics Data System (ADS)

    Obrien, P. S.; Moritz, H. R.; White, K. D.

    2015-12-01

    Coastal infrastructure can be highly vulnerable to changing climate, including increasing sea levels and altered frequency and intensity of coastal storms. Existing coastal infrastructure may be of a sufficient age that it is already experiencing noticeable impacts from global sea level rise, and require a variety of potential preparedness and resilience measures to adapt to changing climate. Methods to determine vulnerability to changing sea level and support planning of potential future adaptation measures are needed for application to projects having multiple purposes (e.g., navigation, coastal risk reduction). Here we describe a potential framework for assessing projects with several components typical of existing coastal infrastructure spanning a range of engineering disciplines (e.g., hydrology, geotechnical, structural, electrical, and mechanical). The US Army Corps of Engineers (USACE) Climate Preparedness and Resilience Register (CPRR) framework is currently under development. It takes a tiered approach as described in earlier USACE guidance (Engineer Technical Letter 1100-2-1) using the three scenarios prescribed by Engineer Regulation ER 1100-2-8162. Level 1 is a qualitative assessment defining the major sea level change-related impacts and ranks them in order of soonest occurrence. Level 2 is a quantitative evaluation that analyzes current and future performance of individual project components, including electrical, mechanical and structural components and functions using the sea level change scenarios prescribed by ER 1100-2-8162. Level 3 proposes adaptation measures per ETL 1100-2-1 and evaluates changes in sea level change-related impacts.

  16. Addressing the vulnerabilities of pass-thoughts

    NASA Astrophysics Data System (ADS)

    Fernandez, Gabriel C.; Danko, Amanda S.

    2016-05-01

    As biometrics become increasingly pervasive, consumer electronics are reaping the benefits of improved authentication methods. Leveraging the physical characteristics of a user reduces the burden of setting and remembering complex passwords, while enabling stronger security. Multi-factor systems lend further credence to this model, increasing security via multiple passive data points. In recent years, brainwaves have been shown to be another feasible source for biometric authentication. Physically unique to an individual in certain circumstances, the signals can also be changed by the user at will, making them more robust than static physical characteristics. No paradigm is impervious however, and even well-established medical technologies have deficiencies. In this work, a system for biometric authentication via brainwaves is constructed with electroencephalography (EEG). The efficacy of EEG biometrics via existing consumer electronics is evaluated, and vulnerabilities of such a system are enumerated. Impersonation attacks are performed to expose the extent to which the system is vulnerable. Finally, a multimodal system combining EEG with additional factors is recommended and outlined.

  17. [Neuroethics and Human Vulnerability in Philosophical Perspective].

    PubMed

    Marcos, Alfredo

    2015-01-01

    This article tries to assess the potentials and limits of neuroethics. It argues that neuroscience and ethics should collaborate each other with mutual respect and preservation of their respective identities, scientific in the first case and philosophical in the second one ( neuroethics as cooperation). The text develops also a criticism in front of any attempt to replace the philosophical ethics by the neurosciences ( neuroethics as substitution). Consequently, the most appropriate ontological and anthropological foundations are explored to develop a cooperative neuroethics. These foundations refer to the Aristotelian hylomorphic conception of the substances. On such foundations it is possible to develop a collaborative neuroethics which includes two aspects: on the one hand, we have an ethics of neuroscience and, on the other one, a neuroscience of ethics. The first one shows us how to conduct neuroscience while preserving human dignity. The second one teaches us about the neurobiological basis of our moral agency. These bases enable our moral behavior without determining it. By studying them our vulnerability as moral agents emerges as evidence. This vulnerability, which is rooted in the very human nature, must be, as it is argued along the last pages of the text, recognized as well as mitigated.

  18. Market mechanisms protect the vulnerable brain.

    PubMed

    Ramchandran, Kanchna; Nayakankuppam, Dhananjay; Berg, Joyce; Tranel, Daniel; Denburg, Natalie L

    2011-07-01

    Markets are mechanisms of social exchange, intended to facilitate trading. However, the question remains as to whether markets would help or hurt individuals with decision-makings deficits, as is frequently encountered in the case of cognitive aging. Essential for predicting future gains and losses in monetary and social domains, the striatal nuclei in the brain undergo structural, neurochemical, and functional decline with age. We correlated the efficacy of market mechanisms with dorsal striatal decline in an aging population, by using market based trading in the context of the 2008 U.S. Presidential Elections (primary cycle). Impaired decision-makers displayed higher prediction error (difference between their prediction and actual outcome). Lower in vivo caudate volume was also associated with higher prediction error. Importantly, market-based trading protected older adults with lower caudate volume to a greater extent from their own poorly calibrated predictions. Counterintuitive to the traditional public perception of the market as a fickle, risky proposition where vulnerable traders are most surely to be burned, we suggest that market-based mechanisms protect individuals with brain-based decision-making vulnerabilities.

  19. Reducing societal vulnerability to drought: A methodology

    SciTech Connect

    Wilhite, D.A.

    1995-12-31

    Given worldwide experience with drought during the past several decades and the magnitude of associated impacts, it is apparent that vulnerability to extended periods of water shortage is escalating. Developing a national or provincial drought policy and preparedness plan is a complicated but essential first step toward reducing societal vulnerability. Until recently, nations had devoted little effort to drought preparedness, preferring instead the reactive or crisis management approach. Presently, an increasing number of nations are pursuing a more proactive approach that emphasizes the principles of risk management and sustainable development. Because of the multitude of impacts associated with drought and the numerous governmental agencies that have responsibility for some aspect of monitoring, assessment, mitigation, and planning, developing a policy and plan must be an integrated process within and between levels of government. This paper outlines a generic process that can be adopted by governments that desire to develop a more comprehensive and long-term approach to drought management and planning. Countries and states or provincial authorities that have adopted this approach is presented as case studies. This process is timely, given the declaration of the 1990s as the International Decade for Natural Disaster Reduction and the recent International Convention to Combat Desertification and Drought (June, 1994), an offshoot of deliberations at the United Nations Conference on Environment and Development.

  20. Evaluating operating system vulnerability to memory errors.

    SciTech Connect

    Ferreira, Kurt Brian; Bridges, Patrick G.; Pedretti, Kevin Thomas Tauke; Mueller, Frank; Fiala, David; Brightwell, Ronald Brian

    2012-05-01

    Reliability is of great concern to the scalability of extreme-scale systems. Of particular concern are soft errors in main memory, which are a leading cause of failures on current systems and are predicted to be the leading cause on future systems. While great effort has gone into designing algorithms and applications that can continue to make progress in the presence of these errors without restarting, the most critical software running on a node, the operating system (OS), is currently left relatively unprotected. OS resiliency is of particular importance because, though this software typically represents a small footprint of a compute node's physical memory, recent studies show more memory errors in this region of memory than the remainder of the system. In this paper, we investigate the soft error vulnerability of two operating systems used in current and future high-performance computing systems: Kitten, the lightweight kernel developed at Sandia National Laboratories, and CLE, a high-performance Linux-based operating system developed by Cray. For each of these platforms, we outline major structures and subsystems that are vulnerable to soft errors and describe methods that could be used to reconstruct damaged state. Our results show the Kitten lightweight operating system may be an easier target to harden against memory errors due to its smaller memory footprint, largely deterministic state, and simpler system structure.

  1. Passenger Deletions Generate Therapeutic Vulnerabilities in Cancer

    PubMed Central

    Muller, Florian L.; Colla, Simona; Aquilanti, Elisa; Manzo, Veronica; Genovese, Giannicola; Lee, Jaclyn; Eisenson, Dan; Narurkar, Rujuta; Deng, Pingna; Nezi, Luigi; Lee, Michelle; Hu, Baoli; Hu, Jian; Sahin, Ergun; Ong, Derrick; Fletcher-Sananikone, Eliot; Ho, Dennis; Kwong, Lawrence; Brennan, Cameron; Wang, Y. Alan; Chin, Lynda; DePinho, Ronald A.

    2013-01-01

    Inactivation of tumor suppressor genes via homozygous deletion is a prototypic event in the cancer genome, yet such deletions often encompass neighboring genes. We hypothesized that homozygous deletions in such passenger genes can expose cancer-specific therapeutic vulnerabilities in the case where the collaterally deleted gene is a member of a functionally redundant family of genes exercising an essential function. The glycolytic gene Enolase 1 (ENO1) in the 1p36 locus is deleted in Glioblastoma (GBM), which is tolerated by expression of ENO2. We demonstrate that shRNA-mediated extinction of ENO2 selectively inhibits growth, survival, and tumorigenic potential of ENO1-deleted GBM cells and that the enolase inhibitor phosphonoacetohydroxamate (PhAH) is selectively toxic to ENO1-deleted GBM cells relative to ENO1-intact GBM cells or normal astrocytes. The principle of collateral vulnerability should be applicable to other passenger deleted genes encoding functionally-redundant essential activities and provide an effective treatment strategy for cancers harboring such genomic events. PMID:22895339

  2. Vulnerability of housing buildings in Bucharest, Romania

    NASA Astrophysics Data System (ADS)

    Bostenaru, M.

    2009-04-01

    The author participates to the World Housing Encyclopedia project (www.world-housing.net), an internet based database of housing buildings in earthquake prone areas of the world. This is a voluntary project run by the Earthquake Engineering Research Institute, Oakland, California and the International Association of Earthquake Engineering, financial means being available only for the website where the information is shared. For broader dissemination in 2004 a summary publication of the reports to date was published. The database can be querried for various parameters and browsed after geographic distribution. Participation is open to any housing experts. Between 2003 and 2006 the author was also member of the editorial board. The author contributed numerous reports about building types in Romania, and each one about building types in Germany and Switzerland. This presentation will be about the contributed reports on building types in Romania. To the Encyclopedia eight reports on building types from Bucharest were contributed, while in further research of the author one more was similarly described regarding the vulnerability and the seismic retrofit. The selection of these types was done considering the historic development of the built substance in Bucharest from 1850 on, time from which a representative amount of housing buildings which can be classified in typologies can be found in Bucharest. While the structural types are not necessarily characteristic for the style, since the style has other time limits, often appearing before the type became common and then remaining being practiced also after another style gained ground, a historic succession can be seen also in this case. The nine types considered can be grouped in seven time categories: - the time 1850-1880, for a vernacular housing type with masonry load bearing walls and timber floors, - the time 1880-1920, for the type of two storey or multi-storey house with masonry walls and timber floors (in which

  3. The Role of Narcissistic Vulnerability in Predicting Adult Posttraumatic Symptoms from Childhood Sexual Abuse.

    PubMed

    Bachar, Eytan; Canetti, Laura; Hadar, Hilit; Baruch, Julia; Dor, Yehuda; Freedman, Sara

    2015-10-01

    The aim of the present study is to determine whether narcissistic vulnerability can aid in clarifying the debate regarding the relationship between childhood sexual abuse (CSA) and adulthood adjustment to traumatic events. 157 survivors (mean age = 31.1, SD = 10.9) of a traumatic event (war activities and road and work accidents) were assessed 1 week, 1, and 4 months following the event. Of the 157 participants, 15 reported experiencing CSA, and 26 reported experiencing childhood physical abuse (CPA). In the first-week assessment, patients were administered the Narcissistic Vulnerability Scale (NVS) and the Beck Depression Inventory (BDI). In the follow-up assessments, subjects were interviewed on the Clinician-Administered PTSD Scale. Narcissistic vulnerability was found, both in 1- and 4-month follow-ups, to increase the likelihood of participants who experienced CSA to develop PTSD symptoms later in their adult life, when exposed to other additional trauma. Narcissistic vulnerability, in both follow-ups, did not increase the likelihood of participants who experienced CPA to develop PTSD symptoms later in their life when exposed to other additional trauma. The NVS predicted the development of PTSD symptoms in the whole sample, both in the 1- and 4-month follow-ups, above and beyond the prediction of the BDI. In other words, narcissistic vulnerability can add additional information above and beyond general negative emotionality. In conclusion, it is recommended to take into consideration the interplay between CSA and the individual's narcissistic vulnerability when assessing the long term effects of CSA such as acute or chronic PTSD.

  4. Social vulnerability indicators as a sustainable planning tool

    SciTech Connect

    Lee, Yung-Jaan

    2014-01-15

    In the face of global warming and environmental change, the conventional strategy of resource centralization will not be able to cope with a future of increasingly extreme climate events and related disasters. It may even contribute to inter-regional disparities as a result of these events. To promote sustainable development, this study offers a case study of developmental planning in Chiayi, Taiwan and a review of the relevant literature to propose a framework of social vulnerability indicators at the township level. The proposed framework can not only be used to measure the social vulnerability of individual townships in Chiayi, but also be used to capture the spatial developmental of Chiayi. Seventeen social vulnerability indicators provide information in five dimensions. Owing to limited access to relevant data, the values of only 13 indicators were calculated. By simply summarizing indicators without using weightings and by using zero-mean normalization to standardize the indicators, this study calculates social vulnerability scores for each township. To make social vulnerability indicators more useful, this study performs an overlay analysis of social vulnerability and patterns of risk associated with national disasters. The social vulnerability analysis draws on secondary data for 2012 from Taiwan's National Geographic Information System. The second layer of analysis consists of the flood potential ratings of the Taiwan Water Resources Agency as an index of biophysical vulnerability. The third layer consists of township-level administrative boundaries. Analytical results reveal that four out of the 18 townships in Chiayi not only are vulnerable to large-scale flooding during serious flood events, but also have the highest degree of social vulnerability. Administrative boundaries, on which social vulnerability is based, do not correspond precisely to “cross-administrative boundaries,” which are characteristics of the natural environment. This study adopts

  5. Susceptibility to mountain hazards in Austria - paradigms of vulnerability revisited

    NASA Astrophysics Data System (ADS)

    Fuchs, Sven

    2010-05-01

    The concept of vulnerability is pillared by multiple disciplinary theories underpinning either a technical or a social origin of the concept and resulting in a range of paradigms for either a qualitative or quantitative assessment of vulnerability. However, efforts to reduce susceptibility to hazards and to create disaster-resilient communities require intersections among these theories, since human activity cannot be seen independently from the environmental setting. Acknowledging different roots of disciplinary paradigms, issues determining structural, economic, institutional and social vulnerability are discussed with respect to mountain hazards in Austria. The underlying idea of taking such an integrative viewpoint was the cognition that human action in mountain environments affects the state of vulnerability, and the state of vulnerability in turn shapes the possibilities of human action. It is argued that structural vulnerability as originator results in considerable economic vulnerability, generated by the institutional settings of dealing with natural hazards and shaped by the overall societal framework. Hence, the vulnerability of a specific location and within a considered point of time is triggered by the hazardous event and the related physical susceptibility of structures, such as buildings located on a torrent fan. Depending on the specific institutional settings, economic vulnerability of individuals or of the society results, above all with respect to imperfect loss compensation mechanisms in the areas under investigation. While this potential for harm can be addressed as social vulnerability, the concept of institutional vulnerability has been developed with respect to the overall political settings of governmental risk management. As a result, the concept of vulnerability, as being used in natural sciences, can be extended by integration of possible reasons why such physical susceptibility of structures exists, and by integration of compensation

  6. Social vulnerability assessment: a growing practice in Europe?

    NASA Astrophysics Data System (ADS)

    Tapsell, S.; McC arthy, S.

    2012-04-01

    This paper builds upon work on social vulnerability from the CapHaz-Net consortium, an ongoing research project funded by the European Commission in its 7th Framework Programme. The project focuses on the social dimensions of natural hazards, as well as on regional practices of risk prevention and management, and aims at improving the resilience of European societies to natural hazards, paying particular attention to social capacity building. The topic of social vulnerability is one of seven themes being addressed in the project. There are various rationales for examining the relevance of social vulnerability to natural hazards. Vulnerability assessment has now been accepted as a requirement for the effective development of emergency management capability, and assessment of social vulnerability has been recognised as being integral to understanding the risk to natural hazards. The aim of our research was to examine social vulnerability, how it might be understood in the context of natural hazards in Europe, and how social vulnerability can be addressed to increase social capacity. The work comprised a review of research on social vulnerability to different natural hazards within Europe and included concepts and definitions of social vulnerability (and related concepts), the purpose of vulnerability assessment and who decides who is vulnerable, different approaches to assessing or measuring social vulnerability (such as the use of 'classical' quantitative vulnerability indicators and qualitative community-based approaches, along with the advantages and disadvantages of both), conceptual frameworks for assessing social vulnerability and three case studies of social vulnerability studies within Europe: flash floods in the Italian Alps, fluvial flooding in Germany and heat waves in Spain. The review reveals variable application of social vulnerability analysis across Europe and there are indications why this might be the case. Reasons could range from the scale of

  7. Competence in Serving Children: Credentials Protectionism and Public Policy.

    ERIC Educational Resources Information Center

    Koocher, Gerald P.

    Professional competency in psychologists wishing to treat children and families is an area of considerable concern and disagreement. Three types of practitioners comprise the bulk of the problem: clinical psychologists, who lack specific child-oriented training; developmental psychologists, who wish to serve children but lack traditional clinical…

  8. 7 CFR 1230.53 - Nominee's agreement to serve.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... any relationship with the Council or a State association or any organization that has a contract with the Board and thereafter disclose, at any time while serving on the Board, any relationship with...

  9. Dimensions of Vocational Education to Serve Special Needs Persons.

    ERIC Educational Resources Information Center

    Buffer, James J., Jr., Ed.

    This handbook for vocational educators and teachers overviews concepts, methodologies, and strategies appropriate for those serving handicapped children. Chapter l discusses organizing and providing appropriate vocational education programs for the handicapped, including the cooperative/team approach, pre- and inservice training, and work…

  10. Caregivers' attitudes regarding portion size served to Head Start children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this study was to identify caregivers' attitudes regarding amounts and types of foods served to Head Start preschoolers using qualitative methods. Researchers conducted 8 focus groups (4 African American; 4 Hispanic) with 33 African American and 29 Hispanic Head Start caregivers. Mode...

  11. Preparing School Leaders to Serve as Agents for Social Transformation

    ERIC Educational Resources Information Center

    Brown, Kathleen M.

    2010-01-01

    The major priorities that should guide leadership education in preparing leaders for their work of leading schools in a democratic society are: (1) Teaching leaders to understand the inequities of society; (2) Teaching leaders to serve as agents for social transformation; and (3) Teaching leaders to help each and every student learn and succeed.…

  12. The Cost of Serving Infants and Toddlers under Part C

    ERIC Educational Resources Information Center

    Johnson, Jean L.; Brown, Susan; Chang, Chuan; Nelson, Dawna; Mrazek, Susan

    2011-01-01

    To identify the per-child cost of providing Part C services, the authors analyzed extensive statewide expenditure data in Hawai'i to determine the monthly and annual costs of providing early intervention services to infants and toddlers and their families. Identified were the costs of serving children with various numbers and percentages of delay,…

  13. 24. 1871 ILLUSTRATION SHOWING MAIN (NORTH) FACADE; ROOFTOP BELVEDERES SERVED ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. 1871 ILLUSTRATION SHOWING MAIN (NORTH) FACADE; ROOFTOP BELVEDERES SERVED AS VENTILATION FLUES. (Source: J.F. Richmond, New York and its Institutions, 1609-1871, E.B. Treat, New York, 1871). - Island Hospital, Roosevelt Island, New York County, NY

  14. 77 FR 58299 - National Hispanic-Serving Institutions Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... Documents#0;#0; ] Proclamation 8866 of September 14, 2012 National Hispanic-Serving Institutions Week, 2012... many Hispanic students and their families, and this week, we celebrate the critical role these colleges... Institutions Week. I call on public officials, educators, and all the people of the United States to...

  15. Staff Development While You Teach: Collaborating to Serve English Learners

    ERIC Educational Resources Information Center

    Walker, Constance; Edstam, Tina Scott

    2013-01-01

    This article examines the nature of a sustained staff development program for teachers serving English learners in elementary schools. It begins by exploring the need for learners to have optimum language and content development, and indicates that many U.S. grade-level and content area teachers have not been prepared to meet that need. Focusing…

  16. Exemplary Dissemination Programs for Intermediate Units Serving Rural Schools.

    ERIC Educational Resources Information Center

    Edington, Everett; Hays, Leonard

    Utilizing information derived from documents, site visits, correspondence, and personal interviews re: 6 intermediate education units serving rural schools which were initially identified via a mail survey, this report describes intermediate education units with exemplary information dissemination programs. Varying considerably, each program is…

  17. Lawyer and Therapist as an Interdisciplinary Team: Serving the Survivors.

    ERIC Educational Resources Information Center

    Bernstein, Barton E.

    1980-01-01

    Prior to death those who are properly prepared have reviewed their wills, insurance, and estate plans. When death arrives, the interdisciplinary team of lawyer, therapist, insurance person, accountant, and banker should serve the survivors so that the final requirements are handled with the least difficulty. (Author)

  18. Working through Our Pain So We Can Serve the People.

    ERIC Educational Resources Information Center

    LaFountaine, Debra

    2002-01-01

    While rediscovering her Chippewa spirituality, the author learned that life's tests are gifts. The ways she learned in the White world had prevented her from serving her people. She had to undergo pain to learn about compassion before she could be of service. Native people need to positively reinforce children and allow them to talk about their…

  19. Educators as Serving Leaders in the Classroom and on Campus

    ERIC Educational Resources Information Center

    Bowman, Richard

    2014-01-01

    Counterintuitively, the more one develops as a leader, the less of a leader one becomes. What do great leaders do? Great leaders are ambitious first and foremost for the cause, the mission, the work--not themselves. Educators as "serving leaders" sense that every action they take, together with every decision that they make, either…

  20. 16 CFR 500.26 - Representations of servings, uses, applications.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... required statement of net contents (e.g., cupsful, tablespoonful, etc.), when such differing terms describe... CFR part 10, by the Department of Commerce, quantitatively defining the meaning of the terms serving... the National Institute of Standards and Technology, Department of Commerce, Washington, DC 20899.)...

  1. Serving the Underserved: Giftedness among Ethnic Minority and Disadvantaged.

    ERIC Educational Resources Information Center

    McIntosh, Stephanie

    1995-01-01

    Properly serving the needs of ethnic minority and economically disadvantaged gifted youth requires early identification, enrichment programs, parental involvement, and specialized teacher training. Primary teachers must be able to identify children exhibiting gifted behaviors not showing up in testing. Profiles San Diego and New Jersey programs…

  2. Serving on Organizational Boards: What Nurses Need to Know

    PubMed

    Stalter, Ann M; Arms, Deborah

    2016-02-26

    If you have ever thought about serving on a board or being actively involved in meetings aimed at making policy decisions, but are not sure you have the knowledge, skills or abilities to serve competently, this article is for you! In this article, the authors describe six competencies needed by nurses who are serving on boards and/or policy committees so as to contribute in a productive manner. These competencies include a professional commitment to serving on a governing board; knowledge about board types, bylaws, and job descriptions; an understanding of standard business protocols, board member roles, and voting processes; a willingness to use principles for managing and leading effective and efficient board meetings; an appreciation for the ethical and legal processes for conducting meetings; and the ability to employ strategies for maintaining control during intense/uncivil situations. They also discuss strategies for demonstrating these competencies and describe personal responsibilities of board members. The authors conclude that a knowledge of these rules and standards is essential in order for nurses to assume leadership roles that will enhance the health of today’s and tomorrow’s societies.

  3. Collaborative Project on Serving Linguistically Diverse Seniors. Final Report.

    ERIC Educational Resources Information Center

    Burt, Miriam

    In 2002, the Center for Applied Linguistics (CAL) collaborated with the Senior Service Association (SSA) and the American Society on Aging (ASA) on a two-phase project to improve the effectiveness of ASA's sub-grantees in serving linguistically and culturally diverse populations. SSA provides subsidized employment for low-income seniors and funds…

  4. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Agreement to serve. 686.12 Section 686.12 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH) GRANT...

  5. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 4 2011-07-01 2011-07-01 false Agreement to serve. 686.12 Section 686.12 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION...

  6. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 4 2014-07-01 2014-07-01 false Agreement to serve. 686.12 Section 686.12 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION...

  7. 34 CFR 686.42 - Discharge of agreement to serve.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 4 2013-07-01 2013-07-01 false Discharge of agreement to serve. 686.42 Section 686.42 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER...

  8. 34 CFR 686.42 - Discharge of agreement to serve.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Discharge of agreement to serve. 686.42 Section 686.42 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION...

  9. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 4 2013-07-01 2013-07-01 false Agreement to serve. 686.12 Section 686.12 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION...

  10. 34 CFR 686.42 - Discharge of agreement to serve.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 4 2011-07-01 2011-07-01 false Discharge of agreement to serve. 686.42 Section 686.42 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER...

  11. 34 CFR 686.42 - Discharge of agreement to serve.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 4 2014-07-01 2014-07-01 false Discharge of agreement to serve. 686.42 Section 686.42 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER...

  12. DIRECTORY OF PUBLIC TRAINING SCHOOLS SERVING DELINQUENT CHILDREN.

    ERIC Educational Resources Information Center

    CARPENTER, KENNETH S., COMP.

    THIS EIGHTH REVISION OF THE DIRECTORY LISTS 320 STATE AND LOCAL TRAINING SCHOOLS, CAMPS, AND RECEPTION-DIAGNOSTIC CENTERS SERVING DELINQUENT CHILDREN COMMITTED BY COURT ORDER IN THE 50 STATES, THE U.S. DEPARTMENT OF JUSTICE, THE DISTRICT OF COLUMBIA, PUERTO RICO, AND THE VIRGIN ISLANDS. DATA INCLUDE RATED CAPACITIES, AVERAGE DAILY POPULATIONS,…

  13. Pedagogy for Equity: Teaching in a Hispanic-Serving Institution

    ERIC Educational Resources Information Center

    Nunez, Anne-Marie; Ramalho, Elizabeth Murakami; Cuero, Kimberley K.

    2010-01-01

    Three female tenure-track faculty members at a Hispanic-Serving Institution explored how their cultural backgrounds inform their pedagogical approaches toward equity. They drew upon Mills's (1959) and Collins's (1993) frameworks to examine how their personal biographies, local social contexts, and broader systemic institutions affect their…

  14. Effects of Posthypnotic Suggestions on the Overhand Volleyball Serve.

    ERIC Educational Resources Information Center

    Buckner, Rose; Wynn, Mary Jo

    This study determines effects of posthypnotic suggestions in dealing with attitudinal impediments of students performing the overhand volleyball serve. Subjects were 54 male and female college students enrolled in beginning volleyball. Subjects were assigned either to a control or to an experimental group. After four class sessions, a 10-trial…

  15. Healthcare Leaders' Intention to Serve as Organizational Teachers

    ERIC Educational Resources Information Center

    Aggarwal, Sushma Kumari

    2014-01-01

    Today's organizational leaders are expected to actively participate and facilitate learning. A highly engaged and knowledgeable workforce, inspired by leaders, may increase the quality of service, and aid in maintaining and attracting loyal employees and customers. These leaders are now being asked to serve as organizational teachers. However,…

  16. The Motivation to Serve Others: Exploring Relations to Career Development

    ERIC Educational Resources Information Center

    Duffy, Ryan D.; Raque-Bogdan, Trisha L.

    2010-01-01

    The current study explored the relation between service motivation, or the desire to serve others through one's future career, and vocational outcomes across two studies. In the first study, using a sample of 225 undergraduate students, an instrument was developed to measure service motivation that demonstrated convergent and discriminant…

  17. A Community-Based Comprehensive Approach to Serving Adolescent Parents.

    ERIC Educational Resources Information Center

    Palmer, Emily

    1981-01-01

    Describes the services of a community-based center providing social services to adolescent parents who cannot yet function independently and who had not previously been served. Emphasis is placed on continuity of services and on cooperation with existing educational, medical, and social institutions. (Author/DB)

  18. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH... teaching service by— (1) Serving as a full-time teacher for a total of not less than four elementary or...) As a highly-qualified teacher; and (iii) In a high-need field in the majority of classes...

  19. 34 CFR 686.42 - Discharge of agreement to serve.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 4 2012-07-01 2012-07-01 false Discharge of agreement to serve. 686.42 Section 686.42 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER...

  20. How Can a Community Clinic Serve Beginning Public School Teachers?

    ERIC Educational Resources Information Center

    Barman, Alicerose

    A community mental health clinic designed to function also as an inservice training agent for beginning public school teachers is described. The clinic's philosophy is based on the psychoanalytic model and its educational program was planned to serve parents and teachers, particularly those of young children. Area schools came to welcome and…

  1. Hispanic-Serving Institutions and the Struggle for Cognitive Justice

    ERIC Educational Resources Information Center

    Garcia, Herman S.

    2012-01-01

    Hispanic-Serving Institution (HSI) colleges and universities were initiated as an enterprise for investing in the academy as a way to provide opportunities for Latin@ students. However, HSIs in colleges and universities have had measured success in that significant numbers of Latin@ students continue to leave campuses with unfinished business. An…

  2. 49 CFR 105.50 - Serving a subpoena.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 2 2011-10-01 2011-10-01 false Serving a subpoena. 105.50 Section 105.50 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... of making sure that you receive them. If PHMSA issues a subpoena to an entity, rather than...

  3. 49 CFR 105.50 - Serving a subpoena.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 2 2013-10-01 2013-10-01 false Serving a subpoena. 105.50 Section 105.50 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... of making sure that you receive them. If PHMSA issues a subpoena to an entity, rather than...

  4. 49 CFR 105.50 - Serving a subpoena.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 2 2014-10-01 2014-10-01 false Serving a subpoena. 105.50 Section 105.50 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... of making sure that you receive them. If PHMSA issues a subpoena to an entity, rather than...

  5. 49 CFR 105.50 - Serving a subpoena.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Serving a subpoena. 105.50 Section 105.50 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... of making sure that you receive them. If PHMSA issues a subpoena to an entity, rather than...

  6. Serving the Society? Historical and Modern Interpretations of Employability

    ERIC Educational Resources Information Center

    Aamodt, Per Olaf; Hovdhaugen, Elisabeth; Bielfeldt, Uta

    2010-01-01

    One of the aims of the implementation of a two-tier degree system was that the new Bachelor's degree should serve two functions: as a basis for further studies (Master's level), and at the same time to qualify for the labour market. This twofold function may be present to a different degree in various countries, but was an explicit policy…

  7. Challenges on the Front Lines: Serving Today's Student Veterans

    ERIC Educational Resources Information Center

    Taylor, Alexander; Parks, Rodney; Edwards, Ashley

    2016-01-01

    In recent years, veterans have enrolled at higher education institutions in vastly increasingly numbers to utilize their Post-9/11 GI Bill benefits. In response to this influx, universities have established a variety of resources and support systems designed to serve the needs of student veterans. There has also been heightened attention toward…

  8. Small Public Libraries Can Serve Big. ERIC Digest.

    ERIC Educational Resources Information Center

    Parry, Norm

    Small public libraries can deliver service like big libraries, without sacrificing hometown warmth and charm. By borrowing strategies used by successful small businesses in the private sector, defining goals and exploiting low cost technologies, small public libraries can serve customer wants as well as much larger institutions. Responding to just…

  9. Serving Wounded Warriors: Current Practices in Postsecondary Education

    ERIC Educational Resources Information Center

    Vance, Mary Lee; Miller, Wayne K., II

    2009-01-01

    From September to October 2009 the Association on Higher Education and Disabilities (AHEAD) invited anonymous voluntary responses from 2,500 members and affiliates to complete a 29-question online survey on current practices in postsecondary education for serving veterans with disabilities (wounded warriors). Two hundred and thirty seven complete…

  10. Serving the Homeless through Recreation Programs. Research Update.

    ERIC Educational Resources Information Center

    Kunstler, Robin

    1993-01-01

    Literature review examines problems faced by homeless adults and children and discusses how recreation programs can serve them. The recreation and leisure profession can offer to the healthy child development through play and recreation, physical fitness, stress management, socialization, opportunities to learn goal-setting, self-esteem building,…

  11. International Organizations Serving Young Children: Part One of a Directory.

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2002-01-01

    This is part one of a directory of organizations serving children under the age of eight in more than one nation. Each entry consists of: (1) organization's name; (2) location; (3) Web site address; and (4) a description of the organization's structure, mission, and major areas of focus. (SD)

  12. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  13. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  14. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  15. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  16. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  17. Meal Pattern Requirements and Offer versus Serve Manual.

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Washington, DC.

    This manual contains information on federal policy regarding meal-pattern requirements for school-nutrition programs. It also describes the Offer Versus Serve (OVS) provision, which allows students to decline either one or two food items they do not intend to eat in order to reduce food waste. The manual explains food components, gives examples of…

  18. Using Title XX to Serve Children and Youth.

    ERIC Educational Resources Information Center

    Twiname, John D.; And Others

    With the passage in early 1975 of the social service amendments to the Social Security Act, referred to as Title XX, a major new opportunity to serve children and youth has emerged. Seizing the opportunity will be largely dependent on the well-prepared presentation of a case for the needs of young people by dedicated advocates in every state.…

  19. DIRECTORY OF SHELTERED WORKSHOPS SERVING THE EMOTIONALLY DISTURBED, 1965.

    ERIC Educational Resources Information Center

    GADLIN, WALTER; AND OTHERS

    A NATIONWIDE QUESTIONNAIRE SURVEYED 490 SHELTERED WORKSHOPS SERVING THE EMOTIONALLY DISTURBED. LISTINGS BY STATES OF SUCH CENTERS PROVIDE ADDRESSES, REFERRAL SOURCES, AGE RANGE OF CLIENTS, YEAR PROGRAMS BEGAN, NUMBER OF PHYSICALLY HANDICAPPED CLIENTS DAILY, NUMBER OF EMOTIONALLY DISTURBED CLIENTS DAILY, AND TYPES OF EMOTIONALLY DISTURBED.…

  20. Self-Serving Communities: Their Contribution to Building Knowledge Infrastructures.

    ERIC Educational Resources Information Center

    Sivan, Yesha Y.

    2000-01-01

    Presents a case study of a virtual professional community for Israeli educators that is built on four "self-serving" principles: restriction, guidance, involvement, and leadership. Describes the four membership phases and their respective principles, and shows how each of these phases contributed to and advanced the individual members…

  1. Multiple meter monitoring circuits served by single alarm

    NASA Technical Reports Server (NTRS)

    Bandini, U.

    1967-01-01

    Circuitry for multiple meter relay circuits provides complete isolation for each circuit served by a single alarm and permits alarm reset after an out-of-tolerance event in one relay circuit so that the remaining relay circuits continue to be alarm protected.

  2. Tsunami vulnerability and damage assessment in the coastal area of Rabat and Salé, Morocco

    NASA Astrophysics Data System (ADS)

    Atillah, A.; El Hadani, D.; Moudni, H.; Lesne, O.; Renou, C.; Mangin, A.; Rouffi, F.

    2011-12-01

    This study, a companion paper to Renou et al. (2011), focuses on the application of a GIS-based method to assess building vulnerability and damage in the event of a tsunami affecting the coastal area of Rabat and Salé, Morocco. This approach, designed within the framework of the European SCHEMA project (www.schemaproject.org) is based on the combination of hazard results from numerical modelling of the worst case tsunami scenario (inundation depth) based on the historical Lisbon earthquake of 1755 and the Portugal earthquake of 1969, together with vulnerability building types derived from Earth Observation data, field surveys and GIS data. The risk is then evaluated for this highly concentrated population area characterized by the implementation of a vast project of residential and touristic buildings within the flat area of the Bouregreg Valley separating the cities of Rabat and Salé. A GIS tool is used to derive building damage maps by crossing layers of inundation levels and building vulnerability. The inferred damage maps serve as a base for elaborating evacuation plans with appropriate rescue and relief processes and to prepare and consider appropriate measures to prevent the induced tsunami risk.

  3. Individual differences and vulnerability to drug addiction: a focus on the endocannabinoid system.

    PubMed

    Sagheddu, Claudia; Melis, Miriam

    2015-01-01

    Vulnerability to drug addiction depends upon the interactions between the biological makeup of the individual, the environment, and age. These interactions are complex and difficult to tease apart. Since dopamine is involved in the rewarding effects of drugs of abuse, it is postulated that innate differences in mesocorticolimbic pathway can influence the response to drug exposure. In particular, higher and lower expression of dopamine D2 receptors in the ventral striatum (i.e. a marker of dopamine function) has been considered a putative protective and a risk factor, respectively, that can influence one's susceptibility to continued drug abuse as well as the transition to addiction. This phenomenon, which is phylogenetically preserved, appears to be a compensatory change to increased impulse activity of midbrain dopamine neurons. Hence, dopamine neuronal excitability plays a fundamental role in the diverse stages of the drug addiction cycle. In this review, a framework for the evidence that modulation of dopamine neuronal activity plays in the context of vulnerability to drug addiction will be presented. Furthermore, since endogenous cannabinoids serve as retrograde messengers to shape afferent neuronal activity in a short- and long-lasting fashion, their role in individual differences and vulnerability to drug addiction will be discussed.

  4. Individual differences in the locus coeruleus-norepinephrine system: Relevance to stress-induced cardiovascular vulnerability.

    PubMed

    Wood, Christopher S; Valentino, Rita J; Wood, Susan K

    2017-04-01

    Repeated exposure to psychosocial stress is a robust sympathomimetic stressor and as such has adverse effects on cardiovascular health. While the neurocircuitry involved remains unclear, the physiological and anatomical characteristics of the locus coeruleus (LC)-norepinephrine (NE) system suggest that it is poised to contribute to stress-induced cardiovascular vulnerability. A major theme throughout is to review studies that shed light on the role that the LC may play in individual differences in vulnerability to social stress-induced cardiovascular dysfunction. Recent findings are discussed that support a unique plasticity in afferent regulation of the LC, resulting in either excitatory or inhibitory input to the LC during establishment of different stress coping strategies. This contrasting regulation of the LC by either afferent regulation, or distinct differences in stress-induced neuroinflammation would translate to differences in cardiovascular regulation and may serve as the basis for individual differences in the cardiopathological consequences of social stress. The goal of this review is to highlight recent developments in the interplay between the LC-NE and cardiovascular systems during repeated stress in an effort to advance therapeutic treatments for the development of stress-induced cardiovascular vulnerability.

  5. Spatial econometric model of natural disaster impacts on human migration in vulnerable regions of Mexico.

    PubMed

    Saldaña-Zorrilla, Sergio O; Sandberg, Krister

    2009-10-01

    Mexico's vast human and environmental diversity offers an initial framework for comprehending some of the prevailing great disparities between rich and poor. Its socio-economic constructed vulnerability to climatic events serves to expand this understanding. Based on a spatial econometric model, this paper tests the contribution of natural disasters to stimulating the emigration process in vulnerable regions of Mexico. Besides coping and adaptive capacity, it assesses the effects of economic losses due to disasters as well as the adverse production and trade conditions of the 1990s on emigration rates in 2000 at the municipality level. Weather-related disasters were responsible for approximately 80 per cent of economic losses in Mexico between 1980 and 2005, mostly in the agricultural sector, which continues to dominate many parts of the country. It is dramatic that this sector generates around only four per cent of gross domestic product but provides a livelihood to about one-quarter of the national population. It is no wonder, therefore, that most emigration from this country arises in vulnerable rural areas.

  6. Childhood physical abuse and aggression: Shame and narcissistic vulnerability.

    PubMed

    Keene, Amanda C; Epps, James

    2016-01-01

    This study examined narcissistic vulnerability and shame-proneness as potential mediators between childhood physical abuse (CPA) and adult anger and aggression. Participants were 400 undergraduate students, 134 of whom had a history of CPA. All participants completed self-report questionnaires assessing history of CPA, shame-proneness, narcissistic vulnerability, physical aggression, trait anger, and hostility. Results indicated abused participants were more angry and aggressive and experienced higher levels of shame-proneness and narcissistic vulnerability than nonabused participants. Multiple mediation analyses showed that narcissistic vulnerability, but not shame-proneness, partially mediated the relation between abuse and physical aggression. However, narcissistic vulnerability and shame-proneness both emerged as partial mediators between abuse and the anger and hostility variables. These findings suggest that narcissistic vulnerability and shame-proneness may function as mediators of adjustment following childhood maltreatment. Study limitations and recommendations for future research are discussed.

  7. Shoulder joint kinetics of the elite wheelchair tennis serve

    PubMed Central

    Reid, Machar; Elliott, Bruce; Alderson, Jacque

    2007-01-01

    Background The shoulder is a key joint in wheelchair locomotion and commonly implicated in injury among virtually all wheelchair populations. In tennis, quantification of the shoulder joint kinetics that characterise the wheelchair serve could enhance injury prevention and rehabilitation practices as well as assist coaches evaluate the efficacy of their current technical instruction. Methods A 12‐camera, 250 Hz Vicon motion analysis system (Oxford Metrics Inc., UK) recorded the 3D flat (WFS) and kick serve (WKS) motions of two male top 30‐ranked international wheelchair players. Mechanical comparisons between wheelchair players, as well as to the previously captured data of 12 high‐performance able‐bodied players executing the same types of serves, were undertaken. Results Without the benefit of a propulsive leg action, wheelchair players developed lower peak absolute (∼32 m/s) and horizontal (∼28 m/s) pre‐impact racquet velocities than able‐bodied players (∼42 m/s, ∼38 m/s). Wheelchair serve tactics nevertheless necessitated that higher pre‐impact horizontal and right lateral racquet velocities characterised the WFS (∼29 m/s, WKS: ∼26 m/s) and WKS (∼4 m/s, WFS: ∼11 m/s) respectively. The shoulder joint kinetics that contributed to the differential racquet velocity profiles were mostly developed independent of wheelchair serve type, but varied with and were likely related to the level and severity of spinal cord injury of the individual players. Conclusions Compared with able‐bodied players, wheelchair players experienced matching pre‐ and post‐impact shoulder joint loads, such that wheelchair and able‐bodied playing populations appear subject to similar shoulder joint injury risk. PMID:17957009

  8. Cyber / Physical Security Vulnerability Assessment Integration

    SciTech Connect

    MacDonald, Douglas G.; Simpkins, Bret E.

    2012-07-28

    Abstract Both physical protection and cyber security domains offer solutions for the discovery of vulnerabilities through the use of various assessment processes and software tools. Each vulnerability assessment (VA) methodology provides the ability to identify and categorize vulnerabilities, and quantifies the risks within their own areas of expertise. Neither approach fully represents the true potential security risk to a site and/or a facility, nor comprehensively assesses the overall security posture. The technical approach to solving this problem was to identify methodologies and processes that blend the physical and cyber security assessments, and develop tools to accurately quantify the unaccounted for risk. SMEs from both the physical and the cyber security domains developed the blending methodologies, and cross trained each other on the various aspects of the physical and cyber security assessment processes. A local critical infrastructure entity volunteered to host a proof of concept physical/cyber security assessment, and the lessons learned have been leveraged by this effort. The four potential modes of attack an adversary can use in approaching a target are; Physical Only Attack, Cyber Only Attack, Physical Enabled Cyber Attack, and the Cyber Enabled Physical Attack. The Physical Only and the Cyber Only pathway analysis are two of the most widely analyzed attack modes. The pathway from an off-site location to the desired target location is dissected to ensure adversarial activity can be detected and neutralized by the protection strategy, prior to completion of a predefined task. This methodology typically explores a one way attack from the public space (or common area) inward towards the target. The Physical Enabled Cyber Attack and the Cyber Enabled Physical Attack are much more intricate. Both scenarios involve beginning in one domain to affect change in the other, then backing outward to take advantage of the reduced system effectiveness, before

  9. Intravascular probe for detection of vulnerable plaque

    NASA Astrophysics Data System (ADS)

    Patt, Bradley E.; Iwanczyk, Jan S.; MacDonald, Lawrence R.; Yamaguchi, Yuko; Tull, Carolyn R.; Janecek, Martin; Hoffman, Edward J.; Strauss, H. William; Tsugita, Ross; Ghazarossian, Vartan

    2001-12-01

    Coronary angiography is unable to define the status of the atheroma, and only measures the luminal dimensions of the blood vessel, without providing information about plaque content. Up to 70% of heart attacks are caused by minimally obstructive vulnerable plaques, which are too small to be detected adequately by angiography. We have developed an intravascular imaging detector to identify vulnerable coronary artery plaques. The detector works by sensing beta or conversion electron radiotracer emissions from plaque-binding radiotracers. The device overcomes the technical constraints of size, sensitivity and conformance to the intravascular environment. The detector at the distal end of the catheter uses six 7mm long by 0.5mm diameter scintillation fibers coupled to 1.5m long plastic fibers. The fibers are offset from each other longitudinally by 6mm and arranged spirally around a guide wire in the catheter. At the proximal end of the catheter the optical fibers are coupled to an interface box with a snap on connector. The interface box contains a position sensitive photomultiplier tube (PSPMT) to decode the individual fibers. The whole detector assembly fits into an 8-French (2.7 mm in diameter) catheter. The PSPMT image is further decoded with software to give a linear image, the total instantaneous count rate and an audio output whose tone corresponds to the count rate. The device was tested with F-18 and Tl-204 sources. Spectrometric response, spatial resolution, sensitivity and beta to background ratio were measured. System resolution is 6 mm and the sensitivity is >500 cps / micrometers Ci when the source is 1 mm from the detector. The beta to background ratio was 11.2 for F-18 measured on a single fiber. The current device will lead to a system allowing imaging of labeled vulnerable plaque in coronary arteries. This type of signature is expected to enable targeted and cost effective therapies to prevent acute coronary artery diseases such as: unstable angina

  10. Assessing Vulnerability to Drought on a pan-European scale

    NASA Astrophysics Data System (ADS)

    Urquijo, Julia; De Stefano, Lucia; González-Tánago, Itziar; Blauhut, Veit; Stahl, Kerstin

    2014-05-01

    During the past decade, a number of theoretical frameworks have been defined within the Disaster Risk Reduction and Climate Change communities to assess drought vulnerability at different scales, sectors, socio-political contexts, and geo-climatic conditions. However, there is still little consensus around the criteria, dimensions and factors used in these assessments; and none of them has been applied at a pan-European scale. This is due to a triple complexity. Firstly, drought as a natural hazard is a complex phenomenon due to the difficulty of determining its onset and its multiscale, multifaceted and dynamic nature. Secondly, there is an on-going debate regarding the concept of vulnerability and its constitutive elements, together with an important diversity of theoretical approaches to assess it. Finally, Europe's diversity in bioclimatic conditions, national water use practice and water use policies adds a challenging characteristic for working on pan-European scale. This work addresses the challenge of defining a methodological approach to the assessment of vulnerability factors to drought at a pan-European scale. For this purpose, we first review existing conceptual frameworks as well as of past initiatives for drought vulnerability assessment. The literature review showed that the high complexity of drought vulnerability assessment requires a clear definition of the concept of vulnerability and the associated terms, and that, before undertaking any assessment, it is necessary to clearly define the "vulnerable unit" i.e. replying to the questions 'whose vulnerability is being assessed?' and 'vulnerability to what type of impact?'. In this context, this work proposes the application of a factor-based approach, consisting in the analysis of significant factors that influence vulnerability in the context of specific situations of potential vulnerability. Those situations are framed within the specific drought characteristics of four different geoclimatic macro

  11. Modelling homogeneous regions of social vulnerability to malaria in Rwanda.

    PubMed

    Bizimana, Jean Pierre; Kienberger, Stefan; Hagenlocher, Michael; Twarabamenye, Emmanuel

    2016-03-31

    Despite the decline in malaria incidence due to intense interventions, potentials for malaria transmission persist in Rwanda. To eradicate malaria in Rwanda, strategies need to expand beyond approaches that focus solely on malaria epidemiology and also consider the socioeconomic, demographic and biological/disease-related factors that determine the vulnerability of potentially exposed populations. This paper analyses current levels of social vulnerability to malaria in Rwanda by integrating a set of weighted vulnerability indicators. The paper uses regionalisation techniques as a spatially explicit approach for delineating homogeneous regions of social vulnerability to malaria. This overcomes the limitations of administrative boundaries for modelling the trans-boundary social vulnerability to malaria. The utilised approach revealed high levels of social vulnerability to malaria in the highland areas of Rwanda, as well as in remote areas where populations are more susceptible. Susceptibility may be due to the populations' lacking the capacity to anticipate mosquito bites, or lacking resilience to cope with or recover from malaria infection. By highlighting the most influential indicators of social vulnerability to malaria, the applied approach indicates which vulnerability domains need to be addressed, and where appropriate interventions are most required. Interventions to improve the socioeconomic development in highly vulnerable areas could prove highly effective, and provide sustainable outcomes against malaria in Rwanda. This would ultimately increase the resilience of the population and their capacity to better anticipate, cope with, and recover from possible infection.

  12. Global analysis of urban surface water supply vulnerability

    NASA Astrophysics Data System (ADS)

    Padowski, Julie C.; Gorelick, Steven M.

    2014-10-01

    This study presents a global analysis of urban water supply vulnerability in 71 surface-water supplied cities, with populations exceeding 750 000 and lacking source water diversity. Vulnerability represents the failure of an urban supply-basin to simultaneously meet demands from human, environmental and agricultural users. We assess a baseline (2010) condition and a future scenario (2040) that considers increased demand from urban population growth and projected agricultural demand. We do not account for climate change, which can potentially exacerbate or reduce urban supply vulnerability. In 2010, 35% of large cities are vulnerable as they compete with agricultural users. By 2040, without additional measures 45% of cities are vulnerable due to increased agricultural and urban demands. Of the vulnerable cities in 2040, the majority are river-supplied with mean flows so low (1200 liters per person per day, l/p/d) that the cities experience ‘chronic water scarcity’ (1370 l/p/d). Reservoirs supply the majority of cities facing individual future threats, revealing that constructed storage potentially provides tenuous water security. In 2040, of the 32 vulnerable cities, 14 would reduce their vulnerability via reallocating water by reducing environmental flows, and 16 would similarly benefit by transferring water from irrigated agriculture. Approximately half remain vulnerable under either potential remedy.

  13. Empirical Estimates of 0Day Vulnerabilities in Control Systems

    SciTech Connect

    Miles A. McQueen; Wayne F. Boyer; Sean M. McBride; Trevor A. McQueen

    2009-01-01

    We define a 0Day vulnerability to be any vulnerability, in deployed software, which has been discovered by at least one person but has not yet been publicly announced or patched. These 0Day vulnerabilities are of particular interest when assessing the risk to well managed control systems which have already effectively mitigated the publicly known vulnerabilities. In these well managed systems the risk contribution from 0Days will have proportionally increased. To aid understanding of how great a risk 0Days may pose to control systems, an estimate of how many are in existence is needed. Consequently, using the 0Day definition given above, we developed and applied a method for estimating how many 0Day vulnerabilities are in existence on any given day. The estimate is made by: empirically characterizing the distribution of the lifespans, measured in days, of 0Day vulnerabilities; determining the number of vulnerabilities publicly announced each day; and applying a novel method for estimating the number of 0Day vulnerabilities in existence on any given day using the number of vulnerabilities publicly announced each day and the previously derived distribution of 0Day lifespans. The method was first applied to a general set of software applications by analyzing the 0Day lifespans of 491 software vulnerabilities and using the daily rate of vulnerability announcements in the National Vulnerability Database. This led to a conservative estimate that in the worst year there were, on average, 2500 0Day software related vulnerabilities in existence on any given day. Using a smaller but intriguing set of 15 0Day software vulnerability lifespans representing the actual time from discovery to public disclosure, we then made a more aggressive estimate. In this case, we estimated that in the worst year there were, on average, 4500 0Day software vulnerabilities in existence on any given day. We then proceeded to identify the subset of software applications likely to be used in some

  14. Disability pornography: the fetishization of women's vulnerabilities.

    PubMed

    Elman, R A

    1997-06-01

    This paper offers a critical exploration of a form of pornography consisting in sexual abuse and exploitation of women and girls with disabilities. This practice allows men to create and maintain their sexual dominance over the female gender. Disability pornography, like all other forms of pornography, but in its own way, contributes to the second-class status of all women, particularly those who are suffering from limitations in mobility and other disabilities. By promoting the castrating, dominant, violent image of women, pornography allows men to justify their abusive behaviors toward women. This form of pornography preys on the vulnerability of disabled women and increases the possibility that they will be abused. The sexually explicit lack of physical mobility is as celebrated in disability pornography as the political mobility of women is condemned in all genres of pornography. Amputee pornography is just one example of this brutal practice.

  15. Hierarchical model of vulnerabilities for emotional disorders.

    PubMed

    Norton, Peter J; Mehta, Paras D

    2007-01-01

    Clark and Watson's (1991) tripartite model of anxiety and depression has had a dramatic impact on our understanding of the dispositional variables underlying emotional disorders. More recently, calls have been made to examine not simply the influence of negative affectivity (NA) but also mediating factors that might better explain how NA influences anxious and depressive syndromes (e.g. Taylor, 1998; Watson, 2005). Extending preliminary projects, this study evaluated two hierarchical models of NA, mediating factors of anxiety sensitivity and intolerance of uncertainty, and specific emotional manifestations. Data provided a very good fit to a model elaborated from preliminary studies, lending further support to hierarchical models of emotional vulnerabilities. Implications for classification and diagnosis are discussed.

  16. Trust, vulnerable populations, and genetic data sharing

    PubMed Central

    Arias, Jalayne J.; Pham-Kanter, Genevieve; Gonzalez, Rosa; Campbell, Eric G.

    2015-01-01

    Recent policies and proposed regulations, including the Notice of Proposed Rulemaking for the Common Rule and the 2014 NIH Genetic Data Sharing Policy, seek to improve research subject protections. Protections for subjects whose genetic data is shared are critical to reduce risks such as loss of confidentiality, stigma, and discrimination. In the article ‘It depends whose data are being shared: considerations for genomic data sharing policies’, Robinson et al. provide a response to our article, ‘The Growth and Gaps of Genetic Data Sharing Policies’. Robinson et al. highlight the importance of individual and group preferences. In this article, we extend the conversation on models for improving protections which will mitigate consequences for individuals and groups that are vulnerable to stigma and discrimination. PMID:27774227

  17. MODELING UNDERGROUND STRUCTURE VULNERABILITY IN JOINTED ROCK

    SciTech Connect

    R. SWIFT; D. STEEDMAN

    2001-02-01

    The vulnerability of underground structures and openings in deep jointed rock to ground shock attack is of chief concern to military planning and security. Damage and/or loss of stability to a structure in jointed rock, often manifested as brittle failure and accompanied with block movement, can depend significantly on jointed properties, such as spacing, orientation, strength, and block character. We apply a hybrid Discrete Element Method combined with the Smooth Particle Hydrodynamics approach to simulate the MIGHTY NORTH event, a definitive high-explosive test performed on an aluminum lined cylindrical opening in jointed Salem limestone. Representing limestone with discrete elements having elastic-equivalence and explicit brittle tensile behavior and the liner as an elastic-plastic continuum provides good agreement with the experiment and damage obtained with finite-element simulations. Extending the approach to parameter variations shows damage is substantially altered by differences in joint geometry and liner properties.

  18. Exploiting epigenetic vulnerabilities for cancer therapeutics.

    PubMed

    Mair, Barbara; Kubicek, Stefan; Nijman, Sebastian M B

    2014-03-01

    Epigenetic deregulation is a hallmark of cancer, and there has been increasing interest in therapeutics that target chromatin-modifying enzymes and other epigenetic regulators. The rationale for applying epigenetic drugs to treat cancer is twofold. First, epigenetic changes are reversible, and drugs could therefore be used to restore the normal (healthy) epigenetic landscape. However, it is unclear whether drugs can faithfully restore the precancerous epigenetic state. Second, chromatin regulators are often mutated in cancer, making them attractive drug targets. However, in most instances it is unknown whether cancer cells are addicted to these mutated chromatin proteins, or whether their mutation merely results in epigenetic instability conducive to the selection of secondary aberrations. An alternative incentive for targeting chromatin regulators is the exploitation of cancer-specific vulnerabilities, including synthetic lethality, caused by epigenetic deregulation. We review evidence for the hypothesis that mechanisms other than oncogene addiction are a basis for the application of epigenetic drugs, and propose future research directions.

  19. Method and tool for network vulnerability analysis

    DOEpatents

    Swiler, Laura Painton; Phillips, Cynthia A.

    2006-03-14

    A computer system analysis tool and method that will allow for qualitative and quantitative assessment of security attributes and vulnerabilities in systems including computer networks. The invention is based on generation of attack graphs wherein each node represents a possible attack state and each edge represents a change in state caused by a single action taken by an attacker or unwitting assistant. Edges are weighted using metrics such as attacker effort, likelihood of attack success, or time to succeed. Generation of an attack graph is accomplished by matching information about attack requirements (specified in "attack templates") to information about computer system configuration (contained in a configuration file that can be updated to reflect system changes occurring during the course of an attack) and assumed attacker capabilities (reflected in "attacker profiles"). High risk attack paths, which correspond to those considered suited to application of attack countermeasures given limited resources for applying countermeasures, are identified by finding "epsilon optimal paths."

  20. Building vulnerability assessment based on cloud model

    NASA Astrophysics Data System (ADS)

    Sun, Xixia; Cai, Chao

    2013-10-01

    This study aims at building a general framework for estimating building vulnerability to blast-fragmentation warhead of a missile. Considering the fuzziness and randomness existing in the damage criterion rules, cloud models are applied to represent the qualitative concepts. On the basis of building geometric description, element criticality analysis, blast wave and fragment movement description, and meeting analysis of fragments and target, kill probabilities of the components are estimated by the shot line method. The damage state of the whole building given the threat is obtained by cloud model based uncertainty reasoning and the proposed similarity measure, enabling both randomness of probability reasoning and the fuzziness of the traditional fuzzy logic to be considered. Experimental results demonstrate that the proposed method can provide useful reference for optimizing warhead design and mission efficiency evaluation.