Sample records for year service life

  1. Home care clients in the last year of life: is material deprivation associated with service characteristics?

    PubMed

    Goodridge, Donna; Buckley, Alan; Marko, Josh; Steeves, Megan; Turner, Hollie; Whitehead, Steve

    2011-09-01

    To compare demographic, social, medical, and health care characteristics of home care clients in the last year of life by quintile of deprivation and examine associations between material deprivation and service characteristics. This retrospective study used administrative data for 700 clients who died while receiving home care services. Outcome measures were the receipt of supportive or palliative home care. Associations were assessed using multiple logistic regression. Material deprivation was not associated with either the hours of home care received or the receipt of supportive home care services. Clients with dementia or stroke, those were older than 80 years and those who were single were less likely to receive palliative care services than other groups. Inequalities in allocation of home care services based on age, diagnosis, and marital status, but not material deprivation, suggest the need to carefully match service with need at the end of life.

  2. Solid Propulsion Systems, Subsystems, and Components Service Life Extension

    NASA Technical Reports Server (NTRS)

    Hundley, Nedra H.; Jones, Connor

    2011-01-01

    The service life extension of solid propulsion systems, subsystems, and components will be discussed based on the service life extension of the Space Transportation System Reusable Solid Rocket Motor (RSRM) and Booster Separation Motors (BSM). The RSRM is certified for an age life of five years. In the aftermath of the Columbia accident there were a number of motors that were approaching the end of their five year service life certification. The RSRM Project initiated an assessment to determine if the service life of these motors could be extended. With the advent of the Constellation Program, a flight test was proposed that would utilize one of the RSRMs which had been returned from the launch site due to the expiration of its five year service life certification and twelve surplus Chemical Systems Division BSMs which had exceeded their eight year service life. The RSRM age life tracking philosophy which establishes when the clock starts for age life tracking will be described. The role of the following activities in service life extension will be discussed: subscale testing, accelerated aging, dissecting full scale aged hardware, static testing full scale aged motors, data mining industry data, and using the fleet leader approach. The service life certification and extension of the BSMs will also be presented.

  3. Evaluation of Hose in Hose transfer line service life

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

    EAGLE, O.H.

    This document presents a determination for the amount of expected service life from Hose-in-Hose Transfer Lines based on vendor information and past HIHTL experience. Based on the information presented in this report and referenced documentation, we conclude the service life of the inner hose establishes the limits of service life for the finished assemblies. Since the process and environmental conditions to which the transfer line is subjected will not adversely affect the hose, the effective service life is that stated by the vendor--three years from the date of initial transfer. Transfer line assemblies have a shelf life of seven yearsmore » from the date of hose manufacture, if stored in accordance with Section 2.1. This evaluation provides documentation showing that a three year service life has been justified. In the event that transfer lines are to be operated after three years from the date of initial transfer and within the shelf life of seven years, they must be reevaluated for their ability to perform intended functions.« less

  4. Quality of Life: Domains for Understanding Maths Anxiety in First Year Pre-Service Teachers through Identity Work

    ERIC Educational Resources Information Center

    Wilson, Sue

    2016-01-01

    Mathematics anxiety in primary pre-service teachers' affects their future teaching of mathematics and achievement of students. Data collected via Critical Incident Technique were used to investigate this anxiety as perceived and identified by first year pre-service teachers. This paper proposes the application of the Quality of Life conceptual…

  5. QUANTIFICATION OF STRESSFUL LIFE EVENTS IN SERVICE PERSONNEL

    PubMed Central

    Raju, M.S.V.K.; Srivastava, Kalpana; Chaudhury, S.; Salujha, S.K.

    2001-01-01

    The role of stressful life events in the etiology of various disorders has been of interest to investigators attempting to establish a link between stressful life events and disorders. None of the available scales are relevant to service personnel. In the present study an attempt was made to construct a scale to measure stressful life events in service personnel. In the first stage of study open-ended questions along with items generated by the expert group by consensus method were administered to 50 soldiers. During the second stage the scale comprising of 59 items was administered in group setting to 165 service personnel. Weightage was assigned on 0-100 range Frequency of occurrence of life events within past one year and lifetime was also noted. Findings revealed that service personnel experience more number of life events within a year as well as in lifetime. Some general items, which are common to civilians are having consistency of weightage being assigned. There is a pattern of uniformity with the civilian counterparts along with differences in the items specific to service personnel. PMID:21407857

  6. Predicting the remaining service life of concrete

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

    Clifton, J.F.

    1991-11-01

    Nuclear power plants are providing, currently, about 17 percent of the U.S. electricity and many of these plants are approaching their licensed life of 40 years. The U.S. Nuclear Regulatory Commission and the Department of Energy`s Oak Ridge National Laboratory are carrying out a program to develop a methodology for assessing the remaining safe-life of the concrete components and structures in nuclear power plants. This program has the overall objective of identifying potential structural safety issues, as well as acceptance criteria, for use in evaluations of nuclear power plants for continued service. The National Institute of Standards and Technology (NIST)more » is contributing to this program by identifying and analyzing methods for predicting the remaining life of in-service concrete materials. This report examines the basis for predicting the remaining service lives of concrete materials of nuclear power facilities. Methods for predicting the service life of new and in-service concrete materials are analyzed. These methods include (1) estimates based on experience, (2) comparison of performance, (3) accelerated testing, (4) stochastic methods, and (5) mathematical modeling. New approaches for predicting the remaining service lives of concrete materials are proposed and recommendations for their further development given. Degradation processes are discussed based on considerations of their mechanisms, likelihood of occurrence, manifestations, and detection. They include corrosion, sulfate attack, alkali-aggregate reactions, frost attack, leaching, radiation, salt crystallization, and microbiological attack.« less

  7. Predictive Service Life Tests for Roofing Membranes

    NASA Astrophysics Data System (ADS)

    Bailey, David M.; Cash, Carl G.; Davies, Arthur G.

    2002-09-01

    The average service life of roofing membranes used in low-slope applications on U.S. Army buildings is estimated to be considerably shorter than the industry-presumed 20-year design life, even when installers carefully adhere to the latest guide specifications. This problem is due in large part to market-driven product development cycles, which do not include time for long-term field testing. To reduce delivery costs, contractors may provide untested, interior membranes in place of ones proven satisfactory in long-term service. Federal procurement regulations require that roofing systems and components be selected according to desired properties and generic type, not brand name. The problem is that a material certified to have satisfactory properties at installation time will not necessarily retain those properties in service. The overall objective of this research is to develop a testing program that can be executed in a matter of weeks to adequately predict a membrane's long-term performance in service. This report details accelerated aging tests of 12 popular membrane materials in the laboratory, and describes outdoor experiment stations set up for long-term exposure tests of those same membranes. The laboratory results will later be correlated with the outdoor test results to develop performance models and predictive service life tests.

  8. Preservatives extend service life of ohia and robusta posts

    Treesearch

    Roger G. Skolmen

    1968-01-01

    Posts of ohia and robusta, pressure- treated with two preservatives--chromated copper arsenate and pentachlorophenol, are being tested for durability at the Makiki Exposure Site, Honolulu, Hawaii. All treated posts are still sound after 5 years. Untreated ohia posts averaged 4 years of service life before failing; untreated robusta posts averaged 4 ½ years....

  9. Maritime vessel obsolescence, life cycle cost and design service life

    NASA Astrophysics Data System (ADS)

    Dinu, O.; Ilie, A. M.

    2015-11-01

    Maritime vessels have long service life and great costs of building, manning, operating, maintaining and repairing throughout their life. Major actions are needed to repair, renovate, sometime built or even replace those scrapped when technology or demand changes determine obsolescence. It is regarded as a concern throughout vessel's entire life cycle and reflects changes in expectation regarding performances in functioning, safety and environmental effects. While service live may differ from physical lives, expectations about physical lives is the main factors that determines design service life. Performance and failure are illustrated conceptually and represented in a simplified form considering the evolution of vessels parameters during its service life. In the proposed methodology an accumulated vessel lifecycle cost is analyzed and obsolescence is characterized from ship's design, performances, maintenance and management parameters point of view. Romanian ports feeding Black Sea are investigated in order to provide comprehensive information on: number and types of vessels, transport capacity and life cycle length. Recommendations are to be made in order to insure a best practice in lifecycle management in order to reduce costs.

  10. Evaluation of Hose in Hose Transfer Line Service Life for Hanfords Interim Stabilization Program

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

    TORRES, T.D.

    RPP-6153, Engineering Task Plan for Hose-in-Hose Transfer System for the Interim Stabilization Program (Torres, 2000a), defines the programmatic goals, functional requirements, and technical criteria for the development and subsequent installation of waste transfer line equipment to support Hanford's Interim Stabilization Program. RPP-6028, Specification for Hose in Hose Transfer Lines for Hanford's Interim Stabilization Program (Torres, 2000b), has been issued to define the specific requirements for the design, manufacture, and verification of transfer line assemblies for specific waste transfer applications associated with Interim Stabilization. Included in RPP-6028 are tables defining the chemical constituents of concern to which transfer lines will bemore » exposed. Current Interim Stabilization Program planning forecasts that the at-grade transfer lines will be required to convey pumpable waste for as much as three years after commissioning, RPP-6028 Section 3.2.7. Performance Incentive Number ORP-05 requires that all the Single Shell Tanks be Interim Stabilized by September 30, 2003. The Tri-Party Agreement (TPA) milestone M-41-00, enforced by a federal consent decree, requires all the Single Shell Tanks to be Interim stabilized by September 30, 2004. By meeting the Performance Incentive the TPA milestone is met. Prudent engineering dictates that the equipment used to transfer waste have a life in excess of the forecasted operational time period, with some margin to allow for future adjustments to the planned schedule. This document evaluates the effective service life of the Hose-in-Hose Transfer Lines, based on information submitted by the manufacturer, published literature and calculations. The effective service life of transfer line assemblies is a function of several factors. Foremost among these are the hose material's resistance to the harmful effects of process fluid characteristics, ambient environmental conditions, exposure to ionizing radiation

  11. Family Life Theatre and youth health services.

    PubMed Central

    Boria, M C; Welch, E J; Vargas, A M

    1981-01-01

    The Family Life Theatre, integrated into the Youth Health Services of a medical institution in a large urban community, has achieved rather unusual success. After seven years of experience marked by a constant quest for improvements, what was started in 1973 as a very modest health education program, through the medium of improvisational theatre, has now become a pilot project, duplicated by many groups and institutions throughout the country. The experiences of the Family Life Theatre, and its multiple ramifications leading to a comprehensive approach to the adolescent health problems, are presented and analyzed in a public health perspective. Images p151-a p152-a p153-a PMID:7457684

  12. Service engineering for grid services in medicine and life science.

    PubMed

    Weisbecker, Anette; Falkner, Jürgen

    2009-01-01

    Clearly defined services with appropriate business models are necessary in order to exploit the benefit of grid computing for industrial and academic users in medicine and life sciences. In the project Services@MediGRID the service engineering approach is used to develop those clearly defined grid services and to provide sustainable business models for their usage.

  13. Quantification of the Service Life Extension and Environmental Benefit of Chloride Exposed Self-Healing Concrete.

    PubMed

    Van Belleghem, Bjorn; Van den Heede, Philip; Van Tittelboom, Kim; De Belie, Nele

    2016-12-23

    Formation of cracks impairs the durability of concrete elements. Corrosion inducing substances, such as chlorides, can enter the matrix through these cracks and cause steel reinforcement corrosion and concrete degradation. Self-repair of concrete cracks is an innovative technique which has been studied extensively during the past decade and which may help to increase the sustainability of concrete. However, the experiments conducted until now did not allow for an assessment of the service life extension possible with self-healing concrete in comparison with traditional (cracked) concrete. In this research, a service life prediction of self-healing concrete was done based on input from chloride diffusion tests. Self-healing of cracks with encapsulated polyurethane precursor formed a partial barrier against immediate ingress of chlorides through the cracks. Application of self-healing concrete was able to reduce the chloride concentration in a cracked zone by 75% or more. As a result, service life of steel reinforced self-healing concrete slabs in marine environments could amount to 60-94 years as opposed to only seven years for ordinary (cracked) concrete. Subsequent life cycle assessment calculations indicated important environmental benefits (56%-75%) for the ten CML-IA (Center of Environmental Science of Leiden University-Impact Assessment) baseline impact indicators which are mainly induced by the achievable service life extension.

  14. Quality of services and quality of life from service providers' perspectives: analysis with focus groups.

    PubMed

    Jenaro, C; Vega, V; Flores, N; Cruz, M

    2013-06-01

    Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this population. The current study aims to identify service providers' perceptions regarding the quality of life of their clients and the quality of services they provide. It also aims to identify similarities and differences of appraisals among professionals, and to identify associations between supports, quality of life and quality of services. Data were collected from 22 service providers who attended three focus groups (professionals, direct support staff, and managers) from whom 424 comments were analysed. Service providers were asked about the required support for users, the meaning of quality of life for those users, and about features that should characterise quality services. Thematic analysis was employed and transcripts of the sessions were coded according to the dimensions of models on supports, quality of life and quality of services. Chi-squared tests were utilised to test for potential differences among groups. Each professional group has its own priorities concerning required supports. Among the organisation different and potentially conflicting perceptions regarding the meaning of experiencing quality of life coexist. Concerning quality of services, only managers mentioned personal outcomes. Finally, institutionalisation has a negative impact on supports, quality of life and quality of services. It is necessary to move beyond a shared awareness of the negative impact of institutionalisation towards the transformation of services in search of personal quality outcomes. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

  15. Service life evaluation of rigid explosive transfer lines

    NASA Technical Reports Server (NTRS)

    Bement, L. J.; Kayser, E. G.; Schimmel, M. L.

    1983-01-01

    This paper describes a joint Army/NASA-sponsored research program on the service life evaluation of rigid explosive transfer lines. These transfer lines are used to initiate emergency crew escape functions on a wide variety of military and NASA aircraft. The purpose of this program was to determine quantitatively the effects of service, age, and degradation on rigid explosive transfer lines to allow responsible, conservative, service life determination. More than 800 transfer lines were removed from the U.S. Army AH-1G and AH-1S, the U.S. Air Force B-1 and F-111, and the U.S. Navy F-14 aircraft for testing. The results indicated that the lines were not adversely affected by age, service, or a repeat of the thermal qualification tests on full-service lines. Extension of the service life of rigid explosive transfer lines should be considered, since considerable cost savings could be realized with no measurable decrease in system reliability.

  16. Service life of fence posts treated by double-diffusion methods

    Treesearch

    Donald C. Markstrom; Lee R. Gjovik

    1999-01-01

    Service-life tests indicate that Engelmann spruce, lodgepole pine, and Rocky Mountain Douglas-fir fence posts treated by double-diffusion methods performed excellently after field exposure of 30 years with no failures. The test site was located in the semiarid Central Plains near Nunn, Colorado. Although Engelmann spruce posts generally defy treatment by other treating...

  17. Quantification of the Service Life Extension and Environmental Benefit of Chloride Exposed Self-Healing Concrete

    PubMed Central

    Van Belleghem, Bjorn; Van den Heede, Philip; Van Tittelboom, Kim; De Belie, Nele

    2016-01-01

    Formation of cracks impairs the durability of concrete elements. Corrosion inducing substances, such as chlorides, can enter the matrix through these cracks and cause steel reinforcement corrosion and concrete degradation. Self-repair of concrete cracks is an innovative technique which has been studied extensively during the past decade and which may help to increase the sustainability of concrete. However, the experiments conducted until now did not allow for an assessment of the service life extension possible with self-healing concrete in comparison with traditional (cracked) concrete. In this research, a service life prediction of self-healing concrete was done based on input from chloride diffusion tests. Self-healing of cracks with encapsulated polyurethane precursor formed a partial barrier against immediate ingress of chlorides through the cracks. Application of self-healing concrete was able to reduce the chloride concentration in a cracked zone by 75% or more. As a result, service life of steel reinforced self-healing concrete slabs in marine environments could amount to 60–94 years as opposed to only seven years for ordinary (cracked) concrete. Subsequent life cycle assessment calculations indicated important environmental benefits (56%–75%) for the ten CML-IA (Center of Environmental Science of Leiden University–Impact Assessment) baseline impact indicators which are mainly induced by the achievable service life extension. PMID:28772363

  18. Prediction of pavement remaining service life based on repetition of load and permanent deformation

    NASA Astrophysics Data System (ADS)

    Usman, R. S.; Setyawan, A.; Suprapto, M.

    2018-03-01

    One of the methods which was applied in the assessment of flexible pavement performance was mechanistic method assuming structures of road pavement to become multi-layer structure for flexible pavement, that the vehicle load working on the pavement layer under repetition with power failure worth 1 (one) unit which was assumed as evenly distributed static load, and therefore the pavement material would provide response in the form of stress, strain, and deflection. This is closely related in order to assess the structure of flexible pavement and to predict the remaining service life on the roads of Pulau Indah sta 0 + 000 to sta. 0 + 845 in Kota Kupang, Nusa Tenggara Timur. The performance appraisal indicator which was used was fatigue cracking happening bottom of the asphalt layer and permanent deformation (rutting) on the surface of subgrade. The strain estimate on the flexible pavement layer structure needs carefulness and high accuracy and therefore a software like KENPAVE which produces horizontal tensile strain of 8,802E-05 and vertical compressive strain of 2,642E-04 was used. By applying equation of The Asphalt Instituteit was obtained repetition of permit load when reaching fatigue cracking (Nf) was 16.071.516 ESAL and permanent deformation (rutting) was 14.703.867 ESAL and also it was predicted the remaining service life of pavement applied the equation of AASTHO 1993 by considering Traffic Multiplier factor (TM 1.8, TM 1.9 and TM 2.0) obtained the remaining life service due to fatigue of 5.51% in the year of 13th (TM 1.8), 7.95% in the year of12th (TM 1.9) and 3.11% (TM 2.0) in the year of 12th, also the remaining service life due to rutting of 4.69% in the year of 12th(TM 1.8), 7.79% in the year of 11th (TM 1.9), and 2.94 in the year of 11th (TM 2.0).

  19. Funding health and social services for older people - a qualitative study of care recipients in the last year of life.

    PubMed

    Hanratty, Barbara; Lowson, Elizabeth; Holmes, Louise; Grande, Gunn; Addington-Hall, Julia; Payne, Sheila; Seymour, Jane

    2012-05-01

    This study explores the views of older adults who are receiving health and social care at the end of their lives, on how services should be funded, and describes their health-related expenditure. Qualitative interview study. North West England. 30 people aged 69-93 years, diagnosed with lung cancer, heart failure or stroke and judged by health professionals to be in their last year of life. Sixteen participants lived in disadvantaged areas. Views of older adults on funding of services. Participants expressed a belief in an earned entitlement to services funded from taxation, based on a broad sense of being a good citizen. Irrespective of social background, older people felt that those who could afford to pay for social care, should do so. Sale of assets and use of children's inheritance to fund care was widely perceived as an injustice. The costs of living with illness are a burden, and families are filling many of the gaps left by welfare provision. People who had worked in low-wage occupations were most concerned to justify their current acceptance of services, and distance themselves from what they described as welfare 'spongers' or 'layabouts.' There is a gap between the health and social care system that older adults expect and what may be provided by a reformed welfare state at a time of financial stringencies. The values that underpinned the views expressed--mutuality, care for the most needy, and the importance of working to contribute to society--are an important contribution to the debate on welfare funding.

  20. How services for children with disabilities in Serbia affect the quality of life of their families.

    PubMed

    Ignjatovic, Tamara Dzamonja; Milanovic, Marko; Zegarac, Nevenka

    2017-09-01

    Families that have children with disabilities face numerous difficulties related to the lack of services support, social isolation and poverty in Serbia. Mostly due to the prolonged effect of social and economic crisis, there are insufficient adequate and diverse community-based services for those families. The aim of the study was to examine the effect of newly introduced services on the quality of families' life. A pretest/posttest study was conducted at the beginning of service and one year later to evaluate the effect of services measured by Family Quality of Life Scale (Hoffman et al., 2006). The sample consists of 153 families of children with disabilities from 35 different places in Serbia. The results show that the services generally improved the families' quality of life, particularly in the aspects targeted by services, but also had significant positive effect on family interaction and parenting. The services had the highest impact on the families that perceived the lowest life quality before using them. The life quality was improved, regardless of the type of services, but the effectiveness is affected by the severity of child disability. The results might be useful for further steps in developing and evaluating individually and flexible tailored service that support families' needs and suits them the best. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Service Use at the End of Life in Medicare Advantage versus Traditional Medicare

    PubMed Central

    Stevenson, David G.; Ayanian, John Z.; Zaslavsky, Alan M.; Newhouse, Joseph P.; Landon, Bruce E.

    2013-01-01

    Background Relative to traditional fee-for-service Medicare, managed care plans caring for Medicare beneficiaries may be better positioned to promote recommended services and discourage burdensome procedures with little clinical value at the end of life. Objective To compare end-of-life service use for enrollees in Medicare Advantage health maintenance organizations (MA-HMO) relative to similar individuals enrolled in traditional Medicare (TM). Research Design, Subjects, Measures For a national cohort of Medicare decedents continuously enrolled in MA-HMOs or TM in their year of death, 2003-2009, we obtained hospice enrollment information and individual-level Healthcare Effectiveness Data and Information Set (HEDIS®) utilization measures for MA-HMO decedents for up to one year prior to death. We developed comparable claims-based measures for TM decedents matched on age, sex, race, and location. Results Hospice use in the year preceding death was higher among MA than TM decedents in 2003 (38% vs. 29%), but the gap narrowed over the study period (46% vs. 40% in 2009). Relative to TM, MA decedents had significantly lower rates of inpatient admissions (5-14% lower), inpatient days (18-29%), and emergency department visits (42-54%). MA decedents initially had lower rates of ambulatory surgery and procedures that converged with TM rates by 2009 and had modestly lower rates of physician visits initially that surpassed TM rates by 2007. Conclusions Relative to comparable TM decedents in the same local areas, MA-HMO decedents more frequently enrolled in hospice and used fewer inpatient and emergency department services, demonstrating that MA plans provide less end-of-life care in hospital settings. PMID:23969590

  2. 26 CFR 1.411(a)-6 - Year of service; hours of service; breaks in service.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... this subdivision by reason of any prior break in service may be disregarded. (2) One-year break in... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Year of service; hours of service; breaks in.... § 1.411(a)-6 Year of service; hours of service; breaks in service. (a) Year of service. Under section...

  3. Service life of treated and untreated Black Hills ponderosa pine fenceposts

    Treesearch

    Donald C. Markstrom; Lee R. Gjovik

    1992-01-01

    Service-life tests indicate that ponderosa pine fenceposts treated with preservatives performed well after field exposure of 30 years. Treating plants in the Black Hills area used commercial methods to treat the posts with creosote, pentachlorophenol, and waterborne arsenicals. Test sites were in the northern Great Plains-one in the semiarid western portion near Scenic...

  4. The Welsh Blood Service - 70 years of continuous change.

    PubMed

    Poole, G D

    2017-06-01

    The National Blood Transfusion Service (NBTS) in England and Wales was established as a single entity in 1946 and operated as such for almost half a century. During those 50 years, the blood service in Wales, as in the rest of the UK, saw many technological and operational changes. The automation of donation testing, the introduction of successive layers of microbiological screening, the creation of the Tissue Typing Laboratory (later renamed the Welsh Transplantation and Immunogenetics Laboratory) and the development of information technology brought - over a relatively long period - highly significant improvements to an organisation that had begun life as an Emergency Medical Service. Differing funding and reporting arrangements for the Welsh and English blood services made little difference in practice, but the devolution of government following the 1997 referendum in Wales would have a profound influence. Four years before the Government of Wales Act (1998) was passed through the UK parliament, the National Blood Authority (NBA) assumed executive control of the English blood services but not the blood service in Wales. The Scottish National Blood Transfusion Service and the Northern Ireland Blood Transfusion Service had been created as independent organisations in 1946; thus, the scene was set for diversification between the four independent blood services, each operating in different political environments with different funding streams. The creation of the UK Blood Services Forum and its Joint Professional Advisory Committee in 1999 has, however, ensured consistency in professional matters. The blood transfusion service in Wales, in its new headquarters in Talbot Green, became known as the Welsh Blood Service (WBS), or Gwasanaeth Gwaed Cymru in Welsh, reporting for most of its life to the Velindre NHS Trust, part of NHS Wales. Considerable changes would impact the WBS in the 21st century. Social changes would mean that the role of recruitment and marketing

  5. Service Life Extension of the ISS Propulsion System Elements

    NASA Technical Reports Server (NTRS)

    Kamath, Ulhas; Grant, Gregory; Kuznetsov, Sergei; Shaevich, Sergey; Spencer, Victor

    2015-01-01

    The International Space Station (ISS) is a result of international collaboration in building a sophisticated laboratory of an unprecedented scale in Low Earth Orbit. After a complex assembly sequence spanning over a decade, some of the early modules launched at the beginning of the program would reach the end of their certified lives, while the newer modules were just being commissioned into operation. To maximize the return on global investments in this one-of-a-kind orbiting platform that was initially conceived for a service life until 2016, it is essential for the cutting edge research on ISS to continue as long as the station can be sustained safely in orbit. ISS Program is assessing individual modules in detail to extend the service life of the ISS to 2024, and possibly to 2028. Without life extension, Functional Cargo Block (known by its Russian acronym as FGB) and the Service Module (SM), two of the early modules on the Russian Segment, would reach the end of their certified lives in 2013 and 2015 respectively. Both FGB and SM are critical for the propulsive function of the ISS. This paper describes the approach used for the service life extension of the FGB propulsion system. Also presented is an overview of the system description along with the process adopted for developing the life test plans based on considerations of system failure modes, fault tolerance and safety provisions. Tests and analyses performed, important findings and life estimates are summarized. Based on the life extension data, FGB propulsion system, in general, is considered ready for a service life until 2028.

  6. Practical theories for service life prediction of critical aerospace structural components

    NASA Technical Reports Server (NTRS)

    Ko, William L.; Monaghan, Richard C.; Jackson, Raymond H.

    1992-01-01

    A new second-order theory was developed for predicting the service lives of aerospace structural components. The predictions based on this new theory were compared with those based on the Ko first-order theory and the classical theory of service life predictions. The new theory gives very accurate service life predictions. An equivalent constant-amplitude stress cycle method was proposed for representing the random load spectrum for crack growth calculations. This method predicts the most conservative service life. The proposed use of minimum detectable crack size, instead of proof load established crack size as an initial crack size for crack growth calculations, could give a more realistic service life.

  7. 42 CFR 84.255 - Requirements for end-of-service-life indicator.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Requirements for end-of-service-life indicator. 84... Special Use Respirators § 84.255 Requirements for end-of-service-life indicator. (a) Each canister or... equipped with a canister or cartridge end-of-service-life indicator which shows a satisfactory indicator...

  8. 42 CFR 84.255 - Requirements for end-of-service-life indicator.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Requirements for end-of-service-life indicator. 84... Special Use Respirators § 84.255 Requirements for end-of-service-life indicator. (a) Each canister or... equipped with a canister or cartridge end-of-service-life indicator which shows a satisfactory indicator...

  9. 42 CFR 84.255 - Requirements for end-of-service-life indicator.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Requirements for end-of-service-life indicator. 84... Special Use Respirators § 84.255 Requirements for end-of-service-life indicator. (a) Each canister or... equipped with a canister or cartridge end-of-service-life indicator which shows a satisfactory indicator...

  10. Documenting the Durability and Service Life of Pressure-treated Wood

    Treesearch

    Stan Lebow; Bessie Woodward; Patricia Lebow

    2014-01-01

    Estimates of service life are increasingly used to compare life cycle costs of building materials. Because of a lack of published data for treated wood, some users assume a relatively low service life for wood in comparison to alternative materials. Such bias against durable wood products may cause alternative materials to appear more economical. This paper discusses...

  11. A Modelling Study for Predicting Life of Downhole Tubes Considering Service Environmental Parameters and Stress

    PubMed Central

    Zhao, Tianliang; Liu, Zhiyong; Du, Cuiwei; Hu, Jianpeng; Li, Xiaogang

    2016-01-01

    A modelling effort was made to try to predict the life of downhole tubes or casings, synthetically considering the effect of service influencing factors on corrosion rate. Based on the discussed corrosion mechanism and corrosion processes of downhole tubes, a mathematic model was established. For downhole tubes, the influencing factors are environmental parameters and stress, which vary with service duration. Stress and the environmental parameters including water content, partial pressure of H2S and CO2, pH value, total pressure and temperature, were considered to be time-dependent. Based on the model, life-span of an L80 downhole tube in oilfield Halfaya, an oilfield in Iraq, was predicted. The results show that life-span of the L80 downhole tube in Halfaya is 247 months (approximately 20 years) under initial stress of 0.1 yield strength and 641 months (approximately 53 years) under no initial stress, which indicates that an initial stress of 0.1 yield strength will reduce the life-span by more than half. PMID:28773872

  12. Impact of landfill liner time-temperature history on the service life of HDPE geomembranes.

    PubMed

    Rowe, R Kerry; Islam, M Z

    2009-10-01

    The observed temperatures in different landfills are used to establish a number of idealized time-temperature histories for geomembrane liners in municipal solid waste (MSW) landfills. These are then used for estimating the service life of different HDPE geomembranes. The predicted antioxidant depletion times (Stage I) are between 7 and 750 years with the large variation depending on the specific HDPE geomembrane product, exposure conditions, and most importantly, the magnitude and duration of the peak liner temperature. The higher end of the range corresponds to data from geomembranes aged in simulated landfill liner tests and a maximum liner temperature of 37 degrees C. The lower end of the range corresponds to a testing condition where geomembranes were immersed in a synthetic leachate and a maximum liner temperature of 60 degrees C. The total service life of the geomembranes was estimated to be between 20 and 3300 years depending on the time-temperature history examined. The range illustrates the important role that time-temperature history could play in terms of geomembrane service life. The need for long-term monitoring of landfill liner temperature and for geomembrane ageing studies that will provide improved data for assessing the likely long-term performance of geomembranes in MSW landfills are highlighted.

  13. Low back pain during military service predicts low back pain later in life.

    PubMed

    Mattila, Ville M; Kyröläinen, Heikki; Santtila, Matti; Pihlajamäki, Harri

    2017-01-01

    The aim of the present study was to assess associations between physician diagnosed unspecified low back pain (LBP) during compulsory military service and self-reported LBP and physical fitness measured on average four years after military service. From a total of 1155 persons who had been pass medical examination for military service and who had completed physically demanding military training between 1997 and 2007, 778 men participated in a refresher military training course and physical tests. In this study, the association between LBP during military service and LBP in later life in addition to the association between LBP and physical fitness were examined. A total of 219 out of 778 participants (28%) had visited a physician due to some musculoskeletal symptom (ICD-10 M-diagnosis) during their military service. Seventy-four participants (9.5%) had visited a physician due to unspecified LBP during their service, and 41 (5.3%) had temporarily been absent from duty due to LBP. At the follow-up examination, 122 (15.7%) had reported LBP during the past month. LBP during military service was associated with self-reported LBP in the follow-up (p = 0.004). Of those who had been absent from duty due to LBP during their military service, 13 (31.7%) reported LBP during the past month. In risk factor analysis, no initial health behaviour and physical performance variables were associated with baseline LBP in the follow-up. The main finding of the present study was that unspecified LBP during military service predicts LBP in later life. On the basis of previous literature, it is also known that LBP is a common symptom and thus, one cannot expect to be symptomless the entire life. Interestingly, none of the health behaviours nor the physical performance studied in the follow-up were associated with baseline LBP. It appears that individuals prone to LBP have symptoms during physically demanding military service and also later in their life.

  14. Low back pain during military service predicts low back pain later in life

    PubMed Central

    Mattila, Ville M.; Kyröläinen, Heikki; Santtila, Matti; Pihlajamäki, Harri

    2017-01-01

    The aim of the present study was to assess associations between physician diagnosed unspecified low back pain (LBP) during compulsory military service and self-reported LBP and physical fitness measured on average four years after military service. From a total of 1155 persons who had been pass medical examination for military service and who had completed physically demanding military training between 1997 and 2007, 778 men participated in a refresher military training course and physical tests. In this study, the association between LBP during military service and LBP in later life in addition to the association between LBP and physical fitness were examined. A total of 219 out of 778 participants (28%) had visited a physician due to some musculoskeletal symptom (ICD-10 M-diagnosis) during their military service. Seventy-four participants (9.5%) had visited a physician due to unspecified LBP during their service, and 41 (5.3%) had temporarily been absent from duty due to LBP. At the follow-up examination, 122 (15.7%) had reported LBP during the past month. LBP during military service was associated with self-reported LBP in the follow-up (p = 0.004). Of those who had been absent from duty due to LBP during their military service, 13 (31.7%) reported LBP during the past month. In risk factor analysis, no initial health behaviour and physical performance variables were associated with baseline LBP in the follow-up. The main finding of the present study was that unspecified LBP during military service predicts LBP in later life. On the basis of previous literature, it is also known that LBP is a common symptom and thus, one cannot expect to be symptomless the entire life. Interestingly, none of the health behaviours nor the physical performance studied in the follow-up were associated with baseline LBP. It appears that individuals prone to LBP have symptoms during physically demanding military service and also later in their life. PMID:28282419

  15. 26 CFR 1.410(a)-5 - Year of service; break in service.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... under this subparagraph by reason of any prior break in service. (ii) Examples. The rules of this... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Year of service; break in service. 1.410(a)-5... service; break in service. (a) Year of service. For the rules relating to years of service under...

  16. Funding health and social services for older people – a qualitative study of care recipients in the last year of life

    PubMed Central

    Hanratty, Barbara; Lowson, Elizabeth; Holmes, Louise; Grande, Gunn; Addington-Hall, Julia; Payne, Sheila; Seymour, Jane

    2012-01-01

    Objectives This study explores the views of older adults who are receiving health and social care at the end of their lives, on how services should be funded, and describes their health-related expenditure. Design Qualitative interview study Setting North West England Participants 30 people aged 69–93 years, diagnosed with lung cancer, heart failure or stroke and judged by health professionals to be in their last year of life. Sixteen participants lived in disadvantaged areas. Main outcome measures Views of older adults on funding of services. Results Participants expressed a belief in an earned entitlement to services funded from taxation, based on a broad sense of being a good citizen. Irrespective of social background, older people felt that those who could afford to pay for social care, should do so. Sale of assets and use of children's inheritance to fund care was widely perceived as an injustice. The costs of living with illness are a burden, and families are filling many of the gaps left by welfare provision. People who had worked in low-wage occupations were most concerned to justify their current acceptance of services, and distance themselves from what they described as welfare ‘spongers’ or ‘layabouts.’ Conclusions There is a gap between the health and social care system that older adults expect and what may be provided by a reformed welfare state at a time of financial stringencies. The values that underpinned the views expressed – mutuality, care for the most needy, and the importance of working to contribute to society – are an important contribution to the debate on welfare funding. PMID:22537882

  17. Are Stressful Life Events (SLEs) Associated with the Utilization of Substance Use Treatment-Related Services?

    PubMed

    Cruz-Feliciano, Miguel A; Ferraro, Aimee; Witt Prehn, Angela

    2017-03-01

    This study described herein explored the association of stressful life events with the utilization of substance use treatment-related services among substance users living in Puerto Rico. A secondary data analysis was conducted using data collected by a research project entitled Puerto Rico Drug Abuse Research Development Program II (PRDARDP II). The study population consisted of 378 individuals from 18 to 35 years of age who were residents of the San Juan metropolitan area and who presented evidence of substance use in the 30 days prior to the interview. The analysis considered demographic data, information on patterns of substance use, substance use treatment history, stressful events, and depression and anxiety symptomatology. As the number of stressful life events increased, substance users were more likely to report having utilized substance use treatment-related services (OR = 1.11, 95% CI [1.06, 1.17], p < 0.001). Relapsing, the inability to afford drugs, and poor working conditions were statistically significant stressful life events associated with the utilization of substance use treatment-related services. Despite the structural limitations associated with access to and with the quality of the services in the substance use treatment-related system of Puerto Rico, findings suggest that stressful life events play a significant role in the utilization of those services. Researchers and clinicians should consider screening for stressful life events in outreach and engagement strategies. At the same time, the assessment of stressful life events should be integrated into the treatment planning stage to support the recovery process of people with substance use disorders.

  18. Service life of treated and untreated fence posts on the Pringle Falls Experimental Forest.

    Treesearch

    Walter G. Dahms

    1952-01-01

    The service life of lodgepole pine fence posts can be greatly extended by a good preservative treatment, After more than 15 years, however, little or no difference can be found between treated lodgepole pine posts and untreated Western redcedar posts. These conclusions have been reached as a result of observations on 517 lodgepole pins posts for 16 years and 355 cedar...

  19. Identifying profiles of service users in housing services and exploring their quality of life and care needs.

    PubMed

    Bitter, Neis A; Roeg, Diana P K; van Nieuwenhuizen, Chijs; van Weeghel, Jaap

    2016-11-23

    Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not always match their recovery. In order to improve the quality of care, this study aims to explore whether subgroups of service users exist based on three dimensions of recovery and to examine and compare the quality of life and care needs of the persons in these subgroups. Latent class analysis was performed with data from 263 service users of housing services in the Netherlands. Classes were based on three variables: personal recovery (Mental Health Recovery Measure), social recovery (Social Functioning Scale), and clinical recovery (Brief Symptom Inventory). Subsequently, the quality of life (MANSA) and care needs (CANSAS) of the different classes were analysed by the use of descriptive and inferential statistics. Three classes could be distinguished. Class 1 (45%) comprised of people who score the highest of the three classes in terms of personal and social recovery and who experience the least number of symptoms. People in class 2 (44%) and class 3 (11%) score significantly lower on personal and social recovery, and they experience significantly more symptoms compared to class 1. The distinction between class 2 and 3 can be made on the significantly higher number of symptoms in class 3. All three classes differ significantly on quality of life and unmet needs. The quality of life of service users of housing services needs improvement, as even persons in the best-recovered subgroup have a lower quality of life than the average population. Workers of housing services need to be aware of the recovery of a client and what his or her individual needs and goals are. Furthermore, better care (allocation) concerning mental and physical health and rehabilitation is needed. Care should be

  20. Years of life lost through Down's syndrome.

    PubMed

    Jones, M B

    1979-10-01

    A congenital genetic condition does not act either as a cause of death or at the time of death only. Hence, years of life lost through such a conditon cannot be calculated in the same way as for a conventional cause of death. The main difference is that a cause of death acting at age x cuts off as many years of life as the dead person might otherwise have expected to live (life expectancy at age x), whereas a congenital genetic condition exposes an affected person to a different schedule of life-threatening risks from birth onwards. In the latter case, years of life lost is calculated as the difference in life expectancy at birth for affected and non-affected persons. This reasoning is worked out in algebraic form and then applied to Down's syndrome. The data base is provided by two large and recent studies, one in Massachusetts and the other in Denmark, of mortality rates among all cases of Down's syndrome, whether in an institution or not, born during a given period of years or living at a given point in time in a fixed geographical area. So calculated, years of life lost through Down's syndrome relative to the United States general population in 1970 was 53.6 years per 1000 livebirths. Prenatal mortality is also discussed.

  1. International Space Station Bacteria Filter Element Post-Flight Testing and Service Life Prediction

    NASA Technical Reports Server (NTRS)

    Perry, J. L.; von Jouanne, R. G.; Turner, E. H.

    2003-01-01

    The International Space Station uses high efficiency particulate air (HEPA) filters to remove particulate matter from the cabin atmosphere. Known as Bacteria Filter Elements (BFEs), there are 13 elements deployed on board the ISS's U.S. Segment. The pre-flight service life prediction of 1 year for the BFEs is based upon performance engineering analysis of data collected during developmental testing that used a synthetic dust challenge. While this challenge is considered reasonable and conservative from a design perspective, an understanding of the actual filter loading is required to best manage the critical ISS Program resources. Thus testing was conducted on BFEs returned from the ISS to refine the service life prediction. Results from this testing and implications to ISS resource management are discussed. Recommendations for realizing significant savings to the ISS Program are presented.

  2. Probabilistic/Fracture-Mechanics Model For Service Life

    NASA Technical Reports Server (NTRS)

    Watkins, T., Jr.; Annis, C. G., Jr.

    1991-01-01

    Computer program makes probabilistic estimates of lifetime of engine and components thereof. Developed to fill need for more accurate life-assessment technique that avoids errors in estimated lives and provides for statistical assessment of levels of risk created by engineering decisions in designing system. Implements mathematical model combining techniques of statistics, fatigue, fracture mechanics, nondestructive analysis, life-cycle cost analysis, and management of engine parts. Used to investigate effects of such engine-component life-controlling parameters as return-to-service intervals, stresses, capabilities for nondestructive evaluation, and qualities of materials.

  3. Outpatient Health Care Utilization of Suicide Decedents in Their Last Year of Life

    ERIC Educational Resources Information Center

    Liu, Hui-Li; Chen, Lih-Hwa; Huang, Shiuh-Ming

    2012-01-01

    The characteristics of health care utilization during the last year of life by Taiwanese who died by suicide were analyzed. The degree of health services utilization was evaluated by extracting the data of National Health Insurance (NHI) outpatient cohort records in 2006. A total of 4,406 fatal suicide cases were matched with the 17,587,901…

  4. 77 FR 37862 - Open-Circuit Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ...; NIOSH-258] Open-Circuit Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance... open-circuit self-contained breathing apparatus (OC- SCBA) remaining service-life indicators... ``Open-Circuit Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance...

  5. Effect of full-service partnerships on homelessness, use and costs of mental health services, and quality of life among adults with serious mental illness.

    PubMed

    Gilmer, Todd P; Stefancic, Ana; Ettner, Susan L; Manning, Willard G; Tsemberis, Sam

    2010-06-01

    Chronically homeless adults with severe mental illness are heavy users of costly inpatient and emergency psychiatric services. Full-service partnerships (FSPs) provide housing and engage clients in treatment. To examine changes in recovery outcomes, mental health service use and costs, and quality of life associated with participation in FSPs. A quasi-experimental, difference-in-difference design with a propensity score-matched control group was used to compare mental health service use and costs of FSP with public mental health services. Recovery outcomes were compared before and after services use, and quality of life was compared cross-sectionally. San Diego County, California, from October 2005 through June 2008. Two hundred nine FSP clients and 154 clients receiving public mental health services. Recovery outcomes (housing, financial support, and employment), mental health service use (use of outpatient, inpatient, emergency, and justice system services), and mental health services and housing costs from the perspective of the public mental health system. Among FSP participants, the mean number of days spent homeless per year declined 129 days from 191 to 62 days; the probability of receiving inpatient, emergency, and justice system services declined by 14, 32, and 17 percentage points, respectively; and outpatient mental health visits increased by 78 visits (P < .001 each). Outpatient costs increased by $9180; inpatient costs declined by $6882; emergency service costs declined by $1721; jail mental health services costs declined by $1641; and housing costs increased by $3180 (P < .003 each). Quality of life was greater among FSP clients than among homeless clients receiving services in outpatient programs. Participation in an FSP was associated with substantial increases in outpatient services and days spent in housing. Reductions in costs of inpatient/emergency and justice system services offset 82% of the cost of the FSP.

  6. Polymer impregnated bridge slabs : interim report, condition of slabs after three years of service life.

    DOT National Transportation Integrated Search

    1983-01-01

    The condition of six concrete bridge slabs that had been in service for three years was evaluated. The top 2 in. of the four slabs that had been impregnated to a depth of about 1 in. with a methyl methacrylate and trimethylolpropane trimethacrylate m...

  7. Protocol for the End-of-Life Social Action Study (ELSA): a randomised wait-list controlled trial and embedded qualitative case study evaluation assessing the causal impact of social action befriending services on end of life experience.

    PubMed

    Walshe, Catherine; Algorta, Guillermo Perez; Dodd, Steven; Hill, Matthew; Ockenden, Nick; Payne, Sheila; Preston, Nancy

    2016-07-13

    Compassionate support at the end of life should not be the responsibility of health and social care professionals alone and requires a response from the wider community. Volunteers, as community members, are a critical part of many end-of-life care services. The impact of their services on important outcomes such as quality of life is currently poorly understood. The purpose of this study is to evaluate a series of social action initiatives which use volunteers to deliver befriending services to people anticipated to be in their last year of life. The aim is to determine if receiving care from a social action volunteer befriending service plus usual care significantly improves quality of life in the last year of life. The research questions will be addressed through a wait-list randomised controlled trial (WLRCT) and qualitative case study evaluation across 12 sites in England. Participants will be randomly allocated to either receive the social action volunteer befriending service straight away or receive the intervention after a four week wait (wait-list arm). The impact of the intervention on end-of-life experience (quality of life as primary outcome, loneliness, social support) will be measured. Repeated assessments will be carried out at baseline and weeks 4 and 8 for the intervention arm and weeks 4, 8 and 12 for the wait-list arm. For selected sites case study evaluation will include interviews, observation and documentary analysis to understand the mechanisms underpinning any found impact. This study will address the need to both provide services which use social action models to support end-of-life care in community settings, and to robustly evaluate these models to determine if they influence the experience of end-of-life care. Such services could work to reduce isolation, help meet emotional needs and maintain a sense of connectedness to the community. ISRCTN 12929812 Registered 20.5.15.

  8. Effects of Planetary Gear Ratio on Mean Service Life

    NASA Technical Reports Server (NTRS)

    Savage, M.; Rubadeux, K. L.; Coe, H. H.

    1996-01-01

    Planetary gear transmissions are compact, high-power speed reductions which use parallel load paths. The range of possible reduction ratios is bounded from below and above by limits on the relative size of the planet gears. For a single plane transmission, the planet gear has no size at a ratio of two. As the ratio increases, so does the size of the planets relative to the sizes of the sun and ring. Which ratio is best for a planetary reduction can be resolved by studying a series of optimal designs. In this series, each design is obtained by maximizing the service life for a planetary with a fixed size, gear ratio, input speed power and materials. The planetary gear reduction service life is modeled as a function of the two-parameter Weibull distributed service lives of the bearings and gears in the reduction. Planet bearing life strongly influences the optimal reduction lives which point to an optimal planetary reduction ratio in the neighborhood of four to five.

  9. Quality of Services and Quality of Life from Service Providers' Perspectives: Analysis with Focus Groups

    ERIC Educational Resources Information Center

    Jenaro, C.; Vega, V.; Flores, N.; Cruz, M.

    2013-01-01

    Background: Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this…

  10. Serviceability modeling : predicting and extending the useful service life of FRT-plywood roof sheathing

    Treesearch

    Jerrold E. Winandy

    2000-01-01

    One of the most, if not the most, efficient methods of extending our existing forest resource is to prolong the service life of wood currently in-service by using those existing structures to meet our future needs (Hamilton and Winandy 1998). It is currently estimated that over 7 x 109 m3 (3 trillion bd. ft) of wood is currently in service within the United States of...

  11. Bridge deck service life prediction and costs.

    DOT National Transportation Integrated Search

    2007-01-01

    The service life of Virginia's concrete bridge decks is generally controlled by chloride-induced corrosion of the reinforcing steel as a result of the application of winter maintenance deicing salts. A chloride corrosion model accounting for the vari...

  12. 78 FR 2618 - Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-14

    ... 0920-AA38 Self-Contained Breathing Apparatus Remaining Service-Life Indicator Performance Requirements... requirements for self-contained breathing apparatus (SCBA) remaining service-life indicators or warning devices... self-contained breathing apparatus (SCBA) used in the fire service, and a firefighters' union. A...

  13. Growing up our way: the first year of life in remote Aboriginal Australia.

    PubMed

    Kruske, Sue; Belton, Suzanne; Wardaguga, Molly; Narjic, Concepta

    2012-06-01

    In this study, we attempted to explore the experiences and beliefs of Aboriginal families as they cared for their children in the first year of life. We collected family stories concerning child rearing, development, behavior, health, and well-being between each infant's birth and first birthday. We found significant differences in parenting behaviors and child-rearing practices between Aboriginal groups and mainstream Australians. Aboriginal parents perceived their children to be autonomous individuals with responsibilities toward a large family group. The children were active agents in determining their own needs, highly prized, and included in all aspects of community life. Concurrent with poverty, neocolonialism, and medical hegemony, child-led parenting styles hamper the effectiveness of health services. Hence, until the planners of Australia's health systems better understand Aboriginal knowledge systems and incorporate them into their planning, we can continue to expect the failure of government and health services among Aboriginal communities.

  14. Outpatient health care utilization of suicide decedents in their last year of life.

    PubMed

    Liu, Hui-Li; Chen, Lih-Hwa; Huang, Shiuh-Ming

    2012-08-01

    The characteristics of health care utilization during the last year of life by Taiwanese who died by suicide were analyzed. The degree of health services utilization was evaluated by extracting the data of National Health Insurance (NHI) outpatient cohort records in 2006. A total of 4,406 fatal suicide cases were matched with the 17,587,901 subjects in the NHI beneficiary registry file. Rate of visit of the suicide decedents for all NHI outpatient services during their last year before death was 85%, and that for mental disorders service only was 30.2%. Average number of visits per person-year of the suicide decedents was 24.5 visits per year, two times higher than that of the survivors. The average numbers of visits (ANV) of male suicide decedents who used the mental disorders services was increased 6.8 times compared to that for all survivors. The increase in female decedents, in contrast, was 2.7 times. The increase in ANV for 15-24 age group was 14.6 times, significantly higher than that for the other age groups (<4 times). Effective prediction or prevention of potential suicides through increased awareness and surveillance of medical care resource utilization is possible, especially for male and young adult patients under mental disorder health care. © 2012 The American Association of Suicidology.

  15. Quality of life of mental health consumers in Hong Kong: Analysis of service perceptions.

    PubMed

    Wu, Crystal F M; Mak, Winnie W S; Wan, Deborah L Y

    2007-02-01

    Successful psychiatric rehabilitation entails fostering overall quality of life of individuals recovering from severe mental illnesses. Understanding how service-related perceptions may be related to quality of life can be useful in improving the effectiveness of community-based care. This study investigated the quality of life of mental health consumers using a service-oriented paradigm. 162 mental health consumers from community-based psychiatric rehabilitation centers were interviewed. Analyses were conducted to investigate the relationships between service perceptions (perceived treatment coercion, rehabilitation needs, and continuity of care) and quality of life. Physical health quality was negatively related to rehabilitation needs. Mental health quality was negatively related to both rehabilitation needs and poorer continuity of service. Life satisfaction was negatively related to poorer continuity of service and higher perceived treatment coercion. This study highlighted the significance of service perceptions in the well-being of individuals with severe mental illness.

  16. Service Life Extension of the Propulsion System of Long-Term Manned Orbital Stations

    NASA Technical Reports Server (NTRS)

    Kamath, Ulhas; Kuznetsov, Sergei; Spencer, Victor

    2014-01-01

    One of the critical non-replaceable systems of a long-term manned orbital station is the propulsion system. Since the propulsion system operates beginning with the launch of station elements into orbit, its service life determines the service life of the station overall. Weighing almost a million pounds, the International Space Station (ISS) is about four times as large as the Russian space station Mir and about five times as large as the U.S. Skylab. Constructed over a span of more than a decade with the help of over 100 space flights, elements and modules of the ISS provide more research space than any spacecraft ever built. Originally envisaged for a service life of fifteen years, this Earth orbiting laboratory has been in orbit since 1998. Some elements that have been launched later in the assembly sequence were not yet built when the first elements were placed in orbit. Hence, some of the early modules that were launched at the inception of the program were already nearing the end of their design life when the ISS was finally ready and operational. To maximize the return on global investments on ISS, it is essential for the valuable research on ISS to continue as long as the station can be sustained safely in orbit. This paper describes the work performed to extend the service life of the ISS propulsion system. A system comprises of many components with varying failure rates. Reliability of a system is the probability that it will perform its intended function under encountered operating conditions, for a specified period of time. As we are interested in finding out how reliable a system would be in the future, reliability expressed as a function of time provides valuable insight. In a hypothetical bathtub shaped failure rate curve, the failure rate, defined as the number of failures per unit time that a currently healthy component will suffer in a given future time interval, decreases during infant-mortality period, stays nearly constant during the service

  17. Leveraging Available Data to Support Extension of Transportation Packages Service Life

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

    Dunn, K.; Abramczyk, G.; Bellamy, S.

    Data obtained from testing shipping package materials have been leveraged to support extending the service life of select shipping packages while in nuclear materials transportation. Increasingly, nuclear material inventories are being transferred to an interim storage location where they will reside for extended periods of time. Use of a shipping package to store nuclear materials in an interim storage location has become more attractive for a variety of reasons. Shipping packages are robust and have a qualified pedigree for their performance in normal operation and accident conditions within the approved shipment period and storing nuclear material within a shipping packagemore » results in reduced operations for the storage facility. However, the shipping package materials of construction must maintain a level of integrity as specified by the safety basis of the storage facility through the duration of the storage period, which is typically well beyond the one year transportation window. Test programs have been established to obtain aging data on materials of construction that are the most sensitive/susceptible to aging in certain shipping package designs. The collective data are being used to support extending the service life of shipping packages in both transportation and storage.« less

  18. 34 CFR 300.106 - Extended school year services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Extended school year services. 300.106 Section 300.106... CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.106 Extended school year services. (a) General. (1) Each public agency must ensure that extended school year services are available...

  19. 34 CFR 300.106 - Extended school year services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Extended school year services. 300.106 Section 300.106... CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.106 Extended school year services. (a) General. (1) Each public agency must ensure that extended school year services are available...

  20. 34 CFR 300.106 - Extended school year services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Extended school year services. 300.106 Section 300.106... CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.106 Extended school year services. (a) General. (1) Each public agency must ensure that extended school year services are available...

  1. 34 CFR 300.106 - Extended school year services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Extended school year services. 300.106 Section 300.106... CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.106 Extended school year services. (a) General. (1) Each public agency must ensure that extended school year services are available...

  2. Durability of yellow-poplar and sweetgum and service life of finishes after long-term exposure

    Treesearch

    R. Sam Williams; William C. Feist

    2004-01-01

    This report describes the results of long-term outdoor exposure on durability of hardwood plywood and the service life of various finishes. Smooth (abrasive-planed) and rough (saw-textured) yellow-poplar (Liriodendron tulipifera L.) and sweetgum (Liquidambar styraciflua L.) plywood panelswere exposed outdoors for 16 years near Madison, Wisconsin. The performance of...

  3. Student-Life Stress in Education and Health Service Majors

    ERIC Educational Resources Information Center

    Zascavage, Victoria; Winterman, Kathleen G.; Buot, Max; Wies, Jennifer R.; Lyzinski, Natalie

    2012-01-01

    In order to better understand the effects of student-life stress on Education and Health Service majors (n = 195) at a private, religious, Midwestern university in the USA, we assessed student perception of overall stress level and physical stress level using the Student-life Stress Inventory. The targeted sample consisted of students with…

  4. Off Their Rockers into Service. Connecting the Generations through Service Learning. Linking Learning with Life.

    ERIC Educational Resources Information Center

    Brandes, Beverly; Green, Rebecca

    This booklet, which is intended for educators interested in establishing service learning programs, examines the benefits, development, and operation of intergenerational service learning programs. Discussed are the benefits of intergenerational programs in view of recent changes in family life and society as a whole. Three types of…

  5. International Space Station Environmental Control and Life Support System Previous Year Status for 2013 - 2014

    NASA Technical Reports Server (NTRS)

    Williams, David E.; Gentry, Gregory J.

    2015-01-01

    The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the past year and the impacts of the international partners' activities on them, covering the period of time between March 2013 and February 2014. The ISS continued permanent crew operations including the continuation of six crew members being on ISS. Work continues on the commercial crew vehicles, and work to try and extend ISS service life.

  6. Escalation of Oncologic Services at the End of Life Among Patients With Gynecologic Cancer at an Urban, Public Hospital

    PubMed Central

    Wu, Eijean; Rogers, Anna; Ji, Lingyun; Sposto, Richard; Church, Terry; Roman, Lynda; Tripathy, Debu; Lin, Yvonne G.

    2015-01-01

    Purpose: Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown. This study characterizes the end-of-life use of medical services by patients with gynecologic cancer at a safety-net hospital. Methods: Oncologic history and metrics of medical use (eg, hospitalizations, chemotherapy infusions, procedures) for patients with gynecologic oncology who died between December 2006 and February 2012 were evaluated. Mixed-effect regression models were used to test time effects and construct usage summaries. Results: Among 116 subjects, cervical cancer accounted for the most deaths (42%). The median age at diagnosis was 55 years; 63% were Hispanic, and 65% had advanced disease. Only 34% died in hospice care. The median times from do not resuscitate/do not intubate documentation and from last therapeutic intervention to death were 9 days and 55 days, respectively. Significant time effects for all services (eg, hospitalizations, diagnostics, procedures, treatments, clinic appointments) were detected during the patient's final year (P < .001), with the most dramatic changes occurring during the last 2 months. Patients with longer duration of continuity of care used significantly fewer resources toward the end of life. Conclusion: To our knowledge, this is the first report enumerating medical services obtained by patients with gynecologic cancer in a large, public hospital during the end of life. Marked changes in interventions in the patient's final 2 months highlight the need for cost-effective, evidence-based metrics for delivering cancer care. Our data emphasize continuity of care as a significant determinant of oncologic resource use during this critical period. PMID:25604595

  7. Escalation of oncologic services at the end of life among patients with gynecologic cancer at an urban, public hospital.

    PubMed

    Wu, Eijean; Rogers, Anna; Ji, Lingyun; Sposto, Richard; Church, Terry; Roman, Lynda; Tripathy, Debu; Lin, Yvonne G

    2015-03-01

    Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown. This study characterizes the end-of-life use of medical services by patients with gynecologic cancer at a safety-net hospital. Oncologic history and metrics of medical use (eg, hospitalizations, chemotherapy infusions, procedures) for patients with gynecologic oncology who died between December 2006 and February 2012 were evaluated. Mixed-effect regression models were used to test time effects and construct usage summaries. Among 116 subjects, cervical cancer accounted for the most deaths (42%). The median age at diagnosis was 55 years; 63% were Hispanic, and 65% had advanced disease. Only 34% died in hospice care. The median times from do not resuscitate/do not intubate documentation and from last therapeutic intervention to death were 9 days and 55 days, respectively. Significant time effects for all services (eg, hospitalizations, diagnostics, procedures, treatments, clinic appointments) were detected during the patient's final year (P < .001), with the most dramatic changes occurring during the last 2 months. Patients with longer duration of continuity of care used significantly fewer resources toward the end of life. To our knowledge, this is the first report enumerating medical services obtained by patients with gynecologic cancer in a large, public hospital during the end of life. Marked changes in interventions in the patient's final 2 months highlight the need for cost-effective, evidence-based metrics for delivering cancer care. Our data emphasize continuity of care as a significant determinant of oncologic resource use during this critical period. Copyright © 2015 by American Society of Clinical Oncology.

  8. 42 CFR 84.83 - Timers; elapsed time indicators; remaining service life indicators; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Timers; elapsed time indicators; remaining service life indicators; minimum requirements. 84.83 Section 84.83 Public Health PUBLIC HEALTH SERVICE... indicators; remaining service life indicators; minimum requirements. (a) Elapsed time indicators shall be...

  9. 42 CFR 84.83 - Timers; elapsed time indicators; remaining service life indicators; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Timers; elapsed time indicators; remaining service life indicators; minimum requirements. 84.83 Section 84.83 Public Health PUBLIC HEALTH SERVICE... indicators; remaining service life indicators; minimum requirements. (a) Elapsed time indicators shall be...

  10. Final report : Polymer concrete overlay on Beulah Road Bridge : condition of overlay after one year in service.

    DOT National Transportation Integrated Search

    1983-01-01

    An evaluation of the thin polymer concrete overlay placed on the Beulah Road bridge indicates that the overlay is securely bonded to the base concrete and is providing low permeability and high skid resistance after 1 year of service life. The lane c...

  11. Retrofitting Steam Turbines with Expired Service Life

    NASA Astrophysics Data System (ADS)

    Dubrovskii, V. G.; Zubov, A. P.; Koshelev, S. A.; Babiev, A. N.; Kremer, V. L.

    2018-06-01

    Many pieces of equipment installed at thermal power stations (TPS) have an expired service life or are close to expiry and are obsolete. In addition, the structure of heat consumption by end users has changed. Among the ways for solving the problem of aging equipment is the retrofitting of turbines that allows for service life recovery and improvement of their performance to the modern level. The service life is recovered through replacement of high-temperature assemblies and parts of a turbine, and the performance is improved by retrofitting and major overhaul of low-temperature assemblies. Implementation of modern engineering solutions and numerical methods in designing upgraded flow paths of steam turbines considerably improves the turbine effectiveness. New flow paths include sabre-like guide vanes, integrally-machined shrouds, and effective honeycomb or axial-radial seals. The flow paths are designed using optimization and hydraulic simulation methods as well as approaches for improving the performance on the turbine blading and internal steam flow paths. Retrofitting of turbines should be performed to meet the customers' needs. The feasibility of implementation of one or another alternative must be determined on a case-by-case basis depending on the turbine conditions, the availability of reserves for generating live steam and supplying circulation water, and the demands and capacities for generation and delivery of power and heat. The main principle of retrofitting is to retain the foundation and the auxiliary and heat-exchange equipment that is fit for further operation. With the example of PT-60-130 and T-100-130, the experience is presented of a comprehensive approach to retrofitting considering the customer's current needs and the actual equipment conditions. Due to the use of modern engineering solutions and procedures, retrofitting yields updating and upgrading of the turbine at a relatively low cost.

  12. International Space Station Environmental Control and Life Support System Status for the Prior Year: 2011 - 2012

    NASA Technical Reports Server (NTRS)

    Williams, David E.; Dake, Jason R.; Gentry, Gregory J

    2013-01-01

    The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the prior year, covering the period of time between March 2011 and February 2012. The ISS continued permanent crew operations including the continuation of six crew members being on ISS. Work continues on the last of the Phase 3 pressurized elements, the commercial cargo resupply vehicles, and work to try and extend ISS service life from 2015 to at least 2028.

  13. Cost per quality-adjusted life year and disability-adjusted life years: the need for a new paradigm.

    PubMed

    Bevan, Gwyn; Hollinghurst, Sandra

    2003-08-01

    Two different paradigms have been proposed for setting priorities for access to healthcare: cost per quality-adjusted life year based on interventions, and disability-adjusted life years based on the burden of disease in a population. These formal paradigms make explicit the assumptions made implicitly every day in delivering and hence rationing access to healthcare. This paper outlines each paradigm's methodological problems and argues that each paradigm is incomplete in terms of providing the information necessary for making budgetary decisions on healthcare. It argues that a scientific revolution is required to create a new paradigm by combining the strengths of each.

  14. Meeting a Growing Demand: Texas A&M AgriLife Extension Service's Early Childhood Educator Online Training Program

    ERIC Educational Resources Information Center

    Green, Stephen

    2013-01-01

    Demand for professional development training in the early childhood field has grown substantially in recent years. To meet the demand, Texas A&M AgriLife Extension Service's Family Development and Resource Management unit developed the Early Childhood Educator Online Training Program, a professional development system that currently offers…

  15. BioCatalogue: a universal catalogue of web services for the life sciences.

    PubMed

    Bhagat, Jiten; Tanoh, Franck; Nzuobontane, Eric; Laurent, Thomas; Orlowski, Jerzy; Roos, Marco; Wolstencroft, Katy; Aleksejevs, Sergejs; Stevens, Robert; Pettifer, Steve; Lopez, Rodrigo; Goble, Carole A

    2010-07-01

    The use of Web Services to enable programmatic access to on-line bioinformatics is becoming increasingly important in the Life Sciences. However, their number, distribution and the variable quality of their documentation can make their discovery and subsequent use difficult. A Web Services registry with information on available services will help to bring together service providers and their users. The BioCatalogue (http://www.biocatalogue.org/) provides a common interface for registering, browsing and annotating Web Services to the Life Science community. Services in the BioCatalogue can be described and searched in multiple ways based upon their technical types, bioinformatics categories, user tags, service providers or data inputs and outputs. They are also subject to constant monitoring, allowing the identification of service problems and changes and the filtering-out of unavailable or unreliable resources. The system is accessible via a human-readable 'Web 2.0'-style interface and a programmatic Web Service interface. The BioCatalogue follows a community approach in which all services can be registered, browsed and incrementally documented with annotations by any member of the scientific community.

  16. 45 CFR 158.231 - Life-years used to determine credible experience.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Life-years used to determine credible experience... and Providing the Rebate § 158.231 Life-years used to determine credible experience. (a) The life-years used to determine the credibility of an issuer's experience are the life-years for the MLR...

  17. 45 CFR 158.231 - Life-years used to determine credible experience.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Life-years used to determine credible experience... and Providing the Rebate § 158.231 Life-years used to determine credible experience. (a) The life-years used to determine the credibility of an issuer's experience are the life-years for the MLR...

  18. Advanced aircraft service life monitoring method via flight-by-flight load spectra

    NASA Astrophysics Data System (ADS)

    Lee, Hongchul

    This research is an effort to understand current method and to propose an advanced method for Damage Tolerance Analysis (DTA) for the purpose of monitoring the aircraft service life. As one of tasks in the DTA, the current indirect Individual Aircraft Tracking (IAT) method for the F-16C/D Block 32 does not properly represent changes in flight usage severity affecting structural fatigue life. Therefore, an advanced aircraft service life monitoring method based on flight-by-flight load spectra is proposed and recommended for IAT program to track consumed fatigue life as an alternative to the current method which is based on the crack severity index (CSI) value. Damage Tolerance is one of aircraft design philosophies to ensure that aging aircrafts satisfy structural reliability in terms of fatigue failures throughout their service periods. IAT program, one of the most important tasks of DTA, is able to track potential structural crack growth at critical areas in the major airframe structural components of individual aircraft. The F-16C/D aircraft is equipped with a flight data recorder to monitor flight usage and provide the data to support structural load analysis. However, limited memory of flight data recorder allows user to monitor individual aircraft fatigue usage in terms of only the vertical inertia (NzW) data for calculating Crack Severity Index (CSI) value which defines the relative maneuver severity. Current IAT method for the F-16C/D Block 32 based on CSI value calculated from NzW is shown to be not accurate enough to monitor individual aircraft fatigue usage due to several problems. The proposed advanced aircraft service life monitoring method based on flight-by-flight load spectra is recommended as an improved method for the F-16C/D Block 32 aircraft. Flight-by-flight load spectra was generated from downloaded Crash Survival Flight Data Recorder (CSFDR) data by calculating loads for each time hack in selected flight data utilizing loads equations. From

  19. [Reimbursed health expenditures during the last year of life, in France, in the year 2008].

    PubMed

    Ricci, P; Mezzarobba, M; Blotière, P O; Polton, D

    2013-02-01

    To measure the reimbursed health expenditures in the last year of life and the proportion it represents in total reimbursement costs in 2008, to analyse the structure of such expenditures and to identify costs by cause of death. Data were obtained from the French national insurance information system (SNIIRAM). Data from the national hospital discharge database were linked to the outpatient reimbursement database for patients covered by the general health insurance scheme (n=49 million persons). The cost of the last year of life was calculated for the exhaustive population (361,328 deaths in 2008). The supposed cause of death was mainly derived from the primary diagnosis of the last hospital stay during which the patient died. The average reimbursed expenses during the last year of life were estimated at 22,000 € per person in 2008, with 12,500 € accounting for public hospital costs. Reimbursed health expenditures varied according to different medical causes of death: 52,300 € for HIV disease and about 40,000 € for tumors. A negative effect of age on the expenditure during the last year of life was observed. Health care spending increased with shorter time before death, the last month of life corresponding to 28% of reimbursed expenditures during the last year of life. Health care use in the last year of life represented 10.5% of the total health expenditures in 2008. This study found results similar to those observed in the past or in other countries. Our results show in particular that the weight of health expenditures during the last year of life on total health expenditures remains stable over the years. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  20. Automatically exposing OpenLifeData via SADI semantic Web Services.

    PubMed

    González, Alejandro Rodríguez; Callahan, Alison; Cruz-Toledo, José; Garcia, Adrian; Egaña Aranguren, Mikel; Dumontier, Michel; Wilkinson, Mark D

    2014-01-01

    Two distinct trends are emerging with respect to how data is shared, collected, and analyzed within the bioinformatics community. First, Linked Data, exposed as SPARQL endpoints, promises to make data easier to collect and integrate by moving towards the harmonization of data syntax, descriptive vocabularies, and identifiers, as well as providing a standardized mechanism for data access. Second, Web Services, often linked together into workflows, normalize data access and create transparent, reproducible scientific methodologies that can, in principle, be re-used and customized to suit new scientific questions. Constructing queries that traverse semantically-rich Linked Data requires substantial expertise, yet traditional RESTful or SOAP Web Services cannot adequately describe the content of a SPARQL endpoint. We propose that content-driven Semantic Web Services can enable facile discovery of Linked Data, independent of their location. We use a well-curated Linked Dataset - OpenLifeData - and utilize its descriptive metadata to automatically configure a series of more than 22,000 Semantic Web Services that expose all of its content via the SADI set of design principles. The OpenLifeData SADI services are discoverable via queries to the SHARE registry and easy to integrate into new or existing bioinformatics workflows and analytical pipelines. We demonstrate the utility of this system through comparison of Web Service-mediated data access with traditional SPARQL, and note that this approach not only simplifies data retrieval, but simultaneously provides protection against resource-intensive queries. We show, through a variety of different clients and examples of varying complexity, that data from the myriad OpenLifeData can be recovered without any need for prior-knowledge of the content or structure of the SPARQL endpoints. We also demonstrate that, via clients such as SHARE, the complexity of federated SPARQL queries is dramatically reduced.

  1. International Space Station Bacteria Filter Element Service Life Evaluation

    NASA Technical Reports Server (NTRS)

    Perry, J. L.

    2005-01-01

    The International Space Station (ISS) uses high-efficiency particulate air filters to remove particulate matter from the cabin atmosphere. Known as bacteria filter elements (BFEs), there are 13 elements deployed on board the ISS's U.S. segment in the flight 4R assembly level. The preflight service life prediction of 1 yr for the BFEs is based upon engineering analysis of data collected during developmental testing that used a synthetic dust challenge. While this challenge is considered reasonable and conservative from a design perspective, an understanding of the actual filter loading is required to best manage the critical ISS program resources. Testing was conducted on BFEs returned from the ISS to refine the service life prediction. Results from this testing and implications to ISS resource management are provided.

  2. Accounting for ecosystem services in life cycle assessment, Part I: a critical review.

    PubMed

    Zhang, Yi; Singh, Shweta; Bakshi, Bhavik R

    2010-04-01

    If life cycle oriented methods are to encourage sustainable development, they must account for the role of ecosystem goods and services, since these form the basis of planetary activities and human well-being. This article reviews methods that are relevant to accounting for the role of nature and that could be integrated into life cycle oriented approaches. These include methods developed by ecologists for quantifying ecosystem services, by ecological economists for monetary valuation, and life cycle methods such as conventional life cycle assessment, thermodynamic methods for resource accounting such as exergy and emergy analysis, variations of the ecological footprint approach, and human appropriation of net primary productivity. Each approach has its strengths: economic methods are able to quantify the value of cultural services; LCA considers emissions and assesses their impact; emergy accounts for supporting services in terms of cumulative exergy; and ecological footprint is intuitively appealing and considers biocapacity. However, no method is able to consider all the ecosystem services, often due to the desire to aggregate all resources in terms of a single unit. This review shows that comprehensive accounting for ecosystem services in LCA requires greater integration among existing methods, hierarchical schemes for interpreting results via multiple levels of aggregation, and greater understanding of the role of ecosystems in supporting human activities. These present many research opportunities that must be addressed to meet the challenges of sustainability.

  3. International Space Station Environmental Control and Life Support System Status for the Prior Year: 2010-2011

    NASA Technical Reports Server (NTRS)

    Williams, David E.; Dake, Jason R.; Gentry, Gregory J.

    2012-01-01

    The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the prior year, covering the period of time between March 2010 and February 2011. The ISS continued permanent crew operations including the continuation of six crew members being on ISS. Work continues on the last of the Phase 3 pressurized elements, the commercial cargo resupply vehicles, and work to try and extend ISS service life from 2015 to no later than 2028.

  4. International Space Station Environmental Control and Life Support System Status for the Prior Year: 2010 - 2011

    NASA Technical Reports Server (NTRS)

    Williams, David E.; Dake, Jason R.; Gentry, Gregory J.

    2011-01-01

    The International Space Station (ISS) Environmental Control and Life Support (ECLS) system includes regenerative and non-regenerative technologies that provide the basic life support functions to support the crew, while maintaining a safe and habitable shirtsleeve environment. This paper provides a summary of the U.S. ECLS system activities over the past year, covering the period of time between March 2010 and February 2011. The ISS continued permanent crew operations including the continuation of six crew members being on ISS. Work continues on the last of the Phase 3 pressurized elements, the commercial cargo resupply vehicles, and work to try and extend ISS service life from 2015 to no later than 2028.

  5. BioCatalogue: a universal catalogue of web services for the life sciences

    PubMed Central

    Bhagat, Jiten; Tanoh, Franck; Nzuobontane, Eric; Laurent, Thomas; Orlowski, Jerzy; Roos, Marco; Wolstencroft, Katy; Aleksejevs, Sergejs; Stevens, Robert; Pettifer, Steve; Lopez, Rodrigo; Goble, Carole A.

    2010-01-01

    The use of Web Services to enable programmatic access to on-line bioinformatics is becoming increasingly important in the Life Sciences. However, their number, distribution and the variable quality of their documentation can make their discovery and subsequent use difficult. A Web Services registry with information on available services will help to bring together service providers and their users. The BioCatalogue (http://www.biocatalogue.org/) provides a common interface for registering, browsing and annotating Web Services to the Life Science community. Services in the BioCatalogue can be described and searched in multiple ways based upon their technical types, bioinformatics categories, user tags, service providers or data inputs and outputs. They are also subject to constant monitoring, allowing the identification of service problems and changes and the filtering-out of unavailable or unreliable resources. The system is accessible via a human-readable ‘Web 2.0’-style interface and a programmatic Web Service interface. The BioCatalogue follows a community approach in which all services can be registered, browsed and incrementally documented with annotations by any member of the scientific community. PMID:20484378

  6. Caregivers’ Quality of Life and Quality of Services for Children with Cancer: A Review from Iran

    PubMed Central

    Sajjadi, Homeira; Vameghi, Meroe; Ghazinour, Mehdi; KhodaeiArdakani, Mohammadreza

    2013-01-01

    Objective: Caregivers of cancer patients are exposed to different types of psychosocial stress which influence their quality of life. The purposes of this study were to assess quality of life in caregivers of children with cancer and to investigate the relationship between the caregivers’ quality of life and quality of services in the social work section. Method: 125 caregivers were recruited. Quality of life was measured by the Iranian version of the WHOQOL-BREF questionnaire and data concerning service quality were obtained from the Iranian version of the SERVQUAL questionnaire. Findings: Scores in physical health, psychological status and environmental conditions for caregivers of children with cancer were significantly lower than the general population. There was a negative correlation between the tangible domain of SERVQUAL and the psychological status and environmental conditions of quality of life. The tangible dimension was the only aspect of service quality to predict caregivers’ quality of life regarding psychological status and environmental conditions. Conclusion: Caregivers of children with a disease are care consumers and, like all consumers, they expect good service. Delivering high quality services consistently is difficult but profitable for a service organization. In other words, trying to deliver more appropriate services than patients expect to receive from their social work care is one of the most reliable ways to promote caregivers’ satisfaction and quality of life. PMID:23618487

  7. Caregivers' quality of life and quality of services for children with cancer: a review from iran.

    PubMed

    Sajjadi, Homeira; Vameghi, Meroe; Ghazinour, Mehdi; Khodaeiardekani, Mohammadreza

    2013-03-04

    Caregivers of cancer patients are exposed to different types of psychosocial stress which influence their quality of life. The purposes of this study were to assess quality of life in caregivers of children with cancer and to investigate the relationship between the caregivers' quality of life and quality of services in the social work section. 125 caregivers were recruited. Quality of life was measured by the Iranian version of the WHOQOL-BREF questionnaire and data concerning service quality were obtained from the Iranian version of the SERVQUAL questionnaire. Scores in physical health, psychological status and environmental conditions for caregivers of children with cancer were significantly lower than the general population. There was a negative correlation between the tangible domain of SERVQUAL and the psychological status and environmental conditions of quality of life. The tangible dimension was the only aspect of service quality to predict caregivers' quality of life regarding psychological status and environmental conditions. Caregivers of children with a disease are care consumers and, like all consumers, they expect good service. Delivering high quality services consistently is difficult but profitable for a service organization. In other words, trying to deliver more appropriate services than patients expect to receive from their social work care is one of the most reliable ways to promote caregivers' satisfaction and quality of life.

  8. Perceptions of Pre-Service Teachers on Student Burnout, Occupational Anxiety and Faculty Life Quality

    ERIC Educational Resources Information Center

    Türkoglu, Muhammet Emin; Cansoy, Ramazan

    2017-01-01

    Perceptions of pre-service teachers on burnout, occupational anxiety and faculty life quality were investigated in this research. The research group consisted of 461 pre-service teachers in total studying at Afyon Kocatepe University faculty of education. "Maslach Burnout Inventory-Student Form," "Faculty Life Quality Scale"…

  9. Estimating quality-adjusted life-year loss due to noncommunicable diseases in Korean adults through to the year 2040.

    PubMed

    Ock, Minsu; Han, Jung Won; Lee, Jin Yong; Kim, Seon-Ha; Jo, Min-Woo

    2015-01-01

    To estimate the loss in quality-adjusted life-years (QALYs) in Korean adults due to 13 noncommunicable diseases (NCDs) in 2010 and predict changes in QALY loss through to the year 2040. Thirteen NCDs (hypertension, diabetes mellitus, hyperlipidemia, stroke, myocardial infarction, angina, arthritis, osteoporosis, asthma, allergic rhinitis, atopic dermatitis, cataract, and depression) were selected from the Korean Community Health Survey 2010. The EuroQol five-dimensional questionnaire index from the Korean Community Health Survey 2010 and the Korean valuation set were used to estimate utility weights according to sex, age, and disease. Morbidity data were also obtained from the Korean Community Health Survey 2010. Mortality data according to disease and life expectancy were retrieved from the Korean Statistical Information Service. To predict future QALY loss, future population projection data from the Korean Statistical Information Service were used as substitutes for 2010 population size. Among the assessed 13 NCDs, the largest total QALY loss was for hypertension (513,113 QALYs; units are omitted hereafter), followed by arthritis (509,317) and stroke (431,049). The largest QALY loss due to mortality was stroke (306,733), whereas the largest QALY loss due to morbidity was arthritis (502,513). By applying the middle estimate of future population, the largest increase in total QALY loss between 2010 and 2040 was for hypertension (840,582), followed by stroke (719,076) and diabetes mellitus (474,607). Hypertension, arthritis, and stroke are important in terms of total QALY loss, which will continuous to increase because of aging. These results could be used to develop cost-effective interventions that reduce the burden of NCDs. Copyright © 2015. Published by Elsevier Inc.

  10. Method and apparatus to predict the remaining service life of an operating system

    DOEpatents

    Greitzer, Frank L.; Kangas, Lars J.; Terrones, Kristine M.; Maynard, Melody A.; Pawlowski, Ronald A. , Ferryman; Thomas A.; Skorpik, James R.; Wilson, Bary W.

    2008-11-25

    A method and computer-based apparatus for monitoring the degradation of, predicting the remaining service life of, and/or planning maintenance for, an operating system are disclosed. Diagnostic information on degradation of the operating system is obtained through measurement of one or more performance characteristics by one or more sensors onboard and/or proximate the operating system. Though not required, it is preferred that the sensor data are validated to improve the accuracy and reliability of the service life predictions. The condition or degree of degradation of the operating system is presented to a user by way of one or more calculated, numeric degradation figures of merit that are trended against one or more independent variables using one or more mathematical techniques. Furthermore, more than one trendline and uncertainty interval may be generated for a given degradation figure of merit/independent variable data set. The trendline(s) and uncertainty interval(s) are subsequently compared to one or more degradation figure of merit thresholds to predict the remaining service life of the operating system. The present invention enables multiple mathematical approaches in determining which trendline(s) to use to provide the best estimate of the remaining service life.

  11. Disability during the Last Two Years of Life

    PubMed Central

    Smith, Alexander K.; Walter, Louise C.; Miao, Yinghui; Boscardin, W. John; Covinsky, Kenneth E.

    2013-01-01

    Importance While many persons at advanced ages live independently and are free of disability, we know little about how likely older people are to be disabled in the basic activities of daily that are necessary for independent living as they enter the last years of life. Objective To determine national estimates of disability during the last two years of life. Design Prospective cohort study. Setting A nationally representative study of older adults Participants Participants ages 50+ who died in the Health and Retirement Study between 1995 and 2010. Each participant was interviewed once at a varying time point in the last 24 months of life. We used these interviews to calculate national estimates of the prevalence of disability across the two years prior to death. We modeled the prevalence of disability in the two years prior to death for groups defined by age at death and gender. Main Outcome Measure Disability was defined as need for help with one of following activities of daily living: dressing, bathing, eating, transferring, walking across the room, and toileting. Results There were 8,232 decedents (mean age at death 79, 52% women). The prevalence of disability rose from 28% (95% CI, 24-31%) 2 years before death to 56% (52-60%) in the last month of life. Those who died at the oldest ages were much more likely to have disability 2 years before death (ages 50-69, 15%; 70-79, 21%; 80-89, 31%; 90+, 50%; p for trend <.0001). Disability was more common in women 2 years before death (32%, 28-36%) then men (21%, 18-24%,p<.0001), even after adjustment for higher age at death. Conclusions Those who live to an older age are likely to be disabled, and thus in need of caregiving assistance, many months or years prior to death. Women have a substantially longer period of end-of-life disability than men. PMID:23836120

  12. Edinburgh Emergency Asthma Admission Service: report on 10 years' experience.

    PubMed Central

    Crompton, G K; Grant, I W; Bloomfield, P

    1979-01-01

    In December 1968 an emergency service was begun in Edinburgh to expedite admission to hospital of patients with severe acute asthma. During the first 10 years requests were made to admit 112 patients to a respiratory unit with provision for intensive care on 360 occasions. Four of the patients died of their disease, one in hospital and three before admission. It was thought that the death rate would have been much higher had conventional admission procedures been observed. Owing to ethical objections to a controlled trial it was not possible to obtain substantive proof that the service reduced deaths from asthma. Nevertheless, there was strong circumstantial evidence that organised facilities for the immediate admission to hospital of patients with a history of life-threatening attacks would result in fewer deaths at home. Earlier admission also apparently reduced hospital mortality and the number of patients requiring tracheal intubation and mechanical ventilation. It is concluded that there is a prima facie case for an emergency asthma admission serivce similar to that operating in Edinburgh to be established in all cities and large towns. PMID:519358

  13. Children's Services Today.

    ERIC Educational Resources Information Center

    Simon, Mary Manz

    1988-01-01

    Examines the implications for children's library services of changes in family life and structure over the past 10 years. Library clientele, materials, hours, location, interior design, and services offered are discussed. (MES)

  14. 78 FR 7858 - Publication of Fiscal Year 2012 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... DEPARTMENT OF THE TREASURY Publication of Fiscal Year 2012 Service Contract Inventory AGENCY: Departmental Offices, Treasury. ACTION: Notice of publication of Fiscal Year 2012 Service Contract Inventory... Fiscal Year (FY) 2012 Service Contract Inventory. The Inventory lists all service contract actions over...

  15. Service life assessment of timber highway bridges in USA climate zones

    Treesearch

    James P. Wacker; Brian K. Brashaw; Thomas G. Williamson; P. David Jones; Matthew S. Smith; Travis K. Hosteng; David L. Strahl; Lola E. Coombe; V.J. Gopu

    2014-01-01

    As engineers begin to estimate life-cycle costs and sustainable design approaches for timber bridges, there is a need for more reliable data about their durability and expected service life. This paper summarizes a comprehensive effort to assess the current condition of more than one hundred timber highway bridge superstructures throughout the United States. This...

  16. A Life Events Scale for Armed Forces personnel

    PubMed Central

    Chaudhury, Suprakash; Srivastava, Kalpana; Raju, M.S.V. Kama; Salujha, S.K.

    2006-01-01

    Background: Armed Forces personnel are routinely exposed to a number of unique stressful life events. None of the available scales are relevant to service personnel. Aim: To construct a scale to measure life events in service personnel. Methods: In the first stage of the study open-ended questions along with items generated by the expert group by consensus method were administered to 50 soldiers. During the second stage a scale comprising 59 items and open-ended questions was administered to 165 service personnel. The final scale of 52 items was administered to 200 service personnel in group setting. Weightage was assigned on a 0 to 100 range. For normative study the Armed Forces Medical College Life Events Scale (AFMC LES) was administered to 1200 Army, 100 Air Force and 100 Navy personnel. Results: Service personnel experience an average of 4 life events in past one year and 13 events in a life-time. On an average service personnel experience 115 life change unit scores in past one year and 577 life change unit scores in life-time on the AFMC LES. The scale has concurrent validity when compared with the Presumptive Stressful Life Events Scale (PSLES). There is internal consistency in the scale with the routine items being rated very low. There is a pattern of uniformity with the civilian counterparts along with differences in the items specific to service personnel. Conclusions: The AFMC LES includes the unique stresses of service personnel that are not included in any life events scale available in India or in the west and should be used to assess stressful life events in service personnel. PMID:20844647

  17. Impact of Child Life Services on Children and Families Admitted to Start the Ketogenic Diet.

    PubMed

    Kossoff, Eric H; Sutter, Lindsay; Doerrer, Sarah C; Haney, Courtney A; Turner, Zahava

    2017-08-01

    Traditionally the ketogenic diet is started as an inpatient admission to the hospital. Starting in January 2015, child life services were made formally available during ketogenic diet admissions to help families cope. One-page surveys were then provided to 15 parents on the day of discharge and again after 3 months. Every family believed that the child life services were helpful. Children who were developmentally appropriate/mildly delayed had higher parent-reported anxiety scores than those who were moderate to severely delayed (4.4 vs 1.0, P = .02). At 3 months, child life services were deemed very helpful for the parents (mean score: 8.9, range: 5-10), and were more helpful for the parent than the child (mean 6.2, range 1-10, P = .047). One of the most helpful services was a prior phone call to parents 1 week prior. In this small pilot study, child life involvement during the start of the ketogenic diet was highly useful.

  18. Measuring Service-Mindedness and Its Relationship with Spirituality and Life Satisfaction

    ERIC Educational Resources Information Center

    Pashak, Travis J.; Laughter, Tim C.

    2012-01-01

    A self-report measure of service-mindedness was designed in order to fill in a gap in the literature and evaluate a potential link between spirituality and satisfaction with life. A sample of 133 undergraduate students at a Catholic university in the Mid-west completed the Service-Mindedness Scale (SMS), along with the Spiritual Involvement and…

  19. 34 CFR 300.106 - Extended school year services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... services means special education and related services that— (1) Are provided to a child with a disability... 34 Education 2 2010-07-01 2010-07-01 false Extended school year services. 300.106 Section 300.106 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION...

  20. Endotoxin Exposure and Eczema in the First Year of Life

    PubMed Central

    Phipatanakul, Wanda; Celedón, Juan C.; Raby, Benjamin A.; Litonjua, Augusto A.; Milton, Donald K.; Sredl, Diane; Weiss, Scott T.; Gold, Diane R.

    2005-01-01

    Objective Exposure to endotoxin in early life has been proposed as a factor that may protect against the development of allergic diseases such as eczema. The objective of this study was to examine the relation between endotoxin exposure in early life and eczema in the first year of life in children with parental history of asthma or allergies. Methods This study used a prospective birth cohort study of 498 children who had a history of allergy or asthma in at least 1 parent and lived in metropolitan Boston. A subset of 401 living rooms had house dust samples adequate for analysis of endotoxin. Results In multivariate analyses adjusting for gender, income, and season of birth, endotoxin levels in the living room at 2 to 3 months of age was inversely associated with physician- or nurse-diagnosed eczema in the first year of life (odds ratio [OR] for each quartile increment: 0.76; 95% confidence interval [CI]: 0.61–0.96). Exposure to a dog in the home at age 2 to 3 months was also inversely associated with eczema in the first year of life, but the CI widened when endotoxin was included in the multivariate model (OR: 0.54; 95% CI: 0.27–1.09). Other variables associated with eczema in the first year of life included paternal history of eczema (OR: 1.91; 95% CI: 1.03–3.55) and maternal specific immunoglobulin E positivity to ≥1 allergen (OR: 1.61; 95% CI: 1.01–2.56). Conclusions Among children with parental history of asthma or allergies, exposure to high levels of endotoxin in early life may be protective against eczema in the first year of life. In these children, paternal history of eczema and maternal sensitization to at least 1 allergen are associated with an increased risk of eczema in the first year of life. PMID:15231902

  1. Design and analysis of seals for extended service life

    NASA Technical Reports Server (NTRS)

    Bower, Mark V.

    1992-01-01

    Space Station Freedom is being developed for a service life of up to thirty years. As a consequence, the design requirements for the seals to be used are unprecedented. Full scale testing to assure the selected seals can satisfy the design requirements are not feasible. As an alternative, a sub-scale test program has been developed by MSFC to calibrate the analysis tools to be used to certify the proposed design. This research has been conducted in support of the MSFC Integrated Seal Test Program. The ultimate objective of this research is to correlate analysis and test results to qualify the analytical tools, which in turn, are to be used to qualify the flight hardware. This research is totally focused on O-rings that are compressed by perpendicular clamping forces. In this type of seal the O-ring is clamped between the sealing surfaces by loads perpendicular to the circular cross section.

  2. Integrating the life course into MCH service delivery: from theory to practice.

    PubMed

    Brady, Carol; Johnson, Faye

    2014-02-01

    To describe the efforts of a community-based maternal and child health coalition to integrate the life course into its planning and programs, as well as implementation challenges and results of these activities. Jacksonville-Duval County has historically had infant mortality rates that are significantly higher than state and national rates, particularly among its African American population. In an effort to address this disparity, the Northeast Florida Healthy Start Coalition embraced the life course approach as a model. This model was adopted as a framework for (1) community needs assessment and planning; (2) delivery of direct services, including case management, education and support in the Magnolia Project, its federal Healthy Start program; (3) development of community collaborations, education and awareness; and, (4) advocacy and grass roots leadership development. Implementation experience as well as challenges in transforming traditional approaches to delivering maternal and child health services are described. Operationalizing the life course approach required the Coalition to think differently about risks, levels of intervention and the way services are organized and delivered. The organization set the stage by using the life course as a framework for its required local planning and needs assessments. Based on these assessments, the content of case management and other key services provided by our federal Healthy Start program was modified to address not only health behaviors but also underlying social determinants and community factors. Individual interventions were augmented with group activities to build interdependence among participants, increasing social capital. More meaningful inter-agency collaboration that moved beyond the usual referral relationships were developed to better address participants' needs. And finally, strategies to cultivate participant advocacy and community leadership skills, were implemented to promote social change at the

  3. Effect of home care service on the quality of life in patients with gynecological cancer.

    PubMed

    Aktas, Demet; Terzioglu, Fusun

    2015-01-01

    The purpose of the research was to determine the effect of home care service on the quality of life in patients with gynecological cancer. This randomized case control study was carried out in a womans hospital between September 2011 and February 2012. Women undergoing gynecological cancer treatment were separated into intervention and control groups, of 35 patients each. The intervention group was provided with nursing care service through hospital and home visits (1st, 12th weeks) within the framework of a specifically developed nursing care plan. The control group was monitored without any intervention through the hospital routine protocols (1st, 12th weeks). Data were collected using An Interview Form, Home Visit Monitoring Form and Quality of Life Scale/Cancer Survivors. Effects of home care service on the quality of life in gynecological cancer patients were investigated using chi-square tests, McNemar's test, independent t-test and ANOVA. This study found that the intervention group receiving home care service had a moderately high quality of life (average mean: 6.01±0.64), while the control group had comparatively lower quality (average mean: 4.35±0.79) within the 12 week post- discharge period (p<0.05). This study found home care services to be efficient in improving the quality of life in patients with gynecological cancer.

  4. Rolling-Bearing Service Life Based on Probable Cause for Removal: A Tutorial

    NASA Technical Reports Server (NTRS)

    Zaretsky, Erwin V.; Branzai, Emanuel V.

    2017-01-01

    In 1947 and 1952, Gustaf Lundberg and Arvid Palmgren developed what is now referred to as the Lundberg-Palmgren Model for Rolling Bearing Life Prediction based on classical rolling-element fatigue. Today, bearing fatigue probably accounts for less than 5 percent of bearings removed from service for cause. A bearing service life prediction methodology and tutorial indexed to eight probable causes for bearing removal, including fatigue, are presented, which incorporate strict series reliability; Weibull statistical analysis; available published field data from the Naval Air Rework Facility; and 224,000 rolling-element bearings removed for rework from commercial aircraft engines.

  5. The relationship between childhood poverty, military service, and later life depression among men: Evidence from the Health and Retirement Study

    PubMed Central

    Bareis, Natalie; Mezuk, Briana

    2017-01-01

    Background Childhood poverty has been associated with depression in adulthood, but whether this relationship extends to later life major depression (MD) or is modified by military service is unclear. Methods Data come from the Health and Retirement Study (HRS) 2010 wave, a longitudinal, nationally representative study of older adults. Men with data on military service and childhood poverty were included (N = 6330). Childhood poverty was assessed by four indicators (i.e., parental unemployment, residential instability) experienced before age 16. Military service was categorized as veteran versus civilian, and during draft versus all-volunteer (after 1973) eras. Past year MD was defined by the Composite International Diagnostic Inventory. Results Four in ten men ever served, with 13.7% in the all-volunteer military. Approximately 12% of civilians, 8% draft era and 24% all-volunteer era veterans had MD. Childhood poverty was associated with higher odds of MD (Odds Ratio (OR): 2.38, 95% Confidence Interval (CI): 1.32–4.32) and higher odds of military service (OR: 2.58, 95% CI: 1.58–4.21). Military service was marginally associated with MD (OR: 1.28, 95% CI: 0.98–1.68) and did not moderate the association between childhood poverty and MD. Limitations Self-report data is subject to recall bias. The HRS did not assess childhood physical and emotional abuse, or military combat exposure. Conclusions Men raised in poverty had greater odds of draft and all-volunteer military service. Early-life experiences, independent of military service, appear associated with greater odds of MD. Assessing childhood poverty in service members may identify risk for depression in later life. PMID:27455351

  6. The relationship between childhood poverty, military service, and later life depression among men: Evidence from the Health and Retirement Study.

    PubMed

    Bareis, Natalie; Mezuk, Briana

    2016-12-01

    Childhood poverty has been associated with depression in adulthood, but whether this relationship extends to later life major depression (MD) or is modified by military service is unclear. Data come from the Health and Retirement Study (HRS) 2010 wave, a longitudinal, nationally representative study of older adults. Men with data on military service and childhood poverty were included (N=6330). Childhood poverty was assessed by four indicators (i.e., parental unemployment, residential instability) experienced before age 16. Military service was categorized as veteran versus civilian, and during draft versus all-volunteer (after 1973) eras. Past year MD was defined by the Composite International Diagnostic Inventory. Four in ten men ever served, with 13.7% in the all-volunteer military. Approximately 12% of civilians, 8% draft era and 24% all-volunteer era veterans had MD. Childhood poverty was associated with higher odds of MD (Odds Ratio (OR): 2.38, 95% Confidence Interval (CI): 1.32-4.32) and higher odds of military service (OR: 2.58, 95% CI: 1.58-4.21). Military service was marginally associated with MD (OR: 1.28, 95% CI: 0.98-1.68) and did not moderate the association between childhood poverty and MD. Self-report data is subject to recall bias. The HRS did not assess childhood physical and emotional abuse, or military combat exposure. Men raised in poverty had greater odds of draft and all-volunteer military service. Early-life experiences, independent of military service, appear associated with greater odds of MD. Assessing childhood poverty in service members may identify risk for depression in later life. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. A snapshot of 3649 Web-based services published between 1994 and 2017 shows a decrease in availability after 2 years.

    PubMed

    Osz, Ágnes; Pongor, Lorinc Sándor; Szirmai, Danuta; Gyorffy, Balázs

    2017-12-08

    The long-term availability of online Web services is of utmost importance to ensure reproducibility of analytical results. However, because of lack of maintenance following acceptance, many servers become unavailable after a short period of time. Our aim was to monitor the accessibility and the decay rate of published Web services as well as to determine the factors underlying trends changes. We searched PubMed to identify publications containing Web server-related terms published between 1994 and 2017. Automatic and manual screening was used to check the status of each Web service. Kruskall-Wallis, Mann-Whitney and Chi-square tests were used to evaluate various parameters, including availability, accessibility, platform, origin of authors, citation, journal impact factor and publication year. We identified 3649 publications in 375 journals of which 2522 (69%) were currently active. Over 95% of sites were running in the first 2 years, but this rate dropped to 84% in the third year and gradually sank afterwards (P < 1e-16). The mean half-life of Web services is 10.39 years. Working Web services were published in journals with higher impact factors (P = 4.8e-04). Services published before the year 2000 received minimal attention. The citation of offline services was less than for those online (P = 0.022). The majority of Web services provide analytical tools, and the proportion of databases is slowly decreasing. Conclusions. Almost one-third of Web services published to date went out of service. We recommend continued support of Web-based services to increase the reproducibility of published results. © The Author 2017. Published by Oxford University Press.

  8. Socioeconomic status and morbidity in the last years of life.

    PubMed Central

    Liao, Y; McGee, D L; Kaufman, J S; Cao, G; Cooper, R S

    1999-01-01

    OBJECTIVES: This study evaluated the effect of socioeconomic status, as characterized by level of education, on morbidity and disability in the last years of life. METHODS: The analysis used data from the National Health Interview Survey (1986-1990), with mortality follow-up through December 1991. RESULTS: Among 10,932 decedents 50 years or older at baseline interview, educational attainment was inversely associated with long-term limitation of activity, number of chronic conditions, number of bed days, and days of short hospital stay during the year preceding the interview. CONCLUSIONS: Decedents with higher socioeconomic status experienced lower morbidity and disability and better quality of life even in their last years of life. PMID:10191805

  9. Automobile Mechanic Second Year: Service and Repair. Student's Guide.

    ERIC Educational Resources Information Center

    Notgrass, Troy

    This student manual on auto service and repair is intended for second-year students in industrial cooperative training who have studied "Automobile Mechanic Fundamentals" during the first year. Based on "Auto Service and Repair," by Martin W. Stockel, this manual is designed for individualized instruction under supervision of a…

  10. [My Kumamoto life of 19 years].

    PubMed

    Okabe, Hiroaki

    2005-12-01

    In this paper titled "My Kumamoto Life of 19 Years; The Travel for Times", the memorial lecture on my retirement from Kumamoto National University Corporation Integrated Medical and Pharmaceutical Sciences, Department of Biomedical Informatics (Chairman) is summarized. As they say "Time flies", time extends from seconds to years. The lecture includes a summary of my short term research and long term studies, such as age-dependant and gene-related changes in ageing over 5 or more years in the healthy elderly. Short-term study mostly involved of newly evaluated assay methods for important substances such as the second level in the cell life span in the variation of lipid metabolite of cardiovascular diseases based on atherosclerosis, Alzheimer disease, and their evaluation by homogeneous assay of HDL-C, LDL-C, enzymatic assay for choline relating metabolites, and lipoperoxide as the results of free radical reactions. The intermediate-term studies were mainly on the development of total laboratory automation (TLA) for the management of the laboratory of the university hospital. The hospital has various degrees of sophistication in its laboratory services. Technicians were allowed to transport specimens immediately by using an air-shooter system after drawing blood, from the emergency room to the central laboratory. Routine specimens could be measured within 30 min and the results could be automatically sent to the physician's office. It greatly minimized reporting errors, decreased the exposure to biohazards, reduced labor expense, improved operation efficiency, and shortened turnaround time. Moreover, for the outpatients and emergency laboratories, we constructed a robotic measuring system which was assembled into a sequential method for the analysis of chemistry, hematology and urinalysis specimens by using a polyarticular robot. The robot arm extends to a bar-coded tube, picking up and placing test tubes on a turn table of autoanalyzers for analysis without

  11. A novel test method to determine the filter material service life of decentralized systems treating runoff from traffic areas.

    PubMed

    Huber, Maximilian; Welker, Antje; Dierschke, Martina; Drewes, Jörg E; Helmreich, Brigitte

    2016-09-01

    In recent years, there has been a significant increase in the development and application of technical decentralized filter systems for the treatment of runoff from traffic areas. However, there are still many uncertainties regarding the service life and the performance of filter materials that are employed in decentralized treatment systems. These filter media are designed to prevent the transport of pollutants into the environment. A novel pilot-scale test method was developed to determine - within a few days - the service lives and long-term removal efficiencies for dissolved heavy metals in stormwater treatment systems. The proposed method consists of several steps including preloading the filter media in a pilot-scale model with copper and zinc by a load of n-1 years of the estimated service life (n). Subsequently, three representative rain events are simulated to evaluate the long-term performance by dissolved copper and zinc during the last year of application. The presented results, which verified the applicability of this method, were obtained for three filter channel systems and six filter shaft systems. The performance of the evaluated systems varied largely for both tested heavy metals and during all three simulated rain events. A validation of the pilot-scale assessment method with field measurements was also performed for two systems. Findings of this study suggest that this novel method does provide a standardized and accurate estimation of service intervals of decentralized treatment systems employing various filter materials. The method also provides regulatory authorities, designers, and operators with an objective basis for performance assessment and supports stormwater managers to make decisions for the installation of such decentralized treatment systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Associated and mediating variables related to quality of life among service users with mental disorders.

    PubMed

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

    2018-02-01

    This study aimed to identify variables associated with quality of life (QoL) and mediating variables among 338 service users with mental disorders in Quebec (Canada). Data were collected using nine standardized questionnaires and participant medical records. Quality of life was assessed with the Satisfaction with Life Domains Scale. Independent variables were organized into a six-block conceptual framework. Using structural equation modeling, associated and mediating variables related to QoL were identified. Lower seriousness of needs was the strongest variable associated with QoL, followed by recovery, greater service continuity, gender (male), adequacy of help received, not living alone, absence of substance use or mood disorders, and higher functional status, in that order. Recovery was the single mediating variable linking lower seriousness of needs, higher service continuity, and reduced alcohol use with QoL. Findings suggest that greater service continuity creates favorable conditions for recovery, reducing seriousness of needs and increasing QoL among service users. Lack of recovery-oriented services may affect QoL among alcohol users, as substance use disorders were associated directly and negatively with QoL. Decision makers and mental health professionals should promote service continuity, and closer collaboration between primary care and specialized services, while supporting recovery-oriented services that encourage service user involvement in their treatment and follow-up. Community-based organizations should aim to reduce the seriousness of needs particularly for female service users and those living alone.

  13. Managing the equipment service life in rendering engineering support to NPP operation

    NASA Astrophysics Data System (ADS)

    Ryasnyy, S. I.

    2015-05-01

    Apart from subjecting metal to nondestructive testing and determining its actual state, which are the traditional methods used for managing the service life of NPP equipment during its operation, other approaches closely linked with rendering engineering support to NPP operation have emerged in recent decades, which, however, have been covered in publications to a lesser extent. Service life management matters occupy the central place in the structure of engineering support measures. Application of the concept of repairing NPP equipment based on assessing its technical state and the risk of its failure makes it possible to achieve significantly smaller costs for maintenance and repairs and produce a larger amount of electricity due to shorter planned outages. Decreasing the occurrence probability of a process-related abnormality through its prediction is a further development of techniques for monitoring the technical state of equipment and systems. The proposed and implemented procedure for predicting the occurrence of process-related deviations from normal NPP operation opens the possibility to record in the online mode the trends in changes of process parameters that are likely to lead to malfunctions in equipment operation and to reduce the probability of power unit unloading when an abnormal technical state of equipment occurs and develops by recording changes in the state at an early stage and taking timely corrective measures. The article presents the structure of interconnections between the objectives and conditions of adjustment and commissioning tests, in which the management of equipment service life (saving and optimizing the service life) occupies the central place. Special attention is paid to differences in resource saving and optimization measures.

  14. Older people and falls: health status, quality of life, lifestyle, care networks, prevention and views on service use following a recent fall.

    PubMed

    Roe, Brenda; Howell, Fiona; Riniotis, Konstantinos; Beech, Roger; Crome, Peter; Ong, Bie Nio

    2009-08-01

    This study has investigated older people's experiences of a recent fall, its impact on their health, lifestyle, quality of life, care networks, prevention and their views on service use. Falls are common in older people and prevalence increases with age. Falls prevention is a major policy and service initiative. An exploratory, qualitative design involving two time points. A convenience sample of 27 older people from two primary care trusts who had a recent fall. Taped semi structured qualitative interviews were conducted and repeated at follow up to detect change over time and repeat falls. Data were collected on their experience of falls, health, activities of living, lifestyle, quality of life, use of services, prevention of falls, informal care and social networks. Content analysis of transcribed interviews identified key themes. The majority of people fell indoors (n = 23), were repeat fallers (n = 22) with more than half alone when they fell (n = 15). For five people it was their first ever fall. Participants in primary care trust 1 had a higher mean age than those in primary care trust 2 and had more injurious falls (n = 12, mean age 87 years vs. n = 15, mean age 81 years). The majority of non-injurious falls went unreported to formal services. Falls can result in a decline in health status, ability to undertake activities of living, lifestyle and quality of life. Local informal care and support networks are as important as formal care for older people at risk of falls or who have fallen. Access to falls prevention programmes and services is limited for people living in more rural communities. Falls prevention initiatives and services should work with local communities, agencies and informal carers to ensure equitable access and provision of information, resources and care to meet the needs of older people at risk or who have fallen.

  15. Using Survival Analysis to Improve Estimates of Life Year Gains in Policy Evaluations.

    PubMed

    Meacock, Rachel; Sutton, Matt; Kristensen, Søren Rud; Harrison, Mark

    2017-05-01

    Policy evaluations taking a lifetime horizon have converted estimated changes in short-term mortality to expected life year gains using general population life expectancy. However, the life expectancy of the affected patients may differ from the general population. In trials, survival models are commonly used to extrapolate life year gains. The objective was to demonstrate the feasibility and materiality of using parametric survival models to extrapolate future survival in health care policy evaluations. We used our previous cost-effectiveness analysis of a pay-for-performance program as a motivating example. We first used the cohort of patients admitted prior to the program to compare 3 methods for estimating remaining life expectancy. We then used a difference-in-differences framework to estimate the life year gains associated with the program using general population life expectancy and survival models. Patient-level data from Hospital Episode Statistics was utilized for patients admitted to hospitals in England for pneumonia between 1 April 2007 and 31 March 2008 and between 1 April 2009 and 31 March 2010, and linked to death records for the period from 1 April 2007 to 31 March 2011. In our cohort of patients, using parametric survival models rather than general population life expectancy figures reduced the estimated mean life years remaining by 30% (9.19 v. 13.15 years, respectively). However, the estimated mean life year gains associated with the program are larger using survival models (0.380 years) compared to using general population life expectancy (0.154 years). Using general population life expectancy to estimate the impact of health care policies can overestimate life expectancy but underestimate the impact of policies on life year gains. Using a longer follow-up period improved the accuracy of estimated survival and program impact considerably.

  16. Mammoth Cave National Park : Green River ferry service life analysis

    DOT National Transportation Integrated Search

    2015-11-09

    The purpose of this study is to assess whether Mammoth Cave National Park should rehabilitate the existing Green River ferry to extend its service life or replace it with a new vessel. The ferry is used to transport cars and light duty equipment acro...

  17. Collaborative Science Learning in Three-Dimensional Immersive Virtual Worlds: Pre-Service Teachers' Experiences in Second Life

    ERIC Educational Resources Information Center

    Nussli, Natalie; Oh, Kevin; McCandless, Kevin

    2014-01-01

    The purpose of this mixed methods study was to help pre-service teachers experience and evaluate the potential of Second Life, a three-dimensional immersive virtual environment, for potential integration into their future teaching. By completing collaborative assignments in Second Life, nineteen pre-service general education teachers explored an…

  18. mORCA: ubiquitous access to life science web services.

    PubMed

    Diaz-Del-Pino, Sergio; Trelles, Oswaldo; Falgueras, Juan

    2018-01-16

    Technical advances in mobile devices such as smartphones and tablets have produced an extraordinary increase in their use around the world and have become part of our daily lives. The possibility of carrying these devices in a pocket, particularly mobile phones, has enabled ubiquitous access to Internet resources. Furthermore, in the life sciences world there has been a vast proliferation of data types and services that finish as Web Services. This suggests the need for research into mobile clients to deal with life sciences applications for effective usage and exploitation. Analysing the current features in existing bioinformatics applications managing Web Services, we have devised, implemented, and deployed an easy-to-use web-based lightweight mobile client. This client is able to browse, select, compose parameters, invoke, and monitor the execution of Web Services stored in catalogues or central repositories. The client is also able to deal with huge amounts of data between external storage mounts. In addition, we also present a validation use case, which illustrates the usage of the application while executing, monitoring, and exploring the results of a registered workflow. The software its available in the Apple Store and Android Market and the source code is publicly available in Github. Mobile devices are becoming increasingly important in the scientific world due to their strong potential impact on scientific applications. Bioinformatics should not fall behind this trend. We present an original software client that deals with the intrinsic limitations of such devices and propose different guidelines to provide location-independent access to computational resources in bioinformatics and biomedicine. Its modular design makes it easily expandable with the inclusion of new repositories, tools, types of visualization, etc.

  19. Mobile phone use for contacting emergency services in life-threatening circumstances.

    PubMed

    Wu, Olivia; Briggs, Andrew; Kemp, Tom; Gray, Alastair; MacIntyre, Kate; Rowley, Jack; Willett, Keith

    2012-03-01

    The potential health benefits of mobile phone use have not been widely studied, except for telemedicine-type applications. This study seeks to determine whether initial contact with emergency services via a mobile phone in life-threatening situations is associated with potential health benefits when compared to contact via a landline. A record-linkage study was carried out in which data from all emergency dispatches for immediately life-threatening events from a United Kingdom county ambulance service were linked to the Patient Admission System at two major local hospitals. Mortality (at the scene, at the emergency department [ED], and during hospitalization); transfer to the ED; admission (inpatient care, and intensive care unit); and length of stay were analyzed for calls classified as Code Red (immediately life-threatening) by initial exposure (mobile phone vs. landline), while controlling for potential confounding variables. Of 354,199 ambulances dispatched to attend emergency incidents, 66% transported patients to the hospital while 2% stood down due to death at the scene. Mobile phone compared to landline reporting of emergencies resulted in significant reductions in the risk of death at the scene (odds ratio [OR] 0.77), but not for death in the ED or during inpatient admission. The risk of being transferred to the ED and subsequent inpatient admission were significantly lower with reporting from mobile phones compared to landline (OR 0.93 and OR 0.82, respectively). In this study, evidence of statistical association was demonstrated between the use of mobile phones to alert ambulance services in life-threatening situations and improved outcomes for patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Computational Everyday Life Human Behavior Model as Servicable Knowledge

    NASA Astrophysics Data System (ADS)

    Motomura, Yoichi; Nishida, Yoshifumi

    A project called `Open life matrix' is not only a research activity but also real problem solving as an action research. This concept is realized by large-scale data collection, probabilistic causal structure model construction and information service providing using the model. One concrete outcome of this project is childhood injury prevention activity in new team consist of hospital, government, and many varieties of researchers. The main result from the project is a general methodology to apply probabilistic causal structure models as servicable knowledge for action research. In this paper, the summary of this project and future direction to emphasize action research driven by artificial intelligence technology are discussed.

  1. 75 FR 52505 - Fiscal Year 2011 Veterinary Import/Export Services, Veterinary Diagnostic Services, and Export...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-26

    ...] Fiscal Year 2011 Veterinary Import/Export Services, Veterinary Diagnostic Services, and Export... certain veterinary diagnostic services; and for export certification of plants and plant products. The..., through September 30, 2011). FOR FURTHER INFORMATION CONTACT: For information on Veterinary Diagnostic...

  2. Thirty-Seven Years of Service with ESO!

    NASA Astrophysics Data System (ADS)

    Breysacher, J.

    2002-12-01

    On December 1st, 2002, after thirty- seven years of service, first in Chile and then in Garching, Ms. Christa Euler will leave ESO to enjoy a welldeserved retirement. Among the current staff, she is probably the only person who started her career at ESO just four years after the Organization was founded.

  3. The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

    PubMed

    Tang, Liyang

    2012-09-14

    Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in

  4. Analysis and modeling of hot extrusion die for its service life enhancement

    NASA Astrophysics Data System (ADS)

    Akhtar, Syed Sohail

    Aluminum extrusion finds extensive application in the construction, automobile and aerospace industries. High pressures, elevated temperatures, complex and intricate section geometries lead to repeated mechanical and thermal stresses in the die and affiliated tooling. Product rework and rejects can be traced back to various defects spread over the die life cycle: die design, die manufacture and heat treatment, process parameters, inprocess die maintenance/correction and, billet type and quality. Therefore, improved and efficient service life of die and related tooling used in the extrusion press is one the most important factors in maximizing productivity and minimizing cost for ensuring the economical efficiency of an aluminum extrusion plant. How often a die has to be scrapped and replaced with a new one directly contributes to the commercial viability of producing a certain profile. The focus of the current work is on three distinct yet inter-related studies pertaining to the improvement of aluminum extrusion die. Study-A (Die Failure Analysis) is an investigation of various modes and critical failure types based on industrial data (Chapter-2 ), examination of failed dies and finite element simulation for identification of critical process parameters and design features in die fatigue-life (Chapter-3). In Study-B (Die Surface Hardening Treatment), two-stage controlled gas nitriding process for H13 steel is evaluated, both experimentally and numerically, in terms of nitrided case morphology and properties (Chapter-4) followed by experimental and numerical investigation of the effects of repeated nitriding (Chapter-5), pre-nitriding surface preparation (Chapter-6) and die profile geometry (Chapter-7) on nitriding performance in regard to die service life. In Study-C (Effect of Billet Quality on Die Life), the effect of billet quality and related influencing extrusion parameters on the die service life is investigated based on industrial data and some regression

  5. Factors associated with quality of life and caregiver strain amongst frail older adults referred to a community rehabilitation service: implications for service delivery.

    PubMed

    Comans, Tracy A; Currin, Michelle L; Brauer, Sandra G; Haines, Terry P

    2011-01-01

    To identify factors contributing to reduced quality of life and increased caregiver strain in an older population referred to a community rehabilitation team and to recommend service delivery models. Analytical cross-sectional study arising from baseline assessments from 107 subjects drawn from a randomised controlled trial of community rehabilitation service delivery models. A community rehabilitation team based in Brisbane, Queensland, Australia. Primary outcome variables include quality of life (EQ-5D & VAS) and Carer Strain Index. Predictor variables include participation in functional activities, history of falls, number of medications, number of co-morbidities, depression, environmental hazards, physical function and nutrition. Association between variables assessed using linear regression. Major factors contributing to reduced quality of life were having reduced participation in daily activities, depression, and having poor vision. Having poor nutrition and no longer driving also contributed to poor quality of life. The major factor contributing to increased caregiver strain was reduced participation in daily activities by the older person. Community rehabilitation services working with older populations must adopt models of care that screen for and address a wide range of factors that contribute to poor quality of life and caregiver strain.

  6. NASA's Evolutionary Xenon Thruster (NEXT) Project Qualification Propellant Throughput Milestone: Performance, Erosion, and Thruster Service Life Prediction After 450 kg

    NASA Technical Reports Server (NTRS)

    Herman, Daniel A.

    2010-01-01

    The NASA s Evolutionary Xenon Thruster (NEXT) program is tasked with significantly improving and extending the capabilities of current state-of-the-art NSTAR thruster. The service life capability of the NEXT ion thruster is being assessed by thruster wear test and life-modeling of critical thruster components, such as the ion optics and cathodes. The NEXT Long-Duration Test (LDT) was initiated to validate and qualify the NEXT thruster propellant throughput capability. The NEXT thruster completed the primary goal of the LDT; namely to demonstrate the project qualification throughput of 450 kg by the end of calendar year 2009. The NEXT LDT has demonstrated 28,500 hr of operation and processed 466 kg of xenon throughput--more than double the throughput demonstrated by the NSTAR flight-spare. Thruster performance changes have been consistent with a priori predictions. Thruster erosion has been minimal and consistent with the thruster service life assessment, which predicts the first failure mode at greater than 750 kg throughput. The life-limiting failure mode for NEXT is predicted to be loss of structural integrity of the accelerator grid due to erosion by charge-exchange ions.

  7. How effective are volunteers at supporting people in their last year of life? A pragmatic randomised wait-list trial in palliative care (ELSA).

    PubMed

    Walshe, Catherine; Dodd, Steven; Hill, Matt; Ockenden, Nick; Payne, Sheila; Preston, Nancy; Perez Algorta, Guillermo

    2016-12-09

    Clinical care alone at the end of life is unlikely to meet all needs. Volunteers are a key resource, acceptable to patients, but there is no evidence on care outcomes. This study aimed to determine whether support from a social action volunteer service is better than usual care at improving quality of life for adults in the last year of life. A pragmatic, multi-centre wait-list controlled trial, with participants randomly allocated to receive the volunteer support intervention either immediately or after a 4 week wait. Trained volunteers provided tailored face-to-face support including befriending, practical support and signposting to services, primarily provided within the home, typically for 2-3 hours per week. The primary outcome was rate of change of quality of life at 4 weeks (WHO QOL BREF, a general, culturally sensitive measure). Secondary outcomes included rate of change of quality of life at 8 weeks and Loneliness (De Jong Gierveld Loneliness Scale), social support (mMOS-SS), and reported use of health and social care services at 4 and 8 weeks. In total, 196 adults (61% (n = 109) female; mean age 72 years) were included in the study. No significant difference was found in main or secondary outcomes at 4 weeks. Rate of change of quality of life showed trends in favour of the intervention (physical quality of life domain: b = 3.98, CI, -0.38 to 8.34; psychological domain: b = 2.59, CI, -2.24 to 7.43; environmental domain: b = 3, CI, -4.13 to 4.91). Adjusted analyses to control for hours of volunteer input found significantly less decrease in physical quality of life in the intervention group (slope (b) 4.43, CI, 0.10 to 8.76). While the intervention also favoured the rate of change of emotional (b = -0.08; CI, -0.52 to 0.35) and social loneliness (b = -0.20; CI, -0.58 to 0.18), social support (b = 0.13; CI, -0.13 to 0.39), and reported use of health and social care professionals (b = 0.16; CI, -0.22 to 0.55), these were

  8. Life table analysis of the United States' Year 2000 mortality objectives.

    PubMed

    Rockett, I R; Pollard, J H

    1995-06-01

    The US Year 2000 mortality objectives are model standards cast as targeted changes in age-adjusted cause-specific death rates. This research centred on the projected impact of such changes on life expectancy and the mortality toll for each sex. A computer simulation was conducted using single decrement, multiple decrement and cause-elimination life table techniques, together with a decomposition procedure. Male and female life expectancy at birth was projected to increase by 1.71 and 1.51 years, respectively, between the designated 1987 baseline and 2000. The leading beneficiaries would be those aged 65 and older, followed by those aged 45-64, and infants. Declines in coronary heart disease, stroke and injury death rates would most influence the projected life expectancy changes, irrespective of sex. Approximately 782,000 male deaths and 730,000 female deaths would be averted under Year 2000 assumptions. Life expectancy would be a useful summary measure to incorporate into official evaluations of the Year 2000 mortality objectives. Targeting of excess male mortality in the US and other highly industrialized nations is recommended.

  9. Promoting Career Development and Life Design in the Early Years of a Person's Life

    ERIC Educational Resources Information Center

    Maree, Jacobus G.

    2018-01-01

    The article discusses the changing world of work and the attendant uncertainty and loss of work-life identity. Little research has been done on career development and life design in the early years of a person's life, especially in developing countries characterized by disadvantage. The underlying theoretical models of career development are…

  10. Understanding DALYs (disability-adjusted life years).

    PubMed

    Murray, C J; Acharya, A K

    1997-12-01

    The measurement unit disability-adjusted life years (DALYs), used in recent years to quantify the burden of diseases, injuries and risk factors on human populations, is grounded on cogent economic and ethical principles and can guide policies toward delivering more cost-effective and equitable health care. DALYs follow from a fairness principle that treats 'like as like' within an information set comprising the health conditions of individuals, differentiated solely by age and sex. The particular health state weights used to account for non-fatal health outcomes are derived through the application of various forms of the person trade-off.

  11. Measuring the Effect of Tourism Services on Travelers' Quality of Life: Further Validation.

    ERIC Educational Resources Information Center

    Neal, Janet D.; Sirgy, M. Joseph; Uysal, Muzaffer

    2004-01-01

    lication and extension study provided additional validational support of the original tourism services satisfaction measure in relation to QOL-related measures.Neal, Sirgy and Uysal (1999) developed a model and a measure to capture the effect of tourism services on travelers' quality of life (QOL). They hypothesized that travelers' overall life…

  12. Quality of life, autonomy, satisfaction, and costs associated with mental health supported accommodation services in England: a national survey.

    PubMed

    Killaspy, Helen; Priebe, Stefan; Bremner, Stephen; McCrone, Paul; Dowling, Sarah; Harrison, Isobel; Krotofil, Joanna; McPherson, Peter; Sandhu, Sima; Arbuthnott, Maurice; Curtis, Sarah; Leavey, Gerard; Shepherd, Geoff; Eldridge, Sandra; King, Michael

    2016-12-01

    Little research has been done into the effectiveness of mental health supported accommodation services. We did a national survey to investigate provision and costs of services and assess service user quality of life and outcomes across England. We randomly sampled three types of services from 14 nationally representative regions-residential care, supported housing, and floating outreach-and recruited up to ten service users per service. Service quality and costs and service users' quality of life, autonomy, and satisfaction with care were assessed in a standardised manner with validated tools and compared by multilevel modelling. 619 service users were recruited from 22 residential care, 35 supported housing, and 30 floating outreach services. Those in residential care and supported housing had more severe mental health problems than those in floating outreach. 348 (57%) were assessed as being at risk of severe self-neglect and 229 (37%) as being vulnerable to exploitation in the previous 2 years. Residential care was most expensive but provided for people with the greatest needs. The mean annual budget was £466 687 for residential care (range £276 000-777 920), compared with £365 452 for supported housing (£174 877-818 000), and £172 114 for floating outreach (£17 126-491 692). Quality of care was best in supported housing. People in supported housing and floating outreach were more socially included but experienced more crime than those in residential care. After adjustment for service quality and service user sociodemographic and clinical factors, quality of life was similar for service users in residential care and supported housing (mean difference -0·138, 95% CI -0·402 to 0·126, p=0·306) and lower for those in floating outreach than in residential care (-0·424, -0·734 to -0·114, p=0·007). However, autonomy was greater for those in supported housing than for those in residential care (0·145, 0·010 to 0·279, p=0

  13. 20 CFR 302.7 - Establishing base year service and compensation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

  14. 20 CFR 302.7 - Establishing base year service and compensation.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

  15. 20 CFR 302.7 - Establishing base year service and compensation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

  16. 20 CFR 302.7 - Establishing base year service and compensation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

  17. 20 CFR 302.7 - Establishing base year service and compensation.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

  18. Challenges in Providing End-of-Life Care for People with Intellectual Disability: Health Services Access

    ERIC Educational Resources Information Center

    Wark, Stuart; Hussain, Rafat; Müller, Arne; Ryan, Peta; Parmenter, Trevor

    2017-01-01

    Background: Increasing life expectancy for people with intellectual disability is resulting in greater need for end-of-life care services. However, limited knowledge is available regarding what barriers to accessing end-of-life care support are evident, particularly comparatively across rural and metropolitan locations. Methods: Focus group…

  19. 38 CFR 8.12 - Payment of the cash value of National Service Life Insurance in monthly installments under...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... thereunder, whichever is later. (b) [Reserved] [36 FR 4384, Mar. 5, 1971. Redesignated and amended at 61 FR... of National Service Life Insurance in monthly installments under section 1917(e) of title 38 U.S.C. 8... SERVICE LIFE INSURANCE Cash Value and Policy Loan § 8.12 Payment of the cash value of National Service...

  20. 38 CFR 8.12 - Payment of the cash value of National Service Life Insurance in monthly installments under...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... thereunder, whichever is later. (b) [Reserved] [36 FR 4384, Mar. 5, 1971. Redesignated and amended at 61 FR... of National Service Life Insurance in monthly installments under section 1917(e) of title 38 U.S.C. 8... SERVICE LIFE INSURANCE Cash Value and Policy Loan § 8.12 Payment of the cash value of National Service...

  1. 26 CFR 1.441-3 - Taxable year of a personal service corporation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 6 2011-04-01 2011-04-01 false Taxable year of a personal service corporation... personal service corporation. (a) Taxable year—(1) Required taxable year. Except as provided in paragraph (a)(2) of this section, the taxable year of a personal service corporation (PSC) (as defined in...

  2. Years of life gained due to leisure-time physical activity in the U.S.

    PubMed

    Janssen, Ian; Carson, Valerie; Lee, I-Min; Katzmarzyk, Peter T; Blair, Steven N

    2013-01-01

    Physical inactivity is an important modifiable risk factor for noncommunicable disease. The degree to which physical activity affects the life expectancy of Americans is unknown. This study estimated the potential years of life gained due to leisure-time physical activity in the U.S. Data from the National Health and Nutrition Examination Survey (2007-2010); National Health Interview Study mortality linkage (1990-2006); and U.S. Life Tables (2006) were used to estimate and compare life expectancy at each age of adult life for inactive (no moderate to vigorous physical activity); somewhat-active (some moderate to vigorous activity but <500 MET minutes/week); and active (≥ 500 MET minutes/week of moderate to vigorous activity) adults. Analyses were conducted in 2012. Somewhat-active and active non-Hispanic white men had a life expectancy at age 20 years that was ~2.4 years longer than that for the inactive men; this life expectancy advantage was 1.2 years at age 80 years. Similar observations were made in non-Hispanic white women, with a higher life expectancy within the active category of 3.0 years at age 20 years and 1.6 years at age 80 years. In non-Hispanic black women, as many as 5.5 potential years of life were gained due to physical activity. Significant increases in longevity were also observed within somewhat-active and active non-Hispanic black men; however, among Hispanics the years-of-life-gained estimates were not significantly different from 0 years gained. Leisure-time physical activity is associated with increases in longevity. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Cargo Commercial Orbital Transportation Services Environmental Control and Life Support Integration

    NASA Technical Reports Server (NTRS)

    Duchesne, Stephanie; Thacker, Karen; Williams, Dave

    2012-01-01

    The International Space Station s (ISS) largest crew and cargo resupply vehicle, the Space Shuttle, retired in 2011. To help augment ISS resupply and return capability, NASA announced a project to promote the development of Commercial Orbital Transportation Services (COTS) for the ISS in January of 2006. By December of 2008, NASA entered into space act agreements with SpaceX and Orbital Sciences Corporation for COTS development and ISS Commercial Resupply Services (CRS). The intent of CRS is to fly multiple resupply missions each year to ISS with SpaceX s Dragon vehicle providing resupply and return capabilities and Orbital Science Corporation s Cygnus vehicle providing resupply capability to ISS. The ISS program launched an integration effort to ensure that these new commercial vehicles met the requirements of the ISS vehicle and ISS program needs. The Environmental Control and Life Support System (ECLSS) requirements cover basic cargo vehicle needs including maintaining atmosphere, providing atmosphere circulation, and fire detection and suppression. The ISS-COTS integration effort brought unique challenges combining NASA s established processes and design knowledge with the commercial companies new initiatives and limited experience with human space flight. This paper will discuss the ISS ECLS COTS integration effort including challenges, successes, and lessons learned.

  4. Commercial Orbital Transportation Cargo Services Environmental Control and Life Support Integration

    NASA Technical Reports Server (NTRS)

    Duchesne, Stephanie; Williams, Dave; Orozco, Nicole; Philistine, Cynthia

    2010-01-01

    The International Space Station s (ISS) largest crew and cargo resupply vehicle, the Space Shuttle, will retire in 2011. To help augment ISS resupply and return capability, NASA announced a project to promote the development of Commercial Orbital Transportation Services (COTS) for the ISS in January of 2006. By December of 2008, NASA entered into space act agreements with SpaceX and Orbital Sciences Corporation for COTS development and ISS Commercial Resupply Services (CRS). The intent of CRS is to fly multiple resupply missions each year to ISS with SpaceX s Dragon vehicle providing resupply and return capabilities and Orbital Science Corporation s Cygnus vehicle providing resupply capability to ISS. The ISS program launched an integration effort to ensure that these new commercial vehicles met the requirements of the ISS vehicle and ISS program needs. The Environmental Control and Life Support System (ECLSS) requirements cover basic cargo vehicle needs including maintaining atmosphere, providing atmosphere circulation, and fire detection and suppression. The ISS-COTS integration effort brought unique challenges combining NASA s established processes and design knowledge with the commercial companies new initiatives and limited experience with human space flight. This paper will discuss the ISS ECLS COTS integration effort including challenges, successes, and lessons learned.

  5. After 10 years of service, NOAA retires GOES-12 satellite

    Science.gov Websites

    Destinations After 10 years of service, NOAA retires GOES-12 satellite Progress continuing toward launch of next-generation GOES-R satellite August 19, 2013 GOES-12 captured this visible image of Hurricane 10 years of stellar service, NOAA's Geostationary Operational Environmental Satellite (GOES)-12

  6. One-Year Plan for Library Services.

    ERIC Educational Resources Information Center

    Caroline County Public Library, Denton, MD.

    This action plan for the Caroline County (MD) Public Library describes the key elements of library service for the 1985-86 fiscal year, derived from the library's long range plan for 1985-90. Objectives, strategies, activities, and timetables for accomplishing the following goals are outlined: (1) citizens of the county will increasingly meet…

  7. Measurement of Quality of Life VI. Quality-Adjusted Life Years (QALY) is an Unfortunate Use of the Quality-of-Life Concept

    PubMed Central

    Ventegodt, Soren; Merrick, Joav; Andersen, Niels Jorgen

    2003-01-01

    The QALY (quality-adjusted life years) attempts to incorporate the dimension of quality of life into the evaluation by adjusting life years by a quality factor. In practice, this is based on discussing with people the progression of a number of hypothetical illnesses and their ensuing side effects. From this information, the person assesses how each state of health described compares with a theoretical maximum state of health. For example, 1 day with a certain condition might the equivalent of living only 0.5 days in good health.We believe that QALY value only represents a superficial impression of a person's quality of life. In short, the QALY does not express what it means for a person to live a life at reduced quality. We believe that if the patients were optimally informed and allowed to decide for themselves, they would more often reject high-tech expensive biomedical treatments that only serve to prolong life and do not increase its quality. The problem of priorities may then turn out to be far more simple and also more ethical: the focus will be on the quality of life, not on QALY, and the question of the meaning of life and death will achieve greater openness and respect. PMID:14570991

  8. Fifteen-year mortality trends due to cardiovascular diseases in Poland using standard expected years of life lost, 2000-2014.

    PubMed

    Pikala, Małgorzata; Maniecka-Bryła, Irena

    2017-01-01

    Measures presenting the number of years of lost life point out social and economic aspects of premature mortality. The aim of the study was to determine trends and pace of changes in years of life lost, in inhabitants of Poland, in 2000-2014, due to cardiovascular diseases (CVD). The study material was a database including 2,587,141 death certificates of Polish inhabitants who died of CVD in 2000-2014. We applied the standard expected years of life lost (SEYLL) indicators per living person (SEYLLp) and per death (SEYLLd) to calculate life years lost. We also estimated annual percentage changes (APC) and average annual percentage changes (AAPC) in the SEYLL indicators. In 2000 the SEYLLp index due to CVD was 860.3 years per 10,000 males and 586.9 years per 10,000 females. In 2000-2004 the indices were decreasing and the average annual rate was -0.8% in the male group and -1.2% in the female group. Eventually, in 2014 its values were 721.4 years per 10,000 males and 475.6 years per 10,000 females. The respondents were losing years of life due to ischaemic heart disease (IHD) most rapidly (AAPC = -3.3% in the male group and -3.2% in the female group) and due to cerebrovascular diseases (AAPC = -2.5% in the male group and AAPC = -3.3% in the female group). On the other hand, there was an increase in the number of years of life lost due to heart failure (HF) (AAPC = 5.7% in the male group and AAPC = 4.4% in the female group). In 2014 SEYLLp due to IHD were 207.3 per 10,000 males and 99.1 per 10,000 females, due to cerebrovascular diseases - 124.3 and 102.2, and due to HF - 155.3 and 104.9. Each male who died of CVD lost on average 19.1 years in the year 2000 and 17.0 years in the year 2014 (AAPC = -0.5%). Regarding women, SEYLLd values were 12.6 years in 2000 and 10.4 years in 2014 (AAPC = -1.4%). A decrease in the SEYLLd value was observed in all analysed causes of mortality, in both males and females. Among CVDs, IHD and cerebrovascular diseases contribute to the

  9. The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China

    PubMed Central

    2012-01-01

    Background Patient’s satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient’s life satisfaction in China’s health delivery system/in various kinds of hospitals. The aim of this study was to test whether and to what extent patient’s satisfaction with medical service delivery/patient’s assessments of various major aspects of medical service/various major aspects of patient’s trust in health delivery system influenced patient’s life satisfaction in China’s health delivery system/in various kinds of hospitals. Methods This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. Results The key considerations in generating patient’s life satisfaction involved patient’s overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient’s life satisfaction were different among low level public hospital, high level public hospital, and private hospital. Conclusion The promotion of patient’s overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient’s trust in prescription, the promotion of patient

  10. Positive life orientation in old age: a 15-year follow-up.

    PubMed

    Eloranta, Sini; Arve, Seija; Lavonius, Sirkku; Routasalo, Pirkko; Lehtonen, Aapo; Viitanen, Matti; Isoaho, Hannu

    2012-01-01

    Positive life orientation (PLO) is considered an important dimension of successful aging. To investigate how self-reported PLO changed among home-dwelling people from age 70 to 80 and 85 years. A prospective, population-based 15-year follow-up study of the age cohort of 70-year-olds living in the city of Turku, Finland. The data were collected in 1991 by a postal questionnaire that was sent to all residents of Turku, Finland, born in 1920 (N=1530). Follow-ups using the same procedure were conducted in 2001 and 2006. PLO was assessed with the following items: life satisfaction, feeling needed, having plans for the future, having zest for life, feeling depressed, and suffering from loneliness. We created a PLO score from the answers to these questions, where 1 represented the best PLO and 0 the poorest. At baseline, the participants showed rather high levels of positive life orientation (PLO total score 0.83). PLO declined markedly after the 70-year-old participants reached the age of 80 and 85 years (p<.001). However, depressive feelings remained quite stable. The decrease was similar among men and women except for the items suffering from loneliness and feeling needed. At age 70 and 80 years women suffered more from loneliness than men, while men experienced feeling needed more than women. Positive life orientation declines during old age, especially from age 70 to 80 years. Thereafter the decline is less steep except for changes in future plans and feeling needed. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. Dental pain, use of dental services and oral health-related quality of life in southern Brazil.

    PubMed

    Cavalheiro, Charles Henrique; Abegg, Claides; Fontanive, Victor Nascimento; Davoglio, Rosane Silvia

    2016-08-18

    This study aimed at assessing the relationship between dental pain and the reason for using dental services and oral health quality of life in people aged 50 to 74 years in southern Brazil. A cross-sectional population-based study was conducted with 720 individuals aged 50 to 74 years, living in three health districts in the city of Porto Alegre. Dental impacts on daily life and sociodemographic data were assessed using structured interviews. The Oral Impacts on Daily Performance - OIDP instrument was used to measure oral impacts. The information was analyzed by Poisson regression with robust variance adjustment, taking into account cluster sampling. Dental pain was present in 32.5% of those reporting an oral impact on their daily activities. Dental pain most frequently affected talking (37.6%), cleaning teeth and gums (37.0%) and enjoying the companionship of people (36.5%). After adjustments to the multivariate analysis, the reason for dental visits due to dental pain was found to have a high impact on daily activities [RP 1.68 (1.11 - 2.54].

  12. The work environment disability-adjusted life year for use with life cycle assessment: a methodological approach

    PubMed Central

    2013-01-01

    Background Life cycle assessment (LCA) is a systems-based method used to determine potential impacts to the environment associated with a product throughout its life cycle. Conclusions from LCA studies can be applied to support decisions regarding product design or public policy, therefore, all relevant inputs (e.g., raw materials, energy) and outputs (e.g., emissions, waste) to the product system should be evaluated to estimate impacts. Currently, work-related impacts are not routinely considered in LCA. The objectives of this paper are: 1) introduce the work environment disability-adjusted life year (WE-DALY), one portion of a characterization factor used to express the magnitude of impacts to human health attributable to work-related exposures to workplace hazards; 2) outline the methods for calculating the WE-DALY; 3) demonstrate the calculation; and 4) highlight strengths and weaknesses of the methodological approach. Methods The concept of the WE-DALY and the methodological approach to its calculation is grounded in the World Health Organization’s disability-adjusted life year (DALY). Like the DALY, the WE-DALY equation considers the years of life lost due to premature mortality and the years of life lived with disability outcomes to estimate the total number of years of healthy life lost in a population. The equation requires input in the form of the number of fatal and nonfatal injuries and illnesses that occur in the industries relevant to the product system evaluated in the LCA study, the age of the worker at the time of the fatal or nonfatal injury or illness, the severity of the injury or illness, and the duration of time lived with the outcomes of the injury or illness. Results The methodological approach for the WE-DALY requires data from various sources, multi-step instructions to determine each variable used in the WE-DALY equation, and assumptions based on professional opinion. Conclusions Results support the use of the WE-DALY in a

  13. The work environment disability-adjusted life year for use with life cycle assessment: a methodological approach.

    PubMed

    Scanlon, Kelly A; Gray, George M; Francis, Royce A; Lloyd, Shannon M; LaPuma, Peter

    2013-03-06

    Life cycle assessment (LCA) is a systems-based method used to determine potential impacts to the environment associated with a product throughout its life cycle. Conclusions from LCA studies can be applied to support decisions regarding product design or public policy, therefore, all relevant inputs (e.g., raw materials, energy) and outputs (e.g., emissions, waste) to the product system should be evaluated to estimate impacts. Currently, work-related impacts are not routinely considered in LCA. The objectives of this paper are: 1) introduce the work environment disability-adjusted life year (WE-DALY), one portion of a characterization factor used to express the magnitude of impacts to human health attributable to work-related exposures to workplace hazards; 2) outline the methods for calculating the WE-DALY; 3) demonstrate the calculation; and 4) highlight strengths and weaknesses of the methodological approach. The concept of the WE-DALY and the methodological approach to its calculation is grounded in the World Health Organization's disability-adjusted life year (DALY). Like the DALY, the WE-DALY equation considers the years of life lost due to premature mortality and the years of life lived with disability outcomes to estimate the total number of years of healthy life lost in a population. The equation requires input in the form of the number of fatal and nonfatal injuries and illnesses that occur in the industries relevant to the product system evaluated in the LCA study, the age of the worker at the time of the fatal or nonfatal injury or illness, the severity of the injury or illness, and the duration of time lived with the outcomes of the injury or illness. The methodological approach for the WE-DALY requires data from various sources, multi-step instructions to determine each variable used in the WE-DALY equation, and assumptions based on professional opinion. Results support the use of the WE-DALY in a characterization factor in LCA. Integrating

  14. 78 FR 18966 - Publication of Fiscal Year 2012 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... Year 2012 Service Contract Inventory AGENCY: Court Services and Offender Supervision Agency for the District of Columbia. ACTION: Notice of Public Availability of FY 2012 Service Contract Inventory. SUMMARY... 2012 Service Contract Inventory. This inventory provides information on service contract actions over...

  15. Transitioning from High School Service to College Service-Learning in a First-Year Seminar

    ERIC Educational Resources Information Center

    Ross, Laurie; Boyle, Mary-Ellen

    2007-01-01

    This article analyzes the challenges encountered in a first-year service-learning course in which students had high expectations for community involvement and a commitment to social responsibility, yet significant difficulty connecting their service orientation to the intellectual inquiry expected of them at the college level. This conflict…

  16. Evaluation of a passive optical based end of service life indicator (ESLI) for organic vapor respirator cartridges

    PubMed Central

    Checky, Melissa; Frankel, Kevin; Goddard, Denise; Johnson, Erik; Thomas, J. Christopher; Zelinsky, Maria; Javner, Cassidy

    2016-01-01

    ABSTRACT A passive visual end of service life indicator (ESLI) for certain organic vapors has been attached to the inside wall of an organic vapor respirator cartridge. The opposite side of the ESLI touches activated carbon inside the cartridge. During use, organic vapors moving through the cartridge adsorb into both the carbon and the ESLI. The cartridge body is clear so that when vapor concentrations meet a certain threshold, the user may observe the progressive development of an indicator bar down the side of the ESLI. The cartridge is deemed ready to change when any part of the indicator bar touches a marked end line. The performance of the ESLI was observed when the cartridge was tested against a variety of organic vapors, exposure concentrations above the minimum indication level, humidities, temperatures, flow rates, and mixtures. In all cases, the ESLI indicated end of service life with more than 10% cartridge service life remaining (which is a NIOSH test criteria). The results were also compared to mathematical predictions of cartridge service life. PMID:26418577

  17. First-Year International Students' Perceived Impact of the International Student Services Office

    ERIC Educational Resources Information Center

    Chissoe, David H.

    2017-01-01

    As international student attendance on college campuses in the US continues to increase in record numbers, International Student Services (ISS) offices across the country are tasked with providing services to aid the growing number and variety of sojourners in their transition to life on campus in the United States. This dissertation is a…

  18. Accelerated life assessment of coating on the radar structure components in coastal environment.

    PubMed

    Liu, Zhe; Ming, ZhiMao

    2016-07-04

    This paper aimed to build an accelerated life test scheme and carry out quantitative analysis between accelerated life test in the laboratory and actual service for the coating composed of epoxy primer and polyurethane paint on structure components of some kind of radar served in the coastal environment of South China Sea. The accelerated life test scheme was built based on the service environment and failure analysis of the coating. The quantitative analysis between accelerated life test and actual service was conducted by comparing the gloss loss, discoloration, chalking, blistering, cracking and electrochemical impedance spectroscopy of the coating. The main factors leading to the coating failure were ultraviolet radiation, temperature, moisture, salt fog and loads, the accelerated life test included ultraviolet radiation, damp heat, thermal shock, fatigue and salt spray. The quantitative relationship was that one cycle of the accelerated life test was equal to actual service for one year. It was established that one cycle of the accelerated life test was equal to actual service for one year. It provided a precise way to predict actual service life of newly developed coatings for the manufacturer.

  19. Maternal Substance Use Disorders and Infant Outcomes in the First Year of Life among Massachusetts Singletons, 2003-2010.

    PubMed

    Hwang, Sunah S; Diop, Hafsatou; Liu, Chia-Ling; Yu, Qi; Babakhanlou-Chase, Hermik; Cui, Xiaohui; Kotelchuck, Milton

    2017-12-01

    To determine the association of maternal substance use disorders (SUDs) during pregnancy with adverse neonatal outcomes and infant hospital re-admissions, observational stays, and emergency department utilization in the first year of life. We analyzed 2 linked statewide datasets from 2002 to 2010: the Massachusetts Pregnancy to Early Life Longitudinal data system and the Massachusetts Bureau of Substance Abuse Services Management Information System. Generalized estimating equations were used to assess the association of maternal SUDs and neonatal outcomes and infant hospital-based care in the first year of life, controlling for maternal and infant characteristics. Maternal SUDs increased from 19.4 per 1000 live births in 2003 to 31.1 per 1000 live births in 2009. In the adjusted analysis, exposed neonates were more likely to be born preterm (aOR 1.85; 95% CI 1.75-1.96) and low birthweight (aOR 1.94; 95% CI 1.80-2.09). After controlling for maternal characteristics and preterm birth, SUD-exposed neonates were more likely to have intrauterine growth restriction, cardiac, respiratory, neurologic, infectious, hematologic, and feeding/nutrition problems, prolonged hospital stay, and higher mortality (aOR range 1.26-3.80). Exposed infants were more likely to be rehospitalized (aOR 1.10; 95% CI 1.04-1.17) but less likely to have an observational stay (aOR 0.90; 95% CI 0.82-0.99) or use the emergency department (aOR 0.87; 95% CI 0.83-0.90) in the first year of life. Infants born to mothers with SUD are at higher risk for adverse health outcomes in the perinatal period and are also more likely to be rehospitalized in the first year of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18-63 years.

    PubMed

    Ekamper, P; van Poppel, F; Stein, A D; Lumey, L H

    2014-10-01

    To quantify the relation between prenatal famine exposure and adult mortality, taking into account mediating effects of intermediary life conditions. Historical follow-up study. The Dutch famine (Hunger Winter) of 1944-1945 which occurred towards the end of WWII in occupied Netherlands. From 408,015 Dutch male births born 1944-1947, examined for military service at age 18, we selected for follow-up all men born at the time of the famine in six affected cities in the Western Netherlands (n=25,283), and a sample of unexposed time (n=10,667) and place (n=9087) controls. These men were traced and followed for mortality through the national population and death record systems. All-cause mortality between ages 18 and 63 years using Cox proportional hazards models adjusted for intermediary life conditions. An increase in mortality was seen after famine exposure in early gestation (HR 1.12; 95% confidence interval (CI): 1.01-1.24) but not late gestation (HR 1.04; 95% CI: 0.96-1.13). Among intermediary life conditions at age 18 years, educational level was inversely associated with mortality and mortality was elevated in men with fathers with manual versus non-manual occupations (HR 1.08; CI: 1.02-1.16) and in men who were declared unfit for military service (HR 1.44; CI: 1.31-1.58). Associations of intermediate factors with mortality were independent of famine exposure in early life and associations between prenatal famine exposure and adult mortality were independent of social class and education at age 18. Timing of exposure in relation to the stage of pregnancy may be of critical importance for later health outcomes independent of intermediary life conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. SMART-OLEV—An orbital life extension vehicle for servicing commercial spacecrafts in GEO

    NASA Astrophysics Data System (ADS)

    Kaiser, Clemens; Sjöberg, Fredrik; Delcura, Juan Manuel; Eilertsen, Baard

    2008-07-01

    Orbital Satellite Services Limited (OSSL) is a satellite servicing company that is developing an orbit life extension vehicle (OLEV) to extend the operational lifetime of geostationary satellites. The industrial consortium of SSC (Sweden), Kayser-Threde (Germany) and Sener (Spain) is in charge to develop and industrialize the space and ground segment. It is a fully commercial program with support of several space agencies during the development phase. The business plan is based on life extension for high value commercial satellites while also providing the satellite operators with various fleet management services such as graveyard burns, slot transfers and on orbit protection against replacement satellite or launch failures. The OLEV spacecraft will be able to dock with a geostationary satellite and uses an electrical propulsion system to extend its life by taking over the attitude control and station keeping functions. The OLEV system is building on the SMART-1 platform developed by Swedish Space Corporation. It was developed for ESA as a technology test-bed to demonstrate the use of electrical propulsion for interplanetary orbit transfer manoeuvres. The concept is called SMART-OLEV and takes advantage of the low cost, low mass SMART-1 platform by a maximum use of recurrent platform technology.

  2. Potential years lost and life expectancy in adults with newly diagnosed epilepsy.

    PubMed

    Granbichler, Claudia A; Zimmermann, Georg; Oberaigner, Willi; Kuchukhidze, Giorgi; Ndayisaba, Jean-Pierre; Taylor, Alexandra; Luef, Gerhard; Bathke, Arne C; Trinka, Eugen

    2017-11-01

    Studies using relative measures, such as standardized mortality ratios, have shown that patients with epilepsy have an increased mortality. Reports on more direct and absolute measure such as life expectancy are sparse. We report potential years lost and how life expectancy has changed over 40 years in a cohort of patients with newly diagnosed epilepsy. We analyzed life expectancy in a cohort of adult patients diagnosed with definite epilepsy between 1970 and 2010. Those with brain tumor as cause of epilepsy were excluded. By retrospective probabilistic record linkage, living or death status was derived from the national death registry. We estimated life expectancy by a Weibull regression model using gender, age at diagnosis, epilepsy etiology, and year of diagnosis as covariates at time of epilepsy diagnosis, and 5, 10, 15, and 20 years after diagnosis. Results were compared to the general population, and 95% confidence intervals are given. There were 249 deaths (105 women, age at death 19.0-104.0 years) in 1,112 patients (11,978.4 person-years, 474 women, 638 men). A substantial decrease in life expectancy was observed for only a few subgroups, strongly depending on epilepsy etiology and time of diagnosis: time of life lost was highest in patients with symptomatic epilepsy diagnosed between 1970 and 1980; the impact declined with increasing time from diagnosis. Over half of the analyzed subgroups did not differ significantly from the general population. This effect was reversed in the later decades, and life expectancy was prolonged in some subgroups, reaching a maximum in those with newly diagnosed idiopathic and cryptogenic epilepsy between 2001 and 2010. Life expectancy is reduced in symptomatic epilepsies. However, in other subgroups, a prolonged life expectancy was found, which has not been reported previously. Reasons may be manifold and call for further study. © 2017 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International

  3. Multiple chronic conditions and life expectancy: a life table analysis.

    PubMed

    DuGoff, Eva H; Canudas-Romo, Vladimir; Buttorff, Christine; Leff, Bruce; Anderson, Gerard F

    2014-08-01

    The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy. We analyze life expectancy in Medicare beneficiaries by number of chronic conditions. A retrospective cohort study using single-decrement period life tables. Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008. Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer, chronic obstructive pulmonary disease, stroke, and Alzheimer disease), and number of comorbid conditions. Comorbidity was measured as a count of conditions collected by Chronic Conditions Warehouse and the Charlson Comorbidity Index. Life expectancy decreases with each additional chronic condition. A 67-year-old individual with no chronic conditions will live on average 22.6 additional years. A 67-year-old individual with 5 chronic conditions and ≥10 chronic conditions will live 7.7 fewer years and 17.6 fewer years, respectively. The average marginal decline in life expectancy is 1.8 years with each additional chronic condition-ranging from 0.4 fewer years with the first condition to 2.6 fewer years with the sixth condition. These results are consistent by sex and race. We observe differences in life expectancy by selected conditions at 67, but these differences diminish with age and increasing numbers of comorbid conditions. Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency.

  4. Services in Counseling/Intervention and Life Skills Education (S.C.I.L.S.E.).

    ERIC Educational Resources Information Center

    Kirk, Mimi

    The report describes the Services in Counseling/Intervention and Life Skills Education (SCILSE) Program, a comprehensive program providing services to emotionally disturbed children in their own homes, under the auspices of the Southern Home for Children, a residential treatment center in Philadelphia. The history of the Southern Home for Children…

  5. Can comprehensive specialised end-of-life care be provided at home? Lessons from a study of an innovative consultant-led community service in the UK

    PubMed Central

    Noble, B; King, N; Woolmore, A; Hughes, P; Winslow, M; Melvin, J; Brooks, J; Bravington, A; Ingleton, C; Bath, PA

    2015-01-01

    The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) is a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes. Of 389 referrals in 2010/11, about 85% were for cancer, from a population of about 155 000. Using a mixed method approach, the evaluation comprised: a retrospective analysis of secondary-care use in the last year of life; financial evaluation of the MMSPCS using an Activity Based Costing approach; qualitative interviews with patients, carers, health and social care staff and MMSPCS staff and volunteers; a postal survey of General Practices; and a postal survey of bereaved caregivers using the MMSPCS. The mean cost is about 3000 GBP (3461 EUR) per patient with mean cost of interventions for cancer patients in the last year of life 1900 GBP (2192 EUR). Post-referral, overall costs to the system are similar for MMSPCS and hospice-led models; however, earlier referral avoided around 20% of total costs in the last year of life. Patients and carers reported positive experiences of support, linked to the flexible way the service worked. Seventy-one per cent of patients died at home. This model may have application elsewhere. PMID:24735122

  6. Years of Life Gained Due to Leisure-Time Physical Activity in the United States

    PubMed Central

    Janssen, Ian; Carson, Valerie; Lee, I-Min; Katzmarzyk, Peter T.; Blair, Steven N.

    2013-01-01

    Background Physical inactivity is an important modifiable risk factor for non-communicable disease. The degree to which physical activity affects the life expectancy of Americans is unknown. This study estimated the potential years of life gained due to leisure-time physical activity across the adult lifespan in the United States. Methods Data from the National Health and Nutrition Examination Survey (2007–2010), National Health Interview Study mortality linkage (1990–2006), and US Life Tables (2006) were used to estimate and compare life expectancy at each age of adult life for inactive (no moderate-to-vigorous physical activity), somewhat active (some moderate-to-vigorous activity but <500 metabolic equivalent min/week) and active (≥500 metabolic equivalent min/week of moderate-to-vigorous activity) adults. Analyses were conducted in 2012. Results Somewhat active and active non-Hispanic white men had a life expectancy at age 20 that was around 2.4 years longer than the inactive men; this life expectancy advantage was 1.2 years at age 80. Similar observations were made in non-Hispanic white women, with a higher life expectancy within the active category of 3.0 years at age 20 and 1.6 years at age 80. In non-Hispanic black women, as many as 5.5 potential years of life were gained due to physical activity. Significant increases in longevity were also observed within somewhat active and active non-Hispanic black men; however, among Hispanics the years of life gained estimates were more variable and not significantly different from 0 years gained. Conclusions Leisure-time physical activity is associated with increases in longevity in the United States. PMID:23253646

  7. Disability-adjusted Life Years Lost to Ischemic Heart Disease in Spain.

    PubMed

    Fernández de Larrea-Baz, Nerea; Morant-Ginestar, Consuelo; Catalá-López, Ferrán; Gènova-Maleras, Ricard; Álvarez-Martín, Elena

    2015-11-01

    The health indicator disability-adjusted life years combines the fatal and nonfatal consequences of a disease in a single measure. The aim of this study was to evaluate the burden of ischemic heart disease in 2008 in Spain by calculating disability-adjusted life years. The years of life lost due to premature death were calculated using the ischemic heart disease deaths by age and sex recorded in the Spanish National Institute of Statistics and the life-table in the 2010 Global Burden of Disease study. The years lived with disability, calculated for acute coronary syndrome, stable angina, and ischemic heart failure, used hospital discharge data and information from population studies. Disability weights were taken from the 2010 Global Burden of Disease study. We calculated crude and age standardized rates (European Standard Population). Univariate sensitivity analyses were performed. In 2008, 539 570 disability-adjusted life years were lost due to ischemic heart disease in Spain (crude rate, 11.8/1000 population; standardized, 8.6/1000). Of the total years lost, 96% were due to premature death and 4% due to disability. Among the years lost due to disability, heart failure accounted for 83%, stable angina 15%, and acute coronary syndrome 2%. In the sensitivity analysis, weighting by age was the factor that changed the results to the greatest degree. Ischemic heart disease continues to have a huge impact on the health of our population, mainly because of premature death. The results of this study provide an overall vision of the epidemiologic situation in Spain and could serve as the basis for evaluating interventions targeting the acute and chronic manifestations of cardiac ischemia. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Human Services Occupations in the Two-Year College: A Handbook.

    ERIC Educational Resources Information Center

    Kiffer, Theodore E.; Burns, Martha A.

    This handbook is intended as a guide for community college administrators in setting up human services programs. (Human services programs refer here to training programs for paraprofessionals involved in helping people.) Data were gathered from 176 two-year colleges regarding the human services curricula offered in 1970-71. In Part I, the survey…

  9. Patterns of Healthcare Spending in the Last Year of Life

    PubMed Central

    Davis, Matthew A.; Nallamothu, Brahmajee K.; Banerjee, Mousumi; Bynum, Julie P.W.

    2016-01-01

    The underlying assumption that healthcare spending skyrockets at the end-of-life may suggest that policymakers should target the last few months of life to control costs. However, spending patterns leading up to death have not been fully examined. We applied a new methodology to administrative claims data for older Medicare beneficiaries who died in 2012 to characterize trajectories of healthcare spending in the last year of life. After adjustment, we identified four unique spending trajectories among decedents: 48.7 percent had High Persistent spending, 29.0 percent had Moderate Persistent spending, 10.2 percent had Progressive spending, and only 12.1 percent had Late Rise spending. High spending throughout the full year before death (approximately half of all decedents) was associated with having multiple chronic conditions but not any specific diseases. These findings suggest that spending at the end-of-life is a marker of general spending patterns often set in motion long before death. PMID:27307350

  10. [Epilepsy and epileptic syndromes during the first year of life].

    PubMed

    Durá-Travé, T; Yoldi-Petri, M E; Hualde-Olascoaga, J; Etayo-Etayo, V

    To analyse the epidemiological characteristics and the relative distribution of the different types of epilepsy and epileptic syndromes during the first year of life. An analysis was performed of the patient records of all patients with epilepsy diagnosed during their first year of life who were submitted to a developmental check-up in the year 2007. The sample consisted of 60 patients (27 boys and 33 girls). Epidemiological and clinical data were collected, together with the findings from complementary examinations. The diagnostic criteria applied were those of the International League Against Epilepsy. The mean age at the time of diagnosis was 6.3 months. The mean follow-up time was 7.6 years. The aetiology was symptomatic in 40 cases (66.7%), cryptogenic in 16 (26.7%) and idiopathic in four cases (6.7%). Neuroimaging tests detected abnormalities in 34 patients (56.7%). West's syndrome (30%), symptomatic focal epilepsies (23.3%) and epilepsies linked to specific syndromes (16.7%) were the epileptic syndromes with the highest prevalence. Learning disabilities were observed in 82.5% of the children. Most epilepsies that present during the first year of life are symptomatic and/or cryptogenic, and are accompanied by psychoneurological impairment and/or resistance to therapy, which condition cognitive disorders that are eligible for specialised psycho-pedagogical intervention.

  11. Predicting current serviceability and residual service life of plywood roof sheathing using kinetics-based models

    Treesearch

    J.E. Winandy; P.K. Lebow; J.F. Murphy

    2002-01-01

    Research programs throughout North America are increasingly focusing on understanding and defining the salient issues of wood durability and maintaining and extending the serviceability of existing wood structures. This report presents the findings and implications of a 10-year research program, carried out at the USDA Forest Service, Forest Products Laboratory, to...

  12. The EMBRACE web service collection

    PubMed Central

    Pettifer, Steve; Ison, Jon; Kalaš, Matúš; Thorne, Dave; McDermott, Philip; Jonassen, Inge; Liaquat, Ali; Fernández, José M.; Rodriguez, Jose M.; Partners, INB-; Pisano, David G.; Blanchet, Christophe; Uludag, Mahmut; Rice, Peter; Bartaseviciute, Edita; Rapacki, Kristoffer; Hekkelman, Maarten; Sand, Olivier; Stockinger, Heinz; Clegg, Andrew B.; Bongcam-Rudloff, Erik; Salzemann, Jean; Breton, Vincent; Attwood, Teresa K.; Cameron, Graham; Vriend, Gert

    2010-01-01

    The EMBRACE (European Model for Bioinformatics Research and Community Education) web service collection is the culmination of a 5-year project that set out to investigate issues involved in developing and deploying web services for use in the life sciences. The project concluded that in order for web services to achieve widespread adoption, standards must be defined for the choice of web service technology, for semantically annotating both service function and the data exchanged, and a mechanism for discovering services must be provided. Building on this, the project developed: EDAM, an ontology for describing life science web services; BioXSD, a schema for exchanging data between services; and a centralized registry (http://www.embraceregistry.net) that collects together around 1000 services developed by the consortium partners. This article presents the current status of the collection and its associated recommendations and standards definitions. PMID:20462862

  13. An Outcomes-Based Assessment of Quality of Life in Social Services

    ERIC Educational Resources Information Center

    Gomez, Laura Elisabet; Arias, Benito; Verdugo, Miguel Angel; Navas, Patricia

    2012-01-01

    The goal of this article consists of describing the calibration of an instrument to assess quality of life-related personal outcomes using Rasch analysis. The sample was composed of 3.029 recipients of social services from Catalonia (Spain) and was selected using a probabilistic polietapic sample design. Results related to unidimensionality, item…

  14. Years of life lost among Iranian people killed in the Iraq-Iran war: the 25-year perspective.

    PubMed

    Mousavi, Batool; Moradi-Lakeh, Maziar; Karbakhsh, Mojgan; Soroush, Mohammadreza

    2014-01-01

    To estimate the years of life lost (YLL), registered deaths due to Iraq-Iran war (1980-2005) were identified considering ICD10 codes of Y36.0 to Y36.9. Estimated YLL was calculated by taking age-weighting options and discount rates. Population life expectancy in each corresponding year was retrieved from the national health database. During 1980-2005, 178,298 Iranian men and 5325 Iranian women died in war. The mean death age was 22.8 ± 9 years, 96.6% occurred during the years of war (September 1980-August 1988). In the years after the war (1988-2005) 6243 (3.4%) of deaths occurred as the result of complication of the war-related injuries or implanted landmines/unexploded ordnances (ICD10 code: Y36.8). YLL in Iraq-Iran war among Iranian victims were calculated as 10,479,405.0 years considering the age weighting and discount rate equal to 0. Age-adjusted YLL were estimated as 10,169,546.2 years in males. Female cases that comprised 2.9% of total victims lost 309,858.8 years. The mean YLL was calculated as 57.1 years for each Iranian victim killed in Iraq-Iran war. The war-related YLL was estimated more than 10 million years that comprised a majority of young men. This study is the first step in estimation of disability adjusted life year (DALY) of Iraq-Iran war on Iranian side.

  15. Human Papillomavirus Seroprevalence Among Men Entering Military Service and Seroincidence After Ten Years of Service

    PubMed Central

    Agan, Brian K.; Macalino, Grace E.; Nsouli-Maktabi, Hala; Wang, Xun; Gaydos, Joel C.; Ganesan, Anuradha; Kortepeter, Mark G.; Sanchez, Jose L.

    2015-01-01

    Vaccination against human papillomavirus (HPV) is recommended to prevent cervical cancer among women, but the benefits of HPV vaccination for males are less obvious. This study characterized HPV acquisition among male military members by evaluating both seroprevalence at entry into service and seroincidence of HPV infection after ten years of service. At entry, 29 of 200 (14.6%) male service members were positive for HPV serotypes 6, 11, 16, or 18. Of 199 initially seronegative for at least one of the four HPV serotypes, 68 (34.2%) seroconverted to one or more serotypes at ten years; more than one-third of these were seropostive for oncogenic HPV serotypes. This estimate of HPV seroprevalence among male military accessions is higher than that reported among U.S. civilian males. Vaccination to prevent genital warts and cancers resulting from HPV infection may decrease health care system burdens. Further analyses are warranted to understand the potential costs and benefits of a policy to vaccinate male service members. PMID:23461307

  16. Viscoelastic analysis of seals for extended service life

    NASA Technical Reports Server (NTRS)

    Bower, Mark V.

    1993-01-01

    The space station is being developed for a service life of up to thirty years. As a consequence, the design requirements for the seals to be used are unprecedented. Full scale testing to assure the selected seals can satisfy the design requirements are not feasible. As an alternative, a sub-scale test program (2) has been developed by MSFC to calibrate the analysis tools to be used to certify the proposed design. This research has been conducted in support of the MSFC Integrated Seal Test Program. The ultimate objective of this research is to correlate analysis and test results to qualify the analytical tools which in turn, are to be used to qualify the flight hardware. Seals are simple devices, in wide spread use. The most common type of seal is the O-ring. O-ring seals are typically rings of rubber with a circular cross section. The rings are placed between the surfaces to be sealed, usually in a groove of some design. The particular design may differ based on a number of different factors. This research is focused on O-rings that are staticly compressed by perpendicular clamping forces, commonly referred to as face seals. In this type of seal the O-ring is clamped between the sealing surfaces by loads perpendicular to the circular cross section.

  17. 46 CFR 185.730 - Servicing of inflatable liferafts, inflatable buoyant apparatus, inflatable life jackets, and...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... inflatable liferaft or inflatable buoyant apparatus must be serviced at a facility specifically approved by... apparatus, inflatable life jackets, and inflated rescue boats. 185.730 Section 185.730 Shipping COAST GUARD... Operational Readiness, Maintenance, and Inspection of Lifesaving Equipment § 185.730 Servicing of inflatable...

  18. 46 CFR 185.730 - Servicing of inflatable liferafts, inflatable buoyant apparatus, inflatable life jackets, and...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... inflatable liferaft or inflatable buoyant apparatus must be serviced at a facility specifically approved by... apparatus, inflatable life jackets, and inflated rescue boats. 185.730 Section 185.730 Shipping COAST GUARD... Operational Readiness, Maintenance, and Inspection of Lifesaving Equipment § 185.730 Servicing of inflatable...

  19. Air Traffic Services Performance Plan for Fiscal Years 2000-2002

    DOT National Transportation Integrated Search

    1999-10-01

    Each year, Air Traffic Services (ATS) executives and staff assess the : organization's performance and actions taken to improve aviation services : during the previous 12 months, and evaluate the current and future challenges : facing its customers. ...

  20. Cost of treating sagittal synostosis in the first year of life.

    PubMed

    Abbott, Megan M; Rogers, Gary F; Proctor, Mark R; Busa, Kathleen; Meara, John G

    2012-01-01

    Endoscopically assisted suturectomy (EAS) has been reported to reduce the morbidity and cost of treating sagittal synostosis when compared with traditional open cranial vault remodeling (CVR) procedures. Whereas the former claim is well substantiated and intuitive, the latter has not been validated by rigorous cost analysis. Patient medical records and financial database reports were culled retrospectively to determine the total cost associated with both EAS and CVR during 1 year of care. Recorded cost data included physician and hospital services, orthotic equipment and fittings, and indirect patient cost. Ten patients treated with CVR were compared with 10 patients who underwent EAS. The CVR patients incurred greater costs in nearly all categories studied, including overall 1-year costs, physician services, hospital services, supplies/equipment, medications/intravenous fluids, and laboratory and blood bank services. Postoperative costs were greater in the EAS group, primarily because of the cost associated with orthotic services and indirect patient costs for travel and lost work. However, overall indirect patient costs for the whole year did not differ between the groups. One-year median costs were $55,121 for CVR and $23,377 for EAS. Early clinical results were similar for the 2 groups. Cranial vault remodeling was more costly in the first year of treatment than EAS, although indirect patient costs were similar. The favorable cost of EAS compared with CVR provides further justification to consider this procedure as first-line treatment of sagittal synostosis in young infants.

  1. Bioelectrical impedance vector distribution in the first year of life.

    PubMed

    Savino, Francesco; Grasso, Giulia; Cresi, Francesco; Oggero, Roberto; Silvestro, Leandra

    2003-06-01

    We assessed the bioelectrical impedance vector distribution in a sample of healthy infants in the first year of life, which is not available in literature. The study was conducted as a cross-sectional study in 153 healthy Caucasian infants (90 male and 63 female) younger than 1 y, born at full term, adequate for gestational age, free from chronic diseases or growth problems, and not feverish. Z scores for weight, length, cranial circumference, and body mass index for the study population were within the range of +/-1.5 standard deviations according to the Euro-Growth Study references. Concurrent anthropometrics (weight, length, and cranial circumference), body mass index, and bioelectrical impedance (resistance and reactance) measurements were made by the same operator. Whole-body (hand to foot) tetrapolar measurements were performed with a single-frequency (50 kHz), phase-sensitive impedance analyzer. The study population was subdivided into three classes of age for statistical analysis: 0 to 3.99 mo, 4 to 7.99 mo, and 8 to 11.99 mo. Using the bivariate normal distribution of resistance and reactance components standardized by the infant's length, the bivariate 95% confidence limits for the mean impedance vector separated by sex and age groups were calculated and plotted. Further, the bivariate 95%, 75%, and 50% tolerance intervals for individual vector measurements in the first year of life were plotted. Resistance and reactance values often fluctuated during the first year of life, particularly as raw measurements (without normalization by subject's length). However, 95% confidence ellipses of mean vectors from the three age groups overlapped each other, as did confidence ellipses by sex for each age class, indicating no significant vector migration during the first year of life. We obtained an estimate of mean impedance vector in a sample of healthy infants in the first year of life and calculated the bivariate values for an individual vector (95%, 75%, and 50

  2. [Causes of symptomatic epilepsy in two first years of life children hospitalized in 2006-2007 years].

    PubMed

    Kroczka, Sławomir; Skowronek-Bała, Barbara; Zajac, Anna

    2008-01-01

    Epilepsy in two first years of life needs constant attention due to diagnostic and therapeutic difficulties. The aim of the study was to identify cause of symptomatic epilepsy in two first years of life children from miopolskie and podkarpackie provinces hospitalized in Pediatric Neurology Clinic of Children and Adolescents Neurology Cathedra UJ in Cracow. 102 children with epilepsy aged from 1 week to 24 months hospitalized between 1st of January 2006 and 31st of December 2007. The group included 47 girls and 55 boys. On the basis of clinical characteristics and results of additional examinations idiopathic epilepsy was diagnosed in 16/102 (13.3%) children and in remaining 86 (87.7%) symtopmatic epilepsy was established. Perinatal burdening was cause of epilepsy in 31/86 (33.72%) children. Other causes were identified in 32/54 children (59.3%) and in remaining 231 54 (40.7%) children the cause was not established. In 3/32 epilepsy occured in the course of hydrocephalus and in 3/32 children as one of CNS inflammation complications. Epilepsy as a result of vascular lesions and bleeding to CNS occured in 4 children. Multiple developmental deffects syndrome was diagnosed in 4 children and in 11 specific neurodevelopmental disorders were the cause of epilepsy. In 6 children epilepsy occured in the course of neurometabolic diseases, neurocutaneous syndromes and neoplasms. In children in two first years of life polimorphic seizures were diagnosed the most often (32/86 that is 37.2%) and tonic, tonic-clonic seizures were less often (21/86 that is 24.43%). Focal seizures occured in 20/86 (23.26%) patients, in 4/86 (4.65%) mioclonic jerks were observed and infantile spasms in 9/86 (10.46%). (1) In most hospitalized children in two first years of life symptomatic epilepsy was diagnosed. (2) Epilepsy in two first years of life was more often in boys. (3) The most often cause of symptomatic epilepsy was pathology of perinatal period. (4) Polymorphic seizures were the most

  3. First-year Pre-service Teachers in Taiwan—Do they enter the teacher program with satisfactory scientific literacy and attitudes toward science?

    NASA Astrophysics Data System (ADS)

    Chin, Chi-Chin

    2005-10-01

    Scientific literacy and attitudes toward science play an important role in human daily lives. The purpose of this study was to investigate whether first-year pre-service teachers in colleges in Taiwan have a satisfactory level of scientific literacy. The domains of scientific literacy selected in this study include: (1) science content; (2) the interaction between science, technology and society (STS); (3) the nature of science; and (4) attitudes toward science. In this study, the instruments used were Chinese translations of the Test of Basic Scientific Literacy (TBSL) and the Test of Science-related Attitudes. Elementary education majors (n = 141) and science education majors (n = 138) from four teachers’ colleges responded to these instruments. The statistical results from the tests revealed that, in general, the basic scientific literacy of first-year pre-service teachers was at a satisfactory level. Of the six scales covered in this study, the pre-service teachers displayed the highest literacy in health science, STS, and life science. Literacy in the areas of the nature of science and earth science was rated lowest. The results also showed that science education majors scored significantly higher in physical science, life science, nature of science, science content, and the TBSL than elementary science majors. Males performed better than females in earth science, life science, science content, and the TBSL. Next, elementary education majors responded with more “don’t know” responses than science education majors. In general, the pre-service teachers were moderately positive in terms of attitudes toward science while science education majors had more positive attitudes toward science. There was no significant difference in attitudes between genders. Previous experience in science indicated more positive attitudes toward science. The results from stepwise regression revealed that STS, the nature of science, and attitudes toward science could explain 50

  4. 46 CFR 122.730 - Servicing of inflatable liferafts, inflatable buoyant apparatus, inflatable life jackets, and...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Inspection of Lifesaving Equipment § 122.730 Servicing of inflatable liferafts, inflatable buoyant apparatus... apparatus must be serviced at a facility specifically approved by the Commandant for the particular brand... apparatus, inflatable life jackets, and inflated rescue boats. 122.730 Section 122.730 Shipping COAST GUARD...

  5. 46 CFR 122.730 - Servicing of inflatable liferafts, inflatable buoyant apparatus, inflatable life jackets, and...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Inspection of Lifesaving Equipment § 122.730 Servicing of inflatable liferafts, inflatable buoyant apparatus... apparatus must be serviced at a facility specifically approved by the Commandant for the particular brand... apparatus, inflatable life jackets, and inflated rescue boats. 122.730 Section 122.730 Shipping COAST GUARD...

  6. Music Perception and Cognition in the First Year of Life.

    ERIC Educational Resources Information Center

    Ilari, Beatriz Senoi

    2002-01-01

    Reviews literature on music perception and cognition in the first year of life and examines their contribution to domains such as child development and music education. Focuses on studies examining musical features and the uses of music in the everyday life of infants and their caretakers. Critiques previous and current literature. Discusses…

  7. Mouse allergen exposure, wheeze and atopy in the first seven years of life

    PubMed Central

    Phipatanakul, W.; Celedón, J. C.; Hoffman, E. B.; Abdulkerim, H.; Ryan, L. M.; Gold, D. R.

    2008-01-01

    Background Little is known about mouse allergen exposure in home environments and the development of wheezing, asthma and atopy in childhood. Objective To examine the relation between mouse allergen exposure and wheezing, atopy, and asthma in the first 7 years of life. Methods Prospective study of 498 children with parental history of allergy or asthma followed from birth to age 7 years, with longitudinal questionnaire ascertainment of reported mouse exposure and dust sample mouse urinary protein allergen levels measured at age 2–3 months. Results Parental report of mouse exposure in the first year of life was associated with increased risk of transient wheeze and wheezing in early life. Current report of mouse exposure was also significantly associated with current wheeze throughout the first 7 years of life in the longitudinal analysis (P = 0.03 for overall relation of current mouse to current wheeze). However, early life mouse exposure did not predict asthma, eczema or allergic rhinitis at age 7 years. Exposure to detectable levels of mouse urinary protein in house dust samples collected at age 2–3 months was associated with a twofold increase in the odds of atopy (sensitization to >=1 allergen) at school age (95% confidence interval for odds ratio = 1.1–3.7; P = 0.03 in a multivariate analysis. Conclusions Among children with parental history of asthma or allergies, current mouse exposure is associated with increased risk of wheeze during the first 7 years of life. Early mouse exposure was associated with early wheeze and atopy later in life. PMID:18616677

  8. Basic life support knowledge of first-year university students from Brazil.

    PubMed

    Santos, S V; Margarido, M R R A; Caires, I S; Santos, R A N; Souza, S G; Souza, J M A; Martimiano, R R; Dutra, C S K; Palha, P; Zanetti, A C G; Pazin-Filho, A

    2015-12-01

    We aimed to evaluate knowledge of first aid among new undergraduates and whether it is affected by their chosen course. A questionnaire was developed to assess knowledge of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de Atendimento Móvel de Urgência; SAMU), recognize a pre-hospital emergency situation and the first aid required for cardiac arrest. The students were also asked about enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04%) new undergraduates. The questionnaires were completed in a 2-week period 1 month after the beginning of classes. Of the 1038 respondents (59.5% studying biological sciences, 11.6% physical sciences, and 28.6% humanities), 58.5% knew how to activate the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02), with an odds ratio (OR)=1.39 (95%CI=1.07-1.81) regardless of age, sex, origin, having a previous degree or having a relative with cardiac disease. The majority could distinguish emergency from non-emergency situations. When faced with a possible cardiac arrest, 17.7% of the students would perform chest compressions (15.5% non-biological vs 19.1% biological first-year university students, P=0.16) and 65.2% would enroll in a first aid course (51.1% non-biological vs 74.7% biological, P<0.01), with an OR=2.61 (95%CI=1.98-3.44) adjusted for the same confounders. Even though a high percentage of the students recognized emergency situations, a significant proportion did not know the MEAS/SAMU number and only a minority had sufficient basic life support skills to help with cardiac arrest. A significant proportion would not enroll in a first aid course. Biological first-year university students were more prone to enroll in a basic life support course.

  9. Residential immersive life skills programs for youth with disabilities: service providers' perceptions of change processes.

    PubMed

    King, Gillian; McPherson, Amy; Kingsnorth, Shauna; Stewart, Debra; Glencross-Eimantas, Tanya; Jones-Galley, Kimberlea; Morrison, Andrea; Isihi, Ana Maria; Gorter, Jan Willem

    2015-05-01

    Residential immersive life skills (RILS) programs are designed to equip youth with physical disabilities with the foundational life skills required to assume adult roles. The objective was to determine RILS service providers' perceptions of the active ingredients of the intervention change process. Thirty-seven service providers from various disciplines completed measures to assess expertise status and participated in qualitative interviews. Qualitative themes were derived, and similarities and differences in themes were identified for blinded groups of novices, intermediates, and experts. The three main themes, reflecting change processes, were: (a) creating a supportive program atmosphere with multiple opportunities for learning, (b) using strategies to support, encourage, and engage youth, and (c) intentionally fostering youth experiences of skill development, social interaction, and pride in accomplishment. In contrast to the novices, experts displayed a more holistic perspective and paid attention to higher-order issues such as providing opportunities and enabling youth. The findings indicate how RILS service providers work to create a program atmosphere and employ strategies to intentionally foster particular youth experiences. The findings explicate service providers' theories of practice, the intentional design of RILS program environments to bring about client change, and the value of service provider expertise. Implications for Rehabilitation Service providers of youth independence-oriented life skills programs can intentionally create a learning-oriented and supportive program atmosphere by using non-directive, coaching/guiding, and engagement strategies Youth experiences of skill development, shared experience with others, and pride in accomplishment can be cultivated by providing a range of learning opportunities, including choice making, problem-solving, and skill mastery Compared to more novice service providers, experts discussed managing the

  10. 'Silent voices' in health services research: ethnicity and socioeconomic variation in participation in studies of quality of life in childhood visual disability.

    PubMed

    Tadic, Valerie; Hamblion, Esther Louise; Keeley, Sarah; Cumberland, Phillippa; Lewando Hundt, Gillian; Rahi, Jugnoo Sangeeta

    2010-04-01

    Purpose. To investigate patterns of participation of visually impaired (VI) children and their families in health services research. Methods. The authors compared clinical and sociodemographic characteristics of children and their families who participated with those who did not participate in two studies of quality of life (QoL) of VI children. In Study 1, the authors interviewed VI children and adolescents, aged 10 to 15 years, about their vision-related quality of life (VRQoL) as the first phase of a program to develop a VRQoL instrument for this population. One hundred seven children with visual impairment (visual acuity in the better eye LogMar worse than 0.51) were invited to participate in the interviews. Study 2 investigated health-related quality of life (HRQoL) of VI children using an existing generic instrument, administered in a postal survey. 151 VI children and adolescents, aged 2 to 16 years, with hereditary retinal disorders were invited to participate in the survey. Results. The overall participation level was below 50%. In both studies, participants from white ethnic and more affluent socioeconomic backgrounds were overrepresented. Participation did not vary by age, sex, or clinical characteristics. Conclusions. The authors suggest that there are barriers to participation in child- and family-centered research on childhood visual disability for children from socioeconomically deprived or ethnic minority groups. They urge assessment and reporting of participation patterns in further health services research on childhood visual disability. Failure to recognize that there are "silent voices" is likely to have important implications for equitable and appropriate service planning and provision for VI children.

  11. Ethical issues arising from variation in health services utilization at the end of life.

    PubMed

    Weeks, William Brinson; Nelson, William A

    2011-01-01

    Research on health services delivery, particularly at the end of life, has demonstrated that more care does not necessarily lead to better technical quality, patient satisfaction, or outcomes. These findings raise three ethical issues: (1) justice in the allocation of scarce resources across health service areas; (2) nonmaleficence in the provision of appropriate amounts of care to patients; and (3) transparency about local healthcare practice so patients can make enlightened decisions about healthcare choices. We conclude that in this era of healthcare accountability, managers and clinicians can use these ethical principles to drive change in the process of providing more efficient, more effective, and more patient-centered care, especially at the end of life.

  12. The Impact of First-Year Seminars on College Students' Life-Long Learning Orientations

    ERIC Educational Resources Information Center

    Padgett, Ryan D.; Keup, Jennifer R.; Pascarella, Ernest T.

    2013-01-01

    Using longitudinal data from the Wabash National Study of Liberal Arts Education, this study measured the impact of first-year seminars on college students' life-long learning orientations. The findings suggest that first-year seminars enhance students' life-long learning orientations and that the effect of first-year seminars is mediated through…

  13. Scientific life should be measured in seven year units.

    PubMed

    Charlton, Bruce G

    2006-01-01

    Traditional wisdom and empirical observation unite in recommending a 7 year unit for measuring human life - including individual and institutional science. But, because of astronomy and the decimal system, things tend to be measured either in years, five years or in decades. A year is too short while a decade is too long to measure the trends and transitions of individual or institutional life. And the half decade, such as the 'five year plan' beloved by politicians and bureaucrats seems too short. Therefore, seven years should become the standard unit for tracking trends and measuring attainment. Precedents for using a seven year unit include the notorious Jesuit saying: 'Give me the child until he is seven, and I will show you the man'; and the 'ninth commandment' of Leo Szilard: 'Do your work for six years; but in the seventh, go into solitude or among strangers, so that the memory of your friends does not prevent you from being what you have become'. In a scientific career, seven years is approximately the time spent at high school, the time taken for a traditional basic scientific training of first degree and doctorate, and the period after the doctorate building the knowledge to become an expert specialist. There seems to be enough anecdotal evidence to support the idea that we should reconsider the universal but un-reflective use of decimal units in planning and evaluation. For instance, seven year fellowships and program grants might replace the current five year versions. A new - and previously unconsidered - field of research beckons.

  14. Recreation as a Related Service: Focusing on the Quality of Life of Students with Disabilities

    ERIC Educational Resources Information Center

    Diodati, Melissa R.

    2017-01-01

    Leisure participation is influential on the quality of life of individuals. Individuals with disabilities can face barriers in leisure participation, impacting their quality of life. IDEA (2004) recognizes recreation as a related service as one way to enhance the leisure experiences for students with disabilities. The purpose of this embedded case…

  15. Fifteen-year Experience with Telemedicine Services in Gangwon Province in Korea

    PubMed Central

    Kim, Hyung-Gi; Choi, Young-A; Choi, Eun-Hi; Kim, Dong-Won; Shin, Se-Gye; Park, Kyung-Suk; Han, Jae-Hyun

    2015-01-01

    Objectives This study attempted to identify the factors that contribute to successful telemedicine service. This was done by analyzing the operational state of successful telemedicine services offered in Gangwon Province of Korea and their outcome for the last fifteen years. Methods A comparative analysis was made based on reports and a thesis on the satisfaction rate of patients and providers, patient compliance to treatment, and economic assessment of Gangwon telemedicine service, which were carried out in three periods: the years 2006, 2010, and 2012. Results The satisfaction surveys in all three periods showed similar results for patients (4.46±0.70 point) and healthcare practitioners, including nurses (3.82±0.62 point) and physicians (3.60±0.56 point), in decreasing order from the year 2012. Through the survey of patients' compliance with treatment, it was confirmed that telemedicine services increased patients' compliance with drug administration, facilitated improvement of lifestyle habits, improved glycated hemoglobin for patients with diabetes mellitus, and enhanced the rate of blood pressure control. In the survey conducted on patients' willingness to pay for telemedicine services in 2007, it was found that those patients were willing to pay about $3.5 for services. Conclusions The telemedicine services of Gangwon Province increased patients' compliance with drug administration, improved blood glucose control, enhanced blood pressure control for patients with hypertension, and provided economic advantage. PMID:26618035

  16. Can comprehensive specialised end-of-life care be provided at home? Lessons from a study of an innovative consultant-led community service in the UK.

    PubMed

    Noble, B; King, N; Woolmore, A; Hughes, P; Winslow, M; Melvin, J; Brooks, J; Bravington, A; Ingleton, C; Bath, P A

    2015-03-01

    The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) is a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes. Of 389 referrals in 2010/11, about 85% were for cancer, from a population of about 155 000. Using a mixed method approach, the evaluation comprised: a retrospective analysis of secondary-care use in the last year of life; financial evaluation of the MMSPCS using an Activity Based Costing approach; qualitative interviews with patients, carers, health and social care staff and MMSPCS staff and volunteers; a postal survey of General Practices; and a postal survey of bereaved caregivers using the MMSPCS. The mean cost is about 3000 GBP (3461 EUR) per patient with mean cost of interventions for cancer patients in the last year of life 1900 GBP (2192 EUR). Post-referral, overall costs to the system are similar for MMSPCS and hospice-led models; however, earlier referral avoided around 20% of total costs in the last year of life. Patients and carers reported positive experiences of support, linked to the flexible way the service worked. Seventy-one per cent of patients died at home. This model may have application elsewhere. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

  17. Military Service, Childhood Socio-Economic Status, and Late-Life Lung Function: Korean War Era Military Service Associated with Smaller Disparities.

    PubMed

    Vable, Anusha M; Kiang, Mathew V; Basu, Sanjay; Rudolph, Kara E; Kawachi, Ichiro; Subramanian, S V; Glymour, M Maria

    2018-03-02

    Military service is associated with smoking initiation, but U.S. veterans are also eligible for special social, financial, and healthcare benefits, which are associated with smoking cessation. A key public health question is how these offsetting pathways affect health disparities; we assessed the net effects of military service on later life pulmonary function among Korean War era veterans by childhood socio-economic status (cSES). Data came from U.S.-born male Korean War era veteran (service: 1950-1954) and non-veteran participants in the observational U.S. Health and Retirement Study who were alive in 2010 (average age = 78). Veterans (N = 203) and non-veterans (N = 195) were exactly matched using coarsened exact matching on birth year, race, coarsened height, birthplace, childhood health, and parental and childhood smoking. Results were evaluated by cSES (defined as maternal education <8 yr/unknown or ≥8 yr), in predicting lung function, as assessed by peak expiratory flow (PEF), measured in 2008 or 2010. While there was little overall association between veterans and PEF [β = 12.8 L/min; 95% confidence interval (CI): (-12.1, 37.7); p = 0.314; average non-veteran PEF = 379 L/min], low-cSES veterans had higher PEF than similar non-veterans [β = 81.9 L/min; 95% CI: (25.2, 138.5); p = 0.005], resulting in smaller socio-economic disparities among veterans compared to non-veterans [difference in disparities: β = -85.0 L/min; 95% CI: (-147.9, -22.2); p = 0.008]. Korean War era military service appears to disproportionately benefit low-cSES veteran lung functioning, resulting in smaller socio-economic disparities among veterans compared with non-veterans.

  18. A Dialogue of Life: Integrating Service Learning in a Community-Immersion Model of Preservice Science-Teacher Preparation

    ERIC Educational Resources Information Center

    Handa, Vicente; Tippins, Deborah; Thomson, Norman; Bilbao, Purita; Morano, Lourdes; Hallar, Brittan; Miller, Kristen

    2008-01-01

    Dubbed a "dialogue of life," community immersion in preservice science-teacher education aims at providing a true-to-life and empowering opportunity for prospective science teachers (both elementary and secondary) to become active participants in community life through field and service-learning experiences. It consists of a three-unit…

  19. Linking Concurrent Self-Reports and Retrospective Proxy Reports About the Last Year of Life: A Prevailing Picture of Life Satisfaction Decline

    PubMed Central

    Gerstorf, Denis; Ram, Nilam; Schupp, Jürgen; Sprangers, Mirjam A. G.; Wagner, Gert G.

    2014-01-01

    Objective. We examined the extent to which retrospective proxy reports of well-being mirror participant self-reports at 12–24 months before death and how proxy reports of well-being change over the last year of life. We also explored the role of sociodemographic, cognitive, and health factors of both participants and proxies in moderating such associations. Method. We used retrospective proxy ratings obtained in the German Socio-Economic Panel Study (N = 164; age at death = 19–99 years). Results. Results revealed moderate agreement between self- and proxy reports (r = .42), but proxies, on average, overestimated participants’ life satisfaction by two thirds of a scale point on a 0–10 scale (or 0.4 SD). Discrepancies were particularly pronounced when proxies themselves reported low life satisfaction. Over the last year of life, participants were viewed to have experienced declines in life satisfaction (−0.54 SD). Declines were stronger for ill participants and proxies who reported low life satisfaction. Discussion. Results qualify theoretical expectations and empirical results based on self-report data that are typically available 1 or 2 years before death. We discuss that retrospective proxy reports in panel surveys can be used as a hypothesis-generating tool to gather insights into late life. PMID:23766436

  20. 77 FR 23293 - Service Contract Inventory for Fiscal Year (FY) 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-18

    ... OFFICE OF SPECIAL COUNSEL Service Contract Inventory for Fiscal Year (FY) 2011 AGENCY: Office of Special Counsel. ACTION: Notice of availability--FY 2011 Service Contract Inventory. SUMMARY: Through this... contract inventory on its Web site, at http://www.osc.gov/RR_OSCReportsAndInformation.htm . A service...

  1. Corrosion protection service life of epoxy-coated reinforcing steel in Virginia bridge decks.

    DOT National Transportation Integrated Search

    2003-01-01

    The corrosion protection service life extension provided by epoxy-coated reinforcement (ECR) was determined by comparing ECR and bare steel bars from 10 Virginia bridge decks built between 1981 and 1995. The objective was to determine the corrosion p...

  2. Child life services.

    PubMed

    Wilson, Jerriann M

    2006-10-01

    Child life programs have become standard in most large pediatric centers and even on some smaller pediatric inpatient units to address the psychosocial concerns that accompany hospitalization and other health care experiences. The child life specialist focuses on the strengths and sense of well-being of children while promoting their optimal development and minimizing the adverse effects of children's experiences in health care or other potentially stressful settings. Using play and psychological preparation as primary tools, child life interventions facilitate coping and adjustment at times and under circumstances that might prove overwhelming otherwise. Play and age-appropriate communication may be used to (1) promote optimal development, (2) present information, (3) plan and rehearse useful coping strategies for medical events or procedures, (4) work through feelings about past or impending experiences, and (5) establish therapeutic relationships with children and parents to support family involvement in each child's care, with continuity across the care continuum. The benefits of this collaborative work with the family and health care team are not limited to the health care setting; it may also optimize reintegration into schools and the community.

  3. Body Representation in the First Year of Life

    ERIC Educational Resources Information Center

    Zieber, Nicole; Bhatt, Ramesh S.; Hayden, Angela; Kangas, Ashley; Collins, Rebecca; Bada, Henrietta

    2010-01-01

    Like faces, bodies are significant sources of social information. However, research suggests that infants do not develop body representation (i.e., knowledge about typical human bodies) until the second year of life, although they are sensitive to facial information much earlier. Yet, previous research only examined whether infants are sensitive…

  4. Family Quality of Life: A Key Outcome in Early Childhood Intervention Services--A Scoping Review

    ERIC Educational Resources Information Center

    Bhopti, Anoo; Brown, Ted; Lentin, Primrose

    2016-01-01

    A scoping review was conducted to identify factors influencing the quality of life of families of children with disability. The review also explored the scales used to measure family quality of life (FQOL) as an outcome in early childhood intervention services (ECIS). Multiple databases were searched from 2000 to 2013 to include studies pertinent…

  5. Associations between quality of life and socioeconomic factors, functional impairments and dissatisfaction with received information and home-care services among survivors living at home two years after stroke onset.

    PubMed

    Baumann, Michèle; Le Bihan, Etienne; Chau, Kénora; Chau, Nearkasen

    2014-04-28

    Quality of life (QoL) assessment is important when monitoring over time the recovery of stroke-survivors living at home. This study explores the associations between QoL and socioeconomic factors, functional impairments and self-reported dissatisfaction with received information and home-care services among survivors two years after stroke onset. This problem remains partially addressed though optimal information and services may improve survivors' QoL. Stroke-survivors admitted to all hospitals in Luxembourg 18 months or more previously were identified using the only care-expenditure-reimbursement national system database. The clinical diagnosis was confirmed. Ninety four patients aged 65 years and living at home were interviewed to gather socioeconomic characteristics, functional impairments, dissatisfaction with information and home-care services, and QoL (using the Newcastle Stroke-Specific QoL, newsqol) assessing 11 domains. Data were analyzed using multiple linear regression models. About 50% of survivors had low education and lower income. Functional impairments were common: sensory (45%), motor (35%), memory (32%), language (31%), and vision (20%). Survivors with education (<12th grade) or lower income had low values for most newsqol domains (sex-age-adjusted regression coefficient saRC, i.e. mean difference, between -23 and -8). Patients who were working had better values for pain, mental feelings and sleep domains than did retired people (saRC between -3.9 and 4.2). Various functional impairments were associated with markedly low values of nearly all domains (saRC between -33.5 and -7.5) and motor, language, memory and sensory impairments had the highest impact. The survivors' perceived QoL was markedly low, especially for the domains of interpersonal relationship, sleep, cognition, mental feelings, and pain. Various QoL domains were strongly related to dissatisfaction with information about stroke and its consequences/changes over time, accuracy of

  6. Years of life lost due to infectious diseases in Poland

    PubMed Central

    Bryla, Marek; Dziankowska-Zaborszczyk, Elzbieta; Bryla, Pawel; Pikala, Malgorzata

    2017-01-01

    Purpose An evaluation of mortality due to infectious diseases in Poland in 1999–2012 and an analysis of standard expected years of life lost due to the above diseases. Methods The study material included a database created on the basis of 5,219,205 death certificates of Polish inhabitants, gathered between 1999 and 2012 and provided by the Central Statistical Office. Crude Death Rates (CDR), Standardized Death Rates (SDR) and Standard Expected Years of Life Lost (SEYLL) due to infectious and parasitic diseases were also evaluated in the study period as well as Standard Expected Years of Life Lost per living person (SEYLLp) and Standard Expected Years of Life Lost per dead person (SEYLLd). Time trends were evaluated with the application of joinpoint models and an annual percentage change in their values. Results Death certificates report that 38,261 people died due to infectious diseases in Poland in the period 1999–2012, which made up 0.73% of the total number of deaths. SDR caused by these diseases decreased, particularly in the male group: Annual Percentage Change (APC = -1.05; 95% CI:-2.0 to -0.2; p<0.05). The most positive trends were observed in mortality caused by tuberculosis (A15-A19) (APC = -5.40; 95% CI:-6.3 to -4.5; p<0.05) and also meningitis, encephalitis, myelitis and encephalomyelitis (G03-G04) (APC = -3.42; 95% CI:-4.7 to -2.1; p<0.05). The most negative mortality trends were observed for intestinal infectious diseases (A00-A09) Annual Average Percentage Change (AAPC = 7.3; 95% CI:3.1 to 11.7; p<0.05). SDR substantially decreased in the first half of the study period, but then significantly increased in the second half. Infectious and parasitic diseases contributed to a loss of around 37,000 standard expected years of life in 1999 and more than 28,000 in 2012. During the study period, the SEYLLp index decreased from 9.59 to 7.39 per 10,000 population and the SEYLLd index decreased from 14.26 to 10.34 years (AAPC = 2.3; 95% CI:-2,9 to -1.7; p<0

  7. Incidence and Disability-Adjusted Life Years (Dalys) Attributable to Leishmaniasis In Iran, 2013.

    PubMed

    Heydarpour, Fatemeh; Sari, Ali Akbari; Mohebali, Mehdi; Shirzadi, Mohammadreza; Bokaie, Saied

    2016-07-01

    Leishmaniasis covers a range of clinical manifestations. Estimation of the burden of leishmaniasis may help guide healthcare management personnel and policy-makers in applying effective interventions. The present study aimed to calculate the incidence and burden of cutaneous and visceral leishmaniasis in Iran in 2013. To evaluate the epidemiological aspects of the disease in Iran, published studies over the past 20 years were searched and the viewpoints of relevant specialists in Iran were obtained. Data were collected from the Ministry of Health and from the Tehran University of Medical Sciences. To calculate years of life lost due to premature death, standard expected years of life lost was used. Standard life table of Global Burden of Disease (GBD) 2010 with the life expectancy of 86.02 years for both sexes was used to calculate the remaining potential years of life at any age from death. The overall incidence of cutaneous and visceral leishmaniasis was calculated as 22 and 0.092 per 100000 population of Iran, respectively. The burden of leishmaniasis was 99.5 years: 95.34 and 4.16 years for cutaneous and visceral, respectively. Sensitivity was analyzed and deaths predicted by the Institute of Health Metrics and Evaluation added, the burden of visceral leishmaniasis was 726 years. The share of leishmaniasis burden in Iran is lower than the global burden of the disease. GBD 2010 standard method is recommended to calculate the burden of leishmaniasis in different countries and set local priorities on the basis of these measures.

  8. Relationship among health-related quality of life, depression and awareness of home care services in elderly patients.

    PubMed

    Polat, Ülkü; Bayrak Kahraman, Burcu; Kaynak, İlknur; Görgülü, Ümit

    2016-11-01

    The present descriptive study was carried out to determine the relationship between health-related quality of life, depression and awareness of home care services among elderly patients. Patients aged 65 years or older staying at the surgery and internal medicine clinics were included in the study. The "Patient Introduction Form," "Short Form-36 Quality of Life Questionnaire" and "Geriatric Depression Scale" were utilized in the collection of data. In the present study, it was determined that only approximately half of elderly patients (54.9%) knew the concept of home care, most of them had not previously received home care and requested home care related to medical care. The mean scores were lower in some areas of the quality of life questionnaire in some factors that could influence home care awareness. These factors were determined as: female sex, history of falling, chronic illness, functionally, moderately or severely dependent, no previous receipt of home care and wishing to receive home care. The home care requirement of elderly patients can be influenced by many physiological, psychological and social factors that can affect their quality of life. Thus, it is of utmost importance that medical professionals evaluate the quality of life of elderly individuals and its influencing factors. Geriatr Gerontol Int 2016; 16: 1211-1219. © 2015 Japan Geriatrics Society.

  9. Advanced Life Support Research and Technology Development Metric: Fiscal Year 2003

    NASA Technical Reports Server (NTRS)

    Hanford, A. J.

    2004-01-01

    This document provides the official calculation of the Advanced Life Support (ALS) Research and Technology Development Metric (the Metric) for Fiscal Year 2003. As such, the values herein are primarily based on Systems Integration, Modeling, and Analysis (SIMA) Element approved software tools or reviewed and approved reference documents. The Metric is one of several measures employed by the National Aeronautics and Space Administration (NASA) to assess the Agency s progress as mandated by the United States Congress and the Office of Management and Budget. Because any measure must have a reference point, whether explicitly defined or implied, the Metric is a comparison between a selected ALS Project life support system and an equivalently detailed life support system using technology from the Environmental Control and Life Support System (ECLSS) for the International Space Station (ISS). More specifically, the Metric is the ratio defined by the equivalent system mass (ESM) of a life support system for a specific mission using the ISS ECLSS technologies divided by the ESM for an equivalent life support system using the best ALS technologies. As defined, the Metric should increase in value as the ALS technologies become lighter, less power intensive, and require less volume. For Fiscal Year 2003, the Advanced Life Support Research and Technology Development Metric value is 1.47 for an Orbiting Research Facility and 1.36 for an Independent Exploration Mission.

  10. Consultant-based otolaryngology emergency service: a five-year experience.

    PubMed

    Barnes, M L; Hussain, S S M

    2011-12-01

    To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

  11. Canadian Rural-urban Differences in End-of-life Care Setting Transitions

    PubMed Central

    Wilson, Donna M.; Thomas, Roger; Burns, Katharina Kovacs; Hewitt, Jessica A.; Jane, Osei-Waree; Sandra, Robertson

    2012-01-01

    Few studies have focused on the care setting transitions that occur in the last year of life. A three part mixed-methods study was conducted to gain an understanding of the number and implications or impact of care setting transitions in the last year of life for rural Canadians. Provincial health services utilization data, national online survey data, and local qualitative interview data were analyzed to gain general and specific information for consideration. Rural Albertans had significantly more healthcare setting transitions than urbanites in the last year of life (M=4.2 vs 3.3). Online family respondents reported 8 moves on average occurred for family members in the last year of life. These moves were most often identified (65%) on a likert-type scale as “very difficult,” with the free text information revealing these trips were often emotionally painful for themselves and physically painful for their ill family member. Eleven informants were then interviewed until data saturation, with constant-comparative data analysis conducted for a more in-depth understanding of rural transitions. Moving from place to place for needed care in the last year of life was identified as common and concerning for rural people and their families, with three data themes developing: (a) needed care in the last year of life is scattered across many places, (b) travelling is very difficult for terminally-ill persons and their caregivers, and (c) local rural services are minimal. These findings indicate planning is needed to avoid unnecessary end-of-life care setting transitions and to make needed moves for essential services in the last year of life less costly, stressful, and socially disruptive for rural people and their families. PMID:22980372

  12. Methods to Prove 20+ Year Life of CPV Products (in less than 20 Years)

    NASA Astrophysics Data System (ADS)

    Bowman, John; Spencer, Mark

    2011-12-01

    Due to the long term life expectations of photovoltaic products and the short duration of most introduced CPV technologies, it is critical for CPV companies to carefully construct field trials to prove product life. Because of the complicated geometric, thermal, and spectral characteristics of CPV systems, conducting very precise power output measurements reproducibly over many months is very difficult. Robust normalization methods specific to the exact optical system and PV cell type must be developed. Once the performance over a specific duration, e.g. one year, is established, then some justification is required to extrapolate to future performance. Comparisons to accelerated test results provide this justification. SolFocus has been conducting field trials of the SF-1100S CPV system for over two years. These field trials consist of controlled populations of SF-1100P modules, operating in grid-tied systems, which have been repeatedly measured at the individual module level over the duration of the trials. In this paper, field data will be presented along with normalization methodology and statistical methods for determining power degradation slope distributions for populations of individual modules. These results will be correlated with accelerated field tests which have been ongoing for 1.5 years and are estimated to be equivalent to 10 to 15 years of non-accelerated operation.

  13. Shift work to balance everyday life - a salutogenic nursing perspective in home help service in Sweden.

    PubMed

    Agosti, Madelaine Törnquist; Andersson, Ingemar; Ejlertsson, Göran; Janlöv, Ann-Christin

    2015-01-01

    Nurses in Sweden have a high absence due to illness and many retire before the age of sixty. Factors at work as well as in private life may contribute to health problems. To maintain a healthy work-force there is a need for actions on work-life balance in a salutogenic perspective. The aim of this study was to explore perceptions of resources in everyday life to balance work and private life among nurses in home help service. Thirteen semi-structured individual interviews and two focus group interviews were conducted with home help service nurses in Sweden. A qualitative content analysis was used for the analyses. In the analyses, six themes of perceptions of recourses in everyday life emerged; (i) Reflecting on life. (ii) Being healthy and taking care of yourself. (iii) Having a meaningful job and a supportive work climate. (iv) Working shifts and part time. (v) Having a family and a supporting network. (vi) Making your home your castle. The result points out the complexity of work-life balance and support that the need for nurses to balance everyday life differs during different phases and transitions in life. In this salutogenic study, the result differs from studies with a pathogenic approach. Shift work and part time work were seen as two resources that contributed to flexibility and a prerequisite to work-life balance. To have time and energy for both private life and work was seen as essential. To reflect on and discuss life gave inner strength to set boundaries and to prioritize both in private life and in work life. Managers in nursing contexts have a great challenge to maintain and strengthen resources which enhance the work-life balance and health of nurses. Salutogenic research is needed to gain an understanding of resources that enhance work-life balance and health in nursing contexts.

  14. Quality of life in stroke survivors under the sixty years of age.

    PubMed

    Vidović, Mirjana; Sinanović, Osman; Smajlović, Dzevdet

    2007-08-01

    The objective of the study was to analyze the quality of life six months after stroke in survivors under sixty years of age, to determine which life activities was the most affected, as well as to correlate the neurological insufficiency and the quality of life. It monitored 200 stroke survivors under sixty years of age treated at the Department of Neurology, University Clinical Centre Tuzla. Average age was 51,83 years (+/-7,02). The ischemic stroke was diagnosed in 77,5% stroke survivors, cerebral hemorrhage in 15%, and subarachnoid hemorrhage in 7,5%. Five stroke survivors suffered hemiplegia (2,5%), 24 (12%) experienced moderate consequences and 143 (71,5%) had mild consequences. No neurological deficit had 28 (14%) stroke survivors. Six months after the onset of disease all stroke survivors have been followed-up and evaluated about quality of life by filling in a modified questionnaire: Questionnaire on Quality of Life after Stroke (2). The questionnaire contained 20 questions covering four fields of life: Working Ability, Home Activity, Family Relations and Leisure Activities. Six months after the onset of stroke a worse quality of life in comparison to the period before the disease was noted in 172 (86%) stroke survivors, the unchanged in 19 (9,5%) and better in 9 (4,5%). The most affected is the field "Leisure Activities", followed by "Family Relations", "Home Activity", and the least affected is "Work Ability". The neurological deficit significantly correlates to the "Home Activities" and "Leisure Activities".

  15. Willingness to pay per quality-adjusted life year for life-saving treatments in Thailand

    PubMed Central

    Nimdet, Khachapon; Ngorsuraches, Surachat

    2015-01-01

    Objective To estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) value for life-saving treatments and to determine factors affecting the WTP per QALY value. Design A cross-sectional survey with multistage sampling and face-to-face interviews. Setting General population in the southern part of Thailand. Participants A total of 600 individuals were included in the study. Only 554 (92.3%) responses were usable for data analyses. Outcome measure Participants were asked for the maximum amount of WTP value for life-saving treatments by an open-ended question. EQ-5D-3L and visual analogue scale (VAS) were used to estimate additional QALY. Results The amount of WTP values varied from 0 to 720 000 Baht/year (approximately 32 Baht=US$1). The averages of additional QALY obtained from VAS and EQ-5D-3L were only slightly different (0.872 and 0.853, respectively). The averages of WTP per QALY obtained from VAS and EQ-5D-3L were 244720 and 243120 Baht/QALY, respectively. As compared to male participants, female participants were more likely to pay less for an additional QALY (p=0.007). In addition, participants with higher household incomes tended to have higher WTP per QALY values (p<0.001). Conclusions Our study added another WTP per QALY value specifically for life-saving treatments, which would complement the current cost-effectiveness threshold used in Thailand and optimise patient access to innovative treatments or technologies. PMID:26438135

  16. Functional outcome and service engagement in major depressive disorder with psychotic features: comparisons with schizophrenia, schizoaffective disorder and bipolar disorder in a 6-year follow-up of the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS).

    PubMed

    Kingston, Tara; Scully, Paul J; Browne, David J; Baldwin, Patrizia A; Kinsella, Anthony; O'Callaghan, Eadbhard; Russell, Vincent; Waddington, John L

    2018-03-25

    While long-term outcome following a first psychotic episode is well studied in schizophrenia (SZ), schizoaffective disorder (SA), and bipolar disorder (BD), major depressive disorder with psychotic features (MDDP) has received less investigation. This study compares MDDP with SZ, SA, and BD at 6-year follow-up. At 6 years after a first psychotic episode, follow-up data on psychopathology, functioning, quality of life, and service engagement were obtained for 27 cases of MDDP in comparison to 60 SZ, 27 SA, and 35 BD. Positive psychotic symptoms were less prominent in MDDP and BD than in SZ and SA. Negative symptoms, impaired functioning, and reduction in objectively determined quality of life were less prominent in MDDP and BD, intermediate in SA and most prominent in SZ. However, subjectively determined quality of life was indistinguishable across diagnoses. Service engagement was highest for MDDP, intermediate for SA and BD, and lowest for SZ. At 6-year follow-up, these diagnoses are characterized by quantitative rather than qualitative differences in psychopathology, functionality, quality of life, and service engagement, with considerable overlap between them. These findings suggest that MDDP should join SZ, SA, and BD in a milieu of psychosis that transcends arbitrary boundaries. © 2018 John Wiley & Sons Ltd.

  17. Extended School Year (ESY) Services: Iowa Standards for Students with Disabilities.

    ERIC Educational Resources Information Center

    Iowa State Dept. of Education, Des Moines. Bureau of Children, Family and Community Services.

    This publication is intended to ensure that consideration for and provision of extended school year services (ESY services) for students with disabilities are consistent with the requirements of federal law, Iowa state rules, and Iowa's adopted educational standards. Part 1 of the document discusses the specific addition of ESY services to the…

  18. Life Cycle Cost for Drainage Structures

    DTIC Science & Technology

    1988-02-01

    36aftSFCURITY CLASSIF"CTION OF TMuS PACA Unclassified -mm/ is. AletmCT (Cestlaed). gldellses presented I* Part II of this report can be used to ,stimato the...life calculated using this method is the average life based on field data. The actual life of individual installations may vary significantly. 12...applicatious where effluents contain petroleum products. Polymer coatings (AASMTO K246), in Several, add about 10 years to the average servics life. A

  19. How many years of life did the fall of the Berlin Wall add? A projection of East German life expectancy.

    PubMed

    Vogt, Tobias C

    2013-01-01

    In the two decades since reunification, East Germans have experienced a large increase in life expectancy and a convergence with the West German mortality level. This gain in life expectancy appears even more impressive if we assume a different scenario in which the Berlin Wall did not fall, and the old East Germany still existed. This analysis takes into account that East German mortality would not have remained static without reunification. Thus, it shows how many years of life expectancy were actually added by the fall of the Berlin Wall. The analysis shows the improvements for single age groups by projecting life expectancy based on mortality levels during the 1970s and 1980s using the Lee-Carter method. I use national-level data for both sexes for East Germany before reunification. I find that, without reunification, current life expectancy at birth among East Germans would be 4.0 years lower for females and 5.7 years lower for males. I also show that older East Germans were the main demographic beneficiaries of reunification. Female and male mortality improvements in the age groups above 60 contributed up to 80% to the actual gains in life expectancy. Had the Berlin Wall not fallen, East German mortality would not have remained static but improved at a far slower rate. Thus, this counterfactual approach shows for the first time how many years of life were actually gained by reunification and how much of these gains were attributable to mortality improvements among the elderly. Copyright © 2013 S. Karger AG, Basel.

  20. Behavioral assessment of language brain processing in the first year of life.

    PubMed

    Guzzetta, Francesco

    2014-09-01

    An up-to-date review of the behavioral assessments of language development in the first year of life is reported. After recalling the anatomical bases of the early development of the auditory system, the different stages of language development during the first year of life are considered: discrimination, transition and perception. The different kinds of behavioral assessment during the course of the first year are then described by stressing their indications and limitations. Copyright © 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  1. Socioeconomic Outcomes in Adults Malnourished in the First Year of Life: A 40-Year Study

    PubMed Central

    Bryce, Cyralene; Waber, Deborah P.; Zichlin, Miriam L.; Fitzmaurice, Garret M.; Eaglesfield, David

    2012-01-01

    OBJECTIVE: Lifelong functional, adaptive, and economic outcomes of moderate to severe infantile malnutrition are not well known. We assessed social status and income at midlife in a cohort of Barbadian adults, hospitalized for protein-energy malnutrition (PEM) during the first year of life, with good nutrition and health thereafter, in the context of a 40-year longitudinal case-control study. We also examined to what extent childhood IQ mediated any group differences. METHODS: Educational achievement, occupational status, and standard of living were assessed by the Hollingshead scales and a site-specific Ecology Questionnaire in Barbadian adults (aged 37–43 years) with a history of malnutrition (n = 80) and a matched healthy control group (n = 63), classmates of the index cases. Malnutrition effects, adjusted for childhood standard of living, were estimated by longitudinal multiple regression analyses, with and without childhood IQ, in the models. RESULTS: PEM predicted poorer socioeconomic outcomes with medium to large effect sizes (0.50–0.94), but childhood IQ substantially attenuated the magnitude of these effects (adjusted effect sizes: 0.17–0.34). The gap in weekly household income between the PEM and control groups increased substantially over the life span (P < .001). CONCLUSIONS: Moderate to severe PEM during the first year of life with adequate nutrition and health care thereafter is associated with significant depression of socioeconomic outcomes in adulthood, mediated in part by cognitive compromise in affected individuals. This finding underscores the potential long-term economic burden of infant malnutrition, which is of major concern given the continued high prevalence of malnutrition worldwide. PMID:22732170

  2. Population Representation in the Military Services, Fiscal Year 1986.

    DTIC Science & Technology

    1987-08-01

    Active Enlisted Force, by Pay Grade, Fiscal Years 1980-1986 .............................. 111-9 111-9 Women as a Percentage of Active Enlisted...such as pay grade (by Service, gender , and minority status) and occupation (by Service, gender , minority status, pay grade, and measure of aptitude...REPRESENTATION In this report an effort is made to explore as many areas of similarity and difference as possible between the military and the general

  3. An 11-Year Study of Home Hospice Service Trends in Singapore from 2000 to 2010.

    PubMed

    Ho, Benedict John; Akhileswaran, Ramaswamy; Pang, Grace Su Yin; Koh, Gerald Choon Huat

    2017-05-01

    Hospice care is most appropriate when a patient no longer benefits from curative treatment and has limited life expectancy. These patients may suffer from any type of life-limiting illness, including end-stage cancer, end-stage heart disease, end-stage renal failure, AIDS, and Alzheimer's disease, among other illnesses. Patients are managed on their pain and symptoms and home hospice care manages these patients in the comfort of their own home, enabling patients to spend their last days with dignity and have a good quality of life. To describe the home hospice patients at HCA Hospice Care (HHC) Singapore from 2000 to 2010. Description of home care patients in terms of their sociodemographic profile and diagnosis at admission. We reviewed the Electronic Medical Records of patients admitted into HHC from 2000 to 2010. Patients had multiple admissions into HHC home hospice as identified in the Electronic Medical Records (EMR) between January 1, 2000, and December 31, 2010, but we only selected patient's first admission into HHC home hospice for this analysis. Of the 25,065 patients in the entire samples, 47.3% were males, 65.2% were married, and 84.3% were Chinese. 50.9% of the patients died at home, 75.5% were referred from public hospitals, 53.9% of primary caregivers were children, and the mean age of the patients was 68.0 years. Among all cancer patients admitted into HHC home hospice, lung cancer (23.6%) was the most common principal diagnosis for admission, followed by colorectal (10.5%) and liver cancers (7.7%). Among noncancer patients, renal failure (7.0%) was the most common diagnosis. Among male patients admitted into HHC home hospice, lung cancer (29.6%) was the most common diagnosis, followed by liver cancer (10.8%), colorectal cancer (10.0%), and end-stage renal failure (5.5%). For female patients, lung cancer (16.9%) was the most common diagnosis, followed by breast cancer (15.9%), colorectal cancer (11.0%), and end-stage renal failure (8.7%). Ten-year

  4. Childhood respiratory illness presentation and service utilisation in primary care: a six-year cohort study in Wellington, New Zealand, using natural language processing (NLP) software.

    PubMed

    Dowell, Anthony; Darlow, Ben; Macrae, Jayden; Stubbe, Maria; Turner, Nikki; McBain, Lynn

    2017-08-01

    To identify childhood respiratory tract-related illness presentation rates and service utilisation in primary care by interrogating free text and coded data from electronic medical records. Retrospective cohort study. Data interrogation used a natural language processing software inference algorithm. 36 primary care practices in New Zealand. Data analysed from January 2008 to December 2013. The records from 77 582 children enrolled were reviewed over a 6-year period to estimate the presentation of childhood respiratory illness and service utilisation. This cohort represents 268 919 person-years of data and over 650 000 unique consultations. Childhood respiratory illness presentation rate to primary care practice, with description of seasonal and yearly variation. Respiratory conditions constituted 46% of all child-general practitioner consultations with a stable year-on-year pattern of seasonal peaks. Upper respiratory tract infection was the most common respiratory category accounting for 21.0% of all childhood consultations, followed by otitis media (12.2%), wheeze-related illness (9.7%), throat infection (7.4%) and lower respiratory tract infection (4.4%). Almost 70% of children presented to their general practitioner with at least one respiratory condition in their first year of life; this reduced to approximately 25% for children aged 10-17. This is the first study to assess the primary care incidence and service utilisation of childhood respiratory illness in a large primary care cohort by interrogating electronic medical record free text. The study identified the very high primary care workload related to childhood respiratory illness, especially during the first 2 years of life. These data can enable more effective planning of health service delivery. The findings and methodology have relevance to many countries, and the use of primary care 'big data' in this way can be applied to other health conditions. © Article author(s) (or their employer

  5. LEVERAGING AGING MATERIALS DATA TO SUPPORT EXTENSION OF TRANSPORTATION SHIPPING PACKAGES SERVICE LIFE

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

    Dunn, K.; Bellamy, S.; Daugherty, W.

    Nuclear material inventories are increasingly being transferred to interim storage locations where they may reside for extended periods of time. Use of a shipping package to store nuclear materials after the transfer has become more common for a variety of reasons. Shipping packages are robust and have a qualified pedigree for performance in normal operation and accident conditions but are only certified over an approved transportation window. The continued use of shipping packages to contain nuclear material during interim storage will result in reduced overall costs and reduced exposure to workers. However, the shipping package materials of construction must maintainmore » integrity as specified by the safety basis of the storage facility throughout the storage period, which is typically well beyond the certified transportation window. In many ways, the certification processes required for interim storage of nuclear materials in shipping packages is similar to life extension programs required for dry cask storage systems for commercial nuclear fuels. The storage of spent nuclear fuel in dry cask storage systems is federally-regulated, and over 1500 individual dry casks have been in successful service up to 20 years in the US. The uncertainty in final disposition will likely require extended storage of this fuel well beyond initial license periods and perhaps multiple re-licenses may be needed. Thus, both the shipping packages and the dry cask storage systems require materials integrity assessments and assurance of continued satisfactory materials performance over times not considered in the original evaluation processes. Test programs for the shipping packages have been established to obtain aging data on materials of construction to demonstrate continued system integrity. The collective data may be coupled with similar data for the dry cask storage systems and used to support extending the service life of shipping packages in both transportation and storage.« less

  6. Empathy, loneliness, burnout, and life satisfaction in Chilean nurses of palliative care and homecare services.

    PubMed

    Marilaf Caro, Magdalena; San-Martín, Montserrat; Delgado-Bolton, Roberto; Vivanco, Luis

    Empathy has been described as an essential competence of healthcare professionals who are working in palliative care and homecare services. In these services, usually accompanied by a high risk of physical and emotional burnout, empathy can play an important role in the improvement of occupational wellbeing. The aim of this study was to confirm the role of empathy in the prevention of loneliness and burn out, and in the promotion of life satisfaction. In 2016, an observational study was carried out in Chile with professional nurses who were working in palliative care and homecare services. Empathy with the patients, loneliness, life satisfaction, and burnout were measured using psychometric scales. Correlation analyses were applied to confirm relationships among the elements measured. In a sample of 64 participants, positive correlations were confirmed between empathy and life satisfaction (P = 0.40; p = 0.003), and between empathy and professional experience (P = 0.29; p = 0.04). On the other hand, inverse correlations were confirmed between empathy and burnout (P = -0.38; p = 0. 01), and between empathy and loneliness (P = -0.41; p = 0.004). These findings confirm the important role that empathy plays in the prevention of loneliness and burnout, and in the promotion of life satisfaction. Evidence found suggests that empathetic abilities can be improved by the professional experience. Copyright © 2017 The Authors. Published by Elsevier España, S.L.U. All rights reserved.

  7. The relationship between health literacy and quality of life among frequent users of health care services: a cross-sectional study.

    PubMed

    Couture, Éva Marjorie; Chouinard, Maud-Christine; Fortin, Martin; Hudon, Catherine

    2017-07-06

    Although health literacy and quality of life are important concepts in health care, the link between them is unclear, especially for a population of frequent users of health care services with chronic diseases. Low health literacy is a common problem that has been linked to several negative health outcomes. Quality of life is an important health outcome in patient-centered care. Frequent users of health care services are a vulnerable population that deserves attention due to high costs and negative outcomes such as lower quality of life and higher mortality. The objective of this study was to examine the relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services with chronic diseases. This study presents the cross-sectional analysis of data collected through the V1SAGES project, a randomized controlled trial on the effectiveness of a case management intervention in primary care in Quebec, Canada. Participants (n = 247) were frequent users of health care services presenting at least one chronic condition. Health literacy was measured by the Newest Vital Sign (NVS), and the physical and mental components of quality of life were evaluated by the Short Form Health Survey Version 2 (SF-12v2). The association between health literacy (independent variable) and the physical and mental components of quality of life was examined using biserial correlation. No association was found between health literacy and quality of life (physical component: r = 0.108, ρ = 0.11; mental component: r = 0.147, ρ = 0.15). This study suggests that there is no relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services. NCT01719991 . Registered October 25, 2012.

  8. Urban form and older residents' service use, walking, driving, quality of life, and neighborhood satisfaction.

    PubMed

    Patterson, Patricia K; Chapman, Nancy J

    2004-01-01

    This study explored the relationship between pedestrian-friendly urban form as reflected in new urbanism design guidelines, and neighborhood service use, walking, driving, quality of life, and neighborhood satisfaction among older women. A cross-sectional survey compared residents of census tracts similar indemographic characteristics but differing in urban form. The setting was urban and suburban areas of Portland, Oregon. The sample consisted of 372 females living alone over age 70 in six census tracts; 133 (36%) completed surveys. The New Urbanism Index rated the physical features of respondents' neighborhoods. The Neighborhood Resident Survey assessed travel modes and neighborhood satisfaction. The Quality of Life Index measured resident well-being. The Dartmouth COOP Functional Health Charts measured health status. Group comparisons were made with t-tests and regression analysis. Although limited by the cross-sectional design, the study showed that new urbanism partially explained several differences in service use and activity: distance to a grocery store (r2 change = .11, p = .001), number of services used within 1 mile from home (r2 change = .06, p = .007), number of walking activities (r2 change = .08, p = .001), number of services accessed by walking (r2 change = .14, p = .000), and number of services accessed by driving (r2 change = .05, p = .001). Traditional urban neighborhoods with mixed services and good pedestrian access were associated with increased walking among older residents.

  9. Age Weights for Health Services Derived from the Relative Social Willingness-to-Pay Instrument.

    PubMed

    Richardson, Jeff; McKie, John; Iezzi, Angelo; Maxwell, Aimee

    2017-04-01

    The effect of a patient's age on the social valuation of health services remains controversial, with empirical results varying in magnitude and implying a different age-value profile. This article employs a new methodology to re-examine these questions. Data were obtained from 2 independent Web-based surveys that administered the Relative Social Willingness to Pay instrument. In the first survey, the age of the patient receiving a life-saving service was varied. Patients were left with either poor mental or physical health. In the second survey, patient age was varied for a service that fully cured the patient's poor mental or physical health. In total, therefore, 4 sets of age weights were obtained: weights for life-extending services with poor physical or mental health outcomes and weights for quality-of-life improvement for patients in poor mental or physical health. Results were consistent. Increasing age was associated in each case with a monotonic decrease in the social valuation of the services. The decrease in value was quantitatively small until age 60 years. By age 80 years, the social value of services had declined by about 50%. The decline commenced at an earlier age in the context of physical health, although the magnitude of the decrement by age 80 years was unrelated to the type of service. With 1 exception, there was little difference in the valuation of services by the age of the survey respondent. Respondents aged >60 years placed a lower, not higher, value on quality-of-life improvement for elderly individuals than other respondents. There was no difference in the valuation of life-extending services.

  10. Five-year change in morale is associated with negative life events in very old age.

    PubMed

    Näsman, Marina; Niklasson, Johan; Saarela, Jan; Nygård, Mikael; Olofsson, Birgitta; Conradsson, Mia; Lövheim, Hugo; Gustafson, Yngve; Nyqvist, Fredrica

    2017-10-27

    The objectives were to study changes in morale in individuals 85 years and older, and to assess the effect of negative life events on morale over a five-year follow-up period. The present study is based on longitudinal data from the Umeå85+/GERDA-study, including individuals 85 years and older at baseline (n = 204). Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). Negative life events were assessed using an index including 13 negative life events occurring during the follow-up period. Linear regression was used for the multivariate analyses. The majority of the sample (69.1%) had no significant changes in morale during the five-year follow-up. However, the accumulation of negative life events was significantly associated with a greater decrease in PGCMS. A higher baseline PGCMS score did not attenuate the adverse effect negative life events had on morale. Morale seemed to be mainly stable in a five-year follow-up of very old people. It seems, nonetheless, that individuals are affected by negative life events, regardless of level of morale. Preventing negative life events and supporting individuals who experience multiple negative life events could have important implications for the care of very old people.

  11. Three-year financial analysis of pharmacy services at an independent community pharmacy.

    PubMed

    Doucette, William R; McDonough, Randal P; Mormann, Megan M; Vaschevici, Renata; Urmie, Julie M; Patterson, Brandon J

    2012-01-01

    To assess the financial performance of pharmacy services including vaccinations, cholesterol screenings, medication therapy management (MTM), adherence management services, employee health fairs, and compounding services provided by an independent community pharmacy. Three years (2008-10) of pharmacy records were examined to determine the total revenue and costs of each service. Costs included products, materials, labor, marketing, overhead, equipment, reference materials, and fax/phone usage. Costs were allocated to each service using accepted principles (e.g., time for labor). Depending on the service, the total revenue was calculated by multiplying the frequency of the service by the revenue per patient or by adding the total revenue received. A sensitivity analysis was conducted for the adherence management services to account for average dispensing net profit. 7 of 11 pharmacy services showed a net profit each year. Those services include influenza and herpes zoster immunization services, MTM, two adherence management services, employee health fairs, and prescription compounding services. The services that realized a net loss included the pneumococcal immunization service, cholesterol screenings, and two adherence management services. The sensitivity analysis showed that all adherence services had a net gain when average dispensing net profit was included. Most of the pharmacist services had an annual positive net gain. It seems likely that these services can be sustained. Further cost management, such as reducing labor costs, could improve the viability of services with net losses. However, even with greater efficiency, external factors such as competition and reimbursement challenge the sustainability of these services.

  12. Characterizing learning-through-service students in engineering by gender and academic year

    NASA Astrophysics Data System (ADS)

    Carberry, Adam Robert

    Service is increasingly being viewed as an integral part of education nationwide. Service-based courses and programs are growing in popularity as opportunities for students to learn and experience their discipline. Widespread adoption of learning-through-service (LTS) in engineering is stymied by a lack of a body of rigorous research supporting the effectiveness of these experiences. In this study, I examine learning-through-service through a nationwide survey of engineering undergraduate and graduate students participating in a variety of LTS experiences. Students (N = 322) participating in some form of service -- service-learning courses or extra-curricular service programs -- from eighty-seven different institutions across the United States completed a survey measuring demographic information (institution, gender, academic year, age, major, and grade point average), self-perceived sources of learning (service and traditional coursework), engineering epistemological beliefs, personality traits, and self-concepts (self-efficacy, motivation, expectancy, and anxiety) toward engineering design. Responses to the survey were used to characterize engineering LTS students and identify differences in these variables in terms of gender and academic year. The overall findings were that LTS students perceived their service experience to be a beneficial source for learning professional skills and, to a lesser degree, technical skills, held moderately sophisticated engineering epistemological beliefs, and were generally outgoing, compassionate, and adventurous. Self-perceived sources of learning, epistemological beliefs, and personality traits were shown to be poor predictors of student engineering achievement. Self-efficacy, motivation, and outcome expectancy toward engineering design were generally high for all LTS students; most possessed rather low anxiety levels toward engineering design. These trends were generally consistent between genders and across the five academic

  13. Does smoking affect hospital use before death? A comparison of ever- and never-smokers in the last years of life.

    PubMed

    McGhee, Sarah M; Schooling, C Mary; Wong, Lai Chin; Leung, Gabriel M; Ho, Lai Ming; Thomas, G Neil; Ho, Daniel S Y; Lam, Tai Hing; Hedley, Anthony J

    2008-06-01

    Given the apparent greater use of health care services by smokers and predictions of higher costs for a never-smoking population, we aimed in this study to determine whether the acute hospital costs in the last years of life of never- and ever-smokers differed before death using a database of the decedents in 1 year in Hong Kong. To compare the acute hospital use of ever- and never-smoker decedents. The data on cause of death, personal characteristics, and public hospital discharges were linked for all decedents in 1998 in Hong Kong. The incidence rate ratio was used to compare, for ever- and never-smokers, the number of days spent in an acute hospital over the prior 7 years. Analyses were done using specific and all cause mortality, adjusted for sex, lifestyle factors, and life expectancy. Compared with never-smokers who died of the same condition, ever-smokers who died of chronic obstructive pulmonary disease used 28% more acute hospital bed days and those dying of smoking-related cancer 9% fewer. These differences cancelled out over the case-mix of deaths with no net difference in acute bed day use by smoking status for all-cause mortality. There was no difference in acute hospital bed days in the last years of life of ever- and never-smokers but some differences by cause of death. Reducing smoking in this population will not increase acute hospital use.

  14. α1-Proteinase inhibitor (human) in the treatment of hereditary emphysema secondary to α1-antitrypsin deficiency: number and costs of years of life gained.

    PubMed

    Sclar, David Alexander; Evans, Marc A; Robison, Linda M; Skaer, Tracy L

    2012-05-01

    α(1)-Antitrypsin deficiency (α-ATD) is a disorder inherited in an autosomal recessive pattern, with co-dominant alleles known as the protease inhibitor system (Pi). The main function of α(1)-antitrypsin (α-AT) is to protect the lungs against a powerful elastase released from neutrophil leucocytes. α-ATD typically presents with a serum α-AT level of <50 mg/dL. In severe α-ATD, phenotype PiZZ, protection of the lungs is compromised, leading to an accelerated decline in forced expiratory volume in 1 second (FEV(1)). As a result, a patient may develop pulmonary emphysema of the panacinar type at a young age (third to fourth decades of life), with cigarette smoking being the most significant additional risk factor. It has been shown that weekly or monthly infusion of human α-AT is effective in raising serum α-AT levels to desired levels (>80 mg/dL), with few, if any, adverse effects. The present study was designed to discern the number of years of life gained, and the expense per year of life gained, associated with use of α-AT augmentation therapy (α(1)-proteinase inhibitor [human]), relative to 'no therapeutic intervention' in persons with α-ATD. Monte Carlo simulation (MCS) was used to: (i) estimate the number of years of life gained; and (ii) estimate the health service expenditures per year of life gained for persons receiving, or not receiving, α-AT augmentation therapy. MCS afforded a decision-analytical framework parameterized with both stochastic (random) and deterministic (fixed) components, and yielded a fiscal risk-profile for each simulated cohort of interest (eight total: by sex, smoking status [non-smoker; or past use (smoker)]; and use of α-AT augmentation therapy). The stochastic components employed in the present inquiry were: (i) age-specific body weight, and height; (ii) age-specific mortality; and (iii) the probability distribution for receipt of a lung transplant, as a function of FEV(1). The deterministic components employed in

  15. Service Use Preceding Opioid-Related Fatality.

    PubMed

    Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Blanco, Carlos

    2017-11-28

    This study analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of noncancer chronic pain. The authors identified opioid-related decedents, age ≤64 years, in the Medicaid program and characterized their clinical diagnoses, filled medication prescriptions, and nonfatal poisoning events during the 30 days and 12 months before death. The study group included 13,089 opioid-related deaths partitioned by presence or absence of chronic noncancer pain diagnoses in the last year of life. Most decedents (61.5%) had received clinical diagnoses of chronic noncancer pain conditions in the last year of life. As compared with decedents without chronic pain diagnoses, those with these diagnoses were significantly more likely to have filled prescriptions for opioids (49.0% versus 17.2%) and benzodiazepines (52.1% versus 26.6%) during the last 30 days of life, while diagnoses of opioid use disorder during this period were uncommon in both groups (4.2% versus 4.3%). The chronic pain group was also significantly more likely than the nonpain group to receive clinical diagnoses of drug use (40.8% versus 22.1%), depression (29.6% versus 13.0%) or anxiety (25.8% versus 8.4%) disorders during the last year of life. Persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare.

  16. The future of life expectancy and life expectancy inequalities in England and Wales: Bayesian spatiotemporal forecasting

    PubMed Central

    Bennett, James E; Li, Guangquan; Foreman, Kyle; Best, Nicky; Kontis, Vasilis; Pearson, Clare; Hambly, Peter; Ezzati, Majid

    2015-01-01

    Summary Background To plan for pensions and health and social services, future mortality and life expectancy need to be forecast. Consistent forecasts for all subnational units within a country are very rare. Our aim was to forecast mortality and life expectancy for England and Wales' districts. Methods We developed Bayesian spatiotemporal models for forecasting of age-specific mortality and life expectancy at a local, small-area level. The models included components that accounted for mortality in relation to age, birth cohort, time, and space. We used geocoded mortality and population data between 1981 and 2012 from the Office for National Statistics together with the model with the smallest error to forecast age-specific death rates and life expectancy to 2030 for 375 of England and Wales' 376 districts. We measured model performance by withholding recent data and comparing forecasts with this withheld data. Findings Life expectancy at birth in England and Wales was 79·5 years (95% credible interval 79·5–79·6) for men and 83·3 years (83·3–83·4) for women in 2012. District life expectancies ranged between 75·2 years (74·9–75·6) and 83·4 years (82·1–84·8) for men and between 80·2 years (79·8–80·5) and 87·3 years (86·0–88·8) for women. Between 1981 and 2012, life expectancy increased by 8·2 years for men and 6·0 years for women, closing the female–male gap from 6·0 to 3·8 years. National life expectancy in 2030 is expected to reach 85·7 (84·2–87·4) years for men and 87·6 (86·7–88·9) years for women, further reducing the female advantage to 1·9 years. Life expectancy will reach or surpass 81·4 years for men and reach or surpass 84·5 years for women in every district by 2030. Longevity inequality across districts, measured as the difference between the 1st and 99th percentiles of district life expectancies, has risen since 1981, and is forecast to rise steadily to 8·3 years (6·8–9·7) for men and 8·3 years (7·1

  17. Willingness to pay per quality-adjusted life year for life-saving treatments in Thailand.

    PubMed

    Nimdet, Khachapon; Ngorsuraches, Surachat

    2015-10-05

    To estimate the willingness to pay (WTP) per quality-adjusted life year (QALY) value for life-saving treatments and to determine factors affecting the WTP per QALY value. A cross-sectional survey with multistage sampling and face-to-face interviews. General population in the southern part of Thailand. A total of 600 individuals were included in the study. Only 554 (92.3%) responses were usable for data analyses. Participants were asked for the maximum amount of WTP value for life-saving treatments by an open-ended question. EQ-5D-3L and visual analogue scale (VAS) were used to estimate additional QALY. The amount of WTP values varied from 0 to 720,000 Baht/year (approximately 32 Baht=US$1). The averages of additional QALY obtained from VAS and EQ-5D-3L were only slightly different (0.872 and 0.853, respectively). The averages of WTP per QALY obtained from VAS and EQ-5D-3L were 244,720 and 243,120 Baht/QALY, respectively. As compared to male participants, female participants were more likely to pay less for an additional QALY (p=0.007). In addition, participants with higher household incomes tended to have higher WTP per QALY values (p<0.001). Our study added another WTP per QALY value specifically for life-saving treatments, which would complement the current cost-effectiveness threshold used in Thailand and optimise patient access to innovative treatments or technologies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. NREL to Receive Public Service Award for 40 Years of Energy Innovation |

    Science.gov Websites

    NREL | News | NREL to Receive Public Service Award for 40 Years of Energy Innovation News Release: NREL to Receive Public Service Award for 40 Years of Energy Innovation July 24, 2017 The U.S . Department of Energy's National Renewable Energy Laboratory (NREL) is again receiving national recognition

  19. Healthy life expectancy of oral squamous cell carcinoma patients aged 75years and older.

    PubMed

    Yamada, Shin-Ichi; Kurita, Hiroshi; Tomioka, Takahiro; Ohta, Ryousuke; Yoshimura, Nobuhiko; Nishimaki, Fumihiro; Koyama, Yoshihito; Kondo, Eiji; Kamata, Takahiro

    2017-01-01

    Healthy life expectancy, an extension of the concept of life expectancy, is a summary measure of population health that takes into account the mortality and morbidity of a population. The aim of the present study was to retrospectively analyze the self-reliance survival times of oral squamous cell carcinoma (OSCC) patients. One hundred and twelve patients aged 75years or older with primary OSCC were included and examined at Shinshu University Hospital. To investigate healthy life expectancy, OSCC patients older than 75years were divided into 3 groups: 75-79, 80-84, and older than 85years. The Kaplan-Meier method was used to estimate the median times of healthy life expectancy. The Log-rank test was used to test significant differences between actual curves. The median self-reliance survival times of patients aged 75-79, 80-84, and older than 85years were 5.7, 1.6, and 1.4years, respectively. Most patients with early stage cancers underwent curative treatments and showed a health expectancy of more than 5years. In patients with advanced cancers, health expectancy was poor (less than one year), except among patients aged 75-79years who underwent standard treatments. It seems that in patients with advanced cancers, health expectancy was poor (less than 1year), except among patients aged 75-79years who underwent standard treatments. In elderly patients, healthy life expectancy (self-reliance survival time) may be one of the measures of patient prognosis as well as overall survival times. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Association between lifestyle factors and quality-adjusted life years in the EPIC-NL cohort.

    PubMed

    Fransen, Heidi P; May, Anne M; Beulens, Joline W J; Struijk, Ellen A; de Wit, G Ardine; Boer, Jolanda M A; Onland-Moret, N Charlotte; Hoekstra, Jeljer; van der Schouw, Yvonne T; Bueno-de-Mesquita, H Bas; Peeters, Petra H M

    2014-01-01

    The aim of our study was to relate four modifiable lifestyle factors (smoking status, body mass index, physical activity and diet) to health expectancy, using quality-adjusted life years (QALYs) in a prospective cohort study. Data of the prospective EPIC-NL study were used, including 33,066 healthy men and women aged 20-70 years at baseline (1993-7), followed until 31-12-2007 for occurrence of disease and death. Smoking status, body mass index, physical activity and adherence to a Mediterranean-style diet (excluding alcohol) were investigated separately and combined into a healthy lifestyle score, ranging from 0 to 4. QALYs were used as summary measure of healthy life expectancy, combining a person's life expectancy with a weight for quality of life when having a chronic disease. For lifestyle factors analyzed separately the number of years living longer in good health varied from 0.12 year to 0.84 year, after adjusting for covariates. A combination of the four lifestyle factors was positively associated with higher QALYs (P-trend <0.0001). A healthy lifestyle score of 4 compared to a score of 0 was associated with almost a 2 years longer life in good health (1.75 QALYs [95% CI 1.37, 2.14]).

  1. An emergency dental service for students: 4-year findings.

    PubMed

    Sinclair, J; Wilson, N H

    1997-06-01

    To describe the arrangements for the provision of emergency dental services for students at the University of Manchester and to report data collected during the first four and a half years of the student emergency dental services (SEDS) unit based at the University Dental Hospital of Manchester. Data pertaining to every student attending SEDS since its inception were collected by means of questionnaire including provision to record diagnoses, treatment needs and the emergency care provided. The incidence of dental emergencies within the student population served by SEDS has been found to be 39 emergencies per 1000 students per annum, with the service being most heavily used by overseas students. Caries, pulpal pathology and failed restorations account for 46 per cent of the presenting emergencies, with pericoronitis (19 per cent) and other emergencies of periodontal origin (14 per cent) being common place. It is concluded that a student emergency dental service may be found to be an important element of student medical and related welfare services.

  2. Longitudinal study of DNA methylation during the first 5 years of life.

    PubMed

    Urdinguio, Rocio G; Torró, María Isabel; Bayón, Gustavo F; Álvarez-Pitti, Julio; Fernández, Agustín F; Redon, Pau; Fraga, Mario F; Lurbe, Empar

    2016-06-03

    Early life epigenetic programming influences adult health outcomes. Moreover, DNA methylation levels have been found to change more rapidly during the first years of life. Our aim was the identification and characterization of the CpG sites that are modified with time during the first years of life. We hypothesize that these DNA methylation changes would lead to the detection of genes that might be epigenetically modulated by environmental factors during early childhood and which, if disturbed, might contribute to susceptibility to diseases later in life. The study of the DNA methylation pattern of 485577 CpG sites was performed on 30 blood samples from 15 subjects, collected both at birth and at 5 years old, using Illumina(®) Infinium 450 k array. To identify differentially methylated CpG (dmCpG) sites, the methylation status of each probe was examined using linear models and the Empirical Bayes Moderated t test implemented in the limma package of R/Bioconductor. Surogate variable analysis was used to account for batch effects. DNA methylation levels significantly changed from birth to 5 years of age in 6641 CpG sites. Of these, 36.79 % were hypermethylated and were associated with genes related mainly to developmental ontology terms, while 63.21 % were hypomethylated probes and associated with genes related to immune function. Our results suggest that DNA methylation alterations with age during the first years of life might play a significant role in development and the regulation of leukocyte-specific functions. This supports the idea that blood leukocytes experience genome remodeling related to their interaction with environmental factors, underlining the importance of environmental exposures during the first years of life and suggesting that new strategies should be take into consideration for disease prevention.

  3. Long life assurance study for manned spacecraft long life hardware. Volume 4: Special long life assurance studies

    NASA Technical Reports Server (NTRS)

    1972-01-01

    Guidelines for the selection of equipment to be used for manned spacecraft in order to assure a five year maintenance-free service life were developed. A special study was conducted to determine the adequacy of the procedures used to determine the quality and effectiveness of various components. The subjects examined are: (1) temperature cycling for acceptance of electronic assemblies; (2) accelerated testing techniques; (3) electronic part screening techniques; (4) electronic part derating practices; (5) vibration life extension of printed circuit board assemblies; and (6) tolerance funnelling and test requirements.

  4. Service-Learning and the First-Year Experience: Preparing Students for Personal Success and Civic Responsibility. The First-Year Experience Monograph Series.

    ERIC Educational Resources Information Center

    Zlotkowski, Edward, Ed.

    This collection presents essays on service-learning and its role in the education of first-year college students. Following a preface by John N. Gardner and an introduction by Edward Zlotkowski, the chapters of section 1, "Making the Case for Service-Learning in the First Year of College," are: (1) "High School Service-Learning and the Preparation…

  5. [Healthy life years (HLY) comprehensive indicator of health situation--recommended by European Union].

    PubMed

    Gromulska, Lucyna; Wysocki, Mirosław J; Goryński, Paweł

    2008-01-01

    This article presents Healthy Life Years (HLY) indicator of functional health status, its application in the field of public health research and monitoring, method of calculation, idea of its construction and relation of HLY to other health status indicators e.g. life expectancy, quality adjusted life years. Current data on HLY in the EU member states are also presented. HLY indicator is one of structural indicators, recommended by European Council to deliver information on the progress of implementation of the Lisbon Strategy resolutions, which main principle is development of knowledge-based economy characterised by growth, social cohesion and respect for environment. HLY shifts the focus from quantity of years of life to its quality, full-productivity health of the population, thus conveying information not only on health status but also referring to the fields--other than medicine or social sciences--such as: finances, economy, politics, development.

  6. The Early Years: "Life" Science

    ERIC Educational Resources Information Center

    Ashbrook, Peggy

    2013-01-01

    Talking about death as part of a life cycle is often ignored or spoken about in hushed tones in early childhood. Books with "life cycle" in the title often do not include the death of the living organism in the information about the cycle. The concept of a complete life cycle does not appear in "A Framework for K-12 Science…

  7. Residence Life Programs and the First-Year Experience. The Freshman Year Experience. Monograph Series No. 5.

    ERIC Educational Resources Information Center

    Zeller, William, Ed.; And Others

    This monograph contains papers which suggest means of implementing residential programs, services, and facilities that will help to meet the needs of first-year college students. Fourteen papers are presented and are as follows: "Reflections on the First Year Residential Experience" (John N. Gardner); "The Role of Residential Programs in the…

  8. Demand for satellite-provided domestic communications services up to the year 2000

    NASA Technical Reports Server (NTRS)

    Stevenson, S.; Poley, W.; Lekan, J.; Salzman, J. A.

    1984-01-01

    Three fixed service telecommunications demand assessment studies were completed for NASA by The Western Union Telegraph Company and the U.S. Telephone and Telegraph Corporation. They provided forecasts of the total U.S. domestic demand, from 1980 to the year 2000, for voice, data, and video services. That portion that is technically and economically suitable for transmission by satellite systems, both large trunking systems and customer premises services (CPS) systems was also estimated. In order to provide a single set of forecasts a NASA synthesis of the above studies was conducted. The services, associated forecast techniques, and data bases employed by both contractors were examined, those elements of each judged to be the most appropriate were selected, and new forecasts were made. The demand for voice, data, and video services was first forecast in fundamental units of call-seconds, bits/year, and channels, respectively. Transmission technology characteristics and capabilities were then forecast, and the fundamental demand converted to an equivalent transmission capacity. The potential demand for satellite-provided services was found to grow by a factor of 6, from 400 to 2400 equivalent 36 MHz satellite transponders over the 20-year period. About 80 percent of this was found to be more appropriate for trunking systems and 20 percent CPS.

  9. Demand for satellite-provided domestic communications services up to the year 2000

    NASA Astrophysics Data System (ADS)

    Stevenson, S.; Poley, W.; Lekan, J.; Salzman, J. A.

    1984-11-01

    Three fixed service telecommunications demand assessment studies were completed for NASA by The Western Union Telegraph Company and the U.S. Telephone and Telegraph Corporation. They provided forecasts of the total U.S. domestic demand, from 1980 to the year 2000, for voice, data, and video services. That portion that is technically and economically suitable for transmission by satellite systems, both large trunking systems and customer premises services (CPS) systems was also estimated. In order to provide a single set of forecasts a NASA synthesis of the above studies was conducted. The services, associated forecast techniques, and data bases employed by both contractors were examined, those elements of each judged to be the most appropriate were selected, and new forecasts were made. The demand for voice, data, and video services was first forecast in fundamental units of call-seconds, bits/year, and channels, respectively. Transmission technology characteristics and capabilities were then forecast, and the fundamental demand converted to an equivalent transmission capacity. The potential demand for satellite-provided services was found to grow by a factor of 6, from 400 to 2400 equivalent 36 MHz satellite transponders over the 20-year period. About 80 percent of this was found to be more appropriate for trunking systems and 20 percent CPS.

  10. Health-related quality of life trajectories of methamphetamine-dependent individuals as a function of treatment completion and continued care over a 1-year period.

    PubMed

    Gonzales, Rachel; Ang, Alfonso; Marinelli-Casey, Patricia; Glik, Deborah C; Iguchi, Martin Y; Rawson, Richard A

    2009-12-01

    This study applies a chronic illness framework to evaluate treatment outcomes among individuals dependent on methamphetamine (MA). Using growth curve modeling, health-related quality of life (HRQOL) trajectories of MA-dependent individuals (N = 723) were examined over a 1-year period. Results show greater improvements in mental HRQOL trajectories as a function of treatment completion and continued care, although fairly static trajectories in physical health status. Other factors affecting HRQOL trajectories included gender, psychosocial functioning, drug use severity, and health impairment. Results extend research on treatment evaluations for MA dependence, highlighting the importance of continued service utilization for improved quality of life outcomes.

  11. 77 FR 36563 - Indian Health Service; Reimbursement Rates for Calendar Year 2012 Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service; Reimbursement Rates for Calendar Year 2012 Correction AGENCY: Indian Health Service, HHS. ACTION: Notice; correction. SUMMARY: The Indian Health Service published a document in the Federal Register on June 6, 2012, concerning rates for...

  12. Associations of Quality of Life with Service Satisfaction in Psychotic Patients: A Meta-Analysis

    PubMed Central

    Petkari, Eleni; Pietschnig, Jakob

    2015-01-01

    Background Quality of life (QoL) has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients. Yet, the relationship between the patients’ satisfaction with services and QoL has not been clearly established, perhaps due to the multidimensionality of the QoL concept and the variability in its assessment. Aim This is the first systematic meta-analysis of all available evidence assessing the relationship between QoL and service satisfaction. Methods: In all, 19 studies reporting data of 21 independent samples (N = 5,337) were included in the present meta-analysis. In moderator analyses, effects of age, sex, diagnoses (schizophrenia vs. other psychoses), treatment context (inpatients vs. outpatients), study design (cross-sectional vs. longitudinal), and QoL domain (subjective vs. health-related) were examined. Results Analyses revealed a highly significant medium-sized effect (r = .30, p < .001) for the associations of QoL and service satisfaction. Effect sizes were significantly stronger for subjective than health-related quality of life (r = .35 vs. r = .14, respectively). Moreover, associations with subjective QoL remained largely robust when accounting for moderating variables, although there was a trend of stronger associations for outpatients compared to inpatients. In contrast, effect sizes for health-related QoL were small and only observable for samples with longitudinal designs. Conclusion Associations between QoL and service satisfaction appear to be robust but are differentiated in regard to QoL domain. Our findings suggest that agents responsible for service design and implementation need to take the patients’ perception of the service adequacy for achieving QoL enhancement into account. PMID:26275139

  13. A survey of the impact of owning a service dog on quality of life for individuals with physical and hearing disability: a pilot study.

    PubMed

    Hall, Sophie S; MacMichael, Jessica; Turner, Amy; Mills, Daniel S

    2017-03-29

    Quality of life refers to a person's experienced standard of health, comfort and happiness and is typically measured using subjective self-report scales. Despite increasing scientific interest in the value of dogs to human health and the growing demand for trained service dogs, to date no research has reported how service dogs may affect client perceptions of quality of life. We compared quality of life scores on the 16 item Flanagan quality of life scale from individuals who owned a trained service dog with those who were eligible to receive a dog, but did not yet have one (waiting list control). Data were analysed separately from two groups; those with a service dog trained for individuals with physical disabilities (with physical service dog: n = 72; waiting for a service dog: n = 24; recruited from Dogs for Good database) and those with a hearing service dog (with hearing service dog = 111; waiting for a service dog = 30; recruited from Hearing Dogs for Deaf People database). When controlling for age and gender individuals scored higher on total quality of life scores if they owned a service dog or a hearing service dog, but this was only statistically significant for those with a service dog. Both groups (physical service dog and hearing service dog) scored significantly higher on items relating to health, working, learning and independence if they owned a service dog, in comparison to those on the waiting list. Those with a physical service dog also scored significantly higher on items relating to recreational activities (including items relating to reading/listening to music, socialising, creative expression), and those involving social interactions (including items relating to participating in organisations, socialising, relationship with relatives). Additionally, those with a physical service dog scored higher on understanding yourself and material comforts than those on the waiting list control. In contrast, those with a hearing service

  14. Quality of life at 6 years after occupational injury.

    PubMed

    Chin, Wei-Shan; Guo, Yue Leon; Liao, Shih-Cheng; Wu, Hsueh-Ching; Kuo, Chun-Ya; Chen, Chih-Chieh; Shiao, Judith Shu-Chu

    2018-03-01

    Occupational injuries have considerable impact on workers' lives. However, data regarding workers' health-related quality of life (HRQOL) at several years after the injury are lacking. This study assessed workers' HRQOL at 6 years after occupational injury and determined related factors in each HRQOL domain. Workers who sustained an occupational injury in 2009 and who responded to a previous survey at 3 or 12 months after their injury were followed up in 2015. A total of 1715 participants were candidates for this study. The Taiwanese version of the World Health Organization Quality of Life scale-abbreviated version (WHOQOL-BREF) was used to assess their HRQOL. Multiple linear regression analysis identified predictive factors for HRQOL at 6 years after occupational injury. A total of 563 workers completed the questionnaire (response rate, 32.8%). Adverse life events and additional severe occupational injuries that occurred within the follow-up period, and decreased salary after the injury were significant factors for low scores in all domains of the WHOQOL-BREF. In addition, unmarried participants had low scores in the social relationship domain. Workers with family members requiring care scored low in the physical and environment domains. Workers whose injuries had major effects on their physical appearance had low scores in the physical and psychological domains. Workers with unstable employment had low scores in physical, psychological, and environment domains. At 6 years after occupational injury, workers' HRQOL was poor among those whose salaries decreased after the injury, after adjustment for other factors.

  15. Years of Potential Life Lost among Heroin Addicts 33 Years after Treatment

    PubMed Central

    Smyth, Breda; Hoffman, Valerie; Fan, Jing; Hser, Yih-Ing

    2007-01-01

    Objective To examine premature mortality in terms of years of potential life lost (YPLL) among a cohort of long-term heroin addicts. Method This longitudinal, prospective study followed a cohort of 581 male heroin addicts in California for more than 33 years. In the latest follow-up conducted in 1996/97, 282 subjects (48.5%) were confirmed as deceased by death certificates. YPLL before age 65 years were calculated by causes of death. Ethnic differences in YPLL were assessed among Whites, Hispanics, and African Americans. Results On average, addicts in this cohort lost 18.3 years (SD = 10.7) of potentiallife before age 65. Of the total YPLL for the cohort, 22.3% of the years lost was due to heroin overdose, 14.0% due to chronic liver disease, and 10.2% to accidents. The total YPLL and YPLL by death cause in addict cohort were significant higher than that of US population. The YPLL among African Americans was significantly lower than that among Whites or Hispanics. Conclusion The YPLL among addicts was much higher than that in the national population; within the cohort, premature mortality was higher among Whites and Hispanics compared to African American addicts. PMID:17291577

  16. Faculty and Civil Service Salaries, Fiscal Year 1996.

    ERIC Educational Resources Information Center

    Illinois State Board of Higher Education, Springfield.

    This report provides data on fiscal year (FY) 1996 average 9-month faculty and civil service salaries (excluding fringe benefits) and information on those salaries since FY 1980 for full-time employees at Illinois colleges and universities and the Illinois Mathematics and Science Academy. The report provides data comparing salaries with economic…

  17. Fiscal Year 1995 Faculty and Civil Service Salaries.

    ERIC Educational Resources Information Center

    Illinois State Board of Higher Education, Springfield.

    This report provides information on the status of fiscal year 1995 faculty and civil service salaries at Illinois colleges and universities and the Illinois Mathematics and Science Academy along with trend analysis based on data beginning in 1980. The report compares salaries with economic indicators to determine how well salaries have kept pace…

  18. Final Environmental Planning Technical Report. Public Services and Facilities

    DTIC Science & Technology

    1984-06-01

    The marked patrol units have a life expectancy of 2 years (90,000 to 100,000 miles) and about one-half of the 15 units are replaced each year...much more visible police force, longer car life , and lower maintenance costs. The proposal has received support from within the City government, but...Burns, Albin, and Carpenter; the Air Force Military Assistance to Safety and Traffic (MAST) helicopter service; Flight for Life ; and several other suppor

  19. Long-term Outcomes of Military Service in Aging and the Life Course: A Positive Re-envisioning

    PubMed Central

    Spiro, Avron; Settersten, Richard A.; Aldwin, Carolyn M.

    2016-01-01

    Most research on military service focuses on its short-term negative consequences, especially the mental and physical injuries of those deployed in warzones. However, studies of long-term outcomes reveal surprisingly positive effects of military service—both those early in adulthood that grow over time and others that can emerge later in life. These multidomain effects have been found in veterans of World War II and the Korean War and are now being seen in veterans of the Vietnam War. Although some are directly attributable to public policies such as the GI Bill, which facilitate educational and economic gains, there are personal developmental gains as well, including autonomy, emotional maturity and resilience, mastery, and leadership skills, that lead to better health and well-being in later life. These long-term effects vary across persons, change over time within persons, and often reflect processes of cumulative advantage and disadvantage. We propose a life-span model of the effects of military service that provides a perspective for probing both long-term positive and negative outcomes for aging veterans. We further explicate the model by focusing on both sociocultural dynamics and individual processes. We identify public-use data that can be examined to evaluate this model, and offer a set of questions that can be used to assess military service. Finally, we outline an agenda for dedicated inquiry into such effects and consider policy implications for the health and well-being of aging veterans in later life. PMID:26655859

  20. Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries

    PubMed Central

    2013-01-01

    Background Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact. Country-specific and service-specific, DALYs averted enables impact comparisons between programs operating in different contexts. This study explores the use of DALYs averted as a social franchise performance metric. Methods Using data collected by the Social Franchising Compendia in 2010 and 2011, we compared franchise performance, analyzing by region and program area. Coefficients produced by Population Services International converted each franchise's service delivery data into DALYs averted. For the 32 networks with two years of data corresponding to these metrics, a paired t-test compared all metrics. Finally, to test data reporting quality, we compared services provided to patient volume. Results Social franchising programs grew considerably from 2010 to 2011, measured by services provided (215%), patient volume (31%), and impact (couple-years of protection (CYPs): 86% and DALYs averted: 519%), but not by the total number of outlets. Non-family planning services increased by 857%, with diversification centered in Asia and Africa. However, paired t-test comparisons showed no significant increase within the networks, whether categorized as family planning or non-family planning. The ratio of services provided to patient visits yielded considerable range, with one network reporting a ratio of 16,000:1. Conclusion In theory, the DALYs averted metric is a more robust and comprehensive metric for social franchising than current program measures. As social

  1. Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries.

    PubMed

    Montagu, Dominic; Ngamkitpaiboon, Lek; Duvall, Susan; Ratcliffe, Amy

    2013-01-01

    Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact. Country-specific and service-specific, DALYs averted enables impact comparisons between programs operating in different contexts. This study explores the use of DALYs averted as a social franchise performance metric. Using data collected by the Social Franchising Compendia in 2010 and 2011, we compared franchise performance, analyzing by region and program area. Coefficients produced by Population Services International converted each franchise's service delivery data into DALYs averted. For the 32 networks with two years of data corresponding to these metrics, a paired t-test compared all metrics. Finally, to test data reporting quality, we compared services provided to patient volume. Social franchising programs grew considerably from 2010 to 2011, measured by services provided (215%), patient volume (31%), and impact (couple-years of protection (CYPs): 86% and DALYs averted: 519%), but not by the total number of outlets. Non-family planning services increased by 857%, with diversification centered in Asia and Africa. However, paired t-test comparisons showed no significant increase within the networks, whether categorized as family planning or non-family planning. The ratio of services provided to patient visits yielded considerable range, with one network reporting a ratio of 16,000:1. In theory, the DALYs averted metric is a more robust and comprehensive metric for social franchising than current program measures. As social franchising spreads beyond family planning

  2. Life: the first two billion years

    PubMed Central

    Bergmann, Kristin D.; Strauss, Justin V.

    2016-01-01

    Microfossils, stromatolites, preserved lipids and biologically informative isotopic ratios provide a substantial record of bacterial diversity and biogeochemical cycles in Proterozoic (2500–541 Ma) oceans that can be interpreted, at least broadly, in terms of present-day organisms and metabolic processes. Archean (more than 2500 Ma) sedimentary rocks add at least a billion years to the recorded history of life, with sedimentological and biogeochemical evidence for life at 3500 Ma, and possibly earlier; phylogenetic and functional details, however, are limited. Geochemistry provides a major constraint on early evolution, indicating that the first bacteria were shaped by anoxic environments, with distinct patterns of major and micronutrient availability. Archean rocks appear to record the Earth's first iron age, with reduced Fe as the principal electron donor for photosynthesis, oxidized Fe the most abundant terminal electron acceptor for respiration, and Fe a key cofactor in proteins. With the permanent oxygenation of the atmosphere and surface ocean ca 2400 Ma, photic zone O2 limited the access of photosynthetic bacteria to electron donors other than water, while expanding the inventory of oxidants available for respiration and chemoautotrophy. Thus, halfway through Earth history, the microbial underpinnings of modern marine ecosystems began to take shape. This article is part of the themed issue ‘The new bacteriology’. PMID:27672146

  3. 26 CFR 1.121-5 - Suspension of 5-year period for certain members of the uniformed services and Foreign Service.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... official extended duty as a member of the Foreign Service of the United States in Brazil. In 2015 B sells... period of ownership and use during his 8-year period of service with the Foreign Service in Brazil. If B...

  4. 26 CFR 1.121-5 - Suspension of 5-year period for certain members of the uniformed services and Foreign Service.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... official extended duty as a member of the Foreign Service of the United States in Brazil. In 2015 B sells... period of ownership and use during his 8-year period of service with the Foreign Service in Brazil. If B...

  5. 26 CFR 1.121-5 - Suspension of 5-year period for certain members of the uniformed services and Foreign Service.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... official extended duty as a member of the Foreign Service of the United States in Brazil. In 2015 B sells... period of ownership and use during his 8-year period of service with the Foreign Service in Brazil. If B...

  6. 26 CFR 1.121-5 - Suspension of 5-year period for certain members of the uniformed services and Foreign Service.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... official extended duty as a member of the Foreign Service of the United States in Brazil. In 2015 B sells... period of ownership and use during his 8-year period of service with the Foreign Service in Brazil. If B...

  7. 26 CFR 1.121-5 - Suspension of 5-year period for certain members of the uniformed services and Foreign Service.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... official extended duty as a member of the Foreign Service of the United States in Brazil. In 2015 B sells... period of ownership and use during his 8-year period of service with the Foreign Service in Brazil. If B...

  8. Symptoms, functioning and quality of life after treatment in a residential sub-acute mental health service in Australia.

    PubMed

    Thomas, Kerry A; Rickwood, Debra J; Brown, Patricia M

    2017-01-01

    The aim of this study was to assess clients' and service providers' perspectives on changes in mental health after an admission to a residential recovery-focused, sub-acute service, in Australia. Clients were either step-up clients, entering the service directly from the community, or step-down clients who were transitioning from an inpatient unit to home. During the 30-month period of data collection (August 2011 to January 2014) all clients (N = 102) were invited to participate in the longitudinal study and 41 clients consented to be involved (38% response rate). At admission and exit, participants completed the Behaviour and Symptom Identification Scale (Basis-32) and service providers completed the Life Skills Profile-16 and Health of the Nations Outcome Scales. Follow-up data 3 months after exit were available for 12 clients, including the Basis-32 and a self-report measure of quality of life (Assessment of Quality of Life 8-dimension). Both client groups reported positive improvements between admission and exit in the areas of relation to self and others, psychosis, daily living and presence of depression or anxiety symptoms. Service providers reported gains for clients in the areas of self-care, level of symptoms and presence of social problems. At 3 months, clients generally reported positive quality of life, although there was no significant change in symptoms and functioning. This study demonstrates that after an admission to a sub-acute service, step-up clients experience an improvement in their symptoms and functioning, have avoided a hospital admission and are well enough to return home. Step-down clients also experience further improvements in their symptoms and functioning, indicating that the service has assisted them in their transition to independent living after a hospital admission. Sub-acute residential units provide a continuation of care for inpatients preparing to return home, and people with a mental health problem living in the

  9. Half-life of leu-enkephalin in the serum of infants of the first year of life on different types of feeding: relationship with temperament.

    PubMed

    Sokolov, O Yu; Kurasova, O B; Kost, N V; Gabaeva, M V; Korneeva, E V; Mikheeva, I G; Zozulya, A A

    2004-04-01

    The half-life of leu-enkephalin in the serum of infants aged under 1 year is significantly shorter than in adults. In girls leu-enkephalin half-life is significantly longer than in boys. The half-life of leu-enkephalin is different in infants on breast and formula feeding. Nine characteristics of temperament in infants of the first year of life were determined using EITQ and ITQ questionnaires. Serum leu-enkephalin half-life directly correlated with temperament characteristics (activity, perception, threshold), but not with the level psychomotor development.

  10. [Health-related quality of life evaluation of elderly aged 65 years and over living at home].

    PubMed

    Jalenques, I; Auclair, C; Rondepierre, F; Gerbaud, L; Tourtauchaux, R

    2015-06-01

    To assess health-related quality of life in French adults aged 65 years and over, living at home, with a specific self-administered questionnaire, the LEIPAD, cross-culturally adapted in French. Elderly completed socio-demographic and medical questionnaires, a questionnaire about negative life events during the last 12 months and the LEIPAD. Data of 195 subjects (mean age: 72.6 years, men: 56.5%) were analyzed. The response rates to the LEIPAD scales were superior to 90%. Elderly reported on the whole a good health-related quality of life. Age had a negative effect on quality on life, which deteriorates over years. Age was correlated to the scales "Physical function", "Self-care", "Cognitive functioning" and "Sexual functioning". Elderly hospitalized in the last year had worse quality of life with a significant difference for "Physical function" scale. The number of health problems was positively correlated to "Physical function" scale. Elderly declaring at least one health problem had worse quality of life for this scale. Problems in couple, materials and financial problems had also negative effects on health-related quality of life. Our study highlights a good health-related quality of life for the majority of these adults aged 65 years and over, as well as the negative effect of age, health, couple, materials and financial problems on their quality of life. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. The influence of clarification and threats on life situation: patients’ experiences 1 year after TSCI

    PubMed Central

    Bjørnshave Noe, Bodil; Bjerrum, Merete; Angel, Sanne

    2017-01-01

    Introduction: The study was conducted at the Spinal Cord Injury Centre of Western Denmark (VCR). The aim of the study was to explore patients’ experiences following traumatic spinal cord injury and to identify characteristics of positive versus negative life situation 1 year post discharge from hospital rehabilitation. This was a qualitative study conducted using inductive content analysis. Case Presentation: In this qualitative study seven patients were interviewed one year after discharge from initial rehabilitation at the VCR. The interviews were analysed using inductive content analysis. Discussion: We found that two categories condensed the patients’ experiences of their life situation 1 year post discharge: ‘clarification in relation to overall life situation’ and ‘threat to core competences’. The transversal analysis across the derived categories identified different combinations of clarification and threats to core competences explaining the patients’ experiences: high degree of clarification combined with low degree of threat to core competences was indicative of positive life situation. Also, positive life situation was seen when a high degree of clarification compensated for high degree of threats on core competencies. In contrast, an overall stressful and negative life situation was influenced by poor clarification combined with a high degree of threat to core competences. However, when core competences can be transformed into new skills, threats were manageable. This study revealed that clarification related to overall life situation in combination with threat to core competences may explain traumatic spinal cord injury patients’ overall life situation 1 year post discharge. An appropriate balance characterises a positive life situation. There might be a need to pay attention to patients who are challenged by low degree of clarification and high degree of threats on core competencies 1 year post discharge as this may influence the life

  12. Life Cycle Energy Assessment of a Multi-storey Residential Building

    NASA Astrophysics Data System (ADS)

    Mehta, Sourabh; Chandur, Arjun; Palaniappan, Sivakumar

    2017-06-01

    This study presents the findings of life cycle energy assessment of two multi-storey residential buildings. These buildings consist of a total of 60 homes. The usable floor area is 43.14 m2 (463.36 ft2) per home. A detailed estimation of embodied energy is carried out by considering the use of materials during building construction. Major contributors of embodied energy are found to be steel, cement and aluminum. Monthly building operation energy was assessed using a total of 2520 data samples corresponding to 3 years of building operation. Analysis of a base case scenario, with 50 years of service life and average monthly operation energy, indicates that the embodied energy and the operation energy account for 16 and 84% of the life cycle energy respectively. Sensitivity analysis is carried out to study the influence of service life and operation energy on the relative contribution of embodied energy and operation energy. It is found that the embodied energy represents as high as 31% of the life cycle energy depending upon the variation in the operation energy and the service life. Hence, strategies towards sustainable building construction should also focus on reducing the embodied energy in the design and construction phases in addition to operation energy.

  13. The Years of Uncertainty: Eighth Grade Family Life Education.

    ERIC Educational Resources Information Center

    Carson, Mary, Ed.; And Others

    The family life sex education unit for eighth graders, "The Years of Uncertainty," consists of a series of daily lesson plans that span a 29-day period of one-hour class sessions. Topics covered are: problem solving, knowledge and attitudes, male and female reproductive systems, conception, pregnancy, birth, birth defects, venereal…

  14. Childhood adverse life events, disordered eating, and body mass index in US Military service members.

    PubMed

    Bakalar, Jennifer L; Barmine, Marissa; Druskin, Lindsay; Olsen, Cara H; Quinlan, Jeffrey; Sbrocco, Tracy; Tanofsky-Kraff, Marian

    2018-03-02

    US service members appear to be at high-risk for disordered eating. Further, the military is experiencing unprecedented prevalence of overweight and obesity. US service members also report a high prevalence of childhood adverse life event (ALE) exposure. Despite consistent links between early adversity with eating disorders and obesity, there is a dearth of research examining the association between ALE exposure and disordered eating and weight in military personnel. An online survey study was conducted in active duty personnel to examine childhood ALE history using the Life Stressor Checklist - Revised, disordered eating using the Eating Disorder Examination - Questionnaire total score, and self-reported body mass index (BMI, kg/m 2 ). Among 179 respondents, multiple indices of childhood ALE were positively associated with disordered eating. Traumatic childhood ALE and subjective impact of childhood ALE were associated with higher BMI and these associations were mediated by disordered eating. Findings support evaluating childhood ALE exposure among service members with disordered eating and weight concerns. Moreover, findings support the need for prospective research to elucidate these relationships. © 2018 Wiley Periodicals, Inc.

  15. A 3.5 year diary study: Remembering and life story importance are predicted by different event characteristics.

    PubMed

    Thomsen, Dorthe Kirkegaard; Jensen, Thomas; Holm, Tine; Olesen, Martin Hammershøj; Schnieber, Anette; Tønnesvang, Jan

    2015-11-01

    Forty-five participants described and rated two events each week during their first term at university. After 3.5 years, we examined whether event characteristics rated in the diary predicted remembering, reliving, and life story importance at the follow-up. In addition, we examined whether ratings of life story importance were consistent across a three year interval. Approximately 60% of events were remembered, but only 20% of these were considered above medium importance to life stories. Higher unusualness, rehearsal, and planning predicted whether an event was remembered 3.5 years later. Higher goal-relevance, importance, emotional intensity, and planning predicted life story importance 3.5 years later. There was a moderate correlation between life story importance rated three months after the diary and rated at the 3.5 year follow-up. The results suggest that autobiographical memory and life stories are governed by different mechanisms and that life story memories are characterized by some degree of stability. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Estimating a Service-Life Distribution Based on Production Counts and a Failure Database

    DOE PAGES

    Ryan, Kenneth J.; Hamada, Michael Scott; Vardeman, Stephen B.

    2017-04-01

    A manufacturer wanted to compare the service-life distributions of two similar products. These concern product lifetimes after installation (not manufacture). For each product, there were available production counts and an imperfect database providing information on failing units. In the real case, these units were expensive repairable units warrantied against repairs. Failure (of interest here) was relatively rare and driven by a different mode/mechanism than ordinary repair events (not of interest here). Approach: Data models for the service life based on a standard parametric lifetime distribution and a related limited failure population were developed. These models were used to develop expressionsmore » for the likelihood of the available data that properly accounts for information missing in the failure database. Results: A Bayesian approach was employed to obtain estimates of model parameters (with associated uncertainty) in order to investigate characteristics of the service-life distribution. Custom software was developed and is included as Supplemental Material to this case study. One part of a responsible approach to the original case was a simulation experiment used to validate the correctness of the software and the behavior of the statistical methodology before using its results in the application, and an example of such an experiment is included here. Because of confidentiality issues that prevent use of the original data, simulated data with characteristics like the manufacturer’s proprietary data are used to illustrate some aspects of our real analyses. Lastly, we also note that, although this case focuses on rare and complete product failure, the statistical methodology provided is directly applicable to more standard warranty data problems involving typically much larger warranty databases where entries are warranty claims (often for repairs) rather than reports of complete failures.« less

  17. Estimating a Service-Life Distribution Based on Production Counts and a Failure Database

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

    Ryan, Kenneth J.; Hamada, Michael Scott; Vardeman, Stephen B.

    A manufacturer wanted to compare the service-life distributions of two similar products. These concern product lifetimes after installation (not manufacture). For each product, there were available production counts and an imperfect database providing information on failing units. In the real case, these units were expensive repairable units warrantied against repairs. Failure (of interest here) was relatively rare and driven by a different mode/mechanism than ordinary repair events (not of interest here). Approach: Data models for the service life based on a standard parametric lifetime distribution and a related limited failure population were developed. These models were used to develop expressionsmore » for the likelihood of the available data that properly accounts for information missing in the failure database. Results: A Bayesian approach was employed to obtain estimates of model parameters (with associated uncertainty) in order to investigate characteristics of the service-life distribution. Custom software was developed and is included as Supplemental Material to this case study. One part of a responsible approach to the original case was a simulation experiment used to validate the correctness of the software and the behavior of the statistical methodology before using its results in the application, and an example of such an experiment is included here. Because of confidentiality issues that prevent use of the original data, simulated data with characteristics like the manufacturer’s proprietary data are used to illustrate some aspects of our real analyses. Lastly, we also note that, although this case focuses on rare and complete product failure, the statistical methodology provided is directly applicable to more standard warranty data problems involving typically much larger warranty databases where entries are warranty claims (often for repairs) rather than reports of complete failures.« less

  18. Services and Supports, Partnership, and Family Quality of Life: Focus on Deaf-Blindness

    ERIC Educational Resources Information Center

    Kyzar, Kathleen B.; Brady, Sara E.; Summers, Jean Ann; Haines, Shana J.; Turnbull, Ann P.

    2016-01-01

    In this study, the authors examined the moderating effects of partnership on the relationship between services and supports adequacy and family quality of life (FQOL) for families of children with deaf-blindness ages birth to 21. A social-ecological approach enabled examining the impact of disability on the family system. A survey, consisting of…

  19. 76 FR 5567 - Service Contract Inventory for Fiscal Year (FY) 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-01

    ... DEPARTMENT OF EDUCATION Service Contract Inventory for Fiscal Year (FY) 2010 AGENCY: Office of the Chief Financial Officer, U.S. Department of Education. ACTION: Notice of availability--FY 2010 Service.... Skelly, Chief Financial Officer. [FR Doc. 2011-2236 Filed 1-28-11; 11:15 am] BILLING CODE 4000-01-P ...

  20. 78 FR 10611 - Service Contract Inventory for Fiscal Year (FY) 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... DEPARTMENT OF EDUCATION Service Contract Inventory for Fiscal Year (FY) 2012 AGENCY: Office of the Chief Financial Officer, U.S. Department of Education. ACTION: Notice of availability--FY 2012 service... Deputy Chief Financial Officer. [FR Doc. 2013-03441 Filed 2-13-13; 8:45 am] BILLING CODE 4000-01-P ...

  1. The cost of an additional disability-free life year for older Americans: 1992-2005.

    PubMed

    Cai, Liming

    2013-02-01

    To estimate the cost of an additional disability-free life year for older Americans in 1992-2005. This study used 1992-2005 Medicare Current Beneficiary Survey, a longitudinal survey of Medicare beneficiaries with a rotating panel design. This analysis used multistate life table model to estimate probabilities of transition among a discrete set of health states (nondisabled, disabled, and dead) for two panels of older Americans in 1992 and 2002. Health spending incurred between annual health interviews was estimated by a generalized linear mixed model. Health status, including death, was simulated for each member of the panel using these transition probabilities; the associated health spending was cross-walked to the simulated health changes. Disability-free life expectancy (DFLE) increased significantly more than life expectancy during the study period. Assuming that 50 percent of the gains in DFLE between 1992 and 2005 were attributable to increases in spending, the average discounted cost per additional disability-free life year was $71,000. There were small differences between gender and racial/ethnic groups. The cost of an additional disability-free life year was substantially below previous estimates based on mortality trends alone. © Health Research and Educational Trust.

  2. [Survey of consciousness of community residents regarding the community life of disabled persons with service dogs].

    PubMed

    Fujiwara, Y; Takayanagi, T; Takayanagi, Y; Uemura, T; Miyao, M; Hoshi, T; Taniguchi, R; Hasegawa, A; Takahashi, K; Shinkai, S

    2001-05-01

    Service dogs have received much attention as effective choices for promoting participation in society of disabled persons. The purpose of this study was to obtain the fundamental data to prepare guidelines regarding service dogs use in community life, by making clear the problems in terms of public health and community welfare through a survey of attitudes towards service dogs in community residents. Study 1 was conducted as follows. The subjects were 423 community residents between their teens and seventies who participated in health and welfare lectures in 4 metropolitan areas. A questionnaire survey was conducted just after watching a promotion video about service dogs, including several items on aspects not accept, were anxious about or were unpleasant in the case of community life of a disabled person and a service dog. Study 2 was as follows. A questionnaire survey was conducted inside a supermarket in the central part of Tokyo. One group of subjects were 103 shopping customers who witnessed a shopping scene featuring a disabled person with her service dog, and the other subjects were 84 customers who were not witnessed to the scene. The same survey was simultaneously performed for impression about the shopping scene. Study 1 showed that 31.8% of all the respondents replied that they had some knowledge of service dogs before watching the video. A total of 20.4% (32.5% of the elderly) replied that there were places where service dogs should not enter. Concretely speaking, these included restaurants for 7.3-22.5% and medical institutions for 8.5-12.5% of the respondents. A third of all the respondents (51.3% of older persons) replied they could not endure some actions by service dogs, concretely "carrying food in the mouth" was highly pointed out by 27.3%. Zoonosis (15.3-19.0%), hair scattering (9.5-21.3%), injuries (4.4-7.4%) were also pointed out as main sources of anxiety or uncomfortable feelings. Such negative opinions were especially apparent among those

  3. On the derivation of a full life table from mortality data recorded in five-year age groups.

    PubMed

    Pollard, J H

    1989-01-01

    Mortality data are often gathered using 5-year age groups rather than individual years of life. Furthermore, it is common practice to use a large open-ended interval (such as 85 and over) for mortality data at the older ages. These limitations of the data pose problems for the actuary or demographer who wishes to compile a full and accurate life table using individual years of life. The author devises formulae which handle these problems. He also devises methods for handling mortality during the 1st year of life and for dealing with other technical problems which arise in the compilation of the full life table from grouped data.

  4. The impact of service and hearing dogs on health-related quality of life and activity level: a Swedish longitudinal intervention study.

    PubMed

    Lundqvist, Martina; Levin, Lars-Åke; Roback, Kerstin; Alwin, Jenny

    2018-06-27

    Individuals with severe disability often require personal assistance and help from informal caregivers, in addition to conventional health care. The utilization of assistance dogs may decrease the need for health and social care and increase the independence of these individuals. Service and hearing dogs are trained to assist specific individuals and can be specialized to meet individual needs. The aim of this study was to describe and explore potential consequences for health-related quality of life, well-being and activity level, of having a certified service or hearing dog. A longitudinal interventional study with a pre-post design was conducted. At inclusion, all participants in the study had a regular (untrained) companion dog. Data were collected before training of the dog started and three months after certification of the dog. Health-related quality of life was assessed with EQ-5D-3L, EQ-VAS and RAND-36. Well-being was measured with WHO-5 and self-esteem with the Rosenberg Self-Esteem Scale. In addition, questions were asked about physical activity and time spent away from home and on social activities. Subgroups were analyzed for physical service and diabetes alert dogs. Fifty-five owner-and-dog pairs completed the study (30 physical service dogs, 20 diabetes alert dogs, 2 epilepsy alert dogs, and 3 hearing dogs). Initially, study participants reported low health-related quality of life compared with the general population. At follow-up, health-related quality of life measured with the EQ-VAS, well-being and level of physical activity had improved significantly. In the subgroup analysis, physical service dog owners had lower health-related quality of life than diabetes alert dog owners. The improvement from baseline to follow-up measured with EQ-5D statistically differed between the subgroups. The target population for service and hearing dogs has an overall low health-related quality of life. Our study indicates that having a certified service or hearing

  5. Challenges in access to health services and its impact on quality of life: a randomised population-based survey within Turkish speaking immigrants in London.

    PubMed

    Topal, Kenan; Eser, Erhan; Sanberk, Ismail; Bayliss, Elizabeth; Saatci, Esra

    2012-01-26

    There are a significant number of Turkish speaking immigrants living in London. Their special health issues including women's health, mental health, and alcohol and smoking habits has been assessed. The aim of this study was to explore the ongoing challenges in access to health care services and its impact on Quality of Life of immigrants. This cross-sectional population-based study was conducted between March and August 2010 with Turkish immigrants (n = 416) living in London. Of these, 308 (74%) were Turkish and 108 (26%) were Turkish Cypriots. All healthy or unhealthy adults of 17-65 years of age were enrolled. A structured questionnaire with 44 items in five subcategories and 26-items WHOQOL BREF were used. Mean duration of stay for Turkish Cypriots (26.9 ± 13.9 years) was significantly longer than Turkish immigrants (13.3 ± 7.5) (p < 0.001). Turkish immigrants (n = 108, 36.5%) need interpretation more often when using health services than Turkish Cypriots (n = 16, 15%) (p < 0.001). Multivariate analyses suggested significant effects of older age, non-homeownership, low socioeconomic class, poor access to health services, being ill, poor community integration and being obese on physical well-being and also significant effects of low income and poor community integration on perceived overall Quality of Life (WHOQOL) of the participants. The results of this study demonstrate how the health and well-being of members of the Turkish speaking community living in London are affected by social aspects of their lives. Providing culturally competent care and interpretation services and advocacy may improve the accessibility of the health care.

  6. Part III: Growth, Maturity, Service: DPE's Second Twenty Years

    ERIC Educational Resources Information Center

    Delta Pi Epsilon Journal, 1976

    1976-01-01

    The second twenty-years history (1956-1975) of Delta Pi Epsilon is a compilation of four authors' findings of what has happened regarding the national executive boards, new chapters, membership status, financial conditions, interchapter relations, service projects, the DPE Journal, and publications. (BP)

  7. Caregiver Experience During Patients’ Advanced Chronic Illness and Last Year of Life

    PubMed Central

    Sautter, Jessica M.; Tulsky, James A.; Johnson, Kimberly S.; Olsen, Maren K.; Burton-Chase, Allison M.; Lindquist, Jennifer Hoff; Zimmerman, Sheryl; Steinhauser, Karen E.

    2014-01-01

    Background/Objectives Caregivers of patients with serious illness endure significant burden, yet it is not clear at what stage of advanced illness patient and caregiver needs are greatest. This study compared prevalence and predictors of caregiver esteem and burden during two different stages of patients’ illnesses – advanced chronic illness and the last year of life. Design Longitudinal, observational cohort study. Setting Community sample recruited from outpatient clinics at Duke University and Durham VA Medical Centers. Participants Patients living with advanced cancer, congestive heart failure, or chronic obstructive pulmonary disease and their primary caregiver, retrospectively coded as chronic-illness (n=62) or end-of-life (n=62) patient-caregiver dyads. Measurements We measured caregiver experience monthly with the Caregiver Reaction Assessment (CRA), which includes caregiver esteem and 4 domains of burden: schedule, health, family, and finances. Results During both chronic-illness and end-of-life, high caregiver esteem was almost universal (95%); health, family, and financial burden were endorsed by <25% of the sample. Schedule burden was the most prevalent form of burden and was experienced more frequently by end-of-life caregivers (58%) than the chronic-illness caregivers (32%). Caregiver esteem and all dimensions of burden were relatively stable over one year. Few factors were associated with burden. Conclusion Caregiver experience is relatively stable over one year and similar among caregivers of patients in the last year of life and those further upstream in advanced illness. Schedule burden stands out as most prevalent and variable among dimensions of experience. Because prevalence of burden is not specific to stage of illness and is relatively stable over time, multidisciplinary healthcare teams should assess caregiver burden and refer burdened caregivers to supportive resources early in the course of chronic illness. PMID:24803020

  8. [Socioeconomic inequalities in oral health service utilization any time in their lives for Mexican schoolchildren from 6 to 12 years old].

    PubMed

    Jiménez-Gayosso, Sandra Isabel; Medina-Solís, Carlo Eduardo; Lara-Carrillo, Edith; Scougal-Vilchis, Rogelio José; de la Rosa-Santillana, Rubén; Márquez-Rodríguez, Sonia; Mendoza-Rodríguez, Martha; Navarrete-Hernández, José de Jesús

    2015-01-01

    To determine the prevalence and the existence of socioeconomic inequalities in dental health service utilization (DHSU) any time in the life of Mexican schoolchildren aged 6-12 years of Pachuca Hidalgo, Mexico. We performed a cross-sectional study in 1,404 school children 6-12 years of age from 14 public schools in the city of Pachuca, Hidalgo, Mexico. Questionnaires were distributed to determine socioeconomic position variables (SEP). The dependent variable was DHSU once in life (0 = No, 1 = Yes). The analysis was performed in Stata 9 using chi-square tests. The mean age was 8.97 ± 1.99 years, 50.1% were boys. The prevalence of DHSU any time in life was 71.4%. The DHSU percentage increased according increasing age (p < 0.05). Significant differences (p < 0.05) in percentages of USSB through SEP variables: health insurance, car ownership in the home, dwelling and household characteristics, a better level of SEP increased prevalence of DHSU. Although in the mother's schooling no differences were observed (p > 0.05), father's schooling was associated (p < 0.05) inversely to expectations. The findings of this study demonstrate that the prevalence of DHSU was not 100%; 28.6% of children have never had contact with a dentist. We identified certain indicator variables of SEP associated with DHSU, indicating the existence of inequalities in this oral health indicator.

  9. Smoking Cessation and Quality of Life: Changes in Life Satisfaction Over Three Years Following a Quit Attempt

    PubMed Central

    Piper, Megan E.; Kenford, Susan; Fiore, Michael C.; Baker, Timothy B.

    2011-01-01

    Background There has been limited research addressing changes in subjective well-being as a result of quitting smoking. Purpose To use longitudinal data to determine the relation between smoking cessation and subjective measures of well-being, including global quality of life (QOL), health-related QOL (HR-QOL), affect, relationship satisfaction and stressor occurrence. Methods As part of a randomized, placebo-controlled smoking cessation trial, 1504 participants (58.2% women; 83.9% white) completed assessments and had their smoking status biochemically confirmed at baseline and Years 1 and 3 post-quit. Results Compared to continuing smokers, quitters showed improved global QOL, HR-QOL, and affect at Years 1 and 3 and fewer stressors by Year 3. Smoking status did not influence marital relationship satisfaction. Conclusions Successful quitters, in contrast to continuing smokers, reported improved subjective well-being, which could be used to motivate quit attempts by individuals with concerns about what life will be like without cigarettes. PMID:22160762

  10. Italian medical students quality of life: years 2005-2015.

    PubMed

    Messina, G; Quercioli, C; Troiano, G; Russo, C; Barbini3, E; Nisticò, F; Nante, N

    2016-01-01

    Quality of Life (QoL) is a concept used to indicate the general wellness of persons or societies. University students report a low quality of life and a worse perception of their health status, because of a situation of greater discomfort in which they live during the course of the study, especially in faculties with an important emotional burden, such as medical schools. The aim of the study was to evaluate the perceived health status of first year medical students. We conducted a cross sectional study in the time span 2005-2015, administering the questionnaire Short Form 36 (SF-36) to first-year students of the School of Medicine of the University of Siena, Italy. In addition to demographic information such as gender and the age we investigated the region of residence, marital status, employment status, and smoking habits; height and weight were required to calculate the body mass index (BMI) to evaluate a possible physical discomfort connected with the perception of health status. The data from the questionnaires were organized and processed by software Stata® SE, version 12.1. 1,104 questionnaires were collected. Medical students reported lower SF-36 scores, compared to the Italian population of the same age. Female gender and smoking habits influence negatively the score of several scales. Body Mass Index is positively correlated with the Physical Activity, while Age is negatively correlated with Social Activities. The perceived quality of life of the Italian medical students is lower when compared to the general population. This confirms that the condition of student implies additional problems, as other studies reports. It would be better to improve it, developing students' resilience. It would be interesting to extend this research to students of other years, from other faculties and other locations, to gain a broader view about the QoL of the Italian students.

  11. Influence of health-related quality of life on health service utilization in Chinese rural-to-urban female migrant workers.

    PubMed

    Lu, Chu-Hong; Wang, Pei-Xi; Lei, Yi-Xiong; Luo, Zhong-Cheng

    2014-08-15

    Rural-to-urban migrant workers have been increasing rapidly in China over recent decades. Health related quality of life (HRQOL) may affect health service utilization. There is a lack of data on HRQOL in relation to health service utilization in Chinese rural-to-urban migrant workers. This study was aimed to explore the influence of HRQOL on health service utilization in Chinese rural-to-urban female migrant workers. This was a cross-sectional survey of 1,438 female rural-to-urban migrant workers in Shenzhen-Dongguan economic zone, China in 2013. HRQOL was assessed by the 36-items Health Survey Short Form (SF-36). Health service utilization was measured by any physician visit over the recent two weeks and any hospitalization over the last 1-year (annual hospitalization). Clustered logistic regression was used to analyze the influence of HRQOL on health service utilization. Lower scores in three HRQOL domains (bodily pain, general health, role physical) were associated with more frequent health service utilization in female rural-to-urban migrant workers. Bodily pain and general health were associated with an independent influence of 15.6% on the risk of recent two-week physician visit, while role physical and general health were associated with an independent influence of 21.2% on the risk of annual hospitalization. The independent influence of HRQOL on health service utilization was smaller than that of socio-demographic and health-related variables. HRQOL may have a modest influence on health service utilization in Chinese rural-to-urban female migrant workers - an underprivileged population in urban China.

  12. Life Stories of Pre-Service Teachers: Bids, Invitations, Resistance and Redemption, and the Hidden Alliance of Blessers

    ERIC Educational Resources Information Center

    Porter, Thomas Alan

    2017-01-01

    The purpose of this study is to examine how pre-service teachers' negative and/or positive life stories inform their future teaching practices. This study used Gee's (2000) theoretical work on identity, particularly his concepts of bids and invitations; and McAdams and Bowman's (2001) empirical study from life story research, focusing on the…

  13. Education Services in Juvenile Corrections: 40 Years of Litigation and Reform

    ERIC Educational Resources Information Center

    Leone, Peter E.; Wruble, Pamela Cichon

    2015-01-01

    Children and youth in juvenile corrections have statutory rights to education services of comparable quality to those found in the public schools. However, during the past 40 years in many states, access to education services that meet state and federal requirements under IDEA and state regulations has been inconsistent and inadequate for youth in…

  14. Abortion service provision in South Africa three years after liberalization of the law.

    PubMed

    Dickson, Kim Eva; Jewkes, Rachel K; Brown, Heather; Levin, Jonathan; Rees, Helen; Mavuya, Luyanda

    2003-12-01

    In 1996, South Africa introduced legislation that liberalized women's access to termination of pregnancy. This study presents the findings of a survey undertaken to describe the availability and accessibility of abortion services in 1999, three years after the law was passed. All facilities that had been officially designated to perform these services were contacted by telephone to determine whether they were providing the services, their capacity, whether they were performing second-trimester as well as first-trimester terminations, and how long women had to wait for these services. Nationally, 292 facilities had been designated, but in 1999 only 32 percent were functioning. Of the functioning facilities, 27 percent were in the private sector. Mapping of available services indicated that substantial parts of the country were entirely without such services. Half of the country's induced abortions were being performed in Gauteng province, although only 19 percent of women of reproductive age were living there. This finding indicates that service provision in other provinces was inadequate or lacking. Although in the first years following the new legislation efforts were made to establish abortion services, this study reveals gross inequality in service availability. Strategies for improving coverage are suggested.

  15. Immunization delivery in the second year of life in Ghana: the need for a multi-faceted approach.

    PubMed

    Nyaku, Mawuli; Wardle, Melissa; Eng, Jodi Vanden; Ametewee, Lynnette; Bonsu, George; Larbi Opare, Joseph Kwadwo; Conklin, Laura

    2017-01-01

    in 2012, pneumococcal conjugate vaccine (PCV), rotavirus vaccine and a second dose of measles-containing vaccine (MCV2) were introduced into the Expanded Program on Immunization (EPI) in Ghana. According to Ghana's EPI schedule, PCV and rotavirus vaccine are given in the first year of life and MCV2 in the second year of life (2YL) at 18 months. Although coverage with the last doses of PCV and rotavirus vaccine reached almost 90% coverage within four years of introduction, MCV2 coverage did not rise above 70%. The World Health Organization Global Measles and Rubella Strategic Plan established a 2020 milestone to achieve at least 95% coverage with the first and second doses of measles-containing vaccine in each district and nationally. We developed a project to address challenges to delivery of immunizations and other child health services at the 18-month visit and throughout the 2YL. from March to April 2016, we conducted a cluster survey of households (HHs) with children 24-35 months of age in three regions in Ghana to assess knowledge, attitudes and beliefs among caregivers about immunization during the 2YL and to collect childhood vaccination history data using vaccination cards. Three independent samples were selected from the Northern (NR), Volta (VR), and Greater Accra (GAR) regions. A survey and direct observations were performed a ta representative sample of health facilities (HFs) providing immunization services in the same regions to further characterize barriers to immunization access, utilization and delivery in the 2YL. data on a total of 464 children ages 24-35 months were collected in the HH survey: 211 in NR, 153 in VR, and 100 in GAR (response rate > 99%). First dose of measles-containing vaccine (MCV1) coverage was (NR: 87%, VR: 96%, GAR: 99%); however, MCV2 coverage was lower (NR: 60%, VR: 83%, GAR: 70%). MCV1 to MCV2 dropout was 32% in NR, 14% in VR, and 31% in GAR. Caregiver awareness of immunization against measles was 69% in NR, 75% in VR, and

  16. NOAA honors New York farmer for 84 years of service as volunteer weather

    Science.gov Websites

    Print Facebook Google StumbleUpon Digg More Destinations NOAA honors New York farmer for 84 years of Weather Service, Herbert Hoover occupied the White House. Since then the Bridgehampton, New York, farmer decades, the new 80-year service award will be named in his honor. Richard G. Hendrickson looks out over

  17. 78 FR 21919 - Public Availability of Fiscal Year 2012 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-12

    ... Inventory AGENCY: Commodity Futures Trading Commission. ACTION: Notice. SUMMARY: The Commodity Futures... Fiscal Year (FY) 2012 Service Contract Inventory. FOR FURTHER INFORMATION CONTACT: Questions regarding the Service Contract Inventory should be directed to Sonda R. Owens, Contracting Officer, in the...

  18. Psoriasis nurse of the year helped me lead a normal life.

    PubMed

    2017-08-09

    I have had psoriasis for about 20 years. I can safely say that the care I have received from advanced nurse practitioner Zahira Koreja over the past two years is the best I have ever had. Her care has been instrumental in helping me finally live a normal life by keeping my psoriasis under control.

  19. Transit bus life cycle cost and year 2007 emissions estimation.

    DOT National Transportation Integrated Search

    2007-06-01

    The report presents a study of transit bus life cycle cost (LCC) analysis, and projected transit bus emissions and fuel economy for 2007 : model year buses. It covers four bus types: diesel buses using ultra low sulfur diesel (ULSD), diesel buses usi...

  20. Post-Test Analysis of a 10-Year Sodium Heat Pipe Life Test

    NASA Technical Reports Server (NTRS)

    Rosenfeld, John H.; Locci, Ivan E.; Sanzi, James L.; Hull, David R.; Geng, Steven M.

    2011-01-01

    High-temperature heat pipes are being evaluated for use in energy conversion applications such as fuel cells, gas turbine re-combustors, Stirling cycle heat sources; and with the resurgence of space nuclear power both as reactor heat removal elements and as radiator elements. Long operating life and reliable performance are critical requirements for these applications. Accordingly, long-term materials compatibility is being evaluated through the use of high-temperature life test heat pipes. Thermacore, Inc., has carried out a sodium heat pipe 10-year life test to establish long-term operating reliability. Sodium heat pipes have demonstrated favorable materials compatibility and heat transport characteristics at high operating temperatures in air over long time periods. A representative one-tenth segment Stirling Space Power Converter heat pipe with an Inconel 718 envelope and a stainless steel screen wick has operated for over 87,000 hr (10 years) at nearly 700 C. These life test results have demonstrated the potential for high-temperature heat pipes to serve as reliable energy conversion system components for power applications that require long operating lifetime with high reliability. Detailed design specifications, operating history, and post-test analysis of the heat pipe and sodium working fluid are described. Lessons learned and future life test plans are also discussed.

  1. Apparatus for determining past-service conditions and remaining life of thermal barrier coatings and components having such coatings

    DOEpatents

    Srivastava, Alok Mani; Setlur, Anant Achyut; Comanzo, Holly Ann; Devitt, John William; Ruud, James Anthony; Brewer, Luke Nathaniel

    2004-05-04

    An apparatus for determining past-service conditions and/or remaining useful life of a component of a combustion engine and/or a thermal barrier coating ("TBC") of the component comprises a radiation source that provides the exciting radiation to the TBC to excite a photoluminescent ("PL") material contained therein, a radiation detector for detecting radiation emitted by the PL material, and means for relating a characteristic of an emission spectrum of the PL material to the amount of a crystalline phase in the TBC, thereby inferring the past-service conditions or the remaining useful life of the component or the TBC.

  2. Continuing screening mammography in women aged 70 to 79 years: impact on life expectancy and cost-effectiveness.

    PubMed

    Kerlikowske, K; Salzmann, P; Phillips, K A; Cauley, J A; Cummings, S R

    1999-12-08

    Mammography is recommended and is cost-effective for women aged 50 to 69 years, but the value of continuing screening mammography after age 69 years is not known. In particular, older women with low bone mineral density (BMD) have a lower risk of breast cancer and may benefit less from continued screening. To compare life expectancy and cost-effectiveness of screening mammography in elderly women based on 3 screening strategies. Decision analysis and cost-effectiveness analysis using a Markov model. General population of women aged 65 years or older. The analysis compared 3 strategies: (1) Undergoing biennial mammography from age 65 to 69 years; (2) undergoing biennial mammography from age 65 to 69 years, measurement of distal radial BMD at age 65 years, discontinuing screening at age 69 years in women in the lowest BMD quartile for age, and continuing biennial mammography to age 79 years in those in the top 3 quartiles of distal radius BMD; and (3) undergoing biennial mammography from age 65 to 79 years. Deaths due to breast cancer averted, life expectancy, and incremental cost-effectiveness ratios. Compared with discontinuing mammography screening at age 69 years, measuring BMD at age 65 years in 10000 women and continuing mammography to age 79 years only in women with BMD in the top 3 quartiles would prevent 9.4 deaths and add, on average, 2.1 days to life expectancy at an incremental cost of $66773 per year of life saved. Continuing mammography to age 79 years in all 10000 elderly women would prevent 1.4 additional breast cancer deaths and add only 7.2 hours to life expectancy at an incremental cost of $117689 per year of life saved compared with only continuing mammography to age 79 years in women with BMD in the top 3 quartiles. This analysis suggests that continuing mammography screening after age 69 years results in a small gain in life expectancy and is moderately cost-effective in those with high BMD and more costly in those with low BMD. Women

  3. Does early-life family income influence later dental pain experience? A prospective 14-year study.

    PubMed

    Ghorbani, Z; Peres, M A; Liu, P; Mejia, G C; Armfield, J M; Peres, K G

    2017-12-01

    The aim of this study was to investigate the association between early-life family income and dental pain experience from childhood to early adulthood. Data came from a 14-year prospective study (1991/1992-2005/2006) carried out in South Australia, which included children and adolescents aged 4-17 years (N = 9875) at baseline. The outcome was dental pain experience obtained at baseline, 14 years later in adulthood and at a middle point of time. The main explanatory variable was early-life family income collected at baseline. The prevalence of dental pain was 22.8% at baseline, 19.3% at 'middle time' and 39.3% at follow up. The proportion of people classified as 'poor' at baseline was 27.7%. Being poor early in life was significantly associated with dental pain at 14-year follow up (odds ratio = 1.45; 95% confidence interval = 1.27-1.66). Early-life relative poverty is associated with more frequent dental pain across the 14-year follow up and may be a key exposure variable for later dental conditions. © 2017 Australian Dental Association.

  4. Microstructure evolution and mechanical properties degradation of HPNb alloy after a five-year service

    NASA Astrophysics Data System (ADS)

    Guo, Jingfeng; Cao, Tieshan; Cheng, Congqian; Meng, Xianming; Zhao, Jie

    2018-04-01

    The microstructure and mechanical properties of ethylene cracking furnace tube (HPNb alloy) are investigated by scanning electronic microscopy (SEM), tensile tests and Charpy impact tests at room temperature, tensile tests and creep tests at high temperature in this paper. The primary carbides of HPNb alloy coarsened and formed a continuous network after a five-year service. Furthermore, a lot of fine secondary carbides precipitated in the dendrite interior. The primary carbides M7C3 and NbC transformed into M23C6 and G phase after service, respectively. The furnace tube after service exhibits higher yield strength, lower tensile strength, worse ductility and toughness than as-cast tube at room temperature. At high temperature, the tensile strength and yield strength of service tube are higher than as-cast tube, but its tensile elongation is lower. The creep strength of HPNb alloy at high temperature decreases after a five-year service. Both microstructure and mechanical properties of ethylene cracking furnace tube have deteriorated after a five-year service.

  5. The Effect of Smoking on Years of Healthy Life (YHL) Lost among Middle-Aged and Older Americans

    PubMed Central

    Østbye, Truls; Taylor, Donald H

    2004-01-01

    Objective To estimate the effects of smoking on quality of life over time, using the Years of Healthy Life (YHL) construct. Data Sources/Study Setting The Health and Retirement Study (HRS) survey (N = 12,652) of persons 50 to 60 years old and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (N = 8,124) of persons≥70 years old, plus spouses regardless of age, followed from 1992/1993 to 2000. Study Design Years of healthy life from baseline to death were estimated. Regression models were developed with smoking as the main explanatory variable and with both YHL and years of life remaining as the outcome variables. Principal Findings Smoking was strongly and consistently related to YHL lost. In HRS, individuals who had quit smoking at least 15 years prior to baseline had a similar number of YHL left as never smokers. Conclusions Efforts to encourage smoking cessation should emphasize the impact of these factors on quality of life. PMID:15149477

  6. Years of life lost to incarceration: inequities between Aboriginal and non-Aboriginal Canadians.

    PubMed

    Owusu-Bempah, Akwasi; Kanters, Steve; Druyts, Eric; Toor, Kabirraaj; Muldoon, Katherine A; Farquhar, John W; Mills, Edward J

    2014-06-11

    Aboriginal representation in Canadian correctional institutions has increased rapidly over the past decade. We calculated "years of life lost to incarceration" for Aboriginal and non-Aboriginal Canadians. Incarceration data from provincial databases were used conjointly with demographic data to estimate rates of incarceration and years of life lost to provincial incarceration in (BC) and federal incarceration, by Aboriginal status. We used the Sullivan method to estimate the years of life lost to incarceration. Aboriginal males can expect to spend approximately 3.6 months in federal prison and within BC spend an average of 3.2 months in custody in the provincial penal system. Aboriginal Canadians on average spend more time in custody than their non-Aboriginal counterparts. The ratio of the Aboriginal incarceration rate to the non-Aboriginal incarceration rate ranged from a low of 4.28 in Newfoundland and Labrador to a high of 25.93 in Saskatchewan. Rates of incarceration at the provincial level were highest among Aboriginals in Manitoba with an estimated rate of 1377.6 individuals in prison per 100,000 population (95% confidence interval [CI]: 1311.8-1443.4). The results indicate substantial differences in life years lost to incarceration for Aboriginal versus non-Aboriginal Canadians. In light of on-going prison expansion in Canada, future research and policy attention should be paid to the public health consequences of incarceration, particularly among Aboriginal Canadians.

  7. Lost life years due to premature mortality caused by diseases of the respiratory system.

    PubMed

    Maniecka-Bryła, Irena; Paciej-Gołębiowska, Paulina; Dziankowska-Zaborszczyk, Elżbieta; Bryła, Marek

    2018-06-04

    In Poland, as in most other European countries, diseases of the respiratory system are the 4th leading cause of mortality; they are responsible for about 8% of all deaths in the European Union (EU) annually. To assess the socio-economic aspects of mortality, it has become increasingly common to apply potential measures rather than conventionally used ratios. The aim of this study was to analyze years of life lost due to premature deaths caused by diseases of the respiratory system in Poland from 1999 to 2013. The study was based on a dataset of 5,606,516 records, obtained from the death certificates of Polish residents who died between 1999 and 2013. The information on deaths caused by diseases of the respiratory system, i.e., coded as J00-J99 according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), was analyzed. The Standard Expected Years of Life Lost (SEYLL) indicator was used in the study. In the years 1999-2013, the Polish population suffered 280,519 deaths caused by diseases of the respiratory system (4.69% of all deaths). In the period analyzed, a gradual decrease in the standardized death rate was observed - from 46.31 per 100,000 inhabitants in 1999 to 41.02 in 2013. The dominant causes of death were influenza and pneumonia (J09-J18) and chronic lower respiratory diseases (J40-J47). Diseases of the respiratory system were the cause of 4,474,548.92 lost life years. The Standard Expected Years of Life Lost per person (SEYLLp) was 104.72 per 10,000 males and 52.85 per 10,000 females. The Standard Expected Years of Life Lost per death (SEYLLd) for people who died due to diseases of the respiratory system was 17.54 years of life on average for men and 13.65 years on average for women. The use of the SEYLL indicator provided significant information on premature mortality due to diseases of the respiratory system, indicating the fact that they play a large role in the health status of the Polish

  8. Prioritization of influenza pandemic vaccination to minimize years of life lost.

    PubMed

    Miller, Mark A; Viboud, Cecile; Olson, Donald R; Grais, Rebecca F; Rabaa, Maia A; Simonsen, Lone

    2008-08-01

    How to allocate limited vaccine supplies in the event of an influenza pandemic is currently under debate. Conventional vaccination strategies focus on those at highest risk for severe outcomes, including seniors, but do not consider (1) the signature pandemic pattern in which mortality risk is shifted to younger ages, (2) likely reduced vaccine response in seniors, and (3) differences in remaining years of life with age. We integrated these factors to project the age-specific years of life lost (YLL) and saved in a future pandemic, on the basis of mortality patterns from 3 historical pandemics, age-specific vaccine efficacy, and the 2000 US population structure. For a 1918-like scenario, the absolute mortality risk is highest in people <45 years old; in contrast, seniors (those >or=65 years old) have the highest mortality risk in the 1957 and 1968 scenarios. The greatest YLL savings would be achieved by targeting different age groups in each scenario; people <45 years old in the 1918 scenario, people 45-64 years old in the 1968 scenario, and people >45 years old in the 1957 scenario. Our findings shift the focus of pandemic vaccination strategies onto younger populations and illustrate the need for real-time surveillance of mortality patterns in a future pandemic. Flexible setting of vaccination priority is essential to minimize mortality.

  9. Multimorbidity patterns of and use of health services by Swedish 85-year-olds: an exploratory study

    PubMed Central

    2013-01-01

    Background As life expectancy continues to rise, more elderly are reaching advanced ages (≥80 years). The increasing prevalence of multimorbidity places additional demands on health-care resources for the elderly. Previous studies noted the impact of multimorbidity on the use of health services, but the effects of multimorbidity patterns on health-service use have not been well studied, especially for very old people. This study determines patterns of multimorbidity associated with emergency-room visits and hospitalization in an 85-year-old population. Methods Health and living conditions were reported via postal questionnaire by 496 Linköping residents aged 85 years (189 men and 307 women). Diagnoses of morbidity were reviewed in patients’ case reports, and the local health-care register provided information on the use of health services. Hierarchical cluster analysis was applied to evaluate patterns of multimorbidity with gender stratification. Factors associated with emergency-room visits and hospitalization were analyzed using logistic regression models. Results Cluster analyses revealed five clusters: vascular, cardiopulmonary, cardiac (only for men), somatic–mental (only for men), mental disease (only for women), and three other clusters related to aging (one for men and two for women). Heart failure in men (OR = 2.4, 95% CI = 1–5.7) and women (OR = 3, 95% CI = 1.3–6.9) as a single morbidity explained more variance than morbidity clusters in models of emergency-room visits. Men's cardiac cluster (OR = 1.6; 95% CI = 1–2.7) and women's cardiopulmonary cluster (OR = 1.7, 95% CI = 1.2–2.4) were significantly associated with hospitalization. The combination of the cardiopulmonary cluster with the men’s cardiac cluster (OR = 1.6, 95% CI = 1–2.4) and one of the women’s aging clusters (OR = 0.5, 95% CI = 0.3–0.8) showed interaction effects on hospitalization. Conclusion In this 85-year-old population, patterns of

  10. The development of maternal touch across the first year of life.

    PubMed

    Ferber, Sari Goldstein; Feldman, Ruth; Makhoul, Imad R

    2008-06-01

    The developmental trajectories of specific forms of maternal touch during natural caregiving were examined across the first year in relation to the development of mother-infant reciprocal communication. One hundred and thirty-one mothers and infants in four groups aged 3, 6, 9, and 12 months were observed in a cross-sectional design at home during natural caregiving and mother-child play sessions. Microanalytic coding of the caregiving sessions considered nine forms of maternal touch, which were aggregated into three global touch categories: affectionate, stimulating, and instrumental. Play sessions were coded for maternal sensitivity and dyadic reciprocity. Maternal affectionate and stimulating touch decreased significantly during the second 6 months of life. In parallel, dyadic reciprocity increased in the second half year. Dyadic reciprocity was predicted by the frequency of affectionate touch but not by any other form of touch. Results contribute to specifying the role of touch as it evolves across the first year of life within the global mother-infant communication system.

  11. The ACT Mental Health Service for People with Intellectual Disability, 10 years on.

    PubMed

    Wurth, Peter; Brandon, Shirley-Anne

    2014-02-01

    Our aim is to describe the establishment and first 10 years' experience of a specialist team for providing psychiatric services to individuals with intellectual disability. This service is unique in Australia in providing a comprehensive mental health assessment and treatment service to this population in a defined catchment area. It can serve as a model for service development in this area of unmet need.

  12. A Comparison of Quality of Life Outcomes for People with Intellectual Disabilities in Supported Employment, Day Services and Employment Enterprises

    ERIC Educational Resources Information Center

    Beyer, Stephen; Brown, Tony; Akandi, Rachel; Rapley, Mark

    2010-01-01

    Background: Policy objectives for people with intellectual disabilities include day service modernization and the promotion of paid employment and quality of life. Quality of life is under represented as an outcome measure in vocational research. This research compares subjective and objective quality of life, and quality of work environment for…

  13. King 2 2519 ATM residual gyros: Reestablishing 5 year life requirements

    NASA Technical Reports Server (NTRS)

    Kayal, B.; Carbocci, L. J.

    1978-01-01

    The technical expertise required to assess the condition of the residual ATM 2519 Singer gyros is discussed. Past build history records, past performance characteristics, and recommendations for particular tests (which were performed by NASA personnel) are summarized. Test results are analyzed. A study of motor performance data and recommendations concerning gyro spin bearing life was performed. A method of reestablishing potential reliability of the bearing for the 5-year life requirement of the power module is also included.

  14. An End of Service Life Assessment of PMMA Lenses from Veteran Concentrator Photovoltaic Systems

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

    Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebecca

    The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their facetedmore » back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. Molecular weight was compared between the incident and faceted surfaces of the lenses.« less

  15. Malnutrition in the First Year of Life and Personality at Age 40

    PubMed Central

    Galler, Janina R.; Bryce, Cyralene P.; Zichlin, Miriam L.; Waber, Deborah P.; Exner, Natalie; Fitzmaurice, Garrett M.; Costa, Paul T.

    2013-01-01

    Background Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Methods Using the NEO-PI-R personality inventory, we compared personality profiles at 37–43 years of age (mean 40.3 years, SD 1.9) of Barbadian adults who had experienced moderate to severe protein-energy malnutrition (PEM) in the first year of life (n=77) with healthy controls, who were former classmates of the index cases and were matched for age, sex and handedness in childhood (n=57). The previously malnourished participants had been rehabilitated, with good health and nutrition documented to 12 years of age, and study participants were followed longitudinally from childhood to 40 y. Group comparisons were adjusted for childhood and adolescent standard of living, with and without correcting for IQ. Results At the broad domain or factor level, previously malnourished participants had higher scores on Neuroticism and lower scores on Extraversion, Openness, Agreeableness and Conscientiousness than did the healthy controls At the sub-domain or facet level, previously malnourished participants reported more anxiety, vulnerability, shyness and lowered sociability, less intellectual curiosity, greater suspiciousness of others, a more egocentric than altruistic orientation, and a lowered sense of efficacy or competence. Conclusions Malnutrition limited to the first year of life with good health and nutrition documented to 12 years of age, is associated with a significant overrepresentation of adult personality trait scores outside of the average range. This outcome has important implications for a variety of important life and mental health outcomes. PMID:23488644

  16. Malnutrition in the first year of life and personality at age 40.

    PubMed

    Galler, Janina R; Bryce, Cyralene P; Zichlin, Miriam L; Waber, Deborah P; Exner, Natalie; Fitzmaurice, Garrett M; Costa, Paul T

    2013-08-01

    Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Using the NEO-PI-R personality inventory, we compared personality profiles at 37-43 years of age (M 40.3 years, SD 1.9) of Barbadian adults who had experienced moderate-to-severe protein-energy malnutrition (PEM) in the first year of life (n = 77) with healthy controls, who were former classmates of the index cases and were matched for age, gender, and handedness in childhood (n = 57). The previously malnourished participants had been rehabilitated, with good health and nutrition documented up to 12 years of age, and study participants were followed longitudinally from childhood to 40 years. Group comparisons were adjusted for childhood and adolescent standard of living, with and without correcting for IQ. At the broad domain or factor level, previously malnourished participants had higher scores on Neuroticism and lower scores on Extraversion, Openness, Agreeableness, and Conscientiousness than did the healthy controls. At the subdomain or facet level, previously malnourished participants reported more anxiety, vulnerability, shyness and lowered sociability, less intellectual curiosity, greater suspiciousness of others, a more egocentric than altruistic orientation, and a lowered sense of efficacy or competence. Malnutrition limited to the first year of life with good health and nutrition documented up to 12 years of age is associated with a significant overrepresentation of adult personality trait scores outside of the average range. This outcome has important implications for a variety of important life and mental health outcomes. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

  17. Fifteen years after parental divorce: mental health and experienced life-events.

    PubMed

    Angarne-Lindberg, Teresia; Wadsby, Marie

    2009-01-01

    The children who experienced their parents' divorce when the divorce rate in Sweden had begun to grow to higher levels than in preceding decades are today adults. The aim of this study was to investigate if adults who had experienced parental divorce 15 years before the time of our study, differed in mental health from those with continuously married parents, taking into account life events other than the divorce. Instruments used were the Symptom Checklist (SCL-90) measuring mental health and the Life Event questionnaire capturing the number and experience of occurred events. Forty-eight persons, who were 7-18 years old when their parents divorced, constituted the divorce group, and 48 persons matched on age, sex and growth environment formed the study groups. The SCL-90 showed a limited difference between the groups, but not concerning total mental health. A main finding was a difference with regard to sex and age; women aged 22-27 in the divorce group displayed poorer mental health than other participants in both groups. The results from the Life Event questionnaire showed that the divorce group had experienced a significantly larger number of events, and more life events were described as negative with difficult adjustment. A regression analysis showed a significant relation between the SCL-90, Global Severity Index and life events experienced as negative with difficult adjustment, divorce events excluded, but not with the divorce itself. It seems highly desirable to pay more attention than has thus far been paid to girls with experience of childhood divorce at age 7-12.

  18. The incompatibility of healthcare services and end-of-life needs in advanced liver disease: A qualitative interview study of patients and bereaved carers.

    PubMed

    Hudson, Benjamin; Hunt, Victoria; Waylen, Andrea; McCune, Catherine Anne; Verne, Julia; Forbes, Karen

    2018-05-01

    Liver disease represents the third commonest cause of death in adults of working age and is associated with an extensive illness burden towards the end of life. Despite this, patients rarely receive palliative care and are unlikely to be involved in advance care planning discussions. Evidence addressing how existing services meet end-of-life needs, and exploring attitudes of patients and carers towards palliative care, is lacking. To explore the needs of patients and carers with liver disease towards the end of life, evaluate how existing services meet need, and examine patient and carer attitudes towards palliative care. Qualitative study - semi-structured interviews analysed using thematic analysis. Settings/participants: A total of 17 participants (12 patients, 5 bereaved carers) recruited from University Hospitals Bristol. Participants described escalating physical, psychological and social needs as liver disease progressed, including disabling symptoms, emotional distress and uncertainty, addiction, financial hardship and social isolation. End-of-life needs were incompatible with the healthcare services available to address them; these were heavily centred in secondary care, focussed on disease modification at the expense of symptom control and provided limited support after curative options were exhausted. Attitudes towards palliative care were mixed, however, participants valued opportunities to express future care preferences (particularly relating to avoidance of hospital admission towards the end of life) and an increased focus on symptomatic and logistical aspects of care. The needs of patients with liver disease and their carers are frequently incompatible with the healthcare services available to them towards the end of life. Novel strategies, which recognise the life-limiting nature of liver disease explicitly and improve coordination with community services, are required if end-of-life care is to improve.

  19. A Comparative Assessment of Life-Cycle Greenhouse Gas Emissions from Hypothetical Electric Airport Transportation Services in Thailand

    NASA Astrophysics Data System (ADS)

    Koiwanit, J.

    2018-05-01

    Global warming is an increase of average temperature in the atmosphere, which causes adverse effects on the environment. Carbon dioxide (CO2) from transportation sector is one of the main contributors of the overall greenhouse gases (GHG). To cope with this issue, electric car services are increasingly seen as popular alternative modes of green transportation especially for urban cities as it is more flexible, more environmentally-friendly, and less expensive than the use of conventional vehicles. The study analyses and compare the hypothetical electric car systems from airport transportation services. Center of Environmental Science of Leiden University (CML) 2001, the Life Cycle Impact Assessment (LCIA) method, is applied to convert life cycle inventory data into environmental impacts. The observed results showed that the electric shuttle bus had the highest impact in global warming potential (GWP) compared to other transportation types. Alternatively, this Life Cycle Assessment (LCA) study that evaluated different transportations provided important information for decision makers on quantifying the differences between each scenario.

  20. Human milk adiponectin affects infant weight trajectory during the second year of life.

    PubMed

    Woo, Jessica G; Guerrero, M Lourdes; Guo, Fukun; Martin, Lisa J; Davidson, Barbara S; Ortega, Hilda; Ruiz-Palacios, Guillermo M; Morrow, Ardythe L

    2012-04-01

    Serum adiponectin (APN) is associated with lower childhood obesity, and APN concentration in human milk is associated with slower growth during active breast-feeding. We examined infant weight gain in the second year of life after exposure to high or low levels of mother's milk APN. Breast-feeding mother-infant pairs were recruited in Mexico City and studied for 2 years; 192 infants with at least 12 months' follow-up were analyzed. Monthly milk samples were assayed for APN; mothers were classified as producing high or low levels of milk APN. Infant and maternal serum APN were assessed during year 1. Infant anthropometry was measured monthly (year 1) or bimonthly (year 2), and World Health Organization z scores were calculated. Longitudinal adjusted models assessed weight-for-age and weight-for-length z score trajectories from 1 to 2 years. Maternal serum APN modestly correlated with milk APN (r=0.37, P<0.0001) and infant serum APN (r=0.29, P=0.01). Infants exposed to high milk APN experienced increasing weight-for-age and weight-for-length z scores between age 1 and 2 years in contrast to low milk APN exposure (P for group × time=0.02 and 0.054, respectively), adjusting for growth in the first 6 months and other covariates. In contrast, infant serum APN in year 1 was not associated with the rate of weight gain in year 2. High human milk APN exposure was associated with accelerated weight trajectory during the second year of life, suggesting its role in catch-up growth after slower weight gain during the first year of life.

  1. Evidence for life on Earth more than 3850 million years ago.

    PubMed

    Holland, H D

    1997-01-03

    A recent study by Mojzsis et al., (Nature 384, 55, 1996) found evidence of life in rocks in Greenland estimated by new isotopic data to be more than 3800 million years old. The author examines this study in relation to studies conducted on rocks between 3250 and 3800 million years old and presents reasons to agree and disagree with the interpretation of data.

  2. Quality of life after TIA and stroke: ten-year results of the Oxford Vascular Study.

    PubMed

    Luengo-Fernandez, Ramon; Gray, Alastair M; Bull, Linda; Welch, Sarah; Cuthbertson, Fiona; Rothwell, Peter M

    2013-10-29

    To evaluate the 5-year impact of stroke and TIA on utility and quality-adjusted survival. TIA and stroke patients from a UK population-based study (Oxford Vascular Study) were recruited from 2002 to 2007, and followed up until 2012. Quality of life was assessed over 5 years using the EQ-5D (EuroQol-5 Dimensions), with responses converted into utilities ranging from -0.59 (worse than death) to 1 (perfect health), using UK population valuations. Utilities for stroke and TIA patients were compared with those in matched controls obtained from the 2006 Health Survey for England. Five-year quality-adjusted life years were estimated by combining utility and survival information. Four hundred forty TIA and 748 stroke patients were ascertained and included. Utility remained constant at approximately 0.78 over the 5 years after TIA. Utility improved from 0.64 one month after stroke to 0.70 at 6 months (p = 0.006), remaining at approximately 0.70 thereafter. Matched controls had considerably higher utility levels than stroke/TIA patients (0.85, p < 0.001). Event severity and recurrent stroke were significant predictors of decreased long-term utility. Five-year quality-adjusted life expectancy was 3.32 (95% confidence interval: 3.22-3.48) quality-adjusted life years after TIA and 2.21 (2.15-2.37) after stroke, varying considerably by severity (minor: 2.94; moderate: 1.65; and severe: 0.70). Quality-adjusted survival is low over the 5 years after stroke and TIA, with severity and recurrent stroke being major predictors. There remains considerable scope for improvements in acute treatment and secondary prevention to improve the quality of life after TIA and stroke.

  3. Explanatory style across the life span: evidence for stability over 52 years.

    PubMed

    Burns, M O; Seligman, M E

    1989-03-01

    Analyzed explanatory style across the life span. 30 Ss whose average age was 72 responded to questions about their current life and provided diaries or letters written in their youth, an average of 52 years earlier. A blind content analysis of explanatory style derived from these 2 sources revealed that explanatory style for negative events was stable throughout adult life (r = .54, p less than .002). In contrast, there appeared to be no stability of explanatory style for positive events between the same 2 time periods. These results suggest that explanatory style for negative events may persist across the life span and may constitute an enduring risk factor for depression, low achievement, and physical illness.

  4. Combinations of Types of Mental Health Services Received in the Past Year Among Young Adults

    MedlinePlus

    ... Spotlight December 08, 2015* Combinations of types of mental health services received in the past year among young adults Combinations of types of mental health services received in the past year among young ...

  5. At Their Service

    ERIC Educational Resources Information Center

    Villano, Matt

    2006-01-01

    For years, doing laundry at Columbia University (New York) was just as labor-intensive as it is at most universities. Fortunately, as of last spring, laundry life at Columbia has changed dramatically. Today, with the help of a real-time Web-based service called LaundryView, students can log on to the system via the LaundryView Web site from a link…

  6. Years of Life Lost Due to External Causes of Death in the Lodz Province, Poland

    PubMed Central

    Pikala, Malgorzata; Bryla, Marek; Bryla, Pawel; Maniecka-Bryla, Irena

    2014-01-01

    Background The aim of the study is the analysis of years of life lost due to external causes of death, particularly due to traffic accidents and suicides. Materials and Methods The study material includes a database containing information gathered from 376,281 death certificates of inhabitants of the Lodz province who died between 1999 and 2010. The Lodz province is characterized by the highest mortality rates in Poland. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (per death) indices were used to determine years of life lost. Joinpoint models were used to analyze time trends. Results In 2010, deaths due to external causes constituted 6.0% of the total number of deaths. The standardized death rate (SDR) due to external causes was 110.0 per 100,000 males and was five times higher than for females (22.0 per 100,000 females). In 2010, the SEYLLp due to external causes was 3746 per 100,000 males and 721 per 100,000 females. Among males, suicides and traffic accidents were the most common causes of death (the values of the SEYLLp were: 1098 years and 887 years per 100,000 people, respectively). Among females, the SEYLLp values were 183 years due to traffic accidents and 143 years due to suicides (per 100,000 people). Conclusions A decrease in the number of years of life lost due to external causes is much higher among females. The authors observe that a growing number of suicides contribute to an increase in the value of the SEYLLp index. This directly contributes to over-mortality of males due to external causes. The analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes. PMID:24810942

  7. Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission.

    PubMed

    Shannon, Stephen; Roche, Eric; Madigan, Kevin; Renwick, Laoise J; Dolan, Catherine; Devitt, Patrick; Feeney, Larkin; Murphy, Kieran C; O'Donoghue, Brian

    2015-08-01

    The study aimed to determine the number of accumulated coercive events experienced by patients during inpatient admission, the patients' functioning and quality of life (QOL) one year after discharge, and associations between these variables and patient characteristics and between follow-up outcomes and number of accumulated coercive events. A prospective cohort study was undertaken at three community services and an independent hospital in Ireland (N=162). Accumulated coercive events scores were based on patients' legal status, perceived coercion, and exposure to physical restraint, seclusion, or forced medication. Most (68%) experienced at least one coercive event. Lower functioning predicted more coercive events. At follow-up, the mean subjective QOL score was 63% of the highest possible score, objective QOL improved for 15% of participants, and functioning improved for 70%. Accumulated coercive events did not predict these outcomes. Coercive events during psychiatric admission appeared unrelated to functioning and QOL at follow-up.

  8. The Interrelation of Prayer and Worship Service Attendance in Moderating the Negative Impact of Life Event Stressors on Mental Well-Being.

    PubMed

    Rainville, G

    2017-09-13

    The interrelation of worship service attendance and private prayer in moderating the negative impact of life event stressors on mental well-being is examined using hierarchical multiple regressions on a national sample of 2601 Americans. A theoretical model is proposed in which stressful life events are made less distressing under conditions in which exposure to pro-social content at worship services is internalized through frequent private prayer. Interactive models controlling for a block of potential confounds are run to confirm that the stress-moderating effects of worship service attendance are noted only when attendance is complemented by relatively frequent engagement in private prayer.

  9. Quality of life 15 years after sex reassignment surgery for transsexualism.

    PubMed

    Kuhn, Annette; Bodmer, Christine; Stadlmayr, Werner; Kuhn, Peter; Mueller, Michael D; Birkhäuser, Martin

    2009-11-01

    To evaluate quality of life and patients' satisfaction in transsexual patients (TS) after sex reassignment operation compared with healthy controls. A case-control study. A tertiary referral center. Patients after sex reassignment operation were compared with a similar group of healthy controls in respect to quality of life and general satisfaction. For quality of life we used the King's Health Questionnaire, which was distributed to the patients and to the control group. Visual analogue scale was used for the determination of satisfaction. Main outcome measures were quality of life and satisfaction. Fifty-five transsexuals participated in this study. Fifty-two were male-to-female and 3 female-to-male. Quality of life as determined by the King's Health Questionnaire was significantly lower in general health, personal, physical and role limitations. Patients' satisfaction was significantly lower compared with controls. Emotions, sleep, and incontinence impact as well as symptom severity is similar to controls. Overall satisfaction was statistically significant lower in TS compared with controls. Fifteen years after sex reassignment operation quality of life is lower in the domains general health, role limitation, physical limitation, and personal limitation.

  10. Symptoms, disabilities, and life satisfaction five years after whiplash injuries.

    PubMed

    Styrke, Johan; Sojka, Peter; Björnstig, Ulf; Stålnacke, Britt-Marie

    2017-12-29

    Background Chronic whiplash-associated disorders (WADs) are often associated with social functioning problems and decreased ability to perform previous activities. This may lead to decreased life satisfaction, which is insufficiently studied in the context of whiplash injuries. Symptoms included in chronic WAD are similar to symptoms frequently reported by persons who have sustained mild traumatic brain injury (MTBI)/concussion. In cases of MTBI, the severity and number of symptoms have been suggested to have a diagnostic value. The corresponding importance of symptoms in chronic WAD has not been documented. Most studies of whiplash injuries have focused on neck pain because this is the dominant complaint, while other symptoms are less studied. The frequency of long-term symptoms after whiplash injuries seems to vary. It is difficult to compare the long-term outcome since the follow-up after whiplash injury in most studies has been rather short. Therefore, the primary aim of this investigation was to study neck pain and other symptoms, disability, and life satisfaction five years after whiplash injury in a defined population and geographical area. Methods The study was carried out at a public hospital in northern Sweden and was a cross-sectional survey of patients five years after the injury event in a cohort of whiplash-injured patients. Five years after the emergency department visit, 186 persons aged 18-64 answered questionnaires on symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ), disabilities (Rivermead Head Injury Follow Up Questionnaire, RHFUQ), and life satisfaction (LiSat-11). The answers were compared to those of a comparison cohort. Results The most common symptoms five years after whiplash injury were fatigue (41%), poor memory (39%), and headache (37%). Inability to sustain previous workload (44%) and fatigue at work (43%) were frequently reported disabilities. Only 39% were satisfied with their somatic health and 60% with their

  11. Quality of life, health status, and health service utilization related to a new measure of health literacy: FLIGHT/VIDAS.

    PubMed

    Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna

    2014-09-01

    Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. EDUCAUSE Core Data Service: Fiscal Year 2006 Summary Report

    ERIC Educational Resources Information Center

    Hawkins, Brian L.; Rudy, Julia A.

    2007-01-01

    EDUCAUSE Core Data Service Fiscal Year 2006 Summary Report summarizes much of the data collected through the 2006 EDUCAUSE core data survey about campus information technology (IT) environments at 933 colleges and universities in the U.S. and abroad. The report presents aggregates of data through more than 100 tables and accompanying descriptive…

  13. EDUCAUSE Core Data Service: Fiscal Year 2007 Summary Report

    ERIC Educational Resources Information Center

    Hawkins, Brian L.; Rudy, Julia A.

    2008-01-01

    EDUCAUSE Core Data Service Fiscal Year 2007 Summary Report summarizes much of the data collected through the 2007 EDUCAUSE core data survey about campus information technology (IT) environments at 994 colleges and universities in the U.S. and abroad. The report presents aggregates of data through more than 100 tables and accompanying descriptive…

  14. Heterogeneity of Mental Health Service Utilization and High Mental Health Service Use Among Women Eight Years After Initiating Substance Use Disorder Treatment.

    PubMed

    Evans, Elizabeth; Padwa, Howard; Li, Libo; Lin, Veronique; Hser, Yih-Ing

    2015-12-01

    The aim of this study was to determine mental health service utilization patterns among women treated for substance use disorders (SUD) and identify factors associated with patterns of high mental health service use. Data were provided by 4447 women treated for SUD in California during 2000-2002 for whom mental health services utilization records were acquired. A latent class model was fitted to women's high use of services (>6 services/year over 8 years). Multinomial logistic regression was used to identify predisposing, enabling, and need factors associated with utilization patterns. In 8 years after initiating SUD treatment, 50% of women utilized mental health services. High use probability was consistently low for most women (76.9%); for others, however, it decreased immediately following SUD treatment and then increased over time (8.7%), increased immediately following SUD treatment and then decreased (9.3%), or remained consistently high (5.1%). Consistently high services use was negatively associated with marriage (OR 0.60, p<0.05) and employment (OR 0.53, p<0.05) and positively associated with older age (OR 1.04, p<0.001), homelessness (OR 1.68, p<0.05), public assistance (OR 1.76, p<0.01), outpatient SUD treatment (OR 3.69, p<0.01), longer SUD treatment retention (OR 1.00, p<0.01), treatment desire (ORs 1.46, p<0.001), and co-occurring disorder diagnosis (ORs 2.89-44.93, p<0.001). Up to 29% of women with co-occurring mental health disorders at SUD treatment entry did not receive any mental health treatment in the subsequent 8 years. Mental health services utilization patterns among women treated for SUD are heterogeneous and dynamic. Understanding factors related to women's utilization patterns may aid efforts to optimize care and ensure appropriate use of mental health services. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Calculating CO2 uptake for existing concrete structures during and after service life.

    PubMed

    Andersson, Ronny; Fridh, Katja; Stripple, Håkan; Häglund, Martin

    2013-10-15

    This paper presents a model that can calculate the uptake of CO2 in all existing concrete structures, including its uptake after service life. This is important for the calculation of the total CO2 uptake in the society and its time dependence. The model uses the well-documented cement use and knowledge of how the investments are distributed throughout the building sector to estimate the stock of concrete applications in a country. The depth of carbonation of these applications is estimated using two models, one theoretical and one based on field measurements. The maximum theoretical uptake potential is defined as the amount of CO2 that is emitted during calcination at the production of Portland cement, but the model can also, with some adjustments, be used for the other cement types. The model has been applied on data from Sweden and the results show a CO2 uptake in 2011 in all existing structures of about 300,000 tonnes, which corresponds to about 17% of the total emissions (calcination and fuel) from the production of new cement for use in Sweden in the same year. The study also shows that in the years 2030 and 2050, an increase in the uptake in crushed concrete, from 12,000 tonnes today to 200,000 and 500,000 tonnes of CO2, respectively, could be possible if the waste handling is redesigned.

  16. Ten-year change in plasma amyloid beta levels and late-life cognitive decline.

    PubMed

    Okereke, Olivia I; Xia, Weiming; Selkoe, Dennis J; Grodstein, Francine

    2009-10-01

    Plasma levels of amyloid beta peptide (Abeta) are potential biomarkers of early cognitive impairment and decline and of Alzheimer disease risk. To relate midlife plasma Abeta measures and 10-year change in plasma Abeta measures since midlife to late-life cognitive decline. Prospective study of a population-based sample. Academic research. Plasma Abeta40 and Abeta42 levels were measured in 481 Nurses' Health Study participants in late midlife (mean age, 63.6 years) and again 10 years later (mean age, 74.6 years). Cognitive testing also began 10 years after the initial blood draw. Participants completed 3 repeated telephone-based assessments (mean span, 4.1 years). Multivariable linear mixed-effects models were used to estimate relations of midlife plasma Abeta40 to Abeta42 ratios and Abeta42 levels to late-life cognitive decline, as well as relations of 10-year change in Abeta40 to Abeta42 ratios and Abeta42 levels to cognitive decline. The 3 primary outcomes were the Telephone Interview for Cognitive Status (TICS) findings, a global score averaging the results of all tests (TICS, immediate and delayed verbal recall, category fluency, and attention), and a verbal memory score averaging the results of 4 tests of verbal recall. Higher midlife plasma Abeta40 to Abeta42 ratios were associated with worse late-life decline on the global score (P = .04 for trend). Furthermore, increase in Abeta40 to Abeta42 ratios since midlife predicted greater decline in the global score (P = .03 for trend) and in the TICS (P = .02 for trend). There was no association of cognitive decline with midlife plasma Abeta42 levels alone or with change in Abeta42 levels since midlife. In this large community-dwelling sample, higher plasma Abeta40 to Abeta42 ratios in late midlife and increases in Abeta40 to Abeta42 ratios 10 years later were significantly associated with greater decline in global cognition at late life.

  17. Student quality-of-life declines during third year surgical clerkship.

    PubMed

    Goldin, Steven B; Wahi, Monika M; Farooq, Osman S; Borgman, Heather A; Carpenter, Heather L; Wiegand, Lucas R; Nixon, Lois L; Paidas, Charles; Rosemurgy, Alexander S; Karl, Richard C

    2007-11-01

    Choosing surgery as a career is declining among U.S. medical students. The 8-wk third year surgery clerkship at our institution can be an intense learning experience, and we hypothesized that during this clerkship medical student quality-of-life would drop significantly from baseline, and that this drop would be greater among certain subgroups, such as women students not interested in pursuing a surgical career, and those who place a high value on a controllable lifestyle. At clerkship orientation (baseline), students were asked to complete a survey that measured quality-of-life on an 84-point scale, and depression on a 40-point scale. The quality-of-life scale was composed of select questions from the Medical Outcomes Study, and the Harvard Department of Psychiatry/NDSD brief screening instrument was used to measure depression. Students were also asked the typical number of hours they slept per night. Demographics, attitude toward a controllable lifestyle, and top three specialties of interest were also gathered at baseline. On week 6 of the clerkship, students were surveyed on the same quality-of -life and depression scales, and asked average hours of sleep per night for the previous week. From June 2005 through December 2006, 143 of 177 (81%) students agreed to participate, and after exclusions for missing data, 137 students were included in the analysis. Sixty-nine students were women (51%), and the average age was 25.8 (sd 2.6). Mean quality-of-life at baseline was 57.0 (sd 11.3) and at week 6 was 50.4 (sd 10.1) representing a statistically significant average decline of 6.6 points (P < 0.0001). Mean depression at baseline was 14.4 (sd 3.8) and at week 6 was 15.1 (sd 3.6), representing a small but significant average decline of 0.7 points (P = 0.0155). Mean sleep at baseline was 6.3 h/night (sd 0.9) and at week 6 was 5.7 h/night (sd 1.2), representing a statistically significant average decline of 0.6 h/night (P < 0.0001). Declines were similar on all outcomes

  18. Quality of life long-term after body contouring surgery following bariatric surgery: sustained improvement after 7 years.

    PubMed

    van der Beek, Eva S J; Geenen, Rinie; de Heer, Francine A G; van der Molen, Aebele B Mink; van Ramshorst, Bert

    2012-11-01

    Bariatric surgery for morbid obesity results in massive weight loss and improvement of health and quality of life. A downside of the major weight loss is the excess of overstretched skin, which may influence the patient's quality of life by causing functional and aesthetic problems. The purpose of the current study was to evaluate the patient's quality of life long-term after body contouring following bariatric surgery. Quality of life was measured with the Obesity Psychosocial State Questionnaire in 33 post-bariatric surgery patients 7.2 years (range, 3.2 to 13.3 years) after body contouring surgery. Data were compared with previous assessments 4.1 years (range, 0.7 to 9.2 years) after body contouring surgery of the quality of life at that time and before body contouring surgery. Compared with appraisals of quality of life before body contouring surgery, a significant, mostly moderate to large, sustained improvement of quality of life was observed in post-bariatric surgery patients 7.2 years after body contouring surgery in six of the seven psychosocial domains. A small deterioration occurred between 4.1- and 7.2-year follow-up on two of the seven domains except for the domain efficacy toward eating, which showed a significant improvement. At 7-year follow-up, 18 patients (55 percent) were satisfied with the result of body contouring surgery. This study indicates a sustained quality-of-life improvement in post-bariatric surgery patients after body contouring surgery. This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity. Therapeutic, IV.

  19. [Access to oral health services in children under twelve years of age in Peru, 2014].

    PubMed

    Hernández-Vásquez, Akram; Azañedo, Diego; Díaz-Seijas, Deysi; Bendezú-Quispe, Guido; Arroyo-Hernández, Hugo; Vilcarromero, Stalin; Agudelo-Suárez, Andrés A

    2016-01-01

    The aim of the study was to explore the patterns of dental health services access in children under twelve years of age in Peru. Data from 25,285 children under 12 years who participated in the Demographic and Family Health Survey of 2014 were reviewed. An exploratory spatial analysis was performed to project the proportions of children with access to dental health services, according to national regions, type of health service and urban or rural place of residence. The results show that of the total sample, 26.7% had access to dental health services in the last six months, 39.6% belonged to the age group 0-4 years, 40.6% lived in the Andean region and 58.3% lived in urban areas. The regions of Huancavelica, Apurimac, Ayacucho, Lima and Pasco had the highest percentages of access nationwide. In conclusion, there is low access to dental health services in the population under 12 years of age in Peru. The spatial distribution of access to dental health services allows regions to be identified and grouped according to similar access patterns, in order to better focus public health actions.

  20. The effect of service satisfaction and spiritual well-being on the quality of life of patients with schizophrenia.

    PubMed

    Lanfredi, Mariangela; Candini, Valentina; Buizza, Chiara; Ferrari, Clarissa; Boero, Maria E; Giobbio, Gian M; Goldschmidt, Nicoletta; Greppo, Stefania; Iozzino, Laura; Maggi, Paolo; Melegari, Anna; Pasqualetti, Patrizio; Rossi, Giuseppe; de Girolamo, Giovanni

    2014-05-15

    Quality of life (QOL) has been considered an important outcome measure in psychiatric research and determinants of QOL have been widely investigated. We aimed at detecting predictors of QOL at baseline and at testing the longitudinal interrelations of the baseline predictors with QOL scores at a 1-year follow-up in a sample of patients living in Residential Facilities (RFs). Logistic regression models were adopted to evaluate the association between WHOQoL-Bref scores and potential determinants of QOL. In addition, all variables significantly associated with QOL domains in the final logistic regression model were included by using the Structural Equation Modeling (SEM). We included 139 patients with a diagnosis of schizophrenia spectrum. In the final logistic regression model level of activity, social support, age, service satisfaction, spiritual well-being and symptoms' severity were identified as predictors of QOL scores at baseline. Longitudinal analyses carried out by SEM showed that 40% of QOL follow-up variability was explained by QOL at baseline, and significant indirect effects toward QOL at follow-up were found for satisfaction with services and for social support. Rehabilitation plans for people with schizophrenia living in RFs should also consider mediators of change in subjective QOL such as satisfaction with mental health services. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Life satisfaction in people with spinal cord injury during the first five years after discharge from inpatient rehabilitation.

    PubMed

    van Leeuwen, Christel M C; Post, Marcel W M; van Asbeck, Floris W A; Bongers-Janssen, Helma M H; van der Woude, Lucas H V; de Groot, Sonja; Lindeman, Eline

    2012-01-01

    To describe the course of life satisfaction in persons with spinal cord injury (SCI) during the first 5 years after discharge from inpatient rehabilitation and to examine its determinants. Multi-centre prospective cohort study with four measurements, the first at discharge from inpatient rehabilitation, the last 5 years after discharge. Data of 162 persons with SCI were analyzed. Life satisfaction was measured as the sum score of 'current life satisfaction' and 'current life satisfaction compared to life satisfaction before SCI'. Lesion characteristics, functional independence, secondary impairments, pain, social support and self-efficacy were analyzed as possible determinants of life satisfaction. Random coefficient analysis was used for the analyses. No significant changes in life satisfaction were found between discharge and 2 years later, however there were significant increases from two to 5 years post discharge. High functional independence, low pain, high everyday social support and high self-efficacy were significant determinants of a positive course of life satisfaction after discharge. Increases in life satisfaction were found in persons with SCI in the long run. High functional status, low pain, good social skills and high self-efficacy were related to high life satisfaction.

  2. Twenty years of nursery history: a Forest Service perspective

    Treesearch

    Frank Burch

    2005-01-01

    I was asked to speak to you concerning 20 years of nursery history from a Forest Service perspective. I hope you will allow me a little leeway here, because while I will focus on events of the past 2 decades, I find it necessary to begin by going a little further back in time.Individual...

  3. UK end-of-life care services in dementia, initiatives and sustainability: results of a national online survey.

    PubMed

    Amador, Sarah; Goodman, Claire; Robinson, Louise; Sampson, Elizabeth L

    2016-10-14

    People living and dying with non-cancer diagnoses, including dementia, have poorer access to generalist and specialist palliative care than people with cancer, and experience worse outcomes in terms of pain and symptom control, and quality and experience of care. In the UK, the National Council for Palliative Care (NCPC) ran a national survey of services for end-of-life care for people with dementia (2008) in which 16 services were identified, and reported on case studies and examples of good practice. We updated the NCPC survey to review progress in previously identified services, identify factors that lead to sustainable services and identify new initiatives in this area of care. An online survey was developed and piloted before use. Initiatives were contacted via targeted (N=63) and open call invitations. The survey was made up of 5 sections. Quantitative data were analysed using descriptive statistics. 15 services responded. They engaged in a wide range of activities predominately providing direct care (80%) and workforce development/advisory or educational activities (87%). Results suggest that sustainability of services is reliant on clinicians with a leadership role and wider system support through funding mechanisms and a minimum level of integration within normal service provision. Recent initiatives are largely built on the expertise of the nursing profession (with or without input from medical consultants), and driven mainly by the charity and hospice sector. This has generated a potential new model of care provision in end of life dementia care, 'Hospice-enabled Dementia Care'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Patterns of End-of-Life Care in Children with Advanced Solid Tumor Malignancies Enrolled on a Palliative Care Service

    PubMed Central

    Vern-Gross, Tamara Z.; Lam, Catherine G.; Graff, Zachary; Singhal, Sara; Levine, Deena R.; Gibson, Deborah; Coan, April; Anghelescu, Doralina L.; Yuan, Ying; Baker, Justin N.

    2015-01-01

    Context Pediatric patients with solid tumors can have a significant symptom burden that impacts quality of life and end-of-life care needs. Objectives We evaluated outcomes and symptoms in children with solid tumors, and compared patterns of end-of-life care after implementation of a dedicated institutional pediatric palliative care service. Methods We performed a retrospective cohort study of children with solid tumors treated at St. Jude Children’s Research Hospital, before and after implementation of the institutional Quality of Life/Palliative Care (QoL/PC) Service in January 2007. Patients who died between July 2001- February 2005 (historical cohort; n=134) were compared to those who died between January 2007- January 2012 (QoL/PC cohort; n=57). Results Median time to first QoL/PC consultation was 17.2 months (range, 9–33 months). At consultation, 60% of children were not receiving or discontinued cancer-directed therapy. Within the QoL/PC cohort, 54 patients had documented symptoms; 94% required intervention for ≥ 3 symptoms; 76% received intervention for ≥ 5 symptoms. Eighty-three percent achieved their preferred place of death. Compared to the historical cohort, the QoL/PC cohort had more end-of-life discussions per patient (median, 12 vs. 3; P<0.001), earlier end-of-life discussions, with longer times before do-not-resuscitate orders (median, 195 vs. 2 days; P<0.001), and greater hospice enrollment (71% vs. 46%, P=0.002). Conclusion Although children with solid tumor malignancies may have significant symptom burden towards end of life, positive changes were documented in communication and in places of care and death following implementation of a pediatric palliative care service. PMID:25891664

  5. Immunization delivery in the second year of life in Ghana: the need for a multi-faceted approach

    PubMed Central

    Nyaku, Mawuli; Wardle, Melissa; Eng, Jodi Vanden; Ametewee, Lynnette; Bonsu, George; Larbi Opare, Joseph Kwadwo; Conklin, Laura

    2017-01-01

    Introduction in 2012, pneumococcal conjugate vaccine (PCV), rotavirus vaccine and a second dose of measles-containing vaccine (MCV2) were introduced into the Expanded Program on Immunization (EPI) in Ghana. According to Ghana’s EPI schedule, PCV and rotavirus vaccine are given in the first year of life and MCV2 in the second year of life (2YL) at 18 months. Although coverage with the last doses of PCV and rotavirus vaccine reached almost 90% coverage within four years of introduction, MCV2 coverage did not rise above 70%. The World Health Organization Global Measles and Rubella Strategic Plan established a 2020 milestone to achieve at least 95% coverage with the first and second doses of measles-containing vaccine in each district and nationally. We developed a project to address challenges to delivery of immunizations and other child health services at the 18-month visit and throughout the 2YL. Methods from March to April 2016, we conducted a cluster survey of households (HHs) with children 24-35 months of age in three regions in Ghana to assess knowledge, attitudes and beliefs among caregivers about immunization during the 2YL and to collect childhood vaccination history data using vaccination cards. Three independent samples were selected from the Northern (NR), Volta (VR), and Greater Accra (GAR) regions. A survey and direct observations were performed a ta representative sample of health facilities (HFs) providing immunization services in the same regions to further characterize barriers to immunization access, utilization and delivery in the 2YL. Results data on a total of 464 children ages 24-35 months were collected in the HH survey: 211 in NR, 153 in VR, and 100 in GAR (response rate > 99%). First dose of measles-containing vaccine (MCV1) coverage was (NR: 87%, VR: 96%, GAR: 99%); however, MCV2 coverage was lower (NR: 60%, VR: 83%, GAR: 70%). MCV1 to MCV2 dropout was 32% in NR, 14% in VR, and 31% in GAR. Caregiver awareness of immunization against

  6. Monograph use at an academic health sciences library: the first three years of shelf life

    PubMed Central

    Blecic, Deborah D.

    2000-01-01

    Objective: To study the circulation of monographs during the first three years of shelf life at an academic health sciences library. Method: A record was kept of monographs added to the circulating collection from mid-1994 to mid-1995. After three years, each monograph was located and the number of times it circulated during the first, second, and third year of shelf life determined by counting checkout stamps on the circulation slip. Results: Of the 1,958 monographs studied, 1,674 had complete data for the first three years of shelf life. Of those 1,674 titles, 81.48% circulated at least once. A total of 7,659 circulations were recorded; 38.69% occurred in the first year of shelf life, 32.37% in the second year, and 28.95% in the third year. The data did not fit the well-known 80/20 rule. Instead, approximately 38% of monographs accounted for 80% of circulation. A small percentage, 2.21%, of monographs accounted for a substantial percentage of circulation, 21.84%. Conclusions: A large percentage of the monographs circulated and use did not decline sharply with age within the first three years of shelf life, indicating a high demand for monographs at this academic health sciences library. These results, combined with the findings of earlier studies, suggested two possibilities. First, academic health sciences libraries might exhibit use of a higher percentage of monograph acquisitions than other types of libraries; or, second, a low monograph-to-user ratio might result in a higher percentage of monographs being used. Perhaps both factors contributed to the results found in this study. Further investigation would be needed to determine the extent to which library type and monograph-to-user ratio influenced monograph use. PMID:10783969

  7. Life Expectancy and Years of Potential Life Lost After Acute Myocardial Infarction by Sex and Race: A Cohort-Based Study of Medicare Beneficiaries.

    PubMed

    Bucholz, Emily M; Normand, Sharon-Lise T; Wang, Yun; Ma, Shuangge; Lin, Haiqun; Krumholz, Harlan M

    2015-08-11

    Most studies of sex and race differences after acute myocardial infarction (AMI) have not taken into account differences in life expectancy in the general population. Years of potential life lost (YPLL) is a metric that takes into account the burden of disease and can be compared by sex and race. This study sought to determine sex and race differences in long-term survival after AMI using life expectancy and YPLL to account for differences in population-based life expectancy. Using data from the Cooperative Cardiovascular Project, a prospective cohort study of Medicare beneficiaries hospitalized for AMI between 1994 and 1995 (N = 146,743), we calculated life expectancy and YPLL using Cox proportional hazards regression with extrapolation using exponential models. Of the 146,743 patients with AMI, 48.1% were women and 6.4% were black; the average age was 75.9 years. Post-AMI life expectancy estimates were similar for men and women of the same race but lower for black patients than white patients. On average, women lost 10.5% (SE 0.3%) more of their expected life than men, and black patients lost 6.2% (SE 0.6%) more of their expected life than white patients. After adjustment, women still lost an average of 7.8% (0.3%) more of their expected life than men, but black race became associated with a survival advantage, suggesting that racial differences in YPLL were largely explained by differences in clinical presentation and treatment between black and white patients. Women and black patients lost more years of life after AMI, on average, than men and white patients, an effect that was not explained in women by clinical or treatment differences. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. Traffic-Related Air Pollution Exposure in the First Year of Life and Behavioral Scores at 7 Years of Age

    PubMed Central

    Ryan, Patrick; LeMasters, Grace; Levin, Linda; Bernstein, David; Hershey, Gurjit K. Khurana; Lockey, James E.; Villareal, Manuel; Reponen, Tiina; Grinshpun, Sergey; Sucharew, Heidi; Dietrich, Kim N.

    2013-01-01

    Background: There is increasing concern about the potential effects of traffic-related air pollution (TRAP) on the developing brain. The impact of TRAP exposure on childhood behavior is not fully understood because of limited epidemiologic studies. Objective: We explored the association between early-life exposure to TRAP using a surrogate, elemental carbon attributed to traffic (ECAT), and attention deficit/hyperactivity disorder (ADHD) symptoms at 7 years of age. Methods: From the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) birth cohort we collected data on exposure to ECAT during infancy and behavioral scores at 7 years of age. Children enrolled in CCAAPS had at least one atopic parent and a birth residence either < 400 m or > 1,500 m from a major highway. Children were followed from infancy through 7 years of age. ECAT exposure during the first year of life was estimated based on measurements from 27 air sampling sites and land use regression modeling. Parents completed the Behavioral Assessment System for Children, 2nd Edition, when the child was 7 years of age. ADHD-related symptoms were assessed using the Hyperactivity, Attention Problems, Aggression, Conduct Problems, and Atypicality subscales. Results: Exposure to the highest tertile of ECAT during the child’s first year of life was significantly associated with Hyperactivity T-scores in the “at risk” range at 7 years of age, after adjustment [adjusted odds ratio (aOR) = 1.7; 95% CI: 1.0, 2.7]. Stratification by maternal education revealed a stronger association in children whose mothers had higher education (aOR = 2.3; 95% CI: 1.3, 4.1). Conclusions: ECAT exposure during infancy was associated with higher Hyperactivity scores in children; this association was limited to children whose mothers had more than a high school education. PMID:23694812

  9. Evaluation of Long-Life Concrete Pavement Practices for Use in Florida

    DOT National Transportation Integrated Search

    2012-11-01

    Current Florida construction practices produce asphalt pavements with a service life of 12 to 20 years before needing rehabilitation; concrete pavements are typically designed for 20 years. However, pavements with much longer design lives are possibl...

  10. The impact of posttraumatic stress disorder on quality of life and health service utilization among veterans who have schizophrenia.

    PubMed

    Calhoun, Patrick S; Bosworth, Hayden B; Stechuchak, Karen A; Strauss, Jennifer; Butterfield, Marian I

    2006-06-01

    The present study examined the impact of comorbid posttraumatic stress disorder (PTSD) on health-related quality of life and objective measures of health service utilization in 165 male veterans who have primary schizophrenia. Comorbid PTSD was assessed with the PTSD Checklist. Comorbid PTSD was significantly associated with decreased quality of life and increased medical service utilization, including increased psychiatric hospitalization and increased outpatient physical health visits, even after controlling for other clinical and demographic variables among this sample of patients who had primary schizophrenia. Veterans who have schizophrenia should be screened carefully for exposure to trauma and posttraumatic stress disorder.

  11. The Cost of an Additional Disability-Free Life Year for Older Americans: 1992–2005

    PubMed Central

    Cai, Liming

    2013-01-01

    Objective To estimate the cost of an additional disability-free life year for older Americans in 1992–2005. Data Source This study used 1992–2005 Medicare Current Beneficiary Survey, a longitudinal survey of Medicare beneficiaries with a rotating panel design. Study Design This analysis used multistate life table model to estimate probabilities of transition among a discrete set of health states (nondisabled, disabled, and dead) for two panels of older Americans in 1992 and 2002. Health spending incurred between annual health interviews was estimated by a generalized linear mixed model. Health status, including death, was simulated for each member of the panel using these transition probabilities; the associated health spending was cross-walked to the simulated health changes. Principal Findings Disability-free life expectancy (DFLE) increased significantly more than life expectancy during the study period. Assuming that 50 percent of the gains in DFLE between 1992 and 2005 were attributable to increases in spending, the average discounted cost per additional disability-free life year was $71,000. There were small differences between gender and racial/ethnic groups. Conclusions The cost of an additional disability-free life year was substantially below previous estimates based on mortality trends alone. PMID:22670874

  12. Changes in Mental Health, Bullying Behavior, and Service Use Among Eight-Year-Old Children Over 24 Years.

    PubMed

    Sourander, André; Lempinen, Lotta; Brunstein Klomek, Anat

    2016-08-01

    The aim of this study was to examine changes in the mental health problems, bullying, and service use of 8-year-old children at 4 different time points (1989, 1999, 2005, and 2013) using population-based, time-trend data. Information from 4 cross-sectional samples was compared over a 24-year period. The target population was Finnish-speaking children born in 1981 (n = 1,038), 1991 (n = 1,035), 1997 (n = 1,030), and 2004 (n = 1,114) and living in selected school districts in the Turku University Hospital area in southwestern Finland. The participation rates varied from 84% (2005) to 95% (1989). Information about the children's psychiatric symptoms, bullying experience, and service use was obtained from parents and teachers using Rutter questionnaires. Child depression was measured using the Children's Depression Inventory (CDI). Parental reports showed that emotional (p < .001) and conduct (p = .001) problems among boys and emotional (p = .002) problems among girls decreased over the 24-year period. In teacher reports, there were no significant changes in hyperactivity, emotional, and conduct problems between 1989 and 2013. Girls' self-reported depression scores increased between 1989 and 2005, but leveled off in 2013. There were no significant decreases in bullying behavior between 2005 and 2013 despite the introduction of a nationwide school-based anti-bullying program in 2009. Mental health service use increased constantly during the study period: in 1989, 4.2% of boys and 0.9% of girls were in contact with services, and by 2013 this had risen to 15.1% and 6.1% (p < .001). No substantial increases in children's mental health problems were seen between 1989 and 2013. Service use increased constantly, indicating lower thresholds for seeking help. Bullying behavior is strongly related to mental health problems, and that is why school-based bullying interventions, including mental health perspectives, are needed. Copyright © 2016 American Academy of Child

  13. Estimation of the temporary service life of DC arc plasmatron cathode

    NASA Astrophysics Data System (ADS)

    Kulygin, V. M.; Pereslavtsev, A. V.; Tresvyatskii, S. S.

    2017-09-01

    The service life of the cathode of a DC arc plasmatron continuously working with tubular electrodes that operate in the air has been considered using the semi-phenomenological approach. The thermal emission, that ensures the necessary flow of electrons, and the evaporation of the cathode material, which determines its erosion, have been taken as the basic physical phenomena that constitute the workflow. The relationships that enable the estimation of the cathode's operating time have been obtained using the known regularities of these phenomena and experimental data available in the literature. The resulting evaluations coincide satisfactorily with the endurance test results.

  14. Early life factors and dental caries in 5-year-old children in China.

    PubMed

    Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Gallagher, Jennifer E; Zheng, Shuguo

    2017-09-01

    This study aimed to explore the association between early life factors and dental caries among 5-year-old Chinese children. Data from 9722 preschool children who participated in the third National Oral Health Survey of China were analysed. Information on early life (birth weight, breastfeeding and age when toothbrushing started), child (sex, ethnicity, birth order and dental behaviours) and family factors (parental education, household income, place of residence, number of children in the family, respondent's age and relation to the child) were obtained from parental questionnaires. Children were also clinically examined to assess dental caries experience using the decayed, missing and filled teeth (dmft) index. The association of early life factors with dmft was evaluated in negative binomial regression models. We found that birth weight was not associated with dental caries experience; children who were exclusively and predominantly formula-fed had lower dmft values than those exclusively breastfed; and children who started brushing later in life had higher dmft values than those who were brushing within the first year. Only one in seven of all children received regular toothbrushing twice per day, and only 34.7% had commenced toothbrushing by the age of 3 years. This study shows certain early life factors play a role in dental caries among Chinese preschool children and provides important insights to shape public health initiatives on the importance of introducing early toothbrushing. The early environment, especially the age when parents introduce toothbrushing to their children, can be an important factor to prevent childhood dental caries. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis.

    PubMed

    McNeil, Ryan; Guirguis-Younger, Manal; Dilley, Laura B; Aubry, Tim D; Turnbull, Jeffrey; Hwang, Stephen W

    2012-05-17

    Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.

  16. Post-marketing surveillance of CustomBone Service implanted in children under 7 years old.

    PubMed

    Frassanito, Paolo; Tamburrini, Gianpiero; Massimi, Luca; Di Rocco, Concezio; Nataloni, Angelo; Fabbri, Greta; Caldarelli, Massimo

    2015-01-01

    The CustomBone Service is a bioceramic implant suitable for cranial repair in both adults and children, although there are no clinical data about its use in children under 7 years of age. This surveillance study investigates the outcome in this age group. Twenty-eight children under 7 years old (range, 2.5-6 years) received CustomBone Service from July 2006 to May 2013 in 16 international hospitals. Data of 23 children (12 males and 11 females), harboring 24 prosthesis, were available with a minimum follow-up of 1 year. Sites of the cranial defect were frontal or parietal (20.8 % each), parieto-temporal (16.7 %), fronto-parietal or occipital (12.5 % each), fronto-parieto-temporal or fronto-temporal (8.3 % each). Initial diseases were trauma (54.2 %), malformation (37.5 %), or tumor of the bone/skin (8.3 %). Rupture of the implant occurred in a single case during the implant (1/26 surgeries, 3.8 %) and the cranial repair was achieved by means of the back-up prosthesis. Five adverse events were registered during the follow-up period consisting of three cases of fracture and two of exposure/infection of the prosthesis. All cases required the removal of the device (20.8 %). The failure rate of CustomBone Service under 7 years of age was higher than reported in adults and children over 7 years old (20.8 vs. 3.8 %), However, CustomBone Service may be considered a valid option under 7 years old since other materials are burdened by more significant rates of complications in the long-term period. Due to specific properties of this material, indication to CustomBone Service in toddlers should be carefully evaluated by the surgeon on a case-by-case basis.

  17. The Chinese community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system

    PubMed Central

    2013-01-01

    Background Although the Chinese government put a lot of effort into promoting the community patient’s life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient’s life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient’s assessment of community medical service and trust in community health delivery system were important considerations when the community patient comprehensively evaluated community medical service to generate life satisfaction. So this study was set up to test whether and to what extent the community patient’s assessments of various major aspects of community medical service/various major aspects of the community patient’s trust in community health delivery system influenced life satisfaction in whole China/in various regions of China. Methods In order to explore the situation of China’s community health delivery system before 2009 and provide a reference for China’s community health delivery system reform, the data that could comprehensively and accurately reflect the community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system in various regions of China was needed, so this study collaborated with the National Bureau of Statistics of China to carry out a large-scale 2008 national community resident household survey (N = 3,306) for the first time in China. And the specified ordered probit models were established to analyze the dataset from this household survey. Results Among major aspects of community medical service, the medical cost (particularly in developed regions), the doctor-patient communication (particularly in developed regions), the medical facility and hospital environment (particularly in developed regions), and the medical treatment process (particularly in underdeveloped regions) were all key considerations (p<0.05 for t statistics) in

  18. Assessing the impact of care farms on quality of life and offending: a pilot study among probation service users in England

    PubMed Central

    Elsey, Helen; Farragher, Tracey; Tubeuf, Sandy; Bragg, Rachel; Elings, Marjolein; Brennan, Cathy; Gold, Rochelle; Shickle, Darren; Wickramasekera, Nyantara; Richardson, Zoe; Cade, Janet; Murray, Jenni

    2018-01-01

    Objectives To assess the feasibility of conducting a cost-effectiveness study of using care farms (CFs) to improve quality of life and reduce reoffending among offenders undertaking community orders (COs). To pilot questionnaires to assess quality of life, connection to nature, lifestyle behaviours, health and social-care use. To assess recruitment and retention at 6 months and feasibility of data linkage to Police National Computer (PNC) reconvictions data and data held by probation services. Design Pilot study using questionnaires to assess quality of life, individually linked to police and probation data. Setting The pilot study was conducted in three probation service regions in England. Each site included a CF and at least one comparator CO project. CFs are working farms used with a range of clients, including offenders, for therapeutic purposes. The three CFs included one aquaponics and horticulture social enterprise, a religious charity focusing on horticulture and a family-run cattle farm. Comparator projects included sorting secondhand clothes and activities to address alcohol misuse and anger management. Participants We recruited 134 adults (over 18) serving COs in England, 29% female. Results 52% of participants completed follow-up questionnaires. Privatisation of UK probation trusts in 2014 negatively impacted on recruitment and retention. Linkage to PNC data was a more successful means of follow-up, with 90% consenting to access their probation and PNC data. Collection of health and social-care costs and quality-adjusted life year derivation were feasible. Propensity score adjustment provided a viable comparison method despite differences between comparators. We found worse health and higher reoffending risk among CF participants due to allocation of challenging offenders to CFs, making risk of reoffending a confounder. Conclusions Recruitment would be feasible in a more stable probation environment. Follow-up was challenging; however, assessing

  19. Life expectancy in a birth cohort of Boxers followed up from weaning to 10 years of age.

    PubMed

    van Hagen, Marjan A E; Ducro, Bart J; van den Broek, Jan; Knol, Bart W

    2005-09-01

    To determine mortality rate over time, risk factors for death, and heritability of life expectancy in Boxers. 1,733 purebred Boxers born in The Netherlands between January 1994 and March 1995. Dogs were followed up from weaning (ie, 49 days of age) to 10 years of age through use of a written questionnaire sent to owners every 6 months. Mortality rate over time, risk factors potentially associated with death, and heritability of life expectancy were examined by use of a proportional hazards model based on the Weibull distribution. stimated mortality rate during the 10-year study period for this birth cohort of Boxers was 45%. The probability of surviving to 5 years of age was 88%; the probability of surviving to 10 years of age was 55%. Estimated effective heritability of life expectancy was 0.076, meaning that in this population, an estimated 76% of the observed variation in life expectancy could be attributed to genetic differences among dogs that were passed from parents to their offspring. Results suggest that cumulative incidence of death from weaning to 10 years of age among this birth cohort of Boxers was 45%. The estimated heritability of life expectancy suggested that life expectancy can be improved by use of selective breeding.

  20. Visual impairment, coping strategies and impact on daily life: a qualitative study among working-age UK ex-service personnel.

    PubMed

    Stevelink, Sharon A M; Malcolm, Estelle M; Fear, Nicola T

    2015-11-12

    Sustaining a visual impairment may have a substantial impact on various life domains such as work, interpersonal relations, mobility and social and mental well-being. How to adjust to the loss of vision and its consequences might be a challenge for the visually impaired person. The purpose of the current study was to explore how younger male ex-Service personnel cope with becoming visually impaired and how this affects their daily life. Semi-structured interviews with 30 visually impaired male ex-Service personnel, all under the age of 55, were conducted. All participants are members of the charity organisation Blind Veterans UK. Interviews were analysed thematically. Younger ex-Service personnel applied a number of different strategies to overcome their loss of vision and its associated consequences. Coping strategies varied from learning new skills, goal setting, integrating the use of low vision aids in their daily routine, to social withdrawal and substance misuse. Vision loss affected on all aspects of daily life and ex-Service personnel experienced an on-going struggle to accept and adjust to becoming visually impaired. Health care professionals, family and friends of the person with the visual impairment need to be aware that coping with a visual impairment is a continuous struggle; even after a considerable amount of time has passed, needs for emotional, social, practical and physical support may still be present.

  1. Perceived stress and life satisfaction: social network service use as a moderator.

    PubMed

    Niu, Qikun; Liu, Yihao; Sheng, Zitong; He, Yue; Shao, Xiaolin

    2011-01-01

    Social Network Service (SNS) has become a buzzword in recent media coverage with the development of the second generation of Web-based communities. In China, SNS has played an increasingly important role in its users' daily lives, especially among students. With a sample of 471 college students, we tested the direct relationship between perceived stress and life satisfaction using a regression analysis. Moreover, we found SNS use could buffer the negative effect of perceived stress. This study has practical implications on Internet users' SNS use.

  2. Expected years of life lost through road traffic injuries in Mexico

    PubMed Central

    Murillo-Zamora, Efrén; Mendoza-Cano, Oliver; Trujillo-Hernández, Benjamín; Guzmán-Esquivel, José; Medina-González, Alfredo; Huerta, Miguel; Sánchez-Piña, Ramón Alberto; Lugo-Radillo, Agustin

    2017-01-01

    ABSTRACT Background: Road traffic injuries (RTIs) are a leading cause of premature mortality, mainly in low- and middle-income countries Objective: To estimate the 2014 burden of RTIs in Mexico calculating years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to evaluate sex, age, and region-related differences in premature mortality. Methods: Mortality data were obtained from the National Institute of Statistics and Geography and 14,637 deaths of individuals 15 years of age and older were analyzed. The YLL and ASYLL were computed. Results: The overall burden of RTIs was 332,922 YLL and 82.4% of the deaths occurred in males. Males from 25 to 34 years of age and females from 15 to 24 years of age showed the highest age-adjusted YLL rates (933 and 158 YLL per 100,000 inhabitants, respectively). The national ASYLL rate was 416 per 100,000 inhabitants and the highest state-stratified mortality rates were observed in Tabasco (851), Sinaloa (709), Durango (656), Zacatecas (642), and Baja California Sur (570). Conclusions: RTIs contributed to the premature mortality rate in the study population. Our findings may be useful from a health policy perspective for designing and prioritizing interventions focused on the prevention of premature loss of life. PMID:28820342

  3. Expected years of life lost through road traffic injuries in Mexico.

    PubMed

    Murillo-Zamora, Efrén; Mendoza-Cano, Oliver; Trujillo-Hernández, Benjamín; Guzmán-Esquivel, José; Medina-González, Alfredo; Huerta, Miguel; Sánchez-Piña, Ramón Alberto; Lugo-Radillo, Agustin

    2017-01-01

    Road traffic injuries (RTIs) are a leading cause of premature mortality, mainly in low- and middle-income countries Objective: To estimate the 2014 burden of RTIs in Mexico calculating years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to evaluate sex, age, and region-related differences in premature mortality. Mortality data were obtained from the National Institute of Statistics and Geography and 14,637 deaths of individuals 15 years of age and older were analyzed. The YLL and ASYLL were computed. The overall burden of RTIs was 332,922 YLL and 82.4% of the deaths occurred in males. Males from 25 to 34 years of age and females from 15 to 24 years of age showed the highest age-adjusted YLL rates (933 and 158 YLL per 100,000 inhabitants, respectively). The national ASYLL rate was 416 per 100,000 inhabitants and the highest state-stratified mortality rates were observed in Tabasco (851), Sinaloa (709), Durango (656), Zacatecas (642), and Baja California Sur (570). RTIs contributed to the premature mortality rate in the study population. Our findings may be useful from a health policy perspective for designing and prioritizing interventions focused on the prevention of premature loss of life.

  4. [DOPPS estimate of patient life years attributable to modifiable hemodialysis practices in France].

    PubMed

    Canaud, Bernard; Combe, Christian; Bragg-Gresham, Jennifer L; Eichleay, Margaret A; Pisoni, Ronald L; Port, Friedrich K

    2008-07-01

    In this study, we used a prevalent cross-sectional sample of French hemodialysis patients from Dialysis Outcomes and Practice Patterns Study (DOPPS) 2 (2002-2004) to determine the percentage of patients whose values failed to meet targets in six different areas of hemodialysis practice (dialysis dose, anemia, serum phosphorus (PO(4)), serum calcium (Ca), serum albumin and catheter use for vascular access). Cox survival models, with adjustments for patient characteristics, were used for these analyses to estimate mortality hazard ratios (HR). Based on the mortality HR, the fraction of patients outside each target and the total HD population in France, we estimated the number of patient life years that could potentially be gained if every chronic, in-center hemodialysis patient in France who is currently outside of the specified target was able to achieve it. The proportion of patients failing to meet one of the six practice targets in France varied from 15% (dialysis dose) to 75% (albumin) while the percentage of patients complying with all six targets was restricted to 1.2%. The relative risk of mortality (RR) associated with being outside these targets varied from 1.12 to 1.46. Based on these two measures the life-years survival was estimated. The projected number of patients and life years potentially gained from adherence to the six targets was estimated close to 10,600 years-patient. In conclusion, this study suggests large opportunities to improve hemodialysis patient care in France still exist. Compliance with two major practice targets, such as albumin and restriction of catheter use will save highly significant life years of hemodialysis patient. Implementing and strict adherence to national and international guidelines should serve as a basic inspiration for continual improvement of hemodialysis patient care.

  5. USA hCG reference service, 10-year report.

    PubMed

    Cole, Laurence A; Laidler, Laura L; Muller, Carolyn Y

    2010-08-01

    The USA hCG Reference Service has been dealing with cases of persistent low levels of hCG and gestational trophoblastic diseases for 10years. Here we present the complete experience. Total hCG in serum and urine was measured using the Siemen's Immulite 1000 assay. Hyperglycosylated hCG, nicked hCG, free ss-subunit and ss-core fragment were measured using microtiterplate assays with antibodies B152, B151, FBT11 and B210, respectively. The USA hCG Reference Service has identified 83 cases of false-positive hCG, 71 cases of aggressive gestational trophoblastic disease (GTD), 52 cases of minimally invasive GTD, 168 cases of quiescent GTD and 22 cases of placenta site trophoblastic tumor (PSTT). In addition, 103 cases of pituitary hCG have been identified, 60 cases of nontrophoblastic tumor, 4 cases of inherited hCG and 2 cases of Munchausen's syndrome. This is 565 cases total. Multiple new methods are described and tested for diagnosing all of these disorders. The USA hCG Reference Service experience shows new methods for detecting multiple hCG-related disorders and recommends new approaches for detecting these hCG-related disorders. 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  6. Patient-Clinician Communication About End-of-Life Care in Patients With Advanced Chronic Organ Failure During One Year.

    PubMed

    Houben, Carmen H M; Spruit, Martijn A; Schols, Jos M G A; Wouters, Emiel F M; Janssen, Daisy J A

    2015-06-01

    Patient-clinician communication is an important prerequisite to delivering high-quality end-of-life care. However, discussions about end-of-life care are uncommon in patients with advanced chronic organ failure. The aim was to examine the quality of end-of-life care communication during one year follow-up of patients with advanced chronic organ failure. In addition, we aimed to explore whether and to what extent quality of communication about end-of-life care changes toward the end of life and whether end-of-life care communication is related to patient-perceived quality of medical care. Clinically stable outpatients (n = 265) with advanced chronic obstructive pulmonary disease, chronic heart failure, or chronic renal failure were visited at home at baseline and four, eight, and 12 months after baseline to assess quality of end-of-life care communication (Quality of Communication questionnaire). Two years after baseline, survival status was assessed, and if patients died during the study period, a bereavement interview was done with the closest relative. One year follow-up was completed by 77.7% of the patients. Quality of end-of-life care communication was rated low at baseline and did not change over one year. Quality of end-of-life care communication was comparable for patients who completed two year follow-up and patients who died during the study. The correlation between quality of end-of-life care communication and satisfaction with medical treatment was weak. End-of-life care communication is poor in patients with chronic organ failure and does not change toward the end of life. Future studies should develop an intervention aiming at initiating high-quality end-of-life care communication between patients with advanced chronic organ failure and their clinicians. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life.

    PubMed

    Almobarak, F; Al-Mobarak, F; Khan, A O

    2009-06-01

    To report complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life. Retrospective institutional case series. Forty-two eyes of 36 patients with Ahmed valve implantation (without prior drainage device surgery) during the first 2 years of life and 2 years' postsurgical follow-up were identified. Most eyes had primary congenital glaucoma (28/42, 66.7%), aphakic glaucoma (5/42, 11.9%) or Peters anomaly (5/42, 11.9%). All but three eyes had prior ocular surgery. Surgery was at a mean age of 11.83 months (m) (SD 5.63). The most common significant postoperative complications were tube malpositioning requiring intervention (11/42, 26.2%), endophthalmitis (3/42, 7.1%; one with tube exposure) and retinal detachment (3/42, 7.1%). Thirty-six eyes (85.8%) required resumption of antiglaucoma medications to maintain intraocular pressure (IOP) < or =22 mm Hg a mean of 7.2 m (SD 6.8) postoperatively. Cumulative probabilities of valve survival (IOP< or =22 mm Hg with or without medication) by Kaplan-Meier analysis were 73.8% and 63.3% at 12 months and 24 months, respectively. Postoperative tube malpositioning that required surgical revision was common in this age group. Infectious endophthalmitis and retinal detachment are known potential complications following any incisional surgery for advanced buphthalmos; however, tube exposure is a unique potential problem following aqueous shunt implantation that can lead to intraocular infection. Cumulative valve survival 2 years following implantation was 63.3%.

  8. Influence of infant feeding patterns over the first year of life on growth from birth to 5 years.

    PubMed

    Betoko, A; Lioret, S; Heude, B; Hankard, R; Carles, S; Forhan, A; Regnault, N; Botton, J; Charles, M A; de Lauzon-Guillain, B

    2017-08-01

    As early-life feeding experiences may influence later health, we aimed to examine relations between feeding patterns over the first year of life and child's growth in the first 5 years of life. Our analysis included 1022 children from the EDEN mother-child cohort. Three feeding patterns were previously identified, i.e. 'Later dairy products introduction and use of ready-prepared baby foods' (pattern-1), 'Long breastfeeding, later main meal food introduction and use of home-made foods' (pattern-2) and 'Use of ready-prepared adult foods' (pattern-3). Associations between the feeding patterns and growth [weight, height and body mass index {BMI}] were analysed by multivariable linear regressions. Anthropometric changes were assessed by the final value adjusted for the initial value. Even though infant feeding patterns were not related to anthropometric measurements at 1, 3 and 5 years, high scores on pattern-1 were associated with higher 1-3 years weight and height changes. High scores on pattern-2 were related to lower 0-1 year weight and height changes, higher 1-5 years weight and height changes but not to BMI changes, after controlling for a wide range of potential confounding variables including parental BMI. Scores on pattern-3 were not significantly related to growth. Additional adjustment for breastfeeding duration reduced the strength of the associations between pattern-2 and growth but not those between pattern-1 and height growth. Our findings emphasize the relevance of considering infant feeding patterns including breastfeeding duration, age of complementary foods introduction as well as type of foods used when examining effects of early infant feeding practices on later health. © 2017 World Obesity Federation. © 2017 World Obesity Federation.

  9. Lost productive life years caused by chronic conditions in Australians aged 45-64 years, 2010-2030.

    PubMed

    Schofield, Deborah J; Shrestha, Rupendra N; Cunich, Michelle; Tanton, Robert; Kelly, Simon; Passey, Megan E; Veerman, Lennert J

    2015-09-21

    To estimate (1) productive life years (PLYs) lost because of chronic conditions in Australians aged 45-64 years from 2010 to 2030, and (2) the impact of this loss on gross domestic product (GDP) over the same period. A microsimulation model, Health&WealthMOD2030, was used to project lost PLYs caused by chronic conditions from 2010 to 2030. The base population consisted of respondents aged 45-64 years to the Australian Bureau of Statistics Survey of Disability, Ageing and Carers 2003 and 2009. The national impact of lost PLYs was assessed with Treasury's GDP equation. Lost PLYs due to chronic disease at 2010, 2015, 2020, 2025 and 2030 (ie, whole life years lost because of chronic disease); the national impact of lost PLYs at the same time points (GDP loss caused by PLYs); the effects of population growth, labour force trends and chronic disease trends on lost PLYs and GDP at each time point. Using Health&WealthMOD2030, we estimated a loss of 347,000 PLYs in 2010; this was projected to increase to 459,000 in 2030 (32.28% increase over 20 years). The leading chronic conditions associated with premature exits from the labour force were back problems, arthritis and mental and behavioural problems. The percentage increase in the number of PLYs lost by those aged 45-64 years was greater than that of population growth for this age group (32.28% v 27.80%). The strongest driver of the increase in lost PLYs was population growth (accounting for 89.18% of the increase), followed by chronic condition trends (8.28%). Our study estimates an increase of 112 000 lost PLYs caused by chronic illness in older workers in Australia between 2010 and 2030, with the most rapid growth projected to occur in men aged 55-59 years and in women aged 60-64 years. The national impact of this lost labour force participation on GDP was estimated to be $37.79 billion in 2010, increasing to $63.73 billion in 2030.

  10. Mortality and potential years of life lost by road traffic injuries in Brazil, 2013

    PubMed Central

    Andrade, Silvânia Suely Caribé de Araújo; de Mello-Jorge, Maria Helena Prado

    2016-01-01

    ABSTRACT OBJECTIVE To estimate the potential years of life lost by road traffic injuries three years after the beginning of the Decade of Action for Traffic Safety. METHODS We analyzed the data of the Sistema de Informações sobre Mortalidade (SIM – Mortality Information System) related to road traffic injuries, in 2013. We estimated the crude and standardized mortality rates for Brazil and geographic regions. We calculated, for the Country, the proportional mortality according to age groups, education level, race/skin color, and type or quality of the victim while user of the public highway. We estimated the potential years of life lost according to sex. RESULTS The mortality rate in 2013 was of 21.0 deaths per 100,000 inhabitants for the Country. The Midwest region presented the highest rate (29.9 deaths per 100,000 inhabitants). Most of the deaths by road traffic injuries took place with males (34.9 deaths per 100,000 males). More than half of the people who have died because of road traffic injuries were of black race/skin color, young adults (24.2%), individuals with low schooling (24.0%), and motorcyclists (28.5%). The mortality rate in the triennium 2011-2013 decreased 4.1%, but increased among motorcyclists. Across the Country, more than a million of potential years of life were lost, in 2013, because of road traffic injuries, especially in the age group of 20 to 29 years. CONCLUSIONS The impact of the high mortality rate is of over a million of potential years of life lost by road traffic injuries, especially among adults in productive age (early mortality), in only one year, representing extreme social cost arising from a cause of death that could be prevented. Despite the reduction of mortality by road traffic injuries from 2011 to 2013, the mortality rates increased among motorcyclists. PMID:27706375

  11. Repair of symptomatic paraesophageal hernias in elderly (>70 years) patients results in sustained quality of life at 5 years and beyond.

    PubMed

    Merzlikin, Oleg V; Louie, Brian E; Farivar, Alexander S; Shultz, Dale; Aye, Ralph W

    2017-10-01

    Paraesophageal hernias (PEHs) involve herniation of stomach and/or other viscera into the mediastinum. These commonly occur in the elderly and can severely limit quality of life. Short term outcomes of repaired PEH demonstrated low morbidity and significant improvement in quality of life, but long-term data for all patients, especially the elderly, are lacking. Retrospective chart review of a prospectively collected database of patients aged 70 or greater with a symptomatic PEH repaired 5+ years ago. Quality of life data were assessed preoperatively, at 12-24 months, and at 5+ years using QOLRAD, GERD-HRQL, and DSS. We identified 137 patients who met the age criteria, with 69 patients undergoing surgery 5+ years ago. With ten patients were lost to follow-up, 59 patients were analyzed, including 24 males and 35 females. Median age at repair was 77 years. There were two 90-day mortalities, with one occurring within 30 days of surgery. Patients alive at evaluation had a median age of 74 years and were followed a median 7.4 years. From baseline, QOLRAD improved from 4 to 6.5, GERD-HRQL improved from 11 to 5, and swallowing improved from 11 to 38. During follow-up, 21 patients died. Deceased patients lived a median of 4 years after repair, with a median age at repair of 80 years. At a median time follow-up of 2 years, this group's QOLRAD improved from 5.1 to 7, GERD-HRQL improved from 16 to 4, and swallowing improved from 14.5 to 35. In elderly patients with symptomatic PEH undergoing surgical repair more than 5 years ago, there was sustained improvement in quality of life. This justifies surgical repair of symptomatic PEH in elderly patients.

  12. Patterns of dental services and factors that influence dental services among 64-65-year-old regular users of dental care in Denmark.

    PubMed

    Christensen, Lisa B; Rosing, Kasper; Lempert, Susanne M; Hede, Børge

    2016-03-01

    To describe the pattern of dental services provided to 64-65-year-old Danes who are regular users of dental care over a 5-year period, to analyse whether this pattern is associated with socio-demographic and/or socioeconomic factors, and if different uses of dental services are related to dental status and caries experience. Finally, to discuss the future planning of dental services aimed at the increasing population of elderly citizens. [Correction made on 21 March 2014, after first online publication: The sentence 'Data on elderly's dental service are scarce, although increased use is seen and more teeth are present in this age group.' was removed.] A cross-sectional study of all aged 64-65 (n = 37 234) who received a dental examination in 2009 was conducted. Clinical data comprised dental services received under the National Health Insurance reimbursement scheme, dental status and DMFT. Geographical, socio-demographic and socioeconomic data derived from public registers. Almost all received restorations, while periodontal treatment was received by <50% during 5 years. Heavy use of dental services was dominated by periodontal services. Periodontal services were most prevalent in the capital and the most affluent areas. Relatively more extractions were related to low income and persons in least affluent areas. Total number of services was highest among women, persons with ≥20 teeth, persons living in the capital, and where the ratio user per dentist was low. For future planning of dental care for elderly, dental status, geographical and social area-based factors and to some degree gender, income, and education must be taken into consideration as all these factors seem to influence the future demand for dental services. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  13. Role and Involvement of Life End Information Forum Physicians in Euthanasia and Other End-of-Life Care Decisions in Flanders, Belgium

    PubMed Central

    Van Wesemael, Yanna; Cohen, Joachim; Onwuteaka-Philipsen, Bregje D; Bilsen, Johan; Distelmans, Wim; Deliens, Luc

    2009-01-01

    Objective To describe role and involvement of Life End Information Forum (LEIF) physicians in end-of-life care decisions and euthanasia in Flanders. Study Design All 132 LEIF physicians in Belgium received a questionnaire inquiring about their activities in the past year, and their end-of-life care training and experience. Principal Findings Response rate was 75 percent. Most respondents followed substantive training in end-of-life care. In 1 year, LEIF physicians were contacted 612 times for consultations in end-of-life decisions, of which 355 concerned euthanasia requests eventually resulting in 221 euthanasia cases. LEIF physicians also gave information about various end-of-life issues (including palliative care) to patients and colleagues. Conclusions LEIF physicians provide a forum for information and advice for physicians and patients. A similar health service providing support to physicians for all end-of-life decisions could also be beneficial for countries without a euthanasia law. PMID:19780854

  14. Incidence, prevalence, and hybrid approaches to calculating disability-adjusted life years

    PubMed Central

    2012-01-01

    When disability-adjusted life years are used to measure the burden of disease on a population in a time interval, they can be calculated in several different ways: from an incidence, pure prevalence, or hybrid perspective. I show that these calculation methods are not equivalent and discuss some of the formal difficulties each method faces. I show that if we don’t discount the value of future health, there is a sense in which the choice of calculation method is a mere question of accounting. Such questions can be important, but they don’t raise deep theoretical concerns. If we do discount, however, choice of calculation method can change the relative burden attributed to different conditions over time. I conclude by recommending that studies involving disability-adjusted life years be explicit in noting what calculation method is being employed and in explaining why that calculation method has been chosen. PMID:22967055

  15. End of Life: An Overview

    ERIC Educational Resources Information Center

    Toner, Mary Ann; Shadden, Barbara B.

    2012-01-01

    Speech-language pathologists (SLPs) provide services to patients confronting the end of life (EOL) in a variety of settings. Instead of targeting improvement of health or sustaining life, EOL services focus primarily on quality of life. Although SLPs may not consider themselves core members of the health care team providing EOL services, the…

  16. 26 CFR 1.803-7 - Taxable years affected.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 8 2013-04-01 2013-04-01 false Taxable years affected. 1.803-7 Section 1.803-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.803-7 Taxable years affected. Sections 1.803-1...

  17. 26 CFR 1.803-7 - Taxable years affected.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 8 2014-04-01 2014-04-01 false Taxable years affected. 1.803-7 Section 1.803-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.803-7 Taxable years affected. Sections 1.803-1...

  18. 26 CFR 1.803-7 - Taxable years affected.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 8 2012-04-01 2012-04-01 false Taxable years affected. 1.803-7 Section 1.803-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.803-7 Taxable years affected. Sections 1.803-1...

  19. 26 CFR 1.803-7 - Taxable years affected.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 8 2011-04-01 2011-04-01 false Taxable years affected. 1.803-7 Section 1.803-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.803-7 Taxable years affected. Sections 1.803-1...

  20. End-of-Life Decision Making for Nursing Home Residents with Dementia: A Survey of Nursing Home Social Services Staff

    ERIC Educational Resources Information Center

    Lacey, Debra

    2006-01-01

    The purpose of this survey was to describe nursing home social services staff roles and perceptions related to end-of-life medical decision making for nursing home residents in endstage dementia. Using a self-designed questionnaire, 138 nursing home social services staff from across New York State answered questions about advance directives,…

  1. Lost life years due to premature deaths caused by diseases of the digestive system in Poland in 2013

    PubMed

    Paciej, Paulina; Ciabiada, Beata; Maniecka-Bryła, Irena

    In order to evaluate the health status of a population, besides indicators measuring the incidence of diseases and deaths, potential measures are becoming more frequently used, ie. measures that take into account life-time potential of the individuals in the population. They can particularly by applied to analyse the problem of premature mortality, which is measured by lost life years. The aim of the study was to evaluate life years lost due to diseases of digestive system in Polish population in 2013. The study was based on a dataset containing 387,312 death certificates of Poles who died in 2013, provided by the Central Statistical Office in Poland. Data on deaths caused by diseases of digestive system (K00-K93 by ICD-10) were used in the study – that were 16,543 records (4.3% of all the deaths). Lost life years were assessed with the measures: SEYLL (Standard Expected Years of Life Lost), SEYLLp (Standard Expected Years of Life Lost per living person), SEYLLd (Standard Expected Years of Life Lost per death). In the analysed year among men there were 9,275 deaths caused by diseases of digestive system and in women 7,268 deaths. SEYLL in the group of men amounted to 102 230.7 and in the group of women it was 53,475.5. The number of lost life years calculated per 10 000 male inhabitants was 54.9, and for 10,000 females it was 26.9. The highest share in lost life years had alcoholic liver disease (SEYLLp for men – 20.87, for women – 6.1), fibrosis and cirrhosis of the liver (SEYLLp for men- 9.7, for women- 5.6) and acute pancreatitis (SEYLLp for men – 5.3, for women – 2.1). The results of the study indicate that diseases of digestive system have an important contribution to the loss of life-time potential in Polish population (6.6% of all SEYLL in 2013). The dominant role in this class of diseases played alcoholic liver disease – K70, fibrosis and cirrhosis of the liver – K74 and acute pancreatitis – K85.

  2. Yesterday's People: Life in Contemporary Appalachia.

    ERIC Educational Resources Information Center

    Weller, Jack E.

    The author attempts to describe life in contemporary Appalachia on the basis of his service as a minister in the mountain region of the area for thirteen years. Included is an interpretation of the individualism, traditionalism, fatalism, and personal orientation which characterize the mountaineer population of Appalachia, as well as extensive…

  3. Real-life Efficacy of Omalizumab After 9 Years of Follow-up.

    PubMed

    Menzella, Francesco; Galeone, Carla; Formisano, Debora; Castagnetti, Claudia; Ruggiero, Patrizia; Simonazzi, Anna; Zucchi, Luigi

    2017-07-01

    Omalizumab is frequently used as add-on treatment to inhaled corticosteroids (ICS) and long-acting β2-agonists in patients with suboptimal control of severe asthma. Patients with severe asthma will typically require chronic treatment, although due to the limited amount of data available there are still some concerns about the safety and efficacy of long-term therapy with omalizumab. Herein, in an extension of a previous 4-year study, we report disease-related outcomes of 8 patients with severe persistent allergic asthma who have been followed for a total of 9 years in a real-life setting. Both quality of life (QoL) (evaluated using the Juniper Asthma-Related QoL Questionnaire [AQLQ]) and forced expiratory volume in 1 second (FEV1) showed sustained improvement at 9 years. The median values of AQLQ and FEV1 at 4 years were 5.5 and 82.0% compared to 5.9 and 85.5%, respectively, at 9 years, which were all significantly increased from baseline. After 9 years, the mean annual number of severe exacerbations was 0.63 compared to 5 at baseline. There also appeared to be a trend toward use of a lower dose of ICS at longer follow-up times. After 9 years, there were no safety concerns for continued use of omalizumab, and no asthma-related hospitalizations or emergency department visits were documented over the last 5 years. The present analysis is the longest reported clinical follow-up of omalizumab. Long-term maintenance treatment with omalizumab for up to 9 years is associated with continued benefits in reducing symptoms, exacerbations, and medication burden without any safety concerns. Copyright © 2017 The Korean Academy of Asthma, Allergy and Clinical Immunology · The Korean Academy of Pediatric Allergy and Respiratory Disease.

  4. Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years

    PubMed Central

    Torgerson, Paul R.; Hagan, José E.; Costa, Federico; Calcagno, Juan; Kane, Michael; Martinez-Silveira, Martha S.; Goris, Marga G. A.; Stein, Claudia; Ko, Albert I.; Abela-Ridder, Bernadette

    2015-01-01

    Background Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis can cause life-threatening disease, there is no global burden of disease estimate in terms of Disability Adjusted Life Years (DALYs) available. Methodology/Principal Findings We utilised the results of a parallel publication that reported global estimates of morbidity and mortality due to leptospirosis. We estimated Years of Life Lost (YLLs) from age and gender stratified mortality rates. Years of Life with Disability (YLDs) were developed from a simple disease model indicating likely sequelae. DALYs were estimated from the sum of YLLs and YLDs. The study suggested that globally approximately 2·90 million DALYs are lost per annum (UIs 1·25–4·54 million) from the approximately annual 1·03 million cases reported previously. Males are predominantly affected with an estimated 2·33 million DALYs (UIs 0·98–3·69) or approximately 80% of the total burden. For comparison, this is over 70% of the global burden of cholera estimated by GBD 2010. Tropical regions of South and South-east Asia, Western Pacific, Central and South America, and Africa had the highest estimated leptospirosis disease burden. Conclusions/Significance Leptospirosis imparts a significant health burden worldwide, which approach or exceed those encountered for a number of other zoonotic and neglected tropical diseases. The study findings indicate that highest burden estimates occur in resource-poor tropical countries, which include regions of Africa where the burden of leptospirosis has been under-appreciated and possibly misallocated to other febrile illnesses such as malaria. PMID:26431366

  5. Tracking hospital costs in the last year of life - The Shanghai experience.

    PubMed

    Zhu, Bifan; Li, Fen; Wang, Changying; Wang, Linan; He, Zhimin; Zhang, Xiaoxi; Song, Peipei; Ding, Lingling; Jin, Chunlin

    2018-01-01

    One aim of the current study was to track end-of-life care using individual data in Shanghai, China to profile hospital costs for decedents and those for the entire population. A second aim of this study was to clarify the effect of proximity to death. Data from the Information Center of the Shanghai Municipal Commission of Health and Family Planning (SMCHFP) were examined. For decedents who died in medical facilities in 2015, inpatient care was tracked for 1 year before death. A total of 43,765 decedents were included in the study, accounting for 35% of total deaths in 2015 in Shanghai. Hospital costs were higher for people who died before the age of 45 (14,228.62 USD) than for those aged 90 or older (8,696.34 USD). The ratio of costs for decedents to the entire population declined significantly with age. Women received less care than men in the last year of life (t = -15.1244, p < 0.05). Average tertiary hospital costs per decedent declined significantly with age, whereas average secondary hospital costs increased slightly with age. Among the top 14 causes of death classified using the ICD-10, rectal cancer incurred the greatest costs (13,973 USD per decedent). Over 43% of hospital costs were incurred during the month before death. Declining costs in the last year of life with age as well as with distance to death demonstrate the existence of a proximity to death phenomenon in health care expenses. Disease-specific studies should be conducted and attention should be paid to gender equity when examining end-of-life medical costs in the future.

  6. Evaluation of Long-Life Concrete Pavement Practices for Use in Florida : [Summary

    DOT National Transportation Integrated Search

    2012-01-01

    Current Florida construction practices produce asphalt pavements with a service life of 12 to 20 years before needing rehabilitation; concrete pavements are typically designed for 20 years. However, pavements with much longer design lives are possibl...

  7. Pulmonary function and health-related quality of life 1-year follow up after cardiac surgery.

    PubMed

    Westerdahl, Elisabeth; Jonsson, Marcus; Emtner, Margareta

    2016-07-08

    Pulmonary function is severely reduced in the early period after cardiac surgery, and impairments have been described up to 4-6 months after surgery. Evaluation of pulmonary function in a longer perspective is lacking. In this prospective study pulmonary function and health-related quality of life were investigated 1 year after cardiac surgery. Pulmonary function measurements, health-related quality of life (SF-36), dyspnoea, subjective breathing and coughing ability and pain were evaluated before and 1 year after surgery in 150 patients undergoing coronary artery bypass grafting, valve surgery or combined surgery. One year after surgery the forced vital capacity and forced expiratory volume in 1 s were significantly decreased (by 4-5 %) compared to preoperative values (p < 0.05). Saturation of peripheral oxygen was unchanged 1 year postoperatively compared to baseline. A significantly improved health-related quality of life was found 1 year after surgery, with improvements in all eight aspects of SF-36 (p < 0.001). Sternotomy-related pain was low 1 year postoperatively at rest (median 0 [min-max; 0-7]), while taking a deep breath (0 [0-4]) and while coughing (0 [0-8]). A more pronounced decrease in pulmonary function was associated with dyspnoea limitations and impaired subjective breathing and coughing ability. One year after cardiac surgery static and dynamic lung function measurements were slightly decreased, while health-related quality of life was improved in comparison to preoperative values. Measured levels of pain were low and saturation of peripheral oxygen was same as preoperatively.

  8. 26 CFR 1.441-3 - Taxable year of a personal service corporation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... section 444, or establishes a business purpose for such fiscal year and obtains the approval of the... adopt any other taxable year must establish a business purpose and obtain the approval of the... performance of services in the fields of health, law, engineering, architecture, accounting, actuarial science...

  9. Improving health related quality of life among rural hypertensive patients through the integrative strategy of health services delivery: a quasi-experimental trial from Chongqing, China.

    PubMed

    Miao, Yudong; Zhang, Liang; Sparring, Vibeke; Sandeep, Sandeep; Tang, Wenxi; Sun, Xiaowei; Feng, Da; Ye, Ting

    2016-08-23

    Integrative strategy of health services delivery has been proven to be effective in economically developed countries, where the healthcare systems have enough qualified primary care providers. However rural China lacks such providers to act as gatekeeper, besides, Chinese rural hypertensive patients are usually of old age, more likely to be exposed to health risk factors and they experience a greater socio-economic burden. All these Chinese rural setting specific features make the effectiveness of integrative strategy of health services in improving health related quality of life among Chinese rural hypertensive patients uncertain. In order to assess the impact of integrative strategy of health services delivery on health related quality of life among Chinese rural hypertensive patients, a two-year quasi-experimental trial was conducted in Chongqing, China. At baseline the sample enrolled 1006 hypertensive patients into intervention group and 420 hypertensive patients into control group. Physicians from village clinics, town hospitals and county hospitals worked collaboratively to deliver multidisciplinary health services for the intervention group, while physicians in the control group provided services without cooperation. The quality of life was studied by SF-36 Scale. Blood pressures were reported by town hospitals. The Difference-in-Differences model was used to estimate the differences in SF-36 score and blood pressure of both groups to assess the impact. The study showed that at baseline there was no statistical difference in SF-36 scores between both groups. While at follow-up the intervention group scored higher in overall SF-36, Role Physical, Body Pain, Social Functioning and Role Emotional than the control group. The Difference-in-Differences result demonstrated that there were statistical differences in SF-36 total score (p = 0.011), Role Physical (p = 0.027), Social Functioning (p = 0.000), Role Emotional (p = 0.002) between both

  10. Adverse psychosocial working conditions and poor quality of life among financial service employees in Brazil.

    PubMed

    Silva, Luiz Sergio; Barreto, Sandhi Maria

    2012-01-01

    Workers in the financial services sector are exposed to great stress at work. This study investigates whether exposure to adverse psychosocial work conditions is independently associated with poor health-related physical and mental quality of life among financial services workers. We studied a nationwide representative sample of 2,054 workers of a large Brazilian state bank in 2008. Adverse psychosocial work conditions were investigated by the Effort-reward imbalance (ERI) scale and the Job content questionnaire (JCQ). Health-related quality of life (HRQL) was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-12). Poor mental and physical HRQL was defined by the lowest quartiles of the SF-12 final score distributions. Associations were investigated using multiple logistic regression analysis. In the multivariate analysis, exposures to low control and lack of social support at work (JCQ) were associated with poor HRQL in the physical domain. Increasing effort-reward imbalance and overcommitment (ERI), on the other hand, were associated with poor HRQL in the mental domain, with a significant statistical trend. Overcommitment was also associated with poor physical HRQL. The results suggest that exposure to adverse psychosocial work conditions has a negative impact on both domains of HRQL among financial service workers. They also indicate that ERI and DC models capture different aspects of job strain.

  11. A method for predicting service life of zinc rich primers on carbon steel

    NASA Technical Reports Server (NTRS)

    Hoppesch, C. W.

    1986-01-01

    The service life of zinc rich primers on carbon steel can be estimated by immersing a primer coated glass slide into an aqueous copper sulfate solution and measuring the amount of zinc that reacts with the copper in 15 minutes. This zinc availability test was used to evaluate eleven primers currently available for which marine beach exposure data was available from previous programs. Results were evaluated and a correlation between zinc availability and ASTM rust grade was shown.

  12. Growth in early life and the development of obesity by age 9 years: are there critical periods and a role for an early life stressor?

    PubMed

    Giles, L C; Whitrow, M J; Rumbold, A R; Davies, C E; de Stavola, B; Pitcher, J B; Davies, M J; Moore, V M

    2013-04-01

    Rapid growth, possibly occurring in critical periods in early life, may be important for the development of obesity. It is unknown whether this is influenced by postnatal exposures such as age-relevant sources of stress. Frequent house moves may be one such stressor. We aimed to examine if there is a period of growth in early life critical for the development of child obesity by age 9 years and assess the role of house moves in modifying any relationships between early life growth and obesity at age 9 years. Prospective Australian birth cohort study. In all, 392 children with serial body size measurements from birth to age 9 years. Standardized body mass index (z-BMI) was available for six time points (spanning birth to 3½ years), and the total number of house moves between birth and 3½ years. The outcomes considered were z-BMI and % body fat (%BF) at age 9 years. Linear regression models were used to estimate the effects of serial measurements of z-BMI and number of house moves on the outcomes. Life-course plots showed that z-BMI at 3½ years was a statistically significant predictor of z-BMI at 9 years (β=0.80; standard error (s.e.), 0.04), whereas z-BMI at 9 months (β=-1.13; s.e., 0.40) and 3½ years (β=4.82; s.e., 0.42) were significant predictors of %BF at age 9 years. There were statistically significant interactions between the number of house moves and change in z-BMI between 9 and 12 months, such that ≥ 3 house moves in early life amplified the detrimental effects of earlier rapid growth on both body size and composition at age 9 years. In the absence of evidence for a single critical period, efforts to prevent overweight and obesity are required throughout childhood. In addition, modifiable postnatal stressors may exacerbate effects of early growth on obesity in later childhood.

  13. Resource utilization and cost analyses of home-based palliative care service provision: the Niagara West End-of-Life Shared-Care Project.

    PubMed

    Klinger, Christopher A; Howell, Doris; Marshall, Denise; Zakus, David; Brazil, Kevin; Deber, Raisa B

    2013-02-01

    Increasing emphasis is being placed on the economics of health care service delivery - including home-based palliative care. This paper analyzes resource utilization and costs of a shared-care demonstration project in rural Ontario (Canada) from the public health care system's perspective. To provide enhanced end-of-life care, the shared-care approach ensured exchange of expertise and knowledge and coordination of services in line with the understood goals of care. Resource utilization and costs were tracked over the 15 month study period from January 2005 to March 2006. Of the 95 study participants (average age 71 years), 83 had a cancer diagnosis (87%); the non-cancer diagnoses (12 patients, 13%) included mainly advanced heart diseases and COPD. Community Care Access Centre and Enhanced Palliative Care Team-based homemaking and specialized nursing services were the most frequented offerings, followed by equipment/transportation services and palliative care consults for pain and symptom management. Total costs for all patient-related services (in 2007 $CAN) were $1,625,658.07 - or $17,112.19 per patient/$117.95 per patient day. While higher than expenditures previously reported for a cancer-only population in an urban Ontario setting, the costs were still within the parameters of the US Medicare Hospice Benefits, on a par with the per diem funding assigned for long-term care homes and lower than both average alternate level of care and hospital costs within the Province of Ontario. The study results may assist service planners in the appropriate allocation of resources and service packaging to meet the complex needs of palliative care populations.

  14. The use of Quality-Adjusted Life Years in cost-effectiveness analyses in palliative care: Mapping the debate through an integrative review.

    PubMed

    Wichmann, Anne B; Adang, Eddy Mm; Stalmeier, Peep Fm; Kristanti, Sinta; Van den Block, Lieve; Vernooij-Dassen, Myrra Jfj; Engels, Yvonne

    2017-04-01

    In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year's value for palliative care. The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped. A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years. Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied. The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to-in addition to the EQ-5D- make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year.

  15. Effectiveness of palliative care services: A population-based study of end-of-life care for cancer patients.

    PubMed

    De Palma, Rossana; Fortuna, Daniela; Hegarty, Sarah E; Louis, Daniel Z; Melotti, Rita Maria; Moro, Maria Luisa

    2018-06-01

    Multiple studies demonstrate substantial utilization of acute hospital care and, potentially excessive, intensive medical and surgical treatments at the end-of-life. To evaluate the relationship between the use of home and facility-based hospice palliative care for patients dying with cancer and service utilization at the end of life. Retrospective, population-level study using administrative databases. The effect of palliative care was analyzed between coarsened exact matched cohorts and evaluated through a conditional logistic regression model. The study was conducted on the cohort of 34,357 patients, resident in Emilia-Romagna Region, Italy, admitted to hospital with a diagnosis of metastatic or poor-prognosis cancer during the 6 months before death between January 2013 and December 2015. Patients who received palliative care experienced significantly lower rates of all indicators of aggressive care such as hospital admission (odds ratio (OR) = 0.05, 95% confidence interval (CI): 0.04-0.06), emergency department visits (OR = 0.23, 95% CI: 0.21-0.25), intensive care unit stays (OR = 0.29, 95% CI: 0.26-0.32), major operating room procedures (OR = 0.22, 95% CI: 0.21-0.24), and lower in-hospital death (OR = 0.11, 95% CI: 0.10-0.11). This cohort had significantly higher rates of opiate prescriptions (OR = 1.27, 95% CI: 1.21-1.33) ( p < 0.01 for all comparisons). Use of palliative care at the end of life for cancer patients is associated with a reduction of the use of high-cost, intensive services. Future research is necessary to evaluate the impact of increasing use of palliative care services on other health outcomes. Administrative databases linked at the patient level are a useful data source for assessment of care at the end of life.

  16. 76 FR 54193 - Fiscal Year 2012 Veterinary Import/Export, Diagnostic Services, and Export Certification for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-31

    ...] Fiscal Year 2012 Veterinary Import/Export, Diagnostic Services, and Export Certification for Plants and.... SUMMARY: This notice pertains to user fees charged for Veterinary Services animal quarantine and other..., organisms, and vectors; for certain veterinary diagnostic services; and for export certification of plants...

  17. Complex home care: Part I--Utilization and costs to families for health care services each year.

    PubMed

    Piamjariyakul, Ubolrat; Ross, Vicki M; Yadrich, Donna Macan; Williams, Arthur R; Howard, Lyn; Smith, Carol E

    2010-01-01

    As many as 120 persons per million people in the United States are dependent on the lifelong, complex, technology-based care of home parenteral nutrition (HPN) infusions. However, data for costs paid by families for HPN-related health care services and for non-reimbursed expenditures are rarely tabulated and most often underestimated. The goals of this study were to describe health care services used by families to manage HPN, report the frequency of each service used annually, and estimate the average annual non-reimbursed costs to families for these health services. The numerous and varied types of services reported and the time required to coordinate and access HPN services illustrates the challenges faced by patients and their family caregivers. The lack of a coordinated and efficient system for delivering complex chronic care results in poorer outcomes for HPN patients and their families on-reimbursed costs and the extensive amount of time required to coordinate multi-professional services negatively impacts the clinical outcomes and quality of life of complex chronic home care.

  18. Quality of Life as Perceived by 30 Year Old Army Veterans. Technical Paper No. 263.

    ERIC Educational Resources Information Center

    Wilson, Sandra Reitz; And Others

    An intensive investigation of the impact Army service has had on the quality of life for a representative sample of young Americans is analyzed in terms of possible improvement in Army personnel procedures. A total of 166 men (of a potential 200) and 49 women (of a potential 50) were interviewed. The information from these interviews; a review of…

  19. Insights into Finnish First-Year Pre-Service Teachers' Twenty-First Century Skills

    ERIC Educational Resources Information Center

    Valtonen, Teemu; Sointu, Erkko Tapio; Kukkonen, Jari; Häkkinen, Päivi; Järvelä, Sanna; Ahonen, Arto; Näykki, Piia; Pöysä-Tarhonen, Johanna; Mäkitalo-Siegl, Kati

    2017-01-01

    This study focuses on Finnish pre-service teachers' perceptions of their twenty-first century skills, especially their learning strategies, collaboration and teamwork, as well as knowledge and attitudes related to ICT in education. The target group consist of 263 first-year pre-service teachers from three universities. The results outline how…

  20. Grasping time scales from galactic life cycles to personal life projects at a linear scale of 1 mm per 100 years

    NASA Astrophysics Data System (ADS)

    Holm Jacobsen, Bo

    2010-05-01

    The ambition is to make the citizen (i.e. pupil/student/scholar/voter/journalist/politician) comprehend better and more scientifically all time scales from the lifespan of the universe to the personal life project by a consistent geographical mapping of time at a scale of 1 mm per 100 years. The processes which change earth systems like life, climate, topography and plate tectonics operate at very different timescales. The understanding of these systems is essential not only for students and scholars of earth science but also for pupils, voters and politicians who make decisions of possibly significant consequence to climate and biodiversity not only for our generation but for thousands or even millions of years ahead. With a consistent linear mapping of time to a scale of 1 millimetre per 100 years, historical time (

  1. The Timing of a Time Out: The Gap Year in Life Course Context

    ERIC Educational Resources Information Center

    Vogt, Kristoffer Chelsom

    2018-01-01

    Based on biographical interviews from a three-generation study in Norway, this article examines the place of the contemporary "gap year" within life course transition trajectories and intergenerational relations embedded in wider patterns of social inequality. Under the heading of taking a gap year, young people on "academic…

  2. Twenty-year follow-up of children with and without speech-language impairments: family, educational, occupational, and quality of life outcomes.

    PubMed

    Johnson, Carla J; Beitchman, Joseph H; Brownlie, E B

    2010-02-01

    Parents, professionals, and policy makers need information on the long-term prognosis for children with communication disorders. Our primary purpose in this report was to help fill this gap by profiling the family, educational, occupational, and quality of life outcomes of young adults at 25 years of age (N = 244) from the Ottawa Language Study, a 20-year, prospective, longitudinal study of a community sample of individuals with (n = 112) and without (n = 132) a history of early speech and/or language impairments. A secondary purpose of this report was to use data from earlier phases of the study to predict important, real-life outcomes at age 25. Participants were initially identified at age 5 and subsequently followed at 12, 19, and 25 years of age. Direct assessments were conducted at all 4 time periods in multiple domains (demographic, communicative, cognitive, academic, behavioral, and psychosocial). At age 25, young adults with a history of language impairments showed poorer outcomes in multiple objective domains (communication, cognitive/academic, educational attainment, and occupational status) than their peers without early communication impairments and those with early speech-only impairments. However, those with language impairments did not differ in subjective perceptions of their quality of life from those in the other 2 groups. Objective outcomes at age 25 were predicted differentially by various combinations of multiple, interrelated risk factors, including poor language and reading skills, low family socioeconomic status, low performance IQ, and child behavior problems. Subjective well-being, however, was primarily associated with strong social networks of family, friends, and others. This information on the natural history of communication disorders may be useful in answering parents' questions, anticipating challenges that children with language disorders might encounter, and planning services to address those issues.

  3. First-Year Analysis of a New, Home-Based Palliative Care Program Offered Jointly by a Community Hospital and Local Visiting Nurse Service.

    PubMed

    Pouliot, Katherine; Weisse, Carol S; Pratt, David S; DiSorbo, Philip

    2017-03-01

    There is a growing need for home-based palliative care services, especially for seriously ill individuals who want to avoid hospitalizations and remain with their regular outside care providers. To evaluate the effectiveness of Care Choices, a new in-home palliative care program provided by the Visiting Nurse Services of Northeastern New York and Ellis Medicine's community hospital serving New York's Capital District. This prospective cohort study assessed patient outcomes over the course of 1 year for 123 patients (49 men and 74 women) with serious illnesses who were new enrollees in the program. Quality of life was assessed at baseline and after 1 month on service. Satisfaction with care was measured after 1 and 3 months on service. The number of emergency department visits and inpatient hospitalizations pre- and postenrollment was measured for all enrollees. Patients were highly satisfied (72.7%-100%) with their initial care and reported greater satisfaction ( P < .05) and stable symptom management over time. Fewer emergency department ( P < .001) and inpatient hospital admissions ( P < .001) occurred among enrollees while on the palliative care service. An in-home palliative care program offered jointly through a visiting nurse service and community hospital may be a successful model for providing quality care that satisfies chronically ill patients' desire to remain at home and avoid hospital admissions.

  4. Service Use and Unmet Needs in Youth Suicide: A Study of Trajectories

    PubMed Central

    Renaud, Johanne; Séguin, Monique; Lesage, Alain D; Marquette, Claude; Choo, Bettina; Turecki, Gustavo

    2014-01-01

    Objective: While 90% of suicide victims have suffered from mental health disorders, less than one-half are in contact with a mental health professional in the year preceding their death. Service use in the last year of life of young suicide victims and control subjects was studied in Quebec. We wanted to determine what kinds of health care services were needed and if they were actually received by suicide victims. Method: We recruited 67 consecutive suicide victims and 56 matched living control subjects (aged 25 years and younger). We evaluated subjects’ psychopathological profile and determined which services would have been indicated by conducting a needs assessment. We then compared this with what services were actually received. Results: Suicide victims were more likely than living control subjects to have a psychiatric diagnosis. They were most in need of services to address substance use disorder, depression, interpersonal distress, and suicide-related problems. There were significant deficits in the domains of coordination and continuity of care, mental health promotion and training, and governance. Conclusions: Our results show that we need to urgently take action to address these identified deficits to prevent further loss of life in our young people. PMID:25565685

  5. Service use and unmet needs in youth suicide: a study of trajectories.

    PubMed

    Renaud, Johanne; Séguin, Monique; Lesage, Alain D; Marquette, Claude; Choo, Bettina; Turecki, Gustavo

    2014-10-01

    While 90% of suicide victims have suffered from mental health disorders, less than one-half are in contact with a mental health professional in the year preceding their death. Service use in the last year of life of young suicide victims and control subjects was studied in Quebec. We wanted to determine what kinds of health care services were needed and if they were actually received by suicide victims. We recruited 67 consecutive suicide victims and 56 matched living control subjects (aged 25 years and younger). We evaluated subjects' psychopathological profile and determined which services would have been indicated by conducting a needs assessment. We then compared this with what services were actually received. Suicide victims were more likely than living control subjects to have a psychiatric diagnosis. They were most in need of services to address substance use disorder, depression, interpersonal distress, and suicide-related problems. There were significant deficits in the domains of coordination and continuity of care, mental health promotion and training, and governance. Our results show that we need to urgently take action to address these identified deficits to prevent further loss of life in our young people.

  6. 26 CFR 1.803-7 - Taxable years affected.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Taxable years affected. 1.803-7 Section 1.803-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Life Insurance Companies § 1.803-7 Taxable years affected. Sections 1.803-1 through 1.803-6...

  7. Medical Costs and Healthcare Utilization among Cancer Decedents in the Last Year of Life in 2009.

    PubMed

    Hwang, Inuk; Shin, Dong Wook; Kang, Kyoung Hee; Yang, Hyung Kook; Kim, So Young; Park, Jong-Hyock

    2016-01-01

    The purpose of this study was to evaluate the cancer care cost during the last year of life of patients in Korea. We studied the breakdown of spending on the components of cancer care. Cancer decedents in 2009 were identified from the Korean Central Cancer Registry and linked with the Korean National Health Insurance Claims Database. The final number of patients included in the study was 70,558. In 2009, the average cancer care cost during the last year of life was US $15,720. Patients under age 20 spent US $53,890 while those 70 or over spent US $11,801. Those with leukemia incurred the highest costs (US $43,219) while bladder cancer patients spent the least (US $13,155). General costs, drugs other than analgesics, and test fees were relatively high (29.7%, 23.8%, and 20.7% of total medical costs, respectively). Analgesic drugs, rehabilitation, and psychotherapy were still relatively low (4.3%, 0.7%, and 0.1%, respectively). Among the results of multiple regression analysis, few were notable. Age was found to be negatively related to cancer care costs while income level was positively associated. Those classified under distant Surveillance, Epidemiology, and End Results stages of cancer and higher comorbidity level also incurred higher cancer care costs. Average cancer care costs varied significantly by patient characteristics. However, the study results suggest an underutilization of support services likely due to lack of alternative accommodations for terminal cancer patients. Further examination of utilization patterns of healthcare resources will help provide tailored evidence for policymakers in efforts to reduce the burdens of cancer care.

  8. Behavioral Health and Adjustment to College Life for Student Service Members/Veterans.

    PubMed

    Schonfeld, Lawrence; Braue, Lawrence A; Stire, Sheryl; Gum, Amber M; Cross, Brittany L; Brown, Lisa M

    2015-01-01

    Increasing numbers of student service members/veterans (SSM/Vs) are enrolling in college. However, little is known about how their previous military experience affects their adjustment to this new role. The present study tested the hypothesis that SSM/Vs who report adjustment problems in college have a higher incidence of posttraumatic stress disorder (PTSD), depression, and other behavioral health problems compared with those who do not report adjustment problems. SSM/Vs (N = 173) at a large, southeastern, public university completed online surveys that included well-validated screens measuring substance use, depression, PTSD, and other mental disorders. Those reporting difficulties adjusting to university life (28%) reported significantly higher frequencies of behavioral and health problems while in the military, and significantly higher levels of PTSD, depression, and mental health disorders, but no difference in substance use. Implications for improved behavioral health screening and coordination of university behavioral health services with veterans' health systems are discussed.

  9. How Shall I Live? Constructing a Life Story in the College Years

    ERIC Educational Resources Information Center

    McAdams, Dan P.; Guo, Jennifer

    2014-01-01

    This chapter applies the concept of narrative identity to college student development. The authors describe a narrative interview method that can be used to promote the development of a purposeful life story in the college years.

  10. A retrospective population based cohort study of access to specialist palliative care in the last year of life: who is still missing out a decade on?

    PubMed

    Rosenwax, Lorna; Spilsbury, Katrina; McNamara, Beverley A; Semmens, James B

    2016-05-10

    Historically, specialist palliative care has been accessed by a greater proportion of people dying with cancer compared to people with other life-limiting conditions. More recently, a variety of measures to improve access to palliative care for people dying from non-cancer conditions have been implemented. There are few rigorous population-based studies that document changes in palliative care service delivery relative to the number of patients who could benefit from such services. A retrospective cohort study of the last year of life of persons with an underlying cause of death in 2009-10 from cancer, heart failure, renal failure, liver failure, chronic obstructive pulmonary disease, Alzheimer's disease, motor neurone disease, Parkinson's disease, Huntington's disease and/or HIV/AIDS. The proportion of decedents receiving specialist palliative care was compared to a 2000-02 cohort. Logistic regression models were used identify social and demographic factors associated with accessing specialist palliative care. There were 12,817 deaths included into the cohort; 7166 (56 %) from cancer, 527 (4 %) from both cancer and non-cancer conditions and 5124 (40 %) from non-cancer conditions. Overall, 46.3 % of decedents received community and/or hospital based specialist palliative care; a 3.5 % (95 % CI 2.3-4.7) increase on specialist palliative care access reported ten years earlier. The majority (69 %; n = 4928) of decedents with cancer accessed palliative care during the last year of life. Only 14 % (n = 729) of decedents with non-cancer conditions accessed specialist palliative care, however, this represented a 6.1 % (95 % CI 4.9-7.3) increase on the specialist palliative care access reported for the same decedent group ten years earlier. Compared to decedents with heart failure, increased odds of palliative care access was observed for decedents with cancer (OR 10.5; 95 % CI 9.1-12.2), renal failure (OR 1.5; 95 % CI 1.3-1.9), liver failure (OR 2.3; 95

  11. [Estimation of the quality of life 8-year-old child with bilateral anophthalmia].

    PubMed

    Sredzińska-Kita, Dorota; Mrugacz, Małgorzata; Bakunowicz-Łazarczyk, Alina

    2009-01-01

    The main aim of our work was to estimate the physical and psychomotor development and the arrangement to the daily life for a 8-year-old girl with inborn bilateral anophthalmia. The basic ophthalmic, pediatric and neurological examinations were performed with additional genetic and radiological examinations. The ophthalmic and MRI examination find out the absence of the eyeballs, optic nerves, optic chiasm, optic tracts and optic radiation. Anophthalmia limits in a big grade an independent life of the child. However, currently the girl's development indicates for good intellectual abilities what is promising for future independent life and professional work.

  12. Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain: a 6-year cohort study.

    PubMed

    Generaal, Ellen; Vogelzangs, Nicole; Macfarlane, Gary J; Geenen, Rinie; Smit, Johannes H; de Geus, Eco J C N; Penninx, Brenda W J H; Dekker, Joost

    2016-05-01

    Dysregulated biological stress systems and adverse life events, independently and in interaction, have been hypothesised to initiate chronic pain. We examine whether (1) function of biological stress systems, (2) adverse life events, and (3) their combination predict the onset of chronic multisite musculoskeletal pain. Subjects (n=2039) of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were identified using the Chronic Pain Grade Questionnaire and followed up for the onset of chronic multisite musculoskeletal pain over 6 years. Baseline assessment of biological stress systems comprised function of the hypothalamic-pituitary-adrenal axis (1-h cortisol awakening response, evening levels, postdexamethasone levels), the immune system (basal and lipopolysaccharide-stimulated inflammation) and the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, respiratory sinus arrhythmia). The number of recent adverse life events was assessed at baseline using the List of Threatening Events Questionnaire. Hypothalamic-pituitary-adrenal axis, immune system and autonomic nervous system functioning was not associated with onset of chronic multisite musculoskeletal pain, either by itself or in interaction with adverse life events. Adverse life events did predict onset of chronic multisite musculoskeletal pain (HR per event=1.14, 95% CI 1.04 to 1.24, p=0.005). This longitudinal study could not confirm that dysregulated biological stress systems increase the risk of developing chronic multisite musculoskeletal pain. Adverse life events were a risk factor for the onset of chronic multisite musculoskeletal pain, suggesting that psychosocial factors play a role in triggering the development of this condition. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Economic evaluation of a psychological intervention for high distress cancer patients and carers: costs and quality-adjusted life years.

    PubMed

    Chatterton, Mary Lou; Chambers, Suzanne; Occhipinti, Stefano; Girgis, Afaf; Dunn, Jeffrey; Carter, Rob; Shih, Sophy; Mihalopoulos, Cathrine

    2016-07-01

    This study compared the cost-effectiveness of a psychologist-led, individualised cognitive behavioural intervention (PI) to a nurse-led, minimal contact self-management condition for highly distressed cancer patients and carers. This was an economic evaluation conducted alongside a randomised trial of highly distressed adult cancer patients and carers calling cancer helplines. Services used by participants were measured using a resource use questionnaire, and quality-adjusted life years were measured using the assessment of quality of life - eight-dimension - instrument collected through a computer-assisted telephone interview. The base case analysis stratified participants based on the baseline score on the Brief Symptom Inventory. Incremental cost-effectiveness ratio confidence intervals were calculated with a nonparametric bootstrap to reflect sampling uncertainty. The results were subjected to sensitivity analysis by varying unit costs for resource use and the method for handling missing data. No significant differences were found in overall total costs or quality-adjusted life years (QALYs) between intervention groups. Bootstrapped data suggest the PI had a higher probability of lower cost and greater QALYs for both carers and patients with high distress at baseline. For patients with low levels of distress at baseline, the PI had a higher probability of greater QALYs but at additional cost. Sensitivity analysis showed the results were robust. The PI may be cost-effective compared with the nurse-led, minimal contact self-management condition for highly distressed cancer patients and carers. More intensive psychological intervention for patients with greater levels of distress appears warranted. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  14. Hands as Companions of the Mind: Essential Practical Life for the 5-Year-Old

    ERIC Educational Resources Information Center

    Gilder, Sharon Allen

    2012-01-01

    Numerous observations in Montessori classrooms led veteran Montessorians Pamela W. Trumble and Eleni Bokas to the conclusion that a universal need exists to bring integrity back to Practical Life, especially for 5-year-olds. Maria Montessori's observations over a century ago revealed the importance of Practical Life and its relationship to the…

  15. The use of Quality-Adjusted Life Years in cost-effectiveness analyses in palliative care: Mapping the debate through an integrative review

    PubMed Central

    Wichmann, Anne B; Adang, Eddy MM; Stalmeier, Peep FM; Kristanti, Sinta; Van den Block, Lieve; Vernooij-Dassen, Myrra JFJ; Engels, Yvonne

    2017-01-01

    Background: In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. Aim: To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year’s value for palliative care. Design: The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped. Data sources: A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years. Findings: Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied. Conclusion: The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to—in addition to the EQ-5D— make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year. PMID:28190374

  16. Syllable-Related Breathing in Infants in the Second Year of Life

    ERIC Educational Resources Information Center

    Parham, Douglas F.; Buder, Eugene H.; Oller, D. Kimbrough; Boliek, Carol A.

    2011-01-01

    Purpose: This study explored whether breathing behaviors of infants within the 2nd year of life differ between tidal breathing and breathing supporting single unarticulated syllables and canonical/articulated syllables. Method: Vocalizations and breathing kinematics of 9 infants between 53 and 90 weeks of age were recorded. A strict selection…

  17. Mid-life occupational grade and quality of life following retirement: a 16-year follow-up of the French GAZEL study

    PubMed Central

    Platts, Loretta G.; Webb, Elizabeth; Zins, Marie; Goldberg, Marcel; Netuveli, Gopalakrishnan

    2015-01-01

    Objectives: This article aims to contribute to the literature on life course influences upon quality of life by examining pathways linking social position in middle age to quality of life following retirement in French men and women. Method: Data are from the GAZEL cohort study of employees at the French national gas and electricity company. A finely grained measure of occupational grade in 1989 was obtained from company records. Annual self-completion questionnaires provided information on quality of life in 2005, measured with the CASP-19 scale, and on participants’ recent circumstances 2002–2005: mental health, physical functioning, wealth, social status, neighbourhood characteristics, social support and social participation. Path analysis using full information maximum likelihood estimation was performed on 11,293 retired participants. Results: Higher occupational grade in 1989 was associated, in a graded relationship, with better quality of life 16 years later. This association was accounted for by individuals’ more recent circumstances, particularly their social status, mental health, physical functioning and wealth. Conclusion: The graded relationship between occupational grade in mid-life and quality of life after labour market exit was largely accounted for by more recent socio-economic circumstances and state of health. The results support a pathway model for the development of social disparities in quality of life, in which earlier social position shapes individual circumstances in later life. PMID:25220504

  18. An end of service life assessment of PMMA lenses from veteran concentrator photovoltaic systems

    DOE PAGES

    Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebeca; ...

    2017-04-04

    The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their facetedmore » back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. The optimal focal distance of the lenses was quantified using the Solar Simulator, and then correlated to lens curvature using a recently developed measurement technique. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. As a result, molecular weight was compared between the incident and faceted surfaces of the lenses.« less

  19. An end of service life assessment of PMMA lenses from veteran concentrator photovoltaic systems

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

    Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebeca

    The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their facetedmore » back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. The optimal focal distance of the lenses was quantified using the Solar Simulator, and then correlated to lens curvature using a recently developed measurement technique. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. As a result, molecular weight was compared between the incident and faceted surfaces of the lenses.« less

  20. Analysis on regulation strategies for extending service life of hydropower turbines

    NASA Astrophysics Data System (ADS)

    Yang, W.; Norrlund, P.; Yang, J.

    2016-11-01

    Since a few years, there has been a tendency that hydropower turbines experience fatigue to a greater extent, due to increasingly more regulation movements of governor actuators. The aim of this paper is to extend the service life of hydropower turbines, by reasonably decreasing the guide vane (GV) movements with appropriate regulation strategies, e.g. settings of PI (proportional-integral) governor parameters and controller filters. The accumulated distance and number of GV movements are the two main indicators of this study. The core method is to simulate the long-term GV opening of Francis turbines with MATLAB/Simulink, based on a sequence of one-month measurements of the Nordic grid frequency. Basic theoretical formulas are also discussed and compared to the simulation results, showing reasonable correspondence. Firstly, a model of a turbine governor is discussed and verified, based on on-site measurements of a Swedish hydropower plant. Then, the influence of governor parameters is discussed. Effects of different settings of controller filters (e.g. dead zone, floating dead zone and linear filter) are also examined. Moreover, a change in GV movement might affect the quality of the frequency control. This is also monitored via frequency deviation characteristics, determined by elementary simulations of the Nordic power system. The results show how the regulation settings affect the GV movements and frequency quality, supplying suggestions for optimizing the hydropower turbine operation for decreasing the wear and tear.

  1. [6-year experience with a drug information service for patients].

    PubMed

    Huber, Martin; Kullak-Ublick, Gerd A; Kirch, Wilhelm

    2009-03-15

    Many patients are inadequately informed about their drug therapy. There is thus a need for providing additional drug information to patients. The authors here report on a 6-year experience with a drug information service for patients. The information service was available by telephone, e-mail or regular mail and was addressed initially to patients in Saxony and since 2005 to patients throughout Germany. Demographic and drug therapy data of the patients were registered and analyzed using a relational database. All enquiries to the information service between August 2001 and January 2007 were evaluated. 5,587 enquiries were registered. 61.4% of the persons calling were female and 33.8% male (sex was unknown in 4.8% by anonymous calls). The most frequent reasons for an enquiry were a general need for information about drugs and therapy (27.5%) and adverse drug reactions (24.7%). The drug group most frequently enquired about were cardiovascular drugs, accounting for 34.4%, followed by neuropsychiatric drugs (15.1%). The results of this analysis show an evident need for a drug information service for patients. This need is possibly caused by the shortage of time that physicians can devote to patients. An independent and competent drug information service may improve the quality of medical care and the satisfaction of the patients involved.

  2. 26 CFR 1.441-3 - Taxable year of a personal service corporation.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... same facts as in Example 1, except that X desires to change to a 52-53-week taxable year ending with... Commissioner's permission to use a September 30 taxable year. Example 2. The facts are the same as in Example 1... performance of services in the fields of health, law, engineering, architecture, accounting, actuarial science...

  3. Internal curing as a new tool for infrastructural renewal : reducing repair congestion, increasing service life, and improving sustainability.

    DOT National Transportation Integrated Search

    2014-04-01

    Internal curing has recently been developed as a new concrete technology that has the potential to : dramatically extend the service life of concrete infrastructure elements like bridge decks. Internal curing : uses prewetted lightweight aggregate in...

  4. Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area

    PubMed Central

    Kusambiza-Kiingi, Adrian; Maleka, Douglas

    2017-01-01

    Background Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. Aim To determine stroke survivors’ levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. Method This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. Results A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p < 0.0001) and QOL (r = 0.51, p < 0.0001). A negative correlation was found between community reintegration and caregiver strain (r = -0.37, p < 0.0001). Conclusion Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services. PMID:28730068

  5. Stroke survivors' levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area.

    PubMed

    Kusambiza-Kiingi, Adrian; Maleka, Douglas; Ntsiea, Veronica

    2017-01-01

    Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. To determine stroke survivors' levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% ( n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services ( r = 0.27, p < 0.0001) and QOL ( r = 0.51, p < 0.0001). A negative correlation was found between community reintegration and caregiver strain ( r = -0.37, p < 0.0001). Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.

  6. Delayed celiac disease diagnosis predisposes to reduced quality of life and incremental use of health care services and medicines: A prospective nationwide study

    PubMed Central

    Fuchs, Valma; Kurppa, Kalle; Huhtala, Heini; Mäki, Markku; Kekkonen, Leila; Kaukinen, Katri

    2018-01-01

    Background Celiac disease is challenging to recognize, predisposing to long diagnostic delay. Currently, associated factors and significance of the delay remain obscure. Objective The objective of this article is to investigate associated sociodemographic risk factors and health consequences of diagnostic delay in celiac disease. Methods Altogether 611 patients were surveyed at diagnosis and after one year on a gluten-free diet regarding sociodemographic variables, well-being and use of medicines and health care services. Quality of life was measured by a validated Psychological General Well-Being (PGWB) questionnaire. The results were compared between patients with and without delayed (≥3 years) diagnosis. Results A total of 332 (54%) individuals reported a delay of ≥3 years. Associated with the delay were being a student or homemaker, but not gender, marital or occupational status, site of diagnosis or place of residence. Patients with the delay also had decreased self-perceived health and poorer PGWB scores compared to those without delay; in anxiety and general health this was seen even on a gluten-free diet. Days of sickness and doctor visits as well as use of drugs for dyspepsia and antidepressants were increased in the delay group both before and after diagnosis. Conclusion A delay in celiac disease diagnosis predisposes to reduced well-being and incremental use of medicines and health care services, both before diagnosis and one year after diagnosis. PMID:29881612

  7. Middle life crisis and industrial workers.

    PubMed

    Shwed, H

    1979-11-01

    Psychiatric consultation with a large utility company has uncovered a unique manifestation of the middle life syndrome. Employees with 20 or more years of service, referred to our psychiatric group, have in common such issues as "institutional transference," unfulfilled employee vocational dreams and fantasies, with concurrent inability to adjust to technological, geographical and personnel changes. The author suggests personnel programs and policies which might help to deal preventively with these problems before employees reach middle life. Methods are suggested in which corporation changes might be more sensitively instituted to meet the psychological needs of employees.

  8. Estimation of Life-Year Loss and Lifetime Costs for Different Stages of Colon Adenocarcinoma in Taiwan

    PubMed Central

    Chen, Po-Chuan; Lee, Jenq-Chang; Wang, Jung-Der

    2015-01-01

    Backgrounds and aims Life-expectancy of colon cancer patients cannot be accurately answered due to the lack of both large datasets and long-term follow-ups, which impedes accurate estimation of lifetime cost to treat colon cancer patients. In this study, we applied a method to estimate life-expectancy of colon cancer patients in Taiwan and calculate the lifetime costs by different stages and age groups. Methods A total of 17,526 cases with pathologically verified colon adenocarcinoma between 2002 and 2009 were extracted from Taiwan Cancer Registry database for analysis. All patients were followed-up until the end of 2011. Life-expectancy, expected-years-of-life-lost and lifetime costs were estimated, using a semi-parametric survival extrapolation method and borrowing information from life tables of vital statistics. Results Patients with more advanced stages of colon cancer were generally younger and less co-morbid with major chronic diseases than those with stages I and II. The LE of stage I was not significantly different from that of the age- and sex-matched general population, whereas those of stages II, III, and IV colon cancer patients after diagnosis were 16.57±0.07, 13.35±0.07, and 4.05±0.05 years, respectively; the corresponding expected-years-of-life-lost were 1.28±0.07, 5.93±0.07 and 16.42±0.06 years, significantly shorter than the general population after accounting for lead time bias. Besides, the lifetime cost of managing stage II colon cancer patients would be US $8,416±1939, 14,334±1,755, and 21,837±1,698, respectively, indicating a big saving for early diagnosis and treatment after stratification for age and sex. Conclusions Treating colon cancer at younger age and earlier stage saves more life-years and healthcare costs. Future studies are indicated to apply these quantitative results into the cost-effectiveness evaluation of screening program for colon cancers. PMID:26207912

  9. A service life extension (SLEP) approach to operating aging aircraft beyond their original design lives

    NASA Astrophysics Data System (ADS)

    Pentz, Alan Carter

    With today's uncertain funding climate (including sequestration and continuing budget resolutions), decision makers face severe budgetary challenges to maintain dominance through all aspects of the Department of Defense (DoD). To meet war-fighting capabilities, the DoD continues to extend aircraft programs beyond their design service lives by up to ten years, and occasionally much more. The budget requires a new approach to traditional extension strategies (i.e., reuse, reset, and reclamation) for structural hardware. While extending service life without careful controls can present a safety concern, future operations planning does not consider how much risk is present when operating within sound structural principles. Traditional structural hardware extension methods drive increased costs. Decision makers often overlook the inherent damage tolerance and fatigue capability of structural components and rely on simple time- and flight-based cycle accumulation when determining aircraft retirement lives. This study demonstrates that decision makers should consider risk in addition to the current extension strategies. Through an evaluation of eight military aircraft programs and the application and simulation of F-18 turbine engine usage data, this dissertation shows that insight into actual aircraft mission data, consideration of fatigue capability, and service extension length are key factors to consider. Aircraft structural components, as well as many critical safety components and system designs, have a predefined level of conservatism and inherent damage tolerance. The methods applied in this study would apply to extensions of other critical structures such as bridges. Understanding how much damage tolerance is built into the design compared to the original design usage requirements presents the opportunity to manage systems based on risk. The study presents the sensitivity of these factors and recommends avenues for further research.

  10. [Changes in average life span of monks and nuns in Poland in the years 1950-2000].

    PubMed

    Jenner, Bartosz

    2002-01-01

    The aim of the research was to find out if healthy lifestyle influences the longevity. The group of 906 monks and 866 nuns who worked and died in Poland in the years 1950-2000 was regarded as people who conducted a healthy lifestyle. The population of adult Poles was chosen as a control group. As a result of the research it is reported that: 1) since 1950 till middle 1960's people in monasteries lived shorter than adult Poles [in the first ten years of the research the average life span of monks was 2.4 years shorter (t162 = 1.99, p = 0.047) and nuns lived 9 years shorter (t56 = 4.2, p < 0.001)], since the middle of 1970's till the end of 1980's the group in question lived as long as the general population, finally, for the last ten years of the investigated period of time people in monasteries lived longer [monks 2.5 (t219 = 2.5, p < 0.05), nuns 2.9 years longer (t209 = 4.6, p < 0.001)]; 2) since 1950's till 2000 the average life span in the investigated group of both sexes was increasing at the rate of 0.175 (t98 = 3.9, p < 0.001) years per calendar year greater than this value in the general population and there is no reason to assume that there have been differences between sexes; 3) as far as men are concerned, joining a monastery in the case of man enter into the monastery a year earlier prolongs life for about 0.1 year (F1,842 = 3.8, P one side test = 0.026). In case of women this relation was not significant (F1,804 < 0.1). The shorter life of people in monasteries after the second world war might be interpreted as a result of their socio-political situation at that time. In the course of time their standard of living and the access to medical treatment has been improving gradually, so their longevity is increasing faster. In the context of the investigated problem the most important results were obtained from the last ten years. These results indicate that healthy lifestyle prolongs life.

  11. Statistical Annex to Employee Training in the Federal Service, Fiscal Year 1968.

    ERIC Educational Resources Information Center

    Civil Service Commission, Washington, DC. Bureau of Training.

    Tables in this statistical supplement are based on data submitted by Federal agencies in their annual training report to the Civil Service Commission for Fiscal Year 1968 (see document AC 004 019). The first table (Tab A) summarizes all training activity and expenditures for the year, with data arranged by occupational levels (GS01-04 through GS…

  12. Service-Learning in a One-Year Alternative Route to Teacher Certification: A Powerful Multicultural Teaching Tool

    ERIC Educational Resources Information Center

    Brown, Elinor L.

    2005-01-01

    This five-year study examined the effectiveness of an innovative approach to service-learning embedded in a one year site-based alternative route to teacher certification. The ten-week school-based study investigated the influence of service-learning on the multicultural perceptions, cross-cultural communication skills, and social justice…

  13. Development of a state-wide pediatric palliative care service in Australia: referral and outcomes over two years.

    PubMed

    Herbert, Anthony; Bradford, Natalie; Donovan, Leigh; Pedersen, Lee-Anne; Irving, Helen

    2014-03-01

    Pediatric palliative care is an evolving specialty that aims to improve the lives of children with a life-limiting condition. As an emerging specialty, there is much to be learned about service provision and the expected outcomes that can be achieved. Additionally, quantification of the needs for pediatric palliative care is complicated by the uncertainty of defining the population that requires care. Our aim was to define the characteristics of the population cared for by a newly formed state-wide service in Queensland, Australia, and describe the development of the service over a 24-month period. Data on all referrals and outcomes were collected. Descriptive statistics were used to describe patterns including the variation in outcomes between children with oncology and non-oncology diagnoses. Other factors influencing the development of the service including involved health professionals and the model of the Australian health care system are also described. Over a 24-month period, 150 patients were referred of whom 117 subsequently died. There was a wide range of diseases and ages, and significantly, 58% of children were from regional or rural locations where there are can be limited access to specialist pediatric services. The average length of service was 83 days. A variety of factors were identified as being important for providing optimal care including ensuring equity in access, timing of referral, and continuity of care. The importance of a population-based approach to pediatric palliative care in a state that is geographically large and diverse like Queensland is highlighted. This article may provide valuable information to other health care providers who care for children with life-limiting illnesses.

  14. Vaccinations in the first year of life and risk of atopic disease - Results from the KiGGS study.

    PubMed

    Schlaud, Martin; Schmitz, Roma; Poethko-Müller, Christina; Kuhnert, Ronny

    2017-09-12

    The study focused on the question of whether and - if so - to what direction and extent immunisations in the 1st year may be associated with the risk of being diagnosed with atopic diseases after the 1st year of life. Data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, 2003-2006) were analysed. For analyses of potential associations between vaccination status and risk of hay fever, atopic dermatitis or asthma, sample sizes of 15254, 14297, and 15262, respectively, were available. Children with a sufficient TDPHiHeP vaccination at the end of the 1st year of life had a lower risk of being diagnosed with hay fever after the 1st year of life (adjusted prevalence ratio 0.85, 95% confidence interval 0.76-0.96). Analyses for associations between TDPHiHeP vaccination and risk of atopic dermatitis or asthma, or between age at onset of vaccination or of the number of antigens vaccinated in the 1st year of life and risk of atopic disease failed to yield statistical significance. Our results provide no evidence that immunisations in the 1st year of life may increase the risk of atopic disease. If any association exists at all, our results may be interpreted as weakly supportive of the hypothesis that immunisations may slightly decrease the risk of atopy in later life. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  16. Quality of life in people with mental illness in non-residential community mental health services in Hong Kong.

    PubMed

    Ng, P; Pan, J Y; Lam, P; Leung, A

    2014-06-01

    To identify the subjective quality of life in people with chronic mental health problems who were in non-residential community mental health services, and to investigate factors affecting their quality of life after the illness. People with mental illness (n = 105) were recruited. They were assessed with the self-rated Hong Kong Chinese version of the World Health Organization Quality of Life Brief questionnaire. The participants had lower total quality-of-life and the 4 domain scores of the questionnaire than the general population. They were particularly dissatisfied with their financial situation. Duration of illness was positively correlated with subjective quality-of-life variables while age at onset of the mental illness was negatively correlated with subjective quality of life, in particular the physical health, psychological health, and environmental domains. This study highlighted the significance of duration and age at onset of illness in subjective quality of life of people with mental illness. A longitudinal study to test the causal relationships between these factors and the quality of life in people with mental illness is recommended.

  17. Predictors of Undergraduate Students' University Support Service Use during the First Year of University

    ERIC Educational Resources Information Center

    Julal, F. S.

    2016-01-01

    University support services can be a beneficial resource for students coping with personal stressors. This study investigated the predictors of service use by undergraduate students during their first year at university. Participants completed self-report measures of problem-solving effectiveness, psychological distress and perceived social…

  18. 77 FR 58104 - Availability of the Fiscal Year 2011 Inventory of Contracts for Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... Director, Defense Procurement and Acquisition Policy, Contract Policy and International Contracting (DPAP... Contracts for Services AGENCY: Department of Defense (DoD). ACTION: Notice of availability. SUMMARY: DoD announces the availability of the Inventory of Contracts for Services for Fiscal Year 2011 pursuant to...

  19. 20 CFR 1002.101 - Does the five-year service limit include periods of service that the employee performed when he...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Does the five-year service limit include... Section 1002.101 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS' EMPLOYMENT AND...-year period runs as to each employer independently, even if those employers share or co-determine the...

  20. Accounting for ecosystem services in Life Cycle Assessment, Part II: toward an ecologically based LCA.

    PubMed

    Zhang, Yi; Baral, Anil; Bakshi, Bhavik R

    2010-04-01

    Despite the essential role of ecosystem goods and services in sustaining all human activities, they are often ignored in engineering decision making, even in methods that are meant to encourage sustainability. For example, conventional Life Cycle Assessment focuses on the impact of emissions and consumption of some resources. While aggregation and interpretation methods are quite advanced for emissions, similar methods for resources have been lagging, and most ignore the role of nature. Such oversight may even result in perverse decisions that encourage reliance on deteriorating ecosystem services. This article presents a step toward including the direct and indirect role of ecosystems in LCA, and a hierarchical scheme to interpret their contribution. The resulting Ecologically Based LCA (Eco-LCA) includes a large number of provisioning, regulating, and supporting ecosystem services as inputs to a life cycle model at the process or economy scale. These resources are represented in diverse physical units and may be compared via their mass, fuel value, industrial cumulative exergy consumption, or ecological cumulative exergy consumption or by normalization with total consumption of each resource or their availability. Such results at a fine scale provide insight about relative resource use and the risk and vulnerability to the loss of specific resources. Aggregate indicators are also defined to obtain indices such as renewability, efficiency, and return on investment. An Eco-LCA model of the 1997 economy is developed and made available via the web (www.resilience.osu.edu/ecolca). An illustrative example comparing paper and plastic cups provides insight into the features of the proposed approach. The need for further work in bridging the gap between knowledge about ecosystem services and their direct and indirect role in supporting human activities is discussed as an important area for future work.

  1. Capitation of public mental health services in Colorado: a five-year follow-up of system-level effects.

    PubMed

    Bloom, Joan R; Wang, Huihui; Kang, Soo Hyang; Wallace, Neal T; Hyun, Jenny K; Hu, Teh-wei

    2011-02-01

    Capitated Medicaid mental health programs have reduced costs over the short term by lowering the utilization of high-cost inpatient services. This study examined the five-year effects of capitated financing in community mental health centers (CMHCs) by comparing not-for-profit with for-profit programs. Data were from the Medicaid billing system in Colorado for the precapitation year (1994) and a shadow billing system for the postcapitation years (1995-1999). In a panel design, a random-effect approach estimated the impact of two financing systems on service utilization and cost while adjusting for all the covariates. Consistent with predictions, in both the for-profit and the not-for-profit CMHCs, relative to the precapitation year, there were significant reductions in each postcapitation year in high-cost treatments (inpatient treatment) for all but one comparison (not-for-profit CMHCs in 1999). Also consistent with predictions, the for-profit programs realized significant reductions in cost per user for both outpatient services and total services. In the not-for-profit programs, there were no significant changes in cost per user for total services; a significant reduction in cost per user for outpatient services was found only in the first two years, 1995 and 1996). The evidence suggests that different strategies were used by the not-for-profit and for-profit programs to control expenditures and utilization and that the for-profit programs were more successful in reducing cost per user.

  2. Fee-for-service cancer rehabilitation programs improve health-related quality of life.

    PubMed

    Kirkham, A A; Neil-Sztramko, S E; Morgan, J; Hodson, S; Weller, S; McRae, T; Campbell, K L

    2016-08-01

    Rigorously applied exercise interventions undertaken in a research setting result in improved health-related quality of life (hrqol) in cancer survivors, but research to demonstrate effective translation of that research to practice is needed. The objective of the present study was to determine the effect of fee-for-service cancer rehabilitation programs in the community on hrqol and on self-reported physical activity and its correlates. After enrolment and 17 ± 4 weeks later, new clients (n = 48) to two fee-for-service cancer rehabilitation programs completed the 36-Item Short Form Health Survey (rand-36: rand Corporation, Santa Monica, CA, U.S.A.), the Godin Leisure-Time Exercise Questionnaire, and questions about physical activity correlates. Normal fee-for-service operations were maintained, including a fitness assessment and individualized exercise programs supervised in a group or one-on-one setting, with no minimum attendance required. Fees were associated with the assessment and with each exercise session. Of the 48 participants, 36 (75%) completed both questionnaires. Improvements in the physical functioning, role physical, pain, and energy/fatigue scales on the rand-36 exceeded minimally important differences and were of a magnitude similar to improvements reported in structured, rigorously applied, and free research interventions. Self-reported levels of vigorous-intensity (p = 0.021), but not moderate-intensity (p = 0.831) physical activity increased. The number of perceived barriers to exercise (p = 0.035) and the prevalence of fatigue as a barrier (p = 0.003) decreased. Exercise self-efficacy improved only in participants who attended 11 or more sessions (p = 0.002). Exercise enjoyment did not change (p = 0.629). Enrolment in fee-for-service cancer rehabilitation programs results in meaningful improvements in hrqol comparable to those reported by research interventions, among other benefits. The fee-for-service model could be an effective model for

  3. How Useful Are Skeletal Surveys in the Second Year of Life?

    ERIC Educational Resources Information Center

    Hansen, Karen Kirhofer; Campbell, Kristine A.

    2009-01-01

    Objective: To evaluate the utility of skeletal surveys in cases of possible physical abuse in the second year of life. Methods: Radiology records for all children under 24 months of age referred to our child protection team from January 2002 through November 2006, who had a skeletal survey performed and/or interpreted by the pediatric radiologists…

  4. Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences.

    PubMed

    Martín-Fernández, Jesus; Polentinos-Castro, Elena; del Cura-González, Ma Isabel; Ariza-Cardiel, Gloria; Abraira, Victor; Gil-LaCruz, Ana Isabel; García-Pérez, Sonia

    2014-07-03

    This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject's self-evaluation, and through lottery games. Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when "out of pocket" payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results. WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning.

  5. Assessing the impact of care farms on quality of life and offending: a pilot study among probation service users in England.

    PubMed

    Elsey, Helen; Farragher, Tracey; Tubeuf, Sandy; Bragg, Rachel; Elings, Marjolein; Brennan, Cathy; Gold, Rochelle; Shickle, Darren; Wickramasekera, Nyantara; Richardson, Zoe; Cade, Janet; Murray, Jenni

    2018-03-17

    To assess the feasibility of conducting a cost-effectiveness study of using care farms (CFs) to improve quality of life and reduce reoffending among offenders undertaking community orders (COs). To pilot questionnaires to assess quality of life, connection to nature, lifestyle behaviours, health and social-care use. To assess recruitment and retention at 6 months and feasibility of data linkage to Police National Computer (PNC) reconvictions data and data held by probation services. Pilot study using questionnaires to assess quality of life, individually linked to police and probation data. The pilot study was conducted in three probation service regions in England. Each site included a CF and at least one comparator CO project. CFs are working farms used with a range of clients, including offenders, for therapeutic purposes. The three CFs included one aquaponics and horticulture social enterprise, a religious charity focusing on horticulture and a family-run cattle farm. Comparator projects included sorting secondhand clothes and activities to address alcohol misuse and anger management. We recruited 134 adults (over 18) serving COs in England, 29% female. 52% of participants completed follow-up questionnaires. Privatisation of UK probation trusts in 2014 negatively impacted on recruitment and retention. Linkage to PNC data was a more successful means of follow-up, with 90% consenting to access their probation and PNC data. Collection of health and social-care costs and quality-adjusted life year derivation were feasible. Propensity score adjustment provided a viable comparison method despite differences between comparators. We found worse health and higher reoffending risk among CF participants due to allocation of challenging offenders to CFs, making risk of reoffending a confounder. Recruitment would be feasible in a more stable probation environment. Follow-up was challenging; however, assessing reconvictions from PNC data is feasible and a potential primary

  6. Coping Trajectories in Later Life: A 20-Year Predictive Study

    PubMed Central

    Brennan, Penny L.; Holland, Jason M.; Schutte, Kathleen K.; Moos, Rudolf H.

    2012-01-01

    Objectives and Method Information about aging-related change in coping is limited mainly to results of cross-sectional studies of age differences in coping, and no research has focused on predictors of aging-related change in coping behavior. To extend research in this area, we used longitudinal multilevel modeling to describe older adults’ (n=719; baseline M=61 years) 20-year, intra-individual approach and avoidance coping trajectories, and to determine the influence of two sets of predictors (threat appraisal and stressor characteristics; gender and baseline personal and social resources) on level and rate of change in these trajectories. Results Over the 20-year study interval participants declined in use of approach coping and most avoidance coping strategies, but there was significant variation in this trend. In simultaneous predictive models, female gender, more threat appraisal, stressor severity, social resources, and depressive symptoms; and fewer financial resources, were independently associated with higher initial levels of coping responses. Having more social resources, and fewer financial resources, at baseline in late-middle-age predicted faster decline over time in approach coping. Having more baseline depressive symptoms, and fewer baseline financial resources, hastened decline in use of avoidance coping. Independent of other variables in these models, decline over time in approach coping and avoidance coping remained statistically significant. Conclusion Overall decline in coping may be a normative pattern of coping change in later life. However, it also is modifiable by older adults’ stressor appraisals, their stressors, and the personal and social resources they possess at entry to later life, in late-middle age. PMID:22394319

  7. Twelve-year history of late-life depression and subsequent feelings to God.

    PubMed

    Braam, Arjan W; Schaap-Jonker, Hanneke; van der Horst, Marleen H L; Steunenberg, Bas; Beekman, Aartjan T F; van Tilburg, Willem; Deeg, Dorly J H

    2014-11-01

    Growing evidence shows several possible relations between religiousness and late-life depression. Emotional aspects of religiousness such as facets of the perceived relationship with God can be crucial in this connection. The aim of the current study was to examine the association between the course of late-life depression and feelings about God and religious coping. Longitudinal survey study; naturalistic; 12-year follow-up. Longitudinal Aging Study Amsterdam; population-based, in three regions in The Netherlands. A subsample of 343 respondents (mean age: 77.2 years), including all respondents with high levels of depressive symptoms at any measurement cycle between 1992 and 2003 (assessed by using the Center for Epidemiologic Studies Depression Scale and the Diagnostic Interview Schedule) and a random sample of nondepressed respondents who completed a postal questionnaire in 2005. Scales on God Image and Religious Coping. Twelve-year depression course trajectories serve as predicting variables and are specified according to recency and seriousness. Persistent and emergent depression are significantly associated with fear of God, feeling wronged by God, and negative religious coping. In terms of negative religious coping, significant associations were observed after adjustment for concurrent depression with a history of repeated minor depression and previous major depression. Late-life depression seems to maintain a pervasive relationship over time with affective aspects of religiousness. Religious feelings may parallel the symptoms of anhedonia or a dysphoric mood and could represent the experience of an existential void. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. A Plasma Reactor for the Synthesis of High-Temperature Materials: Electro Thermal, Processing and Service Life Characteristics

    NASA Astrophysics Data System (ADS)

    Galevskiy, G. V.; Rudneva, V. V.; Galevskiy, S. G.; Tomas, K. I.; Zubkov, M. S.

    2016-08-01

    The three-jet direct-flow plasma reactor with a channel diameter of 0.054 m was studied in terms of service life, thermal, technical, and functional capabilities. It was established that the near-optimal combination of thermal efficiency, required specific enthalpy of the plasma-forming gas and its mass flow rate is achieved at a reactor power of 150 kW. The bulk temperature of plasma flow over the rector of 12 gauges long varies within 5500÷3200 K and the wall temperature within 1900÷850 K, when a cylinder from zirconium dioxide of 0.005 m thick is used to thermally insulate the reactor. The specific electric power reaches a high of 1214 MW/m3. The rated service life of electrodes is 4700 hours for a copper anode and 111 hours for a tungsten cathode. The projected contamination of carbides and borides with elec-trode-erosion products doesn't exceed 0.0001% of copper and 0.00002% of tungsten.

  9. Use of health services in the last year of life and cause of death in people with intellectual disability: a retrospective matched cohort study

    PubMed Central

    Spilsbury, Katrina; Rosenwax, Lorna; Semmens, James

    2018-01-01

    Objective To describe the cause of death together with emergency department presentations and hospital admissions in the last year of life of people with intellectual disability. Method A retrospective matched cohort study using de-identified linked data of people aged 20 years or over, with and without intellectual disability who died during 2009 to 2013 in Western Australia. Emergency department presentations and hospital admissions in the last year of life of people with intellectual disability are described along with cause of death. Results Of the 63 508 deaths in Western Australia from 2009 to 2013, there were 591 (0.93%) decedents with a history of intellectual disability. Decedents with intellectual disability tended to be younger, lived in areas of more social disadvantage, did not have a partner and were Australian born compared with all other decedents. A matched comparison cohort of decedents without intellectual disability (n=29 713) was identified from the general population to improve covariate balance. Decedents with intellectual disability attended emergency departments more frequently than the matched cohort (mean visits 3.2 vs 2.5) and on average were admitted to hospital less frequently (mean admissions 4.1 vs 6.1), but once admitted stayed longer (average length of stay 5.2 days vs 4.3 days). People with intellectual disability had increased odds of presentation, admission or death from conditions that have been defined as ambulatory care sensitive and are potentially preventable. These included vaccine-preventable respiratory disease, asthma, cellulitis and convulsions and epilepsy. Conclusion People with intellectual disability were more likely to experience potentially preventable conditions at the end of their lives. This indicates a need for further improvements in access, quality and coordination of healthcare to provide optimal health for this group. PMID:29478966

  10. Age of Migration Differentials in Life Expectancy with Cognitive Impairment: 20-Year Findings From the Hispanic-EPESE.

    PubMed

    Garcia, Marc A; Saenz, Joseph L; Downer, Brian; Chiu, Chi-Tsun; Rote, Sunshine; Wong, Rebeca

    2017-05-09

    To examine differences in life expectancy with cognitive impairment among older Mexican adults according to nativity (U.S.-born/foreign-born) and among immigrants, age of migration to the United States. This study employs 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to estimate the proportion of life spent cognitively healthy and cognitively impaired prior to death among older Mexican adults residing in the southwestern United States. We combine age-specific mortality rates with age-specific prevalence of cognitive impairment, defined as a Mini-Mental Status Exam score of less than 21 points to calculate Sullivan-based life table models with and without cognitive impairment in later life. Foreign-born Mexican immigrants have longer total life expectancy and comparable cognitive healthy life expectancy regardless of gender compared to U.S.-born Mexican-Americans. However, the foreign-born spend a greater number of years after age 65 with cognitive impairment relative to their U.S.-born counterparts. Furthermore, we document an advantage in life expectancy with cognitive impairment and proportion of years after age 65 cognitively healthy among mid-life immigrant men and women relative to early- and late-life migrants. The relationship between nativity, age of migration, and life expectancy with cognitive impairment means that the foreign-born are in more need of support and time-intensive care in late life. This issue merits special attention to develop appropriate and targeted screening efforts that reduce cognitive decline for diverse subgroups of older Mexican-origin adults as they age. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Dietary patterns in relation to quality-adjusted life years in the EPIC-NL cohort.

    PubMed

    Fransen, Heidi P; Beulens, Joline W J; May, Anne M; Struijk, Ellen A; Boer, Jolanda M A; de Wit, G Ardine; Onland-Moret, N Charlotte; van der Schouw, Yvonne T; Bueno-de-Mesquita, H Bas; Hoekstra, Jeljer; Peeters, Petra H M

    2015-08-01

    Dietary patterns have been associated with the incidence or mortality of individual non-communicable diseases, but their association with disease burden has received little attention. The aim of our study was to relate dietary patterns to health expectancy using quality-adjusted life years (QALYs) as outcome parameter. Data from the EPIC-NL study were used, a prospective cohort study of 33,066 healthy men and women aged 20-70 years at recruitment. A lifestyle questionnaire and a validated food frequency questionnaire were administered at study entry (1993-1997). Five dietary patterns were studied: three a priori patterns (the modified Mediterranean Diet Score (mMDS), the WHO-based Healthy Diet Indicator (HDI) and the Dutch Healthy Diet index (DHD-index)) and two a posteriori data-based patterns. QALYs were used as a summary health measure for healthy life expectancy, combining a person's life expectancy with a weight reflecting loss of quality of life associated with having chronic diseases. The mean QALYs of the participants were 74.9 (standard deviation 4.4). A higher mMDS and HDI were associated with a longer life in good health. Participants who had a high mMDS score (6-9) had 0.17 [95% CI, 0.05; 0.30] more QALYs than participants with a low score (0-3), equivalent to two months longer life in good health. Participants with a high HDI score also had more QALYs (0.15 [95% CI, 0.03; 0.27]) than participants with a low HDI score. A Mediterranean-type diet and the Healthy Diet Indicator were associated with approximately 2months longer life in good health. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Predicting use of case management support services for adolescents and adults living in community following brain injury: A longitudinal Canadian database study with implications for life care planning

    PubMed Central

    Baptiste, B.; Dawson, D.R.; Streiner, D.

    2015-01-01

    Abstract OBJECTIVE: To determine factors associated with case management (CM) service use in people with traumatic brain injury (TBI), using a published model for service use. DESIGN: A retrospective cohort, with nested case-control design. Correlational and logistic regression analyses of questionnaires from a longitudinal community data base. STUDY SAMPLE: Questionnaires of 203 users of CM services and 273 non-users, complete for all outcome and predictor variables. Individuals with TBI, 15 years of age and older. Out of a dataset of 1,960 questionnaires, 476 met the inclusion criteria. METHODOLOGY: Eight predictor variables and one outcome variable (use or non-use of the service). Predictor variables considered the framework of the Behaviour Model of Health Service Use (BMHSU); specifically, pre-disposing, need and enabling factor groups as these relate to health service use and access. RESULTS: Analyses revealed significant differences between users and non-users of CM services. In particular, users were significantly younger than non-users as the older the person the less likely to use the service. Also, users had less education and more severe activity limitations and lower community integration. Persons living alone are less likely to use case management. Funding groups also significantly impact users. CONCLUSIONS: This study advances an empirical understanding of equity of access to health services usage in the practice of CM for persons living with TBI as a fairly new area of research, and considers direct relevance to Life Care Planning (LCP). Many life care planers are CM and the genesis of LCP is CM. The findings relate to health service use and access, rather than health outcomes. These findings may assist with development of a modified model for prediction of use to advance future cost of care predictions. PMID:26409333

  13. Predicting use of case management support services for adolescents and adults living in community following brain injury: A longitudinal Canadian database study with implications for life care planning.

    PubMed

    Baptiste, B; Dawson, D R; Streiner, D

    2015-01-01

    To determine factors associated with case management (CM) service use in people with traumatic brain injury (TBI), using a published model for service use. A retrospective cohort, with nested case-control design. Correlational and logistic regression analyses of questionnaires from a longitudinal community data base. Questionnaires of 203 users of CM services and 273 non-users, complete for all outcome and predictor variables. Individuals with TBI, 15 years of age and older. Out of a dataset of 1,960 questionnaires, 476 met the inclusion criteria. Eight predictor variables and one outcome variable (use or non-use of the service). Predictor variables considered the framework of the Behaviour Model of Health Service Use (BMHSU); specifically, pre-disposing, need and enabling factor groups as these relate to health service use and access. Analyses revealed significant differences between users and non-users of CM services. In particular, users were significantly younger than non-users as the older the person the less likely to use the service. Also, users had less education and more severe activity limitations and lower community integration. Persons living alone are less likely to use case management. Funding groups also significantly impact users. This study advances an empirical understanding of equity of access to health services usage in the practice of CM for persons living with TBI as a fairly new area of research, and considers direct relevance to Life Care Planning (LCP). Many life care planers are CM and the genesis of LCP is CM. The findings relate to health service use and access, rather than health outcomes. These findings may assist with development of a modified model for prediction of use to advance future cost of care predictions.

  14. Health-related quality of life two years after injury due to terrorism.

    PubMed

    Tuchner, Maya; Meiner, Zeev; Parush, Shula; Hartman-Maeir, Adina

    2010-01-01

    During the past few decades, terrorist acts have been an unfortunate reality worldwide. There is a striking paucity of research investigating the multitude of long-term outcomes after severe physical injury due to terrorist attacks, a unique subgroup of trauma patients. The purpose of this study was to provide a profile of the long-term health-related quality of life (HR-QOL) after injury due to terrorist attacks and to explore the relationships between Post Traumatic Stress Disorder (PTSD), occupational status and injury severity with HR-QOL. We included 35 survivors of terrorist attacks living in the community, two years on average after the injury, mean age at follow-up = 32.1 (±13.8), mean Injury Severity Score (ISS) = 27 (±14.2). The subjects were recruited from consecutive admissions to a rehabilitation department in a tertiary care center between September 2000 - June 2004. Most of the subjects suffered multiple trauma. The main outcome measures were the Short-Form Health Survey (SF-36), Post Traumatic Diagnostic Scale and return to work rates. The mean scores on 6/8 of the SF-36 subscales were significantly lower among the survivors compared to normative population norms. Post Traumatic Stress Disorder (PTSD) was found in 39% of the sample and 43% did not resume their main occupation two years after the injury. Multivariate analysis of variance of PTSD and occupational status (returned vs. did not return to work) on quality of life scores revealed significant main effects for both PTSD (p=. 000) and occupational status (p=. 005) with no interaction effect (p=. 476). No significant correlations were found between injury severity and the SF-36 scores. This study demonstrated the long-term impact of injury due to terrorism. Results showed independent effects of PTSD and occupational status on health related quality of life, two years after injury. These findings suggest that this group may benefit from intervention focusing on their emotional and

  15. Cycles of adaptive strategies over the life course.

    PubMed

    Cooper, Margaret; Bigby, Christine

    2014-01-01

    An increasing number of Australia's ageing population are aging with long-term physical impairments. This study explored the life experiences of this group using a qualitative approach. In-depth interviews were conducted with 10 disabled Victorians, aged between 51 and 84 years, and an inductive thematic analysis undertaken. A relationship was found between the adaptive strategies that participants developed as they moved through life phases and the impairment stages. The implications of the emergence of a cyclical process of adaptation across the life course. and particularly in respect of aging, delivery of aged-care services and social workers in this sector are discussed.

  16. Emergency Medical Services Providers' Perspective of End-of-Life Decision Making for People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    McGinley, Jacqueline; Waldrop, Deborah P.; Clemency, Brian

    2017-01-01

    Background: Emergency medical services (EMS) providers are often called to rapidly determine and act upon patients' wishes for end-of-life care. People with intellectual disabilities are living increasingly longer with complex conditions leading to international calls for person-centred advance care planning. Yet, best estimates suggest that very…

  17. The Role of Morbidity for Proxy-Reported Well-Being in the Last Year of Life

    ERIC Educational Resources Information Center

    Gerlach, Katharina; Ram, Nilam; Infurna, Frank J.; Vogel, Nina; Wagner, Gert G.; Gerstorf, Denis

    2017-01-01

    Late-life well-being often shows steep deteriorations, but the contributing factors are not well understood, in part because data about people's final year of life are scarce. Here, we draw from and test theoretical perspectives that health-related vulnerabilities undermine the experience and skills older adults typically use to maintain…

  18. Quality of life among older stroke patients in Taiwan during the first year after discharge.

    PubMed

    Shyu, Yea-Ing L; Maa, Suh-Hwa; Chen, Sien-Tsong; Chen, Min-Chi

    2009-08-01

    To explore the one-year poststroke trajectories in health-related quality of life and physical function in a sample of older stroke patients in Taiwan. Health-related quality of life has repeatedly been reported as decreased in poststroke patients. The vast majority of information on the health-related quality of life of older patients after stroke is based on data collected in Western developed countries. In contrast, little is known about older stroke patients in Asian countries. A descriptive, prospective and correlational design was used. Older stroke survivors (n = 98) were assessed at the end of one, three, six and 12 months after hospital discharge for health-related quality of life (measured by the Medical Outcomes Study Short Form 36) and physical functioning (measured by the Chinese Barthel Index and Instrumental Activities of Daily Living Scale). The subjects, who were 65-88 years old, performed considerably worse at 12 months after hospital discharge in social and physical functioning (means = 61.1, 54.8, respectively) than the age-matched community-dwelling norm (means = 78.7, 69.7, respectively). During the first year after discharge, subjects improved significantly on the Medical Outcomes Study Short Form 36 physical component summary scale and role limitations due to physical problems; during the first three months after discharge, they improved significantly on performance of activities of daily living and instrumental activities of daily living; and from the third to sixth month after discharge, they improved significantly in physical functioning. The first year, especially the first three months after hospital discharge, is critical for improvements in health-related quality of life and physical functioning for older stroke survivors in Taiwan. Older Taiwanese/Chinese people who suffer a stroke will likely benefit from interventions during the first 12 months after discharge and the most effective interventions may be earlier, during the first

  19. Unraveling the insight paradox: One-year longitudinal study on the relationships between insight, self-stigma, and life satisfaction among people with schizophrenia spectrum disorders.

    PubMed

    Chio, Floria H N; Mak, Winnie W S; Chan, Randolph C H; Tong, Alan C Y

    2018-01-30

    The promotion of insight among people with schizophrenia spectrum disorders has posed a dilemma to service providers as higher insight has been linked to positive clinical outcomes but negative psychological outcomes. The negative meaning that people attached to the illness (self-stigma content) and the recurrence of such stigmatizing thoughts (self-stigma process) may explain why increased insight is associated with negative outcomes. The present study examined how the presence of high self-stigma content and self-stigma process may contribute to the negative association between insight and life satisfaction. A total of 181 people with schizophrenia spectrum disorders were assessed at baseline. 130 and 110 participants were retained and completed questionnaire at 6-month and 1-year follow-up, respectively. Results showed that baseline insight was associated with lower life satisfaction at 6-month when self-stigma process or self-stigma content was high. Furthermore, baseline insight was predictive of better life satisfaction at 1-year follow-up when self-stigma process was low. Findings suggested that the detrimental effects of insight can be a result from both the presence of cognitive content and habitual process of self-stigma. Future insight promotion interventions should also address self-stigma content and process among people with schizophrenia spectrum disorders so as to maximize the beneficial effects of insight. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. [Healthy Life Years: a very promising indicator to be handled with caution].

    PubMed

    Zauli Sajani, Stefano; Battista, Alessandra; Frova, Luisa; Lauriola, Paolo

    2014-01-01

    In several public debates, scientific conferences and, recently, also in the scientific literature, some figures from EUROSTAT have been presented; they show a relevant decrease in the healthy life expectancy in Italy. This idea is based on the analysis of the trend of Healthy Life Years (HLY), an indicator synthesizing the grade of functional limitation of individuals based on the answers to a self-completed questionnaire. In particular, the dramatic decrease of HLY in Italy from 2005 to 2007 raised concerns. This paper analyses the reasons suggesting caution in interpreting these data considering first and foremost the changes across years in the formulation of questions and answers. Even though HLY and the other indicators selected by the European Union have a great potential in terms of communication and synthetic view, caution is needed in using these data and in drawing conclusions from figures and instruments of recent application that are still evolving.

  1. Mind the gap--reaching the European target of a 2-year increase in healthy life years in the next decade.

    PubMed

    Jagger, Carol; McKee, Martin; Christensen, Kaare; Lagiewka, Karolina; Nusselder, Wilma; Van Oyen, Herman; Cambois, Emmanuelle; Jeune, Bernard; Robine, Jean-Marie

    2013-10-01

    The European Innovation Partnership on Active and Healthy Ageing seeks an increase of two healthy life years (HLY) at birth in the EU27 for the next 10 years. We assess the feasibility of doing so between 2010 and 2020 and the differential impact among countries by applying different scenarios to current trends in HLY. Data comprised HLY and life expectancy (LE) at birth 2004-09 from Eurostat. We estimated HLY in 2010 in each country by multiplying the Eurostat projections of LE in 2010 by the ratio HLY/LE obtained either from country and sex-specific linear regression models of HLY/LE on year (seven countries retaining same HLY question) or extrapolating the average of HLY/LE in 2008 and 2009 to 2010 (20 countries and EU27). The first scenario continued these trends with three other scenarios exploring different HLY gap reductions between 2010 and 2020. The estimated gap in HLY in 2010 was 17.5 years (men) and 18.9 years (women). Assuming current trends continue, EU27 HLY increased by 1.4 years (men) and 0.9 years (women), below the European Innovation Partnership on Active and Healthy Ageing target, with the HLY gap between countries increasing to 18.3 years (men) and 19.5 years (women). To eliminate the HLY gap in 20 years, the EU27 must gain 4.4 HLY (men) and 4.8 HLY (women) in the next decade, which, for some countries, is substantially more than what the current trends suggest. Global targets for HLY move attention from inter-country differences and, alongside the current economic crisis, may contribute to increase health inequalities.

  2. Transition from children's to adult services for young adults with life-limiting conditions: A realist review of the literature.

    PubMed

    Kerr, Helen; Price, Jayne; Nicholl, Honor; O'Halloran, Peter

    2017-11-01

    Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children's to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts. To explain how intervention processes interact with contextual factors to help transition from children's to adult services for young adults with life-limiting conditions. Systematic realist review of the literature. Literature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers. Data were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools. 78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children's service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders. Early planning, collaboration between children's and adult service providers, and a focus on increasing the young adults' confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents

  3. Predictors of poststroke health-related quality of life in Nigerian stroke survivors: a 1-year follow-up study.

    PubMed

    Hamza, Ashiru Mohammad; Al-Sadat, Nabilla; Loh, Siew Yim; Jahan, Nowrozy Kamar

    2014-01-01

    This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.

  4. Supporting family carers providing end-of-life home care: a qualitative study on the impact of a hospice at home service.

    PubMed

    Jack, Barbara A; O'Brien, Mary R; Scrutton, Joyce; Baldry, Catherine R; Groves, Karen E

    2015-01-01

    To explore bereaved family carers' perceptions and experiences of a hospice at home service. The increasing demand for the development of home-based end-of-life services is not confined to the western world; such services are also emerging in resource-poor countries where palliative care services are developing with limited inpatient facilities. Despite this growing trend, studies show a variety of interrelated factors, with an emphasis on the availability of informal carers and their ability to cope, which can influence whether terminally ill patients actually remain at home. A hospice at home service was developed to meet patients' and families' needs by providing individually tailored resources. A qualitative study. Data were collected by semi-structured, digitally recorded interviews from 20 family carers who had experienced the service. Interviews were transcribed verbatim and a thematic approach adopted for analysis. All participants reported a personal positive impact of the service. Family carers commented the service provided a valued presence, they felt in good hands and importantly it helped in supporting normal life. The impact of an individualised, targeted, hospice at home service using dedicated, palliative care trained, staff, is perceived positively by family carers and importantly, supportive of those with additional caring or employment commitments. The emergence of hospice at home services has resulted in more options for patients and their families, when the increased amount of care a family member has to provide in these circumstances needs to be adequately supported, with the provision of a flexible service tailored to individual needs and delivered by appropriately trained staff. © 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

  5. Technology developments toward 30-year-life of photovoltaic modules

    NASA Technical Reports Server (NTRS)

    Ross, R. G., Jr.

    1984-01-01

    As part of the United States National Photovoltaics Program, the Jet Propulsion Laboratory's Flat-Plate Solar Array Project (FSA) has maintained a comprehensive reliability and engineering sciences activity addressed toward understanding the reliability attributes of terrestrial flat-plate photovoltaic arrays and to deriving analysis and design tools necessary to achieve module designs with a 30-year useful life. The considerable progress to date stemming from the ongoing reliability research is discussed, and the major areas requiring continued research are highlighted. The result is an overview of the total array reliability problem and of available means of achieving high reliability at minimum cost.

  6. Analysis of pharmacist-provided medication therapy management (MTM) services in community pharmacies over 7 years.

    PubMed

    Barnett, Mitchell J; Frank, Jessica; Wehring, Heidi; Newland, Brand; VonMuenster, Shannon; Kumbera, Patty; Halterman, Tom; Perry, Paul J

    2009-01-01

    Although community pharmacists have historically been paid primarily for drug distribution and dispensing services, medication therapy management (MTM) services evolved in the 1990s as a means for pharmacists and other providers to assist physicians and patients in managing clinical, service, and cost outcomes of drug therapy. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA 2003) and the subsequent implementation of Medicare Part D in January 2006 for the more than 20 million Medicare beneficiaries enrolled in the Part D benefit formalized MTM services for a subset of high-cost patients. Although Medicare Part D has provided a new opportunity for defining the value of pharmacist-provided MTM services in the health care system, few publications exist which quantify changes in the provision of pharmacist-provided MTM services over time. To (a) describe the changes over a 7-year period in the primary types of MTM services provided by community pharmacies that have contracted with drug plan sponsors through an MTM administrative services company, and (b) quantify potential MTM-related cost savings based on pharmacists' self-assessments of the likely effects of their interventions on health care utilization. Medication therapy management claims from a multistate MTM administrative services company were analyzed over the 7-year period from January 1, 2000, through December 31, 2006. Data extracted from each MTM claim included patient demographics (e.g., age and gender), the drug and type that triggered the intervention (e.g., drug therapeutic class and therapy type as either acute, intermittent, or chronic), and specific information about the service provided (e.g., Reason, Action, Result, and Estimated Cost Avoidance [ECA]). ECA values are derived from average national health care utilization costs, which are applied to pharmacist self-assessment of the "reasonable and foreseeable" outcome of the intervention. ECA values are updated

  7. Comparing the Life Cycle Energy Consumption, Global Warming and Eutrophication Potentials of Several Water and Waste Service Options

    EPA Science Inventory

    Managing the water-energy-nutrient nexus for the built environment requires, in part, a full system analysis of energy consumption, global warming and eutrophication potentials of municipal water services. As an example, we evaluated the life cycle energy use, greenhouse gas (GHG...

  8. Thermal degradation of fire-retardant -treated wood : predicting residual service life

    Treesearch

    Jerrold E. Winandy

    2001-01-01

    This paper presents a review of more than 10 years of research on the effects of fire-retardant treatments on wood properties and the potential of these treatments for in-service degradation when exposed to elevated temperatures. It presents an in-depth discussion of the findings and implications of a major wood engineering research program to assess the current...

  9. Service Use and Costs of Support 12 Years after Leaving Hospital

    ERIC Educational Resources Information Center

    Hallam, Angela; Beecham, Jennifer; Knapp, Martin; Carpenter, John; Cambridge, Paul; Forrester-Jones, Rachel; Tate, Alison; Coolen-Schrijner, Pauline; Wooff, David

    2006-01-01

    Background: There have been major changes in the provision and organization of services for people with intellectual disabilities in England over the last 30 years, particularly deinstitutionalization and the development of the mixed economy of care. The experiences of the people who participated in the Care in the Community Demonstration…

  10. Arkansas Public Higher Education Personal Services Recommendations: Fiscal Year 2010-2011

    ERIC Educational Resources Information Center

    Arkansas Department of Higher Education, 2010

    2010-01-01

    This publication lists non-classified personal services recommendations of the Arkansas Higher Education Coordinating Board for the Fiscal Year 2010-11. Due to the implementation of the pay plan study, the Office of Personnel Management of the Department of Finance and Administration (OPM) did not make recommendations for classified positions.…

  11. Self- and proxy reports of quality of life among adolescents living in residential youth care compared to adolescents in the general population and mental health services.

    PubMed

    Jozefiak, Thomas; Sønnichsen Kayed, Nanna

    2015-07-22

    Child welfare services are aimed at providing care and protection, fostering well-being and prosocial behaviour. Thus, Quality of Life (QoL) should be an important outcome measure in Residential Youth Care (RYC) institutions. However, the dearth of research in this area gives rise to serious concern. The present study is the first large scale, nationwide study assessing QoL among adolescents living in RYC. To provide a reference frame, adolescent self- and primary contact proxy reports were compared to the general population and to adolescent outpatients in Child and Adolescent Mental Health Service (CAMHS). Also, we investigated the association between self-report of QoL in adolescents living in RYC and proxy reports of their primary contacts at the institution. All residents between the ages of 12-23 years living in RYC in Norway were the inclusion criteria. Eighty-six RYC institutions (with 601 eligible youths) were included, 201 youths/ parents did not give their consent. Finally, 400 youths aged 12-20 years participated, yielding a response rate of 67%. As a reference frame for comparison, a general population (N = 1444) and an outpatient sample of adolescents in CAMHS (N = 68) were available. We used the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). General Linear Model analyses (ANCOVA) were conducted with five KINDL life domains as dependent variables and group as independent variable. Self- and proxy reports of QoL in adolescents living in RYC revealed a significantly (p < 0.001) poorer QoL compared to the general population on the life domains Physical- and Emotional well-being, Self-esteem, and relationship with Friends. Adolescents evaluated their physical well-being as worse compared to adolescents in CAHMS. Self- and proxy reports in RYC differed significantly on two of five life domains, but correlated low to moderate with each other. The results in this study raise major concerns about the poor Qo

  12. Years of potential life lost amongst heroin users in the Australian Treatment Outcome Study cohort, 2001-2015.

    PubMed

    Darke, Shane; Marel, Christina; Mills, Katherine L; Ross, Joanne; Slade, Tim; Tessson, Maree

    2016-05-01

    Heroin use carries the highest burden of disease of any drug of dependence. The study aimed to determine mortality rates of the Australian Treatment Outcome Study cohort over the period 2001-2015, and the years of potential life lost (YPLL). The cohort consisted of 615 heroin users. Crude mortality rates per 1000 person years (PY) and Standardised Mortality Ratios (SMR) were calculated. YPLL were calculated using two criteria: years lost prior to age 65, and years lost prior to average life expectancy. The cohort was followed for 7,790.9 PY. At 2015, 72 (11.7%) of the cohort were deceased, with a crude mortality rate of 9.2 per 1000 PYs. Neither age nor gender associated with mortality. The SMR was 10.2 (males 7.3, females 17.2), matched for age, gender and year of death. The most common mortality cause was opioid overdose (52.8%). Using the<65 years criterion, there were 1988.3 YPLL, with a mean of 27.6 (males 27.6, females 27.7). Using the average life expectancy criterion, there were 3135.1 YPLL, with a mean of 43.5 (males 41.9, females 46.3). Accidental overdose (<65 yr 63.0%, average life expectancy 63.7%) and suicide (<65 yr 12.8%, average life expectancy 13.3%) accounted for three quarters of YPLL where cause of death was known. YPLL associated with heroin use was a quarter of a century, or close to half a century, depending on the criteria used. Given the prominent role of overdose and suicide, the majority of these fatalities, and the associated YPLL, appear preventable. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. [Association between use of antibacterial agents in the first year of life and childhood asthma: a Meta analysis].

    PubMed

    Xie, Meng-Yao; Yuan, Yong-Hua; Liu, Li-Mei; Gu, Rong; Zhao, Xiao-Dong

    2016-10-01

    To evaluate the association between the use of antibacterial agents in the first years of life and childhood asthma. The Chinese and English databases CNKI, Wanfang Data, VIP, PubMed, and EBSCO were searched for prospective cohort studies on the association between the use of antibacterial agents in the first years of life and childhood asthma. Stata12.0 software was used to analyze the association through a Meta analysis. The articles with a high quality score and adjusted effective values for factors for lower respiratory tract infection were pooled, and a total of 8 studies were included. The results of the Meta analysis showed that the use of antibacterial agents in the first years of life increased the risk of childhood asthma (OR=1.14, 95%CI: 1.10-1.17, P<0.05). Compared with the children who used antibacterial agents 0-1 times in the first years of life, those who used more than 4 times had an increased risk of asthma (OR=1.28, 95%CI: 1.19-1.38, P<0.05). High-risk children (at least one immediate family member had asthma) who used antibacterial agents had an increased risk of asthma (OR=1.47, 95%CI: 1.20-1.81, P<0.05). The use of antibacterial agents in the first years of life increases the risk of childhood asthma. High-risk children who use antibacterial agents have an increased risk of asthma. The increased frequency of use of antibacterial agents in the first years of life is associated with an increased risk of childhood asthma, but the detailed dose relationship needs further investigation.

  14. Years of disability-adjusted life gained as a result of thrombolytic therapy for acute ischemic stroke.

    PubMed

    Hong, Keun-Sik; Saver, Jeffrey L

    2010-03-01

    Disability-adjusted life year (DALY) metric reflects years of healthy life lost because of living with disability and years of life lost because of premature mortality. Widely used in epidemiological analyses, DALY has not been applied to acute stroke trials. From previous studies, we derived, for each modified Rankin Scale level, disability weights, disability-linked mortality hazard ratios, and age-specific life expectancies. We then analyzed patient level data from the 2 publicly available National Institute of Neurological Disorders and Stroke (NINDS) recombinant tissue plasminogen activator trials. For each subject, we abstracted age, treatment assignment, and 3-month modified Rankin Scale outcome and calculated the DALYs lost resulting from the qualifying stroke. The disability-linked hazard ratios for premature annual mortality for a modified Rankin Scale score of 0 to 5 were 1.53, 1.52, 2.17, 3.18, 4.55, and 6.55, respectively. In the NINDS recombinant tissue plasminogen activator trials, DALYs (mean+/-SE) lost as a result of the qualifying stroke were substantially less with recombinant tissue plasminogen activator than with placebo (4.64+/-0.17 versus 5.91+/-0.21; P<0.0001), a finding that remained robust after adjustment for baseline prognostic factors. When DALYs gained were apportioned to the 29% of patients experiencing any benefit from lytic therapy, each patient gained an average of 4.4 DALYs. DALY analysis showed greater power than dichotomized modified Rankin Scale analysis in discriminating treatment effects overall and in patients >or=70 years of age. For patients who benefit from treatment, <3-hour thrombolytic therapy adds the equivalent of 4.4 years of healthy life, free of disability. The DALY metric provides a continuous scale that increases statistical power, is intuitively understandable, and is applicable to a wide range of conditions and treatments.

  15. 77 FR 3836 - Public Availability of Social Security Administration Fiscal Year (FY) 2011 Service Contract...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2011-0105] Public Availability of Social Security Administration Fiscal Year (FY) 2011 Service Contract Inventory AGENCY: Social Security Administration. ACTION: Notice of Public Availability of FY 2011 Service Contract Inventories. SUMMARY: In accordance with...

  16. 78 FR 6168 - Public Availability of Social Security Administration Fiscal Year (FY) 2012 Service Contract...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-29

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2013-0001] Public Availability of Social Security Administration Fiscal Year (FY) 2012 Service Contract Inventory AGENCY: Social Security Administration. ACTION: Notice of Public Availability of FY 2012 Service Contract Inventories. SUMMARY: In accordance with...

  17. Integrating Diversity Education and Service Learning: A 15+ Year Journey Continues

    ERIC Educational Resources Information Center

    Womble, Myra N.; Adams, Elaine

    2016-01-01

    This paper reports the 15+ year journey undertaken by university faculty to integrate service learning with diversity education. It has taken the faculty from its initial integration of academic community learning and diversity education in 1999 to its current course offering in 2015. The purpose of this integration has remained the same, to…

  18. Ten‐Year Blood Pressure Trajectories, Cardiovascular Mortality, and Life Years Lost in 2 Extinction Cohorts: the Minnesota Business and Professional Men Study and the Zutphen Study

    PubMed Central

    Tielemans, Susanne M. A. J.; Geleijnse, Johanna M.; Menotti, Alessandro; Boshuizen, Hendriek C.; Soedamah‐Muthu, Sabita S.; Jacobs, David R.; Blackburn, Henry; Kromhout, Daan

    2015-01-01

    Background Blood pressure (BP) trajectories derived from measurements repeated over years have low measurement error and may improve cardiovascular disease prediction compared to single, average, and usual BP (single BP adjusted for regression dilution). We characterized 10‐year BP trajectories and examined their association with cardiovascular mortality, all‐cause mortality, and life years lost. Methods and Results Data from 2 prospective and nearly extinct cohorts of middle‐aged men—the Minnesota Business and Professional Men Study (n=261) and the Zutphen Study (n=632)—were used. BP was measured annually during 1947–1957 in Minnesota and 1960–1970 in Zutphen. BP trajectories were identified by latent mixture modeling. Cox proportional hazards and linear regression models examined BP trajectories with cardiovascular mortality, all‐cause mortality, and life years lost. Associations were adjusted for age, serum cholesterol, smoking, and diabetes mellitus. Mean initial age was about 50 years in both cohorts. After 10 years of BP measurements, men were followed until death on average 20 years later. All Minnesota men and 98% of Zutphen men died. Four BP trajectories were identified, in which mean systolic BP increased by 5 to 49 mm Hg in Minnesota and 5 to 20 mm Hg in Zutphen between age 50 and 60. The third systolic BP trajectories were associated with 2 to 4 times higher cardiovascular mortality risk, 2 times higher all‐cause mortality risk, and 4 to 8 life years lost, compared to the first trajectory. Conclusions Ten‐year BP trajectories were the strongest predictors, among different BP measures, of cardiovascular mortality, all‐cause mortality, and life years lost in Minnesota. However, average BP was the strongest predictor in Zutphen. PMID:25753924

  19. Ten-year blood pressure trajectories, cardiovascular mortality, and life years lost in 2 extinction cohorts: the Minnesota Business and Professional Men Study and the Zutphen Study.

    PubMed

    Tielemans, Susanne M A J; Geleijnse, Johanna M; Menotti, Alessandro; Boshuizen, Hendriek C; Soedamah-Muthu, Sabita S; Jacobs, David R; Blackburn, Henry; Kromhout, Daan

    2015-03-09

    Blood pressure (BP) trajectories derived from measurements repeated over years have low measurement error and may improve cardiovascular disease prediction compared to single, average, and usual BP (single BP adjusted for regression dilution). We characterized 10-year BP trajectories and examined their association with cardiovascular mortality, all-cause mortality, and life years lost. Data from 2 prospective and nearly extinct cohorts of middle-aged men—the Minnesota Business and Professional Men Study (n=261) and the Zutphen Study (n=632)—were used. BP was measured annually during 1947-1957 in Minnesota and 1960-1970 in Zutphen. BP trajectories were identified by latent mixture modeling. Cox proportional hazards and linear regression models examined BP trajectories with cardiovascular mortality, all-cause mortality, and life years lost. Associations were adjusted for age, serum cholesterol, smoking, and diabetes mellitus. Mean initial age was about 50 years in both cohorts. After 10 years of BP measurements, men were followed until death on average 20 years later. All Minnesota men and 98% of Zutphen men died. Four BP trajectories were identified, in which mean systolic BP increased by 5 to 49 mm Hg in Minnesota and 5 to 20 mm Hg in Zutphen between age 50 and 60. The third systolic BP trajectories were associated with 2 to 4 times higher cardiovascular mortality risk, 2 times higher all-cause mortality risk, and 4 to 8 life years lost, compared to the first trajectory. Ten-year BP trajectories were the strongest predictors, among different BP measures, of cardiovascular mortality, all-cause mortality, and life years lost in Minnesota. However, average BP was the strongest predictor in Zutphen. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  20. Quality of Life in South Africa--The First Ten Years of Democracy

    ERIC Educational Resources Information Center

    Moller, Valerie

    2007-01-01

    South Africa celebrated ten years of democracy in 2004. This special issue of "Social Indicators Research" ("SIR") reviews developments that have impacted on the quality of life of ordinary South Africans during the transition period. The issue updates an earlier volume of "SIR" (Volume 41) published in 1997 and as a…

  1. Changes in Low-Value Services in Year 1 of the Medicare Pioneer Accountable Care Organization Program.

    PubMed

    Schwartz, Aaron L; Chernew, Michael E; Landon, Bruce E; McWilliams, J Michael

    2015-11-01

    Wasteful practices are widespread in the US health care system. It is unclear if payment models intended to improve health care efficiency, such as the Medicare accountable care organization (ACO) programs, discourage the provision of low-value services. To assess whether the first year of the Medicare Pioneer ACO program was associated with a reduction in use of low-value services. In a difference-in-differences analysis, we compared use of low-value services between Medicare fee-for-service beneficiaries attributed to health care provider groups that entered the Pioneer program (ACO group) and beneficiaries attributed to other health care providers (control group) before (2009-2011) vs after (2012) Pioneer ACO contracts began. Data analysis was conducted from December 1, 2014, to June 27, 2015. Comparisons were adjusted for beneficiaries' sociodemographic and clinical characteristics as well as for geography. We decomposed estimates according to service characteristics (clinical category, price, and sensitivity to patient preferences) and compared estimates between subgroups of ACOs with higher vs lower baseline use of low-value services. Use of, and spending on, 31 services in instances that provide minimal clinical benefit, measured as annual service counts per 100 beneficiaries and price-standardized annual service spending per 100 beneficiaries. During the precontract period, trends in the use of low-value services were similar for the ACO and control groups. The first year of ACO contracts was associated with a differential reduction (95% CI) of 0.8 low-value services per 100 beneficiaries for the ACO group (-1.2 to -0.4; P < .001), corresponding to a 1.9% differential reduction in service quantity (-2.9% to -0.9%) and a 4.5% differential reduction in spending on low-value services (-7.5% to -1.4%; P = .004). Differential reductions were similar for services less sensitive vs more sensitive to patient preferences and for higher- vs lower-priced services

  2. Does staff-patient agreement on needs for care predict a better mental health outcome? A 4-year follow-up in a community service.

    PubMed

    Lasalvia, A; Bonetto, C; Tansella, M; Stefani, B; Ruggeri, M

    2008-01-01

    Patients treated in primary care settings report better mental outcomes when they agree with practitioners about the nature of their core presenting problems. However, no study has examined the impact of staff-patient agreement on treatment outcomes in specialist mental health services. We investigated whether a better staff-patient agreement on needs for care predicts more favourable outcome in patients receiving community-based psychiatric care. A 3-month prevalence cohort of 188 patients with the full spectrum of psychiatric conditions was assessed at baseline and at 4 years using the Camberwell Assessment of Need (CAN), both staff (CAN-S) and patient versions (CAN-P), and a set of standardized outcome measures. Baseline staff-patient agreement on needs was included among predictors of outcome. Both clinician-rated (psychopathology, social disability, global functioning) and patient-rated (subjective quality of life and satisfaction with services) outcomes were considered. Controlling for the effect of sociodemographics, service utilization and changes in clinical status, better staff-patient agreement makes a significant additional contribution in predicting treatment outcomes not only on patient-rated but also on clinician-rated measures. Mental health care should be provided on the basis of a negotiation process involving both professionals and service users to ensure effective interventions; every effort should be made by services to implement strategies aiming to increase consensus between staff and patients.

  3. Impact of home modification services on ability in everyday life for people ageing with disabilities.

    PubMed

    Petersson, Ingela; Lilja, Margareta; Hammel, Joy; Kottorp, Anders

    2008-04-01

    To examine the impact of home modifications on self-rated ability in everyday life from various aspects for people ageing with disabilities. The study sample was recruited from an agency providing home modification services in Sweden and comprised 73 subjects whose referrals had been approved and who were scheduled to receive home modifications (intervention group) and 41 subjects waiting for their applications to be assessed for approval (comparison group). The subjects rated their ability in everyday life using the Client-Clinician Assessment Protocol Part I on 2 occasions: at baseline and follow-up. The Client-Clinician Assessment Protocol Part I provides data on the clients' self-rated independence, difficulty and safety in everyday life. The data were first subjected to Rasch analysis in order to convert the raw scores into interval measures. Further analyses to investigate changes in self-rated ability were conducted with parametric statistics. Subjects who had received home modifications reported a statistically significant improvement in their self-rated ability in everyday life compared with those in the comparison group. Subjects who had received home modifications reported less difficulty and increased safety, especially in tasks related to self-care in the bathroom and transfers, such as getting in and out of the home. Home modifications have a positive impact on self-rated ability in everyday life, especially on decreasing the level of difficulty and increasing safety.

  4. Increased use of mental health services related to isotretinoin treatment: a 5-year analysis.

    PubMed

    Friedman, Tal; Wohl, Yonit; Knobler, Haim Y; Lubin, Gadi; Brenner, Sarah; Levi, Yehezkel; Barak, Yoram

    2006-08-01

    The association between exposure to Isotretinoin, the development of depression and suicide attempts is controversial. To retrospectively assess pattern of utilization of mental health services in the Israeli Defense Forces (IDF) during a 5-year period for all subjects exposed to Isotretinoin in comparison to a control group consisting of army conscripts suffering from psoriasis. All subjects were young adults (18 to 21 years old) in compulsory military service. Exposure to Isotretinoin mandates reporting and marking as a coded medical profile in the IDFs' computerized medical record of each conscript and soldier. Medical data, tracked by military medical profiles, were summarized from medical records of all subjects treated by Isotretinion during the years 1999-2003 and for the control group for the same period. Use of mental health services was the a-priori defined primary outcome measure. During the study period 1419 subjects were exposed to Isotretinoin and 1102 suffered from psoriasis. Utilization of mental health services was highest for the index group wherein 17.2% (245/1419) of subjects were evaluated or treated compared to 12.5% in the control group (psoriasis). The inter-group differences were statistically significant; Chi-square=15.9 (df=2), p=0.0003. We suggest that psychiatric evaluation be regularly undertaken prior to initiation of Isotretinion treatment in young adults at risk, as well as providing follow-up visits during and at completion of treatment.

  5. [First year of life. Human milk and human milk substitutes].

    PubMed

    Vásquez-Garibay, Edgar M

    2016-09-01

    The nutritional improvement of mothers and their children is one of the most cost-effective tools to achieve optimal human growth and development. The World Health Organization recommends offering «exclusive breastfeeding for the first six months, and then begin the introduction of safe and nutritious food while breastfeeding continues until the second year of life.» Since the second half of the 20th century to date extraordinary progress in the manufacturing and formulation of substitutes for human milk has been accomplished, these being partial or complete substitutes for human milk, whether or not suitable for this purpose. Whole (cow´s) milk is not an adequate substitute for human milk during the first six months of life because of its great nutritional disparity and excess solutes with potential deleterious effects in infants. Therefore, it is an ethical responsibility of health professional to educate and advise parents and caregivers on the proper and timely use of human milk substitutes available in our country.

  6. First seven years of a new NHS mental handicap service 1974-81.

    PubMed Central

    Myers, A M

    1982-01-01

    A new community-focused mental handicap service was started in a single-district area health authority in 1974. Almost 90% of all the severely mentally handicapped people in a population of 250,000 are now known to the service. Although two-thirds of long stay inpatients originally admitted with major behavioural problems have had them resolved, the remaining one-third with persisting problems are noted to have spent many years in large understaffed wards before transfer. Specialist services to mentally handicapped people are not synonymous with beds. The learning opportunities during the waking hours of a mentally handicapped person are where professional help must be concentrated, and extensive support services for those caring for the mentally handicapped at home must be set up. Absence of shared philosophies, policies, and planning among the health and local authorities has produced the problems and frustrations familiar to many professionals in mental handicap. Future developments must be based on clearly defined and declared principles. PMID:6807447

  7. Three year outcomes in an early intervention service for psychosis in a multicultural and multiethnic population.

    PubMed

    Agius, Mark; Shah, Samir; Ramkisson, Roshelle; Persaud, Albert; Murphy, Suzanne; Zaman, Rashid

    2008-12-01

    Concern has been expressed that it may be difficult to provide certain interventions to some ethnic groups in an Early Intervention Service for Psychosis, and that as a consequence, three-year outcomes for the different Ethnic Groups may be different in different groups. To test whether there are differences between the three year outcomes of different ethnic groups represented in the patient population of an Early Intervention service for Psychosis. The three-year outcomes for the first group of 62 Patients to receive three years treatment in the Early Intervention Service in Luton, Bedfordshire were examined. This group well represented the ethnic mix of the population of Luton. It does not appear that there are major differences between the three-year outcomes of any one of the three groups studied. However the South Asian Patients appear to present earlier, with shorter DUPs, seemed more likely to marry, live with their families, and seem more likely to return to higher education after a first psychotic episode of psychosis compared to the Caucasians. Afro-Carribeans and South Asians were more likely to be unemployed, but many South Asians were employed, as were Caucasians. The fewest persons employed were in the Afro-Caribbean group. While slightly more South Asians and Afro-Carribeans were admitted compulsorily under the mental health act over the three years, 60% of each of the two non-white groups were never admitted compulsorily. This is different from the reported national trends of the Mental Health act being used excessively with the Afro-Caribbean population. No previous study has looked at the outcomes of Early Intervention Services for First Psychotic Episodes according to the Ethnic Origin of the Clients. The better outcomes seen with South Asians are probably due to cultural factors among the South Asians born in this country, rather than to issues related to the Psychotic Illness itself. These findings are important in planning services in areas

  8. 20 CFR 1002.100 - Does the five-year service limit include all absences from an employment position that are...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... services? No. The five-year period includes only the time the employee spends actually performing service... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Does the five-year service limit include all... Section 1002.100 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS' EMPLOYMENT AND...

  9. 10 CFR 503.31 - Lack of alternate fuel supply for the first 10 years of useful life.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... useful life. 503.31 Section 503.31 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES... useful life. (a) Eligibility. Section 212(a)(1)(A)(i) of the Act provides for a permanent exemption due to lack of an adequate and reliable supply of alternate fuel within the first 10 years of useful life...

  10. 10 CFR 503.31 - Lack of alternate fuel supply for the first 10 years of useful life.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... useful life. 503.31 Section 503.31 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES... useful life. (a) Eligibility. Section 212(a)(1)(A)(i) of the Act provides for a permanent exemption due to lack of an adequate and reliable supply of alternate fuel within the first 10 years of useful life...

  11. 10 CFR 503.31 - Lack of alternate fuel supply for the first 10 years of useful life.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... useful life. 503.31 Section 503.31 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES... useful life. (a) Eligibility. Section 212(a)(1)(A)(i) of the Act provides for a permanent exemption due to lack of an adequate and reliable supply of alternate fuel within the first 10 years of useful life...

  12. 10 CFR 503.31 - Lack of alternate fuel supply for the first 10 years of useful life.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... useful life. 503.31 Section 503.31 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES... useful life. (a) Eligibility. Section 212(a)(1)(A)(i) of the Act provides for a permanent exemption due to lack of an adequate and reliable supply of alternate fuel within the first 10 years of useful life...

  13. 10 CFR 503.31 - Lack of alternate fuel supply for the first 10 years of useful life.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... useful life. 503.31 Section 503.31 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES... useful life. (a) Eligibility. Section 212(a)(1)(A)(i) of the Act provides for a permanent exemption due to lack of an adequate and reliable supply of alternate fuel within the first 10 years of useful life...

  14. Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences

    PubMed Central

    2014-01-01

    Background This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Methods Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject’s self-evaluation, and through lottery games. Results Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when “out of pocket” payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results. Conclusions WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning. PMID:24989615

  15. Loneliness in Men 60 Years and Over: The Association With Purpose in Life.

    PubMed

    Neville, Stephen; Adams, Jeffery; Montayre, Jed; Larmer, Peter; Garrett, Nick; Stephens, Christine; Alpass, Fiona

    2018-07-01

    Loneliness as a consequence of getting older negatively impacts on the health and well-being of men as they age. Having a purpose in life may mitigate loneliness and therefore positively impact on health and well-being. Limited research into loneliness and purpose in life has been undertaken in older men. This study seeks to understand the relationship between loneliness and purpose in life in a group of older men. Using data from a cross-sectional survey of 614 men aged 60 years and over living in New Zealand, bivariate and multivariate analyses were undertaken to examine the relationship between loneliness and purpose in life using a range of demographic, health, and social connection variables. Bivariate analysis revealed that being unpartnered and having low socioeconomic status, limited social networks, low levels of participation, and mental health issues were associated with loneliness. Multivariate analysis showed that having poor mental health and lower purpose in life were indicators of loneliness. Consequently, improving mental health and purpose in life are likely to reduce loneliness in at-risk older men. As older men are a heterogeneous group from a variety of sociocultural and ethnic backgrounds, a multidimensional approach to any intervention initiatives needs to occur.

  16. End of life care for people with dementia: The views of health professionals, social care service managers and frontline staff on key requirements for good practice

    PubMed Central

    Lee, Richard Philip; Bamford, Claire; Poole, Marie; McLellan, Emma; Exley, Catherine; Robinson, Louise

    2017-01-01

    Background Evidence consistently shows that people with advanced dementia experience suboptimal end of life care compared to those with cancer; with increased hospitalisation, inadequate pain control and fewer palliative care interventions. Understanding the views of those service managers and frontline staff who organise and provide care is crucial in order to develop better end of life care for people with dementia. Methods and findings Qualitative interviews and focus groups were conducted from 2013 to 2015 with 33 service managers and 54 staff involved in frontline care, including doctors, nurses, nursing and care home managers, service development leads, senior managers/directors, care assistants and senior care assistants/team leads. All were audio recorded and transcribed verbatim. Participants represented a diverse range of service types and occupation. Transcripts were subject to coding and thematic analysis in data meetings. Analysis of the data led to the development of seven key themes: Recognising end of life (EOL) and tools to support end of life care (EOLC), Communicating with families about EOL, Collaborative working, Continuity of care, Ensuring comfort at EOL, Supporting families, Developing and supporting staff. Each is discussed in detail and comprise individual and collective views on approaches to good end of life care for people with dementia. Conclusions The significant challenges of providing good end of life care for people with dementia requires that different forms of expertise should be recognised and used; including the skills and knowledge of care assistants. Successfully engaging with people with dementia and family members and helping them to recognise the dying trajectory requires a supportive integration of emotional and technical expertise. The study strengthens the existing evidence base in this area and will be used with a related set of studies (on the views of other stakeholders and observations and interviews conducted in

  17. End of life care for people with dementia: The views of health professionals, social care service managers and frontline staff on key requirements for good practice.

    PubMed

    Lee, Richard Philip; Bamford, Claire; Poole, Marie; McLellan, Emma; Exley, Catherine; Robinson, Louise

    2017-01-01

    Evidence consistently shows that people with advanced dementia experience suboptimal end of life care compared to those with cancer; with increased hospitalisation, inadequate pain control and fewer palliative care interventions. Understanding the views of those service managers and frontline staff who organise and provide care is crucial in order to develop better end of life care for people with dementia. Qualitative interviews and focus groups were conducted from 2013 to 2015 with 33 service managers and 54 staff involved in frontline care, including doctors, nurses, nursing and care home managers, service development leads, senior managers/directors, care assistants and senior care assistants/team leads. All were audio recorded and transcribed verbatim. Participants represented a diverse range of service types and occupation. Transcripts were subject to coding and thematic analysis in data meetings. Analysis of the data led to the development of seven key themes: Recognising end of life (EOL) and tools to support end of life care (EOLC), Communicating with families about EOL, Collaborative working, Continuity of care, Ensuring comfort at EOL, Supporting families, Developing and supporting staff. Each is discussed in detail and comprise individual and collective views on approaches to good end of life care for people with dementia. The significant challenges of providing good end of life care for people with dementia requires that different forms of expertise should be recognised and used; including the skills and knowledge of care assistants. Successfully engaging with people with dementia and family members and helping them to recognise the dying trajectory requires a supportive integration of emotional and technical expertise. The study strengthens the existing evidence base in this area and will be used with a related set of studies (on the views of other stakeholders and observations and interviews conducted in four services) to develop an evidence

  18. National Study of Student Support Services. Third-Year Longitudinal Study Results and Program Implementation Study Update.

    ERIC Educational Resources Information Center

    Chaney, Bradford; Muraskin, Lana; Cahalan, Margaret; Rak, Rebecca

    This follow-up study, part of the National Study of Student Support Services compared the status of 2,900 disadvantaged students receiving student support services (SSS) since entering college 3 years earlier and 2,900 nonparticipating comparable students. Services offered varied among institutions but were all intended to help students stay in…

  19. Perceived physical appearance and life satisfaction: a moderated mediation model of self-esteem and life experience of deaf and hearing adolescents.

    PubMed

    Lu, Aitao; Hong, Xiuxiu; Yu, Yanping; Ling, Hong; Tian, Haiping; Yu, Zuwei; Chang, Lei

    2015-02-01

    In this study, we investigated the relationship between perceived physical appearance and life satisfaction, and the role of self-esteem as mediator and life experience as moderator of the relationship in deaf and hearing adolescents. 118 Chinese deaf adolescents (55.1% male; mean age = 15.12 years, standard deviation [SD] = 2.13) from 5 special education schools and 132 Chinese hearing adolescents (53.8% male; mean age = 13.11 years, SD = .85) completed anonymous questionnaires regarding perceived physical appearance, self-esteem, and life satisfaction. Perceived physical appearance, self-esteem, and life satisfaction were significantly and positively associated with each other. Moreover, self-esteem partially mediated the relationship between perceived physical appearance and life satisfaction; however, this indirect link was weaker for deaf adolescents than it was for hearing adolescents. Implications of the findings and future research directions are discussed, as are potential interventions that can be applied to increase subjective well-being in deaf adolescents. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  20. Life Satisfaction and Perceived Meaningfulness of Learning Experience among First-Year Traditional Graduate Social Work Students

    ERIC Educational Resources Information Center

    Fakunmoju, Sunday; Donahue, Gilpatrick R.; McCoy, Shandria; Mengel, Alison S.

    2016-01-01

    Knowledge about life satisfaction and learning experience among first-year graduate students is sparse, despite its relevance to instructional decisions, academic support, and success of students. Adequate knowledge is crucial, as it may help graduate students manage personal and professional life changes associated with graduate education. Using…