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Sample records for fiziki va mekaniki

  1. OneVA Pharmacy

    Data.gov (United States)

    Department of Veterans Affairs — The OneVA Pharmacy application design consists of 3 main components: VistA Medication Profile screen, Health Data Record Clinical Data Service (HDR/CDS), and OneVA...

  2. State of the VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-01-01

    Full Text Available No abstract available. Article truncated at 150 words. Earlier this week, President Obama gave his last State of the Union Address. Although this usually is a speech giving the President the opportunity of flaunt his accomplishments, no mention was made of the VA (1. Given the troubles at the VA, there seems little to tout. Over 70% of the VA medical centers were discovered to have falsified wait times (2. Because of the wait scandal, VA Secretary Eric Shinseki resigned and VA undersecretary, Robert Petzel MD, retired under pressure. Ironically, Shinseki, a retired Army general and member of the Joint Chiefs of Staff, was viewed in a favorable light by the current administration because of a spat with the Bush administration's Secretary of Defense, Donald Rumsfeld, over the number of troops needed to secure Iran and Afghanistan (3. However, during Shinseki's tenure the number of VA "medical troops", doctors and nurses, was insufficient to care for the number …

  3. The Geometric-VaR Backtesting Method

    DEFF Research Database (Denmark)

    Wei, Wei; Pelletier, Denis

    2014-01-01

    This paper develops a new test to evaluate Value af Risk (VaR) forecasts. VaR is a standard risk measure widely utilized by financial institutions and regulators, yet estimating VaR is a challenging problem, and popular VaR forecast relies on unrealistic assumptions. Hence, assessing...... the performance of VaR is of great importance. We propose the geometric-VaR test which utilizes the duration between the violations of VaR as well as the value of VaR. We conduct a Monte Carlo study based on desk-level data and we find that our test has high power against various alternatives....

  4. VA National Bed Control System

    Data.gov (United States)

    Department of Veterans Affairs — The VA National Bed Control System records the levels of operating, unavailable and authorized beds at each VAMC, and it tracks requests for changes in these levels....

  5. VA administrators breahe a sigh of relief

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-06-01

    Full Text Available No abstract available. Article truncated at 150 words. On May 30, Eric Shinseki, the Secretary for Veterans Affairs (VA, resigned under pressure amidst a growing scandal regarding falsification of patient wait times at nearly 40 VA medical centers. Before leaving office Shinseki fired Sharon Helman, the former hospital director at the Phoenix VA, where the story first broke, along with her deputy and another unnamed administrator. In addition, Susan Bowers, director of VA Veterans Integrated Service Network (VISN 18 and Helman’s boss, resigned. Robert Petzel, undersecretary for the Veterans Health Administration (VHA, head of the VA hospitals and clinics, had resigned earlier. You could hear the sigh of relief from the VA administrators. With their bosses resigning left and right, the VA leadership in shambles and the reputation of the VA soiled for many years to come, why are the VA administrators relieved? The simple answer is that nothing has really changed. There for a moment it looked ...

  6. Report of VA Medical Training Programs

    Data.gov (United States)

    Department of Veterans Affairs — The Report of VA Medical Training Programs Database is used to track medical center health services trainees and VA physicians serving as faculty. The database also...

  7. Non-VA Hospital System (NVH)

    Data.gov (United States)

    Department of Veterans Affairs — The Veterans Health Administration (VHA) pays for care provided to VA beneficiaries in non-VA hospitals through its contract hospitalization program as mandated by...

  8. Geographic Distribution of VA Expenditures FY2008

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  9. Geographic Distribution of VA Expenditures FY2006

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  10. Geographic Distribution of VA Expenditures FY2013

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  11. Geographic Distribution of VA Expenditures FY2010

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  12. Geographic Distribution of VA Expenditures FY2009

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  13. Geographic Distribution of VA Expenditures FY1999

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  14. Geographic Distribution of VA Expenditures FY2001

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  15. Geographic Distribution of VA Expenditures FY2011

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  16. Geographic Distribution of VA Expenditures FY1998

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  17. Geographic Distribution of VA Expenditures FY2000

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  18. OneVA EA Vision and Strategy

    Data.gov (United States)

    Department of Veterans Affairs — The outcomes/goals supported by effective use of an EA are: Improved Service Delivery, Functional Integration, Resource Optimization and Authoritative Reference. VA...

  19. Geographic Distribution of VA Expenditures FY2007

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  20. Geographic Distribution of VA Expenditures FY2003

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  1. Geographic Distribution of VA Expenditures FY1996

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  2. Geographic Distribution of VA Expenditures FY 2016

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  3. Geographic Distribution of VA Expenditures FY2005

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  4. Geographic Distribution of VA Expenditures FY2004

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  5. Geographic Distribution of VA Expenditures FY2002

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  6. Geographic Distribution of VA Expenditures FY1997

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  7. Geographic Distribution of VA Expenditures FY2012

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  8. VA Dental Insurance Program. Final rule.

    Science.gov (United States)

    2013-05-29

    The Department of Veterans Affairs (VA) amends its regulations to establish rules and procedures for the VA Dental Insurance Program (VADIP), a pilot program that offers premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Under the pilot program, VA will contract with a private insurer, through the Federal contracting process, to offer dental insurance to eligible individuals. The private insurer will be responsible for the administration of the dental insurance plan. VA will form the contract and verify the eligibility of individuals who apply for the private dental insurance.

  9. KENO-VA-PVM KENO-VA-SM, KENO5A for Parallel Processors

    International Nuclear Information System (INIS)

    Ramon, Javier; Pena, Jorge

    2002-01-01

    1 - Description of program or function: This package contains versions KENO-Va-SM (Shared Memory version) and KENO-Va-PVM (Parallel Virtual Machine version) based on SCALE-4.1. KENO-Va three-dimensional Boltzmann transport equation for neutron multiplying systems. The primary purpose of KENO-Va is to determine k-effective. Other calculated quantities include lifetime and generation time, energy-dependent leakages, energy- and region-dependent absorptions, fissions, fluxes, and fission densities. 2 - Method of solution: KENO-Va employs the Monte Carlo technique

  10. Technology Reference Model (TRM) Reports: VA Category Mapping Report

    Data.gov (United States)

    Department of Veterans Affairs — The One VA Enterprise Architecture (OneVA EA) is a comprehensive picture of the Department of Veterans Affairs' (VA) operations, capabilities and services and the...

  11. Technology Reference Model (TRM) Reports: VA Category Framework Count Report

    Data.gov (United States)

    Department of Veterans Affairs — The One VA Enterprise Architecture (OneVA EA) is a comprehensive picture of the Department of Veterans Affairs' (VA) operations, capabilities and services and the...

  12. Geographic Distribution of VA Expenditures Report FY2015

    Data.gov (United States)

    Department of Veterans Affairs — Geographic Distribution of VA Expenditures Report (GDX) located on the Expenditures page in the Expenditure Tables category. This report details VA expenditures at...

  13. A failure of oversight at the VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-09-01

    Full Text Available No abstract available. Article truncated at 150 words. On September 8, 2014 the Washington Examiner reported that the Central Office of the VA was allowed to change language in the VA Office of Inspector General (VAOIG report on delays in patient care at the Phoenix VA Medical Center (1. Crucial language that the VAOIG could not “conclusively” prove that delays in care caused patient deaths at a Phoenix hospital was added to its final report after a draft version was sent to agency administrators for comment. Rep. Jeff Miller, chairman of the House veterans' committee, said "there are significant differences between the final IG report and the draft version ...". The following day Richard Griffin, the acting VAOIG, vigorously defended the independence of his office and bristled at the allegations that the VA was allowed to alter his office's report. However, his denials and indignance seem disingenuous. To understand why, we need to go back a few years. ...

  14. VA Personal Health Record Sample Data

    Data.gov (United States)

    Department of Veterans Affairs — My HealtheVet (www.myhealth.va.gov) is a Personal Health Record portal designed to improve the delivery of health care services to Veterans, to promote health and...

  15. Genetics Home Reference: carbonic anhydrase VA deficiency

    Science.gov (United States)

    ... bicarbonate. Bicarbonate is necessary to maintain the proper acid-base balance in the body, which is necessary for most biological reactions to proceed properly. The carbonic anhydrase VA enzyme ...

  16. VaST: A variability search toolkit

    Science.gov (United States)

    Sokolovsky, K. V.; Lebedev, A. A.

    2018-01-01

    Variability Search Toolkit (VaST) is a software package designed to find variable objects in a series of sky images. It can be run from a script or interactively using its graphical interface. VaST relies on source list matching as opposed to image subtraction. SExtractor is used to generate source lists and perform aperture or PSF-fitting photometry (with PSFEx). Variability indices that characterize scatter and smoothness of a lightcurve are computed for all objects. Candidate variables are identified as objects having high variability index values compared to other objects of similar brightness. The two distinguishing features of VaST are its ability to perform accurate aperture photometry of images obtained with non-linear detectors and handle complex image distortions. The software has been successfully applied to images obtained with telescopes ranging from 0.08 to 2.5 m in diameter equipped with a variety of detectors including CCD, CMOS, MIC and photographic plates. About 1800 variable stars have been discovered with VaST. It is used as a transient detection engine in the New Milky Way (NMW) nova patrol. The code is written in C and can be easily compiled on the majority of UNIX-like systems. VaST is free software available at http://scan.sai.msu.ru/vast/.

  17. Insured Veterans' Use of VA and Non-VA Health Care in a Rural State.

    Science.gov (United States)

    West, Alan N; Charlton, Mary E

    2016-09-01

    To understand how working-age VA-enrolled veterans with commercial insurance use both VA and non-VA outpatient care, and how rural residence affects dual use, for common diagnoses and procedures. We analyzed VA and non-VA outpatient treatment records for any months during 2005-2010 that New Hampshire veterans ages health care and commercial insurance (per NH's mandatory claims database). Controlling for covariates, we used analysis of variance to compare urban and rural VA users, non-VA users, and dual users on travel burden, diagnosis counts, duration in outpatient care, and visit frequencies, and logistic regressions to assess whether rural veterans were as likely to be seen for common conditions and procedures. More than half of patients were non-VA users and another third were dual users; rural residents were slightly more likely than urban residents to be dual users. For nearly any common diagnosis or procedure, dual users were more likely to have it at some time during treatment than other patients in either VA or non-VA care, but they seldom had it listed in both care systems. Dual users also were seen most often overall, although within either care system they were seen less often than other patients, particularly if they were rural residents living far from care. Rural residence reduced chances of treatment for a wide variety of conditions, though it also was associated with more musculoskeletal and connective tissue diagnoses. It also reduced chances that patients had some diagnostic and treatment procedures but increased the odds of others that may require fewer visits. Dual users living in rural areas may have less continuity in their health care. Ensuring that rural dual users are identified in primary care should improve access and care coordination. © 2016 National Rural Health Association.

  18. Assessing the quality of VA Human Research Protection Programs: VA vs. affiliated University Institutional Review Board.

    Science.gov (United States)

    Tsan, Min-Fu; Nguyen, Yen; Brooks, Robert

    2013-04-01

    We compared the Human Research Protection Program (HRPP) quality indicator data of the Department of Veterans Affairs (VA) facilities using their own VA institutional review boards (IRBs) with those using affiliated university IRBs. From a total of 25 performance metrics, 13 did not demonstrate statistically significant differences, while 12 reached statistically significance differences. Among the 12 with statistically significant differences, facilities using their own VA IRBs performed better on four of the metrics, while facilities using affiliate IRBs performed better on eight. However, the absolute difference was small (0.2-2.7%) in all instances, suggesting that they were of no practical significance. We conclude that it is acceptable for facilities to use their own VA IRBs or affiliated university IRBs as their IRBs of record.

  19. Determinants of National Guard Mental Health Service Utilization in VA versus Non-VA Settings.

    Science.gov (United States)

    Gorman, Lisa A; Sripada, Rebecca K; Ganoczy, Dara; Walters, Heather M; Bohnert, Kipling M; Dalack, Gregory W; Valenstein, Marcia

    2016-10-01

    To determine associations between need, enabling, and predisposing factors with mental health service use among National Guard soldiers in the first year following a combat deployment to Iraq or Afghanistan. Primary data were collected between 2011 and 2013 from 1,426 Guard soldiers representing 36 units. Associations between Guard soldier factors and any mental health service use were assessed using multivariable logistic regression models in a cross-sectional study. Further analysis among service users (N = 405) assessed VA treatment versus treatment in other settings. Fifty-six percent of Guard soldiers meeting cutoffs on symptom scales received mental health services with 81 percent of those reporting care from the VA. Mental health service use was associated with need (mental health screens and physical health) and residing in micropolitan communities. Among service users, predisposing factors (middle age range and female gender) and enabling factors (employment, income above $50,000, and private insurance) were associated with greater non-VA services use. Overall service use was strongly associated with need, whereas sector of use (non-VA vs. VA) was insignificantly associated with need but strongly associated with enabling factors. These findings have implications for the recent extension of veteran health coverage to non-VA providers. © Health Research and Educational Trust.

  20. Telephone Enrollment in the VA Healthcare System. Interim final rule.

    Science.gov (United States)

    2016-03-16

    This rulemaking amends VA's medical regulations to allow veterans to complete applications for health care enrollment by telephone by providing application information to a VA employee, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided over the phone. This action will make it easier for veterans to apply to enroll and will speed VA processing of applications.

  1. 76 FR 79067 - Payment or Reimbursement for Emergency Treatment Furnished by Non-VA Providers in Non-VA...

    Science.gov (United States)

    2011-12-21

    ... document amends the Department of Veterans Affairs (VA) medical regulations concerning emergency hospital.... We received three comments related to the transfer of veterans from non-VA hospitals. The commenters... VA setting. If the veteran who has an accident on a military installation is personally financially...

  2. Troubles continue for the Phoenix VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-10-01

    Full Text Available No abstract available. Article truncated after 150 words. According to the Joint Commission on the Accreditation of Healthcare Organizations (Joint Commission, JCAHO, an independent organization that reviews hospitals, the Phoenix VA does not comply with U.S. standards for safety, patient care and management (1. The hospital was at the epicenter of the national scandal over the quality of care being afforded to the nation's veterans where the now notorious practice of double-booking patient appointments was first exposed. The hospital's indifferent management provoked congressional investigations that uncovered still more system-wide abuses leading to the removal of the hospital director and the resignation of then VA secretary, Eric Shinseki. The hospital maintains its accreditation but with a follow-up survey in 1-6 months where it must show that it has successfully addressed the 13 identified problems (1. Inspectors who conducted the review in July found that VA employees were unable to report concerns "without retaliatory action from the hospital." Other alarming ...

  3. VA announces aggressive new approach to produce rapid improvements in VA medical centers

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-02-01

    Full Text Available No abstract available. Article truncated at 150 words. The U.S. Department of Veterans Affairs (VA announced steps that it is taking as part of an aggressive new approach to produce rapid improvements at VA’s low-performing medical facilities nationwide (1. VA defines its low-performing facilities as those medical centers that receive the lowest score in its Strategic Analytics for Improvement and Learning (SAIL star rating system, or a one-star rating out of five. The SAIL star rating was initiated in 2016 and uses a variety of measures including mortality, length of hospital stay, readmission rates, hospital complications, physician productivity and efficiency. A complete listing of the VA facilities, their star ratings and the metrics used to determine the ratings is available through the end of fiscal year 2017 (2. Based on the latest ratings, the VA currently has 15 one-star facilities including Denver, Loma Linda, and Phoenix in the Southwest (Table 1. Table 1. VA facilities with one-star ratings …

  4. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Science.gov (United States)

    2010-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  5. Medical Student Psychiatry Examination Performance at VA and Non-VA Clerkship Sites

    Science.gov (United States)

    Tucker, Phebe; von Schlageter, Margo Shultes; Park, EunMi; Rosenberg, Emily; Benjamin, Ashley B.; Nawar, Ola

    2009-01-01

    Objective: The authors examined the effects of medical student assignment to U.S. Department of Veterans Affairs (VA) Medical Center inpatient and outpatient psychiatry clerkship sites versus other university and community sites on the performance outcome measure of National Board of Medical Examiners (NBME) subject examination scores. Methods:…

  6. Telephone Enrollment in the VA Healthcare System. Final rule.

    Science.gov (United States)

    2016-09-12

    The Department of Veterans Affairs (VA) adopts as final, without change, an interim final rule amending its medical regulations. Specifically, this rule allows veterans to complete applications for health care enrollment by providing application information, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided to a VA employee over the phone. This action makes it easier for veterans to apply to enroll and speeds VA processing of applications.

  7. Development of a parallelization method for KENO V.a

    International Nuclear Information System (INIS)

    Basoglu, B.; Bentley, C.; Dunn, M.

    1995-01-01

    The KENO V.a codes is a widely used Monte carlo codes that is part of the SCALE modular codes system for performing standardized computer analysis of nuclear systems for licensing evaluation. In the past few years, attempts have been made to speed up KENO V.a using new generation computers. In this paper we report on the initial development of a parallel version of KENO V.a for the Kendall Square Research supercomputer (KSRI) at ORNL. Investigations thus far have shown that the parallel code provides accurate results with significantly reduced computation times relative to the conventional KENO V.a code

  8. 33 CFR 80.510 - Chesapeake Bay Entrance, VA.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Chesapeake Bay Entrance, VA. 80.510 Section 80.510 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.510 Chesapeake Bay Entrance, VA. A...

  9. 76 FR 52230 - Establishment of Class E Airspace; Forest, VA

    Science.gov (United States)

    2011-08-22

    ...-0378; Airspace Docket No. 11-AEA-11] Establishment of Class E Airspace; Forest, VA AGENCY: Federal... at Forest, VA, to accommodate the new Area Navigation (RNAV) Global Positioning System (GPS) Standard... published in the Federal Register a notice of proposed rulemaking to establish Class E airspace at Forest...

  10. 78 FR 76061 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2013-12-16

    ... INFORMATION CONTACT: Lisa Brown, Chief, Policy Management Department, Department of Veterans Affairs, Chief..., even though the services are in theory available from the VA at other than a `local' VA facility... whether this rulemaking would result in additional administrative burdens for veterans to obtain referrals...

  11. Tropomyosin isoforms bias actin track selection by vertebrate myosin Va

    Science.gov (United States)

    Sckolnick, Maria; Krementsova, Elena B.; Warshaw, David M.; Trybus, Kathleen M.

    2016-01-01

    Tropomyosin (Tpm) isoforms decorate actin with distinct spatial and temporal localization patterns in cells and thus may function to sort actomyosin processes by modifying the actin track affinity for specific myosin isoforms. We examined the effect of three Tpm isoforms on the ability of myosin Va (myoVa) to engage with actin in vitro in the absence or presence of the cargo adapter melanophilin (Mlph), which links myoVa to Rab27a-melanosomes for in vivo transport. We show that both the myosin motor domain and the cargo adapter Mlph, which has an actin-binding domain that acts as a tether, are sensitive to the Tpm isoform. Actin–Tpm3.1 and actin–Tpm1.8 were equal or better tracks compared to bare actin for myoVa-HMM based on event frequency, run length, and speed. The full-length myoVa-Mlph complex showed high-frequency engagement with actin-Tpm3.1 but not with actin-Tpm1.8. Actin–Tpm4.2 excluded both myoVa-HMM and full-length myoVa-Mlph from productive interactions. Of importance, Tpm3.1 is enriched in the dendritic protrusions and cortical actin of melanocytes, where myoVa-Mlph engages in melanosome transport. These results support the hypothesis that Tpm isoforms constitute an “actin–Tpm code” that allows for spatial and temporal sorting of actomyosin function in the cell. PMID:27535431

  12. Microcirculatory assessment of patients under VA-ECMO

    NARCIS (Netherlands)

    A. Kara (Atila); S. Akin (Sakir); D. dos Reis Miranda (Dinis); A. Struijs (Ard); K. Caliskan (Kadir); R.J. van Thiel (Robert); E.A. Dubois; de Wilde, W. (Wouter); F. Zijlstra (Felix); D.A.M.P.J. Gommers (Diederik); C. Ince (Can)

    2016-01-01

    textabstractBackground: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an effective technique for providing emergency mechanical circulatory support for patients with cardiogenic shock. VA-ECMO enables a rapid restoration of global systemic organ perfusion, but it has not been found

  13. Microcirculatory assessment of patients under VA-ECMO

    NARCIS (Netherlands)

    Kara, Atila; Akin, Sakir; Dos Reis Miranda, Dinis; Struijs, Ard; Caliskan, Kadir; van Thiel, Robert J.; Dubois, Eric A.; de Wilde, Wouter; Zijlstra, Felix; Gommers, Diederik; Ince, Can

    2016-01-01

    Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an effective technique for providing emergency mechanical circulatory support for patients with cardiogenic shock. VA-ECMO enables a rapid restoration of global systemic organ perfusion, but it has not been found to always show a

  14. ESTIMASI NILAI VaR PORTOFOLIO MENGGUNAKAN FUNGSI ARCHIMEDEAN COPULA

    Directory of Open Access Journals (Sweden)

    AULIA ATIKA PRAWIBTA SUHARTO

    2017-01-01

    Full Text Available Value at Risk explains the magnitude of the worst losses occurred in financial products investments with a certain level of confidence and time interval. The purpose of this study is to estimate the VaR of portfolio using Archimedean Copula family. The methods for calculating the VaR are as follows: (1 calculating the stock return; (2 calculating descriptive statistics of return; (3 checking for the nature of autocorrelation and heteroscedasticity effects on stock return data; (4 checking for the presence of extreme value by using Pareto tail; (5 estimating the parameters of Achimedean Copula family; (6 conducting simulations of Archimedean Copula; (7 estimating the value of the stock portfolio VaR. This study uses the closing price of TLKM and GGRM. At 90% the VaR obtained using Clayton, Gumbel, Frank copulas are 0.9562%, 1.0189%, 0.9827% respectively. At 95% the VaR obtained using Clayton, Gumbel, Frank copulas are 1.2930%, 1.2522%, 1.3152% respectively. At 99% the VaR obtained using Clayton, Gumbel, Frank copulas are 2.0327%, 1.9164%, is 1.8678% respectively. In conclusion estimation of VaR using Clayton copula yields the highest VaR.

  15. VA office of inspector general releases scathing report of Phoenix VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-08-01

    Full Text Available No abstract available. Article truncated at 150 words. The long-awaited Office of Inspector General’s (OIG report on the Phoenix VA Health Care System (PVAHCS was released on August 27, 2014 (1. The report was scathing in its evaluation of VA practices and leadership. Five questions were investigated: 1.Were there clinically significant delays in care? 2. Did PVAHCS omit the names of veterans waiting for care from its Electronic Wait List (EWL? 3. Were PVAHCS personnel not following established scheduling procedures? 4. Did the PVAHCS culture emphasize goals at the expense of patient care? 5. Are scheduling deficiencies systemic throughout the VA? In each case, the OIG found that the allegations were true. Despite initial denials, the OIG report showed that former PVAHCS director Sharon Helman, associate director Lance Robinson, hospital administration director Brad Curry, chief of staff Darren Deering and other senior executives were aware of delays in care and unofficial wait lists. Perhaps most disturbing is ...

  16. VaR Methodology Application for Banking Currency Portfolios

    Directory of Open Access Journals (Sweden)

    Daniel Armeanu

    2007-02-01

    Full Text Available VaR has become the standard measure that financial analysts use to quantify market risk. VaR measures can have many applications, such as in risk management, to evaluate the performance of risk takers and for regulatory requirements, and hence it is very important to develop methodologies that provide accurate estimates. In particular, the Basel Committee on Banking Supervision at the Bank for International Settlements imposes to financial institutions such as banks and investment firms to meet capital requirements based on VaR estimates. In this paper we determine VaR for a banking currency portfolio and respect rules of National Bank of Romania regarding VaR report.

  17. VA INFORMATION SYSTEMS: Computer Security Weaknesses Persist at the Veterans Health Administration

    National Research Council Canada - National Science Library

    2000-01-01

    .... To determine the status of computer security within VHA, we (1) evaluated information system general controls at the VA Maryland Health Cafe System, the New Mexico VA Health Care System, and the VA North Texas Health Care System and (2...

  18. Time for the VA to clean up its act

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-06-01

    Full Text Available No abstract available. Article truncated after 150 words. One year after a Veterans Affairs (VA scandal was ignited here in Phoenix, the number of veterans on wait lists is 50 percent higher than at the same time last year, according to VA data (1. The VA is also facing a nearly $3 billion budget shortfall. VA Secretary Bob McDonald has asked for “flexibility” to reallocate billions of dollars in clinical funds to cover the shortfall. Since the scandal broke last year, VA providers have increased their workloads, adding 2.7 million more appointments than the previous year. However, the VA has played "games" with patient eligibility for years. When money was plentiful VA administrators would open the doors to patients since the following years' budgets were based on the number of patients seen. However, when money was tight, the doors would be slammed shut leaving many patients in the lurch scrambling to obtain health care elsewhere. Now it appears ...

  19. 1000-kVA arc power supply

    International Nuclear Information System (INIS)

    Wright, R.E.; Barber, G.C.; Ponte, N.S.

    1979-01-01

    Because of ever-increasing power demands for the development of the Oak Ridge duoPIGatron ion source, a continuous-duty arc power supply was constructed for the Medium Energy Test Facility (METF) to furnish power for the plasma generator of experimental ion sources. The power supply utilizes 12-pulse rectification with half-wave switching in a delta and wye full-wave bridge that may be connected in series or parallel. It will deliver 340 V dc, 2500 A to an ion source when series connected and 170 V dc, 5000 A when paralleled connected. Silicon-controlled rectifiers (SCR) in each rectifier bridge can be switched for pulses as short as 10 ms through continuous duty. The filter section that reduces the ripple in the output consists of an inductor-to-capacitor (L-C) filter to smooth the 720-Hz pulses. The power transformer serves as an isolation transformer allowing the secondary to be elevated to the accelerating potential of the ion source. The dc output level is controlled with a 1000-kVA auto transformer connected to the primary of the power transformer. All elevated voltages and currents are monitored at ground potential with an optical telemetry system. This paper describes the power supply in detail, including block diagrams, component specifications, and waveforms when supplying power to an ion source

  20. COPD, COOP and BREATH at the VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2011-02-01

    Full Text Available No abstract available. Article truncated at 150 words. The February 2011 Pulmonary Journal Club reviews a study by Rice and colleagues (1 of high-risk COPD patients (click here for Pulmonary Journal Club. This review was authored by Kevin Park who also authored an ACP Journal Club review (2. In Rice’s study a single educational session, an individualized care plan, and monthly case-manager telephone calls, resulted in a 41% decrease in hospitalizations and emergency room visits and a nonsignficant trend toward decreased mortality.Rice’s study was supported and conducted in the Veterans Integrated Service Network (VISN 23 (Minnesota, Iowa, Nebraska and the Dakotas. The COPD patients in this study were recruited and followed primarily using the VA computer system. The study represents a potential model of data-based management leading to improved patient outcomes. The authors; Robert Petzel MD, then VISN 23 Director (now Veterans Healthcare Administration Undersecretary; and Janet Murphy, then VISN Primary Care Service Line CEO (now VISN …

  1. VA Enterprise Design Patters - 2.5 (Enterprise Architecture)

    Data.gov (United States)

    Department of Veterans Affairs — Enterprise architectural guidelines and constraints that provide references to the use of enterprise capabilities that will enable the VA to access and exchange data...

  2. Service Utilization of Veterans Dually Eligible for VA...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service, 1999-2004 According to findings in Service Utilization of Veterans Dually...

  3. VA Facilities by Congressional District (FY2011): Overview

    Data.gov (United States)

    Department of Veterans Affairs — Maps are organized by state and depict the Veteran population using VetPop2011 data as of 9/30/2013 and VA facilities using Veteran Affairs Site Tracking (VAST) data...

  4. VA Enterprise Design Patterns - 5.1 (Mobility) Mobile

    Data.gov (United States)

    Department of Veterans Affairs — First of a set of guidance documents that establish the architectural foundation for mobile computing in the VA. This document outlines the enterprise capabilities...

  5. An academic-VA partnership: Student interprofessional teams integrated with VA PACT teams.

    Science.gov (United States)

    Swenty, Constance L; Schaar, Gina L; Butler, Ryan M

    2016-12-01

    Veterans are challenged with multiple unique healthcare issues related to their military service environment. Likewise, health care providers must understand the special concerns associated with military conflict and recognize how the veteran's care can be optimized by interprofessional care delivery. Little is taught didactically or clinically that supports nursing students in addressing the unique issues of the veteran or the student's need to work collaboratively with allied health team members to enhance the veteran's care. Because of limited exposure to the veteran's special conditions, nursing students who may seek a career with the veteran population often face challenges in rendering appropriate care. The VA offers an invaluable opportunity for health profession students to collaborate with VA interprofessional Patient Aligned Care Teams (PACT) ultimately optimizing veteran health outcomes. This academic partnership, that implements an interprofessional model, will prepare students to better embrace the veteran population. This article describes the immersion of health profession students in interprofessional collaborative practice (IPCP) using PACT team principles which ultimately promotes the students' ability to link theory content to patient care delivery. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. 76 FR 61150 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the VA...

    Science.gov (United States)

    2011-10-03

    ... Affairs. ACTION: Notice of Intent to Enter into an Enhanced-Use Lease. SUMMARY: The Secretary of VA... homelessness; and provide a supportive services program that guides resident Veterans toward attaining long...

  7. 77 FR 60746 - Proposed Information Collection (VA/DOD Joint Disability Evaluation Board Claim) Activity...

    Science.gov (United States)

    2012-10-04

    ... participation in a joint DOD/VA Disability Evaluation Board and VA compensation after separation from service... retirement, and VA disability compensation. VA Form 21- 0819 will be used to gather the necessary information... Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. BILLING CODE 8320-01-P ...

  8. 78 FR 76412 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2013-12-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... Application, VA Form 0924t. e. National Veterans Wheelchair Games Event Application, VA Form 0925b. f. Voluntary Service Application, VA Form 0925d. g. National Veteran Golden Age Games Application, VA Form 0926...

  9. A Role for Myosin Va in Human Cytomegalovirus Nuclear Egress.

    Science.gov (United States)

    Wilkie, Adrian R; Sharma, Mayuri; Pesola, Jean M; Ericsson, Maria; Fernandez, Rosio; Coen, Donald M

    2018-03-15

    Herpesviruses replicate and package their genomes into capsids in replication compartments within the nuclear interior. Capsids then move to the inner nuclear membrane for envelopment and release into the cytoplasm in a process called nuclear egress. We previously found that nuclear F-actin is induced upon infection with the betaherpesvirus human cytomegalovirus (HCMV) and is important for nuclear egress and capsid localization away from replication compartment-like inclusions toward the nuclear rim. Despite these and related findings, it has not been shown that any specific motor protein is involved in herpesvirus nuclear egress. In this study, we have investigated whether the host motor protein, myosin Va, could be fulfilling this role. Using immunofluorescence microscopy and coimmunoprecipitation, we observed associations between a nuclear population of myosin Va and the viral major capsid protein, with both concentrating at the periphery of replication compartments. Immunoelectron microscopy showed that nearly 40% of assembled nuclear capsids associate with myosin Va. We also found that myosin Va and major capsid protein colocalize with nuclear F-actin. Importantly, antagonism of myosin Va with RNA interference or a dominant negative mutant revealed that myosin Va is important for the efficient production of infectious virus, capsid accumulation in the cytoplasm, and capsid localization away from replication compartment-like inclusions toward the nuclear rim. Our results lead us to suggest a working model whereby human cytomegalovirus capsids associate with myosin Va for movement from replication compartments to the nuclear periphery during nuclear egress. IMPORTANCE Little is known regarding how newly assembled and packaged herpesvirus capsids move from the nuclear interior to the periphery during nuclear egress. While it has been proposed that an actomyosin-based mechanism facilitates intranuclear movement of alphaherpesvirus capsids, a functional role for

  10. VA's National PTSD Brain Bank: a National Resource for Research.

    Science.gov (United States)

    Friedman, Matthew J; Huber, Bertrand R; Brady, Christopher B; Ursano, Robert J; Benedek, David M; Kowall, Neil W; McKee, Ann C

    2017-08-25

    The National PTSD Brain Bank (NPBB) is a brain tissue biorepository established to support research on the causes, progression, and treatment of PTSD. It is a six-part consortium led by VA's National Center for PTSD with participating sites at VA medical centers in Boston, MA; Durham, NC; Miami, FL; West Haven, CT; and White River Junction, VT along with the Uniformed Services University of Health Sciences. It is also well integrated with VA's Boston-based brain banks that focus on Alzheimer's disease, ALS, chronic traumatic encephalopathy, and other neurological disorders. This article describes the organization and operations of NPBB with specific attention to: tissue acquisition, tissue processing, diagnostic assessment, maintenance of a confidential data biorepository, adherence to ethical standards, governance, accomplishments to date, and future challenges. Established in 2014, NPBB has already acquired and distributed brain tissue to support research on how PTSD affects brain structure and function.

  11. Poststroke Rehabilitation and Restorative Care Utilization: A Comparison Between VA Community Living Centers and VA-contracted Community Nursing Homes.

    Science.gov (United States)

    Jia, Huanguang; Pei, Qinglin; Sullivan, Charles T; Cowper Ripley, Diane C; Wu, Samuel S; Bates, Barbara E; Vogel, W Bruce; Bidelspach, Douglas E; Wang, Xinping; Hoffman, Nannette

    2016-03-01

    Effective poststroke rehabilitation care can speed patient recovery and minimize patient functional disabilities. Veterans affairs (VA) community living centers (CLCs) and VA-contracted community nursing homes (CNHs) are the 2 major sources of institutional long-term care for Veterans with stroke receiving care under VA auspices. This study compares rehabilitation therapy and restorative nursing care among Veterans residing in VA CLCs versus those Veterans in VA-contracted CNHs. Retrospective observational. All Veterans diagnosed with stroke, newly admitted to the CLCs or CNHs during the study period who completed at least 2 Minimum Data Set assessments postadmission. The outcomes were numbers of days for rehabilitation therapy and restorative nursing care received by the Veterans during their stays in CLCs or CNHs as documented in the Minimum Data Set databases. For rehabilitation therapy, the CLC Veterans had lower user rates (75.2% vs. 76.4%, P=0.078) and fewer observed therapy days (4.9 vs. 6.4, Prestorative nursing care, CLC Veterans had higher user rates (33.5% vs. 30.6%, Prestorative nursing care (coefficient=5.48±0.37, Prestorative nursing care both before and after risk adjustment.

  12. REACH VA: Moving from Translation to System Implementation.

    Science.gov (United States)

    Nichols, Linda O; Martindale-Adams, Jennifer; Burns, Robert; Zuber, Jeffrey; Graney, Marshall J

    2016-02-01

    Resources for Enhancing All Caregivers Health in the Department of Veterans Affairs (REACH VA) has been implemented in the VA system as a national program for caregivers. We describe the trajectory of REACH VA from national randomized clinical trial through translation to national implementation. The implementation is examined through the six stages of the Fixsen and Blasé implementation process model: exploration and adoption, program installation, initial implementation, full operation, innovation, and sustainability. Different drivers that move the implementation process forward are important at each stage, including staff selection, staff training, consultation and coaching, staff evaluation, administrative support, program evaluation/fidelity, and systems interventions. Caregivers in the REACH VA 4 session intervention currently implemented in the VA had similar outcomes to longer REACH interventions, including Resources for Enhancing Alzheimer's Caregivers Health (REACH II). Caregivers experienced significant decreases in burden, depression, anxiety, number of troubling patient behaviors reported, caregiving frustrations, stress symptoms (feeling overwhelmed, feeling like crying, being frustrated as a result of caregiving, being lonely), and general stress. Effect sizes (Cohen's d) for these significant variables were between small and medium ranging from .24 to .46. The implementation of REACH VA provides a road map for implementation of other behavioral interventions in health care delivery settings. Lessons learned include the importance of implementing a proven, needed intervention, support from both leadership and clinical staff, willingness to respond to staff and organization needs and modify the intervention while preserving its integrity, and fitting the intervention into ongoing routines and practices. Published by Oxford University Press on behalf of the Gerontological Society of America 2014.

  13. The WHO 2016 verbal autopsy instrument: An international standard suitable for automated analysis by InterVA, InSilicoVA, and Tariff 2.0.

    Science.gov (United States)

    Nichols, Erin K; Byass, Peter; Chandramohan, Daniel; Clark, Samuel J; Flaxman, Abraham D; Jakob, Robert; Leitao, Jordana; Maire, Nicolas; Rao, Chalapati; Riley, Ian; Setel, Philip W

    2018-01-01

    Verbal autopsy (VA) is a practical method for determining probable causes of death at the population level in places where systems for medical certification of cause of death are weak. VA methods suitable for use in routine settings, such as civil registration and vital statistics (CRVS) systems, have developed rapidly in the last decade. These developments have been part of a growing global momentum to strengthen CRVS systems in low-income countries. With this momentum have come pressure for continued research and development of VA methods and the need for a single standard VA instrument on which multiple automated diagnostic methods can be developed. In 2016, partners harmonized a WHO VA standard instrument that fully incorporates the indicators necessary to run currently available automated diagnostic algorithms. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality. This VA instrument offers the opportunity to harmonize the automated diagnostic algorithms in the future. Despite all improvements in design and technology, VA is only recommended where medical certification of cause of death is not possible. The method can nevertheless provide sufficient information to guide public health priorities in communities in which physician certification of deaths is largely unavailable. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality.

  14. Hospital Distance and Readmissions Among VA-Medicare Dual-Enrolled Veterans.

    Science.gov (United States)

    Wong, Edwin S; Rinne, Seppo T; Hebert, Paul L; Cook, Meredith A; Liu, Chuan-Fen

    2016-09-01

    Geographic access to inpatient care at the Veterans Affairs (VA) Health Care System is challenging for many veterans with chronic obstructive pulmonary disease (COPD) given relatively few VA hospitals nationwide. Veterans with lengthy travel distances may obtain non-VA care, particularly those dually enrolled in Medicare. Our primary objective was to assess whether distance from VA patients' residence to the nearest VA and non-VA hospitals was associated with 30-day all-cause readmission and the system where patients were readmitted (VA or Medicare). Using VA and Medicare administrative data, we identified 21,273 patients hospitalized for COPD between October 2008 and September 2011 and dually enrolled in VA and fee-for-service Medicare. Outcome variables were dichotomous measures denoting readmission for any cause within 30 days following discharge and whether the readmission occurred in a non-VA hospital through Medicare. Distance to the nearest hospital was defined as the number of miles between patients' residence ZIP code and the ZIP code of the nearest VA and non-VA hospital accepting Medicare, respectively. Probit models with sample selection were applied to examine the relationship between hospital distance and outcome measures. Respective distances to the nearest VA and non-VA hospital were not associated with 30-day all-cause readmission. Greater distance to the nearest VA hospital was associated with a greater conditional probability of choosing non-VA hospitals for readmission. COPD patients with poor geographic access to VA hospitals did not forgo subsequent inpatient care following their index hospitalization, but they were more likely to seek non-VA substitutes. © 2016 National Rural Health Association.

  15. 77 FR 70893 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2012-11-28

    ... INFORMATION: Over the past two decades, the healthcare industry has increasingly emphasized providing care in... healthcare to veterans, VA is, like the rest of the healthcare industry, economically unable to provide all... procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse, Government contracts...

  16. 77 FR 70967 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2012-11-28

    .... SUPPLEMENTARY INFORMATION: Over the past two decades, the healthcare industry has increasingly emphasized... expand the delivery of healthcare to veterans, VA is, like the rest of the healthcare industry... Subjects in 38 CFR Part 17 Administrative practice and procedure, Alcohol abuse, Alcoholism, Claims, Day...

  17. VA Is Here for the People Who Support Our Veterans

    Science.gov (United States)

    ... Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of Hearing Contact Us About About the Veterans Crisis Line FAQs Veteran Suicide VA is here for the people who support our Veterans. Whether you’re a ...

  18. What does Shulkin's firing mean for the VA?

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-03-01

    Full Text Available No abstract available. Article truncated at 150 words. David Shulkin MD, Secretary for Veterans Affairs (VA was finally fired by President Donald Trump ending long speculation (1. Trump nominated his personal physician, Ronny Jackson MD, to fill Shulkin’s post. The day after his firing, Shulkin criticized his firing in a NY Times op-ed claiming pro-privatization factions within the Trump administration led to his ouster (2. “They saw me as an obstacle to privatization who had to be removed,” Dr. Shulkin wrote. “That is because I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits, even if it undermines care for veterans.” Former Secretary Shulkin’s tenure at the VA has had several controversies. First, as undersecretary of Veterans Healthcare and later as secretary money appropriated to the VA to obtain private care under the Veterans Access, Choice, and Accountability Acts of 2014 and the VA Choice and Quality Employment Act of …

  19. 77 FR 67063 - VA Directive 0005 on Scientific Integrity

    Science.gov (United States)

    2012-11-08

    ... 20420. Call (202) 461-4902 for an appointment. Comments A. Purpose, Responsibilities, and Definitions... policies that: Foster a culture of transparency, integrity, and ethical behavior in the development and... ``inappropriate influence.'' The definition of ``inappropriate influence'' should be more explicit. VA Response...

  20. 75 FR 61252 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2010-10-04

    .... The only exceptions are loans made to veterans receiving VA compensation for service-connected disabilities, (or veterans whom, but for receipt of retirement pay, would be entitled to receive compensation...: September 29, 2010. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records...

  1. 75 FR 61859 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2010-10-06

    .... The only exceptions are loans made to veterans receiving VA compensation for service-connected disabilities, (or veterans whom, but for receipt of retirement pay, would be entitled to receive compensation...: September 29, 2010. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records...

  2. 75 FR 78806 - Agency Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2010-12-16

    ... guaranteed. The only exceptions are loans made to veterans receiving VA compensation for service-connected disabilities, (or veterans whom, but for receipt of retirement pay, would be entitled to receive compensation...,000. Dated: December 10, 2010. By direction of the Secretary. Denise McLamb, Program Analyst...

  3. 75 FR 33216 - Payment or Reimbursement for Emergency Treatment Furnished by Non-VA Providers in Non-VA...

    Science.gov (United States)

    2010-06-11

    ... grammatical errors and updating obsolete citations. DATES: Comments must be received by VA on or before August... amendments made to 38 U.S.C. 1725 and 1728, and would make technical changes such as correcting grammatical errors and updating obsolete regulatory citations: 38 CFR 17.120, 17.121, 17.1002, 17.1005, 17.1006, and...

  4. VA Health Care. Additional Efforts to Better Assess Joint Ventures Needed

    National Research Council Canada - National Science Library

    2008-01-01

    .... VA has maintained eight joint ventures with DOD across the country. VA has also developed partnerships, or affiliations, with university medical schools to obtain health care services for veterans and provide training to medical residents...

  5. Number of Veterans who Used VA Benefits by State FY2016

    Data.gov (United States)

    Department of Veterans Affairs — This file shows the number of Veterans in each state who used each of 7 VA benefits during fiscal year 2016. It also shows the unique count of users across all VA...

  6. 78 FR 39599 - Safety Zone; Fort Monroe Fireworks Display, Chesapeake Bay, Hampton, VA

    Science.gov (United States)

    2013-07-02

    ...-AA00 Safety Zone; Fort Monroe Fireworks Display, Chesapeake Bay, Hampton, VA AGENCY: Coast Guard, DHS... navigable waters of the Chesapeake Bay in Hampton, VA to support the Fort Monroe Fireworks. This action is... Authority will host a fireworks display in the Chesapeake Bay off of Fort Monroe in Hampton, VA. The...

  7. 77 FR 35308 - Proposed Amendment of Restricted Area R-6601; Fort A.P. Hill, VA

    Science.gov (United States)

    2012-06-13

    ...-0561; Airspace Docket No. 12-AEA-7] Proposed Amendment of Restricted Area R-6601; Fort A.P. Hill, VA..., Fort A.P. Hill, VA. The U. S. Army requested this action to provide the additional airspace needed to... Garrison, Fort A.P. Hill, VA 22427; telephone: (804) 633-8223. FOR FURTHER INFORMATION CONTACT: Paul...

  8. 75 FR 3968 - Fund Availability Under the VA Homeless Providers Grant and Per Diem Program

    Science.gov (United States)

    2010-01-25

    ... Capital Grant component of VA's Homeless Providers Grant and Per Diem Program. This Notice contains... announces the availability of capital funds for assistance under VA's Homeless Providers Grant and Per Diem... DEPARTMENT OF VETERANS AFFAIRS Fund Availability Under the VA Homeless Providers Grant and Per...

  9. 75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2010-03-01

    ... techniques or the use of other forms of information technology. Titles: a. National Disabled Veterans Winter Sports Clinic Application, VA Form 0924--233 hours. b. National Veterans Wheelchair Games Application, VA.... National Veterans TEE Tournament Application, VA Form 0927--133 hours. e. National Veterans Summer Sports...

  10. 78 FR 18425 - Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment...

    Science.gov (United States)

    2013-03-26

    ... techniques or the use of other forms of information technology. Title: VA Police Officer Pre-Employment... Police Officer Pre-Employment Screening Checklist); Comment Request AGENCY: Office of Operations... approved collection. Abstract: VA personnel complete VA Form 0120 to document pre- employment history and...

  11. VaR: Exchange Rate Risk and Jump Risk

    Directory of Open Access Journals (Sweden)

    Fen-Ying Chen

    2010-01-01

    Full Text Available Incorporating the Poisson jumps and exchange rate risk, this paper provides an analytical VaR to manage market risk of international portfolios over the subprime mortgage crisis. There are some properties in the model. First, different from past studies in portfolios valued only in one currency, this model considers portfolios not only with jumps but also with exchange rate risk, that is vital for investors in highly integrated global financial markets. Second, in general, the analytical VaR solution is more accurate than historical simulations in terms of backtesting and Christoffersen's independence test (1998 for small portfolios and large portfolios. In other words, the proposed model is reliable not only for a portfolio on specific stocks but also for a large portfolio. Third, the model can be regarded as the extension of that of Kupiec (1999 and Chen and Liao (2009.

  12. VA/DoD Collaboration Guidebook for Healthcare Research

    Science.gov (United States)

    2011-01-24

    Research Unit (NMRU), San Antonio, Texas, conducts dental research, directed energy effects, and combat casualty care research. Naval Medical...Healthcare System has been a presence at the VA-sponsored National Veterans Wheelchair Games (NVWG) since 2000, the National Disabled Veterans Winter...an opportunity to disseminate research results, educate wheelchair users on their work, and recruit wheelchair users to participate in studies. Dr

  13. Validation of KENO V.a: Comparison with critical experiments

    International Nuclear Information System (INIS)

    Jordan, W.C.; Landers, N.F.; Petrie, L.M.

    1986-12-01

    Section 1 of this report documents the validation of KENO V.a against 258 critical experiments. Experiments considered were primarily high or low enriched uranium systems. The results indicate that the KENO V.a Monte Carlo Criticality Program accurately calculates a broad range of critical experiments. A substantial number of the calculations showed a positive or negative bias in excess of 1 1/2% in k-effective (k/sub eff/). Classes of criticals which show a bias include 3% enriched green blocks, highly enriched uranyl fluoride slab arrays, and highly enriched uranyl nitrate arrays. If these biases are properly taken into account, the KENO V.a code can be used with confidence for the design and criticality safety analysis of uranium-containing systems. Sections 2 of this report documents the results of investigation into the cause of the bias observed in Sect. 1. The results of this study indicate that the bias seen in Sect. 1 is caused by code bias, cross-section bias, reporting bias, and modeling bias. There is evidence that many of the experiments used in this validation and in previous validations are not adequately documented. The uncertainty in the experimental parameters overshadows bias caused by the code and cross sections and prohibits code validation to better than about 1% in k/sub eff/. 48 refs., 19 figs., 19 tabs

  14. Can reported VaR be used as an indicator of the volatility of share prices? Evidence from UK banks.

    OpenAIRE

    Ou, Shian Kao

    2006-01-01

    Value at Risk (VaR) is used as an indicator to measure the risks contained in a firm. With the uprising development of VaR theory and computational techniques, the VaR is nowadays adopted by banks and reported in annual reports. Since the method to calculate VaR is questioned, and the reported VaR can not be thoroughly audited, this paper attempts to find the relationship between the reported VaR and the volatility of share price for UK listed banks. This paper reviews literature about VaR an...

  15. Cost-Effectiveness of Treatments for Genotype 1 Hepatitis C Virus Infection in Non-VA and VA Populations

    Directory of Open Access Journals (Sweden)

    Shan Liu PhD

    2016-09-01

    Full Text Available Background: Chronic hepatitis C viral (HCV infection affects millions of Americans. Health care systems face complex choices between highly efficacious, costly treatments. This study assessed the cost-effectiveness of treatments for chronic, genotype 1 HCV monoinfected, treatment-naïve individuals in the Department of Veterans Affairs (VA and general US health care systems. Methods: The study used a decision-analytic Markov model, employing appropriate payer perspectives and time horizons, and discounting benefits and costs at 3% annually. Interventions included the following: sofosbuvir/ledipasvir (SOF-LDV; ombitasvir/paritaprevir/ritonavir/dasabuvir (3D; sofosbuvir/simeprevir (SOF-SMV; sofosbuvir/pegylated interferon/ribavirin (SOF-RBV-PEG; boceprevir/pegylated interferon/ribavirin (BOC-RBV-PEG; and pegylated interferon/ribavirin (PEG-RBV. Outcomes were sustained virologic response (SVR, advanced liver disease, costs, quality adjusted life years (QALYs, and incremental cost-effectiveness. Results: SOF-LDV and 3D achieve high SVR rates, reducing advanced liver disease (>20% relative to no treatment, and increasing QALYs by >2 years per person. For the non-VA population, at current prices ($5040 per week for SOF-LDV; $4796 per week for 3D, SOF-LDV’s lifetime cost ($293,370 is $18,000 lower than 3D’s because of its shorter duration in subgroups. SOF-LDV costs $17,100 per QALY gained relative to no treatment. 3D costs $208,000 per QALY gained relative to SOF-LDV. Both dominate other treatments and are even more cost-effective for the VA, though VA aggregate treatment costs still exceed $4 billion at SOF-LDV prices of $3308 per week. Drug prices strongly determine relative cost-effectiveness for SOF-LDV and 3D; with price reductions of 20% to 30% depending on health system, 3D could be cost-effective relative to SOF-LDV. We currently lack head-to-head regimen effectiveness trials. Conclusions: New HCV treatments are cost-effective in multiple

  16. V-A hadronic tau decays : a QCD laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Narison, Stephan E-mail: narison@lpm.univ-montp2.fr

    2001-04-01

    Recent ALEPH/OPAL data on the V-A spectral functions from hadronic {tau} decays are used for fixing the QCD continuum threshold at which the first and second Weinberg sum rules should be satisfied in the chiral limit, and for predicting the values of the low-energy constants f{sub {pi}}, m{sub {pi}{sup +}} - m{sub {pi}{sup 0}} and L{sub 10}. Some DMO-like sum rules and the {tau}-total hadronic widths R{sub {tau}}{sub ,V-A} are also used for extracting the values of the D = 6, 8 QCD vacuum condensates and the corresponding (in the chiral limit) electroweak kaon penguin matrix elements {sub 2{pi}}, where a deviation from the vacuum saturation estimate has been obtained. Combining these results with the one of the QCD penguin matrix element {sub 2{pi}} obtained from a (maximal) q-barq-gluonium mixing scheme from the scalar meson sum rules, we deduce, in the Electroweak Standard Model (ESM), the conservative upper bound for the CP-violating ratio: {epsilon}'/{epsilon} {<=} (22 {+-} 9)10{sup -4}, in agreement with the present measurements.

  17. The use of yoga in specialized VA PTSD treatment programs.

    Science.gov (United States)

    Libby, Daniel J; Reddy, Felice; Pilver, Corey E; Desai, Rani A

    2012-01-01

    Posttraumatic stress disorder (PTSD) is a chronic, debilitating anxiety disorder that is highly prevalent among U.S. military veterans. Yoga, defined to include physical postures (asana) and mindfulness and meditation, is being increasingly used as an adjunctive treatment for PTSD and other psychological disorders. No research or administrative data have detailed the use of these services in Department of Veterans Affairs' (VA) 170 PTSD treatment programs. One hundred twenty-five program coordinators or designated staff completed an 81-item survey of their program's use of complementary and alternative medicine modalities in the past year. This report describes data from a subset of 30 questions used to assess the prevalence, nature, and context of the use of yoga, mindfulness, and meditation other than mindfulness practices. Results revealed that these practices are widely offered in VA specialized PTSD treatment programs and that there is great variability in the context and nature of how they are delivered. Understanding how yoga is used by these programs may inform ongoing efforts to define and distinguish yoga therapy as a respected therapeutic discipline and to create patient-centered care models that mindfully fulfill the unmet needs of individuals with mental health issues, including veterans with PTSD.

  18. V.A. Gorodtsov and Kazan: tour 1920

    Directory of Open Access Journals (Sweden)

    Kuzminykh Sergey V.

    2014-12-01

    Full Text Available A fragment of an archival document is published, that is connected to the September 8-12, 1920, stay in Kazan of V.A. Gorodtsov, who headed the Archaeological Subdepartment with the Museum Department of the RSFSR People’s Commissariat for Education, in the framework of his inspecting tour around the towns of the Volga and Urals region. The document is a diary, and its entries reflect information about the tour and its results that had not been exhaustively reflected in official documentation. It narrates about meetings, polemic exchanges, Gorodtsov’s addresses to scientists and the public, his impressions of the archaeological investigations in the regions, and the state of the museums and collections. V.A. Gorodtsov’s encounters and personal contacts with B.F. Adler, N.F. Katanov, M.G. Hudyakov and other researchers had played a positive role in archaeology development in the Volga-Kama region during the hardest times after the revolution.

  19. 78 FR 21817 - Amendment of Restricted Area R-6601; Fort A.P. Hill, VA

    Science.gov (United States)

    2013-04-12

    ...; Airspace Docket No. 12-AEA-7] RIN 2120-AA66 Amendment of Restricted Area R-6601; Fort A.P. Hill, VA AGENCY... limits and time of designation of restricted area R-6601, Fort A.P. Hill, VA. The U.S. Army requested... limits and increase the time of designation of restricted area R-6601, Fort A.P. Hill, VA, (77 FR 35308...

  20. VA-Index: Quantifying Assortativity Patterns in Networks with Multidimensional Nodal Attributes (Open Access)

    Science.gov (United States)

    2016-01-27

    RESEARCH ARTICLE VA- Index : Quantifying Assortativity Patterns in Networks with Multidimensional Nodal Attributes Konstantinos Pelechrinis*, DongWei...treatment of this problem. In this study we develop a metric, the vector assortativity index (VA- index for short), based on network randomization and...extensive experimental results on synthetic network data show that the VA- index outperforms a baseline extension of the assortativity coeffi- cient, which

  1. 75 FR 70351 - Termination of Environmental Review Process Cities of Chesapeake and Virginia Beach, VA

    Science.gov (United States)

    2010-11-17

    ... Virginia Beach, VA AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Termination of environmental... the Cities of Chesapeake and Virginia Beach, Virginia, is terminated. FOR FURTHER INFORMATION CONTACT...

  2. Helman defends decision to pull VA sponsorship of Veterans day parade

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2013-04-01

    Full Text Available No abstract available. Article truncated after 150 words. Sharon Helman, Phoenix VA Director, defended her decision to cancel VA sponsorship of the annual Phoenix Veterans Day Parade in a 4/10/13 email to VA employees. Helman said that VA sponsorship was cancelled because of “…priorities in the organization (specifically access, and heightened awareness over liability concerns which VA Legal Counsel brought forward”. She concluded her letter by warning “… that all media inquiries should be forwarded to Paul Coupaud, Acting Public Affairs Officer”. VA officials initially said fear of litigation prompted the review of VA support. Last year, a float carrying wounded Veterans in a Midland, Texas, parade collided with a freight train, killing four and injuring 17. Crash victims and their families filed lawsuits in Texas against Union Pacific Railroad and the float owner. The VA was not a defendant, and the VA has not issued any national directives on liability as a result of the tragedy.In…

  3. Neuroimaging overuse is more common in Medicare compared with the VA.

    Science.gov (United States)

    Burke, James F; Kerr, Eve A; McCammon, Ryan J; Holleman, Rob; Langa, Kenneth M; Callaghan, Brian C

    2016-08-23

    To inform initiatives to reduce overuse, we compared neuroimaging appropriateness in a large Medicare cohort with a Department of Veterans Affairs (VA) cohort. Separate retrospective cohorts were established in Medicare and in VA for headache and neuropathy from 2004 to 2011. The Medicare cohorts included all patients enrolled in the Health and Retirement Study (HRS) with linked Medicare claims (HRS-Medicare; n = 1,244 for headache and 998 for neuropathy). The VA cohorts included all patients receiving services in the VA (n = 93,755 for headache and 183,642 for neuropathy). Inclusion criteria were age over 65 years and an outpatient visit for incident neuropathy or a primary headache. Neuroimaging use was measured with Current Procedural Terminology codes and potential overuse was defined using published criteria for use with administrative data. Increasingly specific appropriateness criteria excluded nontarget conditions for which neuroimaging may be appropriate. For both peripheral neuropathy and headache, potentially inappropriate imaging was more common in HRS-Medicare compared with the VA. Forty-nine percentage of all headache patients received neuroimaging in HRS-Medicare compared with 22.1% in the VA (p neuroimaging compared with 9.0% in the VA (p neuroimaging is likely less common in the VA than in a Medicare population. Better understanding the reasons for the more selective use of neuroimaging in the VA could help inform future initiatives to reduce overuse of diagnostic testing. © 2016 American Academy of Neurology.

  4. Characteristics Associated With Utilization of VA and Non-VA Care Among Iraq and Afghanistan Veterans With Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Finley, Erin P; Mader, Michael; Bollinger, Mary J; Haro, Elizabeth K; Garcia, Hector A; Huynh, Alexis K; Pugh, Jacqueline A; Pugh, Mary Jo

    2017-11-01

    Post-traumatic stress disorder (PTSD) affects nearly one-fifth of Iraq and Afghanistan Veterans (IAV). The Department of Veterans Affairs (VA) has invested in making evidence-based psychotherapies for PTSD available at every VA facility nationwide; however, an unknown number of veterans opt to receive care in the community rather than with VA. We compared PTSD care utilization patterns among Texas IAV with PTSD, an ethnically, geographically, and economically diverse group. To identify IAV in Texas with service-connected disability for PTSD, we used a crosswalk of VA administrative data from the Operation Enduring Freedom/Operation Iraqi Freedom Roster and service-connected disability data from the Veterans Benefits Administration. We then surveyed a random sample of 1,128 veterans from the cohort, stratified by sex, rurality, and past use/nonuse of any VA care. Respondents were classified into current utilization groups (VA only, non-VA only, dual care, and no professional PTSD treatment) on the basis of reported PTSD care in the prior 12 months. Responses were weighted to account for sample stratification and for response rate within each strata. Utilization group characteristics were compared to the population mean using the one sample Z-test for proportions, or the t-test for means. A multinomial logistic regression model was used to identify survey variables significantly associated with current utilization group. 249 IAV completed the survey (28.4% response rate). Respondents reported receiving PTSD care: in the VA only (58.3%); in military or community-based settings (including private practitioners) (non-VA only, 8.7%); and in both VA and non-VA settings (dual care, 14.5%). The remainder (18.5%) reported no professional PTSD care in the prior year. Veterans ineligible for Department of Defense care, uncomfortable talking about their problems, and opposed to medication were more likely to receive non-VA care only, whereas those with lower household income

  5. Development of a continuous energy version of KENO V.a

    International Nuclear Information System (INIS)

    Dunn, M.E.; Bentley, C.L.; Goluoglu, S.; Paschal, L.S.; Dodds, H.L.

    1997-01-01

    KENO V.a is a multigroup Monte Carlo code that solves the Boltzmann transport equation and is used extensively in the nuclear criticality safety community to calculate the effective multiplication factor k eff of systems containing fissile material. Because of the smaller amount of disk storage and CPU time required in calculations, multigroup approaches have been preferred over continuous energy (point) approaches in the past to solve the transport equation. With the advent of high-performance computers, storage and CPU limitations are less restrictive, thereby making continuous energy methods viable for transport calculations. Moreover, continuous energy methods avoid many of the assumptions and approximations inherent in multigroup methods. Because a continuous energy version of KENO V.a does not exist, the objective of the work is to develop a new version of KENO V.a that utilizes continuous energy cross sections. Currently, a point cross-section library, which is based on a raw continuous energy cross-section library such as ENDF/B-V is not available for implementation in KENO V.a; however, point cross-section libraries are available for MCNP, another widely used Monte Carlo transport code. Since MCNP cross sections are based on ENDF data and are readily available, a new version of KENO V.a named PKENO V.a has been developed that performs the random walk using MCNP cross sections. To utilize point cross sections, extensive modifications have been made to KENO V.a. At this point in the research, testing of the code is underway. In particular, PKENO V.a, KENO V.a, and MCNP have been used to model nine critical experiments and one subcritical problem. The results obtained with PKENO V.a are in excellent agreement with MCNP, KENO V.a, and experiments

  6. Myosin Va is developmentally regulated and expressed in the human cerebellum from birth to old age

    Directory of Open Access Journals (Sweden)

    C.C.R. Souza

    2013-02-01

    Full Text Available Myosin Va functions as a processive, actin-based motor molecule highly enriched in the nervous system, which transports and/or tethers organelles, vesicles, and mRNA and protein translation machinery. Mutation of myosin Va leads to Griscelli disease that is associated with severe neurological deficits and a short life span. Despite playing a critical role in development, the expression of myosin Va in the central nervous system throughout the human life span has not been reported. To address this issue, the cerebellar expression of myosin Va from newborns to elderly humans was studied by immunohistochemistry using an affinity-purified anti-myosin Va antibody. Myosin Va was expressed at all ages from the 10th postnatal day to the 98th year of life, in molecular, Purkinje and granular cerebellar layers. Cerebellar myosin Va expression did not differ essentially in localization or intensity from childhood to old age, except during the postnatal developmental period. Structures resembling granules and climbing fibers in Purkinje cells were deeply stained. In dentate neurons, long processes were deeply stained by anti-myosin Va, as were punctate nuclear structures. During the first postnatal year, myosin Va was differentially expressed in the external granular layer (EGL. In the EGL, proliferating prospective granule cells were not stained by anti-myosin Va antibody. In contrast, premigratory granule cells in the EGL stained moderately. Granule cells exhibiting a migratory profile in the molecular layer were also moderately stained. In conclusion, neuronal myosin Va is developmentally regulated, and appears to be required for cerebellar function from early postnatal life to senescence.

  7. Adenovirus VA RNA: An essential pro-viral non-coding RNA.

    Science.gov (United States)

    Vachon, Virginia K; Conn, Graeme L

    2016-01-02

    Adenovirus (AdV) 'virus-associated' RNAs (VA RNAs) are exceptionally abundant (up to 10(8)copies/cell), heterogeneous, non-coding RNA transcripts (∼ 150-200 nucleotides). The predominant species, VA RNAI, is best recognized for its essential function in relieving the cellular anti-viral blockade of protein synthesis through inhibition of the double-stranded RNA-activated protein kinase (PKR). More recent evidence has revealed that VA RNAs also interfere with several other host cell processes, in part by virtue of the high level to which they accumulate. Following transcription by cellular RNA polymerase III, VA RNAs saturate the nuclear export protein Exportin 5 (Exp5) and the cellular endoribonculease Dicer, interfering with pre-micro (mi)RNA export and miRNA biogenesis, respectively. Dicer-processed VA RNA fragments are incorporated into the RNA-induced silencing complex (RISC) as 'mivaRNAs', where they may specifically target cellular genes. VA RNAI also interacts with other innate immune proteins, including OAS1. While intact VA RNAI has the paradoxical effect of activating OAS1, a non-natural VA RNAI construct lacking the entire Terminal Stem has been reported to be a pseudoinhibitor of OAS1. Here, we show that a VA RNAI construct corresponding to an authentic product of Dicer processing similarly fails to activate OAS1 but also retains only a modest level of inhibitory activity against PKR in contrast to the non-natural deletion construct. These findings underscore the complexity of the arms race between virus and host, and highlight the need for further exploration of the impact of VA RNAI interactions with host defenses on the outcome of AdV infection beyond that of well-established PKR inhibition. Additional contributions of VA RNAI heterogeneity resulting from variations in transcription initiation and termination to each of these functions remain open questions that are discussed here. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Fireworks algorithm for mean-VaR/CVaR models

    Science.gov (United States)

    Zhang, Tingting; Liu, Zhifeng

    2017-10-01

    Intelligent algorithms have been widely applied to portfolio optimization problems. In this paper, we introduce a novel intelligent algorithm, named fireworks algorithm, to solve the mean-VaR/CVaR model for the first time. The results show that, compared with the classical genetic algorithm, fireworks algorithm not only improves the optimization accuracy and the optimization speed, but also makes the optimal solution more stable. We repeat our experiments at different confidence levels and different degrees of risk aversion, and the results are robust. It suggests that fireworks algorithm has more advantages than genetic algorithm in solving the portfolio optimization problem, and it is feasible and promising to apply it into this field.

  9. Personalities, Cultural Identity, Intercultural Dialogue: V.A. Urechia

    Directory of Open Access Journals (Sweden)

    Anişoara Popa

    2014-12-01

    Full Text Available Considering, as Tzvetan Todorov does, that “the intercultural dimension is part of the cultural dimension” and that personalities assumed different roles, according to the historic circumstances, the ideative sphere of the time, and the specific internal mechanisms of generating elites that each culture has, the goal of this paper is to provide a few comments on the personalities‟ contribution in the intercultural dialogue, starting from the critical examination of the role that V.A. Urechia (1834-1901 - historian, politician and man of letters – had in redefining the national Romanian identity and in the development of the Romanian-Spanish cultural relations at the end of the 19th century. Applying the classical Freudian psychodynamic pattern of the personality structure to the culture, we propose a new point of view on the personalities‟ role in intercultural dialog.

  10. Archetypal Analysis of "Almalek and Albrahmh” from Kalila va Demna

    Directory of Open Access Journals (Sweden)

    Ali Noori

    2016-12-01

    Full Text Available Archetype Theory, has been raised from Carl Gustav Young’s Psychoanalytical School. Young knows mental images and Sediments and Hereditary information which there are in the collective unconscious as Archetype. In other word, archetype is general type of repeated experiences and behaviors of human forefathers which rooted in collective unconscious. the most important Archetypes are "Anima"," Animus", "old wise man", "shadow", "mask", "rebirth" ,and "self" and "individuality". Kalila va Demna is the book which is full of allegorical stories, which because of their mythical aspect, are researchable from Archetypal Analytic criticism. One of this stories which Archetypal color is Dominant in it, is "Almalek and Albrahmh” from 16th chapter of Kalila va Demna. In this study, some archetypes such as "shadow", "Anima", "mask", "old wise man", " self " and "individuality" in the story of "Almalek and Albrahmh" from sixteenth chapter of book, has been analyzed. Since either this tale because of being legendary, and consisting of series of dreams – which have given it mythical, symbolic and interpretable nature – has capacity for archetypal analysis, or archetypal approach has high capacity and power to analyze such narrations. The story was investigated on mentioned view, and it was found that king Heblar which has stricken to a kind of Psychosis, Finds its way into the subconscious through dreams and After a confrontation with his anima, under guidance of old wise meets his self (true self and reach to his individuality and Is rescued from distress. It can be said that the king starts his path of the individual process with a dream.  He, in the bigining of the story, with the help of Iran Dokht and at the end of the story, with the help of minister is released of grief and psychosis.

  11. Expanded Access to Non-VA Care Through the Veterans Choice Program. Interim final rule.

    Science.gov (United States)

    2015-12-01

    The Department of Veterans Affairs (VA) revises its medical regulations that implement section 101 of the Veterans Access, Choice, and Accountability Act of 2014 (hereafter referred to as "the Choice Act"), which requires VA to establish a program to furnish hospital care and medical services through eligible non-VA health care providers to eligible veterans who either cannot be seen within the wait-time goals of the Veterans Health Administration (VHA) or who qualify based on their place of residence (hereafter referred to as the "Veterans Choice Program" or the "Program"). These regulatory revisions are required by the most recent amendments to the Choice Act made by the Construction Authorization and Choice Improvement Act of 2014, and by the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. The Construction Authorization and Choice Improvement Act of 2014 amended the Choice Act to define additional criteria that VA may use to determine that a veteran's travel to a VA medical facility is an "unusual or excessive burden," and the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 amended the Choice Act to cover all veterans enrolled in the VA health care system, remove the 60-day limit on an episode of care, modify the wait-time and 40-mile distance eligibility criteria, and expand provider eligibility based on criteria as determined by VA. This interim final rule revises VA regulations consistent with the changes made to the Choice Act as described above.

  12. 78 FR 56151 - Safety Zone, North Atlantic Ocean; Virginia Beach, VA

    Science.gov (United States)

    2013-09-12

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone, North Atlantic Ocean; Virginia Beach, VA... zone on the navigable waters of the North Atlantic Ocean in Virginia Beach, VA to support the Virginia... Delegation No. 0170.1. ] On September 12, 2013 the City of Virginia Beach will host a fireworks display...

  13. 77 FR 27120 - Safety Zone; Virginia Beach Oceanfront Air Show, Atlantic Ocean, Virginia Beach, VA

    Science.gov (United States)

    2012-05-09

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Virginia Beach Oceanfront Air Show, Atlantic Ocean, Virginia Beach, VA AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The... Beach, VA to support the Virginia Beach Oceanfront Air Show. This action is necessary to provide for the...

  14. 77 FR 13519 - Safety Zone; Virginia Beach Oceanfront Air Show, Atlantic Ocean, Virginia Beach, VA

    Science.gov (United States)

    2012-03-07

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Virginia Beach Oceanfront Air Show, Atlantic Ocean, Virginia Beach, VA AGENCY: Coast Guard, DHS. ACTION: Notice of proposed rulemaking. SUMMARY... Virginia Beach, VA. This action is necessary to provide for the safety of life on navigable waters during...

  15. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements... plan, the minimum goals for award of subcontracts to service-disabled veteran-owned small business...

  16. A Stochastic Dominance Approach to the Basel III Dilemma: Expected Shortfall or VaR?

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); J.A. Jiménez-Martín (Juan-Ángel); E. Maasoumi (Esfandiar); M.J. McAleer (Michael); T. Pérez-Amaral (Teodosio)

    2015-01-01

    markdownabstract__Abstract__ The Basel Committee on Banking Supervision (BCBS) (2013) recently proposed shifting the quantitative risk metrics system from Value-at-Risk (VaR) to Expected Shortfall (ES). The BCBS (2013) noted that “a number of weaknesses have been identified with using VaR for

  17. 38 CFR 58.16 - VA Form 10-0144-Certification Regarding Lobbying.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-0144-Certification Regarding Lobbying. 58.16 Section 58.16 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.16 VA Form 10-0144—Certification Regarding Lobbying. ER06JA00.013 ...

  18. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Form 10-6298, Architect-Engineer Fee Proposal. 853.236-70 Section 853.236-70 Federal Acquisition Regulations System DEPARTMENT OF...-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in 836...

  19. 75 FR 34367 - Safety Zone; Shore Thing & Independence Day Fireworks, Chesapeake Bay, Norfolk, VA

    Science.gov (United States)

    2010-06-17

    ...-AA00 Safety Zone; Shore Thing & Independence Day Fireworks, Chesapeake Bay, Norfolk, VA AGENCY: Coast... zone on the Chesapeake Bay in the vicinity of Ocean View Beach Park, Norfolk, VA in support of the... movement on the Chesapeake Bay [[Page 34368

  20. 75 FR 26155 - Safety Zone; Shore Thing & Independence Day Fireworks, Chesapeake Bay, Norfolk, VA

    Science.gov (United States)

    2010-05-11

    ...-AA00 Safety Zone; Shore Thing & Independence Day Fireworks, Chesapeake Bay, Norfolk, VA AGENCY: Coast... temporary safety zone on the Chesapeake Bay in the vicinity of Ocean View Beach Park, Norfolk, VA in support... traffic movement on the Chesapeake Bay to protect mariners from the hazards associated with fireworks...

  1. 76 FR 38300 - Safety Zone; Shore Thing and Independence Day Fireworks, Chesapeake Bay, Norfolk, VA

    Science.gov (United States)

    2011-06-30

    ...-AA00 Safety Zone; Shore Thing and Independence Day Fireworks, Chesapeake Bay, Norfolk, VA AGENCY: Coast... zone on the Chesapeake Bay in the vicinity of Ocean View Beach Park, Norfolk, VA in support of the... intended to restrict vessel traffic movement on the Chesapeake Bay to protect mariners from the hazards...

  2. 33 CFR 334.350 - Chesapeake Bay off Fort Monroe, Va.; firing range danger zone.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Chesapeake Bay off Fort Monroe, Va.; firing range danger zone. 334.350 Section 334.350 Navigation and Navigable Waters CORPS OF....350 Chesapeake Bay off Fort Monroe, Va.; firing range danger zone. (a) The danger zone. All of the...

  3. 76 FR 27967 - Safety Zone; Shore Thing and Independence Day Fireworks, Chesapeake Bay, Norfolk, VA

    Science.gov (United States)

    2011-05-13

    ...-AA00 Safety Zone; Shore Thing and Independence Day Fireworks, Chesapeake Bay, Norfolk, VA AGENCY: Coast... temporary safety zone on the Chesapeake Bay in the vicinity of Ocean View Beach Park, Norfolk, VA in support... action is intended to restrict vessel traffic movement on the Chesapeake Bay to protect mariners from the...

  4. 75 FR 20774 - Establishment of Class E Airspace; Fort A.P. Hill, VA

    Science.gov (United States)

    2010-04-21

    ... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Part 71 [Docket No. FAA-2009-0739; Airspace Docket No. 09-AEA-14] Establishment of Class E Airspace; Fort A.P. Hill, VA AGENCY... December 7, 2009 that establishes Class E airspace at Fort A.P. Hill, VA. DATES: Effective Date: 0901 UTC...

  5. 77 FR 63734 - Security Zone; James River, Kingsmill Resort, Williamsburg, VA

    Science.gov (United States)

    2012-10-17

    ...-AA00 Security Zone; James River, Kingsmill Resort, Williamsburg, VA AGENCY: Coast Guard, DHS. ACTION... River in the vicinity of Kingsmill Resort Marina, Williamsburg, VA during a visit by The President of... Docket Management Facility in Room W12-140 on the ground floor of the Department of Transportation West...

  6. 76 FR 44288 - Establishment of Class E Airspace; New Market, VA

    Science.gov (United States)

    2011-07-25

    ...-380; Airspace Docket No. 11-AEA-12] Establishment of Class E Airspace; New Market, VA AGENCY: Federal... proposes to establish Class E Airspace at New Market, VA, to accommodate the additional airspace needed for the Standard Instrument Approach Procedures developed for New Market Airport. This action would...

  7. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Science.gov (United States)

    2010-10-01

    ... GENERAL IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST Contractor Responsibility to Avoid Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances... prepared by the VA Office of Inspector General in a common work area within a business segment performing...

  8. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Science.gov (United States)

    2010-07-01

    .... 19012, Pub. L. 99-272) (10) For any disability of a veteran receiving VA contract nursing home care. The veteran is receiving contract nursing home care and requires emergency treatment in non-VA facilities... provisions of this section. When demand is only for infrequent use, individual authorizations may be used...

  9. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Medication prescribed by non-VA physicians. 17.96 Section 17.96 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.96 Medication prescribed by non-VA physicians. Any prescription...

  10. 76 FR 26607 - Safety Zone; Air Power Over Hampton Roads, Back River, Hampton, VA

    Science.gov (United States)

    2011-05-09

    ...-AA00 Safety Zone; Air Power Over Hampton Roads, Back River, Hampton, VA AGENCY: Coast Guard, DHS... navigable waters of the Back River in the vicinity of Hampton, VA. This action is necessary to provide for the safety of life on navigable waters during the Air Power Over Hampton Roads Air Show. This action...

  11. 77 FR 74279 - Agency Information Collection (VA/DOD Joint Disability Evaluation Board Claim): Activity under...

    Science.gov (United States)

    2012-12-13

    ... Joint Disability Evaluation Board Claim): Activity under OMB Review AGENCY: Veterans Benefits... . Please refer to ``OMB Control No. 2900-0704.'' SUPPLEMENTARY INFORMATION: Title: VA/DOD Joint Disability Evaluation Board Claim, VA Form 21- 0819. OMB Control Number: 2900-0704. Type of Review: Extension of a...

  12. 77 FR 72816 - Foreign-Trade Zone 20-Suffolk, VA; Authorization of Production Activity; Usui International...

    Science.gov (United States)

    2012-12-06

    ... Foreign-Trade Zones Board Foreign-Trade Zone 20--Suffolk, VA; Authorization of Production Activity; Usui International Corporation (Diesel Engine Fuel Lines); Chesapeake, VA On June 28, 2012, the Virginia Port Authority, grantee of FTZ 20, submitted a notification of proposed production activity to the Foreign-Trade...

  13. 78 FR 31840 - Safety Zone; USO Patriotic Festival Air Show, Atlantic Ocean; Virginia Beach, VA

    Science.gov (United States)

    2013-05-28

    ...-AA00 Safety Zone; USO Patriotic Festival Air Show, Atlantic Ocean; Virginia Beach, VA AGENCY: Coast... provide for the safety of life on navigable waters during the USO Patriotic Festival Air Show. This action... Patriotic Festival Air Show, Atlantic Ocean; Virginia Beach, VA. (a) Regulated Area. The following area is a...

  14. 75 FR 34934 - Safety Zone; Fireworks for the Virginia Lake Festival, Buggs Island Lake, Clarksville, VA

    Science.gov (United States)

    2010-06-21

    ...-AA00 Safety Zone; Fireworks for the Virginia Lake Festival, Buggs Island Lake, Clarksville, VA AGENCY... Fireworks for the Virginia Lake Festival event. This action is intended to restrict vessel traffic movement... Virginia Lake Festival, Buggs Island Lake, Clarksville, VA (a) Regulated Area. The following area is a...

  15. 76 FR 3017 - VA Veteran-Owned Small Business Verification Guidelines

    Science.gov (United States)

    2011-01-19

    ... that greatly affect today's business climate and put an unnecessary burden on certain business owners... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 74 RIN 2900-AM78 VA Veteran-Owned Small Business... Veterans Affairs (VA) to verify ownership and control of veteran-owned small businesses, including service...

  16. VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs. Final rule.

    Science.gov (United States)

    2013-08-20

    The Department of Veterans Affairs (VA) is amending its VA Health Professional Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP). These regulations comply with and implement sections 302 and 603 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (the 2010 Act). Section 302 of the 2010 Act established the VIOMPSP, which authorizes VA to provide financial assistance to certain students seeking a degree in visual impairment or orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA and the United States. Section 603 of the 2010 Act reauthorized and modified HPSP, a program that provides scholarships for education or training in certain health care occupations.

  17. Empirical analysis on future-cash arbitrage risk with portfolio VaR

    Science.gov (United States)

    Chen, Rongda; Li, Cong; Wang, Weijin; Wang, Ze

    2014-03-01

    This paper constructs the positive arbitrage position by alternating the spot index with Chinese Exchange Traded Fund (ETF) portfolio and estimating the arbitrage-free interval of futures with the latest trade data. Then, an improved Delta-normal method was used, which replaces the simple linear correlation coefficient with tail dependence correlation coefficient, to measure VaR (Value-at-risk) of the arbitrage position. Analysis of VaR implies that the risk of future-cash arbitrage is less than that of investing completely in either futures or spot market. Then according to the compositional VaR and the marginal VaR, we should increase the futures position and decrease the spot position appropriately to minimize the VaR, which can minimize risk subject to certain revenues.

  18. Comparing the health status of VA and non-VA ambulatory patients: the veterans' health and medical outcomes studies.

    Science.gov (United States)

    Rogers, William H; Kazis, Lewis E; Miller, Donald R; Skinner, Katherine M; Clark, Jack A; Spiro, Avron; Fincke, R Graeme

    2004-01-01

    The purpose of this study was to compare health status and disease profiles of ambulatory patients in specific Veterans Administration (VA) and civilian healthcare settings. A random sample of 2425 male veterans seeking care at 4 Boston-area VA outpatient clinics, who took part in the Veterans Health Study (VHS) in 1993-1995, were compared to 1318 male patients seeking civilian outpatient care in 3 major metropolitan areas covered in the Medical Outcomes Study (MOS) in 1986. The MOS sampled patients who had 1 of 5 conditions--hypertension, noninsulin-dependent diabetes, recent myocardial infarction, congestive heart failure, or depression. These 2 samples were age adjusted and compared in terms of the SF-36 Health Status/Quality of Life measures, and a list of 100 clinical variables (diagnostic, symptom, and medical event reports) collected with comparable instruments by a trained clinical observer. Individual odds ratios (VHS to MOS) were calculated for each measure and clinical variables. SF-36 measures of patient health in the VHS were lower than those in the MOS by more than one half of a standard deviation (SD) on 4 of 8 scales, by more than one quarter of a SD on the other 4, by 58% of a SD on the physical health summary scale, and by 37% of a SD on the mental health summary scale (P illness burden than did patients in the MOS. Current economic condition and service-connected disability explain most, if not all, of the differences. The differences were clinically and socially meaningful and would be consistent with substantially higher expected healthcare use.

  19. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria

    Science.gov (United States)

    Peterson, Rachel; Gundlapalli, Adi V.; Metraux, Stephen; Carter, Marjorie E.; Palmer, Miland; Redd, Andrew; Samore, Matthew H.; Fargo, Jamison D.

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations. PMID:26172386

  20. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

    Science.gov (United States)

    Peterson, Rachel; Gundlapalli, Adi V; Metraux, Stephen; Carter, Marjorie E; Palmer, Miland; Redd, Andrew; Samore, Matthew H; Fargo, Jamison D

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

  1. Associations between sex hormones and cognitive and neuropsychiatric manifestations in vascular dementia (VaD).

    Science.gov (United States)

    Xing, Yi; Qin, Wei; Li, Fang; Jia, Xiang-Fei; Jia, Jianping

    2013-01-01

    Although numerous studies have been carried out to determine the effects of sex hormones on Alzheimer's disease (AD), little is known about the associations between sex hormones and VaD. The aim of this study was to compare serum sex hormone levels between VaD patients and normal controls, and to further determine the link between sex hormones and cognitive and neuropsychiatric manifestations of VaD. Serum levels of total estradiol (TE2), total testosterone (TT), luteinizing hormone (LH), and sex hormone binding globulin (SHBG) were measured in 87 VaD patients and 110 cognitive normal controls. The levels of bioavailable estradiol (BE2) and bioavailable testosterone (BT) were calculated. The VaD patients underwent the tests of global cognitive function, verbal memory, and visuospatial, and executive ability. The Neuropsychiatric Inventory (NPI) was used to assess neuropsychiatric symptoms. Compared to controls, the testosterone and SHBG levels were lower in male VaD patients, and the estradiol levels were higher in female VaD patients. The hormones levels were not correlated with cognitive functions among either male or female VaD patients. There were no associations between hormone levels and neuropsychiatric symptoms among male patients, while the TE2 and TT levels were positively associated with apathy and anxiety, respectively among female patients. Our findings suggested there were sex hormone level changes in VaD patients in comparison with cognitive normal controls. Sex hormones were associated with neuropsychiatric symptoms among female but not male VaD patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

    Directory of Open Access Journals (Sweden)

    Rachel Peterson

    Full Text Available Researchers at the U.S. Department of Veterans Affairs (VA have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012 of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services, plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%. Adding allied V60 codes increased that to 31,260 (rate 3.3%. While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

  3. Variation in Utilization of Health Care Services for Rural VA Enrollees With Mental Health-Related Diagnoses.

    Science.gov (United States)

    Johnson, Christopher E; Bush, Ruth L; Harman, Jeffrey; Bolin, Jane; Evans Hudnall, Gina; Nguyen, Ann M

    2015-01-01

    Rural-dwelling Department of Veterans Affairs (VA) enrollees are at high risk for a wide variety of mental health-related disorders. The objective of this study is to examine the variation in the types of mental and nonmental health services received by rural VA enrollees who have a mental health-related diagnosis. The Andersen and Aday behavioral model of health services use and the Agency for Healthcare Research and Quality Medical Expenditure Panel Survey (MEPS) data were used to examine how VA enrollees with mental health-related diagnoses accessed places of care from 1999 to 2009. Population survey weights were applied to the MEPS data, and logit regression was conducted to model how predisposing, enabling, and need factors influence rural veteran health services use (measured by visits to different places of care). Analyses were performed on the subpopulations: rural VA, rural non-VA, urban VA, and urban non-VA enrollees. For all types of care, both rural and urban VA enrollees received care from inpatient, outpatient, office-based, and emergency room settings at higher odds than urban non-VA enrollees. Rural VA enrollees also received all types of care from inpatient, office-based, and emergency room settings at higher odds than urban VA enrollees. Rural VA enrollees had higher odds of a mental health visit of any kind compared to urban VA and non-VA enrollees. Based on these variations, the VA may want to develop strategies to increase screening efforts in inpatient settings and emergency rooms to further capture rural VA enrollees who have undiagnosed mental health conditions. © 2015 National Rural Health Association.

  4. Probabilistic methods for verbal autopsy interpretation: InterVA robustness in relation to variations in a priori probabilities.

    Directory of Open Access Journals (Sweden)

    Edward Fottrell

    Full Text Available InterVA is a probabilistic method for interpreting verbal autopsy (VA data. It uses a priori approximations of probabilities relating to diseases and symptoms to calculate the probability of specific causes of death given reported symptoms recorded in a VA interview. The extent to which InterVA's ability to characterise a population's mortality composition might be sensitive to variations in these a priori probabilities was investigated.A priori InterVA probabilities were changed by 1, 2 or 3 steps on the logarithmic scale on which the original probabilities were based. These changes were made to a random selection of 25% and 50% of the original probabilities, giving six model variants. A random sample of 1,000 VAs from South Africa, were used as a basis for experimentation and were processed using the original InterVA model and 20 random instances of each of the six InterVA model variants. Rank order of cause of death and cause-specific mortality fractions (CSMFs from the original InterVA model and the mean, maximum and minimum results from the 20 randomly modified InterVA models for each of the six variants were compared.CSMFs were functionally similar between the original InterVA model and the models with modified a priori probabilities such that even the CSMFs based on the InterVA model with the greatest degree of variation in the a priori probabilities would not lead to substantially different public health conclusions. The rank order of causes were also similar between all versions of InterVA.InterVA is a robust model for interpreting VA data and even relatively large variations in a priori probabilities do not affect InterVA-derived results to a great degree. The original physician-derived a priori probabilities are likely to be sufficient for the global application of InterVA in settings without routine death certification.

  5. VA Pipeline for Future Nurse Leaders: an Exploration of Current Nurse Leadership Development in the Veteran’s Health Administration

    Science.gov (United States)

    2016-06-10

    chaotic, complex VA landscape is the balance between national and field leadership, the overall VA leadership crisis, and public concern that the...employees and 4.7 million Veterans from World War I, the Spanish American War, and even some Veterans of the Civil War. In 1988, President 15...service to our Nation’s Veterans. With the shifting, expanding, and more complex VA healthcare landscape , this increases the demands for VA leaders to fill

  6. 78 FR 68364 - Payment for Home Health Services and Hospice Care to Non-VA Providers; Delay of Effective Date

    Science.gov (United States)

    2013-11-14

    ... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and... Federal Register on May 6, 2013 (78 FR 26250) a final rule to change the billing methodology for non-VA... INFORMATION: This rulemaking makes the VA regulation governing payments for certain non-VA health care, 38 CFR...

  7. Methods for estimating and comparing VA outpatient drug benefits with the private sector.

    Science.gov (United States)

    Render, Marta L; Nowak, John; Hammond, Emmett K; Roselle, Gary

    2003-06-01

    To estimate and compare Veterans Health Administration (VA) expenditures for outpatient pharmaceuticals for veterans at six VA facilities with hypothetical private sector costs. Using the VA Pharmacy Benefits Management Strategic Health Care Group (PBM) database, we extracted data for all dispensed outpatient prescriptions from the six study sites over federal fiscal year 1999. After extensive data validation, we converted prescriptions to the same units and merged relevant VA pricing information by National Drug Code to Redbook listed average wholesale price and the Medicaid maximal allowable charge, where available. We added total VA drug expenditures to personnel cost from the pharmacy portion of that medical center's cost distribution report. Hypothetical private sector payments were $200.8 million compared with an aggregate VA budget of $118.8 million. Using National Drug Code numbers, 97% of all items dispensed from the six facilities were matched to private sector price data. Nonmatched pharmaceuticals were largely generic over-the-counter pain relievers and commodities like alcohol swabs. The most commonly prescribed medications reflect the diseases and complaints of an older male population: pain, cardiovascular problems, diabetes, and depression or other psychiatric disorders. Use of the VA PBM database permits researchers to merge expenditure and prescription data to patient diagnoses and sentinel events. A critical element in its use is creating similar units among the systems. Such data sets permit a deeper view of the variability in drug expenditures, an important sector of health care whose inflation has been disproportionate to that of the economy and even health care.

  8. Effects of inspired CO2, hyperventilation, and time on VA/Q inequality in the dog

    Science.gov (United States)

    Tsukimoto, K.; Arcos, J. P.; Schaffartzik, W.; Wagner, P. D.; West, J. B.

    1992-01-01

    In a recent study by Tsukimoto et al. (J. Appl. Physiol. 68: 2488-2493, 1990), CO2 inhalation appeared to reduce the size of the high ventilation-perfusion ratio (VA/Q) mode commonly observed in anesthetized mechanically air-ventilated dogs. In that study, large tidal volumes (VT) were used during CO2 inhalation to preserve normocapnia. To separate the influences of CO2 and high VT on the VA/Q distribution in the present study, we examined the effect of inspired CO2 on the high VA/Q mode using eight mechanically ventilated dogs (4 given CO2, 4 controls). The VA/Q distribution was measured first with normal VT and then with increased VT. In the CO2 group at high VT, data were collected before, during, and after CO2 inhalation. With normal VT, there was no difference in the size of the high VA/Q mode between groups [10.5 +/- 3.5% (SE) of ventilation in the CO2 group, 11.8 +/- 5.2% in the control group]. Unexpectedly, the size of the high VA/Q mode decreased similarly in both groups over time, independently of the inspired PCO2, at a rate similar to the fall in cardiac output over time. The reduction in the high VA/Q mode together with a simultaneous increase in alveolar dead space (estimated by the difference between inert gas dead space and Fowler dead space) suggests that poorly perfused high VA/Q areas became unperfused over time. A possible mechanism is that elevated alveolar pressure and decreased cardiac output eliminate blood flow from corner vessels in nondependent high VA/Q regions.

  9. National comparison of literally homeless male and female VA service users: entry characteristics, clinical needs, and service patterns.

    Science.gov (United States)

    Tsai, Jack; Kasprow, Wesley J; Kane, Vincent; Rosenheck, Robert A

    2014-01-01

    Although there are growing numbers of homeless female U.S. veterans, the U.S. Department of Veterans Affairs (VA) has traditionally served a predominantly male population; thus, it is important to examine differences between homeless female and male veterans in their service needs and the current provision of VA homeless services. A national registry of 119,947 users of VA homeless services from 2011 to 2012 was used to 1) estimate the proportion of female veterans among VA homeless service users, 2) examine the proportion of VA homeless service users who are literally homeless by gender, and 3) report differences between female and male VA homeless service users who are literally homeless on sociodemographic and clinical characteristics, as well as on outreach, referral, and admission patterns for an array of specialized VA services. Of VA homeless service users, 8% were female compared with 7% among all homeless veterans, 6% among all VA service users, and 7% among all veterans. Of female VA homeless service users, 54% were literally homeless, slightly fewer than the 59% of male VA homeless service users. Comparing literally homeless VA service users, females were younger, 21% more had dependent children, 8% more were diagnosed with non-military-related posttraumatic stress disorder, and 19% to 20% more were referred and admitted to VA's supported housing program than males. Female veterans use VA homeless services at a rate similar to their use of general VA services and they have unique needs, especially for child care, which may require additional specialized resources. Published by Elsevier Inc.

  10. Comparison of historically simulated VaR: Evidence from oil prices

    International Nuclear Information System (INIS)

    Costello, Alexandra; Asem, Ebenezer; Gardner, Eldon

    2008-01-01

    Cabedo and Moya [Cabedo, J.D., Moya, I., 2003. Estimating oil price 'Value at Risk' using the historical simulation approach. Energy Economics 25, 239-253] find that ARMA with historical simulation delivers VaR forecasts that are superior to those from GARCH. We compare the ARMA with historical simulation to the semi-parametric GARCH model proposed by Barone-Adesi et al. [Barone-Adesi, G., Giannopoulos, K., Vosper, L., 1999. VaR without correlations for portfolios of derivative securities. Journal of Futures Markets 19 (5), 583-602]. The results suggest that the semi-parametric GARCH model generates VaR forecasts that are superior to the VaR forecasts from the ARMA with historical simulation. This is due to the fact that GARCH captures volatility clustering. Our findings suggest that Cabedo and Moya's conclusion is mainly driven by the normal distributional assumption imposed on the future risk structure in the GARCH model. (author)

  11. 75 FR 52989 - Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application...

    Science.gov (United States)

    2010-08-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application for Reconsideration By applications dated July 9, 2010 and July 16, 2010...

  12. 75 FR 41577 - VBA/VHA Musculoskeletal Forum: Improving VA's Disability Evaluation Criteria

    Science.gov (United States)

    2010-07-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS VBA/VHA Musculoskeletal Forum: Improving VA's Disability Evaluation Criteria AGENCY: Department of... Veterans Benefits Administration (VBA)/Veterans Health Administration (VHA) Musculoskeletal Forum...

  13. DoD-VA Health Care: A Case Study in Interagency Reform

    National Research Council Canada - National Science Library

    Cho, John M

    2008-01-01

    .... Examination of the DoD-VA health care partnership in the aftermath of Walter Reed provides new insight into the timing, proportion, and necessity of IAR legislation for improving interagency collaboration...

  14. 48 CFR 852.219-71 - VA mentor-protégé program.

    Science.gov (United States)

    2010-10-01

    ... increase their participation as VA prime contractors and as subcontractors. (b) The program consists of: (1... calculated on a dollar-for-dollar basis and reported by the large business prime contractor via the...

  15. 77 FR 12647 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program

    Science.gov (United States)

    2012-03-01

    ... Providers Grant and Per Diem Program as a part of the effort to end homelessness among our Nation's veterans... ``Transition in Place'' housing model to aid in VA's efforts to end homelessness among veterans. The...

  16. 75 FR 3970 - Fund Availability Under the VA Homeless Providers Grant and Per Diem Program

    Science.gov (United States)

    2010-01-25

    ... Homeless Providers Grant and Per Diem Program as a part of the effort to end chronic homelessness among our... effort to end chronic homelessness among all veterans. It is important to be aware that VA places great...

  17. Electronic Health Records: DOD's and VA's Sharing of Information Could Benefit from Improved Management

    National Research Council Canada - National Science Library

    2009-01-01

    ...) and the Department of Veterans Affairs (VA) are required to accelerate the exchange of health information between the departments and to develop systems or capabilities that allow for interoperability...

  18. 78 FR 12600 - VA Homeless Providers Grant and Per Diem Program

    Science.gov (United States)

    2013-02-25

    ... between 2009 and 2011 VA and the Department of Housing and Urban Development had successfully housed a... post-traumatic stress disorder (PTSD), based on a diagnosis from a licensed mental health professional... that remain in development; [[Page 12607

  19. 78 FR 38452 - Agency Information Collection (VA Police Officer Pre-Employment Screening Checklist) Activities...

    Science.gov (United States)

    2013-06-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (VA Police Officer Pre-Employment Screening Checklist) Activities Under OMB Review AGENCY: Office of Policy, Planning and Preparedness, Department of Veterans Affairs...

  20. Combined Analysis of the VA and DOD Gulf War Clinical Registries

    National Research Council Canada - National Science Library

    Kang, Han

    2002-01-01

    .... Merging of VA PGR and CCEP with linkage to other data resources, 2. General descriptive report on the demographic and military characteristics, overall symptom and diagnosis reporting, and self-reported exposures of the combined data, 3...

  1. 78 FR 51067 - VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility...

    Science.gov (United States)

    2013-08-20

    ... Visual Impairment and Orientation and Mobility Professional Scholarship Programs AGENCY: Department of... program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP... orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA...

  2. Activating Ras mutations fail to ensure efficient replication of adenovirus mutants lacking VA-RNA

    DEFF Research Database (Denmark)

    Schümann, Michael; Dobbelstein, Matthias

    2006-01-01

    Adenoviruses lacking their PKR-antagonizing VA RNAs replicate poorly in primary cells. It has been suggested that these virus recombinants still replicate efficiently in tumor cells with Ras mutations and might therefore be useful in tumor therapy. The ability of interferon-sensitive viruses...... to grow in Ras-mutant tumor cells is generally ascribed to a postulated inhibitory effect of mutant Ras on PKR. We have constructed a set of isogenic adenoviruses that lack either or both VA RNA species, and tested virus replication in a variety of cell species with different Ras status. In tendency, VA...... mutational status, upon infection with VA-less adenoviruses in the presence of interferon, but also upon addition of the PKR activator polyIC to cells. When comparing two isogenic cell lines that differ solely with regard to the presence or absence of mutant Ras, no difference was observed concerning...

  3. 46 CFR 7.45 - Cape Henlopen, DE to Cape Charles, VA.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Cape Henlopen, DE to Cape Charles, VA. 7.45 Section 7.45... Atlantic Coast § 7.45 Cape Henlopen, DE to Cape Charles, VA. (a) A line drawn from the easternmost extremity of Indian River Inlet North Jetty to latitude 38°36.5′ N. longitude 75°02.8′ W. (Indian River...

  4. On Conditional Value at Risk (CoVaR for tail-dependent copulas

    Directory of Open Access Journals (Sweden)

    Jaworski Piotr

    2017-01-01

    Full Text Available The paper deals with Conditional Value at Risk (CoVaR for copulas with nontrivial tail dependence. We show that both in the standard and the modified settings, the tail dependence function determines the limiting properties of CoVaR as the conditioning event becomes more extreme. The results are illustrated with examples using the extreme value, conic and truncation invariant families of bivariate tail-dependent copulas.

  5. Employment status, employment functioning, and barriers to employment among VA primary care patients.

    Science.gov (United States)

    Zivin, Kara; Yosef, Matheos; Levine, Debra S; Abraham, Kristen M; Miller, Erin M; Henry, Jennifer; Nelson, C Beau; Pfeiffer, Paul N; Sripada, Rebecca K; Harrod, Molly; Valenstein, Marcia

    2016-03-15

    Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactive. In adjusted analyses, participants with depression or anxiety (43%) were less likely to be employed, had lower job search self-efficacy, had lower levels of work performance, and reported more employment barriers. Depression and anxiety were not associated with perceived likelihood of job loss among employed or likelihood of job seeking among not employed. Single VA primary care clinic; cross-sectional study. Employment rates are low among working-aged VA primary care patients, particularly those with mental health conditions. Offering primary care interventions to patients that address mental health issues, job search self-efficacy, and work performance may be important in improving health, work, and economic outcomes. Published by Elsevier B.V.

  6. Electronic Health Records: VA and DOD Need to Establish Goals and Metrics for Their Interoperability Efforts

    Science.gov (United States)

    2015-10-27

    systems. What GAO Recommends In its August 2015 report, GAO recommended that VA and DOD, working with the IPO , establish a time frame for...Veterans Affairs (VA) and Defense (DOD), with guidance from the Interagency Program Office ( IPO ) tasked with facilitating the departments’ efforts to...In accordance with its responsibilities, the IPO issued guidance outlining the technical approach for achieving interoperability between the

  7. Feasibility and acceptability of interventions to delay gun access in VA mental health settings.

    Science.gov (United States)

    Walters, Heather; Kulkarni, Madhur; Forman, Jane; Roeder, Kathryn; Travis, Jamie; Valenstein, Marcia

    2012-01-01

    The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully. Published by Elsevier Inc.

  8. Report on the evaluation of the VA/Seattle below-knee prosthesis.

    Science.gov (United States)

    Ellepola, W; Sheredos, S J

    1993-01-01

    The Department of Veterans Affairs (VA), Rehabilitation Research and Development (Rehab R&D) Service, Technology Transfer Section (TTS) with collaboration from the Prosthetic and Sensory Aids Service (PSAS) managed clinical trials to evaluate the VA/Seattle Below-Knee (BK) Prosthetic System. The clinical trials were held at the Prosthetic Treatment Center (PTC), VA Medical Center, Hines, Illinois. Five other VA medical centers participated in the outreach program of the trials as satellite stations, with PTC Hines as the central fabrication facility. The VA/Seattle BK system is the first complete prosthetic system designed and developed by the Department of Veterans Affairs. It consists of a socket designed and fabricated using computer-aided, automated technology, and off-the-shelf modular components: a lightweight pylon and an ankle unit, and a lightweight, energy-storing foot. The computer-based socket design software, the modular components, and the prosthetic foot were developed with funds from the VA Rehab R&D Service. The evaluation trials were conducted to determine the efficacy of the VA/Seattle prosthesis, its reliability, and acceptance by veterans. The clinical trials began in April 1991 and were completed in August 1992. Forty-six BK amputee veterans were fitted with the VA/Seattle prosthesis. Their progress with the prosthesis was followed for a period of 6 months and data were gathered at intervals of 2 weeks, 3 months, and 6 months. Forty sets of subject data instruments were collected. In order to maintain the accuracy of the results, TTS used the 22 sets that were complete for data analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. 46 CFR 7.55 - Cape Henry, VA to Cape Fear, NC.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Cape Henry, VA to Cape Fear, NC. 7.55 Section 7.55 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.55 Cape Henry, VA to Cape Fear, NC. (a) A line drawn from Rudee Inlet Jetty Light “2” to...

  10. VaRank: a simple and powerful tool for ranking genetic variants

    Directory of Open Access Journals (Sweden)

    Véronique Geoffroy

    2015-03-01

    Full Text Available Background. Most genetic disorders are caused by single nucleotide variations (SNVs or small insertion/deletions (indels. High throughput sequencing has broadened the catalogue of human variation, including common polymorphisms, rare variations or disease causing mutations. However, identifying one variation among hundreds or thousands of others is still a complex task for biologists, geneticists and clinicians.Results. We have developed VaRank, a command-line tool for the ranking of genetic variants detected by high-throughput sequencing. VaRank scores and prioritizes variants annotated either by Alamut Batch or SnpEff. A barcode allows users to quickly view the presence/absence of variants (with homozygote/heterozygote status in analyzed samples. VaRank supports the commonly used VCF input format for variants analysis thus allowing it to be easily integrated into NGS bioinformatics analysis pipelines. VaRank has been successfully applied to disease-gene identification as well as to molecular diagnostics setup for several hundred patients.Conclusions. VaRank is implemented in Tcl/Tk, a scripting language which is platform-independent but has been tested only on Unix environment. The source code is available under the GNU GPL, and together with sample data and detailed documentation can be downloaded from http://www.lbgi.fr/VaRank/.

  11. Teacher factors contributing to dosage of the KiVa anti-bullying program.

    Science.gov (United States)

    Swift, Lauren E; Hubbard, Julie A; Bookhout, Megan K; Grassetti, Stevie N; Smith, Marissa A; Morrow, Michael T

    2017-12-01

    The KiVa Anti-Bullying Program (KiVa) seeks to meet the growing need for anti-bullying programming through a school-based, teacher-led intervention for elementary school children. The goals of this study were to examine how intervention dosage impacts outcomes of KiVa and how teacher factors influence dosage. Participants included 74 teachers and 1409 4th- and 5th-grade students in nine elementary schools. Teachers and students completed data collection at the beginning and end of the school year, including measures of bullying and victimization, correlates of victimization (depression, anxiety, peer rejection, withdrawal, and school avoidance), intervention cognitions/emotions (anti-bullying attitudes, and empathy toward victims), bystander behaviors, and teacher factors thought to relate to dosage (self-efficacy for teaching, professional burnout, perceived principal support, expected effectiveness of KiVa, perceived feasibility of KiVa). The dosage of KiVa delivered to classrooms was measured throughout the school year. Results highlight dosage as an important predictor of change in bullying, victimization, correlates of victimization, bystander behavior, and intervention cognitions/emotions. Of the teacher factors, professional burnout uniquely predicted intervention dosage. A comprehensive structural equation model linking professional burnout to dosage and then to child-level outcomes demonstrated good fit. Implications for intervention design and implementation are discussed. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  12. Partnership to improve quality care for veterans: the VA Nursing Academy.

    Science.gov (United States)

    Harper, Doreen C; Selleck, Cynthia S; Eagerton, Gregory; Froelich, Kimberly

    2015-01-01

    More than 22 million living veterans reside in the United States. In fact, understanding military culture and the experiences of these veterans is important to their ongoing health care and the unique challenges faced by many. The Veterans Affairs (VA) Nursing Academy began in 2007 to fund pilot partnerships between schools of nursing and local VA health care facilities to better serve our veteran population. Fifteen academic/service partnerships were selected for funding between 2007 and 2009 with the goals of expanding faculty and professional development, increasing nursing student enrollment, providing opportunities for educational and practice innovations, and increasing the recruitment and retention of VA nurses. This article details critical components of the partnership developed between the Birmingham VA Medical Center and the University of Alabama at Birmingham School of Nursing, a VA Nursing Academy partnership funded in the 2009 cohort. Site-specific goals of the partnership are described along with a discussion of the framework used to develop the Birmingham VA Nursing Academy, which includes relationship building, engagement, governance, evaluation of outcomes, and sustainability. The logic model developed for the partnership is included, and the interim outputs and outcomes of this practice-academic partnership are detailed, a number of which can be replicated by VAs and schools of nursing across the country. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. PERHITUNGAN VaR PORTOFOLIO SAHAM MENGGUNAKAN DATA HISTORIS DAN DATA SIMULASI MONTE CARLO

    Directory of Open Access Journals (Sweden)

    WAYAN ARTHINI

    2012-09-01

    Full Text Available Value at Risk (VaR is the maximum potential loss on a portfolio based on the probability at a certain time.  In this research, portfolio VaR values calculated from historical data and Monte Carlo simulation data. Historical data is processed so as to obtain stock returns, variance, correlation coefficient, and variance-covariance matrix, then the method of Markowitz sought proportion of each stock fund, and portfolio risk and return portfolio. The data was then simulated by Monte Carlo simulation, Exact Monte Carlo Simulation and Expected Monte Carlo Simulation. Exact Monte Carlo simulation have same returns and standard deviation  with historical data, while the Expected Monte Carlo Simulation satistic calculation similar to historical data. The results of this research is the portfolio VaR  with time horizon T=1, T=10, T=22 and the confidence level of 95 %, values obtained VaR between historical data and Monte Carlo simulation data with the method exact and expected. Value of VaR from both Monte Carlo simulation is greater than VaR historical data.

  14. Semi-nonparametric VaR forecasts for hedge funds during the recent crisis

    Science.gov (United States)

    Del Brio, Esther B.; Mora-Valencia, Andrés; Perote, Javier

    2014-05-01

    The need to provide accurate value-at-risk (VaR) forecasting measures has triggered an important literature in econophysics. Although these accurate VaR models and methodologies are particularly demanded for hedge fund managers, there exist few articles specifically devoted to implement new techniques in hedge fund returns VaR forecasting. This article advances in these issues by comparing the performance of risk measures based on parametric distributions (the normal, Student’s t and skewed-t), semi-nonparametric (SNP) methodologies based on Gram-Charlier (GC) series and the extreme value theory (EVT) approach. Our results show that normal-, Student’s t- and Skewed t- based methodologies fail to forecast hedge fund VaR, whilst SNP and EVT approaches accurately success on it. We extend these results to the multivariate framework by providing an explicit formula for the GC copula and its density that encompasses the Gaussian copula and accounts for non-linear dependences. We show that the VaR obtained by the meta GC accurately captures portfolio risk and outperforms regulatory VaR estimates obtained through the meta Gaussian and Student’s t distributions.

  15. VA/Q distribution during heavy exercise and recovery in humans: implications for pulmonary edema

    Science.gov (United States)

    Schaffartzik, W.; Poole, D. C.; Derion, T.; Tsukimoto, K.; Hogan, M. C.; Arcos, J. P.; Bebout, D. E.; Wagner, P. D.

    1992-01-01

    Ventilation-perfusion (VA/Q) inequality has been shown to increase with exercise. Potential mechanisms for this increase include nonuniform pulmonary vasoconstriction, ventilatory time constant inequality, reduced large airway gas mixing, and development of interstitial pulmonary edema. We hypothesized that persistence of VA/Q mismatch after ventilation and cardiac output subside during recovery would be consistent with edema; however, rapid resolution would suggest mechanisms related to changes in ventilation and blood flow per se. Thirteen healthy males performed near-maximal cycle ergometry at an inspiratory PO2 of 91 Torr (because hypoxia accentuates VA/Q mismatch on exercise). Cardiorespiratory variables and inert gas elimination patterns were measured at rest, during exercise, and between 2 and 30 min of recovery. Two profiles of VA/Q distribution behavior emerged during heavy exercise: in group 1 an increase in VA/Q mismatch (log SDQ of 0.35 +/- 0.02 at rest and 0.44 +/- 0.02 at exercise; P less than 0.05, n = 7) and in group 2 no change in VA/Q mismatch (n = 6). There were no differences in anthropometric data, work rate, O2 uptake, or ventilation during heavy exercise between groups. Group 1 demonstrated significantly greater VA/Q inequality, lower vital capacity, and higher forced expiratory flow at 25-75% of forced vital capacity for the first 20 min during recovery than group 2. Cardiac index was higher in group 1 both during heavy exercise and 4 and 6 min postexercise. However, both ventilation and cardiac output returned toward baseline values more rapidly than did VA/Q relationships. Arterial pH was lower in group 1 during exercise and recovery. We conclude that greater VA/Q inequality in group 1 and its persistence during recovery are consistent with the hypothesis that edema occurs and contributes to the increase in VA/Q inequality during exercise. This is supported by observation of greater blood flows and acidosis and, presumably therefore

  16. Interaction of blood coagulation factor Va with phospholipid vesicles examined by using lipophilic photoreagents

    International Nuclear Information System (INIS)

    Krieg, U.C.; Isaacs, B.S.; Yemul, S.S.; Esmon, C.T.; Bayley, H.; Johnson, A.E.

    1987-01-01

    Two different lipophilic photoreagents, [ 3 H]adamantane diazirine and 3-(trifluoromethyl)-3-(m-[ 125 I]iodophenyl)diazirine (TID), have been utilized to examine the interactions of blood coagulation factor Va with calcium, prothrombin, factor Xa, and, in particular, phospholipid vesicles. With each of these structurally dissimilar reagents, the extent of photolabeling of factor Va was greater when the protein was bound to a membrane surface than when it was free in solution. Specifically, the covalent photoreaction with Vl, the smaller subunit of factor Va, was 2-fold higher in the presence of phosphatidylcholine/phosphatidylserine (PC/PS, 3:1) vesicles, to which factor Va binds, than in the presence of 100% PC vesicles, to which the protein does not bind. However, the magnitude of the PC/PS-dependent photolabeling was much less than has been observed previously with integral membrane proteins. It therefore appears that the binding of factor Va to the membrane surface exposes Vl to the lipid core of the bilayer, but that only a small portion of the Vl polypeptide is exposed to, or embedded in, the bilayer core. Addition of either prothrombin or active-site-blocked factor Xa to PC/PS-bound factor Va had little effect on the photolabeling of Vl with TID, but reduced substantially the covalent labeling of Vh, the larger subunit of factor Va. This indicates that prothrombin and factor Xa each cover nonpolar surfaces on Vh when the macromolecules associate on the PC/PS surface. It therefore seems likely that the formation of the prothrombinase complex involves a direct interaction between Vh and factor Xa and between Vh and prothrombin.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. GeneX Va: VBC open source microarray database and analysis software.

    Science.gov (United States)

    Lee, Jae K; Laudeman, Tom; Kanter, Jodi; James, Teela; Siadaty, Mir S; Knaus, William A; Prorok, Alyson; Bao, Yongde; Freeman, Brad; Puiu, Daniela; Wen, Li Min; Buck, Gregory A; Schlauch, Karen; Weller, Jennifer; Fox, Jay W

    2004-04-01

    Developed by the Virginia Bioinformatics Consortium (VBC), GeneX Va is an open source, freeware database and bioinformatics analysis software for archiving and analyzing Affymetrix GeneChip data. It provides an integrated framework for management, documentation, and analysis of microarray experiments and data to support a range of users, from individual research laboratories to institutional microarray facilities. GeneX Va also provides web-based access to a PostgreSQL relational database system with a comprehensive security system. Data can be extracted from the database and delivered to interactive or scriptable statistical analysis protocols. The security system allows each investigator to manage their own array data and analysis output files and also provides custom access privileges for other users, groups, and internal/external collaborators. The analysis interface uses "Analysis Trees," an innovative user interface that allows researchers to interactively create a tree-structured flow chart of analysis routines. The latest GeneX Va software is available from and can be freely downloaded at the Sourceforge web site http://va-genex.sourceforge.net. To allow researchers to access the database and analysis capabilities of the GeneX Va system, microarray data from many VBC GeneChip experiments have been deposited into a public section of the GeneX Va system at the University of Virginia. The VBC GeneX Va sites, which include documentation, are at http://genes.med.virginia.edu/ of the University of Virginia and at http://genex.csbc.vcu.edu/ of the Virginia Commonwealth University.

  18. In aftermath of financial investigation Phoenix VA employee demoted after her testimony

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2013-03-01

    Full Text Available No abstract available. Article truncated after 150 words. A previous Southwest Journal of Pulmonary and Critical Care Journal editorial commented on fiscal mismanagement at the Department of Veterans Affairs (VA Medical Center in Phoenix (1. Now Paula Pedene, the former Phoenix VA public affairs officer, claims she was demoted for testimony she gave to the VA Inspector General’s Office (OIG regarding that investigation (2. In 2011, the OIG investigated the Phoenix VA for excess spending on private care of patients (3. The report blamed systemic failures for controls so weak that $56 million in medical fees were paid during 2010 without adequate review. The report particularly focused on one clinician assigned by the Chief of Staff to review hundreds of requests per week and the intensive care unit physicians for transferring patients to chronic ventilator units (1,3. After the investigation, the director and one of the associate directors left the VA and the chief of staff was promoted …

  19. Effectiveness of Expanded Implementation of STAR-VA for Managing Dementia-Related Behaviors Among Veterans.

    Science.gov (United States)

    Karel, Michele J; Teri, Linda; McConnell, Eleanor; Visnic, Stephanie; Karlin, Bradley E

    2016-02-01

    Nonpharmacological, psychosocial approaches are first-line treatments for managing behavioral symptoms in dementia, but they can be challenging to implement in long-term care settings. The Veterans Health Administration implemented STAR-VA, an interdisciplinary behavioral approach for managing challenging dementia-related behaviors in its Community Living Center (CLCs, nursing home care) settings. This study describes how the program was implemented and provides an evaluation of Veteran clinical outcomes and staff feedback on the intervention. One mental health professional and registered nurse team from 17 CLCs completed STAR-VA training, which entailed an experiential workshop followed by 6 months of expert consultation as they worked with their teams to implement STAR-VA with Veterans identified to have challenging dementia-related behaviors. The frequency and severity of target behaviors and symptoms of depression, anxiety, and agitation were evaluated at baseline and at intervention completion. Staff provided feedback regarding STAR-VA feasibility and impact. Seventy-one Veterans completed the intervention. Behaviors clustered into 6 types: care refusal or resistance, agitation, aggression, vocalization, wandering, and other. Frequency and severity of target behaviors and symptoms of depression, anxiety, and agitation all significantly decreased, with overall effect sizes of 1 or greater. Staff rated both benefits for Veterans and program feasibility favorably. This evaluation supports the feasibility and effectiveness of STAR-VA, an interdisciplinary, behavioral intervention for managing challenging behaviors among residents with dementia in CLCs. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  20. Isolation and characterization of specific bacteriophage Va1 to Vibrio alginolyticus

    Directory of Open Access Journals (Sweden)

    Carla Fernández Espinel

    2017-04-01

    Full Text Available Vibrio alginolyticus is associated with diseases in aquaculture. The misuse of antibiotics has led to the search for alternatives in the treatment of bacterial diseases, among them the application of bacteriophages that infect and destroy bacteria selectively. In this way, a highly lytic V. alginolyticus bacteriophage, termed Va1, was isolated, with the aim to evaluate its physical chemical parameters. For this purpose, different temperature, pH, chloroform exposure and host range conditions were evaluated. The temperature stability of phage Va1 showed higher titers at 20 and 30 °C decreasing from 40 °C. With respect to pH, the highest titers for the bacteriophage were between 5 and 8, and chloroform exposure reduced viability of the Va1 phage by 25%. The one-step curve determined that the latency period and the burst size were 20 minutes and 192 PFU / infective center respectively. Under the transmission electron microscope, the Va1 phage showed an icosahedral head and a non-contractile tail, belonging to the Podoviridae family. In conclusion, Va1 phage presents potential characteristics for use in phage therapy.

  1. Continuous-energy version of KENO V.a for criticality safety applications

    International Nuclear Information System (INIS)

    Dunn, Michael E.; Greene, N. Maurice; Petrie, Lester M.

    2003-01-01

    KENO V.a is a multigroup Monte Carlo code that solves the Boltzmann transport equation and is used extensively in the criticality safety community to calculate the effective multiplication factor of systems with fissionable material. In this work, a continuous-energy or pointwise version of KENO V.a has been developed by first designing a new continuous-energy cross-section format and then by developing the appropriate Monte Carlo transport procedures to sample the new cross-section format. In order to generate pointwise cross sections for a test library, a series of cross-section processing modules were developed and used to process 50 ENDF/B-6 Release 7 nuclides for the test library. Once the cross-section processing procedures were in place, a continuous-energy version of KENO V.a was developed and tested by calculating 21 critical benchmark experiments. The point KENO-calculated results for the 21 benchmarks are in agreement with calculated results obtained with the multigroup version of KENO V.a using the 238-group ENDF/B-5 and 199-group ENDF/B-6 Release 3 libraries. Based on the calculated results with the prototypic cross-section library, a continuous-energy version of the KENO V.a code has been successfully developed and demonstrated for modeling systems with fissionable material. (author)

  2. Value at risk (VaR in uncertainty: Analysis with parametric method and black & scholes simulations

    Directory of Open Access Journals (Sweden)

    Humberto Banda Ortiz

    2014-07-01

    Full Text Available VaR is the most accepted risk measure worldwide and the leading reference in any risk management assessment. However, its methodology has important limitations which makes it unreliable in contexts of crisis or high uncertainty. For this reason, the aim of this work is to test the VaR accuracy when is employed in contexts of volatility, for which we compare the VaR outcomes in scenarios of both stability and uncertainty, using the parametric method and a historical simulation based on data generated with the Black & Scholes model. VaR main objective is the prediction of the highest expected loss for any given portfolio, but even when it is considered a useful tool for risk management under conditions of markets stability, we found that it is substantially inaccurate in contexts of crisis or high uncertainty. In addition, we found that the Black & Scholes simulations lead to underestimate the expected losses, in comparison with the parametric method and we also found that those disparities increase substantially in times of crisis. In the first section of this work we present a brief context of risk management in finance. In section II we present the existent literature relative to the VaR concept, its methods and applications. In section III we describe the methodology and assumptions used in this work. Section IV is dedicated to expose the findings. And finally, in Section V we present our conclusions.

  3. Implementing brief Dynamic Interpersonal Therapy (DIT) in a VA Medical Center.

    Science.gov (United States)

    Chen, Cory K; Ingenito, Christine P; Kehn, Michelle M; Nehrig, Nicole; Abraham, Karen S

    2017-07-12

    Given increasing mental health needs in the VA, identifying strategies to deliver new services is critical. This paper describes the process of navigating provider, patient and systems barriers of an initiative to increase choice, access and quality of psychotherapy at the VA by incorporating an evidence-based short-term, psychodynamic psychotherapy. Brief Dynamic Interpersonal Therapy (DIT) was selected as a viable model for implementation. Data were gathered on the process of implementation, barriers, Veterans seen, and access to psychodynamic psychotherapy. Nine psychologists and 22 masters level pre-doctoral psychology externs have delivered DIT to 73 Veterans. Veterans referred for psychodynamic psychotherapy annually increased 360%. Furthermore, DIT has become the dominant form of psychodynamic psychotherapy requested of the psychology service representing 70.1% of psychodynamic psychotherapy referrals. Strategies are presented for addressing: (1) provider ability, flexibility and motivation, (2) Veteran perception of relevance, distinctiveness and adaptability to complex presenting issues and (3) administrative support. Implementing an evidence-based short-term psychodynamic treatment option in the VA is feasible. VA mental health providers can be trained in brief psychodynamic psychotherapy and can successfully implement those approaches in VA settings. Finally, psychodynamic treatment approaches may serve as a promising alternative to currently available treatments.

  4. VA Health Care: Actions Needed to Address Higher-Than-Expected Demand for the Family Caregiver Program

    Science.gov (United States)

    2014-09-01

    benefit for veterans who require assistance from a caregiver. It can be added to a veteran’s existing pension if the veteran requires assistance with...AL 2 241 1:121 22 VA Long Beach HCS Long Beach, CA 2 245 1:123 22 VA Loma Linda HCS Loma Linda, CA 3 375 1:125 18 New Mexico VA HCS Albuquerque, NM

  5. Information Technology: DOD and VA Have Increased Their Sharing of Health Information, but Further Actions Are Needed

    National Research Council Canada - National Science Library

    Melvin, Valerie C

    2008-01-01

    ...) and the Department of Veterans Affairs (VA) to accelerate the exchange of health information between the departments and to develop systems or capabilities that allow for full interoperability...

  6. VA Disability Compensation and Money Spent on Substance Use Among Homeless Veterans: A Controversial Association.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2015-06-01

    There has long been concern that public support payments are used to support addictive behaviors. This study examined the amount of money homeless veterans spend on alcohol and drugs and the association between public support income, including VA disability compensation, and expenditures on alcohol and drugs. Data were from 1,160 veterans from 19 sites on entry into the Housing and Urban Development-Veterans Affairs Supportive Housing program. Descriptive statistics and nonparametric analyses were conducted. About 33% of veterans reported spending money on alcohol and 22% reported spending money on drugs in the past month. No significant association was found between public support income, VA disability compensation, and money spent on alcohol and drugs. A substantial proportion of homeless veterans spend some income on alcohol and drugs, but disability income, including VA compensation, does not seem to be related to substance use or money spent on addictive substances.

  7. The Burr X Pareto Distribution: Properties, Applications and VaR Estimation

    Directory of Open Access Journals (Sweden)

    Mustafa Ç. Korkmaz

    2017-12-01

    Full Text Available In this paper, a new three-parameter Pareto distribution is introduced and studied. We discuss various mathematical and statistical properties of the new model. Some estimation methods of the model parameters are performed. Moreover, the peaks-over-threshold method is used to estimate Value-at-Risk (VaR by means of the proposed distribution. We compare the distribution with a few other models to show its versatility in modelling data with heavy tails. VaR estimation with the Burr X Pareto distribution is presented using time series data, and the new model could be considered as an alternative VaR model against the generalized Pareto model for financial institutions.

  8. Calculating operational value-at-risk (OpVaR in a retail bank

    Directory of Open Access Journals (Sweden)

    Ja'nel Esterhuysen

    2012-05-01

    Full Text Available The management of operational value-at-risk (OpVaR in financial institutions is presented by means of a novel, robust calculation technique and the influence of this value on the capital held by a bank for operational risk. A clear distinction between economic and regulatory capital is made, as well as the way OpVaR models may be used to calculate both types of capital. Under the Advanced Measurement Approach (AMA, banks may employ OpVaR models to calculate regulatory capital; this article therefore illustrates the differences in regulatory capital when using the AMA and the Standardised Approach (SA, by means of an example. Economic capital is found to converge with regulatory capital using the AMA, but not if the SA is used.

  9. LIFE JOURNEY: MEDICAL AND SCIENTIFIC WORK OF PROFESSOR V.A. SOKOLOV

    Directory of Open Access Journals (Sweden)

    P. A. Ivanov

    2017-01-01

    Full Text Available The article is dedicated to doctor of medicine, professor V.A. Sokolov. In 2017 he celebrates his eightieth birthday. Professor V.A. .Sokolov is one of the founders of polytrauma treatment in USSR and Russia. For a long time he had been heading polytrauma department at the N.V. Sklifosovsky Research Institute for Emergency Medicine. Due to his work, algorithms of life sustaining and recovery of serious patients were developed. Professor V.A. Sokolov is the author of 6 monographies and about 300 periodical papers. Besides, he is the holder of 32 patents. Some of his inventions were popularized and manufactured. He had been leading active scientific work, which resulted in 6 doctoral dissertations and 15 candidate theses. The staff of N.V. Sklifosovsky Research Institute for Emergency Medicine congratulates on the anniversary.

  10. Waves from the Sun: to the 100th anniversary of V.A. Troitskaya's birth

    Science.gov (United States)

    Guglielmi, Anatol; Potapov, Alexander

    2017-09-01

    It has been one hundred years since the birth of the outstanding scientist Professor V.A. Troitskaya. Her remarkable achievements in solar-terrestrial physics are widely known. For many years, Valeria A. Troitskaya was the President of the International Association of Geomagnetism and Aeronomy. This article deals with only one aspect of the multifaceted creative activity of V.A. Troitskaya. It relates to the problem of sources of ultra-low frequency (ULF) electromagnetic oscillations and waves outside Earth’s magnetosphere. We were fortunate to work under the leadership of V.A. Troitskaya on this problem. In this paper, we briefly describe the history from the emergence of the idea of the extramagnetospheric origin of dayside permanent ULF oscillations in the late 1960s to the modern quest made by ground and satellite means for ULF waves excited by solar surface oscillations propagating in the interplanetary medium and reaching Earth.

  11. VA health service utilization for homeless and low-income Veterans: a spotlight on the VA Supportive Housing (VASH) program in greater Los Angeles.

    Science.gov (United States)

    Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M; Rubenstein, Lisa V; Gelberg, Lillian

    2014-05-01

    The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program-the VA's Housing First effort-is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. We performed a secondary database analysis of Veterans (n=62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care.

  12. Myosin-Va and Dynamic Actin Oppose Microtubules to Drive Long-Range Organelle Transport

    Science.gov (United States)

    Evans, Richard D.; Robinson, Christopher; Briggs, Deborah A.; Tooth, David J.; Ramalho, Jose S.; Cantero, Marta; Montoliu, Lluis; Patel, Shyamal; Sviderskaya, Elena V.; Hume, Alistair N.

    2014-01-01

    Summary In animal cells, microtubule and actin tracks and their associated motors (dynein, kinesin, and myosin) are thought to regulate long- and short-range transport, respectively [1–8]. Consistent with this, microtubules extend from the perinuclear centrosome to the plasma membrane and allow bidirectional cargo transport over long distances (>1 μm). In contrast, actin often comprises a complex network of short randomly oriented filaments, suggesting that myosin motors move cargo short distances. These observations underpin the “highways and local roads” model for transport along microtubule and actin tracks [2]. The “cooperative capture” model exemplifies this view and suggests that melanosome distribution in melanocyte dendrites is maintained by long-range transport on microtubules followed by actin/myosin-Va-dependent tethering [5, 9]. In this study, we used cell normalization technology to quantitatively examine the contribution of microtubules and actin/myosin-Va to organelle distribution in melanocytes. Surprisingly, our results indicate that microtubules are essential for centripetal, but not centrifugal, transport. Instead, we find that microtubules retard a centrifugal transport process that is dependent on myosin-Va and a population of dynamic F-actin. Functional analysis of mutant proteins indicates that myosin-Va works as a transporter dispersing melanosomes along actin tracks whose +/barbed ends are oriented toward the plasma membrane. Overall, our data highlight the role of myosin-Va and actin in transport, and not tethering, and suggest a new model in which organelle distribution is determined by the balance between microtubule-dependent centripetal and myosin-Va/actin-dependent centrifugal transport. These observations appear to be consistent with evidence coming from other systems showing that actin/myosin networks can drive long-distance organelle transport and positioning [10, 11]. PMID:25065759

  13. BMP-2 Overexpression Augments Vascular Smooth Muscle Cell Motility by Upregulating Myosin Va via Erk Signaling

    Directory of Open Access Journals (Sweden)

    Ming Zhang

    2014-01-01

    Full Text Available Background. The disruption of physiologic vascular smooth muscle cell (VSMC migration initiates atherosclerosis development. The biochemical mechanisms leading to dysfunctional VSMC motility remain unknown. Recently, cytokine BMP-2 has been implicated in various vascular physiologic and pathologic processes. However, whether BMP-2 has any effect upon VSMC motility, or by what manner, has never been investigated. Methods. VSMCs were adenovirally transfected to genetically overexpress BMP-2. VSMC motility was detected by modified Boyden chamber assay, confocal time-lapse video assay, and a colony wounding assay. Gene chip array and RT-PCR were employed to identify genes potentially regulated by BMP-2. Western blot and real-time PCR detected the expression of myosin Va and the phosphorylation of extracellular signal-regulated kinases 1/2 (Erk1/2. Immunofluorescence analysis revealed myosin Va expression locale. Intracellular Ca2+ oscillations were recorded. Results. VSMC migration was augmented in VSMCs overexpressing BMP-2 in a dose-dependent manner. siRNA-mediated knockdown of myosin Va inhibited VSMC motility. Both myosin Va mRNA and protein expression significantly increased after BMP-2 administration and were inhibited by Erk1/2 inhibitor U0126. BMP-2 induced Ca2+ oscillations, generated largely by a “cytosolic oscillator”. Conclusion. BMP-2 significantly increased VSMCs migration and myosin Va expression, via the Erk signaling pathway and intracellular Ca2+ oscillations. We provide additional insight into the pathophysiology of atherosclerosis, and inhibition of BMP-2-induced myosin Va expression may represent a potential therapeutic strategy.

  14. Validity testing and neuropsychology practice in the VA healthcare system: results from recent practitioner survey (.).

    Science.gov (United States)

    Young, J Christopher; Roper, Brad L; Arentsen, Timothy J

    2016-05-01

    A survey of neuropsychologists in the Veterans Health Administration examined symptom/performance validity test (SPVT) practices and estimated base rates for patient response bias. Invitations were emailed to 387 psychologists employed within the Veterans Affairs (VA), identified as likely practicing neuropsychologists, resulting in 172 respondents (44.4% response rate). Practice areas varied, with 72% at least partially practicing in general neuropsychology clinics and 43% conducting VA disability exams. Mean estimated failure rates were 23.0% for clinical outpatient, 12.9% for inpatient, and 39.4% for disability exams. Failure rates were the highest for mTBI and PTSD referrals. Failure rates were positively correlated with the number of cases seen and frequency and number of SPVT use. Respondents disagreed regarding whether one (45%) or two (47%) failures are required to establish patient response bias, with those administering more measures employing the more stringent criterion. Frequency of the use of specific SPVTs is reported. Base rate estimates for SPVT failure in VA disability exams are comparable to those in other medicolegal settings. However, failure in routine clinical exams is much higher in the VA than in other settings, possibly reflecting the hybrid nature of the VA's role in both healthcare and disability determination. Generally speaking, VA neuropsychologists use SPVTs frequently and eschew pejorative terms to describe their failure. Practitioners who require only one SPVT failure to establish response bias may overclassify patients. Those who use few or no SPVTs may fail to identify response bias. Additional clinical and theoretical implications are discussed.

  15. Effects of the KiVa antibullying program on cyberbullying and cybervictimization frequency among Finnish youth.

    Science.gov (United States)

    Williford, Anne; Elledge, L Christian; Boulton, Aaron J; DePaolis, Kathryn J; Little, Todd D; Salmivalli, Christina

    2013-01-01

    Cyberbullying among school-aged children has received increased attention in recent literature. However, no empirical evidence currently exists on whether existing school-based antibullying programs are effective in targeting the unique aspects of cyberbullying. To address this important gap, the present study investigates the unique effects of the KiVa Antibullying Program on the frequency of cyberbullying and cybervictimization among elementary and middle school youth. Using data from a group randomized controlled trial, multilevel ordinal regression analyses were used to examine differences in the frequencies of cyberbullying and cybervictimization between intervention (N = 9,914) and control students (N = 8,498). The effects of age and gender on frequencies of cyber behaviors were also assessed across conditions. Results revealed a significant intervention effect on the frequency of cybervictimization; KiVa students reported lower frequencies of cybervictimization at posttest than students in a control condition. The effect of condition on the perpetration of cyberbullying was moderated by age. When student age was below the sample mean, KiVa students reported lower frequencies of cyberbullying than students in the control condition. We also found evidence of classroom level variation in cyberbullying and cybervictimization, suggesting cyberbullying is in part a classroom-level phenomenon. KiVa appears to be an efficacious program to address cyber forms of bullying and victimization. We discuss several unique aspects of KiVa that may account for the significant intervention effects. Results suggest that KiVa is an intervention option for schools concerned with reducing cyberbullying behavior and its deleterious effects on children's adjustment.

  16. Analisis del VaR en crisis y estabilidad: El caso de Mexico y Argentina

    Directory of Open Access Journals (Sweden)

    Cortez, K.A.

    2008-07-01

    Full Text Available The present analysis shows the possible effects of the risk to which the economies of Mexico and Argentina are exposed. The article studies the methodology of the VaR using the parametric model of average variance in individual in the type of change of the economies of Mexico and Argentina. The types from changes of the two economies are taken and the evolution of the VaR at time of crisis and exchange stability is analyzed. The main disadvantages of the Bar like metric are explained of measurement of risk.

  17. Influence of PVP/VA copolymer composition on drug-polymer solubility.

    Science.gov (United States)

    Rask, Malte Bille; Knopp, Matthias Manne; Olesen, Niels Erik; Holm, René; Rades, Thomas

    2016-03-31

    In this study, the influence of copolymer composition on drug-polymer solubility was investigated. The solubility of the model drug celecoxib (CCX) in various polyvinylpyrrolidone/vinyl acetate (PVP/VA) copolymer compositions (70/30, 60/40, 50/50 and 30/70 w/w) and the pure homopolymers polyvinylpyrrolidone (PVP) and polyvinyl acetate (PVA) was predicted at 25 °C using a thermal analysis method based on the recrystallization of a supersaturated amorphous dispersion (recrystallization method). These solubilities were compared with a prediction based on the solubility of CCX in the liquid monomeric precursors of PVP/VA, N-vinylpyrrolidone (NVP) and vinyl acetate (VA), using the Flory-Huggins lattice theory (liquid monomer solubility approach). The solubilities predicted from the liquid monomer solubility approach increased linearly with increasing VP/VA ratio from 0.03-0.60 w/w. Even though the solubilities predicted from the recrystallization method also increased with increasing VP/VA ratio from 0.02-0.40 w/w, the predicted solubility seemed to approach a plateau at high VP/VA ratios. Increasing positive deviations from the Gordon-Taylor equation with increasing VP/VA ratio indicated strong interactions between CCX and the VP repeat unit, which was in accordance with the relatively high solubilities predicted using both methods. As the solubility plateau may be a consequence of steric hindrance caused by the size differences between CCX and the VP repeat units, it is likely that a CCX molecule interacting with a VP repeat unit hinders another CCX molecule from binding to the neighboring repeat units in the polymer chain. Therefore, it is possible that replacing these neighboring hygroscopic VP repeat units with hydrophobic VA repeat units, could increase the physical stability of an amorphous solid dispersion without compromising the drug-polymer solubility. This knowledge could be used advantageously in future development of amorphous drug delivery systems as

  18. Myosin Va participates in acrosomal formation and nuclear morphogenesis during spermatogenesis of Chinese mitten crab Eriocheir sinensis.

    Directory of Open Access Journals (Sweden)

    Xiao Sun

    Full Text Available BACKGROUND: The Chinese mitten crab Eriocheir sinensis belongs to the Class Crustacea, Decapoda, Brachyura. The spermatozoon of this species is of aflagellated type, it has a spherical acrosome surrounded by the cup-shaped nucleus, which are unique to brachyurans. For the past several decades, studies on the spermatogenesis of the mitten crab mainly focus on the morphology. Compared with the extensive study of molecular mechanism of spermatogenesis in mammals, relatively less information is available in crustacean species. Myosin Va, a member of Class V myosin, has been implicated in acrosome biogenesis and vesicle transport during spermatogenesis in mammals. In the present study we demonstrate the expression and cellular localization of myosin Va during spermatogenesis in E. sinensis. METHODOLOGY/PRINCIPAL FINDINGS: Western blot demonstrated that myosin Va is expressed during spermatogenesis. Immunocytochemical and ultrastructural analyses showed that myosin Va mainly localizes in the cytoplasm in spermatocytes. At the early stage of spermiogenesis, myosin Va binds to the endoplasmic reticulum vesicle (EV and proacrosomal granule (PG. Subsequently, myosin Va localizes within the proacrosomal vesicle (PV formed by PG and EV fusion and locates in the membrane complex (MC at the mid spermatid stage. At the late spermatid stage, myosin Va is associated with the shaping nucleus and mitochondria. In mature spermatozoon, myosin Va predominates in acrosomal tubule (AT and nucleus. CONCLUSIONS/SIGNIFICANCE: Our study demonstrates that myosin Va may be involved in acrosome biogenesis and nuclear morphogenesis during spermatogenesis in E. sinensis. Considering the distribution and molecular characteristics of myosin Va, we also propose a hypothesis of AT formation in this species. It is the first time to uncover the role of myosin Va in crustacean spermatogenesis.

  19. 33 CFR 334.280 - James River between the entrance to Skiffes Creek and Mulberry Point, Va.; army training and...

    Science.gov (United States)

    2010-07-01

    ... to Skiffes Creek and Mulberry Point, Va.; army training and small craft testing area. 334.280 Section... Creek and Mulberry Point, Va.; army training and small craft testing area. (a) The restricted area... regulations of the Department of the Army, nor will the passage of fishing vessels to or from authorized traps...

  20. 75 FR 23800 - Notice of Intent to Repatriate a Cultural Item: Virginia Museum of Fine Arts, Richmond, VA

    Science.gov (United States)

    2010-05-04

    ...). Records from the Portland Art Museum read as follows: ``Purchase, Indian Collection Subscription Fund. To...: Virginia Museum of Fine Arts, Richmond, VA AGENCY: National Park Service, Interior. ACTION: Notice. Notice... of Fine Arts, Richmond, VA, that meets the definition of ``object of cultural patrimony'' under 25 U...

  1. 75 FR 44720 - Safety Zone; Live-Fire Gun Exercise, M/V Del Monte, James River, VA

    Science.gov (United States)

    2010-07-29

    ... DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 165 [Docket No. USCG-2010-0585] RIN 1625-AA00 Safety Zone; Live-Fire Gun Exercise, M/V Del Monte, James River, VA AGENCY: Coast Guard, DHS... follows: Sec. 165.T05-0585 Safety Zone; Live-Fire Gun Exercise, M/V Del Monte, James River, VA (a...

  2. A configurational and conformational study of aframodial and its diasteriomers via experimental and theoretical VA and VCD spectroscopies

    DEFF Research Database (Denmark)

    Jalkanen, Karl J.; Gale, J.D.; Lassen, Peter Rygaard

    2008-01-01

    In this work we present the experimental and theoretical vibrational absorption (VA) and the theoretical vibrational circular dichroism (VCD) spectra for aframodial. In addition, we present the theoretical VA and VCD spectra for the diasteriomers of aframodial. Aframodial has four chiral centers ...

  3. 77 FR 12997 - Drug and Drug-Related Supply Promotion by Pharmaceutical Company Representatives at VA Facilities

    Science.gov (United States)

    2012-03-05

    ... it would be inappropriate to allow, as a general rule, drug marketing to target health professional...,'' ``promotional materials,'' ``patient education materials,'' and ``individual departments.'' We disagree with the... representatives and VA staff. Commenters also suggested that VA define the term ``marketing activities'' as used...

  4. 75 FR 15721 - Back Bay National Wildlife Refuge, City of Virginia Beach, VA

    Science.gov (United States)

    2010-03-30

    ... Fish and Wildlife Service Back Bay National Wildlife Refuge, City of Virginia Beach, VA AGENCY: Fish... will also hold public meetings in Virginia Beach, Virginia during the 30-day review period to receive... Back Bay NWR, 4005 Sandpiper Road, Virginia Beach, Virginia. U.S. Postal Service: Thomas Bonetti...

  5. 33 CFR 80.505 - Cape Henlopen, DE to Cape Charles, VA.

    Science.gov (United States)

    2010-07-01

    ... to Cape Charles, VA. (a) A line drawn from the seaward extremity of Indian River Inlet North Jetty to Indian River Inlet South Jetty Light. (b) A line drawn from Ocean City Inlet Light 6, 225° true across... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Cape Henlopen, DE to Cape Charles...

  6. Intra-Operative Indocyanine Green-Videoangiography (ICG-VA) in ...

    African Journals Online (AJOL)

    Methods: Fifteen consecutive patients with anterior circulation aneurysms who underwent craniotomy and clipping of the aneurysms were included in this study. Intraoperative ICG-VA was performed in all cases after exposure of the aneurysm and the branches in the vicinity of the aneurysm or the parent vessel before ...

  7. Choosing Expected Shortfall Over VaR in Basel III Using Stochastic Dominance

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); J.A. Jiménez-Martín (Juan-Ángel); E. Maasoumi (Esfandiar); M.J. McAleer (Michael); T. Pérez-Amaral (Teodosio)

    2016-01-01

    textabstractWe compare Value at Risk (VaR) and Expected Shortfall (ES) following a Stochastic Dominance (SD) approach frequently used to order distributions in terms of welfare and in portfolio selection. Basel Committee on Banking Supervision (BCBS) recommends bank risk managers to shift the

  8. 76 FR 2148 - Specialty Minerals, Inc., Franklin, VA; Notice of Revised Determination on Reconsideration

    Science.gov (United States)

    2011-01-12

    ... Employment and Training Administration Specialty Minerals, Inc., Franklin, VA; Notice of Revised... Minerals, Inc., Franklin, Virginia (the subject firm). The Notice was published ] in the Federal Register... reconsideration, I determine that workers of Specialty Minerals, Inc., Franklin, Virginia, who are engaged in...

  9. DOD and VA Health Care: Actions Needed to Help Ensure Appropriate Medication Continuation and Prescribing Practices

    Science.gov (United States)

    2016-01-01

    GAO-16-158 DOD and VA Health Care medications.56 When we discussed the concept of a single formulary with officials, VHA officials expressed concern...Director; Jennie F. Apter; Pamela Dooley; Joshua D. Ferencik; Jacquelyn Hamilton; Toni Harrison; Katie McConnell ; and Daniel Ries made key

  10. Homeless Veterans: Management Improvements Could Help VA Better Identify Supportive Housing Projects

    Science.gov (United States)

    2016-12-01

    Coalition for Homeless Veterans, and Vietnam Veterans of America . We also interviewed officials in select locations that either have large populations of... homelessness : The National Alliance to End Homelessness , National Coalition for Homeless Veterans, U.S. Vets, Vietnam Veterans of America , and the... HOMELESS VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects Report to

  11. 78 FR 56271 - FY 2014-2020 Draft VA Strategic Plan

    Science.gov (United States)

    2013-09-12

    ... developing our workforce with the skills, tools, and leadership to meet our clients' needs and expectations... requires agencies require more frequent reporting and reviews (quarterly instead of annually) that are... leadership to meet our clients' needs and expectations. VA's FY 2014-2020 strategic goals are to: (1) Empower...

  12. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Science.gov (United States)

    2011-11-21

    ... concerning the billing methodology for non-VA providers of home health services and hospice care. The... health services and hospice care. The reasons that we would make the billing methodology in Sec. 17.56... could be interpreted as providing an alternate billing methodology applicable only to these services...

  13. Le CERN va supprimer 600 postes d'ici a 2007

    CERN Document Server

    2002-01-01

    "Le Laboratoire europeen pour la physique des particules (CERN), qui doit economiser quelque 340 millions d'euros jusqu'en 2008, va reduire ses effectifs de 600 postes d'ici a 2007, a annonce jeudi son porte-parole, James Gillies" (1/2/ page).

  14. Processing and Characterization of High Density Polyethylene/Ethylene Vinyl Acetate Blends with Different VA Contents

    Directory of Open Access Journals (Sweden)

    Othman Y. Alothman

    2012-01-01

    Full Text Available Different series of high density Polyethylene/Ethylene Vinyl Acetate (HDPE/EVA blends were prepared via melt blending in a corotating intermeshing twin screw extruder. The effects of VA percentage and EVA loading ratio on the thermal, rheological viscoelastic, mechanical, and fracture toughness of the blends were analyzed. The results showed that the addition of EVA to HDPE reduces the thermal, elastic, and viscoelastic properties of the blends. The microscopic examination of the fracture surface confirmed the ductile fracture of HDPE/EVA blends for all blend ratios and VA percentages. Increasing the EVA ratio and VA content caused a significant reduction in the blend crystallinity but had no significant effect on melting temperature. The complex viscosity increased with increasing the percentage of EVA due to the restriction of molecular mobility and reduction of free volume, induced by the addition of EVA. The storage modulus decreased with increasing the EVA ratio and temperature, while it increased with increasing the frequency. Young’s modulus, yield strength, and fracture strain decreased with increasing the EVA ratio. Similarly, the fracture toughness decreased proportional to the EVA percentage. Finally the results indicated that the VA content has significant effects on the mechanical, thermal, and dynamic properties of HDPE/EVA blends.

  15. 76 FR 34248 - Equestrian Stables at Meadowood Special Recreation Management Area, VA; Information Sharing Meeting

    Science.gov (United States)

    2011-06-13

    ... DEPARTMENT OF THE INTERIOR Equestrian Stables at Meadowood Special Recreation Management Area, VA; Information Sharing Meeting AGENCY: Bureau of Land Management, Interior. ACTION: Notice of public meeting... about the condition of the equestrian stables at Meadowood Special Recreation Management Area (SRMA...

  16. The VA and VCD spectra of various isotopomers of L-alanine in aqueous solution

    DEFF Research Database (Denmark)

    Abdali, Salim; Jalkanen, Karl J.; Bohr, Henrik

    2002-01-01

    Density functional theory (DFT) at the Becke 3LYP level has been used to calculate the vibrational absorption (VA) and vibrational circular dichroism (VCD) spectra of various deuterated species Of L-alanine. The effect of replacing the methine hydrogen, CH1, the methyl group, CH3, and both...

  17. Note from North America: "Linda, VA AG 2013 and Knitting Needles" and "Words"

    Science.gov (United States)

    Alper, Paul

    2014-01-01

    This article is comprised of two essays by Paul Alper. The first essay, "Linda VA AG 2013 and Knitting Needles," provides examples of how a natural language does not necessarily work the way of logic. The second essay, "Words," discusses how the words of winners tend to become what we call the enduring historical record. The…

  18. 30 CFR 57.22229 - Weekly testing (I-A, III, and V-A mines).

    Science.gov (United States)

    2010-07-01

    ... METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Ventilation § 57.22229 Weekly testing (I... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Weekly testing (I-A, III, and V-A mines). 57...

  19. 77 FR 21158 - VA Directive 0005 on Scientific Integrity: Availability for Review and Comment

    Science.gov (United States)

    2012-04-09

    ... Friday (except holidays). Call (202) 461-4902 for an appointment. Those without computer access may call..., and ethical behavior in the development and application of scientific and technological findings in VA... research, including the protection of human subjects, laboratory animal welfare, research safety and...

  20. Differential effects of the KiVa anti-bullying program on popular and unpopular bullies

    NARCIS (Netherlands)

    Garandeau, Claire F.; Lee, Ihno A.; Salmivalli, Christina

    2014-01-01

    This study utilized data from the evaluation of the Finnish KiVa program in testing the prediction that school bullies' high perceived popularity would impede the success of anti-bullying interventions. Multiple-group structural equation modeling (SEM) analyses were conducted on a subsample of 911

  1. 38 CFR 1.9 - Description, use, and display of VA seal and flag.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Description, use, and display of VA seal and flag. 1.9 Section 1.9 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... stars represent the five branches of military service. The crossed flags represent our nation's history...

  2. 77 FR 33089 - OPSAIL 2012 Virginia, Port of Hampton Roads, VA

    Science.gov (United States)

    2012-06-05

    ...] RIN 1625-AA00, AA08, AA11 OPSAIL 2012 Virginia, Port of Hampton Roads, VA AGENCY: Coast Guard, DHS... of Hampton Roads, Virginia for Operation Sail (OPSAIL) 2012 Virginia activities. This regulation is..., Hampton Roads, the James River and Elizabeth River. DATES: This rule is effective from June 6, 2012 to...

  3. 75 FR 30782 - Reorganization/Expansion of Foreign-Trade Zone 20; Hampton Roads, VA, Area

    Science.gov (United States)

    2010-06-02

    ... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board [Order No. 1683] Reorganization/Expansion of Foreign-Trade Zone 20; Hampton Roads, VA, Area Pursuant to its authority under the Foreign-Trade Zones Act...) in the Hampton Roads, Virginia, area within the Norfolk Customs and Border Protection port of entry...

  4. 75 FR 76953 - Foreign-Trade Zone 238-Dublin, VA Site Renumbering Notice

    Science.gov (United States)

    2010-12-10

    ... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board Foreign-Trade Zone 238--Dublin, VA Site Renumbering Notice Foreign-Trade Zone 238 was approved by the Foreign-Trade Zones Board on August 5, 1999... Boulevard, Pulaski. For further information, contact Maureen Hinman at [email protected]trade.gov or (202) 482...

  5. 75 FR 76953 - Foreign-Trade Zone 207-Richmond, VA Site Renumbering Notice

    Science.gov (United States)

    2010-12-10

    ... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board Foreign-Trade Zone 207--Richmond, VA Site Renumbering Notice Foreign-Trade Zone 207 was approved by the Foreign-Trade Zones Board on March 31, 1995... [email protected]trade.gov or (202) 482-0627. Dated: December 1, 2010. Andrew McGilvray, Executive Secretary...

  6. 77 FR 56709 - Proposed Information Collection (VA Subcontracting Report for Service Disabled Veteran-Owned...

    Science.gov (United States)

    2012-09-13

    ... Subcontracting Report for Service Disabled Veteran-Owned Small Business and Veteran-Owned Small Business Concerns... use of other forms of information technology. Title: VA Subcontracting Report for Service Disabled... direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. 2012-22488...

  7. Choosing Expected Shortfall over VaR in Basel III Using Stochastic Dominance

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); J.A. Jiménez-Martín (Juan-Ángel); E. Maasoumi (Esfandiar); M.J. McAleer (Michael)

    2015-01-01

    textabstractBank risk managers follow the Basel Committee on Banking Supervision (BCBS) recommendations that recently proposed shifting the quantitative risk metrics system from Value-at-Risk (VaR) to Expected Shortfall (ES). The Basel Committee on Banking Supervision (2013, p. 3) noted that: “a

  8. 77 FR 48127 - Foreign-Trade Zone 20-Suffolk, VA; Notification of Proposed Production Activity, Usui...

    Science.gov (United States)

    2012-08-13

    ..., Usui International Corporation, (Diesel Engine Fuel Lines), Chesapeake, VA The Virginia Port Authority... is located within Site 9 of FTZ 20. The facility is used for the production of diesel engine fuel lines. Production under FTZ procedures could exempt Usui from customs duty payments on foreign status...

  9. 48 CFR 819.602-3 - Resolving differences between VA and the Small Business Administration.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Resolving differences between VA and the Small Business Administration. 819.602-3 Section 819.602-3 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Certificates of Competency and Determinations of...

  10. 77 FR 19975 - VA Acquisition Regulation: Simplified Acquisition Procedures for Health-Care Resources (Section...

    Science.gov (United States)

    2012-04-03

    ... to which technology, economic conditions, or other factors have changed in the area affected by the... comments on factors described in the Supplementary Information. DATES: Comments must be received by VA on... (003A2A), Office of Acquisition, Logistics and Construction, Department of Veterans Affairs, 810 Vermont...

  11. Forecasting VaR and ES of stock index portfolio: A Vine copula method

    Science.gov (United States)

    Zhang, Bangzheng; Wei, Yu; Yu, Jiang; Lai, Xiaodong; Peng, Zhenfeng

    2014-12-01

    Risk measurement has both theoretical and practical significance in risk management. Using daily sample of 10 international stock indices, firstly this paper models the internal structures among different stock markets with C-Vine, D-Vine and R-Vine copula models. Secondly, the Value-at-Risk (VaR) and Expected Shortfall (ES) of the international stock markets portfolio are forecasted using Monte Carlo method based on the estimated dependence of different Vine copulas. Finally, the accuracy of VaR and ES measurements obtained from different statistical models are evaluated by UC, IND, CC and Posterior analysis. The empirical results show that the VaR forecasts at the quantile levels of 0.9, 0.95, 0.975 and 0.99 with three kinds of Vine copula models are sufficiently accurate. Several traditional methods, such as historical simulation, mean-variance and DCC-GARCH models, fail to pass the CC backtesting. The Vine copula methods can accurately forecast the ES of the portfolio on the base of VaR measurement, and D-Vine copula model is superior to other Vine copulas.

  12. Le CERN va devoir supprimer quelques 600 postes d'ici a 2007

    CERN Multimedia

    2002-01-01

    "Le Laboratoire europeen pour la physique des particules (CERN) qui procede actuellement a la construction du LHC (Large Hadron Collider) , le plus grand accelerateur de particules du monde, va devoir supprimer, comme cela avait ete evoque en juin, quelques 600 postes d'ici a 2007" (1 paragraph).

  13. Exploring the Relevance and Quality of the VaRemba Initiation ...

    African Journals Online (AJOL)

    district in Zimbabwe as well as assess its impact on formal schooling. When exploring issues ... to analyse the impact of the VaRemba initiation curriculum on formal education; and. • to suggest possible ..... towards men, including their male teachers, and a negative attitude towards female teachers. One teacher described ...

  14. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief... Profile. ER06JA00.000 ER06JA00.001 ER06JA00.002 ...

  15. 78 FR 77204 - Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys...

    Science.gov (United States)

    2013-12-20

    ... use of other forms of information technology. Titles: VA National Veterans Sports Programs and Special... National Veterans Sports Programs and Special Event Surveys Data Collection) Activity: Comment Request... needed to evaluate the National Veterans Sports Programs and Special Event Surveys Data Collection is...

  16. Data of evolutionary structure change: 1A4VA-1GFUA [Confc[Archive

    Lifescience Database Archive (English)

    Full Text Available 1A4VA-1GFUA 1A4V 1GFU A A KQFTKCELSQLLKDI--DGYGGIALPELICTMFHTSGYD...ine> 1GFU A 1GFU...A 390 TYR CA 428 1GFU A 1GFU...e> TYR CA 329 1GFU A 1GFU...ine> GLU CA 184 GLN CA 218 TRP CA 302 1GFU

  17. 75 FR 60171 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Science.gov (United States)

    2010-09-29

    ... credit history in order to properly underwrite the veteran's loan. VA loans may not be guaranteed unless the veteran is a satisfactory credit risk. The data collected on the following forms will be used to... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0521] Proposed Information Collection (Credit...

  18. 75 FR 76082 - Agency Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Science.gov (United States)

    2010-12-07

    ... must obtain specific information concerning a veteran's credit history in order to properly underwrite the veteran's loan. VA loans may not be guaranteed unless the veteran is a satisfactory credit risk... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0521] Agency Information Collection (Credit...

  19. 78 FR 60379 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Science.gov (United States)

    2013-10-01

    ... credit history in order to properly underwrite the veteran's loan. VA loans may not be guaranteed unless the Veteran is a satisfactory credit risk. The data collected on the following forms will be used to... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0521] Proposed Information Collection (Credit...

  20. 76 FR 44279 - Radio Broadcasting Services; Clinchco, VA, and Coal Run, KY

    Science.gov (United States)

    2011-07-25

    ...] Radio Broadcasting Services; Clinchco, VA, and Coal Run, KY AGENCY: Federal Communications Commission... Station WPKE-FM, Coal Run Kentucky, from Channel 276A to Channel 221C3. DATES: Effective August 1, 2011... 221C3 at Coal Run, Kentucky, are 37-23-57 NL and 82-23-42 WL, and for Channel 276A at Clinchco, Virginia...

  1. On Setting Day-Ahead Equity Trading Risk Limits: VaR Prediction at Market Close or Open?

    Directory of Open Access Journals (Sweden)

    Ana-Maria Fuertes

    2016-09-01

    Full Text Available This paper investigates the information content of the ex post overnight return for one-day-ahead equity Value-at-Risk (VaR forecasting. To do so, we deploy a univariate VaR modeling approach that constructs the forecast at market open and, accordingly, exploits the available overnight close-to-open price variation. The benchmark is the bivariate VaR modeling approach proposed by Ahoniemi et al. that constructs the forecast at the market close instead and, accordingly, it models separately the daytime and overnight return processes and their covariance. For a small cap portfolio, the bivariate VaR approach affords superior predictive ability than the ex post overnight VaR approach whereas for a large cap portfolio the results are reversed. The contrast indicates that price discovery at the market open is less efficient for small capitalization, thinly traded stocks.

  2. Use of outpatient care in VA and Medicare among disability-eligible and age-eligible veteran patients

    Directory of Open Access Journals (Sweden)

    Liu Chuan-Fen

    2012-03-01

    Full Text Available Abstract Background More than half of veterans who use Veterans Health Administration (VA care are also eligible for Medicare via disability or age, but no prior studies have examined variation in use of outpatient services by Medicare-eligible veterans across health system, type of care or time. Objectives To examine differences in use of VA and Medicare outpatient services by disability-eligible or age-eligible veterans among veterans who used VA primary care services and were also eligible for Medicare. Methods A retrospective cohort study of 4,704 disability- and 10,816 age-eligible veterans who used VA primary care services in fiscal year (FY 2000. We tracked their outpatient utilization from FY2001 to FY2004 using VA administrative and Medicare claims data. We examined utilization differences for primary care, specialty care, and mental health outpatient visits using generalized estimating equations. Results Among Medicare-eligible veterans who used VA primary care, disability-eligible veterans had more VA primary care visits (p p p p p p Conclusions Greater use of primary care and specialty care visits by disability-eligible veterans is most likely related to greater health needs not captured by the patient characteristics we employed and eligibility for VA care at no cost. Outpatient care patterns of disability-eligible veterans may foreshadow care patterns of veterans returning from Afghanistan and Iraq wars, who are entering the system in growing numbers. This study provides an important baseline for future research assessing utilizations among returning veterans who use both VA and Medicare systems. Establishing effective care coordination protocols between VA and Medicare providers can help ensure efficient use of taxpayer resources and high quality care for disabled veterans.

  3. The Characters’ Transactional Analysis in Shir-va-Gav (lion and cow Story (one of Kelile-va-Demne stories

    Directory of Open Access Journals (Sweden)

    a razi

    2012-05-01

    The results of the analysis of the components of transactional analysis in Shir-va-Gav story show that the characters' relations have continuity, and among triple aspects of the character's structure, Kelile’s, Demne’s, and Shir's behaviors are assessable in the form of adult, parent, and child, respectively. Transactions among characters are of complementary kind in the beginning but throughout the story they turn into interaction of crossed kind and cause disorder in behavior.

  4. Headache diagnoses among Iraq and Afghanistan war veterans enrolled in VA: a gender comparison.

    Science.gov (United States)

    Carlson, Kathleen F; Taylor, Brent C; Hagel, Emily M; Cutting, Andrea; Kerns, Robert; Sayer, Nina A

    2013-01-01

    To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care. Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample. We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses. In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back

  5. Physical stability of solid dispersions with respect to thermodynamic solubility of tadalafil in PVP-VA.

    Science.gov (United States)

    Wlodarski, K; Sawicki, W; Kozyra, A; Tajber, L

    2015-10-01

    The aim of this paper was to evaluate physical stability of solid dispersions in respect to the drug, tadalafil (Td), in vinylpyrrolidone and vinyl acetate block copolymer (PVP-VA). Nine solid dispersions of Td in PVP-VA (Td/PVP-VA) varied in terms of quantitative composition (1:9-9:1, w/w) were successfully produced by spray-drying. Their amorphous nature, supersaturated character and molecular level of mixing (a solid solution structure) were subsequently confirmed using DSC, PXRD, SEM and calculation of Hansen total solubility parameters. Due to thermal degradation of both components before the melting point of Td (302.3°C), an approach based on the drug crystallization from the supersaturated solid dispersion was selected to calculate the solubility of Td in the polymer. Annealing of the Td/PVP-VA solid dispersion (1:1, w/w) at selected temperatures above its Tg resulted in different stable solid dispersions. According to the Gordon-Taylor equation their new Tgs gave the information about the quantitative composition which corresponded to the thermodynamic solubility of Td in PVP-VA at given temperatures of annealing. The obtained relationship was fitted to the exponential function, with the calculated solubility of Td of 20.5% at 25°C. This value was in accordance with the results of hot stage polarizing light microscopy as well as stability tests carried out at 80°C and 0% RH, in which Td solid dispersions containing 10-20% of the drug were the only systems that did not crystallize within two months. A thermal analysis protocol utilizing a fast heating rate was shown to generate Td solubility data complementing the solid dispersion method. The Flory-Huggins model applied for the Td/PVP-VA system yielded the solubility value of 0.1% at 25°C, showing the lack of applicability in this case. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Dynamic VaR Measurement of Gold Market with SV-T-MN Model

    Directory of Open Access Journals (Sweden)

    Fenglan Li

    2017-01-01

    Full Text Available VaR (Value at Risk in the gold market was measured and predicted by combining stochastic volatility (SV model with extreme value theory. Firstly, for the fat tail and volatility persistence characteristics in gold market return series, the gold price return volatility was modeled by SV-T-MN (SV-T with Mixture-of-Normal distribution model based on state space. Secondly, future sample volatility prediction was realized by using approximate filtering algorithm. Finally, extreme value theory based on generalized Pareto distribution was applied to measure dynamic risk value (VaR of gold market return. Through the proposed model on the price of gold, empirical analysis was investigated; the results show that presented combined model can measure and predict Value at Risk of the gold market reasonably and effectively and enable investors to further understand the extreme risk of gold market and take coping strategies actively.

  7. Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers.

    Science.gov (United States)

    Molinari, Victor A; Brown, Lisa M; Frahm, Kathryn A; Schinka, John A; Casey, Roger

    2013-05-01

    To understand the needs and challenges encountered by older homeless veterans. We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs. Major themes for VA staff liaison/housing intervention providers: 1) belief that the transitional housing program has made a positive change; 2) need for individualized criteria to address the unique needs of veterans; 3) distinct differences between older and younger homeless veterans; 4) outreach services; 5) permanent housing issues; and 6) coordination of services. Compared with younger veterans, older veterans have less social support, greater employment and health challenges, and, perhaps greater motivation to change.

  8. KENO3D Visualization Tool for KENO V.a and KENO-VI Geometry Models

    International Nuclear Information System (INIS)

    Horwedel, J.E.; Bowman, S.M.

    2000-01-01

    Criticality safety analyses often require detailed modeling of complex geometries. Effective visualization tools can enhance checking the accuracy of these models. This report describes the KENO3D visualization tool developed at the Oak Ridge National Laboratory (ORNL) to provide visualization of KENO V.a and KENO-VI criticality safety models. The development of KENO3D is part of the current efforts to enhance the SCALE (Standardized Computer Analyses for Licensing Evaluations) computer software system

  9. Veterans Justice Outreach Program: VA Could Improve Management by Establishing Performance Measures and Fully Assessing Risks

    Science.gov (United States)

    2016-04-01

    stakeholders, such as VA homeless and mental health program officials; as well as external stakeholders, such as representatives from the National ...others face difficulties, such as mental illness, substance abuse, unemployment, homelessness , and other serious issues. For some veterans, these...Program in 2009. The VJO Program is designed to connect veterans to supports and services to reduce and prevent re- incarceration and homelessness .2

  10. Suppression of Antifolate Resistance by Targeting the Myosin Va Trafficking Pathway in Melanoma

    Directory of Open Access Journals (Sweden)

    María Piedad Fernández-Pérez

    2013-07-01

    Full Text Available Human melanoma is a significant clinical problem. As most melanoma patients relapse with lethal drug-resistant disease, understanding and preventing mechanism(s of resistance is one of the highest priorities to improve melanoma therapy. Melanosomal sequestration and the cellular exportation of cytotoxic drugs have been proposed to be important melanoma-specific mechanisms that contribute to multidrug resistance in melanoma. Concretely, we found that treatment of melanoma with methotrexate (MTX altered melanogenesis and accelerated the exportation of melanosomes; however, the cellular and molecular processes by which MTX is trapped into melanosomes and exported out of cells have not been elucidated. In this study, we identified myosin Va (MyoVa as a possible mediator of these cellular processes. The results demonstrated that melanoma treatment with MTX leads to Akt2- dependent MyoVa phosphorylation, which enhances its ability to interact with melanosomes and accelerates their exportation. To understand the mechanism(s by which MTX activates Akt2, we examined the effects of this drug on the activity of protein phosphatase 2A, an Akt inhibitor activated by the methylation of its catalytic subunit. Taken together, this study identified a novel trafficking pathway in melanoma that promotes tumor resistance through Akt2/MyoVa activation. Because of these findings, we explored several MTX combination therapies to increase the susceptibility of melanoma to this drug. By avoiding MTX exportation, we observed that the E2F1 apoptotic pathway is functional in melanoma, and its induction activates p73 and apoptosis protease-activating factor 1 following a p53-autonomous proapoptotic signaling event.

  11. A Survey on Power and Political Culture in Kalile va Demne

    Directory of Open Access Journals (Sweden)

    J Dehghanian

    2011-04-01

    Postmodernist thinkers, especially Michel Foucault, make it clear that power and political culture are so complicated and affect private and social life. It is possible to claim that there is a meaningful relationship between people’s deed and power in each society. In this article, we take a look at political culture and power in Kalile va Demne and will analyze its effects on people’s thoughts and deeds.

  12. Effectiveness of the KiVa Antibullying Program: Grades 1-3 and 7-9

    Science.gov (United States)

    Karna, Antti; Voeten, Marinus; Little, Todd D.; Alanen, Erkki; Poskiparta, Elisa; Salmivalli, Christina

    2013-01-01

    This study investigated the effectiveness of the KiVa Antibullying Program in two samples of students, one from Grades 1-3 (7-9 years old, N = 6,927) and the other from Grades 7-9 (13-15 years old, N = 16, 503). The Grades 1-3 students were located in 74 schools and Grades 7-9 students in 73 schools that were randomly assigned to intervention and…

  13. 33 CFR 334.220 - Chesapeake Bay, south of Tangier Island, Va.; naval firing range.

    Science.gov (United States)

    2010-07-01

    ... ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.220 Chesapeake Bay, south of Tangier Island, Va.; naval firing range. (a) The danger zone. Beginning... to latitude 37°45′00″, longitude 76°09′48″; thence to latitude 37°45′00″, longitude 76°08′51″; and...

  14. 5kVa power inverter design and simulation based on boost ...

    African Journals Online (AJOL)

    Five (5) kVA power inverter was designed and simulated base on two topologies; Boost converter and Half-bridge inverter topology. A 555 timer IC was used as the control at fixed frequencies of 25 kHz and 50 Hz for the two stages. The results of the simulation were obtained. The graphs for both stages were plotted and the ...

  15. VA OpenNotes: exploring the experiences of early patient adopters with access to clinical notes.

    Science.gov (United States)

    Nazi, Kim M; Turvey, Carolyn L; Klein, Dawn M; Hogan, Timothy P; Woods, Susan S

    2015-03-01

    To explore the experience of early patient adopters who accessed their clinical notes online using the Blue Button feature of the My HealtheVet portal. A web-based survey of VA patient portal users from June 22 to September 15, 2013. 33.5% of respondents knew that clinical notes could be viewed, and nearly one in four (23.5%) said that they had viewed their notes at least once. The majority of VA Notes users agreed that accessing their notes will help them to do a better job of taking medications as prescribed (80.1%) and be better prepared for clinic visits (88.6%). Nine out of 10 users agreed that use of visit notes will help them understand their conditions better (91.8%), and better remember the plan for their care (91.9%). In contrast, 87% disagreed that VA Notes will make them worry more, and 88.4% disagreed that access to VA Notes will be more confusing than helpful. Users who had either contacted their provider or healthcare team (11.9%) or planned to (13.5%) primarily wanted to learn more about a health issue, medication, or test results (53.7%). Initial assessment of the patient experience within the first 9 months of availability provides evidence that patients both value and benefit from online access to clinical notes. These findings are congruent with OpenNotes study findings on a broader scale. Additional outreach and education is needed to enhance patient awareness. Healthcare professionals should author notes keeping in mind the opportunity patient access presents for enhanced communication. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Color perception differentiates Alzheimer's Disease (AD) from Vascular Dementia (VaD) patients.

    Science.gov (United States)

    Arnaoutoglou, N A; Arnaoutoglou, M; Nemtsas, P; Costa, V; Baloyannis, S J; Ebmeier, K P

    2017-08-01

    Alzheimer's Disease (AD) and Vascular Dementia (VaD) are the most common causes of dementia in older people. Both diseases appear to have similar clinical symptoms, such as deficits in attention and executive function, but specific cognitive domains are affected. Current cohort studies have shown a close relationship between αβ deposits and age-related macular degeneration (Johnson et al., 2002; Ratnayaka et al., 2015). Additionally, a close link between the thinning of the retinal nerve fiber (RNFL) and AD patients has been described, while it has been proposed that AD patients suffer from a non-specific type of color blindness (Pache et al., 2003). Our study included 103 individuals divided into three groups: A healthy control group (n = 35), AD (n = 32) according to DSM-IV-TR, NINCDS-ADRDA criteria, and VaD (n = 36) based on ΝΙΝDS-AIREN, as well as Magnetic Resonance Imaging (MRI) results. The severity of patient's cognitive impairment, was measured with the Mini-Mental State Examination (MMSE) and was classified according to the Reisberg global deterioration scale (GDS). Visual perception was examined using the Ishihara plates: "Ishihara Color Vision Test - 38 Plate." The three groups were not statistically different for demographic data (age, gender, and education). The Ishihara color blindness test has a sensitivity of 80.6% and a specificity of 87.5% to discriminate AD and VaD patients when an optimal (32.5) cut-off value of performance is used. Ishihara Color Vision Test - 38 Plate is a promising potential method as an easy and not time-consuming screening test for the differential diagnosis of dementia between AD and VaD.

  17. Sediment as a Regional Resource in the Low-Commercial-Use Navigation Program, Mathews County, VA

    Science.gov (United States)

    2013-09-01

    Commercial fishing, boat repair, marine construction, ecotourism , and other marine activities are important economic endeavors that provide sources of...to subside, future damages will likely worsen and begin impacting new areas. The mean sea level trend at Gloucester Point, VA (16 miles south of...Mathews County), is 3.81 millimeters per year (mm/year) rise with a 95% confidence interval of +/- 0.47 mm/year rise based on monthly mean sea level data

  18. VA Health Care: Improved Monitoring Needed for Effective Oversight of Care for Women Veterans

    Science.gov (United States)

    2016-12-01

    clerk stations and a lack of privacy curtains in examination rooms, as required by VHA policy. GAO also found weaknesses in VHA’s oversight of the...VHA officials said not all facilities require onsite gynecologists and facilities may authorize gynecological services from non-VA providers. They...does not have such measures for women veterans’ sex-specific care, such as mammography, maternity care, or gynecology . VHA’s data show poor

  19. Prothrombotic skeletal muscle myosin directly enhances prothrombin activation by binding factors Xa and Va

    Science.gov (United States)

    Deguchi, Hiroshi; Sinha, Ranjeet K.; Marchese, Patrizia; Ruggeri, Zaverio M.; Zilberman-Rudenko, Jevgenia; McCarty, Owen J. T.; Cohen, Mitchell J.

    2016-01-01

    To test the hypothesis that skeletal muscle myosins can directly influence blood coagulation and thrombosis, ex vivo studies of the effects of myosin on thrombogenesis in fresh human blood were conducted. Addition of myosin to blood augmented the thrombotic responses of human blood flowing over collagen-coated surfaces (300 s−1 shear rate). Perfusion of human blood over myosin-coated surfaces also caused fibrin and platelet deposition, evidencing myosin’s thrombogenicity. Myosin markedly enhanced thrombin generation in both platelet-rich plasma and platelet-poor plasma, indicating that myosin promoted thrombin generation in plasma primarily independent of platelets. In purified reaction mixtures composed only of factor Xa, factor Va, prothrombin, and calcium ions, myosin greatly enhanced prothrombinase activity. The Gla domain of factor Xa was not required for myosin’s prothrombinase enhancement. When binding of purified clotting factors to immobilized myosin was monitored using biolayer interferometry, factors Xa and Va each showed favorable binding interactions. Factor Va reduced by 100-fold the apparent Kd of myosin for factor Xa (Kd ∼0.48 nM), primarily by reducing koff, indicating formation of a stable ternary complex of myosin:Xa:Va. In studies to assess possible clinical relevance for this discovery, we found that antimyosin antibodies inhibited thrombin generation in acute trauma patient plasmas more than in control plasmas (P = .0004), implying myosin might contribute to acute trauma coagulopathy. We posit that myosin enhancement of thrombin generation could contribute either to promote hemostasis or to augment thrombosis risk with consequent implications for myosin’s possible contributions to pathophysiology in the setting of acute injuries. PMID:27421960

  20. DoD/VA Health Information Technology (IT) Data Sharing to Benefit Our Patients

    Science.gov (United States)

    2011-01-25

    GRISCOM. MISS Q Oemograpi-Ocs -U~H:::: Alergy Wetness l lrnrru1izations V•ol Signs Review PKC Couplers Readineu Patient Questionnaires l =~otes...Authorization Act (NDAA) FY 2008, Section 1635 required DoD and VA to “ develop and implement electronic health record (EHR) systems or... developed and funded 36 2011 MHS Conference 37 Recruitment Accession/Training Routine Care Readiness/ Pre-Deployment Deployed/Theater CareCare in

  1. Non-intubated recovery from refractory cardiogenic shock on percutaneous VA-extracorporeal membrane oxygenation

    OpenAIRE

    van Houte, J; Donker, D W; Wagenaar, L J; Slootweg, A P; Kirkels, J H; van Dijk, D

    2015-01-01

    We report on the use of percutaneous femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in a fully awake, non-intubated and spontaneously breathing patient suffering from acute, severe and refractory cardiogenic shock due to a (sub)acute anterior myocardial infarction. Intensified heart failure therapy was closely monitored with a pulmonary artery catheter and allowed gradual weaning off the ECMO support without additional invasive measures, notably without mechanical ventila...

  2. VA Disability Benefits: Additional Planning Would Enhance Efforts to Improve the Timeliness of Appeals Decisions

    Science.gov (United States)

    2017-03-01

    2017, VA officials also noted the agency is in the process of developing additional components, including document review software for VLJs and...average time taken to recruit, and skills needed in recruits, or identified metrics (other than hiring goals) against which it would measure the... Tester Ranking Member Committee on Veterans’ Affairs United States Senate The Honorable Jerry Moran Chairman The Honorable Brian Schatz Ranking

  3. Phenomenology of MaVaN’s Models in Reactor Neutrino Data

    Directory of Open Access Journals (Sweden)

    M. F. Carneiro

    2013-01-01

    Full Text Available Mass Varying Neutrinos (MaVaN’s mechanisms were proposed to link the neutrino mass scale with the dark energy density, addressing the coincidence problem. In some scenarios, this mass can present a dependence on the baryonic density felt by neutrinos, creating an effective neutrino mass that depends both on the neutrino and baryonic densities. In this work, we study the phenomenological consequence of MaVaN’s scenarios in which the matter density dependence is induced by Yukawa interactions of a light neutral scalar particle which couples to neutrinos and matter. Under the assumption of one mass scale dominance, we perform an analysis of KamLAND neutrino data which depends on 4 parameters: the two standard oscillation parameters, Δm0,212 and tan2θ12, and two new coefficients which parameterize the environment dependence of neutrino mass. We introduce an Earth’s crust model to compute precisely the density in each point along the neutrino trajectory. We show that this new description of density does not affect the analysis with the standard model case. With the MaVaN model, we observe a first order effect in lower density, which leads to an improvement on the data description.

  4. Matching prosthetics order records in VA National Prosthetics Patient Database to healthcare utilization databases.

    Science.gov (United States)

    Smith, Mark W; Su, Pon; Phibbs, Ciaran S

    2010-01-01

    The National Prosthetics Patient Database (NPPD) is the national Department of Veterans Affairs (VA) dataset that records characteristics of individual prosthetic and assistive devices. It remains unknown how well NPPD records can be matched to encounter records for the same individuals in major VA utilization databases. We compared the count of prosthetics records in the NPPD with the count of prosthetics-related procedures for the same individuals recorded in major VA utilization databases. We then attempted to match the NPPD records to the utilization records by person and date. In general, 40% to 60% of the NPPD records could be matched to outpatient utilization records within a 14-day window around the NPPD dataset entry date. Match rates for inpatient data were lower: 10% to 16% within a 14-day window. The NPPD will be particularly important for studies of certain veteran groups, such as those with spinal cord injury or blast-related polytraumatic injury. Health services researchers should use both the NPPD and utilization databases to develop a full understanding of prosthetics use by individual patients.

  5. Evaluation of a simplified version of KENO V.a on a parallel processors computer

    International Nuclear Information System (INIS)

    Ugolini, D.; Petrie, L.M.; Dodds, H.L. Jr.

    1987-01-01

    KENO V.a is a widely used Monte Carlo criticality code developed by Oak Ridge National Laboratory for use primarily on large single processor mainframe computers. The code can be very costly to use if a large number of histories is required because the histories are performed sequentially via the single processor. With the advent of parallel processor computers, it should be possible to reduce computing costs (i.e., computer run time) by performing the histories in parallel. The purposes of this work is to implement KENO V.a on a parallel processor computer, specifically the NCUBE and then to compare results obtained on the NCUBE (i.e., accuracy and computing time) with results obtained on a large mainframe computer (IBM 3033). The NCUBE is a message-passing machine with no shared memory. A simplified version of KENO V.a was developed for this study because the standard version was too large to compile on the NCUBE. In addition, a special 1-group cross-section library, reduced from the standard 16-group Hansen Roach Library, was also used. The sample problem used in this study was an 18-cm-diam sphere of 235 U at 0.05 atom/b x cm

  6. Treatment of veterans with mental health symptoms in VA primary care prior to suicide.

    Science.gov (United States)

    Denneson, Lauren M; Williams, Holly B; Kaplan, Mark S; McFarland, Bentson H; Dobscha, Steven K

    2016-01-01

    We describe Veterans Affairs (VA) primary care received by veterans with mental health symptoms in the year prior to suicide to identify opportunities to improve care. Death certificate data from 11 states were linked to VA national patient care data for veterans who died by suicide in 2009 and had received VA care. We identified 118 age-, sex- and clinician-matched case-control pairs (suicide decedents and living controls) with mental health symptoms. Using McNemar's chi-square and paired t tests, we compare primary care follow-up received during the year prior to death. Cases and controls received similar primary care clinician follow-up and treatment for mental health symptoms. Cases were less likely than controls to fill 90 or more total days of an antidepressant during the year (P=.02), despite no differences in prescription orders from clinicians (P=.05). Cases and controls were equally likely to fill 90 or more consecutive days of an antidepressant (P=.47). Across both groups, 48% (n=113) received assessment for suicidal ideation in primary care. We identified two areas to improve primary care for veterans at risk for suicide: monitoring antidepressant treatment adherence and improving suicidal ideation assessment and follow-up for veterans with mental health symptoms. Published by Elsevier Inc.

  7. Trade in Value Added (TiVA in EU New Member States (EU NMS

    Directory of Open Access Journals (Sweden)

    Ines Kersan-Škabić

    2017-01-01

    Full Text Available Contemporary trade analysis indicates the necessity of calculating trade in value added (TiVA which is created through global value chains (GVCs. This paper aims to determine the characteristics and importance of GVC trade in the EU new member states (EU NMS with special emphasis placed on the industry level. The results demonstrate different levels of GVC participation of the EU NMS, where Hungary is the most integrated country and Croatia the least integrated. Regional GVCs exist because a huge part of value added (VA comes from EU member states, as in gross export as well as in final demand (Europe as a hub. The most important source countries are Germany and Italy and there is also evidence of geographical and historical relations between the countries. The domination of backward participation has been found in the analysis made on the industrial level, i.e. the EU NMS are highly dependent on the import of intermediates for the production and export of final products. Strong interconnections between imports of intermediate products and exports of final products have been found in the manufacture of computers, electronics and optical products; manufacture of wood, paper, printing and reproduction. This research has contributed to the scarce literature concerning GVC (TiVA in EU NMS and has opened up new possibilities for further research and analysis.

  8. VaProS: a database-integration approach for protein/genome information retrieval

    KAUST Repository

    Gojobori, Takashi

    2016-12-24

    Life science research now heavily relies on all sorts of databases for genome sequences, transcription, protein three-dimensional (3D) structures, protein–protein interactions, phenotypes and so forth. The knowledge accumulated by all the omics research is so vast that a computer-aided search of data is now a prerequisite for starting a new study. In addition, a combinatory search throughout these databases has a chance to extract new ideas and new hypotheses that can be examined by wet-lab experiments. By virtually integrating the related databases on the Internet, we have built a new web application that facilitates life science researchers for retrieving experts’ knowledge stored in the databases and for building a new hypothesis of the research target. This web application, named VaProS, puts stress on the interconnection between the functional information of genome sequences and protein 3D structures, such as structural effect of the gene mutation. In this manuscript, we present the notion of VaProS, the databases and tools that can be accessed without any knowledge of database locations and data formats, and the power of search exemplified in quest of the molecular mechanisms of lysosomal storage disease. VaProS can be freely accessed at http://p4d-info.nig.ac.jp/vapros/.

  9. Revenue Based Budgeting at VA Northern California Health Care System: A Model for Financially Aligning Organizational Incentives and Operations

    National Research Council Canada - National Science Library

    Stockwell, David

    1999-01-01

    .... Changes in sharing agreement regulations, TRICARE, and Medical Care Cost Recovery (MCCR) also provided each network with the ability to generate revenue from sources outside the traditional VA appropriation...

  10. 76 FR 60965 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Science.gov (United States)

    2011-09-30

    .... SUMMARY: The Secretary of VA intends to enter into an EUL on a 1.9-acre parcel of land at the Canandaigua... homelessness and their families; and provide a supportive services program that guides resident Veterans toward...

  11. 76 FR 72045 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Science.gov (United States)

    2011-11-21

    ... Affairs. ACTION: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA... homelessness, and provide on-site supportive services. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office...

  12. KiVa Antibullying Program: Overview of Evaluation Studies Based on a Randomized Controlled Trial and National Rollout in Finland

    Directory of Open Access Journals (Sweden)

    Christina Salmivalli

    2012-12-01

    Full Text Available The effects of a Finnish national school-based antibullying program (KiVa were evaluated in a randomized controlled trial (2007–2009 and during nationwide implementation (since 2009. The KiVa program is been found to reduce bullying and victimization and increase empathy towards victimized peers and self-efficacy to support and defend them. KiVa increases school liking and motivation and contributes to significant reductions in anxiety, depression, and negative peer perceptions. Somewhat larger reductions in bullying and victimization were found in the randomized controlled trial than in the broad rollout, and the largest effects were obtained in primary school (grades 1–6. The uptake of the KiVa program is remarkable, with 90 percent of Finnish comprehensive schools currently registered as program users.

  13. Electronic Health Records: DOD and VA Have Increased Their Sharing of Health Information, but More Work Remains

    National Research Council Canada - National Science Library

    Melvin, Valerie C; Oliver, Barbara S; Collier, Barbara; Shaw, Kelly; Williams, Jr, Robert

    2008-01-01

    ...) and the Department of Veterans Affairs (VA) are required to accelerate the exchange of health information between the departments and to develop systems or capabilities that allow for full interoperability...

  14. 30 CFR 57.22208 - Auxiliary fans (I-A, II-A, III, and V-A mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Auxiliary fans (I-A, II-A, III, and V-A mines... fans (I-A, II-A, III, and V-A mines). (a) Auxiliary fans, except fans used in shops and other areas... applicable requirements of 30 CFR part 18, and be operated so that recirculation is minimized. Auxiliary fans...

  15. A measurement of the V-A x V-A structure of the weak charged current in semileptonic b decays and missing energy measurements

    CERN Document Server

    Behner, Frank

    1995-01-01

    The polarization of the W-propagator in semileptonic b decays is measured with the 13 experiment at LEP via simultaneous observation of the charged lepton and the neutrino spectrum. The polarization is seen with more than 3 standard deviations and found to be in agreement with the V-AxV-A structure. The measurement excludes the V+Ax V-A polarization with more than 6 standard deviations. Furthermore, the branching ratio in B_, vX is measured and found to be 22.7%±0.8%(stat.)±l.5%(syst.) which corresponds to a branching ratio of B_,evX of 10.1%±0.8%.

  16. Rural women veterans demographic report: defining VA users' health and health care access in rural areas.

    Science.gov (United States)

    Brooks, Elizabeth; Dailey, Nancy; Bair, Byron; Shore, Jay

    2014-01-01

    While many women choose to live in rural areas after retiring from active military duty, a paucity of studies examine rural women veterans' health care needs. This report is the first of its kind to describe the population demographics and health care utilization of rural female veteran patients enrolled in the Department of Veterans Affairs (VA). Using the National Patient Care Datasets (n = 327,785), we ran adjusted regression analyses to examine service utilization between (1) urban and rural and (2) urban and highly rural women veterans. Rural and highly rural women veterans were older and more likely to be married than their urban counterparts. Diagnostic rates were generally similar between groups for several mental health disorders, hypertension, and diabetes, with the exception of nonposttraumatic stress anxiety that was significantly lower for highly rural women veterans. Rural and highly rural women veterans were less likely to present to the VA for women's specific care than urban women veterans; highly rural women veterans were less likely to present for mental health care compared to urban women veterans. Among the users of primary care, mental health, women's specific, and all outpatient services, patients' annual utilization rates were similar. Improved service options for women's specific care and mental health visits may help rural women veterans access care. Telehealth technologies and increased outreach, perhaps peer-based, should be considered. Other recommendations for VA policy and planning include increasing caregiver support options, providing consistency for mental health services, and revising medical encounter coding procedures. © 2013 National Rural Health Association.

  17. VA Health Service Utilization for Homeless and Low-income Veterans

    Science.gov (United States)

    Gabrielian, Sonya; Yuan, Anita H.; Andersen, Ronald M.; Rubenstein, Lisa V.; Gelberg, Lillian

    2016-01-01

    Background The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program—the VA’s Housing First effort—is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. Objectives We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. Research Design We performed a secondary database analysis of Veterans (n = 62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. Results HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Conclusions Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care. PMID:24714583

  18. Adenovirus Vector-Derived VA-RNA-Mediated Innate Immune Responses

    Directory of Open Access Journals (Sweden)

    Hiroyuki Mizuguchi

    2011-07-01

    Full Text Available The major limitation of the clinical use of replication-incompetent adenovirus (Ad vectors is the interference by innate immune responses, including induction of inflammatory cytokines and interferons (IFN, following in vivo application of Ad vectors. Ad vector-induced production of inflammatory cytokines and IFNs also results in severe organ damage and efficient induction of acquired immune responses against Ad proteins and transgene products. Ad vector-induced innate immune responses are triggered by the recognition of Ad components by pattern recognition receptors (PRRs. In order to reduce the side effects by Ad vector-induced innate immune responses and to develop safer Ad vectors, it is crucial to clarify which PRRs and which Ad components are involved in Ad vector-induced innate immune responses. Our group previously demonstrated that myeloid differentiating factor 88 (MyD88 and toll-like receptor 9 (TLR9 play crucial roles in the Ad vector-induced inflammatory cytokine production in mouse bone marrow-derived dendritic cells. Furthermore, our group recently found that virus associated-RNAs (VA-RNAs, which are about 160 nucleotide-long non-coding small RNAs encoded in the Ad genome, are involved in IFN production through the IFN-β promoter stimulator-1 (IPS-1-mediated signaling pathway following Ad vector transduction. The aim of this review is to highlight the Ad vector-induced innate immune responses following transduction, especially VA-RNA-mediated innate immune responses. Our findings on the mechanism of Ad vector-induced innate immune responses should make an important contribution to the development of safer Ad vectors, such as an Ad vector lacking expression of VA-RNAs.

  19. Making housing first happen: organizational leadership in VA's expansion of permanent supportive housing.

    Science.gov (United States)

    Kertesz, Stefan G; Austin, Erika Laine; Holmes, Sally K; Pollio, David E; Schumacher, Joseph E; White, Bert; Lukas, Carol VanDeusen

    2014-12-01

    While most organizational literature has focused on initiatives that transpire inside the hospital walls, the redesign of American health care increasingly asks that health care institutions address matters outside their walls, targeting the health of populations. The US Department of Veterans Affairs (VA)'s national effort to end Veteran homelessness represents an externally focused organizational endeavor. Our aim was to evaluate the role of organizational practices in the implementation of Housing First (HF), an evidence-based homeless intervention for chronically homeless individuals. This was an interview-based comparative case study conducted across eight VA Medical Centers (VAMCs). Front line staff, mid-level managers, and senior leaders at VA Medical Centers were interviewed between February and December 2012. Using a structured narrative and numeric scoring, we assessed the correlation between successful HF implementation and organizational practices devised according to the organizational transformation model (OTM). Scoring results suggested a strong association between HF implementation and OTM practice. Strong impetus to house Veterans came from national leadership, reinforced by Medical Center directors closely tracking results. More effective Medical Center leaders differentiated themselves by joining front-line staff in the work (at public events and in process improvement exercises), by elevating homeless-knowledgeable persons into senior leadership, and by exerting themselves to resolve logistic challenges. Vertical alignment and horizontal integration advanced at sites that fostered work groups cutting across service lines and hierarchical levels. By contrast, weak alignment from top to bottom typically also hindered cooperation across departments. Staff commitment to ending homelessness was high, though sustainability planning was limited in this baseline year of observation. Key organizational practices correlated with more successful

  20. Social work in the Veterans Health Administration (VA) System: rewards, challenges, roles and interventions.

    Science.gov (United States)

    Beder, Joan; Postiglione, Paul

    2013-01-01

    For the social worker in the Veterans Health Administration (VA) System, numerous challenges are faced and met while serving the nation's Veterans. As part of the multidisciplinary team, social workers perform a variety of tasks and function in diverse roles. The qualitative survey research reported in this article sought to detail what social workers identified about the impact and rewards of their work and what they saw as the challenges and frustrations. In addition the social workers were asked to clarify their role with the patient and the family. Intervention strategies used in the course of the social workers interaction with the Veterans was also ascertained.

  1. Fermion number non-conservation and cold neutral fermionic matter in (V-A) gauge theories

    International Nuclear Information System (INIS)

    Matveev, V.A.; Rubakov, V.A.; Tavkhelidze, A.N.; Tokarev, V.F.

    1987-01-01

    It is shown that in four-dimensional abelian (V-A) theories, the ground state of cold neutral fermionic matter is an anomalous state containing domains of abnormal phase surrounded by the normal vacuum. Inside these domains, there exists a gauge field condensate which makes real fermions disappear both inside and outside the domains. In non-abelian theories, the abnormal matter is unstable in its turn, and the system rolls back down into the normal state with a small number of fermions above the topologically non-trivial vacuum. Thus, in several non-abelian gauge theories, the fermion number density of cold neutral matter cannot exceed some critical value. (orig.)

  2. The Orbital Evolution of 2007 VA85, an Amor-type Asteroid on a Retrograde Orbit.

    Science.gov (United States)

    Kankiewicz, P.; Włodarczyk, I.

    2010-06-01

    Among the known population of asteroids on retrograde orbits (i > 90°) we found an object classified as an Amor-type asteroid. During the analysis of the first results of astrometry, we found some possible Earth-impact solutions for this asteroid. After taking into account the latest observations, we excluded any significant impact solution. However, this asteroid is the first known example of potentially hazardous object on a retrograde orbit. We also investigated the orbital evolution of 2007 VA85 (1 My in the past), obtaining possible scenarios of its dynamical origin.

  3. Določanje meje naselja na primeru strnjenih vaških naselij

    OpenAIRE

    Vidic, Nina

    2015-01-01

    Namen diplomske naloge je določitev meje strnjenih vaških naselij glede na različne kazalnike na podlagi razpoložljivih prostorskih podatkov. V teoretičnem delu so predstavljene različne definicije meje naselja od slovenske prostorske zakonodaje do različnih avtorjev, ki so se ukvarjali s proučevanjem naselij. Na podlagi razpoložljivih podatkov in izbranih kazalnikov smo na primeru treh testnih naseljih Gorica in Studenčice v Občini Radovljica ter Kočna v Občini Jesenice, določili mejo naselj...

  4. Radioiodination of the protein complex of the VA-MENGOC-BC vaccine

    International Nuclear Information System (INIS)

    Caso, R.; Lastre, M.; Alvarez, L.

    1996-01-01

    In this work was made the labelling of the protein complex of the vaccine VA-MEMGOC-BC with I-125 in order to study its immunological responses. These proteins were in both forms: dissolved and conjugated with polisacarids of the C-group. There were used three methods of iodination: chloramine-T iodogen and lactoperoxidase. Was found out that dissolved proteins can be iodinated using these methods with 0,1 mCi of I-125, and the obtained specific activities were similar

  5. Uloga i važnost interne revizije u upravljanju poduzećem

    OpenAIRE

    Kostelac, Ivan

    2016-01-01

    Za uspješnost svakog poslovanja veoma je važna politika poslovanja te ciljevi i misije kako bi poduzeće moglo poslovati efikasno i efektivno. Kako bi se što bolje postavili ciljevi i misije te samim time izveo i uspješan poslovan plan veoma je bitna interna revizija. Interna revizija je veoma bitna zato što prije svega pomaže u kvalitetnijem ispunjenju ciljeva i misija uz smanjenje eventualnih pogrešaka te otkrivanje mogućih rizika koji bi mogli nastati i naštetiti cjelokupnom poslovnom pl...

  6. Influence of PVP/VA copolymer composition on drug-polymer solubility

    DEFF Research Database (Denmark)

    Rask, Malte Bille; Knopp, Matthias Manne; Olesen, Niels Erik

    2016-01-01

    In this study, the influence of copolymer composition on drug-polymer solubility was investigated. The solubility of the model drug celecoxib (CCX) in various polyvinylpyrrolidone/vinyl acetate (PVP/VA) copolymer compositions (70/30, 60/40, 50/50 and 30/70 w/w) and the pure homopolymers...... dispersion without compromising the drug-polymer solubility. This knowledge could be used advantageously in future development of amorphous drug delivery systems as copolymers could be customized to provide optimal drug-polymer solubility and physical stability....

  7. VaR and CVaR Implied in Option Prices

    Directory of Open Access Journals (Sweden)

    Giovanni Barone Adesi

    2016-02-01

    Full Text Available VaR (Value at Risk and CVaR (Conditional Value at Risk are implied by option prices. Their relationships to option prices are derived initially under the pricing measure. It does not require assumptions about the distribution of portfolio returns. The effects of changes of measure are modest at the short horizons typically used in applications. The computation of CVaR from option price is very convenient, because this measure is not elicitable, making direct comparisons of statistical inferences from market data problematic.

  8. The electrical characteristics of copper slags in a 270 kVA DC arc furnace

    International Nuclear Information System (INIS)

    Derin, Bora; Sahin, Filiz Cinar; Yucel, Onuralp

    2003-01-01

    The electrical resistance of slags is the main criteria to determine the design and the operation conditions of slag resistance furnace (SRF) depending on temperature and composition. In this study, a 270 kVA DC electric arc furnace were used to determine the electrical characteristic of molten ancient copper slags. The specific conductivity of the slag was estimated by using furnace geometric factor given in the literature as an empirical formula and by using furnace resistance measured during smelting of the copper slag with or without different additives such as coke, CaO and Al 2 O 3 . (Original)

  9. The Analysis of The Starting Pattern in Nezami’s Khosrow va Shirin, Leili va Majnoun and Haft Peykar

    Directory of Open Access Journals (Sweden)

    Tayebe Ja’fari

    2016-05-01

    Full Text Available AbstractAccording to what Nezami states in his versified story Khosro va Shirin, King Hormoz is a fair and peasant-supporter monarch and everything is alright in his time. The only matter which bothers the King’s mind and feelings is the sadness of having no child. But this piteous sadness is removed after vowing, sacrificing and being born a boy as a result. This boy is totally different from his age children because of his unique characteristics.    Leili va Majnoon’s starting pattern can be Khosro va Shirin’s starting pattern simply by having some changes in characters. In this poem, the memoir related to the chieftain of Amer, who was one of the Arab grandees and has a settled land, is expressed. He is an artist who has a significant reputation in hospitality and being mendicant-adherent, but the sadness of having no child makes him like King Hormoz, so he decides to vow and sacrifice and asks God to give him a child.   Based on an archetypal approach, the boy who has been requested by prayer in Khosrow va Shirin, Leili va Majnoon, and other myths is an archetypal item that these literary works’ starting patterns are the expression of common conditions before, during, and after his birth. He is the heavenly child who has been born to make a great upheaval.   Based on an archetypal approach, the heavenly child can be considered as the best form of emanation of the potential aspect of Ego in dreams and myths in which the king, as the actual aspect of this archetype, wishes this child’s birth; to reach his perfect ideal. With this paraphastic approach, Khosrow Parviz and King Hormoz are respectively the potential and the actual aspect of Ego. Hormoz is the actual part that is almost perfect. He is an ideal, fair and peasant-supporter king. But this perfect person is only some parts of his talent who has reached the actuality and can be manifest. This potential aspect is the child whom the king is

  10. Variations in the implementation and characteristics of chiropractic services in VA.

    Science.gov (United States)

    Lisi, Anthony J; Khorsan, Raheleh; Smith, Monica M; Mittman, Brian S

    2014-12-01

    In 2004, the US Department of Veterans Affairs expanded its delivery of chiropractic care by establishing onsite chiropractic clinics at select facilities across the country. Systematic information regarding the planning and implementation of these clinics and describing their features and performance is lacking. To document the planning, implementation, key features and performance of VA chiropractic clinics, and to identify variations and their underlying causes and key consequences as well as their implications for policy, practice, and research on the introduction of new clinical services into integrated health care delivery systems. Comparative case study of 7 clinics involving site visit-based and telephone-based interviews with 118 key stakeholders, including VA clinicians, clinical leaders and administrative staff, and selected external stakeholders, as well as reviews of key documents and administrative data on clinic performance and service delivery. Interviews were recorded, transcribed, and analyzed using a mixed inductive (exploratory) and deductive approach. Interview data revealed considerable variations in clinic planning and implementation processes and clinic features, as well as perceptions of clinic performance and quality. Administrative data showed high variation in patterns of clinic patient care volume over time. A facility's initial willingness to establish a chiropractic clinic, along with a higher degree of perceived evidence-based and collegial attributes of the facility chiropractor, emerged as key factors associated with higher and more consistent delivery of chiropractic services and higher perceived quality of those services.

  11. Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic.

    Science.gov (United States)

    Gentes, Emily L; Schry, Amie R; Hicks, Terrell A; Clancy, Carolina P; Collie, Claire F; Kirby, Angela C; Dennis, Michelle F; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

    2016-05-01

    Recent research has documented high rates of comorbidity between cannabis use disorders and posttraumatic stress disorder (PTSD) in veterans. However, despite possible links between PTSD and cannabis use, relatively little is known about cannabis use in veterans who present for PTSD treatment, particularly among samples not diagnosed with a substance use disorder. This study examined the prevalence of cannabis use and the psychological and functional correlates of cannabis use among a large sample of veterans seeking treatment at a Veterans Affairs (VA) PTSD specialty clinic. Male veterans (N = 719) who presented at a VA specialty outpatient PTSD clinic completed measures of demographic variables, combat exposure, alcohol, cannabis and other drug use, and PTSD and depressive symptoms. The associations among demographic, psychological, and functional variables were estimated using logistic regressions. Overall, 14.6% of participants reported using cannabis in the past 6 months. After controlling for age, race, service era, and combat exposure, past 6-month cannabis use was associated with unmarried status, use of tobacco products, other drug use, hazardous alcohol use, PTSD severity, depressive symptom severity, and suicidality. The present findings show that cannabis use is quite prevalent among veterans seeking PTSD specialty treatment and is associated with poorer mental health and use of other substances. It may be possible to identify and treat individuals who use cannabis in specialty clinics (e.g., PTSD clinics) where they are likely to present for treatment of associated mental health issues. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. KENO3D visualization tool for KENO V.a geometry models

    International Nuclear Information System (INIS)

    Bowman, S.M.; Horwedel, J.E.

    1999-01-01

    The standardized computer analyses for licensing evaluations (SCALE) computer software system developed at Oak Ridge National Laboratory (ORNL) is widely used and accepted around the world for criticality safety analyses. SCALE includes the well-known KENO V.a three-dimensional Monte Carlo criticality computer code. Criticality safety analysis often require detailed modeling of complex geometries. Checking the accuracy of these models can be enhanced by effective visualization tools. To address this need, ORNL has recently developed a powerful state-of-the-art visualization tool called KENO3D that enables KENO V.a users to interactively display their three-dimensional geometry models. The interactive options include the following: (1) having shaded or wireframe images; (2) showing standard views, such as top view, side view, front view, and isometric three-dimensional view; (3) rotating the model; (4) zooming in on selected locations; (5) selecting parts of the model to display; (6) editing colors and displaying legends; (7) displaying properties of any unit in the model; (8) creating cutaway views; (9) removing units from the model; and (10) printing image or saving image to common graphics formats

  13. RESPONSE OF TWO SUNFLOWER (HELIANTHUS ANNUUS L. GENOTYPES TO VA-MYCORRHIZAL INOCULATION AND PHOSPHORUS LEVELS

    Directory of Open Access Journals (Sweden)

    C.P. CHANDRASHEKARA, V.C. PATIL

    1995-01-01

    Full Text Available The performance of two sunflower genotypes (Morden and MSFH-8 with and without VA-mycorrhizal fungi at three P levels (38, 56 and 75 kg P2O5 ha-1 in vertisol of Dharwad was studied to determine the effect of mycorrhizal inoculation on plant growth, yield and P uptake. The results showed that the VAM inoculation increased sunflower yield (14%, total biomass (16%, oil content (3.1% and P uptake (30.5% over uninoculated control. The percent root colonization and chlamydo-spore count decreased with increasing P levels. The total biomass production, seed yield and P uptake of mycorrhizal plants at 38 kg P2O5 ha-1 more than the non-mycorrhizal plants at 75 kg P2O5 ha-1. The biomass and seed yield of mycorrhizal plants at same P level were more than the non-mycorrhizal plants. Mycorrhizal plants of Morden at 38 kg P2O5 ha-1 and MSFH-8 at 56 kg P2O5 ha-1 produced higher seed yield, oil content and total biomass than non-mycorrhizal plants supplied with 75 kg P2O5 ha-1. The results indicated that, VA-mycorrhizal inoculation helps in saving 25 and 50 percent of recommended dose of phosphatic fertilizer (75 kg P2O5 ha-1 in MSFH-8 (single cross hybrid and Morden (open pollinated variety, respectively.

  14. VA nursing home residents with substance use disorders: Mental health comorbidities, functioning, and problem behaviors.

    Science.gov (United States)

    Lemke, Sonne; Schaefer, Jeanne A

    2010-07-01

    This research addresses whether residents with substance use disorders (SUDs) in VA nursing homes (VANHs) are distinctive in terms of their demographic characteristics, medical and mental health comorbidities, functioning, and problem behaviors. Residents over age 55 admitted to VANHs (n = 27,002) were identified in VA administrative files, and SUD and non-SUD residents were compared. Compared with other residents, the residents with SUDs (18% of admissions over age 55) were more likely to be younger, male, African-American, unmarried, have low income and a tobacco use disorder. Controlling for demographic factors and smoking, SUD residents were more likely to have mental health comorbidities (dementia, serious mental illness, depressive disorders, and post-traumatic stress disorder), as well as AIDS/hepatitis, pulmonary disease, gastro-intestinal disorders, and injuries. SUD residents were less likely to have cancer, diabetes, neurological disorders, heart failure, and renal failure. SUD residents were more independent in activities of daily living, such as mobility and toileting. They were more likely to engage in verbal disruption but not in other problem behaviors such as aggression. With demographic factors and comorbidities controlled, the functioning differences were diminished, and SUD and non-SUD residents did not differ in the levels of problem behaviors. VANH residents with SUDs have distinctive patterns of comorbidities and functioning. SUD appears to represent a separate risk factor for VANH admission. Residents with SUDs present challenges but may have good potential for positive discharge outcomes if their substance use problems and limited resources can be addressed.

  15. Mixed-Methods Research in a Complex Multisite VA Health Services Study: Variations in the Implementation and Characteristics of Chiropractic Services in VA

    Directory of Open Access Journals (Sweden)

    Raheleh Khorsan

    2013-01-01

    Full Text Available Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs’ healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches—insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS. Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1 the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study’s analysis plan and its data collection instruments and codebook and (2 ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis.

  16. Validating physician-certified verbal autopsy and probabilistic modeling (InterVA approaches to verbal autopsy interpretation using hospital causes of adult deaths

    Directory of Open Access Journals (Sweden)

    Tsofa Benjamin

    2011-08-01

    Full Text Available Abstract Background The most common method for determining cause of death is certification by physicians based either on available medical records, or where such data are not available, through verbal autopsy (VA. The physician-certification approach is costly and inconvenient; however, recent work shows the potential of a computer-based probabilistic model (InterVA to interpret verbal autopsy data in a more convenient, consistent, and rapid way. In this study we validate separately both physician-certified verbal autopsy (PCVA and the InterVA probabilistic model against hospital cause of death (HCOD in adults dying in a district hospital on the coast of Kenya. Methods Between March 2007 and June 2010, VA interviews were conducted for 145 adult deaths that occurred at Kilifi District Hospital. The VA data were reviewed by a physician and the cause of death established. A range of indicators (including age, gender, physical signs and symptoms, pregnancy status, medical history, and the circumstances of death from the VA forms were included in the InterVA for interpretation. Cause-specific mortality fractions (CSMF, Cohen's kappa (κ statistic, receiver operating characteristic (ROC curves, sensitivity, specificity, and positive predictive values were applied to compare agreement between PCVA, InterVA, and HCOD. Results HCOD, InterVA, and PCVA yielded the same top five underlying causes of adult deaths. The InterVA overestimated tuberculosis as a cause of death compared to the HCOD. On the other hand, PCVA overestimated diabetes. Overall, CSMF for the five major cause groups by the InterVA, PCVA, and HCOD were 70%, 65%, and 60%, respectively. PCVA versus HCOD yielded a higher kappa value (κ = 0.52, 95% confidence interval [CI]: 0.48, 0.54 than the InterVA versus HCOD which yielded a kappa (κ value of 0.32 (95% CI: 0.30, 0.38. Overall, (κ agreement across the three methods was 0.41 (95% CI: 0.37, 0.48. The areas under the ROC curves were 0

  17. Comparison of topical fixed-combination fortified vancomycin-amikacin (VA solution) to conventional separate therapy in the treatment of bacterial corneal ulcer.

    Science.gov (United States)

    Chiang, C-C; Lin, J-M; Chen, W-L; Chiu, Y-T; Tsai, Y-Y

    2009-02-01

    In an in vitro study, fixed-combination fortified vancomycin and amikacin ophthalmic solutions (VA solution) had the same potency and stable physical properties as the separate components. In this retrospective clinical study, we evaluated the efficacy of the topical VA solution in the treatment of bacterial corneal ulcer and comparison with separate topical fortified vancomycin and amikacin. Separate topical fortified eye drops was used prior to January 2004 and switched to the VA solution afterwards in the treatment of bacterial corneal ulcer. The medical records of 223 patients diagnosed with bacterial corneal ulcers between January 2002 and December 2005 were reviewed retrospectively. There were 122 patients in the VA group and 101 in the separate group. Cure was defined as complete healing of the ulcer accompanied by a nonprogressive stromal infiltrate on two consecutive visits. No significant difference was found between the VA and separate therapy group. The mean treatment duration was 15.4 days in the VA group and 16.1 days in the separate therapy group. The average hospital stay was 5.4 days (VA) and 7.2 days (separate antibiotics). Stromal infiltration regressed significantly without further expansion in both groups. All corneal ulcers completely re-epithelialized without complications related to drugs. VA solution provided similar efficacy to the conventional separate therapy in the treatment of bacterial corneal ulcers; however, it is more convenient and tolerable, promotes patient's compliance, avoids the washout effect, and reduces nurse utilization. Hence, VA solution is a good alternative to separate therapy.

  18. VaCPK20 gene overexpression significantly increased resveratrol content and expression of stilbene synthase genes in cell cultures of Vitis amurensis Rupr.

    Science.gov (United States)

    Aleynova-Shumakova, O A; Dubrovina, A S; Manyakhin, A Y; Karetin, Y A; Kiselev, K V

    2014-06-01

    Resveratrol, a naturally occurring plant phenol, has been reported to exhibit a wide range of valuable biological and pharmacological properties. In the present investigation, we show that transformation of a Vitis amurensis Rupr. cell suspension with the gene VaCPK20 for a calcium-dependent protein kinase (CDPK) under the control of double CaMV 35S promoter increased resveratrol production in five independently transformed cell lines in 9-68 times compared with control cells. The VaCPK20-transformed calli were capable of producing 0.04-0.42 % dry wt. of resveratrol, while the control calli produced up to 0.008 % dry wt. of resveratrol Also, we characterized expression of stilbene synthase (STS) genes in the five VaCPK20-transgenic cell lines of V. amurensis. In all VaCPK20-transgenic cell lines, expression of VaSTS7 increased; while expression of VaSTS1 decreased. We suggest that transformation of V. amurensis calli with the VaCPK20 gene induced resveratrol accumulation via enhancement of expression of the VaSTS7 gene involved in resveratrol biosynthesis. The obtained data first demonstrate that overexpression of a CDPK gene resulted in increased accumulation of a stilbenoid phytoalexine in transgenic plant cells. We propose that the VaCPK20 gene could play an important role in the regulation of resveratrol biosynthesis in grape cells.

  19. Global financial crisis and VaR performance in emerging markets: A case of EU candidate states - Turkey and Croatia

    Directory of Open Access Journals (Sweden)

    Bora Aktan

    2009-06-01

    Full Text Available We investigate the relative performance of a wide array of Value at Risk (VaR models with the daily returns of Turkish (XU100 and Croatian (CROBEX stock index prior to and during the ongoing financial crisis. In addition to widely used VaR models, we also study the behaviour of conditional and unconditional extreme value theory (EVT and hybrid historical simulation (HHS models to generate 95, 99 and 99.5% confidence level estimates. Results indicate that during the crisis period all tested VaR model except EVT and HHS models seriously underpredict the true level of risk, with EVT models doing so at a higher cost of capital compared to HHS model

  20. Towards a Heterogeneous, Polystore-like Data Architecture for the US Department of Veteran Affairs (VA) Enterprise Analytics

    Energy Technology Data Exchange (ETDEWEB)

    Begoli, Edmon [ORNL; Bates, Jack [Veterans Administration; Kistler, Derek E [ORNL

    2016-01-01

    The Polystore architecture revisits the federated approach to access and querying of the standalone, independent databases in the uniform and optimized fashion, but this time in the context of heterogeneous data and specialized analyses. In the light of this architectural philosophy, and in the light of the major data architecture development efforts at the US Department of Veterans Administration (VA), we discuss the need for the heterogeneous data store consisting of the large relational data warehouse, an image and text datastore, and a peta-scale genomic repository. The VA's heterogeneous datastore would, to a larger or smaller degree, follow the architectural blueprint proposed by the polystore architecture. To this end, we discuss the current state of the data architecture at VA, architectural alternatives for development of the heterogeneous datastore, the anticipated challenges, and the drawbacks and benefits of adopting the polystore architecture.

  1. Waves from the Sun: to the 100th anniversary of V.A. Troitskaya’s birth

    Directory of Open Access Journals (Sweden)

    Guglielmi A.V.

    2017-09-01

    Full Text Available It has been one hundred years since the birth of the outstanding scientist Professor V.A. Troitskaya. Her remarkable achievements in solar-terrestrial physics are widely known. For many years, Valeria A. Troitskaya was the President of the International Association of Geomagnetism and Aeronomy. This article deals with only one aspect of the multifaceted creative activity of V.A. Troitskaya. It relates to the problem of sources of ultra-low frequency (ULF electromagnetic oscillations and waves outside Earth’s magnetosphere. We were fortunate to work under the leadership of V.A. Troitskaya on this problem. In this paper, we briefly describe the history from the emergence of the idea of the extramagnetospheric origin of dayside permanent ULF oscillations in the late 1960s to the modern quest made by ground and satellite means for ULF waves excited by solar surface oscillations propagating in the interplanetary medium and reaching Earth.

  2. A new formulation for minimum input volt-ampere (VA-slip relationship of three-phase induction motors

    Directory of Open Access Journals (Sweden)

    Haroon Ashfaq

    2017-07-01

    Full Text Available The magnetization component of input current of low-rating three-phase induction motor is large which results in poor power factor particularly at low-load conditions. The situation becomes critical when motor is fed from a distributed generating (DG system. In this paper, the performance analysis of induction motor is carried out for minimum input VA. A distinct novel slip is found at which the input VA is minimum independent of the load conditions. This optimum slip is expressed in terms of motor per-phase equivalent circuit parameters. This novel relationship is valid for every induction motor. As compared to rated conditions, a drastic reduction in VA with a large improvement in power factor is observed. Although, a marginal change in output power and efficiency is recorded. All the analytical, simulated and experimental results match each other with a very fair degree of accuracy.

  3. Myosin Va Plays a Role in Nitrergic Smooth Muscle Relaxation in Gastric Fundus and Corpora Cavernosa of Penis

    Science.gov (United States)

    Carew, Josephine A.; Goyal, Raj K.; Sullivan, Maryrose P.

    2014-01-01

    The intracellular motor protein myosin Va is involved in nitrergic neurotransmission possibly by trafficking of neuronal nitric oxide synthase (nNOS) within the nerve terminals. In this study, we examined the role of myosin Va in the stomach and penis, proto-typical smooth muscle organs in which nitric oxide (NO) mediated relaxation is critical for function. We used confocal microscopy and co-immunoprecipitation of tissue from the gastric fundus (GF) and penile corpus cavernosum (CCP) to localize myosin Va with nNOS and demonstrate their molecular interaction. We utilized in vitro mechanical studies to test whether smooth muscle relaxations during nitrergic neuromuscular neurotransmission is altered in DBA (dilute, brown, non-agouti) mice which lack functional myosin Va. Myosin Va was localized in nNOS-positive nerve terminals and was co-immunoprecipitated with nNOS in both GF and CCP. In comparison to C57BL/6J wild type (WT) mice, electrical field stimulation (EFS) of precontracted smooth muscles of GF and CCP from DBA animals showed significant impairment of nitrergic relaxation. An NO donor, Sodium nitroprusside (SNP), caused comparable levels of relaxation in smooth muscles of WT and DBA mice. These normal postjunctional responses to SNP in DBA tissues suggest that impairment of smooth muscle relaxation resulted from inhibition of NO synthesis in prejunctional nerve terminals. Our results suggest that normal physiological processes of relaxation of gastric and cavernosal smooth muscles that facilitate food accommodation and penile erection, respectively, may be disrupted under conditions of myosin Va deficiency, resulting in complications like gastroparesis and erectile dysfunction. PMID:24516539

  4. KiVa Anti-Bullying Program in Italy: Evidence of Effectiveness in a Randomized Control Trial.

    Science.gov (United States)

    Nocentini, Annalaura; Menesini, Ersilia

    2016-11-01

    The present study aims to evaluate the effectiveness of the KiVa anti-bullying program in Italy through a randomized control trial of students in grades 4 and 6. The sample involved 2042 students (51 % female; grade 4, mean age = 8.85; ds = 0.43; grade 6, mean age = 10.93; ds = 0.50); 13 comprehensive schools were randomly assigned into intervention (KiVa) or control (usual school provision) conditions. Different outcomes (bullying, victimization, pro-bullying attitudes, pro-victim attitudes, empathy toward victims), analyses (longitudinal mixed model with multiple-item scales; longitudinal prevalence of bullies and victims using Olweus' single question), and estimates of effectiveness (Cohen's d; odds ratios) were considered in order to compare the Italian results with those from other countries. Multilevel models showed that KiVa reduced bullying and victimization and increased pro-victim attitudes and empathy toward the victim in grade 4, with effect sizes from 0.24 to 0.40. In grade 6, KiVa reduced bullying, victimization, and pro-bullying attitudes; the effects were smaller as compared to grade 4, yet significant (d ≥ 0.20). Finally, using Olweus dichotomous definition of bullies and victims, results showed that the odds of being a victim were 1.93 times higher for a control student than for a KiVa student in grade 4. Overall, the findings provide evidence of the effectiveness of the program in Italy; the discussion will focus on factors that influenced successfully the transportability of the KiVa program in Italy.

  5. Physicochemical properties of direct compression tablets with spray dried and ball milled solid dispersions of tadalafil in PVP-VA.

    Science.gov (United States)

    Wlodarski, K; Tajber, L; Sawicki, W

    2016-12-01

    The aim of this research was to develop immediate release tablets comprising solid dispersion (IRSDTs) of tadalafil (Td) in a vinylpyrrolidone and vinyl acetate block copolymer (PVP-VA), characterized by improved dissolution profiles. The solid dispersion of Td in PVP-VA (Td/PVP-VA) in a weight ratio of 1:1 (w/w) was prepared using two different processes i.e. spray drying and ball milling. While the former process has been well established in the formulation of IRSDTs the latter has not been exploited in these systems yet. Regardless of the preparation method, both Td/PVP-VA solid dispersions were amorphous as confirmed by PXRD, DSC and FTIR. However, different morphology of particles (SEM) resulted in differences in water apparent solubility and disk intrinsic dissolution rate (DIDR). Both solid dispersions and crystalline Td were successfully made into directly compressible tablets at three doses of Td, i.e. 2.5mg, 10mgand20mg, yielding nine different formulations (D 1 -D 9 ). Each of the lots met the requirements set by Ph.Eur. and was evaluated with respect to appearance, diameter, thickness, mass, hardness, friability, disintegration time and content of Td. IRSDTs performed as supersaturable formulations and had significantly improved water dissolution profiles in comparison with equivalent tablets containing crystalline Td and the marketed formulations. Tablets with both spray dried and ball milled Td/PVP-VA revealed the greatest improvement in dissolution depending on the investigated doses, i.e. 2.5mgand20mg, respectively. Also, dissolution of Td from Td/PVP-VA delivered in different forms occurred in the following order: powders>tablets>capsules. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans Affairs – VA Manhattan Campus

    Energy Technology Data Exchange (ETDEWEB)

    Stephen Schey; Jim Francfort

    2014-10-01

    This report focuses on the Department of Veterans Affairs, VA Manhattan Campus (VA- Manhattan) fleet to identify the daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support successful introduction of plug-in electric vehicles (PEVs) into the agency’s fleet. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively called PEVs) can fulfill the mission requirements.

  7. High users of VA emergency room facilities: are outpatients abusing the system or is the system abusing them?

    Science.gov (United States)

    Schneider, K C; Dove, H G

    1983-01-01

    A phenomenon well known to emergency room personnel is the high use of ER facilities by a small number of patients. In this study of 335 patients followed in outpatient specialty clinics at a university-affiliated VA medical center, 23% of the patients accounted for 73% of the ER visits. Although some patients may be abusing the system, the problem is difficult to correct because of congressional legislation that deters the VA from providing primary care. Thus, a small subset of patients with chronic medical problems who live close to the hospital are likely to continue to consume a disproportionate amount of ER resources.

  8. Childhood cause-specific mortality in rural Western Kenya: application of the InterVA-4 model

    Directory of Open Access Journals (Sweden)

    Nyaguara O. Amek

    2014-10-01

    Full Text Available Background: Assessing the progress in achieving the United Nation's Millennium Development Goals in terms of population health requires consistent and reliable information on cause-specific mortality, which is often rare in resource-constrained countries. Health and demographic surveillance systems (HDSS have largely used medical personnel to review and assign likely causes of death based on the information gathered from standardized verbal autopsy (VA forms. However, this approach is expensive and time consuming, and it may lead to biased results based on the knowledge and experience of individual clinicians. We assessed the cause-specific mortality for children under 5 years old (under-5 deaths in Siaya County, obtained from a computer-based probabilistic model (InterVA-4. Design: Successfully completed VA interviews for under-5 deaths conducted between January 2003 and December 2010 in the Kenya Medical Research Institute/US Centers for Disease Control and Prevention HDSS were extracted from the VA database and processed using the InterVA-4 (version 4.02 model for interpretation. Cause-specific mortality fractions were then generated from the causes of death produced by the model. Results: A total of 84.33% (6,621 childhood deaths had completed VA data during the study period. Children aged 1–4 years constituted 48.53% of all cases, and 42.50% were from infants. A single cause of death was assigned to 89.18% (5,940 of cases, 8.35% (556 of cases were assigned two causes, and 2.10% (140 were assigned ‘indeterminate’ as cause of death by the InterVA-4 model. Overall, malaria (28.20% was the leading cause of death, followed by acute respiratory infection including pneumonia (25.10%, in under-5 children over the study period. But in the first 5 years of the study period, acute respiratory infection including pneumonia was the main cause of death, followed by malaria. Similar trends were also reported in infants (29 days–11 months and

  9. The prevalence of body dysmorphic disorder and its clinical correlates in a VA primary care behavioral health clinic.

    Science.gov (United States)

    Kelly, Megan M; Zhang, Jinxin; Phillips, Katharine A

    2015-07-30

    We examined the prevalence of body dysmorphic disorder (BDD) in a Veterans Affairs (VA) primary care behavioral health clinic. Of 100 Veterans, 11% (95% CI = 6.3-18.6%) had current BDD and 12% (95% CI = 7.0-19.8%) had lifetime BDD. However, only 8.3% of these Veterans had been diagnosed with BDD. BDD was significantly associated with a substantially elevated rate of suicide attempts, major depression, and obsessive-compulsive disorder. This severe disorder appears to be underdiagnosed in VA settings. Published by Elsevier Ireland Ltd.

  10. PVP VA64 as a novel release-modifier for sustained-release mini-matrices prepared via hot melt extrusion.

    Science.gov (United States)

    Li, Yongcheng; Lu, Ming; Wu, Chuanbin

    2017-11-10

    The purpose of this study was to explore poly(vinylpyrrolidone-co-vinyl acetate) (PVP VA64) as a novel release-modifier to tailor the drug release from ethylcellulose (EC)-based mini-matrices prepared via hot melt extrusion (HME). Quetiapine fumarate (QF) was selected as model drug. QF/EC/PVP VA64 mini-matrices were extruded with 30% drug loading. The physical state of QF in extruded mini-matrices was characterized using differential scanning calorimetry, X-ray powder diffraction, and confocal Raman microscopy. The release-controlled ability of PVP VA64 was investigated and compared with that of xanthan gum, crospovidone, and low-substituted hydroxypropylcellulose. The influences of PVP VA64 content and processing temperature on QF release behavior and mechanism were also studied. The results indicated QF dispersed as the crystalline state in all mini-matrices. The release of QF from EC was very slow as only 4% QF was released in 24 h. PVP VA64 exhibited the best ability to enhance the drug release as compared with other three release-modifiers. The drug release increased to 50-100% in 24 h with the addition of 20-40% PVP VA64. Increasing processing temperature slightly slowed down the drug release by decreasing free volume and pore size. The release kinetics showed good fit with the Ritger-Peppas model. The values of release exponent (n) increased as PVP VA64 is added (0.14 for pure EC, 0.41 for 20% PVP VA64, and 0.61 for 40% PVP VA64), revealing that the addition of PVP VA64 enhanced the erosion mechanism. This work presented a new polymer blend system of EC with PVP VA64 for sustained-release prepared via HME.

  11. ¿Hacia dónde va la integración?

    Directory of Open Access Journals (Sweden)

    Alberto Acosta

    2015-01-01

    Full Text Available La ola integracionista se filtra por todas partes, en especial, en la formación de bloques económicos. Los periodistas juegan un papel importante como agentes dinamizadores. Aborda el Plan Bush vs. Integración, la crisis de la hegemonía a la integración, limitaciones del desarrollo dependiente. Responde a la pregunta de ¿Hacia donde va la integración en América latina? Advierte que la integración deberá construirse sobre una movilización ideológica en tormo a la definición de objetivos y metas que hagan posible las transformaciones en todas las sociedades involucradas.

  12. Study of cancer cell lines with Fourier transform infrared (FTIR)/vibrational absorption (VA) spectroscopy

    DEFF Research Database (Denmark)

    Uceda Otero, E. P.; Eliel, G. S. N.; Fonseca, E. J. S.

    2013-01-01

    In this work we have used Fourier transform infrared (FTIR) / vibrational absorption (VA) spectroscopy to study two cancer cell lines: the Henrietta Lacks (HeLa) human cervix carcinoma and 5637 human bladder carcinoma cell lines. Our goal is to experimentally investigate biochemical changes...... and differences in these cells lines utilizing FTIR spectroscopy. We have used the chemometrical and statistical method principal component analysis (PCA) to investigate the spectral differences. We have been able to identify certain bands in the spectra which are so-called biomarkers for two types of cell lines......, three groups for the 5637 human bladder carcinoma cell line (5637A, 5637B and 5637C), and another one for the HeLa human cervix carcinoma cell line. The vibrational modes can be assigned to specific bands involving characteristic motions of the protein backbone. This work shows that infrared vibrational...

  13. Myosin Va becomes a low duty ratio motor in the inhibited form.

    Science.gov (United States)

    Sato, Osamu; Li, Xiang-Dong; Ikebe, Mitsuo

    2007-05-04

    Vertebrate myosin Va is a typical processive motor with high duty ratio. Recent studies have revealed that the actin-activated ATPase activity of the full-length myosin Va (M5aFull) is inhibited at a low [Ca(2+)], which is due to the formation of a folded conformation of M5aFull. To clarify the underlying inhibitory mechanism, we analyzed the actin-activated ATP hydrolysis mechanism of the M5aFull at the inhibited and the activated states, respectively. Marked differences were found in the hydrolysis, P(i) release, and ADP release steps between the activated and the inhibited states. The kinetic constants of these steps of the activated state were similar to those of the unregulated S1 construct, in which the rate-limiting step was the ADP release step. On the other hand, the P(i) release rate from acto-M5aFull was decreased in EGTA by >1,000-fold, which makes this step the rate-limiting step for the actin-activated ATP hydrolysis cycle of M5aFull. The ADP off rate from acto-M5aFull was decreased by approximately 10-fold, and the equilibrium between the prehydrolysis state and the post hydrolysis state was shifted toward the former state in the inhibited state of M5aFull. Because of these changes, M5aFull spends a majority of the ATP hydrolysis cycling time in the weak actin binding state. The present results indicate that M5aFull molecules at a low [Ca(2+)] is inhibited as a cargo transporter not only due to the decrease in the cross-bridge cycling rate but also due to the decrease in the duty ratio thus being dissociated from actin.

  14. Continuity in a VA patient-centered medical home reduces emergency department visits.

    Directory of Open Access Journals (Sweden)

    Krisda H Chaiyachati

    Full Text Available One major goal of the Patient-Centered Medical Home (PCMH is to improve continuity of care between patients and providers and reduce the utilization of non-primary care services like the emergency department (ED.To characterize continuity under the Veterans Health Administration's PCMH model--the Patient Aligned Care Team (PACT, at one large Veterans Affair's (VA's primary care clinic, determine the characteristics associated with high levels of continuity, and assess the association between continuity and ED visits.Retrospective, observational cohort study of patients at the West Haven VA (WHVA Primary Care Clinic from March 2011 to February 2012.The 13,495 patients with established care at the Clinic, having at least one visit, one year before March 2011.Our exposure variable was continuity of care--a patient seeing their assigned primary care provider (PCP at each clinic visit. The outcome of interest was having an ED visit.The patients encompassed 42,969 total clinic visits, and 3185 (24% of them had 15,458 ED visits. In a multivariable logistic regression analysis, patients with continuity of care--at least one visit with their assigned PCP--had lower ED utilization compared to individuals without continuity (adjusted odds ratio [AOR] 0.54; 95% CI: 0.41, 0.71, controlling for frequency of primary care visits, comorbidities, insurance, distance from the ED, and having a trainee PCP assigned. Likewise, the adjusted rate of ED visits was 544/1000 person-year (PY for patients with continuity vs. 784/1000 PY for patients without continuity (p = 0.001. Compared to patients with low continuity (50% continuity were less likely to utilize the ED.Strong continuity of care is associated with decreased ED utilization in a PCMH model and improving continuity may help reduce the utilization of non-primary care services.

  15. Exploring end-of-residency transitions in a VA Patient Aligned Care Team.

    Science.gov (United States)

    Wang, Emily S; Conde, Michelle V; Simon, Bret; Leykum, Luci K

    2014-07-01

    End-of-residency transitions create disruptions in primary care continuity. The national implementation of Patient Aligned Care Teams (PACT) in Veterans Health Administration (VA) primary care clinics creates an opportunity to mitigate this discontinuity through the provision of team-based care. To identify team-based solutions to end-of-residency transitions in a resident PACT continuity clinic by assessing the knowledge, attitudes, and perceptions of non-physician PACT members and resident PACT physicians. Cross-sectional survey of 27 resident physicians and 24 non-physician PACT members in the Internal Medicine Clinic at the Audie L. Murphy VA Hospital in the South Texas Veterans Health Care System. Twenty-seven residents and 24 non-physician PACT members completed the survey, with response rates of 90 % and 100 %, respectively. All residents and 96 % of non-physician PACT members agreed or strongly agreed that the residents were responsible for informing patients about end-of-residency transitions. Only 38 % of non-physician PACT members versus 52 % of residents indicated that non-physician PACT members should be responsible for this transition. Approximately 80 % of resident physicians and non-physician PACT members agreed there should be a formalized approach to these transitions; 67 % of non-physician PACT members were willing to support this transition. Potential barriers to team-based care transitions were identified. Major themes of write-in suggestions for improving the transition focused on communication and relationships between the patient and PACT and among the PACT members. PACT implementation changes the roles and relationship structures among all team members. While end-of-residency transitions create a disruption in the relationship system, the remainder of the PACT may bridge this transition. Our results demonstrate the importance of a team-based solution that engages all PACT members by improving communication and fostering effective team

  16. Huddle up!: The adoption and use of structured team communication for VA medical home implementation.

    Science.gov (United States)

    Rodriguez, Hector P; Meredith, Lisa S; Hamilton, Alison B; Yano, Elizabeth M; Rubenstein, Lisa V

    2015-01-01

    Daily clinical team meetings (i.e., "huddles") may be helpful in implementing new roles and responsibilities for patient care because they provide a regular opportunity for member learning and feedback. We examined how huddles were implemented in the context of the VA patient-centered medical home (PCMH) transformation, including assessing barriers and facilitators to regular huddling among small teams ("teamlets"). We assessed the extent to which teamlet members that huddled had higher self-efficacy for PCMH changes, reported better teamwork experiences, and perceived more supportive practice environments. We used a convergent mixed-methods approach to analyze 79 teamlet member interviews from six VA primary care practices and 418 clinician and staff PCMH survey responses from the six interviewed practices and 13 additional practices in the same region. Most members reported participating in teamlet huddles when asked in surveys (85%). A minority of interview participants, however, described routine huddling focused on previsit planning that included all members. When members reported routine teamlet huddling, activities included (a) previsit planning, (b) strategizing treatment plans for patients with special or complex needs, (c) addressing daily workflow and communication issues through collective problem solving, and (d) ensuring awareness of what team members do and what actions are happening on the teamlet and in the practice. Primary care providers (PCPs) were least likely to report routine huddling. PCP huddlers reported greater self-efficacy for implementing PCMH changes. All huddlers, irrespective of role, reported better teamwork and more supportive practice climates. The most common barriers to teamlet huddling were limited time and operational constraints. In order to improve the impact of huddles on patient care, practice leaders should clearly communicate the goals, requirements, and benefits of huddling and provide adequate time and resources to

  17. Comparisons and Characterizations of the Mean-Variance, Mean-VaR, Mean-CVaR Models for Portfolio Selection With Background Risk

    OpenAIRE

    Xu, Guo; Wing-Keung, Wong; Lixing, Zhu

    2013-01-01

    This paper investigates the impact of background risk on an investor’s portfolio choice in a mean-VaR, mean-CVaR and mean-variance framework, and analyzes the characterizations of the mean-variance boundary and mean-VaR efficient frontier in the presence of background risk. We also consider the case with a risk-free security.

  18. VA Benefits: Increasing Outreach and Measuring Outcomes Would Improve the Post-9/11 GI Bill On-the-Job Training and Apprenticeship Programs

    Science.gov (United States)

    2015-11-01

    provide case- management to veterans with significant barriers to employment, such as homelessness or disabilities.40...determined that the data were sufficiently reliable for the purposes of this report. The summary statistics that VA provided from its LTS data...analyzed them. In addition, VA provided summary information from the WEAMS dataset as of March 23, 2015 on the number of facilities (employers or

  19. 76 FR 44087 - Agency Information Collection (Supplement to VA Forms 21-526, 21-534, and 21-535 (For Philippine...

    Science.gov (United States)

    2011-07-22

    ... AFFAIRS Agency Information Collection (Supplement to VA Forms 21-526, 21- 534, and 21-535 (For Philippine..., 21-534, and 21-535 (For Philippine Claims), VA Form 21-4169. OMB Control Number: 2900-0094. Type of... Philippines or recognized guerrilla services. An agency may not conduct or sponsor, and a person is not...

  20. High-Level Heat Resistance of Spores of Bacillus amyloliquefaciens and Bacillus licheniformis Results from the Presence of a spoVA Operon in a Tn1546 Transposon

    NARCIS (Netherlands)

    Berendsen, Erwin M; Koning, Rosella A; Boekhorst, Jos; de Jong, Anne; Kuipers, Oscar P; Wells-Bennik, Marjon H J

    2016-01-01

    Bacterial endospore formers can produce spores that are resistant to many food processing conditions, including heat. Some spores may survive heating processes aimed at production of commercially sterile foods. Recently, it was shown that a spoVA operon, designated spoVA(2mob), present on a Tn1546

  1. Serving homeless veterans in the VA Desert Pacific Healthcare Network: a needs assessment to inform quality improvement endeavors.

    Science.gov (United States)

    Gabrielian, Sonya; Yuan, Anita; Rubenstein, Lisa; Andersen, Ronald M; Gelberg, Lillian

    2013-08-01

    This report describes a needs assessment of VA programs for homeless Veterans in Southern California and Nevada, the geographic region with the most homeless Veterans in the nation. The assessment was formulated through key informant interviews. Current service provisions are discussed, along with salient unmet needs for this vulnerable population.

  2. 48 CFR 852.219-11 - VA notice of total veteran-owned small business set-aside.

    Science.gov (United States)

    2010-10-01

    ... representations: That it is a veteran-owned small business concern, and that it is a small business concern under...-owned small business set-aside. 852.219-11 Section 852.219-11 Federal Acquisition Regulations System... Provisions and Clauses 852.219-11 VA notice of total veteran-owned small business set-aside. As prescribed in...

  3. 33 CFR 334.340 - Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Chesapeake Bay off Plumtree... REGULATIONS § 334.340 Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area. (a) The danger zone. The waters of Chesapeake Bay and connecting waters within an area bounded as follows...

  4. 77 FR 23615 - Payment or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-VA...

    Science.gov (United States)

    2012-04-20

    ....'' The 2010 Act removed ``or in part'' from this exclusion. In order to remove this partial payment exclusion from VA regulations, we are removing the clause ``or in part'' from Sec. 17.1002(g) to parallel... revises Sec. Sec. 17.1001, 17.1002, 17.1004, and 17.1005. These revisions eliminate certain exclusions...

  5. Uus trend - süvaõpe ülikoolis / Kalle Tammemäe ; intervjueerinud Raivo Juurak

    Index Scriptorium Estoniae

    Tammemäe, Kalle, 1958-

    2011-01-01

    Intervjuu TTÜ õppeprorektori Kalle Tammemäega kavandatavast süvaõppesüsteemist, mis hakkab toetama eelkõige teadustööst huvitatud üliõpilasi, aidates mõnelgi neist aja jooksul õppejõuks-teaduriks kasvada

  6. Federal Health Care Center: VA and DOD Need to Develop Better Information to Monitor Operations and Improve Efficiency

    Science.gov (United States)

    2017-01-01

    managers , who supervise active duty staff on the West Campus, on how to effectively utilize such staff, particularly Navy hospital corpsmen. General...MTF designation would introduce additional operational requirements and challenges to the FHCC, including financial management and quality assurance... manage their operations with separate governance structures, workforces, and budgets. VA and DOD’s joint review team concluded that converting the

  7. Going to Scale: A Nonrandomized Nationwide Trial of the KiVa Antibullying Program for Grades 1-9

    Science.gov (United States)

    Karna, Antti; Voeten, Marinus; Little, Todd D.; Poskiparta, Elisa; Alanen, Erkki; Salmivalli, Christina

    2011-01-01

    Objective: The effects of school-based antibullying programs have typically been examined on small samples, with number of schools ranging from 1 to 78 (Farrington & Ttofi, 2009). This study investigated the effectiveness of the KiVa antibullying program in the beginning of its nationwide implementation in Finland. Method: At each time point,…

  8. Contribution of soil-32P, fertilizer-32P and VA mycorrhizal fungi to phosphorus nutrition of corn plant

    International Nuclear Information System (INIS)

    Feng Gu; Yang Maoqiu; Bai Dengsha; Huang Quansheng

    1997-01-01

    32 P labelled fertilizer and five synthetic phosphates (dicalcium phosphate, octocalcium phosphate, iron phosphate, aluminium phosphate and apatite), which were used to simulate inorganic phosphates such as Ca 2 -P, Ca 8 -P, Fe P , Al-P and Ca 10 -P in calcareous soil, were applied to corn plants inoculating with and without vesicular-arbuscular (VA) mycorrhizal fungi in a calcareous soil. The results showed that VA mycorrhizal fungi and dicalcium phosphate, octocalcium phosphate, iron phosphate, aluminium phosphate promoted growth and increased phosphorus content of corn plant. The four synthetic phosphates except apatite had higher contributions to corn plant growth than VA mycorrhizal fungi. Contributions of fertilizer-P, soil-P and synthetic phosphates to phosphorus nutrition of corn plant were in order of synthetic phosphates (except apatite) > soil- P > fertilizer-P. Inoculating with VA mycorrhizal fungi increased the contribution of soil-P and decreased the contribution of synthetic phosphates, but did not affect the contribution of fertilizer-P

  9. VA Community Mental Health Service Providers' Utilization of and Attitudes toward Telemental Health Care: The Gatekeeper's Perspective

    Science.gov (United States)

    Jameson, John Paul; Farmer, Mary Sue; Head, Katharine J.; Fortney, John; Teal, Cayla R.

    2011-01-01

    Context: Mental health (MH) providers in community-based outpatient clinics (CBOCs) are important stakeholders in the development of the Veterans Health Administration (VA) telemental health (TMH) system, but their perceptions of these technologies have not been systematically examined. Purpose: The purpose of this study was to investigate the…

  10. 75 FR 24510 - Drug and Drug-Related Supply Promotion by Pharmaceutical Company Sales Representatives at VA...

    Science.gov (United States)

    2010-05-05

    ... those programs and materials focus on clinician education as opposed to marketing of drugs and drug... that the proposed rule allow VA medical professionals to become educated through the promotion of such... financing, intended to support the program. (2) Marketing activities cannot be conducted during an...

  11. 75 FR 26160 - Drug and Drug-Related Supply Promotion by Pharmaceutical Company Sales Representatives at VA...

    Science.gov (United States)

    2010-05-11

    ... those programs and materials focus on clinician education as opposed to marketing of drugs and drug... that the proposed rule allow VA medical professionals to become educated through the promotion of such...) Marketing activities cannot be conducted during an educational program. (3) Promotional materials are not to...

  12. 75 FR 38979 - Expansion/Reorganization of Foreign-Trade Zone 204, Tri-Cities Area, TN/VA

    Science.gov (United States)

    2010-07-07

    ... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board [Order No. 1691] Expansion/Reorganization of Foreign-Trade Zone 204, Tri-Cities Area, TN/VA Pursuant to its authority under the Foreign-Trade Zones Act of June 18, 1934, as amended (19 U.S.C. 81a-81u), the Foreign-Trade Zones Board (the Board) adopts...

  13. 78 FR 54571 - Special Local Regulation for Marine Event Hampton Bay Days Festival, Hampton River; Hampton, VA

    Science.gov (United States)

    2013-09-05

    ...-AA08 Special Local Regulation for Marine Event Hampton Bay Days Festival, Hampton River; Hampton, VA... Fifth Coast Guard District. This regulation applies only to the Hampton Bay Days Festival, which... Purpose Hampton Bay Days is sponsoring the three days Hampton Bay Days Festival, which includes a...

  14. Modeling of Mean-VaR portfolio optimization by risk tolerance when the utility function is quadratic

    Science.gov (United States)

    Sukono, Sidi, Pramono; Bon, Abdul Talib bin; Supian, Sudradjat

    2017-03-01

    The problems of investing in financial assets are to choose a combination of weighting a portfolio can be maximized return expectations and minimizing the risk. This paper discusses the modeling of Mean-VaR portfolio optimization by risk tolerance, when square-shaped utility functions. It is assumed that the asset return has a certain distribution, and the risk of the portfolio is measured using the Value-at-Risk (VaR). So, the process of optimization of the portfolio is done based on the model of Mean-VaR portfolio optimization model for the Mean-VaR done using matrix algebra approach, and the Lagrange multiplier method, as well as Khun-Tucker. The results of the modeling portfolio optimization is in the form of a weighting vector equations depends on the vector mean return vector assets, identities, and matrix covariance between return of assets, as well as a factor in risk tolerance. As an illustration of numeric, analyzed five shares traded on the stock market in Indonesia. Based on analysis of five stocks return data gained the vector of weight composition and graphics of efficient surface of portfolio. Vector composition weighting weights and efficient surface charts can be used as a guide for investors in decisions to invest.

  15. Association of substance use and VA service-connected disability benefits with risk of homelessness among veterans.

    Science.gov (United States)

    Edens, Ellen L; Kasprow, Wes; Tsai, Jack; Rosenheck, Robert A

    2011-01-01

    Recent public attention on homelessness has shifted beyond emergency services and supportive housing to primary prevention. This study compares a national sample of homeless and nonhomeless Veterans Affairs (VA) mental health services users to determine risk and protective factors for homelessness. Using VA administrative data, veterans were identified as homeless (ie, used VA homeless services or received a diagnostic code for "lack of housing") or nonhomeless and compared using logistic regression. Additional analyses were conducted for two low-risk subgroups: veterans who served in current Middle East wars (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]) and veterans with ≥50% service-connected disability. Among all VA mental health users, OEF/OIF (odds ratio [OR]) = 0.4) and ≥50% service-connected (OR = .3) veterans were less likely to be homeless. In the overall and subgroup analyses, illicit drug use (OR = 3.3-4.7) was by far the strongest predictor of homelessness, followed by pathological gambling (PG) (OR = 2.0-2.4), alcohol use disorder (OR = 1.8-2.0), and having a personality disorder (OR = 1.6-2.2). In both low-risk groups, severe mental illness (schizophrenia or bipolar disorder), along with substance use disorders, PG, and personality disorders, increased homelessness risk. Substance use, PG, and personality disorders confer the greatest modifiable risk of homelessness among veterans using VA services, while service-connected disability conferred reduced risk. Clinical prevention efforts could focus on these factors.  © American Academy of Addiction Psychiatry.

  16. Multimethod evaluation of the VA's peer-to-peer Toolkit for patient-centered medical home implementation.

    Science.gov (United States)

    Luck, Jeff; Bowman, Candice; York, Laura; Midboe, Amanda; Taylor, Thomas; Gale, Randall; Asch, Steven

    2014-07-01

    Effective implementation of the patient-centered medical home (PCMH) in primary care practices requires training and other resources, such as online toolkits, to share strategies and materials. The Veterans Health Administration (VA) developed an online Toolkit of user-sourced tools to support teams implementing its Patient Aligned Care Team (PACT) medical home model. To present findings from an evaluation of the PACT Toolkit, including use, variation across facilities, effect of social marketing, and factors influencing use. The Toolkit is an online repository of ready-to-use tools created by VA clinic staff that physicians, nurses, and other team members may share, download, and adopt in order to more effectively implement PCMH principles and improve local performance on VA metrics. Multimethod evaluation using: (1) website usage analytics, (2) an online survey of the PACT community of practice's use of the Toolkit, and (3) key informant interviews. Survey respondents were PACT team members and coaches (n = 544) at 136 VA facilities. Interview respondents were Toolkit users and non-users (n = 32). For survey data, multivariable logistic models were used to predict Toolkit awareness and use. Interviews and open-text survey comments were coded using a "common themes" framework. The Consolidated Framework for Implementation Research (CFIR) guided data collection and analyses. The Toolkit was used by 6,745 staff in the first 19 months of availability. Among members of the target audience, 80 % had heard of the Toolkit, and of those, 70 % had visited the website. Tools had been implemented at 65 % of facilities. Qualitative findings revealed a range of user perspectives from enthusiastic support to lack of sufficient time to browse the Toolkit. An online Toolkit to support PCMH implementation was used at VA facilities nationwide. Other complex health care organizations may benefit from adopting similar online peer-to-peer resource libraries.

  17. Priority setting and the ethics of resource allocation within VA healthcare facilities: results of a survey.

    Science.gov (United States)

    Foglia, Mary Beth; Pearlman, Robert A; Bottrell, Melissa M; Altemose, Jane A; Fox, Ellen

    2008-01-01

    Setting priorities and the subsequent allocation of resources is a major ethical issue facing healthcare facilities, including the Veterans Health Administration (VHA), the largest integrated healthcare delivery network in the United States. Yet despite the importance of priority setting and its impact on those who receive and those who provide care, we know relatively little about how clinicians and managers view allocation processes within their facilities. The purpose of this secondary analysis of survey data was to characterize staff members' perceptions regarding the fairness of healthcare ethics practices related to resource allocation in Veterans Administration (VA) facilities. The specific aim of the study was to compare the responses of clinicians, clinician managers, and non-clinician managers with respect to these survey items. We utilized a paper and web-based survey and a cross-sectional design of VHA clinicians and managers. Our sample consisted of a purposive stratified sample of 109 managers and a stratified random sample of 269 clinicians employed 20 or more hours per week in one of four VA medical centers. The four medical centers were participating as field sites selected to test the logistics of administering and reporting results of the Integrated Ethics Staff Survey, an assessment tool aimed at characterizing a broad range of ethical practices within a healthcare organization. In general, clinicians were more critical than clinician managers or non-clinician managers of the institutions' allocation processes and of the impact of resource decisions on patient care. Clinicians commonly reported that they did not (a) understand their facility's decision-making processes, (b) receive explanations from management regarding the reasons behind important allocation decisions, or (b) perceive that they were influential in allocation decisions. In addition, clinicians and managers both perceived that education related to the ethics of resource

  18. Prevalence and trends of selected urologic conditions for VA healthcare users

    Directory of Open Access Journals (Sweden)

    Fischer Michael J

    2006-11-01

    Full Text Available Abstract Background Conducted as part of the Urologic Diseases in America project whose aim was to quantify the burden of urologic diseases on the American public, this study focuses on Veterans Health Administration (VHA users as a special population to supplement data on overall prevalence rates and trends in the United States. Veterans comprise 25% of the male population 18 years or older and contribute substantially to the overall burden of urologic conditions. The objective of this study is to describe the prevalence rates and trends of urologic cancers and selected benign conditions from 1999 to 2002 for VHA users. Methods VHA administrative files for 1999 – 2002 and Medicare claims files for the same years were used to identify those who had a diagnosis of qualifying urologic conditions. Results Among the conditions evaluated, prostate cancer was listed as a primary diagnosis for 5.4% of VHA users in 2002, followed in decreasing prevalence by erectile dysfunction (2.9%, renal mass (1.5%, interstitial cystitis (1.4%, and prostatitis (1.1%. Age-adjusted rates showed significant increases for renal mass (31%, interstitial cystitis (14%, and erectile dysfunction (8% between 1999 and 2002. Systematic variations in prevalence rates and trends were observed by age, race/ethnicity, and region. Those in the Western region generally had lower age-adjusted prevalence rates and their increases were also slower than other regions. Addition of Medicare data resulted in large increases (21 to 489% in prevalence among VHA users, suggesting substantial amount of non-VA urological care provided to VHA users. Conclusion Prevalence rates for many urologic diseases increased between 1999 and 2002, which were not entirely attributable to the aging of veterans. This changing urologic disease burden has substantial implications for access to urologic care and treatment capacity, especially in light of the level of urologic care delivered to veterans by

  19. Multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak and its control after use of the Veterans Affairs (VA) MRSA bundle in a VA long-term care facility, 2004-2014.

    Science.gov (United States)

    Webb, Risa M; Denton, Carmelita; Spruill, Emily; Henson, Gay; Bruce, Lisa; Woods, Gail L; Swiatlo, Andrea; Walker, Erica D; Peel, Chere; Sullivan, Donna

    2016-06-01

    A multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak with 91 infections occurred in our Veterans Affairs (VA) community living center over 46 months. Both similar and unique strains were shown by repetitive polymerase chain reaction to contribute to the outbreak, including 1 strain causing infections over a 33-month period. Most infections were soft tissue infections (67%). For 21 months after the initiation of the VA MRSA bundle, no infections were identified, and low rates of infection have been sustained an additional 4 years. The average annual rate of MRSA infection decreased by 62% (P < .001) from 0.6 per 1,000 resident days for 4 years prior to the bundle implementation to 0.09 per 1,000 resident days for 4 years after the bundle implementation. Published by Elsevier Inc.

  20. Air pollution and DNA methylation: interaction by psychological factors in the VA Normative Aging Study.

    Science.gov (United States)

    Madrigano, Jaime; Baccarelli, Andrea; Mittleman, Murray A; Sparrow, David; Spiro, Avron; Vokonas, Pantel S; Cantone, Laura; Kubzansky, Laura; Schwartz, Joel

    2012-08-01

    DNA methylation is a potential pathway linking air pollution to disease. Studies indicate that psychological functioning modifies the association between pollution and morbidity. The authors estimated the association of DNA methylation with ambient particulate matter less than 2.5 µm in diameter (PM(2.5)) and black carbon, using mixed models. DNA methylation of the inducible nitric oxide synthase gene, iNOS, and the glucocorticoid receptor gene, GCR, was measured by quantitative polymerase chain reaction pyrosequencing of 1,377 blood samples from 699 elderly male participants in the VA Normative Aging Study (1999-2009). The authors also investigated whether this association was modified by psychological factors including optimism or pessimism, anxiety, and depression. iNOS methylation was decreased after acute exposure to both black carbon and PM(2.5). A 1-μg/m(3) increase in exposure to black carbon in the 4 hours preceding the clinical examination was associated with a 0.9% decrease in 5-methylcytosine (95% CI: 0.4, 1.4) in iNOS, and a 10-μg/m(3) increase in exposure to PM(2.5) was associated with a 0.6% decrease in 5-methylcytosine (95% CI: 0.03, 1.1) in iNOS. Participants with low optimism and high anxiety had associations that were 3-4 times larger than those with high optimism or low anxiety. GCR methylation was not associated with particulate air pollution exposure.

  1. A PC [personal computer]-based version of KENO V.a

    International Nuclear Information System (INIS)

    Nigg, D.A.; Atkinson, C.A.; Briggs, J.B.; Taylor, J.T.

    1990-01-01

    The use of personal computers (PCs) and engineering workstations for complex scientific computations has expanded rapidly in the last few years. This trend is expected to continue in the future with the introduction of increasingly sophisticated microprocessors and microcomputer systems. For a number of reasons, including security, economy, user convenience, and productivity, an integrated system of neutronics and radiation transport software suitable for operation in an IBM PC-class environment has been under development at the Idaho National Engineering Laboratory (INEL) for the past 3 yr. Nuclear cross-section data and resonance parameters are preprocessed from the Evaluated Nuclear Data Files Version 5 (ENDF/B-V) and supplied in a form suitable for use in a PC-based spectrum calculation and multigroup cross-section generation module. This module produces application-specific data libraries that can then be used in various neutron transport and diffusion theory code modules. This paper discusses several details of the Monte Carlo criticality module, which is based on the well-known highly-sophisticated KENO V.a package developed at Oak Ridge National Laboratory and previously released in mainframe form by the Radiation Shielding Information Center (RSIC). The conversion process and a variety of benchmarking results are described

  2. Improving Patient Safety: Avoiding Unread Imaging Exams in the National VA Enterprise Electronic Health Record.

    Science.gov (United States)

    Bastawrous, Sarah; Carney, Benjamin

    2017-06-01

    In the current digital and filmless age of radiology, rates of unread radiology exams remain low, however, may still exist in unique environments. Veterans Affairs (VA) health care systems may experience higher rates of unread exams due to coexistence of Veterans Health Information Systems and Technology Architecture (VistA) imaging and commercial picture archiving and communication systems (PACS). The purpose of this patient safety initiative was to identify any unread exams and causes leading to unread exams. Following approval by departmental quality assurance committee, a comprehensive review was performed of all radiology exams within VistA imaging from July 1, 2009 to June 30, 2014 to identify unread radiology exams. Over the 5-year period, the total unread exam rate was calculated to be 0.17%, with the highest yearly unread exam rate of 0.25%. The leading majority of unread exam type was plain radiographs. Analysis revealed unfinished dictations, unassociated accession numbers, technologist errors, and inefficient radiologist work lists as top contributors to unread exams. Once unread radiology exams were discovered and the causes identified, valuable process changes were implemented within our department to ensure simultaneous tracking of all unread exams in VistA imaging as well as the commercial PACS.

  3. Enhancing the power output of the VA-955 UHF-TV klystron

    International Nuclear Information System (INIS)

    Bowen, O.N.; Lawson, J.Q.

    1977-01-01

    The Varian VA-955 UHF-TV klystron is rated at 50 kW CW, and four of these klystrons were used to provide 200 kW of RF power for lower hybrid heating experiments on the ATC machine at 800 MHz. These proven, production-type tubes were wanted to generate more power for larger type machines, such as the PDX. Varian was asked whether the tubes were capable of higher-power operation in pulsed applications. They replied that they had no experimental data but felt that the tubes were capable of greatly enhanced performance under pulsed conditions. By using cathode modulation instead of modulating anode control of the klystron, and thus limiting the time that high voltage is applied to the cathode, it was shown that the tube is capable of an output power of 200 kW for tens of milliseconds compared to its normal CW rating of 50 kW. A description is given of the experimental results, the required modifications to the klystron and output transmission circuit, the details of operation of the regulating modulator used to perform the experiment. Upgrade kits are now being fabricated to allow 200 kW operation of the two 50 kW units which were lent to General Atomic for Doublet II experiments

  4. Expression of Vitis amurensis VaERF20 in Arabidopsis thaliana Improves Resistance to Botrytis cinerea and Pseudomonas syringae pv. Tomato DC3000

    OpenAIRE

    Mengnan Wang; Yanxun Zhu; Rui Han; Wuchen Yin; Chunlei Guo; Zhi Li; Xiping Wang

    2018-01-01

    Ethylene response factor (ERF) transcription factors play important roles in regulating immune responses in plants. In our study, we characterized a member of the ERF transcription factor family, VaERF20, from the Chinese wild Vitis genotype, V. amurensis Rupr “Shuangyou”. Phylogenetic analysis indicated that VaERF20 belongs to group IXc of the ERF family, in which many members are known to contribute to fighting pathogen infection. Consistent with this, expression of VaERF20 was induced by t...

  5. Partnering With VA Stakeholders to Develop a Comprehensive Patient Safety Data Display: Lessons Learned From the Field.

    Science.gov (United States)

    Chen, Qi; Shin, Marlena H; Chan, Jeffrey A; Sullivan, Jennifer L; Borzecki, Ann M; Shwartz, Michael; Rivard, Peter E; Hatoun, Jonathan; Rosen, Amy K

    2016-01-01

    Health care systems are increasingly burdened by the large numbers of safety measures currently being reported. Within the Veterans Administration (VA), most safety reporting occurs within organizational silos, with little involvement by the frontline users of these measures. To provide a more integrated picture of patient safety, the study team partnered with multiple VA stakeholders and engaged potential frontline users at 2 hospitals to develop a Guiding Patient Safety (GPS) tool. The GPS is currently in its fourth generation; once approval is obtained from senior leadership, implementation will begin. Stakeholders were enthusiastic about the GPS's user-friendly format, comprehensive content, and potential utility for improving safety. These findings suggest that stakeholder engagement is a critical first step in the development of tools that will more likely be used by frontline users. Policy makers and researchers may consider adopting this innovative partnered-research model in developing future national initiatives to deliver meaningful programs to frontline users. © The Author(s) 2014.

  6. 30 CFR 57.22212 - Air flow (I-C, II-A, and V-A mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Air flow (I-C, II-A, and V-A mines). 57.22212 Section 57.22212 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for Methane in Metal and Nonmeta...

  7. Demonstration of Electro-Osmotic Pulse Technology in Earth-Covered Magazines at Fort A.P. Hill, VA

    Science.gov (United States)

    2009-08-01

    damage, and growth of pathogens such as mold and microorganisms. At Fort A.P. Hill, VA, large amounts of water seep through the concrete walls...to the walls using galvanized steel angles. The an- gles were held in place using screws going through the wall and base with nuts to keep them...between them at the apex of the arch and held in place using nuts . Figure C-10 shows the completed model under testing. Prior to assembling the

  8. Annotated bibliography for liquid metal surface tensions of groups III-A, IV-A, and V-A metals

    International Nuclear Information System (INIS)

    Murtha, M.J.; Burnet, G.

    1976-04-01

    An annotated bibliography has been prepared which includes summaries of 82 publications dating from 1920 and dealing with the measurement of the surface tensions of Groups III-A, IV-A, and V-A metals in the liquid state. The bibliography is organized by key element investigated, and contains a tabulation of correlations for surface tension as a function of temperature. A brief discussion dealing with variables and methods has been included

  9. Effects of a pain education program in Complementary and Alternative Medicine treatment utilization at a VA medical center.

    Science.gov (United States)

    Cosio, David; Lin, Erica H

    2015-06-01

    Past studies have shown that U.S. Veterans are consumers of CAM. However, more than 75% of Veteran non-users report they would utilize these treatment options if made available. Thus, Veterans may not be fully aware of the CAM options currently available to them in the current U.S. VA health care system. The current study tested the hypothesis that Veterans would report an increase in CAM utilization after completing a formal pain education program in a VA medical center. The study used a quasi-experimental, one-group, pre/post-test design. Midwestern, U.S. VA Medical Center. The responses from 103 Veterans who elected to participate in the program and the assessment measures were included in the outcome analyses. "Pain Education School" is a 12-week, educational program that is open to all Veterans and their families. It is a comprehensive program that introduces patients to 23 different disciplines at the VA Medical Center that deal with chronic, non-cancer pain. An adaptation of the Complementary and Alternative Medicine Questionnaire(©), SECTION A: Use of Alternative Health Care Providers. There was a significant difference found in overall utilization of CAM after completing the pain education program. The most utilized CAM modality was the chiropractor; the least utilized were hypnosis and aromatherapy. Not all health care systems or providers may have access to an education-focused, professionally driven program as an amenity. However, lessons can be learned from this study in terms of what pain providers may be able to accomplish in their practice. Published by Elsevier Ltd.

  10. Federal Health Care Center: VA and DOD Need to Address Ongoing Difficulties and Better Prepare for Future Integrations

    Science.gov (United States)

    2016-02-01

    FHCC leadership, some of whom also served as the past and current co- chairs of the FHCC Advisory Board (Advisory Board).12 These officials included the...VISN 12 director serves as the VA co- chair on the Advisory Board. The commander for DOD’s Navy Medicine East serves as the DOD co- chair ...21Medical and dental services are provided to Navy recruits on

  11. Validity of code based algorithms to identify primary open angle glaucoma (POAG) in Veterans Affairs (VA) administrative databases.

    Science.gov (United States)

    Biggerstaff, K S; Frankfort, B J; Orengo-Nania, S; Garcia, J; Chiao, E; Kramer, J R; White, D

    2018-04-01

    The validity of the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9) code for primary open angle glaucoma (POAG) in the Department of Veterans Affairs (VA) electronic medical record has not been examined. We determined the accuracy of the ICD-9 code for POAG and developed diagnostic algorithms for the detection of POAG. We conducted a retrospective study of abstracted data from the Michael E. DeBakey VA Medical Center's medical records of 334 unique patients with at least one visit to the Eye Clinic between 1999 and 2013. Algorithms were developed to validly identify POAG using ICD-9 codes and pharmacy data. The positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and percent agreement of the various algorithms were calculated. For the ICD-9 code 365.1x, the PPV was 65.9%, NPV was 95.2%, sensitivity was 100%, specificity was 82.6%, and percent agreement was 87.8%. The algorithm with the highest PPV was 76.3%, using pharmacy data in conjunction with two or more ICD-9 codes for POAG, but this algorithm also had the lowest NPV at 88.2%. Various algorithms for identifying POAG in the VA administrative databases have variable validity. Depending on the type of research being done, the ICD-9 code 365.1x can be used for epidemiologic or health services database research.

  12. Temporal variability of radon in the atmosphere of Domica and Važecká Karst caves (Slovakia).

    Science.gov (United States)

    Smetanová, I; Holý, K; Zelinka, J; Omelka, J

    2014-07-01

    Continual monitoring of radon activity concentration was performed in two caves: Domica and Važecká. Radon in the air of the Domica cave was monitored from June 2010 to July 2011. Radon research in the Važecká cave started in June 2012 and it is still being carried out. Radon concentration in cave atmosphere exhibited seasonal, short-term and daily variations. Daily average of radon in Domica varied from 0.5 to 2.7 kBq m(-3). Seasonal trend was characterised by the highest concentration in September and the lowest from February to March. Radon concentration in the Važecká cave was significantly higher, and the daily average ranged from 1.0 to 5.3 kBq m(-3). The highest values were registered from June to September and in January. The seasonal and daily variations of 222Rn activity concentration in the atmosphere of both caves are assumed to be associated with the atmospheric temperature. No effect of atmospheric pressure on radon short-term variation was found. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Implementation outcomes of evidence-based quality improvement for depression in VA community based outpatient clinics

    Directory of Open Access Journals (Sweden)

    Fortney John

    2012-04-01

    Full Text Available Abstract Background Collaborative-care management is an evidence-based practice for improving depression outcomes in primary care. The Department of Veterans Affairs (VA has mandated the implementation of collaborative-care management in its satellite clinics, known as Community Based Outpatient Clinics (CBOCs. However, the organizational characteristics of CBOCs present added challenges to implementation. The objective of this study was to evaluate the effectiveness of evidence-based quality improvement (EBQI as a strategy to facilitate the adoption of collaborative-care management in CBOCs. Methods This nonrandomized, small-scale, multisite evaluation of EBQI was conducted at three VA Medical Centers and 11 of their affiliated CBOCs. The Plan phase of the EBQI process involved the localized tailoring of the collaborative-care management program to each CBOC. Researchers ensured that the adaptations were evidence based. Clinical and administrative staff were responsible for adapting the collaborative-care management program for local needs, priorities, preferences and resources. Plan-Do-Study-Act cycles were used to refine the program over time. The evaluation was based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance Framework and used data from multiple sources: administrative records, web-based decision-support systems, surveys, and key-informant interviews. Results Adoption: 69.0% (58/84 of primary care providers referred patients to the program. Reach: 9.0% (298/3,296 of primary care patients diagnosed with depression who were not already receiving specialty care were enrolled in the program. Fidelity: During baseline care manager encounters, education/activation was provided to 100% (298/298 of patients, barriers were assessed and addressed for 100% (298/298 of patients, and depression severity was monitored for 100% (298/298 of patients. Less than half (42.5%, 681/1603 of follow-up encounters during the acute

  14. Pessimistic orientation in relation to telomere length in older men: the VA Normative Aging Study

    Science.gov (United States)

    Ikeda, Ai; Schwartz, Joel; Peters, Junenette L.; Baccarelli, Andrea A.; Hoxha, Mirjam; Dioni, Laura; Spiro, Avron; Sparrow, David; Vokonas, Pantel; Kubzansky, Laura D.

    2014-01-01

    Background Recent research suggests pessimistic orientation is associated with shorter leukocyte telomere length (LTL). However, this is the first study to look not only at effects of pessimistic orientation on average LTL at multiple time points, but also at effects on the rate of change in LTL over time. Methods Participants were older men from the VA Normative Aging Study (n=490). The Life Orientation Test (LOT) was used to measure optimistic and pessimistic orientations at study baseline, and relative LTL by telomere to single copy gene ratio (T:S ratio) was obtained repeatedly over the course of the study (1999-2008). A total of 1,010 observations were included in the analysis. Linear mixed effect models with a random subject intercept were used to estimate associations. Results Higher pessimistic orientation scores were associated with shorter average LTL (percent difference by 1-SD increase in pessimistic orientation (95% CI): -3.08 (-5.62, -0.46)), and the finding was maintained after adjusting for the higher likelihood that healthier individuals return for follow-up visits (-3.44 (-5.95,-0.86)). However, pessimistic orientation scores were not associated with rate of change in LTL over time. No associations were found between overall optimism and optimistic orientation subscale scores and LTL. Conclusion Higher pessimistic orientation scores were associated with shorter LTL in older men. While there was no evidence that pessimistic orientation was associated with rate of change in LTL over time, higher levels of pessimistic orientation were associated with shorter LTL at baseline and this association persisted over time. PMID:24636503

  15. Toxicidad de VA-DIFTET® por administración a dosis repetida en ratones

    Directory of Open Access Journals (Sweden)

    Pablo González

    2000-06-01

    Full Text Available Una vez estudiada la toxicidad de la vacuna VA-DIFTET® (vacuna antidiftérica antitetánica por administración a dosis única en dos especies de animales, se impone la evaluación a dosis repetida, teniendo en cuenta que el esquema de inmunización en humanos prevé la aplicación de tres dosis cuando el componente pertusis de la DPT está contraindicado. Se emplearon 210 ratones OF-1 de ambos sexos. Los grupos experimentales fueron similares a los de la prueba a dosis única con la vacuna dúplex, anatoxina diftérica, anatoxina tetánica, adyuvante, tiomersal, solución salina fisiológica y un grupo control no tratado. Un grupo de hembras y otro de machos fue asignado aleatoriamente a cada tratamiento y para recibir 1, 2 ó 3 dosis por vía intramuscular. Tras cada aplicación se evaluó la aparición de síntomas clínicos, el incremento de peso, el consumo de agua y alimento y la dinámica de la respuesta inmune contra las anatoxinas tetánica y diftérica, específicamente de tipo IgG, mediante ELISA indirecto. Al término de las observaciones los animales fueron sacrificados y se realizaron estudios anatomopatológicos. Además, durante el sacrificio se evaluó el índice relativo de bazo y timo, así como la relación bazo/timo. No se comprobaron alteraciones que evidenciaran toxicidad por parte de la vacuna y sus componentes. Asimismo, se demostró una marcada respuesta inmune en los grupos vacunales e inoculados con las anatoxinas. Se considera que los resultados de la prueba fueron satisfactorios.

  16. The work of V.A. Snegirev: an historical and psychological study

    Directory of Open Access Journals (Sweden)

    Mazilov V.A.

    2017-03-01

    Full Text Available In the history of psychology there are many scientists whose names and contributions have been forgotten. One poorly studied area in the history of psychology is the psychological views of theologians. Among these is Veniamin Alekseevich Snegirev, a psychologist and theologian at Kazan Theological Academy, whose contributions are not fully appreciated today. The authors identify V.A. Snegirev’s contribution to several fields of psychological science at the end of the 19th century: methodology, theory, general psychology, and the psychology of dreams. The research is based on archival materials, encyclopedia articles, reviews of the activity of Kazan Theological Academy in the 19th century, works of Snegirev and other researchers who have studied his contributions. The authors describe the scientist’s childhood, his student period, and work as a professor. his work at the Kazan Theological Academy and the University of Kazan is discussed in detail: he taught courses on psychology, logic, and metaphysics, was a member of the Academy Council, took part in the functioning of the library, was recognized with several awards and honors. Snegirev’s teaching activity is described by the recollections of his student, the famous philosopher Viktor I. Nesmelov. Snegirev considered psychology to be based in philosophy, because philosophical problems represent the content of human consciousness. A bibliography of Snegirev’s scientific works is provided. The psychological and philosophical views of the Russian scientist are signifi- cant: his main points are to recognize the object of science – the human being – as a “living person”, thinking, feeling, and exercising his will; and the rejection of the idea that a person can be reduced to a sum of mental phenomena. There are several common concepts in the works of Snegirev and European and American philosophers, such as Wilhelm Dilthey and William James. Snegirev participated in the

  17. The Multiple-component Binary Hyad, vA 351 - a Progress Report

    Science.gov (United States)

    Benedict, George Fritz; Franz, Otto G.; Wasserman, Lawrence H.

    2017-06-01

    We extend results first announced by Franz et al. (1998) in the abstract, http://adsabs.harvard.edu/abs/1998AAS...19310207F ,that identified vA 351 = H346 in the Hyades as a multiple star system containing a white dwarf. With HST/FGS fringe tracking and scanning, spanning four years, we establish a parallax, relative orbit, and mass fraction for the A-B components, with a period, P~5.47y. With ground-based radial velocities from the McDonald Observatory Struve 2.1m telescope and Sandiford Spectrograph, spanning 14 years, we find that component B consists of BC, two M dwarf stars orbiting with a very short period (P(BC)~0.75 days), having a mass ratio C/B~0.94. We confirm that the total mass of the system can only be reconciled with the distance and component photometry by including a fainter, higher mass component, proposed to be a ~0.8Msun white dwarf. Thus, the quadruple system consists of three M dwarfs (A,B,C) and one white dwarf (D). The M dwarf masses and absolute magnitudes are consistent with the Benedict et al. (2016, http://adsabs.harvard.edu/abs/2016AJ....152..141B) lower Main Sequence Mass-Luminosity Relation. The radial velocity signal has so far yielded a signature only for the short-period BC orbital motion. Velocities from H-α and He I emission lines confirm the BC period from absorption lines, with similar (He I) and higher (H-α) velocity amplitudes.

  18. Behavioral Treatment for Veterans with Obesity: 24-Month Weight Outcomes from the ASPIRE-VA Small Changes Randomized Trial.

    Science.gov (United States)

    Lutes, Lesley D; Damschroder, Laura J; Masheb, Robin; Kim, Hyungjin Myra; Gillon, Leah; Holleman, Robert G; Goodrich, David E; Lowery, Julie C; Janney, Carol; Kirsh, Susan; Richardson, Caroline R

    2017-04-01

    Small Changes (SC) is a weight management approach that demonstrated superior 12-month outcomes compared to the existing MOVE! ® Weight Management Program at two Veterans Affairs (VA) sites. However, approaches are needed to help graduates of treatment continue to lose or maintain their weight over the longer term. The purpose of the present study was to examine the effectiveness of a second year of low-intensity SC support compared to support offered by the usual care MOVE! programs. Following participation in the year-long Aspiring to Lifelong Health in VA (ASPIRE-VA) randomized controlled trial, participants were invited to extend their participation in their assigned program for another year. Three programs were extended to include six SC sessions delivered via telephone (ASPIRE-Phone) or an in-person group (ASPIRE-Group), or 12 sessions offered by the MOVE! programs. Three hundred thirty-two overweight/obese veterans who consented to extend their participation in the ASPIRE-VA trial by an additional year. Twenty-four-month weight change (kg). Twenty-four months after baseline, participants in all three groups had modest weight loss (-1.40 kg [-2.61 to -0.18] in the ASPIRE-Group, -2.13 kg [-3.43 to -0.83] in ASPIRE-Phone, and -1.78 kg [-3.07 to -0.49] in MOVE!), with no significant differences among the three groups. Exploratory post hoc analyses revealed that participants diagnosed with diabetes initially benefited from the ASPIRE-Group program (-2.6 kg [-4.37 to 0.83]), but experienced significant weight regain during the second year (+2.8 kg [0.92-4.69]) compared to those without diabetes. Participants in all three programs lost weight and maintained a statistically significant, though clinically modest, amount of weight loss over a 24-month period. Although participants in the ASPIRE-Group initially had greater weight loss, treatment was not sufficient to sustain weight loss through the second year, particularly in veterans with diabetes. Consistent

  19. RİSK ÖLÇÜMÜNDE ALTERNATİF YAKLAŞIMLAR: RİSKE MARUZ DEĞER (VaR ve BEKLENEN KAYIP (ES UYGULAMALARI

    Directory of Open Access Journals (Sweden)

    SEZER BOZKUŞ

    2013-06-01

    Full Text Available This article shows that Value-at-Risk (VaR, the most popular risk measure in practice, has a considerable positive bias when used for a portfolio with fat-tail distribution. Numerical examples, i.e. USD/Euro daily prices and ISE-100 Index monthly returns, are given to demonstrate the use of our method. In the search for a suitable alternative to VaR, Expected Shortfall (ES or conditional VaR has been characterized as the coherent risk measure to dominate VaR. We discuss properties of VaR and ES and compare them in terms of consistency with elimination of tail risk, strengths and weaknesses. We conclude that ES is more applicable than VaR since ES is free of tail risk and consistent under more lenient conditions than VaR is.

  20. The KiVa antibullying program in primary schools in Chile, with and without the digital game component: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Gaete, Jorge; Valenzuela, Daniela; Rojas-Barahona, Cristian; Valenzuela, Eduardo; Araya, Ricardo; Salmivalli, Christina

    2017-02-20

    Bullying is a major problem worldwide and Chile is no exception. Bullying is defined as a systematic aggressive behavior against a victim who cannot defend him or herself. Victims suffer social isolation and psychological maladjustment, while bullies have a higher risk for conduct problems and substance use disorders. These problems appear to last over time. The KiVa antibullying program has been evaluated in Finland and other European countries, showing preventive effects on victimization and self-reported bullying. The aims of this study are (1) to develop a culturally appropriate version of the KiVa material and (2) to test the effectiveness of the KiVa program, with and without the online game, on reducing experiences of victimization and bullying behavior among vulnerable primary schools in Santiago (Chile), using a cluster randomized controlled trial (RCT) design with three arms: (1) full KiVa program group, (2) partial KiVa (without online game) program group and (3) control group. This is a three-arm, single-blind, cluster randomized controlled trial (RCT) with a target enrolment of 1495 4th and 5th graders attending 13 vulnerable schools per arm. Students in the full and partial KiVa groups will receive universal actions: ten 2-h lessons delivered by trained teachers during 1 year; they will be exposed to posters encouraging them to support victims and behave constructively when witnessing bullying; and a person designated by the school authorities will be present in all school breaks and lunchtimes using a visible KiVa vest to remind everybody that they are in a KiVa school. KiVa schools also will have indicated actions, which consist of a set of discussion groups with the victims and with the bullies, with proper follow-up. Only full KiVa schools will also receive an online game which has the aim to raise awareness of the role of the group in bullying, increase empathy and promote strategies to support victimized peers. Self-reported victimization

  1. Adaptation of a probabilistic method (InterVA of verbal autopsy to improve the interpretation of cause of stillbirth and neonatal death in Malawi, Nepal, and Zimbabwe

    Directory of Open Access Journals (Sweden)

    Munjanja Stephan P

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy (VA is a widely used method for analyzing cause of death in absence of vital registration systems. We adapted the InterVA method to extrapolate causes of death for stillbirths and neonatal deaths from verbal autopsy questionnaires, using data from Malawi, Zimbabwe, and Nepal. Methods We obtained 734 stillbirth and neonatal VAs from recent community studies in rural areas: 169 from Malawi, 385 from Nepal, and 180 from Zimbabwe. Initial refinement of the InterVA model was based on 100 physician-reviewed VAs from Malawi. InterVA indicators and matrix probabilities for cause of death were reviewed for clinical and epidemiological coherence by a pediatrician-researcher and an epidemiologist involved in the development of InterVA. The modified InterVA model was evaluated by comparing population-level cause-specific mortality fractions and individual agreement from two methods of interpretation (physician review and InterVA for a further 69 VAs from Malawi, 385 from Nepal, and 180 from Zimbabwe. Results Case-by-case agreement between InterVA and reviewing physician diagnoses for 69 cases from Malawi, 180 cases from Zimbabwe, and 385 cases from Nepal were 83% (kappa 0.76 (0.75 - 0.80, 71% (kappa 0.41(0.32-0.51, and 74% (kappa 0.63 (0.60-0.63, respectively. The proportion of stillbirths identified as fresh or macerated by the different methods of VA interpretation was similar in all three settings. Comparing across countries, the modified InterVA method found that proportions of preterm births and deaths due to infection were higher in Zimbabwe (44% than in Malawi (28% or Nepal (20%. Conclusion The modified InterVA method provides plausible results for stillbirths and newborn deaths, broadly comparable to physician review but with the advantage of internal consistency. The method allows standardized cross-country comparisons and eliminates the inconsistencies of physician review in such comparisons.

  2. 30 CFR 57.22205 - Doors on main fans (I-A, II-A, III, and V-A mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Doors on main fans (I-A, II-A, III, and V-A... main fans (I-A, II-A, III, and V-A mines). In mines ventilated by multiple main fans, each main fan... reversal through the fan. The doors shall be located so that they are not in direct line with explosive...

  3. 30 CFR 57.22202 - Main fans (I-A, I-B, I-C, II-A, III, V-A, and V-B mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Main fans (I-A, I-B, I-C, II-A, III, V-A, and V... Main fans (I-A, I-B, I-C, II-A, III, V-A, and V-B mines). (a) Main fans shall be— (1) Installed on the... mines, provided with an automatic signal device to give an alarm when the fan stops. The signal device...

  4. Determining Clinically Relevant Changes in Community Walking Metrics to Be Tracked by the VA as Part of Routine Care in Lower Limb Amputee Veterans

    Science.gov (United States)

    2017-10-01

    PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Modus Health, LLC 123 Second Ave South...by the VA as part of the new VA initiative. The metrics are the following: 1) functional level assessment, 2) peak performance index, 3) daily...for an upcoming abstract submission for a prosthetic conference or the Association of Academic Physiatrists annual conference. The other presented a

  5. 30 CFR 57.22204 - Main fan operation and inspection (I-A, II-A, III, and V-A mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Main fan operation and inspection (I-A, II-A, III, and V-A mines). 57.22204 Section 57.22204 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... Main fan operation and inspection (I-A, II-A, III, and V-A mines). Main fans shall be— (a) Provided...

  6. Expression of Vitis amurensis VaERF20 in Arabidopsis thaliana Improves Resistance to Botrytis cinerea and Pseudomonas syringae pv. Tomato DC3000.

    Science.gov (United States)

    Wang, Mengnan; Zhu, Yanxun; Han, Rui; Yin, Wuchen; Guo, Chunlei; Li, Zhi; Wang, Xiping

    2018-03-01

    Ethylene response factor (ERF) transcription factors play important roles in regulating immune responses in plants. In our study, we characterized a member of the ERF transcription factor family, VaERF20 , from the Chinese wild Vitis genotype, V. amurensis Rupr "Shuangyou". Phylogenetic analysis indicated that VaERF20 belongs to group IXc of the ERF family, in which many members are known to contribute to fighting pathogen infection. Consistent with this, expression of VaERF20 was induced by treatment with the necrotrophic fungal pathogen Botrytis cinerea (B. cinerea ) in "Shuangyou" and V. vinifera "Red Globe". Arabidopsis thaliana plants over-expressing VaERF20 displayed enhanced resistance to B. cinerea and the bacterium Pseudomonas syringae pv. tomato ( Pst ) DC3000. Patterns of pathogen-induced reactive oxygen species (ROS) accumulation were entirely distinct in B. cinerea and Pst DC3000 inoculated plants. Examples of both salicylic acid (SA) and jasmonic acid/ethylene (JA/ET) responsive defense genes were up-regulated after B. cinerea and Pst DC3000 inoculation of the VaERF20 -overexpressing transgenic A. thaliana plants. Evidence of pattern-triggered immunity (PTI), callose accumulation and stomatal defense, together with increased expression of PTI genes, was also greater in the transgenic lines. These data indicate that VaERF20 participates in various signal transduction pathways and acts as an inducer of immune responses.

  7. Expression of Vitis amurensis VaERF20 in Arabidopsis thaliana Improves Resistance to Botrytis cinerea and Pseudomonas syringae pv. Tomato DC3000

    Directory of Open Access Journals (Sweden)

    Mengnan Wang

    2018-03-01

    Full Text Available Ethylene response factor (ERF transcription factors play important roles in regulating immune responses in plants. In our study, we characterized a member of the ERF transcription factor family, VaERF20, from the Chinese wild Vitis genotype, V. amurensis Rupr “Shuangyou”. Phylogenetic analysis indicated that VaERF20 belongs to group IXc of the ERF family, in which many members are known to contribute to fighting pathogen infection. Consistent with this, expression of VaERF20 was induced by treatment with the necrotrophic fungal pathogen Botrytis cinerea (B. cinerea in “Shuangyou” and V. vinifera “Red Globe”. Arabidopsis thaliana plants over-expressing VaERF20 displayed enhanced resistance to B. cinerea and the bacterium Pseudomonas syringae pv. tomato (Pst DC3000. Patterns of pathogen-induced reactive oxygen species (ROS accumulation were entirely distinct in B. cinerea and PstDC3000 inoculated plants. Examples of both salicylic acid (SA and jasmonic acid/ethylene (JA/ET responsive defense genes were up-regulated after B. cinerea and PstDC3000 inoculation of the VaERF20-overexpressing transgenic A. thaliana plants. Evidence of pattern-triggered immunity (PTI, callose accumulation and stomatal defense, together with increased expression of PTI genes, was also greater in the transgenic lines. These data indicate that VaERF20 participates in various signal transduction pathways and acts as an inducer of immune responses.

  8. Employing external facilitation to implement cognitive behavioral therapy in VA clinics: a pilot study

    Directory of Open Access Journals (Sweden)

    Blevins Dean

    2010-10-01

    Full Text Available Abstract Background Although for more than a decade healthcare systems have attempted to provide evidence-based mental health treatments, the availability and use of psychotherapies remains low. A significant need exists to identify simple but effective implementation strategies to adopt complex practices within complex systems of care. Emerging evidence suggests that facilitation may be an effective integrative implementation strategy for adoption of complex practices. The current pilot examined the use of external facilitation for adoption of cognitive behavioral therapy (CBT in 20 Department of Veteran Affairs (VA clinics. Methods The 20 clinics were paired on facility characteristics, and 23 clinicians from these were trained in CBT. A clinic in each pair was randomly selected to receive external facilitation. Quantitative methods were used to examine the extent of CBT implementation in 10 clinics that received external facilitation compared with 10 clinics that did not, and to better understand the relationship between individual providers' characteristics and attitudes and their CBT use. Costs of external facilitation were assessed by tracking the time spent by the facilitator and therapists in activities related to implementing CBT. Qualitative methods were used to explore contextual and other factors thought to influence implementation. Results Examination of change scores showed that facilitated therapists averaged an increase of 19% [95% CI: (2, 36] in self-reported CBT use from baseline, while control therapists averaged a 4% [95% CI: (-14, 21] increase. Therapists in the facilitated condition who were not providing CBT at baseline showed the greatest increase (35% compared to a control therapist who was not providing CBT at baseline (10% or to therapists in either condition who were providing CBT at baseline (average 3%. Increased CBT use was unrelated to prior CBT training. Barriers to CBT implementation were therapists' lack of

  9. Solar Terminator Waves in the Ionosphere Measured by the Wallops Island, VA Dynasonde

    Science.gov (United States)

    Zabotin, N. A.; Song, H.; Bullett, T. W.

    2017-12-01

    Solar terminator represents a unique source of atmospheric waves possessing of near-ideal coherent properties: its geometry and magnitude of the impact changes very little from day to day. This feature has been used in [Forbes et al., GRL, 2008] to obtain "snapshots" of terminator waves in the neutral atmosphere at the altitude 400 km by averaging CHAMP accelerometer data over relatively long sequences of the satellite passes. The results were represented in the geographic latitude vs local time coordinates. We apply a similar approach averaging time series of Wallops Island, VA Dynasonde Doppler data to obtain "snapshots" of terminator waves in the ionosphere in the true altitude vs local "terminator time" coordinates. The averaging is performed independently for every month of the yearlong observation period from May 2013 to April 2014. The altitude range covered is 90 km to 400 km with 2 km resolution, representing the entire bottom-side ionosphere. Individual local time segments used for the averaging were 12 hours long and all centered at the times of the sunrise or sunset terminator passing at every specific altitude. This procedure effectively suppresses all kinds of incoherent wave activity and allows one to reveal the perturbation phenomenon mainly caused by the solar terminator. This is an important advantage of this technique compared to multiple "terminator wave" studies based on simple time coincidence. Both sunrise and sunset terminator waves are easily visualized in all of the monthly images. Our results confirm observations of [Forbes et al., GRL, 2008] of the wave structures existing on both sides of the terminator. The phase fronts of the sunset terminator wave are propagating downward indicating upward movement of the terminator-related disturbance and of the wave energy generated by it. The phase fronts of the sunrise terminator waves are propagating upward indicating downward movement of the terminator-related disturbance and of the wave energy

  10. A distinct correlation between the vibrational and thermal transport properties of group VA monolayer crystals.

    Science.gov (United States)

    Kocabaş, Tuğbey; Çakır, Deniz; Gülseren, Oğuz; Ay, Feridun; Kosku Perkgöz, Nihan; Sevik, Cem

    2018-04-17

    The investigation of thermal transport properties of novel two-dimensional materials is crucially important in order to assess their potential to be used in future technological applications, such as thermoelectric power generation. In this respect, the lattice thermal transport properties of the monolayer structures of group VA elements (P, As, Sb, Bi, PAs, PSb, PBi, AsSb, AsBi, SbBi, P3As1, P3Sb1, P1As3, and As3Sb1) with a black phosphorus like puckered structure were systematically investigated by first-principles calculations and an iterative solution of the phonon Boltzmann transport equation. Phosphorene was found to have the highest lattice thermal conductivity, κ, due to its low average atomic mass and strong interatomic bonding character. As a matter of course, anisotropic κ was obtained for all the considered materials, owing to anisotropy in frequency values and phonon group velocities calculated for these structures. However, the determined linear correlation between the anisotropy in the κ values of P, As, and Sb is significant. The results corresponding to the studied compound structures clearly point out that thermal (electronic) conductivity of pristine monolayers might be suppressed (improved) by alloying them with the same group elements. For instance, the room temperature κ of PBi along the armchair direction was predicted to be as low as 1.5 W m-1 K-1, whereas that of P was predicted to be 21 W m-1 K-1. In spite of the apparent differences in structural and vibrational properties, we peculiarly revealed an intriguing correlation between the κ values of all the considered materials as κ = c1 + c2/m2, in particular along the zigzag direction. Furthermore, our calculations on compound structures clearly showed that the thermoelectric potential of these materials can be improved by suppressing their thermal properties. The presence of ultra-low κ values and high electrical conductivity (especially along the armchair direction) makes this

  11. Reproductive and other health outcomes in Iraq and Afghanistan women veterans using VA health care: association with mental health diagnoses.

    Science.gov (United States)

    Cohen, Beth E; Maguen, Shira; Bertenthal, Daniel; Shi, Ying; Jacoby, Vanessa; Seal, Karen H

    2012-09-01

    An increasing number of women serve in the military and are exposed to trauma during service that can lead to mental health problems. Understanding how these mental health problems affect reproductive and physical health outcomes will inform interventions to improve care for women veterans. We analyzed national Department of Veterans Affairs (VA) data from women Iraq and Afghanistan veterans who were new users of VA healthcare from October 7, 2001, through December 31, 2010 (n = 71,504). We used ICD-9 codes to categorize veterans into five groups by mental health diagnoses (MH Dx): Those with no MH Dx, posttraumatic stress disorder (PTSD), depression, comorbid PTSD and depression, and a MH Dx other than PTSD and depression. We determined the association between mental health category and reproductive and other physical health outcomes defined by ICD-9 codes. Categories included sexually transmitted infections, other infections (e.g., urinary tract infections), pain-related conditions (e.g., dysmenorrhea and dsypareunia), and other conditions (e.g., polycystic ovarian syndrome, infertility, sexual dysfunction). Models were adjusted for sociodemographic and military service factors. There were 31,481 patients (44%) who received at least one mental health diagnosis. Women veterans with any mental health diagnosis had significantly higher prevalences of nearly all categories of reproductive and physical disease diagnoses (p women with PTSD, depression, and comorbid PTSD and depression (p for trend Afghanistan women veterans with mental health diagnoses had significantly greater prevalences of several important reproductive and physical health diagnoses. These results provide support for VA initiatives to address mental and physical health concerns and improve comprehensive care for women veterans. Published by Elsevier Inc.

  12. Multicenter randomized trial of robot-assisted rehabilitation for chronic stroke: methods and entry characteristics for VA ROBOTICS.

    Science.gov (United States)

    Lo, Albert C; Guarino, Peter; Krebs, Hermano I; Volpe, Bruce T; Bever, Christopher T; Duncan, Pamela W; Ringer, Robert J; Wagner, Todd H; Richards, Lorie G; Bravata, Dawn M; Haselkorn, Jodie K; Wittenberg, George F; Federman, Daniel G; Corn, Barbara H; Maffucci, Alysia D; Peduzzi, Peter

    2009-10-01

    Chronic upper extremity impairment due to stroke has significant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during the chronic stroke period. . To test the safety and efficacy of the MIT-Manus robotic device for chronic upper extremity impairment following stroke. . The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with upper extremity impairment >/=6 months poststroke were randomized to robot-assisted therapy (RT), intensive comparison therapy (ICT), or usual care (UC). RT and ICT consisted of three 1-hour treatment sessions per week for 12 weeks. The primary outcome was change in the Fugl-Meyer Assessment upper extremity motor function score at 12 weeks relative to baseline. Secondary outcomes included the Wolf Motor Function Test and the Stroke Impact Scale. . A total of 127 participants were randomized: 49 to RT, 50 to ICT, and 28 to UC. The majority of participants were male (96%), with a mean age of 65 years. The primary stroke type was ischemic (85%), and 58% of strokes occurred in the anterior circulation. Twenty percent of the participants reported a stroke in addition to their index stroke. The average time from the index stroke to enrollment was 56 months (range, 6 months to 24 years). The mean Fugl-Meyer score at entry was 18.9. . VA ROBOTICS demonstrates the feasibility of conducting multicenter clinical trials to rigorously test new rehabilitative devices before their introduction to clinical practice. The results are expected in early 2010.

  13. Single-cycle terahertz pulses with >0.2 V/A field amplitudes via coherent transition radiation

    International Nuclear Information System (INIS)

    Daranciang, Dan; Goodfellow, John; Fuchs, Matthias; Ghimire, Shambhu; Wen, Haidan; Reis, David A.; Loos, Henrik; Fisher, Alan S.; Lindenberg, Aaron M.

    2011-01-01

    We demonstrate terahertz pulses with field amplitudes exceeding 0.2 V/A generated by coherent transition radiation. Femtosecond, relativistic electron bunches generated at the Linac Coherent Light Source are passed through a beryllium foil, and the emitted radiation is characterized as a function of the bunch duration and charge. Broadband pulses centered at a frequency of 10 THz with energies of 140 μJ are measured. These far-below-bandgap pulses drive a nonlinear optical response in a silicon photodiode, with which we perform nonlinear autocorrelations that yield information regarding the terahertz temporal profile. Simulations of the spatiotemporal profile agree well with experimental results.

  14. Do Health Behaviors Explain the Effect of Neuroticism on Mortality? Longitudinal Findings from the VA Normative Aging Study

    Science.gov (United States)

    Mroczek, Daniel K.; Spiro, Avron; Turiano, Nick

    2009-01-01

    Studies have shown that higher levels of neuroticism are associated with greater risk of mortality. Yet what accounts for this association? One major theoretical position holds that persons higher in neuroticism engage in poorer health behaviors, such as smoking and excessive drinking, thus leading to earlier death. We tested this hypothesis using 30-year mortality in 1,788 men from the VA Normative Aging Study. Using proportional hazards (Cox) models we found that one health behavior, smoking, attenuated the effect of neuroticism on mortality by 40%. However, 60% remained unexplained, suggesting that the effects of other pathways (e.g., biological) also influence the relationship between neuroticism and mortality. PMID:20161240

  15. Validation of KENO V.a for criticality safety calculations of low-enriched uranium-235 systems

    International Nuclear Information System (INIS)

    McCamis, R.H.

    1991-02-01

    The criticality safety analysis program KENO V.a, together with a 27-energy-group ENDF/B-IV criticality safety cross-section library, has been validated by comparison of calculations with the experimental results from critical benchmarks dealing with low-enriched (≤ 5 wt%) 235 U systems, obtained both from the literature and from recent AECL Research experiments with the SLOWPOKE Demonstration Reactor. The combination of the code and this data library is shown to be very suitable for criticality safety analyses of low-enriched 235 U systems, with mean values of the calculated reactivities being within 1% of the experimental values. (6 figs., 3 tabs., 37 refs.)

  16. A Comparison of Collaborative Care Outcomes in Two Health Care Systems: VA Clinics and Federally Qualified Health Centers.

    Science.gov (United States)

    Grubbs, Kathleen M; Fortney, John C; Pyne, Jeffrey; Mittal, Dinesh; Ray, John; Hudson, Teresa J

    2018-01-16

    Collaborative care for depression results in symptom reduction when compared with usual care. No studies have systematically compared collaborative care outcomes between veterans treated at Veterans Affairs (VA) clinics and civilians treated at publicly funded federally qualified health centers (FQHCs) after controlling for demographic and clinical characteristics. Data from two randomized controlled trials that used a similar collaborative care intervention for depression were combined to conduct post hoc analyses (N=759). The Telemedicine-Enhanced Antidepressant Management intervention was delivered in VA community-based outpatient clinics (CBOCs), and the Outreach Using Telemedicine for Rural Enhanced Access in Community Health intervention was delivered in FQHCs. Multivariate logistic regression was used to determine whether veteran status moderated the effect of the intervention on treatment response (>50% reduction in symptoms). There was a significant main effect for intervention (odds ratio [OR]=5.23, p<.001) and a moderating effect for veteran status, with lower response rates among veterans compared with civilians (OR=.21, p=.01). The addition of variables representing medication dosage and number of mental health and general health appointments did not influence the moderating effect. A sensitivity analysis stratified by gender found a significant moderating effect of veteran status for men but not women. Veteran status was a significant moderator of collaborative care effectiveness for depression, indicating that veterans receiving collaborative care at a CBOC are at risk of nonresponse. Unmeasured patient- or system-level characteristics may contribute to poorer response among veterans.

  17. Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management

    Directory of Open Access Journals (Sweden)

    Enrique Jiménez-Rodríguez

    2018-03-01

    Full Text Available Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE. The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs. Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR concept in combination to the Loss Distribution Approach (LDA is proved to be a proactive tool, within the frame of balanced scorecard (BSC, in health organizations. For this purpose, the historical events recorded in the Algo-OpData® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls.

  18. Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management.

    Science.gov (United States)

    Jiménez-Rodríguez, Enrique; Feria-Domínguez, José Manuel; Sebastián-Lacave, Alonso

    2018-03-30

    Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData ® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls.

  19. Educational system factors that engage resident physicians in an integrated quality improvement curriculum at a VA hospital: a realist evaluation.

    Science.gov (United States)

    Ogrinc, Greg; Ercolano, Ellyn; Cohen, Emily S; Harwood, Beth; Baum, Karyn; van Aalst, Robertus; Jones, Anne C; Davies, Louise

    2014-10-01

    Learning about quality improvement (QI) in resident physician training is often relegated to elective or noncore clinical activities. The authors integrated teaching, learning, and doing QI into the routine clinical work of inpatient internal medicine teams at a Veterans Affairs (VA) hospital. This study describes the design factors that facilitated and inhibited the integration of a QI curriculum-including real QI work-into the routine work of inpatient internal medicine teams. A realist evaluation framework used three data sources: field notes from QI faculty; semistructured interviews with resident physicians; and a group interview with QI faculty and staff. From April 2011 to July 2012, resident physician teams at the White River Junction VA Medical Center used the Model for Improvement for their QI work and analyzed data using statistical process control charts. Three domains affected the delivery of the QI curriculum and engagement of residents in QI work: setting, learner, and teacher. The constant presence of the QI material on a public space in the team workroom was a facilitating mechanism in the setting. Explicit sign-out of QI work to the next resident team formalized the handoff in the learner domain. QI teachers who were respected clinical leaders with QI expertise provided role modeling and local system knowledge. Integrating QI teaching into the routine clinical and educational systems of an inpatient service is challenging. Identifiable, concrete strategies in the setting, learner, and teacher domains helped integrate QI into the clinical and educational systems.

  20. The Feasibility of Using Large-Scale Text Mining to Detect Adverse Childhood Experiences in a VA-Treated Population.

    Science.gov (United States)

    Hammond, Kenric W; Ben-Ari, Alon Y; Laundry, Ryan J; Boyko, Edward J; Samore, Matthew H

    2015-12-01

    Free text in electronic health records resists large-scale analysis. Text records facts of interest not found in encoded data, and text mining enables their retrieval and quantification. The U.S. Department of Veterans Affairs (VA) clinical data repository affords an opportunity to apply text-mining methodology to study clinical questions in large populations. To assess the feasibility of text mining, investigation of the relationship between exposure to adverse childhood experiences (ACEs) and recorded diagnoses was conducted among all VA-treated Gulf war veterans, utilizing all progress notes recorded from 2000-2011. Text processing extracted ACE exposures recorded among 44.7 million clinical notes belonging to 243,973 veterans. The relationship of ACE exposure to adult illnesses was analyzed using logistic regression. Bias considerations were assessed. ACE score was strongly associated with suicide attempts and serious mental disorders (ORs = 1.84 to 1.97), and less so with behaviorally mediated and somatic conditions (ORs = 1.02 to 1.36) per unit. Bias adjustments did not remove persistent associations between ACE score and most illnesses. Text mining to detect ACE exposure in a large population was feasible. Analysis of the relationship between ACE score and adult health conditions yielded patterns of association consistent with prior research. Copyright © 2015 International Society for Traumatic Stress Studies.

  1. Tout va bien ! méthode de français : cahier d'exercices 1

    CERN Document Server

    Augé, H; Marlhens, C; Martin, L

    2005-01-01

    Tout va bien ! est une méthode de français destinée aux grands adolescents et adultes débutants ou faux-débutants. Ses objectifs respectent scrupuleusement les recommandations du Cadre européen commun de référence pour les langues, comme en témoigne le portfolio qui accompagne le livre de l'élève. Tout va bien ! propose : Des supports et des situations de communication authentiques ou proches de l'authentique, permettant à l'élève de se sensibiliser aux différents registres et de découvrir certains aspects de la culture francophone tout autant que la langue. De très nombreuses activités visant l'acquisition des quatre compétences de communication et l'utilisation de stratégies spécifiques. Un travail sur la grammaire et le vocabulaire associés aux situations et au service de la communication faisant une large place à l'observation et à la réflexion. Une invitation régulière à l'évaluation, au travail an autonomie et à l'auto-évaluation.

  2. Tout va bien ! méthode de français : cahier d'exercices 2

    CERN Document Server

    Augé, H; Marlhens, C; Martin, L

    2005-01-01

    Tout va bien ! est une méthode de français destinée aux grands adolescents et adultes débutants ou faux-débutants. Ses objectifs respectent scrupuleusement les recommandations du Cadre européen commun de référence pour les langues, comme en témoigne le portfolio qui accompagne le livre de l'élève. Tout va bien ! propose : Des supports et des situations de communication authentiques ou proches de l'authentique, permettant à l'élève de se sensibiliser aux différents registres et de découvrir certains aspects de la culture francophone tout autant que la langue. De très nombreuses activités visant l'acquisition des quatre compétences de communication et l'utilisation de stratégies spécifiques. Un travail sur la grammaire et le vocabulaire associés aux situations et au service de la communication faisant une large place à l'observation et à la réflexion. Une invitation régulière à l'évaluation, au travail an autonomie et à l'auto-évaluation.

  3. VaCPK20, a calcium-dependent protein kinase gene of wild grapevine Vitis amurensis Rupr., mediates cold and drought stress tolerance.

    Science.gov (United States)

    Dubrovina, Alexandra S; Kiselev, Konstantin V; Khristenko, Valeriya S; Aleynova, Olga A

    2015-08-01

    Abiotic stresses, such as drought, salinity, cold and heat, are major environmental factors that limit crop productivity. Vitis amurensis Rupr. is a wild grapevine species displaying a high level of abiotic and biotic stress resistance. Protein kinases, including Ca(2+)-dependent protein kinases (CDPKs), are known to mediate plant acclimation to various environmental changes. However, the functions of most grape CDPKs have not been clarified. A recent CDPK gene expression analysis revealed that 10 CDPK genes of V. amurensis were up-regulated under different abiotic stress treatments. The expression of the VaCPK20 gene was significantly up-regulated under low and high temperature stress in V. amurensis. In the current study, the effects of overexpressing the VaCPK20 gene in callus cell lines of V. amurensis and transgenic plants of A. thaliana on their responses to abiotic stresses were investigated. Transgenic Arabidopsis overexpressing the VaCPK20 gene showed higher tolerance to freezing and drought stresses, and transgenic grape cell cultures overexpressing the VaCPK20 gene showed higher resistance to cold stress in comparison with the controls transformed by the "empty" vector. Heat and salt stress resistance of the transgenic V. amurensis calli and A. thaliana was comparable to that of the wild type and vector controls. Overexpression of the VaCPK20 gene increased the expression of stress-responsive genes, such as COR47, NHX1, KIN1, or ABF3, in the transgenic Arabidopsis plants under non-stress conditions, after freezing, and under drought stress. The results imply that VaCPK20 may act as a regulatory factor involved in cold and drought stress response pathways. Copyright © 2015 Elsevier GmbH. All rights reserved.

  4. InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries

    Directory of Open Access Journals (Sweden)

    Peter Byass

    2013-10-01

    Full Text Available Background: Reliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world’s AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. Objective: The aim of this article is to validate the InterVA-4 verbal autopsy (VA interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine the distribution of cause-specific mortality among HIV-positive and HIV-negative people. Design: Data from six sites of the Alpha Network, including HIV sero-status and VA interviews, were pooled. VA data according to the 2012 WHO format were extracted, and processed using the InterVA-4 model into likely causes of death. The model was blinded to the sero-status data. Cases with known pre-mortem HIV infection status were used to determine the specificity with which InterVA-4 could attribute HIV/AIDS as a cause of death. Cause-specific mortality fractions by HIV infection status were calculated, and a person-time model was built to analyse adjusted cause-specific mortality rate ratios. Results: The InterVA-4 model identified HIV/AIDS-related deaths with a specificity of 90.1% (95% CI 88.7–91.4%. Overall sensitivity could not be calculated, because HIV-positive people die from a range of causes. In a person-time model including 1,739 deaths in 1,161,688 HIV-negative person-years observed and 2,890 deaths in 75,110 HIV-positive person-years observed, the mortality ratio HIV-positive:negative was 29.0 (95% CI 27.1–31.0, after adjustment for age, sex, and study site. Cause-specific HIV-positive:negative mortality ratios for acute respiratory infections, HIV/AIDS-related deaths, meningitis, tuberculosis, and malnutrition were higher than the all-cause ratio; all causes had HIV-positive:negative mortality ratios significantly higher than unity. Conclusions

  5. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans Affairs. James J. Peters VA Medical Center, Bronx, NY

    Energy Technology Data Exchange (ETDEWEB)

    Schey, Stephen [Intertek Testing Services, North America, Phoenix, AZ (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-10-01

    This report focuses on the Department of Veterans Affairs, James J. Peters VA Medical Center (VA - Bronx) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively referred to as PEVs) can fulfill the mission requirements.

  6. Prescription and repair rates of prosthetic limbs in the VA healthcare system: implications for national prosthetic parity.

    Science.gov (United States)

    Etter, Katherine; Borgia, Matthew; Resnik, Linda

    2014-05-22

    Abstract Purpose: To quantify prescription and repair rates of prosthetic limbs in the Department of Veterans Affairs (VA) and explore differences by level, type, and age. Methods: Veterans (N = 32 440) with an initial prosthetic prescription between 2000 and 2010 were classified by amputation level and type. Annual rates of prescription and repair were calculated using person-time and compared by group. Results: Veterans with upper limb amputation had lower annual prescription and repair rates (0.28 and 0.21) compared with those with lower limb amputation (0.40 and 0.56). Myoelectric devices users had higher prescription rates. However, body-powered users had higher repair rates. Prescription and repair rates for microprocessor knee joints were higher than for fluid and friction devices. Veterans under 65 had 0.07 and 0.16 higher rates of prescription and repair than those over 65 (p < 0.0001). Conclusions: Because the VA is unconstrained by co-pays or caps, data on prosthetic prescription and repair can be used to estimate rates that might occur if national prosthetic parity laws were adopted. Given the rates found, it is likely that annual costs would exceed the typical annual and/or lifetime caps in most insurance plans. In states without prosthetic parity laws, such costs likely limit access to needed devices. Implications for Rehabilitation For the almost 2 million people in the United States living with an amputation or congenital limb loss, purchasing and maintaining a prosthetic limb can be costly, with insurances often imposing annual or lifetime caps. Data on prosthetic purchasing and repair is limited and reliant on self-reported information. Because the VA is unconstrained by co-pays or caps, claims data on prosthetic prescription and repair can be used to estimate rates that might occur if national prosthetic parity laws were adopted. Given the rates found, it is likely that annual costs would exceed the typical annual and/or lifetime caps

  7. Tailoring an educational program on the AHRQ Patient Safety Indicators to meet stakeholder needs: lessons learned in the VA.

    Science.gov (United States)

    Shin, Marlena H; Rivard, Peter E; Shwartz, Michael; Borzecki, Ann; Yaksic, Enzo; Stolzmann, Kelly; Zubkoff, Lisa; Rosen, Amy K

    2018-02-14

    Given that patient safety measures are increasingly used for public reporting and pay-for performance, it is important for stakeholders to understand how to use these measures for improvement. The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) are one particularly visible set of measures that are now used primarily for public reporting and pay-for-performance among both private sector and Veterans Health Administration (VA) hospitals. This trend generates a strong need for stakeholders to understand how to interpret and use the PSIs for quality improvement (QI). The goal of this study was to develop an educational program and tailor it to stakeholders' needs. In this paper, we share what we learned from this program development process. Our study population included key VA stakeholders involved in reviewing performance reports and prioritizing and initiating quality/safety initiatives. A pre-program formative evaluation through telephone interviews and web-based surveys assessed stakeholders' educational needs/interests. Findings from the formative evaluation led to development and implementation of a cyberseminar-based program, which we tailored to stakeholders' needs/interests. A post-program survey evaluated program participants' perceptions about the PSI educational program. Interview data confirmed that the concepts we had developed for the interviews could be used for the survey. Survey results informed us on what program delivery mode and content topics were of high interest. Six cyberseminars were developed-three of which focused on two content areas that were noted of greatest interest: learning how to use PSIs for monitoring trends and understanding how to interpret PSIs. We also used snapshots of VA PSI reports so that participants could directly apply learnings. Although initial interest in the program was high, actual attendance was low. However, post-program survey results indicated that perceptions about the

  8. La técnica de Western Blot aplicada a la vacuna antimeningocócica VA MENGOC BC® Western Blot technique applied to VA MENCOG BC® antimeningococcal vaccine

    Directory of Open Access Journals (Sweden)

    R. Rosario Diéguez Castro

    2009-12-01

    Full Text Available Se desarrolló y validó la técnica de Western Blot aplicada a la vacuna antimeningocócica VA MENGOC BC® producida en el Instituto Finlay con el objetivo de demostrar criterio de identidad. Con el empleo de esta técnica se identificaron las proteínas antigénicas del tipo P1, P3, P5, 70 y 80 K presentes en la vesícula de membrana externa y vacuna final, por lo cual se utilizó como antisuero la gamma antimeningocócica. Los parámetros desarrollados en la validación de la técnica fueron: especificidad, límite de detección, repetibilidad, precisión intermedia, reproducibilidad y robustez. La técnica de identidad cumplió con los parámetros señalados anteriormente, por lo que se considera validada.ABSTRACT Western Blot technique applied to VA MENGOC BC® antimeningococcal vaccine was developed and validated and produced in "Carlos J. Finlay" Institute to demonstrate the identity criterion. Using this technique it was possible to identify antigenic proteins type P1, P3, P5 70 and 80 K present in the vesicle of external membrane and final vaccine, thus, we used the antimeningococcal gamma. Parameters developed in validation of this technique included: specificity, detection limit, repetition, average accuracy, reproduction, and strength, identity technique fulfilled with abovementioned parameters, considering like validated

  9. Optimisasi Portofolio Mean-VaR di bawah CAPM Transformasi Koyck dengan Volatilitas Tak Konstan dan Efek Long Memory

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    Sukono Sukono

    2010-01-01

    Full Text Available In this paper we formulated mean-VaR portfolio optimization through CAPM Koyck transformation. We assumed that lagged of risk premium which have highly influence on stock returns is infinite, while model parameters decrease geometrically. We also assumed that rate of return in risk premium market index is not constant, in other word has a non-constant volatility rate, and also has a long memory effect. The later was analyzed using ARFIMA. Non constant volatility rate was modeled via GARCH model. The portfolio optimization was constructed using Langrangian multiplier and the Kuhn-Tucker theorem was employed to obtain the solution by the least square method. Finally, we provide a numerical example of the optimization model based on several stocks traded in Indonesian capital market.

  10. ICD discrimination of SVT versus VT with 1:1 V-A conduction: A review of the literature.

    Science.gov (United States)

    Cardoso, Rhanderson N; Healy, Chris; Viles-Gonzalez, Juan; Coffey, James O

    2015-01-01

    Inappropriate ICD shocks are associated with increased mortality. They also impair patients' quality of life, increase hospitalizations, and raise health-care costs. Nearly 80% of inappropriate ICD shocks are caused by supraventricular tachycardia. Here we report the case of a patient who received a single-lead dual-chamber sensing ICD for primary prevention of sudden cardiac death and experienced inappropriate ICD shocks. V-A time, electrogram morphology, and response to antitachycardia pacing suggested atrioventricular nodal reentry tachycardia, which was confirmed in an electrophysiology study. Inspired by this case, we performed a literature review to discuss mechanisms for discrimination of supraventricular tachycardia with 1:1 A:V relationship from ventricular tachycardia with 1:1 retrograde conduction.

  11. Production of electricity through biomass gasification system downdraft and generator group with a capacity of 50 kVA

    Directory of Open Access Journals (Sweden)

    Fabrízio Luiz Figueiredo

    2012-11-01

    Full Text Available This paper presents the results of tests performed with an internal combustion engine adapted to MWM Otto cycle, coupled to an electricity generator with a capacity of 50 kVA, fed exclusively with synthesis gas from a biomass gasifier downdraft, using wood eucalyptus. Also featured are the characteristics and efficiency of the generator set, in order to assess the feasibility of applying the system in remote locations, where biomass is available and the system of conventional electric power transmission is hampered by distance. The synthesis gas generated showed the average composition of 16,9% H2, 20% CO, 10,9% CO2, CH4, 2% and 50,1% N2. The performance of the span was monitored by applying loads of 0, 7, 13, 20,1 and 26,4 kW, the generator, keeping the average voltage of 222 V and currents of 0, 18,5, 33, 51, 84 and 67 A.

  12. Viveret Patrick, 2005, Pourquoi ça ne va pas plus mal?, Fayard, 264 p.

    Directory of Open Access Journals (Sweden)

    Fabien Thurette

    2008-05-01

    Full Text Available Patrick Viveret est philosophe de formation et Conseiller-maître à la Cour des comptes. Il a, en outre, été chargé d’une mission, confiée par l'éphémère Secrétaire d'État à l'économie solidaire Guy Hascoët, puis prolongée par le Président Chirac sur une « autre approche de la richesse », dont le rapport final a été publié sous le titre Reconsidérer la richesse (2004.Dans son essai Pourquoi ça ne va pas plus mal ? publié en 2005, Patrick Viveret nous livre une analyse philosophique sur le « m...

  13. Influence of Copolymer Composition on In Vitro and In Vivo Performance of Celecoxib-PVP/VA Amorphous Solid Dispersions

    DEFF Research Database (Denmark)

    Knopp, Matthias Manne; Nguyen, Julia Hoang; Mu, Huiling

    2016-01-01

    water-soluble drug as an amorphous solid dispersion using a copolymer, the copolymer composition has a significant influence on the dissolution profile and in vivo performance. Thus, the dissolution profile of a drug can theoretically be tailored by changing the monomer ratio of a copolymer with respect......Previous studies suggested that an amorphous solid dispersion with a copolymer consisting of both hydrophobic and hydrophilic monomers could improve the dissolution profile of a poorly water-soluble drug compared to the crystalline form. Therefore, this study investigated the influence...... of the copolymer composition of polyvinylpyrrolidone/vinyl acetate (PVP/VA) on the non-sink in vitro dissolution behavior and in vivo performance of celecoxib (CCX) amorphous solid dispersions. The study showed that the hydrophilic monomer vinylpyrrolidone (VP) was responsible for the generation of CCX...

  14. Housing first on a large scale: Fidelity strengths and challenges in the VA's HUD-VASH program.

    Science.gov (United States)

    Kertesz, Stefan G; Austin, Erika L; Holmes, Sally K; DeRussy, Aerin J; Van Deusen Lukas, Carol; Pollio, David E

    2017-05-01

    Housing First (HF) combines permanent supportive housing and supportive services for homeless individuals and removes traditional treatment-related preconditions for housing entry. There has been little research describing strengths and shortfalls of HF implementation outside of research demonstration projects. The U.S. Department of Veterans Affairs (VA) has transitioned to an HF approach in a supportive housing program serving over 85,000 persons. This offers a naturalistic window to study fidelity when HF is adopted on a large scale. We operationalized HF into 20 criteria grouped into 5 domains. We assessed 8 VA medical centers twice (1 year apart), scoring each criterion using a scale ranging from 1 ( low fidelity ) to 4 ( high fidelity ). There were 2 HF domains (no preconditions and rapidly offering permanent housing) for which high fidelity was readily attained. There was uneven progress in prioritizing the most vulnerable clients for housing support. Two HF domains (sufficient supportive services and a modern recovery philosophy) had considerably lower fidelity. Interviews suggested that operational issues such as shortfalls in staffing and training likely hindered performance in these 2 domains. In this ambitious national HF program, the largest to date, we found substantial fidelity in focusing on permanent housing and removal of preconditions to housing entry. Areas of concern included the adequacy of supportive services and adequacy in deployment of a modern recovery philosophy. Under real-world conditions, large-scale implementation of HF is likely to require significant additional investment in client service supports to assure that results are concordant with those found in research studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Examining evidence of ‘shift-contagion’ in African stock markets: A CoVaR-copula approach

    Directory of Open Access Journals (Sweden)

    Gideon Boako

    2017-12-01

    Full Text Available This paper examines for the first time contagion to African stock markets with particular attention to the quantification of, and testing for the impact of (extreme downside movements in foreign exchange and developed stock markets on the (extreme downside risks in Africa stock markets. Using data of weekly periodicity, the empirical analysis captured the pre, during (both turmoil and acute, and post periods of the 2007–2009 global financial crisis. We analyzed contagion by comparing (extreme downside cumulative mean distribution conditional value-at-risk (CoVaR values for African stock markets for successive periods and tested for significance of contagion using the Kolmogorov–Smirnoff (KS bootstrap technique. We used the KS statistic to test the hypothesis of equality or no systemic impact between the conditional African stock market return quantiles (for different successive sub-samples. CoVaR values are computed from four copula specifications — Gaussian, Student-t, Gumbel and Rotated Gumbel. By situating the empirical analysis within the shift-contagion thesis, we found evidence of contagion from some exchange rate and developed equity markets to African stocks only in the acute and the post-crisis periods. The findings are consistent with the view that global shocks propagation to developing markets may stagger during crisis and intensify post-crisis. A practical implication from the results is that given the relatively scarce resources and levels of technological know-how available to African governments, efforts to wean the continent’s equity markets from adverse effects of global market crashes should be geared towards plans and programmes to mitigate the shocks not at the early stages but latter stages, where the effects to Africa could be pronouncedly felt.

  16. SCC-TB, DFT/B3LYP, MP2, AM1, PM3 and RHF study of ethylene oxide and propylene oxide structures, VA and VCD spectra

    DEFF Research Database (Denmark)

    Jalkanen, Karl J.; Frimand, Kenneth

    2002-01-01

    -binding method for equilibrium structures, VA and VCD spectra of ethylene oxide and propylene oxide in the gas-phase. Comparison to conventional methods AM1, PM3, MP2, RHF and DFT/B3LYP is carried out. We report results over a wider range of frequencies than previous work. In particular, we find indications...

  17. Leg for life? The use of sartorius muscle flap for the treatment of an infected vascular reconstructions after VA-ECMO use. A case report

    Directory of Open Access Journals (Sweden)

    George V. Patrut

    2015-01-01

    Conclusion: Although ischemic complications associated with VA-ECMO are accepted by intensivists under the slogan “leg for life”, for the repair of the femoral artery in the presence of groin infection the sartorius muscle remains an efficient solution for limb salvage.

  18. 33 CFR 334.275 - North and Southwest Branch, Back River, Hampton, U.S. Air Force Base, Langley, Va.; restricted area.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false North and Southwest Branch, Back River, Hampton, U.S. Air Force Base, Langley, Va.; restricted area. 334.275 Section 334.275 Navigation... RESTRICTED AREA REGULATIONS § 334.275 North and Southwest Branch, Back River, Hampton, U.S. Air Force Base...

  19. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Science.gov (United States)

    2010-10-01

    ... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small... Affairs, “Service-disabled veteran-owned small business concern”: (1) Means a small business concern: (i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of...

  20. U.S. Department of Energy Hydrogen and Fuel Cells Program 2012 Annual Merit Review and Peer Evaluation Report: May 14-18, 2012, Arlington, VA

    Energy Technology Data Exchange (ETDEWEB)

    2012-09-01

    This document summarizes the comments provided by peer reviewers on hydrogen and fuel cell projects presented at the fiscal year (FY) 2012 U.S. Department of Energy (DOE) Hydrogen and Fuel Cells Program and Vehicle Technologies Program Annual Merit Review and Peer Evaluation Meeting (AMR), held May 14-18, 2012, in Arlington, VA.

  1. The role of cytochrome c oxidase subunit Va in non-small cell lung carcinoma cells: association with migration, invasion and prediction of distant metastasis

    Directory of Open Access Journals (Sweden)

    Chen Wen-Liang

    2012-06-01

    Full Text Available Abstract Background Lung cancer is one of the most lethal malignancies worldwide, but useful biomarkers of lung cancer are still insufficient. The aim of this study is to identify some membrane-bound protein(s associated with migration and invasion in human non-small cell lung cancer (NSCLC cells. Methods We classified four NSCLC cell lines into high and low migration/invasion groups by Transwell and Matrigel assays. Using two-dimensional gel electrophoresis and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS, we identified 10 membrane-associated proteins being significantly overexpressed in the high migration/invasion group. The expression of the target protein in the four NSCLC cell lines was then confirmed by reverse transcription polymerase chain reaction (RT-PCR, western blot and immunostaining. RNA interference technique was applied to observe the influence of the target protein on migration and invasion. Gelatin zymography was also performed to evaluate the activities of matrix metalloproteinase (MMP-2 and MMP-9. Expression condition of the target protein on surgical specimens was further examined by immunohistochemical staining and the clinicopathologic data were analyzed. Results We identified a mitochondria-bound protein cytochrome c oxidase subunit Va (COX Va because of its abundant presence found exclusively in tumorous areas. We also demonstrated that migration and invasion of NSCLC cells decreased substantially after knocking down COX Va by siRNA. Meanwhile, we found a positive correlation between COX Va expression, Bcl-2 expression and activities of MMP-2 and MMP-9 in NSCLC cells. Immunohistochemical staining of surgically resected lung adenocarcinomas in 250 consecutive patients revealed that strong COX Va expression was found in 54.8% (137/250 of patients and correlated positively with the status of lymph node metastasis (P = 0.032. Furthermore, strong COX Va expression was

  2. The role of cytochrome c oxidase subunit Va in non-small cell lung carcinoma cells: association with migration, invasion and prediction of distant metastasis

    International Nuclear Information System (INIS)

    Chen, Wen-Liang; Kuo, Kuang-Tai; Chou, Teh-Ying; Chen, Chien-Lung; Wang, Chih-Hao; Wei, Yau-Huei; Wang, Liang-Shun

    2012-01-01

    Lung cancer is one of the most lethal malignancies worldwide, but useful biomarkers of lung cancer are still insufficient. The aim of this study is to identify some membrane-bound protein(s) associated with migration and invasion in human non-small cell lung cancer (NSCLC) cells. We classified four NSCLC cell lines into high and low migration/invasion groups by Transwell and Matrigel assays. Using two-dimensional gel electrophoresis and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), we identified 10 membrane-associated proteins being significantly overexpressed in the high migration/invasion group. The expression of the target protein in the four NSCLC cell lines was then confirmed by reverse transcription polymerase chain reaction (RT-PCR), western blot and immunostaining. RNA interference technique was applied to observe the influence of the target protein on migration and invasion. Gelatin zymography was also performed to evaluate the activities of matrix metalloproteinase (MMP)-2 and MMP-9. Expression condition of the target protein on surgical specimens was further examined by immunohistochemical staining and the clinicopathologic data were analyzed. We identified a mitochondria-bound protein cytochrome c oxidase subunit Va (COX Va) because of its abundant presence found exclusively in tumorous areas. We also demonstrated that migration and invasion of NSCLC cells decreased substantially after knocking down COX Va by siRNA. Meanwhile, we found a positive correlation between COX Va expression, Bcl-2 expression and activities of MMP-2 and MMP-9 in NSCLC cells. Immunohistochemical staining of surgically resected lung adenocarcinomas in 250 consecutive patients revealed that strong COX Va expression was found in 54.8% (137/250) of patients and correlated positively with the status of lymph node metastasis (P = 0.032). Furthermore, strong COX Va expression was associated with the presence of distant metastasis (P = 0

  3. High-Level Heat Resistance of Spores of Bacillus amyloliquefaciens and Bacillus licheniformis Results from the Presence of a spoVA Operon in a Tn1546 Transposon

    Science.gov (United States)

    Berendsen, Erwin M.; Koning, Rosella A.; Boekhorst, Jos; de Jong, Anne; Kuipers, Oscar P.; Wells-Bennik, Marjon H. J.

    2016-01-01

    Bacterial endospore formers can produce spores that are resistant to many food processing conditions, including heat. Some spores may survive heating processes aimed at production of commercially sterile foods. Recently, it was shown that a spoVA operon, designated spoVA2mob, present on a Tn1546 transposon in Bacillus subtilis, leads to profoundly increased wet heat resistance of B. subtilis spores. Such Tn1546 transposon elements including the spoVA2mob operon were also found in several strains of Bacillus amyloliquefaciens and Bacillus licheniformis, and these strains were shown to produce spores with significantly higher resistances to wet heat than their counterparts lacking this transposon. In this study, the locations and compositions of Tn1546 transposons encompassing the spoVA2mob operons in B. amyloliquefaciens and B. licheniformis were analyzed. Introduction of these spoVA2mob operons into B. subtilis 168 (producing spores that are not highly heat resistant) rendered mutant 168 strains that produced high-level heat resistant spores, demonstrating that these elements in B. amyloliquefaciens and B. licheniformis are responsible for high level heat resistance of spores. Assessment of growth of the nine strains of each species between 5.2°C and 57.7°C showed some differences between strains, especially at lower temperatures, but all strains were able to grow at 57.7°C. Strains of B. amyloliquefaciens and B. licheniformis that contain the Tn1546 elements (and produce high-level heat resistant spores) grew at temperatures similar to those of their Tn1546-negative counterparts that produce low-level heat resistant spores. The findings presented in this study allow for detection of B. amyloliquefaciens and B. licheniformis strains that produce highly heat resistant spores in the food chain. PMID:27994575

  4. High-level heat resistance of spores of Bacillus amyloliquefaciens and Bacillus licheniformis results from the presence of a spoVA operon in a Tn1546 transposon.

    Directory of Open Access Journals (Sweden)

    Erwin M. Berendsen

    2016-12-01

    Full Text Available Bacterial endospore formers can produce spores that are resistant to many food processing conditions, including heat. Some spores may survive heating processes aimed at production of commercially sterile foods. Recently, it was shown that a spoVA operon, designated spoVA2mob, present on a Tn1546 transposon in Bacillus subtilis, leads to profoundly increased wet heat resistance of B. subtilis spores. Such Tn1546 transposon elements including the spoVA2mob operon were also found in several strains of Bacillus amyloliquefaciens and Bacillus licheniformis, and these strains were shown to produce spores with significantly higher resistances to wet heat than their counterparts lacking this transposon. In this study, the locations and compositions of Tn1546 transposons encompassing the spoVA2mob operons in B. amyloliquefaciens and B. licheniformis were analyzed. Introduction of these spoVA2mob operons into B. subtilis 168 (producing spores that are not highly heat resistant rendered mutant 168 strains that produced high-level heat resistant spores, demonstrating that these elements in B. amyloliquefaciens and B. licheniformis are responsible for high level heat resistance of spores. Assessment of growth of the nine strains of each species between 5.2°C and 57.7°C showed some differences between strains, especially at lower temperatures, but all strains were able to grow at 57.7°C. Strains of B. amyloliquefaciens and B. licheniformis that contain the Tn1546 elements (and produce high-level heat resistant spores grew at temperatures similar to those of their Tn1546-negative counterparts that produce low-level heat resistant spores. The findings presented in this study allow for detection of B. amyloliquefaciens and B. licheniformis strains that produce highly heat resistant spores in the food chain.

  5. Alcohol screening and risk of postoperative complications in male VA patients undergoing major non-cardiac surgery.

    Science.gov (United States)

    Bradley, Katharine A; Rubinsky, Anna D; Sun, Haili; Bryson, Chris L; Bishop, Michael J; Blough, David K; Henderson, William G; Maynard, Charles; Hawn, Mary T; Tønnesen, Hanne; Hughes, Grant; Beste, Lauren A; Harris, Alex H S; Hawkins, Eric J; Houston, Thomas K; Kivlahan, Daniel R

    2011-02-01

    Patients who misuse alcohol are at increased risk for surgical complications. Four weeks of preoperative abstinence decreases the risk of complications, but practical approaches for early preoperative identification of alcohol misuse are needed. To evaluate whether results of alcohol screening with the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) questionnaire-up to a year before surgery-were associated with the risk of postoperative complications. This is a cohort study. Male Veterans Affairs (VA) patients were eligible if they had major noncardiac surgery assessed by the VA's Surgical Quality Improvement Program (VASQIP) in fiscal years 2004-2006, and completed the AUDIT-C alcohol screening questionnaire (0-12 points) on a mailed survey within 1 year before surgery. One or more postoperative complication(s) within 30 days of surgery based on VASQIP nurse medical record reviews. Among 9,176 eligible men, 16.3% screened positive for alcohol misuse with AUDIT-C scores ≥ 5, and 7.8% had postoperative complications. Patients with AUDIT-C scores ≥ 5 were at significantly increased risk for postoperative complications, compared to patients who drank less. In analyses adjusted for age, smoking, and days from screening to surgery, the estimated prevalence of postoperative complications increased from 5.6% (95% CI 4.8-6.6%) in patients with AUDIT-C scores 1-4, to 7.9% (6.3-9.7%) in patients with AUDIT-Cs 5-8, 9.7% (6.6-14.1%) in patients with AUDIT-Cs 9-10 and 14.0% (8.9-21.3%) in patients with AUDIT-Cs 11-12. In fully-adjusted analyses that included preoperative covariates potentially in the causal pathway between alcohol misuse and complications, the estimated prevalence of postoperative complications increased significantly from 4.8% (4.1-5.7%) in patients with AUDIT-C scores 1-4, to 6.9% (5.5-8.7%) in patients with AUDIT-Cs 5-8 and 7.5% (5.0-11.3%) among those with AUDIT-Cs 9-10. AUDIT-C scores of 5 or more up to a year before surgery were

  6. Lead Exposure, B Vitamins, and Plasma Homocysteine in Men 55 Years of Age and Older: The VA Normative Aging Study

    Science.gov (United States)

    Park, Sung Kyun; Weisskopf, Marc G.; Tucker, Katherine L.; Sparrow, David; Spiro, Avron; Vokonas, Pantel S.; Nie, Linda Huiling; Hu, Howard; Weuve, Jennifer

    2014-01-01

    Background: Lead (Pb) exposure may influence the plasma concentration of homocysteine, a one-carbon metabolite associated with cardiovascular and neurodegenerative diseases. Little is known about the associations between Pb and homocysteine over time, or the potential influence of dietary factors. Objectives: We examined the longitudinal association of recent and cumulative Pb exposure with homocysteine concentrations and the potential modifying effect of dietary nutrients involved in one-carbon metabolism. Methods: In a subcohort of the Veterans Affairs (VA) Normative Aging Study (1,056 men with 2,301 total observations between 1993 and 2011), we used mixed-effects models to estimate differences in repeated measures of total plasma homocysteine across concentrations of Pb in blood and tibia bone, assessing recent and cumulative Pb exposure, respectively. We also assessed effect modification by dietary intake and plasma concentrations of folate, vitamin B6, and vitamin B12. Results: An interquartile range (IQR) increment in blood Pb (3 μg/dL) was associated with a 6.3% higher homocysteine concentration (95% CI: 4.8, 7.8%). An IQR increment in tibia bone Pb (14 μg/g) was associated with a 3.7% higher homocysteine (95% CI: 1.6, 5.6%), which was attenuated to 1.5% (95% CI: –0.5, 3.6%) after adjusting for blood Pb. For comparison, a 5-year increase in time from baseline was associated with a 5.7% increase in homocysteine (95% CI: 4.3, 7.1%). The association between blood Pb and homocysteine was significantly stronger among participants with estimated dietary intakes of vitamin B6 and folate below (vs. above) the study population medians, which were similar to the U.S. recommended dietary allowance intakes. Conclusions: Pb exposure was positively associated with plasma homocysteine concentration. This association was stronger among men with below-median dietary intakes of vitamins B6 and folate. These findings suggest that increasing intake of folate and B6 might

  7. Implementing and evaluating a regional strategy to improve testing rates in VA patients at risk for HIV, utilizing the QUERI process as a guiding framework: QUERI Series

    Directory of Open Access Journals (Sweden)

    Osborn Teresa

    2008-03-01

    Full Text Available Abstract Background We describe how we used the framework of the U.S. Department of Veterans Affairs (VA Quality Enhancement Research Initiative (QUERI to develop a program to improve rates of diagnostic testing for the Human Immunodeficiency Virus (HIV. This venture was prompted by the observation by the CDC that 25% of HIV-infected patients do not know their diagnosis – a point of substantial importance to the VA, which is the largest provider of HIV care in the United States. Methods Following the QUERI steps (or process, we evaluated: 1 whether undiagnosed HIV infection is a high-risk, high-volume clinical issue within the VA, 2 whether there are evidence-based recommendations for HIV testing, 3 whether there are gaps in the performance of VA HIV testing, and 4 the barriers and facilitators to improving current practice in the VA. Based on our findings, we developed and initiated a QUERI step 4/phase 1 pilot project using the precepts of the Chronic Care Model. Our improvement strategy relies upon electronic clinical reminders to provide decision support; audit/feedback as a clinical information system, and appropriate changes in delivery system design. These activities are complemented by academic detailing and social marketing interventions to achieve provider activation. Results Our preliminary formative evaluation indicates the need to ensure leadership and team buy-in, address facility-specific barriers, refine the reminder, and address factors that contribute to inter-clinic variances in HIV testing rates. Preliminary unadjusted data from the first seven months of our program show 3–5 fold increases in the proportion of at-risk patients who are offered HIV testing at the VA sites (stations where the pilot project has been undertaken; no change was seen at control stations. Discussion This project demonstrates the early success of the application of the QUERI process to the development of a program to improve HIV testing rates

  8. The content and composition of humus in pseudogleys of slopes and plains in South Mačva and Pocerina

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    Dugonjić Mladen

    2013-01-01

    Full Text Available The scope of this paper was to examine the influence of two subtypes of pseudogley soil (of planes and of slopes and three different land uses (forest, grassland and arable land on the content and composition of humus in south Mačva and Pocerina. The humus content was determined by dichromate method, and hu­mus components were measured using the method proposed by Kononova and Bel­cikova. The studied soils are mostly characterized by low humus content. Humus content is significantly higher in pseudogleys of plains compared to pseudogleys of slopes. Pseudogleys under grass and crops have significantly lower content of humus compared to the pseudogleys under forest. Important characteristic of hu­mus composition of surface horizon is dominant portion of fulvic over humic acids. Pseudogleys of plains have statistically significant higher amount of humic acids. The composition of humus is significantly different in pseudogley under forest compared to pseudogleys under grass and crops: it has more fulvic acids, less humin, and lower Ch:Cf ratio. Changes in pseudogley land use have produced better humus quality.

  9. Investigation of Energy Indices and Energy Consumption Optimization for Peach Production- Case Study: Saman Region in Chaharmahal va Bakhtiari Province

    Directory of Open Access Journals (Sweden)

    M Ghasemi-Varnamkhasti

    2015-03-01

    Full Text Available As one of the most important conditions in sustainable agriculture, optimization of energy consumption in agriculture is necessary in order to reduce the production cost and saving non renewable resources as well as reduction of air pollutants. In this regard, this study was conducted in Saman region, Chaharmahal va Bakhtiari province. A linear programming based on Data Envelopment Analysis (DEA was used for optimization of energy consumption in peach production in order to increase the technical efficiency. By performing a linear regression analysis, some inputs including animal fertilizer, pesticide, human labor and machinery had no significant influence on product yield, while some other inputs including fuel, electricity, water and chemical fertilizer showed a significant effect on the product yield. Therefore, the latter inputs and the product yield were considered as the inputs and output, respectively. Selecting the BCC model (efficiency to variable scale model of input nature and using DEA Solver software, efficient and inefficient farmers were determined. The efficient farmers had the technical efficiency of unit (one and the inefficient farmers had this value within 0.47-0.94. Also, the technical efficiency of inefficient farmers was computed as 0.74. This means that using 74% of the inputs and keeping the current yield, the inefficient farmers can approach to the efficiency limit. Total technical efficiency of all farmers was found to be 0.82. Based on the results, the maximum value of inefficiency belonged to electricity energy with 65.32%.

  10. Detection of Infectious Bronchitis Virus (4/91 type in Broiler Chickens in Chahrmahal-va-bakhtiyari Province

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    M Gholami-Ahangaran

    2012-08-01

    Full Text Available Infectious bronchitis (IB disease is a viral contagious respiratory disease. The causing agent of this disease has several serotypes. In this study, 4/91 type of Infectious bronchitis (IB was identified. For this, tracheal samples were taken from 18 broiler chickens flocks having respiratory signs suspected to IB disease with one percent mortality in day. After RNA extraction from tissue samples in one step RT-PCR reaction, a fragment of S1 gene was amplified by common primers for all IB viruses. Then RT-PCR product was amplified for identification of 4/91(793/B type by type specific primers in Nested-PCR. Results showed, 11 out 18 flocks (61.1% were infected to IB that 45.45% of IB infected flocks were infected to 4/91 type. Therefore it seems 4/91 type of IB has role in forming and complexing of respiratory signs in broiler chickens suffering to respiratory syndrome in Chahrmahal-va-bakhtiyari province and it is necessary to give a suitable controlling strategy for prevention of 4/91 infection.

  11. Isolation and identification of Salmonella typhimurium from raw cow, sheep and goat milk in Chahamaha Va Bakhteyari Province

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    F Tajbakhsh

    2014-05-01

    Full Text Available Salmonella typhimurium and S. enteritidisare known as the major causes of food-borne infection throughout the world. The present study was carried out to investigate the prevalence of S. typhimurium in raw milks of Chahamaha Va Bakhteyari province. For this reason, a total of 550 raw milks (consisting of 200 cow, 175 sheep and 175 goat milk samples were collected through October 2011 to March 2012 from dairy herds around Shahrekord. The samples were cultured and the isolated colonies were confirmed by PCR using species-specific ST11 and ST15 primers. According to the results, a total of 20 samples (3.63% were found positive for Salmonellaspp.Amongst, 14 (2.54% of cow milk, 2 (0.36% of sheep milk and 4 (0.72% of goat milk samples were contaminated. Using PCR, 9 (1.63% samples were contaminated with S. typhimurium. The results indicated a relatively high occurrence of S. typhimurium in raw milks. Therefore, it is essential to maintain hygienic measures during milking and handling. Besides, it is recommended not to use raw milk for the manufacturing of dairy products such as cheese and ice-cream.

  12. Supra-complete surgery via dual intraoperative visualization approach (DiVA) prolongs patient survival in glioblastoma.

    Science.gov (United States)

    Eyüpoglu, Ilker Y; Hore, Nirjhar; Merkel, Andreas; Buslei, Rolf; Buchfelder, Michael; Savaskan, Nicolai

    2016-05-03

    Safe and complete resection represents the first step in the treatment of glioblastomas and is mandatory in increasing the effectiveness of adjuvant therapy to prolong overall survival. With gross total resection currently limited in extent to MRI contrast enhancing areas, the extent to which supra-complete resection beyond obvious contrast enhancement could have impact on overall survival remains unclear. DiVA (dual intraoperative visualization approach) redefines gross total resection as currently accepted by enabling for the first time supra-complete surgery without compromising patient safety. This approach exploits the advantages of two already accepted surgical techniques combining intraoperative MRI with integrated functional neuronavigation and 5-ALA by integrating them into a single surgical approach. We investigated whether this technique has impact on overall outcome in GBM patients. 105 patients with GBM were included. We achieved complete resection with intraoperative MRI alone according to current best-practice in glioma surgery in 75 patients. 30 patients received surgery with supra-complete resection. The control arm showed a median life expectancy of 14 months, reflecting current standards-of-care and outcome. In contrast, patients receiving supra-complete surgery displayed significant increase in median survival time to 18.5 months with overall survival time correlating directly with extent of supra-complete resection. This extension of overall survival did not come at the cost of neurological deterioration. We show for the first time that supra-complete glioma surgery leads to significant prolongation of overall survival time in GBM patients.

  13. Development of a single-phase 330kVA HTS transformer using GdBCO tapes

    Science.gov (United States)

    Hu, Daoyu; Li, Zhuyong; Hong, Zhiyong; Jin, Zhijian

    2017-08-01

    With the mature of manufacture process and technology of high temperature superconductors, the critical current and stability are gradually increased. High temperature superconductors could be used in transformer, current limiter, generator, magnet and etc. This paper focuses on development and characteristic tests of a single-phase high temperature superconducting (HTS) power transformer with capacity of 330 kVA by using GdBCO tapes, which is 1/3 model of a 1 MVA / 10 kV / 0.4 kV HTS transformer. The specifications of iron core, HTS windings and cryostat are described in detail. The iron core is made of silicon steel plate. The arrangement of HTS windings are based on experimental and simulated results. The cryostat with a room temperature bore is manufactured using nonmetallic materials. Several characteristic tests and insulation tests are performed in liquid nitrogen of 77 K. The efficiency and AC loss at rated load is 99.90% and 243.7 W, respectively. In addition, an overload test was also performed.

  14. Association of perceived barriers with prospective use of VA mental health care among Iraq and Afghanistan veterans.

    Science.gov (United States)

    Hoerster, Katherine D; Malte, Carol A; Imel, Zachary E; Ahmad, Zeba; Hunt, Stephen C; Jakupcak, Matthew

    2012-04-01

    The relationship between perceived barriers and prospective use of mental health care among veterans was examined. The sample included Iraq and Afghanistan veterans (N=305) who endorsed symptoms of depression or posttraumatic stress disorder (PTSD) or alcohol misuse at intake to a postdeployment clinic between May 2005 and August 2009. Data on receipt of adequate treatment (nine or more mental health visits in the year after intake) were obtained from a VA database. Adequate treatment was more likely for women (odds ratio [OR]=4.82, 95% confidence interval (CI)=1.37-16.99, p=.014) and for those with more severe symptoms of PTSD (OR=1.03, CI=1.01-1.05, p=.003) and depression (OR=1.06, CI=1.01-1.11, p=.01). Perceived barriers were not associated with adequate treatment. Male veterans with mental health problems should be targeted with outreach to reduce unmet need. Research is needed to identify perceived barriers to treatment among veterans.

  15. Un juego serio en que se va la vida. Fragmentos, citas, reescrituras en Zettel, de Héctor Libertella

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    Agustina Pérez

    2015-06-01

    Full Text Available Los papeles sueltos de Zettel, último libro Héctor Libertella, tienen algo de la tarea obstinada que Antoine Compagnon encuentra en niños y ancianos, trabajo del papel como cortar y pegar, juego serio en que se va la vida, o llega. Se revisará Zettel a la luz de otros textos de Libertella para indagar su vínculo con el fragmento como tipo de exposición que no aspira a la exhaustividad sino a lo inacabado, siendo siempre en germen (Lacoue-Labarthe y Nancy y con el trabajo de la citación (Compagnon, donde el texto se vuelve producto de la fuerza del desplazamiento. The loose papers of Zettel, Héctor Libertella’s last book, involve some of the stubborn task that Antoine Compagnon finds in children and the eldery, working paper as cut and paste, serious game in which life slips away, or arrives. This work reads Zettel in the light of another of his works to examine their connection with the fragment as a type of exposition that doesn’t looks for exhaustivity but the unfinished, being always in germ (Lacoue-Labarthe y Nancy and with the work of citation (Compagnon in which text becomes the result of the force of displacement.

  16. Expression of the Grape VaSTS19 Gene in Arabidopsis Improves Resistance to Powdery Mildew and Botrytis cinerea but Increases Susceptibility to Pseudomonas syringe pv Tomato DC3000

    OpenAIRE

    Wang, Yaqiong; Wang, Dejun; Wang, Fan; Huang, Li; Tian, Xiaomin; van Nocker, Steve; Gao, Hua; Wang, Xiping

    2017-01-01

    Stilbene synthase (STS) is a key enzyme that catalyzes the biosynthesis of resveratrol compounds and plays an important role in disease resistance. The molecular pathways linking STS with pathogen responses and their regulation are not known. We isolated an STS gene, VaSTS19, from a Chinese wild grape, Vitis amurensis Rupr. cv. “Tonghua-3”, and transferred this gene to Arabidopsis. We then generated VaSTS19-expressing Arabidopsis lines and evaluated the functions of VaSTS19 in various pathoge...

  17. Systems innovation model: an integrated interdisciplinary team approach pre- and post-bariatric surgery at a veterans affairs (VA) medical center.

    Science.gov (United States)

    Eisenberg, Dan; Lohnberg, Jessica A; Kubat, Eric P; Bates, Cheryl C; Greenberg, Lauren M; Frayne, Susan M

    2017-04-01

    Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management. This is a description of an interdisciplinary clinic and bariatric program at a VA healthcare system and a report on program evaluation findings. Retrospective data of a prospective database was abstracted. For program evaluation, we abstracted charts to characterize patient data and conducted a patient survey. Since 2009, 181 veterans have undergone bariatric surgery. Referrals came from 7 western U.S. states. Mean preoperative body mass index was 46 kg/m 2 (maximum 71). Mean age was 53 years, with 33% aged>60 years; 79% were male. Medical co-morbidity included diabetes (70%), hypertension (85%), and lower back or extremity joint pain (84%). A psychiatric diagnosis was present in 58%. At 12 months, follow-up was 81% and percent excess body mass index loss was 50.5%. Among 54 sequential clinic patients completing anonymous surveys, overall satisfaction with the interdisciplinary team approach and improved quality of life were high (98% and 94%, respectively). The integrated, interdisciplinary team approach using a hub-and-spokes model is well suited to the VA bariatric surgery population, with its heavy burden of medical and mental health co-morbidity and its system of geographically dispersed patients receiving treatment at specialty centers. As the VA seeks to expand the use of bariatric surgery as an option for obese veterans, interdisciplinary models crafted to address case complexity, care coordination, and long-term outcomes should be part of policy planning efforts. Published by

  18. A systematic exploration of differences in contextual factors related to implementing the MOVE! weight management program in VA: A mixed methods study

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    Fletcher Carol E

    2011-09-01

    Full Text Available Abstract Background In January 2006, Veterans Affairs (VA disseminated the MOVE!® Weight Management Program to VA medical centers to address the high prevalence of overweight/obesity. In its second year, MOVE! implementation varied widely across facilities. The objective of this study was to understand contextual factors that facilitated or impeded implementation of MOVE! in VA medical centers in the second year after its dissemination. Methods We used an embedded mixed methods cross-sectional study design. Qualitative and quantitative data were collected simultaneously with the primary purpose to explore contextual factors most likely to influence MOVE! implementation effectiveness at five purposively selected facilities. Facilities were selected to maximize variation with respect to participation in MOVE! by candidate Veterans. Semi-structured phone interviews were conducted with 24 staff across the five facilities. Quantitative responses were elicited followed by open-ended questions. The quantitative measures were adapted from a published implementation model. Qualitative analysis was conducted using rigorous content analysis methods. Results Qualitative and quantitative data converged to strengthen findings that point to several recommendations. Management support can help increase visibility of the program, commit needed resources, and communicate the importance of implementation efforts. Establishing a receptive implementation climate can be accomplished by emphasizing the important role that weight management may have in reducing incidence and severity of obesity-related chronic conditions. Coalescing highly functioning multi-disciplinary teams was an essential step for more effective implementation of MOVE!. In some situations, local champions can overcome challenging barriers in facilities that lack sufficient management support. Conclusions Key organizational factors at local VA medical centers were strongly associated with MOVE

  19. The KiVa antibullying program in primary schools in Chile, with and without the digital game component: study protocol for a randomized controlled trial.

    OpenAIRE

    Gaete, J; Valenzuela, D; Rojas-Barahona, C; Valenzuela, E; Araya, R; Salmivalli, C

    2017-01-01

    Background Bullying is a major problem worldwide and Chile is no exception. Bullying is defined as a systematic aggressive behavior against a victim who cannot defend him or herself. Victims suffer social isolation and psychological maladjustment, while bullies have a higher risk for conduct problems and substance use disorders. These problems appear to last over time. The KiVa antibullying program has been evaluated in Finland and other European countries, showing preventive effects on victi...

  20. 30 CFR 57.22220 - Air passing unsealed areas (I-A, II-A, III, and V-A mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Air passing unsealed areas (I-A, II-A, III, and V-A mines). 57.22220 Section 57.22220 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for...

  1. Ekonomie a správa životního prostředí – informace o novém magisterském oboru

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    Petr Šauer

    2007-08-01

    Full Text Available Text představuje nový navazující magisterský studijní obor Ekonomie a správa životního prostředí, který byl otevřen na Národohospodářské fakultě Vysoké školy ekonomické v Praze.

  2. 77 FR 4897 - Safety Zone; M/V Del Monte Live-Fire Gun Exercise, James River, Isle of Wight, VA

    Science.gov (United States)

    2012-02-01

    ...-AA00 Safety Zone; M/V Del Monte Live-Fire Gun Exercise, James River, Isle of Wight, VA AGENCY: Coast... provide for the safety of life on navigable waters during the live-fire gun exercises on the M/V Del Monte... associated with the live-fire gun exercise. DATES: This rule is effective in the CFR on February 1, 2012...

  3. Proceedings of the National Conference on Ada (trade mark) Technology (6th) Held on 14-18 March 1988 in Arlington, VA.

    Science.gov (United States)

    1988-03-01

    Advanced Ada Tasking Techniques for Motor Simula- Queueing Networks Modeling and Simulation-O. tion and Control-i LT L. S. Kim, Ft. Belvoir, VA ....... 269...sends the BC its PROCESO C status word where it is checked to determine the success of the information transfer. 4.2 Simulation Environment eI The...the communications sycste oes nal-ot eacnt f or interface system is unusable with dynamically proceso fauit-erace (foesor cassti declared data that

  4. Divulgación del valor en riesgo (VaR previo a la crisis en el sector bancario español

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    Pablo Farías

    2014-12-01

    Full Text Available La gestión del riesgo ha asumido una enorme importancia en las instituciones financieras. Los bancos divulgan su exposición a los riesgos del mercado a través del Valor en Riesgo (Value at risk, VaR. Este trabajo evalúa la divulgación de esta medida de gestión del riesgo en el sector bancario español previo a la crisis española iniciada en el año 2008. Se efectuó un análisis de contenido de los informes anuales de los bancos en España. Se analizaron doce ítems en cuanto a la calidad de la información relacionada al VaR. Este estudio muestra que la divulgación efectuada previa a la crisis fue deficiente en términos de calidad y comparabilidad. También fue posible observar que la calidad de la información entregada acerca del VaR estuvo asociada positivamente al tamaño del banco. El caso del sector bancario español previo a la crisis destaca la importancia de mejorar la supervisión financiera y las prácticas de gestión de riesgos.

  5. Female Veterans of Iraq and Afghanistan seeking care from VA specialized PTSD Programs: comparison with male veterans and female war zone veterans of previous eras.

    Science.gov (United States)

    Fontana, Alan; Rosenheck, Robert; Desai, Rani

    2010-04-01

    Differences in the characteristics and mental health needs of female veterans of the Iraq/Afghanistan war compared with those of veterans of other wars may have useful implications for VA program and treatment planning. Female veterans reporting service in the Iraq/Afghanistan war were compared with women reporting service in the Persian Gulf and Vietnam wars and to men reporting service in the Iraq/Afghanistan war. Subjects were drawn from VA administrative data on veterans who sought outpatient treatment from specialized posttraumatic stress disorder (PTSD) treatment programs. A series of analyses of covariance (ANCOVA) was used to control for program site and age. In general, Iraq/Afghanistan and Persian Gulf women had less severe psychopathology and more social supports than did Vietnam women. In turn, Iraq/Afghanistan women had less severe psychopathology than Persian Gulf women and were exposed to less sexual and noncombat nonsexual trauma than their Persian Gulf counterparts. Notable differences were also found between female and male veterans of the Iraq/Afghanistan war. Women had fewer interpersonal and economic supports, had greater exposure to different types of trauma, and had different levels of diverse types of pathology than their male counterparts. There appear to be sufficient differences within women reporting service in different war eras and between women and men receiving treatment in VA specialized treatment programs for PTSD that consideration should be given to program planning and design efforts that address these differences in every program treating female veterans reporting war zone service.

  6. Associations between Changes in City and Address Specific Temperature and QT Interval - The VA Normative Aging Study

    Science.gov (United States)

    Mehta, Amar J.; Kloog, Itai; Zanobetti, Antonella; Coull, Brent A.; Sparrow, David; Vokonas, Pantel; Schwartz, Joel

    2014-01-01

    Background The underlying mechanisms of the association between ambient temperature and cardiovascular morbidity and mortality are not well understood, particularly for daily temperature variability. We evaluated if daily mean temperature and standard deviation of temperature was associated with heart rate-corrected QT interval (QTc) duration, a marker of ventricular repolarization in a prospective cohort of older men. Methods This longitudinal analysis included 487 older men participating in the VA Normative Aging Study with up to three visits between 2000–2008 (n = 743). We analyzed associations between QTc and moving averages (1–7, 14, 21, and 28 days) of the 24-hour mean and standard deviation of temperature as measured from a local weather monitor, and the 24-hour mean temperature estimated from a spatiotemporal prediction model, in time-varying linear mixed-effect regression. Effect modification by season, diabetes, coronary heart disease, obesity, and age was also evaluated. Results Higher mean temperature as measured from the local monitor, and estimated from the prediction model, was associated with longer QTc at moving averages of 21 and 28 days. Increased 24-hr standard deviation of temperature was associated with longer QTc at moving averages from 4 and up to 28 days; a 1.9°C interquartile range increase in 4-day moving average standard deviation of temperature was associated with a 2.8 msec (95%CI: 0.4, 5.2) longer QTc. Associations between 24-hr standard deviation of temperature and QTc were stronger in colder months, and in participants with diabetes and coronary heart disease. Conclusion/Significance In this sample of older men, elevated mean temperature was associated with longer QTc, and increased variability of temperature was associated with longer QTc, particularly during colder months and among individuals with diabetes and coronary heart disease. These findings may offer insight of an important underlying mechanism of temperature

  7. Tackling acute cases of school bullying in the KiVa anti-bullying program: a comparison of two approaches.

    Science.gov (United States)

    Garandeau, Claire F; Poskiparta, Elisa; Salmivalli, Christina

    2014-08-01

    Whether cases of bullying should be handled in a direct, condemning mode or in a manner that does not involve blaming the perpetrator is a controversial issue among school professionals. This study compares the effectiveness of a Confronting Approach where the bully is openly told that his behavior must cease immediately to a Non-Confronting Approach where the adult shares his concern about the victim with the bully and invites him to provide suggestions on what could improve the situation. We analysed 339 cases of bullying involving 314 children from grades 1 to 9 (mean age = 11.95). Cases were handled in 65 schools as part of the implementation of the KiVa anti-bullying program. In each school, a team of three teachers addressed cases coming to their attention by organizing discussions with the bullies using either a Confronting or a Non-Confronting Approach; schools were randomly assigned to one of the two conditions. Victims reported that bullying stopped in 78 % of the cases. Logistic regression analyses indicated that neither approach was overall more effective than the other, controlling for grade level, duration of victimization and type of aggression. The Confronting Approach worked better than the Non-Confronting Approach in secondary school (grades 7 to 9), but not in primary school (grades 1 to 6). The Confronting Approach was more successful than the Non-Confronting Approach in cases of short-term victimization, but not in cases of long-term victimization. The type of aggression used did not moderate the effectiveness of either approach.

  8. Developing a toolkit for panel management: improving hypertension and smoking cessation outcomes in primary care at the VA.

    Science.gov (United States)

    Savarimuthu, Stella M; Jensen, Ashley E; Schoenthaler, Antoinette; Dembitzer, Anne; Tenner, Craig; Gillespie, Colleen; Schwartz, Mark D; Sherman, Scott E

    2013-11-21

    As primary care practices evolve into medical homes, there is an increasing need for effective models to shift from visit-based to population-based strategies for care. However, most medical teams lack tools and training to manage panels of patients. As part of a study comparing different approaches to panel management at the Manhattan and Brooklyn campuses of the VA New York Harbor Healthcare System, we created a toolkit of strategies that non-clinician panel management assistants (PMAs) can use to enhance panel-wide outcomes in smoking cessation and hypertension. We created the toolkit using: 1) literature review and consultation with outside experts, 2) key informant interviews with staff identified using snowball sampling, 3) pilot testing for feasibility and acceptability, and 4) further revision based on a survey of primary care providers and nurses. These steps resulted in progressively refined strategies for the PMAs to support the primary care team. Literature review and expert consultation resulted in an extensive list of potentially useful strategies. Key informant interviews and staff surveys identified several areas of need for assistance, including help to manage the most challenging patients, providing care outside of the visit, connecting patients with existing resources, and providing additional patient education. The strategies identified were then grouped into 5 areas - continuous connection to care, education and connection to clinical resources, targeted behavior change counseling, adherence support, and patients with special needs. Although panel management is a central aspect of patient-centered medical homes, providers and health care systems have little guidance or evidence as to how teams should accomplish this objective. We created a toolkit to help PMAs support the clinical care team for patients with hypertension or tobacco use. This toolkit development process could readily be adapted to other behaviors or conditions. Clinical

  9. Barriers to and Facilitators of Alcohol Use Disorder Pharmacotherapy in Primary Care: A Qualitative Study in Five VA Clinics.

    Science.gov (United States)

    Williams, Emily C; Achtmeyer, Carol E; Young, Jessica P; Berger, Douglas; Curran, Geoffrey; Bradley, Katharine A; Richards, Julie; Siegel, Michael B; Ludman, Evette J; Lapham, Gwen T; Forehand, Mark; Harris, Alex H S

    2018-03-01

    Three medications are FDA-approved and recommended for treating alcohol use disorders (AUD) but they are not offered to most patients with AUD. Primary care (PC) may be an optimal setting in which to offer and prescribe AUD medications, but multiple barriers are likely. This qualitative study used social marketing theory, a behavior change approach that employs business marketing techniques including "segmenting the market," to describe (1) barriers and facilitators to prescribing AUD medications in PC, and (2) beliefs of PC providers after they were segmented into groups more and less willing to prescribe AUD medications. Qualitative, interview-based study. Twenty-four providers from five VA PC clinics. Providers completed in-person semi-structured interviews, which were recorded, transcribed, and analyzed using social marketing theory and thematic analysis. Providers were divided into two groups based on consensus review. Barriers included lack of knowledge and experience, beliefs that medications cannot replace specialty addiction treatment, and alcohol-related stigma. Facilitators included training, support for prescribing, and behavioral staff to support follow-up. Providers more willing to prescribe viewed prescribing for AUD as part of their role as a PC provider, framed medications as a potentially effective "tool" or "foot in the door" for treating AUD, and believed that providing AUD medications in PC might catalyze change while reducing stigma and addressing other barriers to specialty treatment. Those less willing believed that medications could not effectively treat AUD, and that treating AUD was the role of specialty addiction treatment providers, not PC providers, and would require time and expertise they do not have. We identified barriers to and facilitators of prescribing AUD medications in PC, which, if addressed and/or capitalized on, may increase provision of AUD medications. Providers more willing to prescribe may be the optimal target of a

  10. Decreasing 30-day surgical mortality in a VA Medical Center utilizing the ACS NSQIP Surgical Risk Calculator.

    Science.gov (United States)

    Kuy, SreyRam; Romero, Ramon A L

    2017-07-01

    The Overton Brooks VA Medical Center Surgical Service had a high mortality. In an effort to reduce surgical mortality, we implemented a series of quality improvement interventions, including utilization of the ACS Surgical Risk Calculator to identify high-risk surgical patients for discussion in a multidisciplinary Pre-Operative Consultation Committee. Retrospective study describing the implementation of a risk stratification intervention incorporating the ACS Surgical Risk Calculator Tool and a multidisciplinary Pre-Operative Consultation Committee to target high-risk patients. Measurement of 30 day surgical mortality and risk adjusted Observed to Expected (O/E) mortality ratio. From May 2013 to September 2014, 614 high-risk patients were selected utilizing the ACS Risk Calculator and presented at the Pre-Operative Consultation Committee. Following implementation of this risk stratification intervention, 30-day mortality decreased by 66% from 0.9% to 0.3%, and risk adjusted O/E mortality ratio decreased from 2.5 to 0.8. Among the high risk patients presented, there was no increase in referrals to other facilities. There was a significant increase in cases requiring further preoperative optimization, from 6.3% at the beginning of the study period to 17.5% at the end of the study period. Implementation of a preoperative risk stratification intervention utilizing the ACS Surgical Risk Calculator along with a multidisciplinary Pre-Operative Consultation Committee can be successfully accomplished, with a significant decrease in 30-day surgical mortality. This is the first published report of utilization of the ACS Risk calculator as part of a systematic quality improvement tool to decrease surgical mortality. Published by Elsevier Inc.

  11. SiO MASERS AROUND WX PSC MAPPED WITH THE KVN AND VERA ARRAY (KaVA)

    International Nuclear Information System (INIS)

    Yun, Youngjoo; Cho, Se-Hyung; Kim, Jaeheon; Choi, Yoon Kyung; Kim, Dong-Jin; Yoon, Dong-Hwan; Byun, Do-Young; Chung, Hyunsoo; Chung, Moon-Hee; Han, Myoung-Hee; Imai, Hiroshi; Oyadomari, Miyako; Asaki, Yoshiharu; Chibueze, James O.; Dodson, Richard; Rioja, María J.; Kusuno, Kozue; Matsumoto, Naoko; Hagiwara, Yoshiaki; Min, Cheulhong

    2016-01-01

    We present the first images of the v = 1 and v = 2 J = 1 → 0 SiO maser lines taken with KaVA, i.e., the combined array of the Korean Very Long Baseline Interferometry (VLBI) Network and the VLBI Exploration of Radio Astrometry (VERA), toward the OH/IR star WX Psc. The combination of long and short antenna baselines enabled us to detect a large number of maser spots, which exhibit a typical ring-like structure in both the v = 1 and v = 2 J = 1 → 0 SiO masers as those that have been found in previous VLBI observational results of WX Psc. The relative alignment of the v = 1 and v = 2 SiO maser spots are precisely derived from astrometric analysis, due to the absolute coordinates of the reference maser spot that were well determined in an independent astrometric observation with VERA. The superposition of the v = 1 and v = 2 maser spot maps shows a good spatial correlation between the v = 1 and v = 2 SiO maser features. Nevertheless, it is also shown that the v = 2 SiO maser spot is distributed in an inner region compared to the v = 1 SiO maser by about 0.5 mas on average. These results provide good support for the recent theoretical studies of the SiO maser pumping, in which both the collisional and the radiative pumping predict the strong spatial correlation and the small spatial discrepancy between the v = 1 and v = 2 SiO maser.

  12. The Association of Team-Specific Workload and Staffing with Odds of Burnout Among VA Primary Care Team Members.

    Science.gov (United States)

    Helfrich, Christian D; Simonetti, Joseph A; Clinton, Walter L; Wood, Gordon B; Taylor, Leslie; Schectman, Gordon; Stark, Richard; Rubenstein, Lisa V; Fihn, Stephan D; Nelson, Karin M

    2017-07-01

    Work-related burnout is common in primary care and is associated with worse patient safety, patient satisfaction, and employee mental health. Workload, staffing stability, and team completeness may be drivers of burnout. However, few studies have assessed these associations at the team level, and fewer still include members of the team beyond physicians. To study the associations of burnout among primary care providers (PCPs), nurse care managers, clinical associates (MAs, LPNs), and administrative clerks with the staffing and workload on their teams. We conducted an individual-level cross-sectional analysis of survey and administrative data in 2014. Primary care personnel at VA clinics responding to a national survey. Burnout was measured with a validated single-item survey measure dichotomized to indicate the presence of burnout. The independent variables were survey measures of team staffing (having a fully staffed team, serving on multiple teams, and turnover on the team), and workload both from survey items (working extended hours), and administrative data (patient panel overcapacity and average panel comorbidity). There were 4610 respondents (estimated response rate of 20.9%). The overall prevalence of burnout was 41%. In adjusted analyses, the strongest associations with burnout were having a fully staffed team (odds ratio [OR] = 0.55, 95% CI 0.47-0.65), having turnover on the team (OR = 1.67, 95% CI 1.43-1.94), and having patient panel overcapacity (OR = 1.19, 95% CI 1.01-1.40). The observed burnout prevalence was 30.1% lower (28.5% vs. 58.6%) for respondents working on fully staffed teams with no turnover and caring for a panel within capacity, relative to respondents in the inverse condition. Complete team staffing, turnover among team members, and panel overcapacity had strong, cumulative associations with burnout. Further research is needed to understand whether improvements in these factors would lower burnout.

  13. Causes of death in two rural demographic surveillance sites in Bangladesh, 2004–2010: automated coding of verbal autopsies using InterVA-4

    Directory of Open Access Journals (Sweden)

    Nurul Alam

    2014-10-01

    Full Text Available Objective: Population-based information on causes of death (CoD by age, sex, and area is critical for countries with limited resources to identify and address key public health issues. This study analysed the demographic surveillance and verbal autopsy (VA data to estimate age- and sex-specific mortality rates and cause-specific mortality fractions in two well-defined rural populations within the demographic surveillance system in Abhoynagar and Mirsarai subdistricts, located in different climatic zones. Design: During 2004–2010, the sample demographic surveillance system registered 1,384 deaths in Abhoynagar and 1,847 deaths in Mirsarai. Trained interviewers interviewed the main caretaker of the deceased with standard VA questionnaires to record signs and symptoms of diseases or conditions that led to death and health care experiences before death. The computer-automated InterVA-4 method was used to analyse VAs to determine probable CoD. Results: Age- and sex-specific death rates revealed a higher neonatal mortality rate in Abhoynagar than Mirsarai, and death rates and sex ratios of male to female death rates were higher in the ages after infancy. Communicable diseases (CDs accounted for 16.7% of all deaths in Abhoynagar and 21.2% in Mirsarai – the difference was due mostly to more deaths from acute respiratory infections, pneumonia, and tuberculosis in Mirsarai. Non-communicable diseases (NCDs accounted for 56.2 and 55.3% of deaths in each subdistrict, respectively, with leading causes being stroke (16.5–19.3%, neoplasms (13.2% each, cardiac diseases (8.9–11.6%, chronic obstructive pulmonary diseases (5.1–6.3%, diseases of the digestive system (3.1–4.1%, and diabetes (2.8–3.5%, together accounting for 49.2–51.2% points of the NCD deaths in the two subdistricts. Injury and other external causes accounted for another 7.5–7.7% deaths, with self-harm being higher among females in Abhoynagar. Conclusions: The computer

  14. Expression of the Grape VaSTS19 Gene in Arabidopsis Improves Resistance to Powdery Mildew and Botrytis cinerea but Increases Susceptibility to Pseudomonas syringe pv Tomato DC3000.

    Science.gov (United States)

    Wang, Yaqiong; Wang, Dejun; Wang, Fan; Huang, Li; Tian, Xiaomin; van Nocker, Steve; Gao, Hua; Wang, Xiping

    2017-09-17

    Stilbene synthase (STS) is a key enzyme that catalyzes the biosynthesis of resveratrol compounds and plays an important role in disease resistance. The molecular pathways linking STS with pathogen responses and their regulation are not known. We isolated an STS gene, VaSTS19 , from a Chinese wild grape, Vitis amurensis Rupr. cv. "Tonghua-3", and transferred this gene to Arabidopsis . We then generated VaSTS19 -expressing Arabidopsis lines and evaluated the functions of VaSTS19 in various pathogen stresses, including powdery mildew, B. cinerea and Pseudomonas syringae pv. tomato DC3000 ( Pst DC3000). VaSTS19 enhanced resistance to powdery mildew and B. cinerea , but increased susceptibility to Pst DC3000. Aniline blue staining revealed that VaSTS19 transgenic lines accumulated more callose compared to nontransgenic control plants, and showed smaller stomatal apertures when exposed to pathogen-associated molecular patterns (flagellin fragment (flg22) or lipopolysaccharides (LPS)). Analysis of the expression of several disease-related genes suggested that VaSTS19 expression enhanced defense responses though salicylic acid (SA) and/or jasmonic acid (JA) signaling pathways. These findings provide a deeper insight into the function of STS genes in defense against pathogens, and a better understanding of the regulatory cross talk between SA and JA pathways.

  15. Expression of the Grape VaSTS19 Gene in Arabidopsis Improves Resistance to Powdery Mildew and Botrytis cinerea but Increases Susceptibility to Pseudomonas syringe pv Tomato DC3000

    Directory of Open Access Journals (Sweden)

    Yaqiong Wang

    2017-09-01

    Full Text Available Stilbene synthase (STS is a key enzyme that catalyzes the biosynthesis of resveratrol compounds and plays an important role in disease resistance. The molecular pathways linking STS with pathogen responses and their regulation are not known. We isolated an STS gene, VaSTS19, from a Chinese wild grape, Vitis amurensis Rupr. cv. “Tonghua-3”, and transferred this gene to Arabidopsis. We then generated VaSTS19-expressing Arabidopsis lines and evaluated the functions of VaSTS19 in various pathogen stresses, including powdery mildew, B. cinerea and Pseudomonas syringae pv. tomato DC3000 (PstDC3000. VaSTS19 enhanced resistance to powdery mildew and B. cinerea, but increased susceptibility to PstDC3000. Aniline blue staining revealed that VaSTS19 transgenic lines accumulated more callose compared to nontransgenic control plants, and showed smaller stomatal apertures when exposed to pathogen-associated molecular patterns (flagellin fragment (flg22 or lipopolysaccharides (LPS. Analysis of the expression of several disease-related genes suggested that VaSTS19 expression enhanced defense responses though salicylic acid (SA and/or jasmonic acid (JA signaling pathways. These findings provide a deeper insight into the function of STS genes in defense against pathogens, and a better understanding of the regulatory cross talk between SA and JA pathways.

  16. ORTHOIMAGERY, Alleghany County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Digital orthographic imagery datasets contain georeferenced images of the Earth's surface, collected by a sensor in which object displacement has been removed for...

  17. ORTHOIMAGERY, Botetourt County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Digital orthographic imagery datasets contain georeferenced images of the Earth's surface, collected by a sensor in which object displacement has been removed for...

  18. VA Enterprise Data Inventory

    Data.gov (United States)

    Department of Veterans Affairs — The Department of Veterans Affairs Enterprise Data Inventory accounts for all of the datasets used in the agency's information systems. This entry was approved for...

  19. SURVEY, Lancaster County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The field survey data for this coastal study includes a field report that exhibits photos and transect information collected in the field survey phase of the study....

  20. VA~ GII5RALTAR

    African Journals Online (AJOL)

    Die Rots was sedert die au beskawings n veelbegeerde besitting en ... die Rots is tussen. 1309 en 1462 agt keel' beleel' en telkens on- der 'n nuwe regeerder geplaas. In 1502 is. Gibraltar formeel deur koningin Isabella van. Spanje as 'n besitting van die ... France, Flanders, Spain, Italy and Spanish. America in one vast ...

  1. ORTHOIMAGERY, Dinwiddie County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — These files contain Digital Orthophoto files for the State of Virginia developed from imagery acquired in spring 2006 and 2007. In the spring of 2006, the...

  2. ORTHOIMAGERY, Pittsylvania County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Digital orthographic imagery datasets contain georeferenced images of the Earth's surface, collected by a sensor in which object displacement has been removed for...

  3. [)IE VAL VA~ ()RETORIA

    African Journals Online (AJOL)

    Vaalrivier gestaan waar hy by wyse van pro- klamasie die Oranje-Vrystaat geannekseer het in die naam van Haar Majesteit, koningin Vic- toria van Engeland. Die spoed waarmee lord .... Van der Hoven onderneem om 'n liefdadig- heidskonsert in St .... voet in die wind oeslaan het en dat Pretoria as ope stad aan die ...

  4. VA Caregiver Support

    Science.gov (United States)

    ... the Media Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament ...

  5. Dietary anthocyanin intake and age-related decline in lung function: longitudinal findings from the VA Normative Aging Study123

    Science.gov (United States)

    Mehta, Amar J; Cassidy, Aedín; Litonjua, Augusto A; Sparrow, David; Vokonas, Pantel; Schwartz, Joel

    2016-01-01

    Background: It is unknown whether habitual intake of dietary flavonoids, known for their antioxidative and anti-inflammatory properties, affects longitudinal change in lung function. Objective: We investigated whether different flavonoid subclasses present in the habitual diet were associated with beneficial changes in lung function over time in the elderly. Design: This longitudinal analysis included 839 participants from the VA (Veterans Affairs) Normative Aging Study whose lung function [forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)] was measured at 2 and up to 5 visits between 1992 and 2008 (n = 2623 measurements). Yearly average intake of major flavonoid subclasses (anthocyanins, flavanones, flavan-3-ols, flavonols, flavones, and polymers) was calculated from food-frequency questionnaires at each visit. We estimated adjusted differences in annual change in lung function associated with each flavonoid subclass, categorized into quartiles, in linear mixed-effects regression models after adjustment for lifestyle and dietary confounders. Results: Strong inverse associations were found between anthocyanin intake and age-related decline in lung function. Independent of dietary and nondietary risk factors, slower rates of FEV1 and FVC decline by 23.6 (95% CI: 16.6, 30.7) and 37.3 (95% CI: 27.8, 46.8) mL/y, respectively, were observed in participants in the fourth quartile of intake compared with participants in the first quartile (P-trend < 0.0001). The protective associations observed for anthocyanin intake were present in both current/former and never smokers. Compared with no or very low intakes, an intake of ≥2 servings of anthocyanin-rich blueberries/wk was associated with slower decline in FEV1 and FVC by 22.5 (95% CI: 10.8, 34.2) and 37.9 (95% CI: 22.1, 53.7) mL/y, respectively. To a lesser extent, higher flavan-3-ol intake was also associated with slower lung function decline. Conclusions: An attenuation of age-related lung function

  6. Long-term ambient particle exposures and blood DNA methylation age: findings from the VA normative aging study

    Science.gov (United States)

    Nwanaji-Enwerem, Jamaji C.; Colicino, Elena; Trevisi, Letizia; Kloog, Itai; Just, Allan C.; Shen, Jincheng; Brennan, Kasey; Dereix, Alexandra; Hou, Lifang; Vokonas, Pantel; Schwartz, Joel; Baccarelli, Andrea A.

    2016-01-01

    Abstract Background: Ambient particles have been shown to exacerbate measures of biological aging; yet, no studies have examined their relationships with DNA methylation age (DNAm-age), an epigenome-wide DNA methylation based predictor of chronological age. Objective: We examined the relationship of DNAm-age with fine particulate matter (PM2.5), a measure of total inhalable particle mass, and black carbon (BC), a measure of particles from vehicular traffic. Methods: We used validated spatiotemporal models to generate 1-year PM2.5 and BC exposure levels at the addresses of 589 older men participating in the VA Normative Aging Study with 1–3 visits between 2000 and 2011 (n = 1032 observations). Blood DNAm-age was calculated using 353 CpG sites from the Illumina HumanMethylation450 BeadChip. We estimated associations of PM2.5 and BC with DNAm-age using linear mixed effects models adjusted for age, lifestyle/environmental factors, and aging-related diseases. Results: After adjusting for covariates, a 1-μg/m3 increase in PM2.5 (95% CI: 0.30, 0.75, P models showed similar patterns of association (β = 3.02, 95% CI: 0.48, 5.57, P = 0.02). Only PM2.5 (β = 0.54, 95% CI: 0.24, 0.84, P = 0.0004) remained significantly associated with DNAm-age in two-particle models. Methylation levels from 20 of the 353 CpGs contributing to DNAm-age were significantly associated with PM2.5 levels in our two-particle models. Several of these CpGs mapped to genes implicated in lung pathologies including LZTFL1, PDLIM5, and ATPAF1. Conclusion: Our results support an association of long-term ambient particle levels with DNAm-age and suggest that DNAm-age is a biomarker of particle-related physiological processes. PMID:27453791

  7. Optimization model of peach production relevant to input energies – Yield function in Chaharmahal va Bakhtiari province, Iran

    International Nuclear Information System (INIS)

    Ghatrehsamani, Shirin; Ebrahimi, Rahim; Kazi, Salim Newaz; Badarudin Badry, Ahmad; Sadeghinezhad, Emad

    2016-01-01

    The aim of this study was to determine the amount of input–output energy used in peach production and to develop an optimal model of production in Chaharmahal va Bakhtiari province, Iran. Data were collected from 100 producers by administering a questionnaire in face-to-face interviews. Farms were selected based on random sampling method. Results revealed that the total energy of production is 47,951.52 MJ/ha and the highest share of energy consumption belongs to chemical fertilizers (35.37%). Consumption of direct energy was 47.4% while indirect energy was 52.6%. Also, Total energy consumption was divided into two groups; renewable and non-renewable (19.2% and 80.8% respectively). Energy use efficiency, Energy productivity, Specific energy and Net energy were calculated as 0.433, 0.228 (kg/MJ), 4.38 (MJ/kg) and −27,161.722 (MJ/ha), respectively. According to the negative sign for Net energy, if special strategy is used, energy dismiss will decrease and negative effect of some parameters could be omitted. In the present case the amount is indicating decimate of production energy. In addition, energy efficiency was not high enough. Some of the input energies were applied to machinery, chemical fertilizer, water irrigation and electricity which had significant effect on increasing production and MPP (marginal physical productivity) was determined for variables. This parameter was positive for energy groups namely; machinery, diesel fuel, chemical fertilizer, water irrigation and electricity while it was negative for other kind of energy such as chemical pesticides and human labor. Finally, there is a need to pursue a new policy to force producers to undertake energy-efficient practices to establish sustainable production systems without disrupting the natural resources. In addition, extension activities are needed to improve the efficiency of energy consumption and to sustain the natural resources. - Highlights: • Replacing non-renewable energy with renewable

  8. A pilot study of a heuristic algorithm for novel template identification from VA electronic medical record text.

    Science.gov (United States)

    Redd, Andrew M; Gundlapalli, Adi V; Divita, Guy; Carter, Marjorie E; Tran, Le-Thuy; Samore, Matthew H

    2017-07-01

    Templates in text notes pose challenges for automated information extraction algorithms. We propose a method that identifies novel templates in plain text medical notes. The identification can then be used to either include or exclude templates when processing notes for information extraction. The two-module method is based on the framework of information foraging and addresses the hypothesis that documents containing templates and the templates within those documents can be identified by common features. The first module takes documents from the corpus and groups those with common templates. This is accomplished through a binned word count hierarchical clustering algorithm. The second module extracts the templates. It uses the groupings and performs a longest common subsequence (LCS) algorithm to obtain the constituent parts of the templates. The method was developed and tested on a random document corpus of 750 notes derived from a large database of US Department of Veterans Affairs (VA) electronic medical notes. The grouping module, using hierarchical clustering, identified 23 groups with 3 documents or more, consisting of 120 documents from the 750 documents in our test corpus. Of these, 18 groups had at least one common template that was present in all documents in the group for a positive predictive value of 78%. The LCS extraction module performed with 100% positive predictive value, 94% sensitivity, and 83% negative predictive value. The human review determined that in 4 groups the template covered the entire document, with the remaining 14 groups containing a common section template. Among documents with templates, the number of templates per document ranged from 1 to 14. The mean and median number of templates per group was 5.9 and 5, respectively. The grouping method was successful in finding like documents containing templates. Of the groups of documents containing templates, the LCS module was successful in deciphering text belonging to the template

  9. Towards Predicting Street-Level Inundation: using Operational Forecast Modeling Techniques during 2011 Hurricane Irene in Hampton Roads, VA

    Science.gov (United States)

    Loftis, D.; Loftis, J. D.; Stiles, W. A.

    2016-02-01

    Storm surge-induced coastal inundation poses numerous personal, commercial, industrial, and sociopolitical challenges for society. Flooding can be caused by the combination of storm surge and river-induced inland flooding in many locations throughout the coastal plain. The cross-disciplinary nature of the hydrodynamics involved (hydraulics, oceanography, and hydrology), coupled with the complexity of the atmospheric forcing, makes a numerical model the best approach for a comprehensive study of the dynamics of coastal inundation. This study builds upon the lessons learned from forecast modeling experiences during 2011 Hurricane Irene in Tidewater Virginia, to ascertain the most effective way to approach predicting street-level inundation. During the storm event, an open-source large-scale ocean model, SCHISM, was provided atmospheric forcing from the National Oceanic and Atmospheric Administration's Global Forecast System, updated every 6 hours to simulate 9 separate 30-hour simulations, which were provided to emergency managers and the National Weather Service in Wakefield, VA. To accurately predict street-level inundation, water elevations at key points near the mouths of vulnerable tributaries can be used to drive a separate street-level high-resolution sub-grid model (UnTRIM) to simulate localized flooding events on the scale of 5-meter resolution. To this end, high-resolution Digital Elevation Models including building and roadway infrastructure were developed from Lidar-derived topography for the Hampton Roads Region of Virginia, and used to accurately predict flooding in low-lying areas of the Cities of Norfolk, Portsmouth, and Chesapeake along the Elizabeth and Lafayette Rivers, the City of Virginia Beach along the Lynnhaven River, and along Hampton, York, and Poquoson along the Back River. Tropical storm surge flood heights were validated via temporal comparison with water level observations from NOAA, the USGS, and NASA aggregated to an average R2

  10. Isolation of bioactive compound from marine seaweeds against fish pathogenic bacteria Vibrio alginolyticus (VA09 and characterisation by FTIR

    Directory of Open Access Journals (Sweden)

    Rajasekar Thirunavukkarasu

    2013-08-01

    Full Text Available Objective: Fresh marine seaweeds Gracilaria edulis, Gracillaria verrcosa, Acanthospora spicifera, Ulva facita, Ulva lacta (U. lacta, Kappaphycus spicifera, Sargassum ilicifolium, Sargassum wightii (S. wightii, Padina tetramatica and Padina gymonospora were collected from Mandapam (Rameshwaram, Tamil Nadu of South East coast of India and were screened for antibacterial activity. Methods: All the collected seaweeds were extracted by using five different solvent (methanol, isopropanol, acetone, chloroform, diethyl ether to study their extracts against fish pathogenic bacteria V. alginolyticus (VA09 purchased from MTCC. And minimum inhibition carried out by using Resazurin micro-titre assay. Crude extract of S. wightii analysied by FTIR. Results: The methanolic extract of S. wightii produced a maximum zone of inhibition (1.95±0.11 cm, isopropanol extract maximum inhibition was produced by S. wightii (1.93±0.78 cm, Acetone extract of Gracilaria verrcosa showed maximum zone of inhibition (1.36±0.05 cm, chloroform extract of S. wightii produced a maximum zone (1.56±0.25 cm and diethyl ether extract of S. wightii produced maximum zone of inhibition(1.86±0.11 cm. Based on the antibacterial activity S. wightii, U. lacta and Padina tetramatica showed best antibacterial activity against Vibrio harveyi. In this three seaweeds were taken for MIC study. The S. wightii methanolic extract, U. lacta diethyl ether extract and Padina tetramatica methanolic extract showed a higher MIC values, and despectively were 25 mg/mL, 50 mg/mL and 50 mg/mL. FTIR result showed that mostly phenolic compounds were present in the S. wightii. Conclusions: Based on the FTIR result S. wightii have high amount of phenolic compound. Phenolic compound have the good antimicrobial activity. The results clearly show that seaweed S. wightii is an interesting source for biologically active compounds that may be applied for prophylaxis and therapy of bacterial fish diseases and it should

  11. Une façon d’indiquer la « non-coïncidence entre les mots et les choses », on va dire...

    Directory of Open Access Journals (Sweden)

    Labeau Emmanuelle

    2012-07-01

    Full Text Available Nous souhaitons nous pencher ici sur un emploi particulier de la périphrase en aller + infinitif qui n’a fait l’objet – à notre connaissance – que d’un article (Lansari 2010. Cet emploi « modalisant » que Lansari limite à la formule 'on va dire' mériterait d’être approfondi pour plusieurs raisons. D’une part, l’emploi n’est décrit que sur base de « vingt exemples tirés d’internet, de blogs ou de forums » (Lansari 2010: 120 alors que, de l’aveu de Lansari elle-même, l’emploi relève de l’oral. Il serait donc utile d’enrichir – quantitativement et qualitativement - le corpus et d’y intégrer des occurrences d’oral authentique. D’autre part, Lansari restreint l’emploi modalisant à la séquence 'on va dire' ; on pourrait s’interroger sur la capacité de séquences comme 'je vais dire' à remplir les mêmes fonctions discursives. Dans cet article, nous commencerons par un – forcément bref – état de la question. Après avoir présenté le corpus, nous testerons les hypothèses précédemment défendues à la lueur du corpus rassemblé: (a Le corpus CFPP2000 issu du projet Discours sur la ville. Corpus de Français Parlé Parisien des années 2000 (disponible en ligne à http://cfpp2000.univ-paris3.fr/Corpus.html. CFPP2000 donne la parole à 41 informateurs en 28 interviews (2198 min et a généré 96 occurrences de on va dire modalisant. (b Le corpus CLAPI comprenant 45 heures d’interactions interrogeables en ligne à http://clapi.univ-lyon2.fr/analyse_requete_aide.php?menu=outils. On y a relevé 12 exemples de on va dire modalisant. (c Un corpus personnel d’interviews (163min réalisées pendant l’année académique 2009-10 auprès de cinq étudiants Erasmus français grâce au soutien d’une bourse de la Délégation Générale à la Langue Française et aux Langues de France (DGLFLF. Les entretiens avec une assistante de recherche, basés sur les thèmes suivants, étaient suppos

  12. Effects of VA Facility Dog on Hospitalized Veterans Seen by a Palliative Care Psychologist: An Innovative Approach to Impacting Stress Indicators.

    Science.gov (United States)

    Krause-Parello, Cheryl A; Levy, Cari; Holman, Elizabeth; Kolassa, John E

    2018-01-01

    The United States is home to 23 million veterans. In many instances, veterans with serious illness who seek healthcare at the VA receive care from a palliative care service. Animal-assisted intervention (AAI) is gaining attention as a therapeutic stress reducing modality; however, its effects have not been well studied in veterans receiving palliative care in an acute care setting. A crossover repeated-measures study was conducted to examine the effects of an animal-assisted intervention (AAI) in the form of a therapy dog on stress indicators in 25 veterans on the palliative care service at the VA Eastern Colorado Healthcare System in Denver, CO. Veterans had a visit from a therapy dog and the dog's handler, a clinical psychologist (experimental condition) and an unstructured visit with the clinical psychologist alone (control condition). Blood pressure, heart rate, and the salivary biomarkers cortisol, alpha-amylase, and immunoglobulin A were collected before, after, and 30-minutes after both the experimental and control conditions. Significant decreases in cortisol were found when the before time period was compared to the 30-minutes after time period for both the experimental ( p = 0.007) and control condition ( p = 0.036). A significant decrease in HR was also found when the before time period was compared to the 30-minutes after time period for both the experimental ( p = 0.0046) and control ( p = 0.0119) condition. Results of this study supported that a VA facility dog paired with a palliative care psychologist had a measurable impact on salivary cortisol levels and HR in veterans.

  13. Task Delegation and Burnout Trade-offs Among Primary Care Providers and Nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs).

    Science.gov (United States)

    Edwards, Samuel T; Helfrich, Christian D; Grembowski, David; Hulen, Elizabeth; Clinton, Walter L; Wood, Gordon B; Kim, Linda; Rose, Danielle E; Stewart, Greg

    2018-01-01

    Appropriate delegation of clinical tasks from primary care providers (PCPs) to other team members may reduce employee burnout in primary care. However, (1) the extent to which delegation occurs within multidisciplinary teams, (2) factors associated with greater delegation, and (3) whether delegation is associated with burnout are all unknown. We performed a national cross-sectional survey of Veterans Affairs (VA) PCP-nurse dyads in Department of VA primary care clinics, 4 years into the VA's patient-centered medical home initiative. PCPs reported the extent to which they relied on other team members to complete 15 common primary care tasks; paired nurses reported how much they were relied on to complete the same tasks. A composite score of task delegation/reliance was developed by taking the average of the responses to the 15 questions. We performed multivariable regression to explore predictors of task delegation and burnout. Among 777 PCP-nurse dyads, PCPs reported delegating tasks less than nurses reported being relied on (PCP mean ± standard deviation composite delegation score, 2.97± 0.64 [range, 1-4]; nurse composite reliance score, 3.26 ± 0.50 [range, 1-4]). Approximately 48% of PCPs and 35% of nurses reported burnout. PCPs who reported more task delegation reported less burnout (odds ratio [OR], 0.62 per unit of delegation; 95% confidence interval [CI], 0.49-0.78), whereas nurses who reported being relied on more reported more burnout (OR, 1.83 per unit of reliance; 95% CI, 1.33-2.5). Task delegation was associated with less burnout for PCPs, whereas task reliance was associated with greater burnout for nurses. Strategies to improve work life in primary care by increasing PCP task delegation must consider the impact on nurses. © Copyright 2018 by the American Board of Family Medicine.

  14. Evaluation of Microbial Contamination and Chemical Qualities of Cream-filled Pastries in Confectioneries of Chaharmahal Va Bakhtiari Province (Southwestern Iran).

    Science.gov (United States)

    Sharifzadeh, Ali; Hajsharifi-Shahreza, Mohammad; Ghasemi-Dehkordi, Payam

    2016-12-01

    High consumption of bakery products such as cream-filled pastries may cause serious health risks and food poisoning to humans. Therefore, investigation of the microbial and chemical qualities of bakery products containing cream is necessary. The purpose of the present study was to investigate the chemical qualities and microbial contaminations of cream-filled pastries collected from confectioneries located in six cities in Chaharmahal Va Bakhtiari province (Southwestern Iran). Microbial tests and chemical characteristics (fat and acidity level) were done on 228 cream-filled pastries samples that were collected randomly from various confectioneries. After microbial tests, it was found that 33.33% of all samples were contaminated by microbial agents. The microbial tests showed that Shahrekord (10.09%) and Broujen (9.21%) cities had high levels of contamination and in Koohrang (1.31%) it was low compared with the other four cities. High contamination of coliforms (61.84%), staphylococci (48.68%), and yeast (27.63%) were observed in almost all samples. The chemical analysis showed maximum amounts of fat content and titratable acidity in cream-filled pastry samples obtained from Lordegan and Shahrekord cities, respectively. The findings of the present work demonstrated that the microbial contamination and chemical quality of cream-filled pastries produced in confectionaries of Chaharmahal Va Bakhtiari province were not in acceptable ranges. These problems may be related to fecal contamination of cream samples or lack of hygiene by handlers and it is necessary to observe the standards of hygiene and to develop safe food handling techniques and aseptic pastry manufacturing systems in some confectioneries of Chaharmahal Va Bakhtiari province.

  15. PREOCUPĂRI PRIVIND ORGANIZAREA EUROPEI ÎN GÂNDIREA ROMÂNEASCĂ: V.A. URECHIA (1834-1901

    Directory of Open Access Journals (Sweden)

    Anisoara Popa

    2006-05-01

    Full Text Available The debate on the organizational ways of the European space, coming from the conscience of a certain identity and common destiny, had remarkable contributions in the 19th century, also coming from Romanian cultural background. After focusing upon the ideatic specificity of the time, we are to find some important matters that V.A. Urechia, as a historian and politician, stated within this debate. It is known that his entire political, social and scientific activity was influenced by these ideas. Then, we are to highlight his international recognition, evoking Albert Gobat’s statements regarding Urechia’s aspiration to candidate to the Nobel Prize for peace, in 1901.

  16. Portadores de Neisseria meningitidis, caracterización de las cepas aisladas y respuesta inmune basal a VA-MENGOC-BC

    OpenAIRE

    María J. Valdés; Isabel Martínez; Gustavo Sierra; María A. Camaraza; Iván Cuevas; Mayelin Mirabal; Pedro Rodríguez; Yadira Fuentes; Graciela Bolaños; Isabel Villasusa

    2008-01-01

    Con el propósito de conocer la prevalencia de portadores de Neisseria meningitidis en un grupo de adolescentes, los marcadores epidemiológicos de las cepas aisladas, así como los factores de riesgo asociados con el estado de portador y la respuesta inmune basal a VA-MENGOC-BC , se realizó un estudio transversal descriptivo de portadores en 189 estudiantes de 12-19 años de un politécnico de Ciego de Ávila, siguiendo las Normas Bioéticas establecidas. A los estudiantes se les realizó un exudado...

  17. Causes of death among persons of all ages within the Kilifi Health and Demographic Surveillance System, Kenya, determined from verbal autopsies interpreted using the InterVA-4 model

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    Carolyne Ndila

    2014-10-01

    Full Text Available Background: The vast majority of deaths in the Kilifi study area are not recorded through official systems of vital registration. As a result, few data are available regarding causes of death in this population. Objective: To describe the causes of death (CODs among residents of all ages within the Kilifi Health and Demographic Surveillance System (KHDSS on the coast of Kenya. Design: Verbal autopsies (VAs were conducted using the 2007 World Health Organization (WHO standard VA questionnaires, and VA data further transformed to align with the 2012 WHO VA instrument. CODs were then determined using the InterVA-4 computer-based probabilistic model. Results: Five thousand one hundred and eighty seven deaths were recorded between January 2008 and December 2011. VA interviews were completed for 4,460 (86% deaths. Neonatal pneumonia and birth asphyxia were the main CODs in neonates; pneumonia and malaria were the main CODs among infants and children aged 1–4, respectively, while HIV/AIDS was the main COD for adult women of reproductive age. Road traffic accidents were more commonly observed among men than women. Stroke and neoplasms were common CODs among the elderly over the age of 65. Conclusions: We have established the main CODs among people of all ages within the area served by the KHDSS on the coast of Kenya using the 2007 WHO VA questionnaire coded using InterVA-4. We hope that our data will allow local health planners to estimate the burden of various diseases and to allocate their limited resources more appropriately.

  18. National integration of mental health providers in VA home-based primary care: an innovative model for mental health care delivery with older adults.

    Science.gov (United States)

    Karlin, Bradley E; Karel, Michele J

    2014-10-01

    To promote mental health (MH) service access and quality for veterans with complex and chronic medical, social, and behavioral conditions, the U.S. Department of Veterans Affairs (VA) has integrated a full-time MH provider into each VA home-based primary care (HBPC) team. The goal of the current evaluation is to examine the nature and extent to which MH care processes and practices have been integrated into HBPC nationally. Separate surveys assessing the integration of a wide range of MH care practices and HBPC team processes were sent to MH providers and program directors in each HBPC program in 2010. A total of 132 MH providers representing 119 HBPC programs, and 112 program directors completed the surveys. The most common clinical issues addressed by MH providers were depression, coping with illness and disability, anxiety, caregiver/family stress, and cognitive evaluation. Other team members typically conducted initial MH screenings, with MH providers' time focusing on cases with identified needs. Approximately 40% of MH providers' time was devoted to direct clinical care. Significant time was also spent on team activities, driving, and charting. Integration of MH services into HBPC is feasible and facilitates service access for a vulnerable population. Mental health care delivery in HPBC generally involves a high degree of interdisciplinary practice. Mental health integration into HBPC may serve as a model for other systems interested in promoting MH care delivery among homebound and other older individuals. Published by Oxford University Press on behalf of The Gerontological Society of America 2013.

  19. Compatibilization of immiscible poly(vinyl chloride) (PVC)/polystyrene (PS) blends with maleic anhydride-styrene-vinyl acetate terpolymer (MAStVA)

    Science.gov (United States)

    İmren, Dilek

    2010-01-01

    In this study, compatibilizing effects of maleic anhydride-styrene-vinyl acetate (MAStVA) with various terpolymer ratios on immiscible blends of poly(vinyl chloride) (PVC) and polystyrene (PS) blends were investigated by viscometry method, thermo-mechanical analysis (TMA) and infrared spectroscopy (FTIR). The viscosimetric measurements were carried out for PVC, PS, a (70:30) blend of PVC/PS and a blend of PVC/PS/MAStVA containing 2-10% of the terpolymer in the range of concentrations (0.25-2.00 g dL -1) where tetrahydrofuran (THF) is the solvent. The interaction parameter (Δ b) was used to study the miscibility and compatibility of polymer blend in solution, obtained from the modified Krigbaum and Wall theory. TMA and FTIR measurements were also used to investigate the miscibility of this pair of polymers. In consequence of the study, it was observed that a considerable improvement was achieved in the miscibility of PVC/PS blends by adding among 4 and 10 wt.% of compatibilizer.

  20. Autoridades tradicionais vaNdau de Moçambique: o regresso do indirect rule ou uma espécie de neo-indirect rule?

    Directory of Open Access Journals (Sweden)

    Fernando Florêncio

    2008-04-01

    Full Text Available Neste artigo, partindo do exemplo Ndau de Moçambique, pretende-se compreender a importância do lugar social que as autoridades tradicionais detêm na actualidade e qual o seu papel no processo de formação do Estado ao nível distrital. Pretende-se demonstrar que, à semelhança do passado colonial, o Estado moçambicano tem procurado usar as autoridades tradicionais vaNdau em processos administrativos que se podem caracterizar como uma espécie de neo-indirect rule.Using the example of the Ndau of Mozambique, this article seeks to interpret the significance of the social standing of traditional authorities in modern life and their role in state formation at the district level. It endeavours to show how, as in the colonial past, the Mozambican state has sought to use the traditional vaNdau authorities in administrative roles which can best be described as a kind of neo-indirect rule.

  1. Ammonium Oxidation Kinetics in the Presence of Nitrification Inhibitor Dicyandiamide (DCD in some Calcareous Soils of Chaharmahal va Bakhtiari Province

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    roza kazemi

    2017-02-01

    Full Text Available Introduction: Nitrification inhibitors (NIs are compounds that retard the biological oxidation of ammonium to nitrite by depressing the activity of Nitrosomonas bacteria in the soil. Many popular NIs such as nitrapyrine (NP, dicyandiamide (DCD and 3,4-dimethylpyrazole phosphate (DMPP are produced and used in agricultural soils. Dicyandiamide is a very popular NI in some of the world countries. It delays nitrification process in the soil through its bacterial static property. It is easy to blend with commercial fertilizers such as urea, due to its low volatile nature. Application of urea in combination with nitrification inhibitor DCD lengthens nitrogen presence in soil as ammonium form. It has several beneficial effects for agriculture and enhances environmental protection. Studying the ammonium oxidation kinetics in the presence of nitrification inhibitor DCD can provide the experts in agriculture with very useful information regarding the ammoniumdurability in different soils. This research has been done to study the effect of using NI dicyandiamide on the kinetics of ammoniumloss in some calcareous soils of Chaharmahal Va Bakhtiari province, Iran. Materials and Methods: This research was conducted as factorial using completely randomized design with two factors of nitrogen fertilizer type and soil type with three replications at laboratory conditions. In this experiment, nitrogen fertilizer type included 2 levels of: 1- urea 2- urea plus nitrification inhibitor DCD (3.2%. A no added nitrogen fertilizer was considered as control treatment.The soil factor also consisted of 5different soils with a wide variation in soil physical and chemical characteristics. Five selected soils were non-saline (EC1:2=0.14-0.76 dS m-1 and alkaline (pH1:2=7.5-8.2. Organic carbon and cation exchange capacity (CEC ranged from 0.48 to 2.34% and 10 to 30 cmolc kg-1, respectively. The dose of applied nitrogen in all experimental treatments was 50 mg kg-1 N as urea

  2. Who died of what in rural KwaZulu-Natal, South Africa: a cause of death analysis using InterVA-4

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    Joël Mossong

    2014-10-01

    Full Text Available Background: For public health purposes, it is important to see whether men and women in different age groups die of the same causes in South Africa. Objective: We explored sex- and age-specific patterns of causes of deaths in a rural demographic surveillance site in northern KwaZulu-Natal in South Africa over the period 2000–2011. Design: Deaths reported through the demographic surveillance were followed up by a verbal autopsy (VA interview using a standardised questionnaire. Causes of death were assigned likelihoods using the publicly available tool InterVA-4. Cause-specific mortality fractions were determined by age and sex. Results: Over the study period, a total of 5,416 (47% and 6,081 (53% deaths were recorded in men and women, respectively. Major causes of death proportionally affecting more women than men were (all p<0.0001: human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS (20.1% vs. 13.6%, other and unspecified cardiac disease (5.9% vs. 3.2%, stroke (4.5% vs. 2.7%, reproductive neoplasms (1.7% vs. 0.4%, diabetes (2.4% vs. 1.2%, and breast neoplasms (0.4% vs. 0%. Major causes of deaths proportionally affecting more men than women were (all p<0.0001 assault (6.1% vs. 1.7%, pulmonary tuberculosis (34.5% vs. 30.2%, road traffic accidents (3.0% vs. 1.0%, intentional self-harm (1.3% vs. 0.3%, and respiratory neoplasms (2.5% vs. 1.5%. Causes of death due to communicable diseases predominated in all age groups except in older persons. Conclusions: While mortality during the 2000s was dominated by tuberculosis and HIV/AIDS, we found substantial sex-specific differences both for communicable and non-communicable causes of death, some which can be explained by a differing sex-specific age structure. InterVA-4 is likely to be a valuable tool for investigating causes of death patterns in other similar Southern African settings.

  3. Etno parks in the function of cultural tourism development in the Mačva, Šabačka Posavina and Pocerina

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    Grčić Ljiljana

    2010-01-01

    Full Text Available The monuments of folk architecture have its historical, artistic and tourist value. They illustrate the characteristics of local culture and way of life, and therefore should be preserved for the future. The main touristic functions in them can be cognitive, educational, fun, and also vacation and recreation. If we would like to keep the traditional folk architecture, it is necessary to protect vulnerable areas at the source or in the open air museums. This paper presents an overview of the ethno-parks and other facilities in the Mačva, Šabac, Šabačka Pocerina and Posavina, which seems preserved examples of folk architecture and architecture from the nineteenth and early twentieth century, are part of the cultural heritage not only of these areas, but also the whole of Serbia.

  4. A survey about prophage induction ability in Escherichia coli K-12(λ by ethnic medicinal plants of Kohgiluyeh va Boyerahmad, Iran

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    M. Hamzeloo-Moghadam

    2014-10-01

    Full Text Available Background and objectives: There is a growing trend towards investigating natural products as sources of compounds with biological effects and many researches have been carried out in order to find effective medications against many diseases. Cancer is no exception and studies focusing on evaluating the effects of different materials on DNA, give valuable information in cancer researches and carcinogenicity studies; thus the present study was focused on evaluating the impact of medicinal plants from  Kohgiluyeh va Boyerahmad province, Iran on DNA. Methods: Thirty five plant species collected have been investigated for prophage induction ability in Escherichia coli K-12(λthroughinductest. Results:The assay demonstrated that 8 plants were able to affect DNA. Conclusion: The results confirm the role of natural resources for biologic effects and what’s more, potential drug candidates in new drug discovery.

  5. Assessment of Degree of Applicability of Benchmarks for Gadolinium Using KENO V.a and the 238-Group SCALE Cross-Section Library

    Energy Technology Data Exchange (ETDEWEB)

    Goluoglu, S.

    2003-12-01

    A review of the degree of applicability of benchmarks containing gadolinium using the computer code KENO V.a and the gadolinium cross sections from the 238-group SCALE cross-section library has been performed for a system that contains {sup 239}Pu, H{sub 2}O, and Gd{sub 2}O{sub 3}. The system (practical problem) is a water-reflected spherical mixture that represents a dry-out condition on the bottom of a sludge receipt and adjustment tank around steam coils. Due to variability of the mixture volume and the H/{sup 239}Pu ratio, approximations to the practical problem, referred to as applications, have been made to envelop possible ranges of mixture volumes and H/{sup 239}Pu ratios. A newly developed methodology has been applied to determine the degree of applicability of benchmarks as well as the penalty that should be added to the safety margin due to insufficient benchmarks.

  6. El bosón de Higgs no te va a hacer la cama la física como nunca te la han contado

    CERN Document Server

    Santaolalla, Javier

    2016-01-01

    Viajes en el tiempo, agujeros negros, motores de antimateria, aceleración del universo… La física moderna suena a película, pero es ciencia, de la de verdad verdadera, la que nos cuenta una historia fascinante de descubrimientos y sueños cumplidos, de luchas y disputas, de pasión por comprender la naturaleza. Este divertido libro te ayudará a entender de una vez por todas lo que nos rodea, desde lo más pequeño a lo más grande, y a saber que el bosón de Higgs no te va a hacer la cama, ¡ni aunque le insistas!

  7. Detection and Molecular Characterization of Cryptosporidium Species in Recreational Waters of Chaharmahal va Bakhtiyari Province of Iran Using Nested-PCR-RFLP

    Directory of Open Access Journals (Sweden)

    K Manouchehri Naeini

    2011-03-01

    Full Text Available Background: The aim of this study was to detect and characterize Cryptosporidium spp. in water sam­ples collected from recreational ponds of Chaharmahal va Bakhtiyari Province of Iran .Meth­ods: Thirty water samples were collected from November 2009 to May 2010. Each sample con­tained 10 liters of water. We used the SSU rRNA-based PCR-RFLP technique.Results: Out of thirty samples examined, 6 (20% were positive for different Cryptosporidium spp. Restriction pattern analysis showed that C. parvum has been the most prevalent genotype, fol­lowed by C. hominis and C. canis , respectively. In this area, the higher prevalence of C. par­vum compared with other genotypes is consistent with the distribution of cattle.Conclusion: Farm animals, particularly cattle are the main source of cryptosporidial contamina­tion for recreational waters in this area.

  8. Comparison of DSM-IV and DSM-5 criteria for alcohol use disorders in VA primary care patients with frequent heavy drinking enrolled in a trial.

    Science.gov (United States)

    Takahashi, Traci; Lapham, Gwen; Chavez, Laura J; Lee, Amy K; Williams, Emily C; Richards, Julie E; Greenberg, Diane; Rubinsky, Anna; Berger, Douglas; Hawkins, Eric J; Merrill, Joseph O; Bradley, Katharine A

    2017-07-18

    Criteria for alcohol use disorders (AUD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) were intended to result in a similar prevalence of AUD as DSM-IV. We evaluated the prevalence of AUD using DSM-5 and DSM-IV criteria, and compared characteristics of patients who met criteria for: neither DSM-5 nor DSM-IV AUD, DSM-5 alone, DSM-IV alone, or both, among Veterans Administration (VA) outpatients in the Considering Healthier drinking Options In primary CarE (CHOICE) trial. VA primary care patients who reported frequent heavy drinking and enrolled in the CHOICE trial were interviewed at baseline using the DSM-IV Mini International Neuropsychiatric Interview for AUD, as well as questions about socio-demographics, mental health, alcohol craving, and substance use. We compared characteristics across 4 mutually exclusive groups based on DSM-5 and DSM-IV criteria. Of 304 participants, 13.8% met criteria for neither DSM-5 nor DSM-IV AUD; 12.8% met criteria for DSM-5 alone, and 73.0% met criteria for both DSM-IV and DSM-5. Only 1 patient (0.3%) met criteria for DSM-IV AUD alone. Patients meeting both DSM-5 and DSM-IV criteria had more negative drinking consequences, mental health symptoms and self-reported readiness to change compared with those meeting DSM-5 criteria alone or neither DSM-5 nor DSM-IV criteria. In this sample of primary care patients with frequent heavy drinking, DSM-5 identified 13% more patients with AUD than DSM-IV. This group had a lower mental health symptom burden and less self-reported readiness to change compared to those meeting criteria for both DSM-IV and DSM-5 AUD. Trial Registration ClinicalTrials.gov NCT01400581. 2011 February 17.

  9. VIRAL HEPATITIS B AND C AS COMORBIDITY IN RHEUMATIC DISEASES: ANALYSIS OF THE DATA OF THE V.A. NASONOVA RESEARCH INSTITUTE OF RHEUMATOLOGY CLINIC OVER 4 YEARS

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    A. E. Karateev

    2016-01-01

    Full Text Available Hepatitis B virus (HBV and hepatitis C virus (HCV infection is a serious problem that substantially hinders the treatment of patients with rheumatic diseases (RD particular when there is a need for using cytotoxic and biological agents (BAs.Objective: to estimate the rate of HBV and HCV infection in RD patients followed up at the V.A. Nasonova Research Institute of Rheumatology Clinic in 2011 to 2014.Subjects and methods. All case histories of the RD patients hospitalized in the given period were analyzed. Infection with HBV and HCV was assessed from the presence of HBsAg and anti-HCV, respectively.Results and discussion. There were a total of 16,553 admissions to the V.A. Nasonova Research Institute of Rheumatology Clinic over 4 years. HBV and HCV were detected in 0.33 and 0.74%, respectively; their combination was found in 0.03% (a total of 1.1% of the patients. About half of the patients took cytotoxic agents and glucocorticoids; 29.8% received BAs, mainly rituximab. Moderate and high chronic hepatitis activity was noted in 4.9% of the patients; liver cirrhosis was observed in 2.7%. Over the follow-up period, alanine aminotransferase and aspartate aminotransferase levels were not elevated in the vast majority of patients.Conclusion. HBV and HCV infection is often detected in patients with RD. The infected patients and persons with chronic viral hepatitis require careful follow-up and the decision whether to perform prophylactic antiviral therapy when using cytotoxic agents and BAs.

  10. Nivel de corte de los ELISAs para cuantificación de anticuerpos inducidos por la vacuna antimeningocócica VA-MENGOC-BC

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    Rolando Ochoa

    2001-06-01

    Full Text Available Para medir el grado de protección inducido por vacunas antimeningocócicas se ha establecido el Ensayo Bactericida en Suero (EBS y se perfeccionan otros ensayos inmunobiológicos, sin embargo, es necesario contar con pruebas sencillas como el ELISA, capaz de evaluar un gran número de muestras. Se estimó el nivel de corte de los ELISAs para la cuantificación de IgG humana contra los antígenos de VA-MENGOC-BC, vacuna antimeningocócica compuesta por vesículas proteicas de membrana externa de meningococo B y polisacárido capsular de meningococo C, con respecto a un panel de muestras de suero de lactantes, caracterizado por Ensayo Bactericida en Sangre Total (EBST. Los valores correspondientes a la máxima sensibilidad y especificidad fueron respectivamente; 2 μg/mL y 12 μg/mL para antipolisacárido C, y 1000 U/mL y 7000 U/mL para antiproteínas de membrana externa. La mayor coincidencia se obtuvo con 6 μg/mL y 2500 U/mL. Se evaluó otro panel de muestras de suero de adolescentes entre 14 y 18 años, por ELISA y EBS para Neisseria meningitidis serogrupos B y C, alcanzándose una buena concordancia. Doce años después de la inmunización con VA-MENGOC-BC persiste una importante concentración de anticuerpos contra los antígenos vacunales en los sueros estudiados.

  11. STUDIES DEVOTED TO ANTIPHOSPHOLIPID SYNDROME AT THE V.A. NASONOVA RESEARCH INSTITUTE OF RHEUMATOLOGY: MAIN ACHIEVEMENTS (ON THE OCCASION OF THE 40th ANNIVERSARY OF THE DISSERTATION BOARD

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    T. M. Reshetnyak

    2016-01-01

    Full Text Available The paper presents achievements associated with the study of antiphospholipid syndrome from its description to the present time, i.e. over the last 30 years, worldwide and at the V.A. Nasonova Research Institute of Rheumatology.

  12. Design criteria for flood-defense structures based on probabilistic cost-benefit optimization with value at risk (VaR methods. Application to the Choluteca River in Tegucigalpa (Honduras

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    Alonso Eduardo García

    2016-01-01

    Full Text Available A probabilistic CBA framework, combined with a Value at risk (VaR methods, as applied in financial risk management, can be used to select the best mitigation scheme among several alternatives and reliability levels, based on a quantitative and objective procedure. The proposed method looks for the alternative that minimizes the accumulated maximum damage that can be produce by any particular sequence of events, over the life span of the structure, using numerical simulation and possibly including interactions among individual events (two large floods within a short time cannot damage twice the same assets. This is equivalent to a stochastic optimization problem, where the entity to be minimized are the maximum losses. The optimal alternative, based on a VaR criteria (including conditional VaR, differs largely from the one that maximizes the average NPV, and is more stable, compared with the average or a deterministic NPV. To demonstrate the proposed procedure, and show the differences among the three performance indicators (average NPV, VaR and CVaR, the case of the Choluteca River in Tegucigalpa, capital city of Honduras, are used, with real data of economic and human damages provided by a recent study by IDB.

  13. National Dam Safety Program. South River Number 6 (ID VA-01509), Potomac River Basin, Gum Springs Branch, Deep Pond Run, Cold Spring Branch. Augusta County, Virginia. Phase I Inspection Report.

    Science.gov (United States)

    1980-02-01

    Stratified silty, clay (Ver7 light weight) Chocolate brown 30 - LO Stratified silty clay yellow bromn, vertical bedding U.S.DEPARTmENT OF ASPICULTURE VA-336-G...the vicinity of the str -icture. For type of borrow material see M 200,201. The emergency spillway cut will supply a large amount of fill ard the

  14. Cuantificación de IGG contra los componentes inmunogénicos de VA-ENGOC-BC en plasma de lactantes vacunados

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    José Rodríguez Canosa

    1997-04-01

    Full Text Available Debido a las características particulares de la respuesta inmune en lactantes, así como a la eficacia mostrada por la vacuna cubana antimeningocóccica VA-MENGOC-BC, nos propusimos cuantificar la respuesta de la inmunoglobulina G contra los componentes inmunogénicos de los meningococos B y C presentes en la vacuna, en lactantes vacunados. Se tomó muestra por punción capilar a 109 lactantes entre 3 y 6 meses de edad antes de la vacunación a los 31,4 ± 2 días después de la primera y 32,3 ± días después de la segunda dosis vacunal. Se determinaron las concentraciones de inmunoglobulina G contra cada inmunógeno de la vacuna. Los niveles de inmunoglobulina G específica prevacunación, fueron elevadas contra el meningococo C. Se produjo un incremento estadísticamente significativo de anticuerpos para ambos inmunógenos después de la primera y segunda dosis, más marcado contra el meningococo C en la primera y para el meningococo B en la segunda, lo que apoya la presencia de memoria inmunológicaDue to the particular characteristics of the immune response in infants and to the efficacy shown by the Cuban antimeningococcal vaccine denominated VA-MENGOC-BC, we propose ourselves to quantify the response of immunoglobulin G against the immunogenic components of the meningococci B and C present in the vaccine among the vaccinated infants. The sample was taken by capillary puncture from 109 infants between 3 and 6 months before vaccination, at 31.4±2 days after the first dose and at 32.3± days after the second one. The concentrations of immunoglobulin G against each immunogen of the vaccine were determined. The levels of prevaccination specific immunoglobulin G were elevated against meningococcus C. There was a statistically significant increase of atibodies for both immunogens after the first and second dose. It was more marked against meningococcus C in the first, and for meningococcus B in the secons one, which supports the presence of

  15. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil Mercury exposure among Pakaanóva Indians, Amazon Region, Brazil

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    Elisabeth C. Oliveira Santos

    2003-02-01

    Full Text Available Um estudo seccional foi realizado para avaliar os níveis de exposição ao mercúrio (Hg entre 910 índios Pakaanóva, residentes nos municípios de Guajará Mirim e Nova Marmoré no Estado de Rondônia, Brasil. Amostras de cabelo da região occipital foram coletadas de cada participante do estudo e os teores de Hg determinados por Espectrofotometria de Absorção Atômica com Geração de Vapor Frio. Os teores médios de Hg nas amostras de cabelo foram de 8,37µg/g (0,52-83,89µg/g, indicando exposição elevada. Crianças de até 2 anos e entre 3 e 5 anos de idade apresentaram médias de 10,54µg/g e 9,34µg/g, respectivamente. Os teores médios de Hg nas mulheres (8,91µg/g são mais elevados do que os valores observados nos homens (7,55µg/g, sendo esta diferença estatisticamente significante (t = 3,26; p A cross-sectional study was conducted to evaluate mercury (Hg exposure among 910 Pakaanóva Indians from the counties of Guajará Mirim and Nova Marmoré, Rondônia State, Brazil. Individual hair samples were taken from the occipital region, and Hg was measured by atomic absorption spectrometry with cold vapor generation. Mean Hg in hair samples was 8.37 µg/g (range 0.52-83.89, indicating high exposure. Young children (< 2 years old showed a mean Hg of 10.54 µg/g, and children from 3 to 5 years old had a mean Hg of 9.34µg/g. Mercury levels in women (8,91µg/g were higher than in men (7.55µg/g, and this difference was significant (t = 3.26; p < 0.01. These results indicate the need for surveillance programs and complementary studies including the Pakaanóva Indians in Rondônia State.

  16. Laboratory Load Model Based on 150 kVA Power Frequency Converter and Simulink Real-Time – Concept, Implementation, Experiments

    Directory of Open Access Journals (Sweden)

    Robert Małkowski

    2016-09-01

    Full Text Available First section of the paper provides technical specification of laboratory load model basing on 150 kVA power frequency converter and Simulink Real-Time platform. Assumptions, as well as control algorithm structure is presented. Theoretical considerations based on criteria which load types may be simulated using discussed laboratory setup, are described. As described model contains transformer with thyristor-controlled tap changer, wider scope of device capabilities is presented. Paper lists and describes tunable parameters, both: tunable during device operation and changed only before starting the experiment. Implementation details are given in second section of paper. Hardware structure is presented and described. Information about used communication interface, data maintenance and storage solution, as well as used Simulink real-time features are presented. List and description of all measurements is provided. Potential of laboratory setup modifications is evaluated. Third section describes performed laboratory tests. Different load configurations are described and experimental results are presented. This includes simulation of under frequency load shedding, frequency and voltage dependent characteristics of groups of load units, time characteristics of group of different load units in a chosen area and arbitrary active and reactive power regulation basing on defined schedule. Different operation modes of control algorithm are described: apparent power control, active and reactive power control, active and reactive current RMS value control.

  17. A Life-span Perspective on Combat Exposure and PTSD Symptoms in Later Life: Findings From the VA Normative Aging Study.

    Science.gov (United States)

    Kang, Sungrok; Aldwin, Carolyn M; Choun, Soyoung; Spiro, Avron

    2016-02-01

    We tested a life-span model of combat exposure on posttraumatic stress disorder (PTSD) symptoms in later life, examining the direct and indirect effects of prewar, warzone, and postwar factors. The sample included 947 male World War II and Korean War veterans from the VA Normative Aging Study (Mage = 65, SD = 7). They completed mail surveys on childhood family environment, military service and postwar experience, stressful life events, and PTSD symptoms (response rates > 80%). We constructed an initial path model testing cumulative advantage and disadvantage pathways. Although all hypothesized relationships were significant, the model was not a good fit to the data. Subsequent models showed that all three life-span periods had both direct and indirect effects on PTSD symptoms and that there were interesting cross-links between the two sets of pathways. The life-span perspective provides a useful heuristic to model various developmental effects on later-life outcomes. A supportive childhood family environment can have lifelong protective effects, whereas a conflictual one can set up lifelong patterns of pessimistic appraisals. © The Author 2015. 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.

  18. In search of an African dining experience: International visitors views on service at V&A Waterfront restaurants in Cape Town

    Directory of Open Access Journals (Sweden)

    Takawira Windy Mutsago

    2011-01-01

    Full Text Available Culturalism and ethnicity form integral parts of destination attractions in tourism and hospitality. The article explores the degree of African authenticity expected by international travelers from a dining experiences in restaurants located in a popular tourist hub, the Victoria and Alfred Waterfront in Cape Town. The research reveals that integrating traditional African values and standards to five star dining international standards is difficult and problematic. Consequently international diners seeking authentic African dining experience in popular tourists’ hubs have been disappointed. The paper revealed that the majority 75.3% perceived the dining experience in the V&A Waterfront as just a copy of the Western countries, 19, 2% percent noted some African traits largely diluted by foreign standards and 6, 5% believed it was truly an African dining experience. The article recommends that, for commercial purposes a staged African experience be created using such strategies as manipulating the architecture, the music, interior décor, staff uniforms and anything that immediately identifies with Africa or South Africa on a more local level.

  19. The distribution of phosphorus in Popes Creek, VA, and in the Pocomoke River, MD: Two watersheds with different land management practices in the Chesapeake Bay Basin

    Science.gov (United States)

    Simon, N.S.; Bricker, O.P.; Newell, W.; McCoy, J.; Morawe, R.

    2005-01-01

    This paper compares phosphorus (P) concentrations in sediments from two watersheds, one with, and one without, intensive animal agriculture. The watersheds are in the coastal plain of the Chesapeake Bay and have similar physiographic characteristics. Agriculture in the Pocomoke River, MD, watershed supplied 2.7 percent of all broiler chickens produced in the USA in 1997. Poultry litter is an abundant, local source of manure for crops. Broiler chickens are not produced in the Popes Creek, VA, watershed and poultry manure is, therefore, not a major source of fertilizer. The largest concentrations of P in sediment samples are found in floodplain and main-stem bottom sediment in both watersheds. Concentrations of total P and P extracted with 1N HCl are significantly larger in main-stem bottom sediments from the Pocomoke River than in main-stem bottom sediments from Popes Creek. Larger concentrations of P are associated with what are potentially redox sensitive iron oxyhydroxides in sediment samples from the Pocomoke River watershed than are associated with what are potentially redox sensitive iron oxyhydroxides in sediment samples from the Popes Creek watershed. Data for P and iron (Fe) concentrations in sediments from the Popes Creek watershed provide a numerical framework (baseline) with which to compare P and Fe concentrations in sediment from the Pocomoke River watershed. ?? Springer 2005.

  20. Low CD4 cells and viral co-infection increase the risk of VaIN: Use of SCCA1 and Ki67 as diagno-prognostic biomarkers.

    Science.gov (United States)

    Okoye, Jude Ogechukwu; Erinle, Charles; Ngokere, Antony Ajuluchukwu; Jimoh, Abimbola

    2018-03-01

    This study evaluated the correlation of SCCA1, Ki67 and CD4 cell expressions and classified vaginal smears in individuals co-infected with Human immunodeficiency virus (HIV), Herpes simplex virus 2 (HSV2), Epstein Barr virus (EBV) and Human Papilloma virus (HPV). This crossectional study included 173 participants within the age range of 20-70 years. Vaginal smears were stained by Papanicolaou technique and classified into high-grade squamous cell intraepithelial lesion (HSIL), low-grade squamous intraepithelial lesion (LSIL), atypical squamous cells of undetermined significance (ASCUS) and negative for intraepithelial lesion (NIL). Presence of immunoglobulin M and G antibodies for EBV, HIV, HPV and HSV2, and SCCA1 and Ki67 antigens were determined by ELISA method. Result showed that biomarkers SCCA1 had higher sensitivity (87.5%) to vaginal lesions when compared with Ki67 which had a sensitivity of 70.8% (p > .01). Assays revealed viral co-infections of 96.0% and 16.8% in smears positive and negative for vaginal lesions, respectively (p biomarkers for vaginal intraepithelial neoplasia (VaIN). Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Summary of the panel session at the 38th Annual Surgical Symposium of the Association of VA Surgeons: what is the big deal about frailty?

    Science.gov (United States)

    Anaya, Daniel A; Johanning, Jason; Spector, Seth A; Katlic, Mark R; Perrino, Albert C; Feinleib, Jessica; Rosenthal, Ronnie A

    2014-11-01

    Owing to the phenomenon known as "global graying," elderly-specific conditions, including frailty, will become more prominent among patients undergoing surgery. The concept of frailty, its effect on surgical outcomes, and its assessment and management were discussed during the 38th Annual Surgical Symposium of the Association of VA Surgeons panel session entitled "What's the Big Deal about Frailty?" and held in New Haven, Connecticut, on April 7, 2014. The expert panel discussed the following questions and topics: (1) Why is frailty so important? (2) How do we identify the frail patient prior to the operating room? (3) The current state of the art: preoperative frail evaluation. (4) Preoperative interventions for frailty prior to operation: do they work? (5) Intraoperative management of the frail patient: does anesthesia play a role? (6) Postoperative care of the frail patient: is rescue the issue? This special communication summarizes the panel session topics and provides highlights of the expert panel's discussions and relevant key points regarding care for the geriatric frail surgical patient.

  2. Prevalence of class 1 and 2 integrons in multi-drug resistant Escherichia coli isolated from aquaculture water in Chaharmahal Va Bakhtiari province, Iran.

    Science.gov (United States)

    Tajbakhsh, Elahe; Khamesipour, Faham; Ranjbar, Reza; Ugwu, Ifeoma Chinyere

    2015-07-31

    Integrons play important role in the spread and maintenance of antimicrobial resistance among strains of Escherichia coli (E. coli) and other species of Enterobacteriaceae. This study investigated the prevalence of class 1 and 2 integrons among E. coli strains isolated from aquaculture water of fish fields in Iran. One hundred and fifty water samples from different geographical regions in Chaharmahal Va Bakhtiari province were examined over a 2 months period. Isolation was through culture and biochemical tests. Integrons were identified through polymerase chain reaction (PCR) using oligonucleotide primers specific for class 1 and 2 integrons. Antimicrobial susceptibility testing was carried out using disc diffusion methods. Eighteen percent of the water samples were positive for E. coli. All the strains were multi-drug resistant; 100% to ciprofloxacin, chloramphenicol, gentamycin, ampicillin and tetracycline and least resistant to imipenem (7.2%). Ten (50%) of the most resistant strains were positive for class 1 (40%) and class 2 (10%). Escherichia coli in aquaculture in Iran carried integrons class 1 and 2 which could be of public health concern since they could play a role in the spread and maintenance of antimicrobial resistance among bacterial population in the region and should be constantly monitored.

  3. Investigation of the flora, life forms and chorotypes of the plants in the Meymand Protected Area, Kohkilouyeh va Boyer Ahmad provice, Iran

    Directory of Open Access Journals (Sweden)

    Ali-Asghar Naghipour Borj

    2014-11-01

    Full Text Available Floristic studies have great importance as it represent the existence and the status of all plant species in an area. This study aimed to investigate the flora of Meymand Protected Area, located in central Zagros and in Kohkilouyeh va Boyer Ahmad provice with an elevation range of 1806 to 2730 meters from sea level. Plant families, genera and species were identified using taxonomic methods and available resources. According to the results, the flora of this area included 279 plant species belonging to 198 genera from 48 families. The richest families were Asteraceae with 50 species (17.9%, Poaceae, Lamiaceae with each 23 species (8.2% and Fabaceae with 22 species (7.8%. The dominance of hemicryptophytes and therophytes (totally, 82% life forms in the flora, were the characteristics of mountainous regions in central part of Iran. The high proportion of hemicryptophytes plants in the flora also indicated the dominance of a cold and montinious climates in the study area. The chorotypes of plants species showed that 57 percent (160 species of the plant species belonged to Irano-Touranian zone but other remaining species (119 speciecs grew in other geobotanical zones too. There were 5 vulnerable, 24 lower risks and 1 data deficient species in this protected area.

  4. Do You Really Expect Me to Get MST Care in a VA Where Everyone is Male? Innovative Delivery of Evidence-Based Psychotherapy to Women with Military Sexual Trauma

    Science.gov (United States)

    2015-08-01

    Based Psychotherapy to Women with Military Sexual Trauma PRINCIPAL INVESTIGATOR: Ronald Acierno, PhD CONTRACTING ORGANIZATION: Medical University of...a VA Where Everyone is Male? Innovative Delivery of Evidence-Based Psychotherapy to Women with Military Sexual Trauma 5a. CONTRACT NUMBER 5b...Military Sexual Trauma (MST) related PTSD using videoconferencing technology, which allows a therapist and patient, who are at great distance from

  5. 30 CFR 57.22201 - Mechanical ventilation (I-A, I-B, I-C, II-A, II-B, III, IV, V-A, and V-B mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Mechanical ventilation (I-A, I-B, I-C, II-A, II...-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Ventilation § 57.22201 Mechanical ventilation (I-A, I-B, I-C, II-A, II-B, III, IV, V-A, and V-B mines). All mines shall...

  6. Associations of cumulative Pb exposure and longitudinal changes in Mini-Mental Status Exam scores, global cognition and domains of cognition: The VA Normative Aging Study

    Science.gov (United States)

    Farooqui, Zishaan; Bakulski, Kelly M.; Power, Melinda C.; Weisskopf, Marc G.; Sparrow, David; Spiro, Avron; Vokonas, Pantel S.; Nie, Huiling; Hu, Howard; Park, Sung Kyun

    2016-01-01

    Background Lead (Pb) exposure has been associated with poorer cognitive function cross-sectionally in aging adults, however the association between cumulative Pb exposure and longitudinal changes in cognition is little characterized. Methods In a 1993–2007 subcohort of the VA Normative Aging Study (Mini-mental status exam (MMSE) n=741; global cognition summary score n=715), we used linear mixed effects models to test associations between cumulative Pb exposure (patella or tibia bone Pb) and repeated measures of cognition (MMSE, individual cognitive tests, and global cognition summary). Cox proportional hazard modeling assessed the risk of an MMSE score falling below 25. Results Among men 51–98 at baseline, higher patella Pb concentration (IQR: 21 µg/g) was associated with −0.13 lower baseline MMSE (95% CI: −0.25, −0.004) and faster longitudinal MMSE decline (−0.016 units/year, 95% CI: −0.032, −0.0004) over 15 years. Each IQR increase in patella Pb was associated with increased risk of a MMSE score below 25 (HR=1.21, 95% CI: 0.99, 1.49; p=0.07). There were no significant associations between Pb and global cognition (both baseline and longitudinal change). Patella Pb was associated with faster longitudinal decline in Word List Total Recall in the language domain (0.014 units/year, 95% CI: −0.026, −0.001) and Word List Delayed Recall in the memory domain (0.014 units/year, 95% CI: −0.027, −0.002). We found weaker associations with tibia Pb. Conclusions Cumulative Pb exposure is associated with faster declines in MMSE and Word List Total and Delayed Recall tests. These findings support the hypothesis that Pb exposure accelerates cognitive aging. PMID:27770710

  7. Correlates of VA mental health treatment utilization among OEF/OIF/OND veterans: Resilience, stigma, social support, personality, and beliefs about treatment.

    Science.gov (United States)

    DeViva, Jason C; Sheerin, Christina M; Southwick, Steven M; Roy, Alicia M; Pietrzak, Robert H; Harpaz-Rotem, Ilan

    2016-05-01

    Veterans of Operations Iraqi Freedom/Enduring Freedom/New Dawn (OEF/OIF/OND) tend not to engage in mental health care. Identifying modifiable factors related to mental health service utilization could facilitate development of interventions to increase utilization. The current study examined the relationship between mental health care utilization and measures of PTSD symptoms, resilience, stigma, beliefs about mental health care, perceived barriers to mental health care, posttraumatic growth and meaning, social support, and personality factors in a sample of 100 OEF/OIF/OND veterans with PTSD symptoms referred to VA mental health care. Participants who received psychotherapy and pharmacotherapy (PP) scored higher on measures of PTSD symptoms, stigma, and adaptive beliefs about mental health treatment, and lower on measures of resilience, postdeployment social support, emotional stability, and conscientiousness, than participants who received no treatment (NT). Participants who received psychotherapy only (PT) scored higher on a measure of PTSD symptoms than NT participants. PT participants scored higher on an emotional stability measure and lower on measures of PTSD symptoms and stigma than PP participants. Multinomial logistic regression including all variables significantly related to treatment utilization indicated that PTSD symptoms and adaptive beliefs about psychotherapy and pharmacotherapy were higher in the PT and PP groups than in the NT group, and concerns about discrimination were higher in the PP group than the NT group. Interventions targeting beliefs about mental health care could increase mental health treatment utilization among OEF/OIF/OND veterans. Concerns about stigma may affect the utilization process differently at different decision points. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. "Mr Smith's been our problem child today…": anticipatory management communication (AMC) in VA end-of-shift medicine and nursing handoffs.

    Science.gov (United States)

    Bergman, Alicia A; Flanagan, Mindy E; Ebright, Patricia R; O'Brien, Colleen M; Frankel, Richard M

    2016-02-01

    Tools and procedures designed to improve end-of-shift handoffs through standardisation of processes and reliance on technology may miss contextually sensitive information about anticipated events that emerges during face-to-face handoff interactions. Such information, what we refer to as anticipatory management communication (AMC), is necessary to ensure timely and safe patient care, but has been little studied and understood. To investigate AMC and the role it plays in nursing and medicine handoffs. Qualitative thematic analysis based on audio recordings of nurse-to-nurse, medical resident-to-resident and surgical intern-to-intern handoffs. 27 nurse handoff dyads and 18 medical resident and surgical intern handoff dyads at one VA Medical Center. Heads-up information was the most frequent type of AMC across all handoff dyads (N=257; 108 resident and 149 nursing). Indirect instructions AMC was used in a little over half the resident handoff dyads, but occurred in all nursing dyads (292 instances). Direct instructions AMC occurred in roughly equal proportion across all dyads but at a modest frequency (N=45; 28 resident and 17 nursing). Direct (if/then) contingency AMC occurred in resident handoffs more frequently than in nursing handoffs (N=32; 30 resident and 2 nursing). The different frequencies for types of AMC likely reflect differences in how residents and nurses work and disparate professional cultures. But, verbal communication in both groups included important information unlikely to be captured in written handoff tools or the electronic medical record, underscoring the importance of direct communication to ensure safe handoffs. 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/

  9. Records of Coastal Change within a Progradational, Wave-Dominated Barrier Island: Morphostratigraphic Framework of the Southern Recurved Spit of Assateague Island, VA

    Science.gov (United States)

    Shawler, J. L.; Seminack, C.; DeMarco, K. R.; Hein, C. J.; Petruny, L. M.

    2017-12-01

    Although generally retrogradational in nature, barrier islands commonly contain progradational segments which may preserve records of past coastal dynamics and environmental changes which affected their formation. In particular, recurved-spit ridges may record former shoreline positions on the surface, while in their stratigraphic architecture contain evidence of the processes influencing spit growth. This study uses topographic mapping and nearly 40 km of ground-penetrating radar (GPR) transects to investigate the pre-historic (ca. 1000-1850 C.E.) and historic elongation of Assateague Island, VA (USA) and affiliated progradation of Chincoteague Island. These data uncovered three previously unknown former tidal inlets which have no discernible surface signatures. GPR data further reveal southerly migration (up to 95 m) and closure of these tidal inlets. In addition, GPR data indicates the apparent overprinting of multiple inlets, suggesting later reoccupation of former channels. Seaward-dipping clinoforms (5-15°) indicate that, following inlet closure, the island widened and elongated through beach-ridge growth, proceeded by the development of aeolian foredune ridges. In particular, two large (5 m elevation, 150 m wide) ridges, bounded by smaller (1-3 m elevation, 20-50 m wide) ridge sets, comprise the relict recurved-spit of Assateague Island. This contrasts with the adjacent beach-ridge plain of Chincoteague Island, where surface morphology is characterized by more spatially uniform ridges (1-2 m high, 50-100 m wide). Thus, despite sharing similar internal structure as imaged in GPR, the formational processes associated with these two systems differ: the large, widely-spaced ridges of Assateague are likely indicative of punctuated progradation possibly associated with sediment pulses or complex inlet dynamics, whereas Chincoteague Island may have been built in a semi-protected environment through sediment delivered by inlet bypassing and local longshore

  10. Associations of cumulative Pb exposure and longitudinal changes in Mini-Mental Status Exam scores, global cognition and domains of cognition: The VA Normative Aging Study.

    Science.gov (United States)

    Farooqui, Zishaan; Bakulski, Kelly M; Power, Melinda C; Weisskopf, Marc G; Sparrow, David; Spiro, Avron; Vokonas, Pantel S; Nie, Linda H; Hu, Howard; Park, Sung Kyun

    2017-01-01

    Lead (Pb) exposure has been associated with poorer cognitive function cross-sectionally in aging adults, however the association between cumulative Pb exposure and longitudinal changes in cognition is little characterized. In a 1993-2007 subcohort of the VA Normative Aging Study (Mini-mental status exam (MMSE) n=741; global cognition summary score n=715), we used linear mixed effects models to test associations between cumulative Pb exposure (patella or tibia bone Pb) and repeated measures of cognition (MMSE, individual cognitive tests, and global cognition summary). Cox proportional hazard modeling assessed the risk of an MMSE score falling below 25. Among men 51-98 at baseline, higher patella Pb concentration (IQR: 21μg/g) was associated with -0.13 lower baseline MMSE (95% CI: -0.25, -0.004) and faster longitudinal MMSE decline (-0.016 units/year, 95% CI: -0.032, -0.0004) over 15 years. Each IQR increase in patella Pb was associated with increased risk of a MMSE score below 25 (HR=1.21, 95% CI: 0.99, 1.49; p=0.07). There were no significant associations between Pb and global cognition (both baseline and longitudinal change). Patella Pb was associated with faster longitudinal decline in Word List Total Recall in the language domain (0.014 units/year, 95% CI: -0.026, -0.001) and Word List Delayed Recall in the memory domain (0.014 units/year, 95% CI: -0.027, -0.002). We found weaker associations with tibia Pb. Cumulative Pb exposure is associated with faster declines in MMSE and Word List Total and Delayed Recall tests. These findings support the hypothesis that Pb exposure accelerates cognitive aging. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Effectiveness and micro-costing of the KiVa school-based bullying prevention programme in Wales: study protocol for a pragmatic definitive parallel group cluster randomised controlled trial.

    Science.gov (United States)

    Clarkson, Suzy; Axford, Nick; Berry, Vashti; Edwards, Rhiannon Tudor; Bjornstad, Gretchen; Wrigley, Zoe; Charles, Joanna; Hoare, Zoe; Ukoumunne, Obioha C; Matthews, Justin; Hutchings, Judy

    2016-02-01

    Bullying refers to verbal, physical or psychological aggression repeated over time that is intended to cause harm or distress to the victims who are unable to defend themselves. It is a key public health priority owing to its widespread prevalence in schools and harmful short- and long-term effects on victims' well-being. There is a need to strengthen the evidence base by testing innovative approaches to preventing bullying. KiVa is a school-based bullying prevention programme with universal and indicated elements and an emphasis on changing bystander behaviour. It achieved promising results in a large trial in Finland, and now requires testing in other countries. This paper describes the protocol for a cluster randomised controlled trial (RCT) of KiVa in Wales. The study uses a two-arm waitlist control pragmatic definitive parallel group cluster RCT design with an embedded process evaluation and calculation of unit cost. Participating schools will be randomised a using a 1:1 ratio to KiVa plus usual provision (intervention group) or usual provision only (control group). The trial has one primary outcome, child self-reported victimisation from bullying, dichotomised as 'victimised' (bullied at least twice a month in the last couple of months) versus 'not victimised'. Secondary outcomes are: bullying perpetration; aspects of child social and emotional well-being (including emotional problems, conduct, peer relations, prosocial behaviour); and school attendance. Follow-up is at 12 months post-baseline. Implementation fidelity is measured through teacher-completed lesson records and independent school-wide observation. A micro-costing analysis will determine the costs of implementing KiVa, including recurrent and non-recurrent unit costs. Factors related to the scalability of the programme will be examined in interviews with head teachers and focus groups with key stakeholders in the implementation of school-based bullying interventions. The results from this trial

  12. VA Suicide Prevention Applications Network

    Science.gov (United States)

    Stephens, Brady; Morley, Sybil; Thompson, Caitlin; Kemp, Janet; Bossarte, Robert M.

    2016-01-01

    Objectives: The US Department of Veterans Affairs’ Suicide Prevention Applications Network (SPAN) is a national system for suicide event tracking and case management. The objective of this study was to assess data on suicide attempts among people using Veterans Health Administration (VHA) services. Methods: We assessed the degree of data overlap on suicide attempters reported in SPAN and the VHA’s medical records from October 1, 2010, to September 30, 2014—overall, by year, and by region. Data on suicide attempters in the VHA’s medical records consisted of diagnoses documented with E95 codes from the International Classification of Diseases, Ninth Revision. Results: Of 50 518 VHA patients who attempted suicide during the 4-year study period, data on fewer than half (41%) were reported in both SPAN and the medical records; nearly 65% of patients whose suicide attempt was recorded in SPAN had no data on attempted suicide in the VHA’s medical records. Conclusion: Evaluation of administrative data suggests that use of SPAN substantially increases the collection of data on suicide attempters as compared with the use of medical records alone, but neither SPAN nor the VHA’s medical records identify all suicide attempters. Further research is needed to better understand the strengths and limitations of both systems and how to best combine information across systems. PMID:28123228

  13. An Appreciation of TAT VA

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 10; Issue 3. An Appreciation of TATVA. Ambat Vijayakumar. Book Review Volume 10 Issue 3 March 2005 pp ... Author Affiliations. Ambat Vijayakumar1. Department of Mathematics, Cochin University of Science and Technology, Cochin 682 022, India.

  14. Va-Room: Motorcycle Safety.

    Science.gov (United States)

    Keller, Rosanne

    One of a series of instructional materials produced by the Literacy Council of Alaska, this booklet provides information about motorcycle safety. Using a simplified vocabulary and shorter sentences, it offers statistics concerning motorcycle accidents; information on how to choose the proper machine; basic information about the operation of the…

  15. VA Atlantic Coast Recreational Use

    Data.gov (United States)

    Virginia Department of Environmental Quality — As a member of the Mid-Atlantic Regional Council on the Ocean (MARCO), Virginia, through its Coastal Zone Management (CZM) Program, collected information on how the...

  16. 2013 USGS Lidar: Norfolk (VA)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Laser Mapping Specialist, Inc (LMSI) and The Atlantic Group (Atlantic) provided high accuracy, calibrated multiple return LiDAR for roughly 1,130 square miles around...

  17. Lead exposure and fear-potentiated startle in the VA Normative Aging Study: a pilot study of a novel physiological approach to investigating neurotoxicant effects.

    Science.gov (United States)

    Grashow, Rachel; Miller, Mark W; McKinney, Ann; Nie, Linda H; Sparrow, David; Hu, Howard; Weisskopf, Marc G

    2013-01-01

    Physiologically-based indicators of neural plasticity in humans could provide mechanistic insights into toxicant actions on learning in the brain, and perhaps prove more objective and sensitive measures of such effects than other methods. We explored the association between lead exposure and classical conditioning of the acoustic startle reflex (ASR)-a simple form of associative learning in the brain-in a population of elderly men. Fifty-one men from the VA Normative Aging Study with cumulative bone lead exposure measurements made with K-X-Ray-Fluorescence participated in a fear-conditioning protocol. The mean age of the men was 75.5years (standard deviation [sd]=5.9) and mean patella lead concentration was 22.7μg/g bone (sd=15.9). Baseline ASR eyeblink response decreased with age, but was not associated with subsequent conditioning. Among 37 men with valid responses at the end of the protocol, higher patella lead was associated with decreased awareness of the conditioning contingency (declarative learning; adjusted odds ratio [OR] per 20μg/g patella lead=0.91, 95% confidence interval [CI]: 0.84, 0.99, p=0.03). Eyeblink conditioning (non-declarative learning) was 0.44sd less (95% CI: -0.91, 0.02; p=0.06) per 20μg/g patella lead after adjustment. Each result was stronger when correcting for the interval between lead measurement and startle testing (awareness: OR=0.88, 95% CI: 0.78, 0.99, p=0.04; conditioning: -0.79sd less, 95% CI: -1.56, 0.03, p=0.04). This initial exploration suggests that lead exposure interferes with specific neural mechanisms of learning and offers the possibility that the ASR may provide a new approach to physiologically explore the effects of neurotoxicant exposures on neural mechanisms of learning in humans with a paradigm that is directly comparable to animal models. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Portadores de Neisseria meningitidis, caracterización de las cepas aisladas y respuesta inmune basal a VA-MENGOC-BC

    Directory of Open Access Journals (Sweden)

    María J. Valdés

    2008-08-01

    Full Text Available Con el propósito de conocer la prevalencia de portadores de Neisseria meningitidis en un grupo de adolescentes, los marcadores epidemiológicos de las cepas aisladas, así como los factores de riesgo asociados con el estado de portador y la respuesta inmune basal a VA-MENGOC-BC , se realizó un estudio transversal descriptivo de portadores en 189 estudiantes de 12-19 años de un politécnico de Ciego de Ávila, siguiendo las Normas Bioéticas establecidas. A los estudiantes se les realizó un exudado faríngeo y una extracción de sangre para la obtención de suero, así como una encuesta relacionada con aspectos de la investigación. La identificación de N. meningitidis se hizo por el sistema API NH (bioMérieux. Los serosubtipos e inmunotipos se clasificaron por ELISA de células enteras con anticuerpos monoclonales y la respuesta inmune basal se detectó por el Ensayo Bactericida del Suero. Se determinó la susceptibilidad antimicrobiana de las cepas frente a la penicilina, cloranfenicol, rifampicina, sulfadiacina sódica, ceftriaxona y ciprofloxacina. La prevalencia de portadores de N. meningitidis fue del 17%. Predominaron las cepas no agrupables (84,7%, seguidas por los serogrupos B (12,5% y Z (3,1%, destacándose la ausencia del C. Prevaleció el fenotipo NA:NT:P1.NST:L3,7,9 (12,5%, las cepas resistentes a la sulfadiacina (78,2% y sensibles a penicilina (81,3%, aunque el 18,7% mostró sensibilidad intermedia a este fármaco. Al resto de los antimicrobianos todas fueron sensibles. Se constató una respuesta inmune de memoria a la vacuna antimeningocócica (VAMENGOC-BC®, 12 años después de su aplicación, con títulos bactericidas anti C y B de 25 y 42%, respectivamente, resultados que pudieran estar influenciados por la inmunización sistemática que se realiza en Cuba con esta vacuna desde 1991.

  19. Influence of the Co-Administration of Heptavalent Conjugate Vaccine PCV7-TT on the Immunological Response Elicited by VA-MENGOC-BC® and Heberpenta®-L in Rabbits.

    Science.gov (United States)

    Espinosa-Viñals, Carlos; García-Rivera, Dagmar; Rodríguez Noda, Laura; Amador Gómez, Aylín; Nicot, Milagros; Valle, Orialys; Núñez, Juan F; Martin, Yanet; Santana, Darielys; Valdés, Yury; Vérez Bencomo, Vicente

    2017-05-01

    Finlay Vaccine Institute is developing a new heptavalent conjugate vaccine against Streptococcus pneumoniae. As infants are the target population, PCV7-TT will be necessarily co-administered with other vaccines, and then, the interactions represent a concern. The aim of this work is to evaluate the possible immunological interferences in rabbits as animal experimental model. Rabbits were immunized with Heberpenta®-L, VA-MENGOC-BC®, and PCV7-TT. Blood samples were taken fourteen days after final immunization for obtaining sera. Antibody responses to all antigens were evaluated by indirect ELISA. Functional responses against diphtheria and tetanus toxoid were done by in vivo seroneutralization assay. No interference was observed by PCV7-TT over the humoral response against diphtheria toxoid and meningococcal antigens (p > 0.05). A nonstatistically significant reduction (p > 0.05) was observed in the case of the humoral response against Haemophilus influenzae type b oligosaccharide. Concomitant administration of Heberpenta®-L and PCV7-TT increased twice the antibody titers as well as the protective activity against tetanus toxoid, but no statistical differences were found. The co-administration did not induce a reduction in the percent of responders against pneumococcal polysaccharides contained in PCV7-TT vaccine. Concomitant administration of PCV7-TT did not induce interferences over the evaluated antigens of Heberpenta®-L and VA-MENGOC-BC®. Also, no interference was observed on the immune response elicited by PCV7-TT. These preclinical results suggest that PCV7-TT will not result in a serious problem over the immune response elicited by the licensed vaccines Heberpenta®-L and VA-MENGOC-BC®. However, the clinical interference could be strictly studied during clinical trials in infants.

  20. PENINGKATAN HASIL BELAJAR MATERI PENYESUAIAN MAKHLUK HIDUP DALAM PEMBELAJARAN KOOPERATIF METODE THINK-PAIR-SHARE DIPADU DENGAN METODE PICTURE AND PICTURE PADA SISWA KELAS V-A SD MUHAMMADIYAH 8 DAU MALANG

    Directory of Open Access Journals (Sweden)

    Citra Marina

    2015-03-01

    Full Text Available From interviews result, we can say 45% of the number of students has a low learning outcomes. The research purposes are: To determine the increase in the learning material adjustment Beings through cooperative learning combined the TPS method with P & P method at the VA graders SD Muhammadiyah 8 Dau Malang. Implementation of TPS learning combined with P & P already performing optimally. Based on the results of correcting data analysis sheet formative test on cycle-3 students who scored> SKM as many as 27 people (90%,whereas the received value